Hard drugs used to be legal in the U. S.

By David Joel Miller.

Making drugs illegal is a new thing.

Drug Tolerance

Hard drugs used to be legal.
Photo courtesy of Pixabay.com

It’s roughly 400 years since the Europeans arrived in America. For seventy-five percent of the time since that arrival drugs have been legal. The path from full legality to today’s many restrictions on drugs has been a long and involved one.

In early American history, first the colonial governments, and then the federal government not only allowed drug use but encouraged it. In colonial times, there were laws on the books requiring farmers to grow cannabis (Hemp) on a specific percentage of their land. During the US, Civil War more men died in camp of diseases than died in battle. Officers would routinely hand out opium gum for soldiers to chew. Whiskey was the primary painkiller. With the discovery of morphine, it became common to mix morphine into the whiskey to produce a beverage called laudanum. Between 1860 and 1900 the use of morphine, cocaine and other drugs mixed in alcoholic beverages became commonplace.

Laws regulating drug use are a recent development in American history. Here are some of the more significant drug laws from US history.

The San Francisco Ordinance.

The first notable US drug law was an ordinance passed in San Francisco, California. Interesting to note that while today California takes a more lenient view of drug use, San Francisco is the first place to pass a significant drug regulation ordinance.

The San Francisco Ordinance, passed in 1875, banned the smoking of opium, in an opium den. Opium could still be smoked in private homes and beverages containing opium, or its derivative compound morphine could still be consumed. The main thrust of the ordinance was to try to keep white people, especially young females, from frequenting Chinese opium businesses. This ordinance only applied to the city and County of San Francisco. It would be over thirty years before another law was passed regulating drugs.

The Pure Food and Drug Act.

This law was passed by Congress in 1906. The Pure Food and Drug Act was primarily aimed at controlling opiate addiction. The belief was that by labeling products which contained drugs people would be less likely to consume them. Between the US Civil War and 1906, products containing morphine and cocaine had become extremely popular. Many women consumed tonics containing morphine and babies were often given soothing syrups which contained morphine and alcohol.

The early thinking was that if a parent had a choice between a baby product containing one percent morphine and another containing two percent morphine, the parent would probably choose the product with a lower percentage of drugs. Unfortunately, many parents thought that if one percent morphine stopped the baby from crying and allowed them to sleep, then two percent morphine would be even better.

The Harrison Narcotic Tax Act.

Many laws regulating drugs and alcohol began as taxation. Once you can tax something, you can also regulate its use. Raising taxes has repeatedly been tried in efforts to reduce drug consumption. Besides imposing regulations and taxes on drugs, the Harrison Narcotic Tax Act, passed in 1914, just before World War I, restricted sales of drugs to licensed pharmacies and required a doctor’s prescription.

One provision in the law continues to cause problems. Doctors are not supposed to prescribe drugs to maintain a drug addict’s addiction. Rather than prescribed heroin addicts heroin, or morphine addicts morphine, doctors now switch opiate addicts to methadone an even more addicting drug.

Alcohol Prohibition.

Prohibition was inducted in 1920 with the passage of the eighteenth amendment. At the time, it was described as the Great Experiment. The effects of the Great Experiment continue to be debated. There were widespread efforts to evade the law. The law did not prohibit consumption of alcoholic beverages or home manufacturer of beer and wine. What it did prohibit was the commercial manufacturing, transporting, and sale of alcoholic beverages.

During prohibition, hospital admissions for alcohol-related health problems declined significantly. What didn’t decline during prohibition was illegal activity. Because of the widespread violence and the unpopularity of the law, prohibition was repealed by the twenty-first amendment passed in 1933.

The Controlled Substance Act.

The Controlled Substance Act passed in 1970 created a system of classifying or scheduling drugs which continues to this day. The period since 1970 has seen the passage of many additional laws attempting to regulate drug use. These laws include the law creating the Drug Enforcement Administration, anti-trafficking laws, Analog Act, Anti-Drug Abuse Act, and specific laws providing additional regulation and enforcement activities involving methamphetamine, ecstasy, tobacco smoking, and synthetic drug abuse.

Much of the legal activity in the period from 1970 to today was a part of the well-publicized “War on Drugs.”

That’s a little of the background on drug laws which people who work in the substance abuse treatment and prevention fields are expected to know. In a future post, we should take a closer look at the current system of scheduling drugs and why some of the newer laws have created enforcement problems.

For more on this topic see – Drug Use, Abuse, and Addiction and Recovery

Two David Joel Miller Books are available now!

Bumps on the Road of Life.

Bumps on the Road of Life.

Bumps on the Road of Life.
David Joel Miller.

Your cruising along the road of life and then wham, something knocks you in the ditch.

Sometimes you get your life going again quickly. Other times you may stay off track and in the ditch for a considerable time. If you have gone through a divorce, break up or lost a job you may have found your life off track. Professionals call those problems caused by life-altering events “Adjustment Disorders.” Bumps on the Road of Life is the story of Adjustment Disorders, how they get people off track and how to get your life out of the ditch. Bumps on the Road of Life is now available in both Kindle and paperback format.

Casino Robbery.

The robbers wanted more than money; they planned to kill Arthur’s fiancé and her boss.

Casino Robbery. David Joel Miller

Casino Robbery.
David Joel Miller

Arthur Mitchell was trying to start his life over with a fiancé and a new job. That all ends when the casino robbers shoot Arthur, kill his fiancée, and her boss. Arthur would like to forget that horrible day, but the traumatic nightmares and constant reminders won’t let him, and someone is still out to get him. When he tries to start over by running a rural thrift store, someone knocks him unconscious, vandalize the store, and finally tries to kill him. His only chance to find peace is to figure out what the killers want from him and why.

Casino Robbery is a novel that explores the world of a man with PTSD who has to cope with his symptoms to solve the mystery and create a new life. Casino Robbery is available now in both Kindle and paperback editions.

Other books are due out soon; please visit my Amazon Author Page – David Joel Miller

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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Why do drugs affect people differently?

By David Joel Miller.

Many factors affect the way people experience drugs.

Drugs

Drugs.
Photo courtesy of Pixabay.com

Whether it’s legally obtained drugs, or the prescription kind, obtained from a drugstore with a doctor’s prescription, the way people experience those drugs varies widely. Recently we’ve seen an epidemic of deaths because of use and abuse of prescription pain medication. Some people are in chronic pain; pain medications alleviate their suffering and allow them to function. Other people like the way those drugs make them feel or the way they keep them from having to feel anything.

People who take powerful painkillers for emotional reasons, to get high, run a high risk of becoming addicted. Three characteristics of addiction tell us that as people develop tolerance, experience withdrawals, and begin to have cravings for a drug of abuse, the risk that will take larger and larger amounts increases.

What are some of the factors that affect the drug using experience and may result in drug use turning into abuse, addiction, and the development of the drug use disorder?

Drug dosage influences the using experience.

With most drugs, small amounts of drugs produce smaller effects. Common over-the-counter pain relievers a relatively safe and not likely to cause addiction when taken as directed. Take large amounts of over-the-counter pain relievers and the risk of permanent damage to your liver or kidney, possibly even death, becomes a real possibility.

Drink one standard drink, let’s say a single twelve-ounce beer, each day, and you’re not likely to develop an alcohol use disorder. Drinking a six-pack a day and you will begin to build tolerance. Eventually, that drinker will need to drink a case of beer a day to feel the same effect. The higher the blood alcohol content goes on anyone drinking occasion, the more the risks.

A large percentage of the people in America have tried marijuana. Most find it doesn’t affect their lives. But a small number of marijuana smokers voluntarily seek treatment for cannabis use disorder.  What is different about the people who seek out treatment for a marijuana-related problem? Most of the people who develop problems marijuana smoke every day and the quantity they smoke has increased over time.

When it comes to opiates, stimulant drugs, or other recreational drugs, the higher the dose, the more the risk.

How the drug gets into your body affects the experience.

The way in which drugs enter the body is referred to as route of administration.

Let’s use opiates as an example. It’s possible to smoke heroin, the high is experienced almost instantaneously, but a lot of the potency is lost in the process of smoking. Any drug that is smoked produces a rapid high and equally rapid withdrawal.

An equal amount of heroin mixed into a beverage and swallowed will be slower to take effect. Much of the potency is destroyed as the drug goes through the stomach. Stomach acids neutralize a large part of the potency of many drugs.

That same dose of heroin can be injected, producing a much more intense effect when the large dose reaches the brain. People who inject drugs experience much more intensive effects.

Psychological factors alter the experience of drug use.

Psychological set, the mood someone is in impacts the drug using experience. Someone who is in a happy mood and drinks alcohol may feel an increase in their happiness. They are celebrating. Someone who was angry and drinks may become angrier and more likely to act on that anger as the alcohol disinhibits them. A person who is sad and depressed who drinks alcohol is at an increased risk of developing severe depression and possibly making a suicide attempt.

Setting, the place where someone uses the drug, also alters the effects of the user experiences. Millions of people receive painkillers while in the hospital. Most of them do not become addicted. But the same quantity of drugs, purchased in an alley from a drug dealer for recreational use, are much more likely to result in a substance use disorder.

Other psychological factors that alter the drug using experience are the placebo effect and the Nocebo effect.

Your belief that the drug will have a beneficial effect is likely to produce that effect, whether that effect is positive or negative. If you think a pill will cure your headache, it probably will, even if it does not contain any active ingredient. People who believe that a particular medication will give them headaches are more likely to get headaches even when the pill is a sugar pill.

For more on this topic see – Drug Use, Abuse, and Addiction and Recovery

Two David Joel Miller Books are available now!

Bumps on the Road of Life.

Bumps on the Road of Life.

Bumps on the Road of Life.

Your cruising along the road of life and then wham, something knocks you in the ditch.

Sometimes you get your life going again quickly. Other times you may stay off track and in the ditch for a considerable time. If you have gone through a divorce, break up or lost a job you may have found your life off track. Professionals call those problems caused by life-altering events “Adjustment Disorders.” Bumps on the Road of Life is the story of Adjustment Disorders, how they get people off track and how to get your life out of the ditch. Bumps on the Road of Life is now available in both Kindle and paperback format.

Casino Robbery.

Casino Robbery. David Joel Miller

Casino Robbery.
David Joel Miller

The robbers wanted more than money; they planned to kill Arthur’s fiancé and her boss.

Arthur Mitchell was trying to start his life over with a fiancé and a new job. That all ends when the casino robbers shoot Arthur, kill his fiancée, and her boss. Arthur would like to forget that horrible day, but the traumatic nightmares and constant reminders won’t let him, and someone is still out to get him. When he tries to start over by running a rural thrift store, someone knocks him unconscious, vandalize the store, and finally tries to kill him. His only chance to find peace is to figure out what the killers want from him and why.

Casino Robbery is a novel that explores the world of a man with PTSD who has to cope with his symptoms to solve the mystery and create a new life. Casino Robbery is available now in both Kindle and paperback editions.

Other books are due out soon; please visit my Amazon Author Page – David Joel Miller

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Dysfunctional family roles.

By David Joel Miller.

Were you the good kid or the bad kid?

Family Roles.

Family Roles.
Photo courtesy of Pixabay.com

It’s common in dysfunctional families for people to be assigned roles. It’s almost as if the family had a closet full of hats and when you were born you were given one of those hats. Just like every person may become depressed sometimes, every family will have a little bit of dysfunction. The more dysfunction the family, the more rigid the roles are likely to become.

Discussion of dysfunctional family roles is common, in substance use disorder treatment, but these roles may occur in any family with noticeable dysfunction. Various authors have used alternative names for these roles. In large families, additional roles may be created, and in small families, one person may have to play several roles.

Having these defined roles takes the attention off the family dysfunction. Do you recognize some or all of these roles from the family you grew up in? Which role did you play?

The black sheep – the bad child.

Dysfunctional families often select one person to be the scapegoat. That might be, the oldest child, the one whose conception forced the couple into a relationship. Other times it was a younger child who came along as the dysfunction became apparent. The black sheep could have been sickly, overactive, or had difficulty in school. Ever after this child is blamed for everything that goes wrong in the family.

Hero – the good child.

Were you the hero in your family? The one who was expected to get all A’s, be a star athlete, and still help around the house. The hero child may have worked a part-time job to help with the family expenses.

The clown – comic relief.

Some families had a resident comedian. The clown makes funny noises, tells jokes, and acts crazy, anything for a laugh. Some families combine the clown job with the black sheep role.

The lost child – missing in action.

The lost child never got noticed. They may have been a great student. Or the lost child may have spent their childhood anxious and depressed, hold up in their room. When the lost child turns eighteen, they may pack their bags and move to France. They will be gone for months before anyone notices they are missing.

Junior mom.

Junior mom, or Junior dad, might be eight years old, and in the third grade, but they rushed home to change their baby brothers diaper and feed their younger siblings, because, by the time school let out mom would be too drunk or high to function.

The over functioning person – codependent or enabler.

Some families had one person, usually a parent, who tried to do everything. Mom may have worked, managed the finances, took care of the children, and still found time to provide care for dad, whose drinking prevented him from functioning at all.

The under-functioning person – alcoholic, addict, or the compulsive gambler.

At the heart of every dysfunctional family is the under-functioning person. That may have been the mother, the father, a grandparent or any other family member. These dysfunctional family roles, like hats, could have been handed out to any family member, regardless of their age.

How about you?

Did you play one of these roles? Did you come to believe the role was who you are? For some people, over time, they played several of these roles. You may have been the black sheep who later became the alcoholic. The hero may grow up to marry an addict, and they become the codependent. Dysfunction families have a way of repeating these roles, generation after generation.

Two David Joel Miller Books are available now!

Bumps on the Road of Life is now available in both Kindle and paperback format.

Bumps on the Road of Life.

Bumps on the Road of Life.

Bumps on the Road of Life.
By David Joel Miller

Your cruising along the road of life and then wham, something knocks you in the ditch.

Sometimes you get your life going again quickly. Other times you may stay off track and in the ditch for a considerable time. If you have gone through a divorce, break up or lost a job you may have found your life off track. Professionals call those problems caused by life-altering events “Adjustment Disorders.” Bumps on the Road of Life is the story of Adjustment Disorders, how they get people off track and how to get your life out of the ditch.

Bumps on the Road of Life

Please visit my Amazon Author Page – David Joel Miller

Casino Robbery.

Photo of Casino Robbery book

Casino Robbery.

The robbers wanted more than money; they planned to kill Arthur’s fiancé and her boss.

Arthur Mitchell was trying to start his life over with a fiancé and a new job. That all ends when the casino robbers shoot Arthur, kill his fiancée, and her boss. Arthur would like to forget that horrible day, but the traumatic nightmares and constant reminders won’t let him, and someone is still out to get him. When he tries to start over by running a rural thrift store, someone knocks him unconscious, vandalize the store, and finally tries to kill him. His only chance to find peace is to figure out what the killers want from him and why.

Casino Robbery is a novel that explores the world of a man with PTSD who has to cope with his symptoms to solve the mystery and create a new life.

Casino Robbery is available now in both Kindle and paperback editions.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Urge Surfing Prevents Relapses.

By David Joel Miller.

Don’t let urges knock you down.

Urge Surfing Prevents Relapses.

Urge Surfing Prevents Relapses.
Photo courtesy of Pixabay.com

Urge surfing is an idea that comes from substance use disorder treatment. Learning to cope with urges can help prevent relapses into depression, anxiety, substance use disorders, and many other mental, emotional, and behavioral disorders.

A coworker and I discussed the similarities between surfing on the ocean and surfing urges. He is an avid surfer and tells me that not having a good relationship with the waves can leave scars. Ignoring urges and what is causing them can leave mental and emotional scars.

What is an urge?

Urges are sudden, intense impulses to do something. People with urges often feel compelled to act. When the idea enters the mind, it can become a compulsion. Urges can be intense, unpleasant sensations. Once the urge arises, it is hard to avoid acting on it. Wrestling with urges results in a lot of relapses into unhelpful thinking, and unhealthy behaviors.

Urges rise and fall.

Urges, in the early stages, can come on slowly and gradually, other times they rise rapidly, like a heavy ocean swell. You could easily be swept away before you realize the danger of the urge. The challenge with urges is to maintain your position without being carried away by the urge. Typically urges last 20 to 30 minutes.

Concentrating too much on ocean waves leaves you unprepared when they arrive. You should prepare for the rising and falling urges ahead of time also.

Wrestling urges, wears you out.

The typical response to urges is to try to avoid thinking about them and resist acting. The more you struggle, the more tired you become. Trying to not think about something makes the thought grow. To defeat urges you need to do two things. First, do not give in. Sometimes giving in and sometimes not amounts to intermittent reinforcement, one of the hardest things to overcome. Second, don’t exhaust yourself swimming directly into the urge. Practice floating above the surface, riding out the comings and goings of urges.

Urges can affect your thinking, your feelings, and your behavior.

Surfers who develop a negative attitude don’t last long. If you engage in self-criticism, telling yourself you should have caught the last wave, you need to wait for the next one; you don’t surf, you get washed ashore. Having cravings and urges is a natural part of recovery. Don’t beat yourself up for having urges. Having urges can make you feel like you’re not doing recovery correctly. Don’t let your urges take you places you should not go. Stick to the behaviors that will further your recovery.

Make peace with your urges.

Surfing the urges allows you to reach a place of neutrality where you neither wrestle the urge nor give in to it. What you need to do is to step back from the urge and begin to watch it as an outside observer. From this vantage point, you will see that your urges rise and fall. If you can stay in this relaxed state for a time, the urge recedes.

Accept that it is okay to feel however you are feeling.

You do not have to take action to change your feelings. Your life is a real life. There are things you like about it, and there are things that you will not like. Sometimes you will feel happy, and sometimes sad. Sometimes you will be calm, and sometimes you will be anxious. The key to making peace with your feelings, and not being swept away by urges, is to learn to recognize what you are feeling without rushing to change that feeling.

What feeling is coming up for you?

As you feel the urges rising, work on identifying what that feeling is. Are you feeling anxious, depressed, or frustrated? When urges rise, you may be thinking about others. Are you telling yourself it’s not fair that you must quit drinking or drugging, while others are continuing to do these things?

Learn the signs of oncoming cravings.

A water surfer notices the wave coming. Begins to paddle before the wave reaches them. They are up to speed when the wave reaches them. Notice the onset of uncomfortable feelings when urges are on the rise. Pay attention to increases in unhelpful thoughts. Watch your body for signs of negative emotions, that pain in the neck, the queasy stomach.

Practice urge reduction skills before the urge waves wash over you. Learn grounding techniques, scanning your body for tension, and use other relaxation methods. Breathing is especially important when it comes to keeping your head above water. Positive self-talk, affirmations, and grounding techniques can keep you prepared for the next round of urges.

New Book Bumps on the Road of Life is now available in Kindle format for preorder. It will be released on 11/13/17. The paperback version is ready now.

Bumps on the Road of Life.

Your cruising along the road of life and then wham, something knocks you in the ditch.

Sometimes you get your life going again quickly. Other times you may stay off track and

Bumps on the Road of Life.

Bumps on the Road of Life.
By David Joel Miller

in the ditch for a considerable time. If you have gone through a divorce, break up or lost a job you may have found your life off track. Professionals call those problems caused by life-altering events “Adjustment Disorders.” Bumps on the Road of Life is the story of Adjustment Disorders, how they get people off track and how to get your life out of the ditch.

Bumps on the Road of life

Amazon Author Page – David Joel Miller

More to come as other books are completed.

Thanks to all my readers for all your support.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Alcohol Myths

By David Joel Miller.

How many alcohol myths do you believe?

Alcohol is a stimulant.

Bottles of alcohol.

Alcoholic Beverages.
Photo courtesy of Pixabay.com

Many people think and alcohol stimulates them and gives them more energy.  This belief was so common in the past among newspaper reporters and writers that these professions developed high rates of alcoholism.  The truth is alcohol is not a stimulant.  Alcohol is a depressant and while it may initially disinhibit you, the more you drink, the less energy you will have.  Over the long run drinking alcohol results in depression.

Alcohol makes you sexy or more sexual.

Alcohol shuts off the part of the brain that tells you “hey stupid don’t do that.”  As a result, when drinking people are more likely to engage in sexual behavior.  The truth is drunk people do not look sexy to sober people.  While having high levels of alcohol in your bloodstream makes you more likely to act on your sexual thoughts it also reduces the ability to engage in sex.  In men, regular alcohol consumption may result in impotence.

Alcohol makes you more of a man or woman.

The ability to drink, and to drink large quantities, increases the likelihood you will do things you would not do when sober.  This increased alcohol consumption results in tolerance to alcohol and requiring ever-increasing quantities to create the same effect.  Taking action after having a few drinks is sometimes described as “liquid courage.” Being intoxicated or frequently drunk does not produce the qualities that we think of as being either masculine or feminine.

Alcohol will cure your ills.

It’s common to think that having a few drinks will solve all your physical or emotional problems.  The truth is that using alcohol to regulate emotions leaves you depended on alcohol and less able to handle life without it.  Alcohols has some germ killing properties when used externally.  But when used internally, alcohol can cause damage in every cell in touches.

Alcohol will make you less anxious or scared.

Temporarily alcohol can make you feel less anxious.  In the long run, however, using alcohol to treat anxiety makes it worse, not better.  When you drink to cope with anxiety, the alcohol quickly wears off.  This leaves you more anxious than before.  The result is that you will need ever-increasing amounts of alcohol to cope with your anxiety.

Alcohol will make you function better.

Drinking alcohol, especially drinking it heavily, only makes people think they are performing better.  Having alcohol in the bloodstream interferes with coordination, memory, and judgment.

Alcohol makes you warmer.

Alcohol dilates the blood vessels close to the skin.  This results in a temporary feeling of warmth.  It also results in a rapid loss of heat from the core of the body.  Drinking alcohol when you are cold actually, causes the body to lose heat more rapidly.

Most people drink alcohol on a regular basis.

The truth is that more than half of the adults in America have not had a drink of alcohol in the last month.  Many Americans only have a drink of alcohol once or twice in any one year.  A handful of alcohol drinkers, the 20% heaviest drinkers, consumed 80% of all the alcohol that is drunk.

How many of these alcohol myths do you believe?  Have you discovered any other alcohol myths?

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Do you have an acute or a chronic illness?

By David Joel Miller.

Getting the right kind of treatment for your illness is important.

Acute or Chronic Illness

Acute or Chronic Illness?
Photo courtesy of Pixabay.com

 

Whether it’s a physical, emotional or mental disorder, getting the right treatment makes all the difference.  One of the problems we have in the behavioral health field is a tendency to treat chronic illnesses as if they were acute illnesses.

What is an acute illness?

Acute illness is something like breaking your leg. It happened suddenly, you go to the hospital and the Doctor sets it in a cast.  Eventually, the broken leg heals and you walk normally. Another example of an acute illness would be a case of pneumonia.  This can be quite serious and may result in a hospital stay.  You may need emergency treatment.  When that pneumonia goes away and you can return home.  You may have some after effects, But at some point, you will be pronounced cured of your pneumonia.

How is a chronic illness different?

Chronic illnesses have to be managed not cured.  Things like diabetes and heart disease are managed.  With a chronic illness, the Doctor continues to provide care and monitoring to keep the disease from getting worse.  In the past, acute illnesses were the main things doctors treated, today more than 75% of what doctors’ treat are chronic illnesses.

Mental health and substance use disorders are chronic illnesses.

For years we’ve made a mistake by thinking that we can treat mental and emotional illnesses as if they were acute. Someone is under the influence of a substance and are sent to detox for 72 hours.  As if substance use disorders were the same sort of things as a broken leg or an overdose of poison.

The belief used to be that once the drugs were out of their system that person was cured.  If the substance use disorder was an acute disorder, like poisoning, that would have work.  It is common for people straight out of detox to pick up drugs again within a few days. Detoxification does not work to cure substance use disorders because they are chronic illnesses.

The person sent to the psychiatric hospital for a suicide attempt might be released after two or three days when they no longer were feeling suicidal.  Sometimes that person gets additional care after the hospitalization.  But not always.

This is often another case of treating a chronic illness as if it were an acute illness. Without further treatment, after the brief hospitalization, there is a good chance that the depression and thoughts of suicide will return.

Mental health problems and substance use disorders require long-term treatment.

Repeatedly we have found that people with mental health problems who get treatment over a longer period of time are less likely to have a return of symptoms. Those people who continue to stay in treatment for up to two years after an episode of depression are less likely to have a recurrence of that depression.

With substance use disorders we find that those people who continue to stay in some form of continuing care are less likely to have a relapse.  Staying connected to whatever program or treatment helped you to recover from your substance use disorder improves the chances that you will stay recovered. In drug and alcohol treatment this continuing care is often referred to as aftercare.

One thing that has been sorely missing in mental health treatment is some form of continuing care after the initial episode. Far too often mental health issues are treated as if they were acute illnesses rather than the chronic conditions they are. Providing some kind of continuing support, groups, or individual counseling, reduces the risk of relapse into an active state of mental illness.

One highly effective continuing care system is the development of a written wellness and recovery plan.

For more about aftercare see the post in the “What is.” series.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is Amotivational Syndrome?

By David Joel Miller.

Have you lost your drive or your desire to do something?

unmotivated

Low Motivation.
Photo courtesy of Pixabay.com

Amotivational Syndrome is often connected with the smoking of marijuana.  This is something quite different from what we see in depression.  In depression, people lose the desire to do things they use to make them happy.  We call that loss of pleasure anhedonia.

In Amotivational Syndrome people seem to spend more time looking inward and contemplating things and less time actively doing them.  This syndrome was originally recognized in younger, marijuana smokers who were heavier daily users.

Does marijuana smoking cause loss of motivation?

Things that are, or were, associated with Amotivational Syndrome include the development of apathy and loss of ambition.  Heavy smokers just seem to become indifferent and stop caring about anything except smoking.  They seem to have fewer goals and decreased effectiveness.  Problems with attention and concentration have also been attributed to heavy marijuana smoking and Amotivational Syndrome.

Many of these characteristics are seen in daily, heavy, marijuana smokers.  What is unclear is whether the marijuana smoking causes this cluster of symptoms or whether those people who are low in motivation like to smoke marijuana.  At one point it was commonly accepted that some marijuana smokers are likely to suffer from Amotivational Syndrome.

Not all marijuana smokers are low in motivation.

Because of the many famous, popular people, who have been reported to be regular marijuana smokers, the connection between smoking marijuana and low motivation has come into question. It is unclear how common this condition is, or even if this is a valid syndrome.  Amotivational Syndrome has not been reported in countries other than the United States.  There’s some question whether Amotivational Syndrome is, in fact, a cultural rather than a mental condition.

Animals on marijuana don’t lose motivation.

Laboratory studies of both humans and animals have not found evidence of the Amotivational Syndrome for those using marijuana.  Amotivational Syndrome or loss of goals and direction has been found in many groups of young people who are not using marijuana on a regular basis.  This has led some writers to conclude that Amotivational Syndrome is a personality characteristic rather than the result of smoking marijuana.  It may be that those people with low motivation are attracted to using marijuana and other intoxicating substances.

One other possibility that has been suggested is that those people who are under the influence of drugs and alcohol or other substances may have low motivations to do anything while under the influence.  What we may be seeing in those people who were described as having Amotivational Syndrome may, in fact, be the effects of intoxication and withdrawal from marijuana or other substances.

As with the other things we are calling a mental illness or symptoms of a mental illness Amotivational Syndrome would need to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress for it to be the focus of clinical attention. Otherwise, while you may have lost some motivation you will not be identified as someone needing clinical assistance.  If the only time you have low motivation is when you are under the influence of marijuana or another drug this would be diagnosed as drug intoxication.

For more on this and related topics see the other posts on counselorssoapbox.com under        Drug Use, Abuse, and Addiction

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books