Category Archives: Drugs and Addiction

One preventable disease killing seniors up 1100%

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Elderly couple.
Photo courtesy of Pixabay.com

One disease has resulted in an 11 fold increase in accidental deaths among seniors.

When we think of the illnesses plaguing seniors we tend to think of heart disease, cancer, and diabetes, diseases that have long been associated with the process of growing old. As the population of the elderly, and almost-elderly, has risen, one disease has taken off in unprecedented numbers.

Drug use and abuse among seniors are out of control.

Past generations left drug use and abuse to the young people. As people age across the lifespan, they tended to give up bad habits and settle down to more responsible lives. The current generation of aged has pioneered a new trend in this as in so many other areas. Seniors are abusing more drugs and dying as a result of that abuse at alarming rates. This is a trend that is not likely to abate any time soon.

Senior’s deaths from accidental drug overdoses are rising rapidly.

Government statistics report large and rising rates of drug use among seniors. The “baby boomer” – “old hippy” age group has held onto their drugs of choice while adding to the drugs they use. Large studies take time to complete but the more seniors enter the statistics the more startling the trend becomes. Some of these drug-related deaths are obvious, some are more hidden.

Being an almost-senior puts you at risk also.

CDC reported recently that 12,000 baby boomers in the age range 45 to 64 died in one year (2013) from accidental drug overdoses. That is more than the total number of deaths from car accidents, influenza, and pneumonia combined.

Seniors have held onto their drug of choice longer than past generations.

Many baby boomers have held onto their drug of choice as they have aged. Up to 50% of all hospital emergency room admissions of senior citizens is the result of an overdose of drugs and or alcohol. In the year 2015 seniors age 60 to 65 are three times more likely to be using illicit drugs that those who were in that age group in the year 2000. Old hippies are still getting high, sometimes with life-threatening consequences.

Prescription drug deaths predominate.

Just because the drug comes from the doctor or pharmacy does not make it safe. More and more drug abusers, particularly seniors, are moving from questionable street drugs to prescription medications as their drug of choice.

Two groups of drugs account for the bulk of these drug overdoses, painkillers, and anti-anxiety drugs. Overdoses can be the result of people taking the medication and then before that med has time to act taking more. Certainly, confusion and forgetting what was taken can play a role. Still, the overwhelming conclusion is that many of these drug overdoses deaths in seniors are the result of intentional abuse rather than accidental overdose. Recreational use of these drugs by seniors is the dominant problem.

Some of these overdose deaths come from the cumulative effects of multiple drugs take together. One study found that among seniors, those taking eight or more prescribed medications had a 100% chance that two of them were interacting and causing an unintended result.  It is recommended that anyone taking medications carry a list of those medications with them and let their treating professions see what they are taking. It also helps to get all your prescriptions filled at one pharmacy. That list should include over the counter and street drugs also. Your doctor and pharmacist need to know about all the drugs you take.

Sometimes suicide is the reason for senior drug overdose deaths.

It seems possible that some of these reported “accidental” drug overdoses are in fact deliberate. We know that older people have increased rates of suicide attempts. The older a person gets the more the chances that they will attempt suicide. Before we alibi this as somehow related to incurable diseases or right to die issues, we need to also consider the way in which seniors are routinely hidden away and marginalized. Society’s discard of the elderly has resulted in a great national resource that is being wasted as the elderly have progressively less of a role in society.

Accepting high rates of addiction, alcoholism, and suicide among the elderly as inevitable diminishes us all. Loss of hope fuels drug use, as well as suicidal thinking at all ages and particularly so as the years, add up.

For the record drugs as a way to end one’s life is neither a reliable or painless alternative in many cases.

Alcohol is the lubricant that facilities senior drug abuse.

A large proportion of drug overdoses at all ages are the direct result of having alcohol in the bloodstream. One study reported that binge drinkers are fifty-five times more likely to attempt suicide. Many drug overdose deaths are facilitated by having alcohol in the bloodstream.

V. A. reported that half of their hospital beds are attributable to alcohol-related health problems. Among the seniors, one drink per day may be way too much given the other medications and health-related problems.

As we age the percentage of water in our bodies tends to decline. Less water results in a higher blood alcohol content. With age, the blood flow through the liver declines. If you drink the same amount each day, at age 90 your blood alcohol will be 50% higher than it was at 20. The amount of alcohol that used to be tolerable now results in intoxication.

Alcohol abuse by seniors often goes unrecognized, the symptoms attributed to dementia. Alcohol abuse makes the symptoms of cognitive decline worse.

As little as one drink per day results in an 800% increase in the rate of serious falls.

Growing need for senior-specific drug treatment.

There is a rapidly growing need for drug treatment for seniors. Treatment programs are having to modify themselves to meet this need. Seniors often abuse different drugs than younger people. They have been abusing drugs longer and have more health problems as a result. They have mobility issues, can’t get into bunk beds, or may need the program to be wheelchair or handicap accessible.

Abuse of drugs and alcohol by seniors is not something we should accept. If you or someone you know has a problem with substances, please talk with your doctor or seek out professional help. Abusing substances reduces the quality of life at any age and the older we get the more that drug will steal away what is left of your life.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Is your problem drugs or people?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

Are people in your life making too much out of your recreational drug use?

A number of people recently have been describing how they do not feel they have a problem with drugs. They are not addicted. They have or have had a job. There have been no awful withdrawal symptoms. These people report that they are not addicted and that they just use drugs for fun. These conversations have been both in person and via mail or chat.

The common complaint is that others in this person’s life are being unreasonable and are upset because this person wants to have fun. The common thread in these conversations is that these others are off base because they object to the person I am talking with have fun, enjoying themselves, and doing drugs recreationally.

This blog post is of course written in generalities. I do not know each reader’s situation. Your situation may be very different from the ones I will describe. Let’s take a look at some of these interpersonal conflicts that occur around drug use and how both the user and others in their life are perceiving this recreational drug use. Below are some of the people who have objected to someone’s drug use.

The topic is drugs but as far as I am concerned alcohol should get lumped in as a drug. Alcohol alters consciousness and it impairs functioning at times. Our societal attitude to alcohol may be less rigid than the attitude towards other drugs but those attitudes are changing and penalties for doing things while intoxicated continue to increase.

Your Spouse or romantic partner objects to your drug use.

Often the first person to notice a problem with your drug use will be a close romantic partner.  So you need to ask yourself did this person have a problem with your behavior before you two moved in together or has their opinion changed and why?

If they said nothing before you became a couple but are now asking you to cut out or stop your drug use what has changed? If situations have changed, you have kids, need to make a house payment and so on that may be the reason they are talking differently now. They may just have thought that once you were in a committed relationship you would act more grown-up.

Some people are ready to settle down for the kids and the future before others. Consider which is more important, your ability to do all the drugs you want because you do not see them as being a problem or making your partner happy and being a good parent?

It is also possible that the people in your house can see the signs of trouble in you before you can see them. If more than one person has complained about your partying, you need to look at this carefully.

Do your parents criticize your drug use?

One big reason that parents tell their kids that drugs or alcohol is a problem? Because they have done those things and gotten themselves in trouble. That or they grew up in an environment where people were acting irresponsibly as a result of substances.  It is rarely because your parents are trying to hog all the fun.

As people grow up there is a tendency to push parents away, separate yourself, and become who you are as an individual. Some people pick a new career, change their religious preference, or join another political party.

Other people dabble with drugs and alcohol. If your parents are noticing your drug use, then it is likely that you are already having problems. If when you use bad things have happened, you need to take another look at that use.

Are coworkers commenting on your drug use?

If your coworkers are expressing concern about your substance use then it is likely that your use has interfered with your job performance.

Frequently I hear that the person’s drug use is not causing any problems. They might say something like “The only one I am hurting is me.”

If you are missing work, coming in late on Mondays, or calling in sick a lot, the truth is your drug use is making your coworker’s life harder when they have to cover for you.

Your boss knows you are partying.

Bosses often notice an employee has a problem early on. Many people in drug treatment have to deal with the added issue of having been fired from several jobs. Bosses may ask you if there is something going on, problems at home? If your performance has gone downhill, is substandard, or you are late and absent a lot your partying is getting in the way of having a job.

Police contact suggests something is wrong.

If you are having issues with the police then ask yourself, would you have those same issues if you were not doing drugs or drinking? Yes, you can do what you want with your life, but if it is impairing your ability to drive, getting you into fights, or attracting the notice of the police then there is something wrong.

Did the Judge say you needed treatment?

If the judge says you need a drug treatment program then you need one. Why? Not necessarily because your drug use is that bad. You may not be an addict. Yet. But the fact that you are in front of the judge and that this person knows about your drinking and drugging tells us that your use has become a problem. Maybe it is only a legal problem, but it is still a problem.

Are you on parole or probation?

If you are on Parole or Probation take another look at you. When you are trying to get your life straight any drug use, alcohol included, can impair your judgment and send you back.

You say “I should be able to do what I want?” Maybe, someday. But really is your right to drink or drug more important than staying out of jail?

Consider that one study concluded the vast majority of people in prison were drunk or high in the 24 hours before they committed the crime that put them away. Alcohol and drugs are not your friends. Not the kind of friends that want you to stay out anyway.

The person who was injured in the accident you had knows it’s a problem.

If you hurt someone either intentionally or accidentally while under the influence, that was like not cool. Everyone can have an accident, but if you were high when it happened we think this is not so much an accident as a case of your ability to function was impaired and your hurt someone else as a result.

Clearly, you were not just hurting yourself.

Did you know there are countries in Europe where the legal limit for a DUI is point-zero-two (.02)? That’s right- one drink and you can’t drive over there.

Will all these reasons keep people from drinking and using?

Not likely. Many people will still say that they should be able to do what they want because they are only hurting themselves. Every year a whole new crop of humans will experiment with drugs and alcohol. But if you find that any of the people on this list are complaining about your drinking and drugging then maybe you need to take a hard look at how much of your life you are giving up to do those things.

For more on this topic see:

Drug Use, Abuse, and Addiction

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Is addiction real? Does it have a cause?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Cigarette smoking is addictive.
Photo courtesy of Pixabay.com

Comments on the deltaFosB post and the causes of addiction.

Some comments came in on the DeltaFosB post I think need discussing.

Normally I do not answer or re-comment on comments on posts. If you like a post cool. I will thank the reader for the like and that is that. If you disagree, then you are entitled to your opinion. I reserve the right to be wrong and so should all of you. Further arguing with people about their comments is not likely to change their minds so I try to use as much of my time as productively as possible and move on to new things.

This time feels different. On the chance that there are others who drew the same conclusions from the post that one reader “Tom” drew, I thought it would be worth further discussion.  I posted the headline to the original post with a link to the post on google+ and this comment from Tom was received over there.

First Toms comment on the post and then my explanations of why I think Tom is off base here.

“…there really does seem to be a physical change in the brain that accounts for why some people become addicted to chemicals, drugs in particular, and behaviors…”


I think that’s confusing hypothesis with findings. No one is seriously reporting that they have found the cause of addiction. For one thing, there is seriously insufficient research to support a global generalization of that sort.

People have been trying to find this mythical organic cause of addiction, and failing, for decades. What you report does go beyond the speculative, although it surely is not pure speculation. The research we have only supports informed speculation, to my mind.

The ambiguity in this phrase – “…that accounts for why some people become addicted…” is dangerous. I think what you’re really trying to say is something like “…that accounts for why some addicts become addicts…” As written, you appear to be talking about all addicts, and that is far beyond what we can address with the research you review, I think.

The fact remains that most people who drink alcohol are not addicts. Most people who use heroin are not addicts (little-known fact). Most people given opiates for pain can’t wait to get off of them, because of their unpleasant cognitive side effects. Those who become addicted are a small minority, and they seem all to have something in common: a persistent uncomfortable mental state which psychoactive substances/behaviors moderates. Happy people do not become addicts.

This has been known for a long, long time. But people just don’t want to let go of the “demon dope” hypothesis. The reality is more complex.

My response to Tom’s comments:

It appears that you are reaching conclusions from what I wrote that is not what I was saying. I suspect we have some fundamental philosophical differences here. We seem to be using words differently also. Look up the word addiction in a number of dictionaries and you will get a variety of definitions. I am concerned that people are using the term Addict as a pejorative term. The homeless and the mentally ill get that treatment also. Asserting that “addicts” are in some fundamental way different from non-addicted people is reassuring to some. If you have a job and a home you can tell yourself that you are not an “addict.” This obscures the very real issue of a growing problem of substance use and behavior use disorders in our society.

Let me try to clarify what I was saying about the criticisms you raised of the blog post.

  1. The term “some people” was written because I believe that those who develop an addiction, chemical or behavioral are people. To argue that “addicts” are somehow different from other people is to blame the person with the disorder for their condition. This is often done with other social issues like homelessness, poverty, and crime.
  2. The research reported on was concerning epigenetics and gene expression. This suggests that something happens which turns people who are not addicted to a behavior or a substance into those who have a dependency or reliance on this as a way of functioning. Behavioral “addictions” remain controversial with only gambling having been added to the most recent DSM. This research point to changes in the brain functioning when people reach a point of losing control over their use of that behavior or substance.
  3. If we call “it” addiction we get one paradigm. If we refer to something as chemical dependency or having a substance use disorder we get another. As a society, we are moving towards a “doublethink” approach to this issue. People who take prescribed medications do develop tolerance and withdrawal. There has been some pressure to alter the description of chemical dependency (the new term for what used to be called addiction) by adding craving as a characteristic of addiction. This might lead to the conclusion that someone can be “addicted” to a medication and not be an addict. This simply changes the terms to define away the problem of what is causing this condition.
  4. Referring to the premise that behaviors and drugs can at some point, for some unknown reason take someone from experimentation or use to being addicted as a “demon dope” hypothesis is a stretch.

If we accept that addiction could be a disease then the disease model fits. Compare this to the “demon Bacteria” theory of tuberculosis. One way of determining if something is a disease is to ask three questions.

Is there a specific agent that may be causing this condition?

Is there a host that gets the disease?

Is there a way in which this agent gets into the host?

Does this “demon bacteria” cause tuberculosis?

There are people who are around some specific other but do not get the disease. Does this mean that the bacteria is not the cause and that people who get T.B want to have it?    “Bad air,” wearing dirty clothing, and failure to wash your feet, along with a raft of other behaviors, have been postulated as causing the thing that we now attribute to the disease tuberculosis.  You can be around someone with an infection, and you may or may not get the disease. Your immune system, the length, and severity of exposure the room size, and other factors can influence whether you get the disease.

Do addictions fit this model? Yes, mostly. There are agents, pornography, or a drug (alcohol and prescribed medications could be included here.) Yes, it is an individual host that gets the disease, though with what we are calling addictions, the family and society are also affected. Lastly, there has to be an exposure to the agent. Unless you view pornography, take drugs or drink, you will not develop an addiction to these behaviors or substances.

  1. Reporting “a cause” is not the same as reporting a one and only one cause. We are reasonably sure that faulty brakes can result in automobile accidents. Faulty brakes are not the only reason for auto accidents. It seems likely that further research will find other things occurring in the brain before, during, and after exposure to the behaviors or drugs which cause chemical dependency. My statement is further qualified by the statement “seems to be.” This hypothesis or theory needs more research and testing. What has emerged to my satisfaction is that there is some sort of actual brain change occurring in “Some” of these people we currently describe as having a substance use disorder, addiction, or as being “addicts.”

I am increasingly unconformable using the word “addict.” We do not describe people with other disorders as their disorder. We do not, or should not, refer to someone who has been diagnosed with cancer as “the Cancer.”

  1. Absolutely it is likely that this one pathway, the repeated exposure to a behavior or substance, is not the only possible mechanism or reason. Smoking is not the only cause of lung cancer but the connection seems far beyond any chance correlation. Early research on Alcoholism reported that many “problem drinkers” drank to unconsciousness or blackout the first time they drank. Additional research has pointed to a genetic risk factor as well as exposure to alcohol playing a role. Research on genetic causes of alcoholism has been inconsistent. One study reported having a bio parent who drank alcoholically increased the risk that a person would become an alcoholic by 400% even if they never met that bio parent. Other studies have pointed to the increased risk of the environment. None of this negates the probability that repeated exposure to a behavior or chemical could change the “default setting” in the brain and result in the use of substances being an automatic behavior.
  2. Your statement that “Happy people do not become addicts.” is on its face false for several reasons.
  3. No one is or should be happy all the time. People who might be described as “happy people” all experience episodes of other emotions. There are no such people who are always happy.

Many people drink or use drugs to celebrate, at some point, sometimes the very first time, they go to extremes and develop a substance use disorder. Someone who drinks only one time a year, say for New Years, but over the last three years received two DUI’s and was arrested once for a bar fight clearly has an alcohol use disorder.

  1. Alcoholics or addicts do not look different than the non-addicted person. About 70% of drug addicts, those who report to treatment with a substance use disorder, have full-time jobs. About 95% of alcoholics work full-time but still find themselves unable to control their drinking when they try.
  2. Most teens who begin to use substances report the reasons they first tried substances was because it sounded like “fun.” Later in the process of developing a substance use disorder, they will report that they do it “socially” and eventually that it has stopped being “fun” and now they continue with the drug or behavior because it is difficult and painful to stop.
    While there are many factors involved there is increasing evidence that there are not two kinds of people “normal happy” ones and “addicts” but that for reasons we do not yet fully understand at some point a behavior or a substance can alter brain functioning and result in an addiction. Describing people who take prescribed medications and develop tolerance, withdrawals, and a physical addiction as not being addicts is, in my opinion, a distinction without a genuine difference.

Thanks for the comment anyway, it inspired this further explanation.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Why people become addicted – deltaFosB

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Addiction.
Photo courtesy of Pixabay

Is there really something different in the brains of addicted people?

Yes, there really does seem to be a physical change in the brain that accounts for why some people become addicted to chemicals, drugs in particular, and behaviors also. These brain changes may explain why and how people move from just experimenting, trying new novel exciting things, to the point of being addicted. Once addicted, the brain begins to demand more of the chemical or the behavior it has become dependent on.

One possible explanation for this brain change is deltaFosB.

It was quite by accident that I came across a description of deltaFosB and how it was causing a behavioral addiction. That instance had nothing to do with drugs, alcohol, or chemical dependency but came from the field of research on erectile dysfunction.

Erectile dysfunction was once considered purely a problem among older men and presumably their partners. Recently we have discovered there is a group of men who are developing erectile dysfunction at an amazingly young age.

The common denominator in this early onset of erectile dysfunction? Watching pornography. A few views appear to be no problem but those who watch a lot gradually develop a dependency on the watching of porn and become unable to be aroused by a real physical partner. The brain has rewired itself to become dependent on or addicted to porn to achieve sexual arousal.

For more on this see: Your Brain on Porn.

For those of you who like to watch – there is a YouTube TEDx Talks video on this research titled The Great Porn Experiment.

These brain changes do not happen suddenly but a little at a time.

Research on cocaine, morphine, nicotine, ethanol (drinkable alcohol), and Delta (9)-tetrahydrocannabinol (Delta (9)-THC, the active ingredient in marijuana, found they all produce specific changes in the brain. These changes do not happen suddenly from one dose but gradually over time the levels of deltaFosB increase and at some point, different for different people or different for different mice, and the brain begins to rewire itself to depend on the drug.  Interestingly enough each drug changes the brain in a different characteristic way.

Patterns of addiction to different drugs involve different changes in the brain. For more on this see: Distinct Patterns of ΔFosB Induction in Brain by Drugs of Abuse by Perrotti LI, Et. Al. Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas.

A full explanation of the chemistry involved is beyond my expertise or the scope of this blog but I have included a few links to some resources on the topic for those of you who are so inclined.

Wikipedia describes the role of deltaFosB this way.

“The ΔFosB splice variant has been identified as playing a central, crucial (necessary and sufficient) role in the development of many forms of behavioral plasticity and neuroplasticity involved in both behavioral addictions (associated with natural rewards) and drug addictions.”

How many doses does it take to become addicted – Gene Expression.

Genes are a lot more complicated than we used to think. When I went to school back in the post dark-ages era, we thought genes were yes or no things. You inherit your gene for eye color, hair color, height, and so on from your parents in a predictable, dominant-recessive way. Right?

Not really.

There is a thing called gene expression.

My gene for hair color dictated dark black hair. At least in my teens, it did. Those of you who have seen my blog bio picture realize that most of my hair is now gray, Ok maybe we should call it white. How did the gene for my hair color change?

As we age, or under the influence of environment and substances our genes can “Flip.” That switch in our genes moves and now that gene for black hair becomes the gene for white. The same thing happens for behaviors and drugs.

That chemical that used to be just an extra add-on for your pleasure becomes something you must have just to feel passable.

Here is a specific study on the process for those who take cocaine.

Expression of the transcription factor deltaFosB in the brain controls sensitivity to cocaine.

Now we have an explanation, of sorts, for how someone can use a substance or do a behavior for a while with no problem and then at some point the switch flips and they are now addicted to that drug or behavior. Presumably, this would also allow us to determine which behaviors fit the model as true behavioral addictions and which are just bad habits.

Can we flip that switch back? So far we have not found a way to turn an addict or an alcoholic back into a non-addicted person. You can dye your hair or you can let it go but once you turn gray you are stuck.

Be careful with the behaviors you practice and the chemical you use. They may be changing your brain.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is the DSM?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is the DSM?
Photo courtesy of Pixabay.

DSM is short for Diagnostic and Statistical Manual of Mental Disorders.

The DSM, short for Diagnostic and Statistical Manual of Mental Disorders is a book created and published by the APA (American Psychiatric Association) which seeks to codify the classification of mental, emotional, or behavioral diagnoses. Currently, the DSM is in its fifth edition (DSM-5.) Each successive edition has seen significant shifts in how we understand and diagnose mental illnesses.

While this volume is published by an American organization it has been widely used throughout the world. A number of reasons for the creation of the DSM have been suggested but a few large reasons stand out as the most important.

The early lists of diseases were about mortality, morbidity, and treatment.

Some of the earliest efforts to categorize diseases had to do with classifying causes of death. Other methods of classification were used on census reports to describe those who were unable to work because of mental retardation or mental illnesses.

It was also useful to doctors to have lists of diseases in order to help direct treatment. That medical model continues to influence mental health treatment. The APA is an organization of those people from a medical specialist who can prescribe medication. The result of reliance on doctors to write the classification system has been the medicalization of mental illness. If the main tool you have to treat illness is medications then they get classified by those disorders that will respond to a particular class of medication rather than those that will be best treated by a particular talk therapy.

Your diagnosis should not change with the place you live or who sees you.

One goal in encouraging the universal use of the DSM (and the International Classification of Diseases or ICD, more on the ICD in another post) is to increase the likelihood that when clinicians in various countries diagnose someone with a mental illness they are using the same definitions and criteria.

When you do research it is important to be researching the same disorder.

Standardized criteria, sometimes called strict criteria, are important in researching the treatment of mental disorders. Being sure that everyone in the research study has the same illness improves the chances that a treatment that works once with one group might work again on people with similar symptoms.

The DSM has undergone some huge alterations over the years. Early thinking separated mental illness into neuroses, the problems of living, and psychosis, the loss of contact with reality. Often mental retardation was tossed in with mental illness or vice versa.

Every time the list of mental illnesses has been revised the list has gotten longer. There is still a lot of debate over whether we have all the possible mental health issues listed in the DSM. The result of this uncertainty is a chapter in the back of the DSM-5 called “conditions for further study.” Some of these conditions will eventually get listed as disorders and some will disappear again.

The first or original version of the DSM came out in 1952. It is reported to have been influenced by government efforts to test soldiers during WWII. This was revised into DSM-II in 1968.

DSM-III was introduced in 1980. It introduced a thing called the “multi-axial system.” This was partially a recognition that the boundaries between mental illness, environmental issues, personality disorders, and physical illness were not always easy to fix precisely. The multi-axial system survived officially until Oct of 2015 when all were, in theory, required to adopt the new DSM-5. In the DSM-5 there is no longer a 5 axis system though we still look for most of the things that used to be placed on these five axes.

The DSM-III version was revised to be DSM-III-R in 1987 with lots of stuff changed and moved around.

In 1994 the DSM became DSM-IV, followed in 2000 by a minor text revision to become the DSM-4-TR.

The latest DSM revision was released in 2013 as the DSM-5. This version includes the codes for use with both the ICD-9 and the ICD-10. For those clinicians trained over the last 20 years, the DSM-5 was a sort of culture shock as some of the things we thought we knew about mental illness have been redefined. There was and continue to be some professional disagreements about how the DSM-5 classifies certain human problems.

The process of treatment research, especially in the area of brain scans and neuroscience makes it likely that our understanding of the human brain and mental illness will continue to change.

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.”

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What does my dream mean?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Dreams

Dream On!
Photo courtesy of Pixabay.com

Ever wondered what your dream meant?

Many readers email me about what their dream may mean. They want answers and hope I can provide them. Dreams can provide useful information for your awake life. Over simplistic interpretations can be harmful. I have written previously about some common drug-using dreams that clients have reported to me and what I and they thought these dreams meant.

Dreams about relationships and life events seem, to me, to be open to a lot more possible interpretations than the common drug use dreams I wrote about in those posts.

Dream interpretation used to get more attention.

First I will offer some thoughts on the topic of dream interpretation, then some suggestions for interpreting your particular dreams.

There was a time when interpreting dreams was a large part of what people in the psychology field did. The key concept in dream interpretation was the Freudian interpretation of mental processes and the role that was ascribed to the unconscious. Jung wrote about the collective unconscious and there are “depth” psychologists today that work in this area.

Interpreting dreams went out of fashion.

Somewhere along the line the study of normal psychology and the study of mental health and mental illness, sometimes called “abnormal psychology” were divorced.

Today the predominant model for treatment of mental illness or improving mental wellness is cognitive-behavioral therapy. Rather than looking for answers to life problems in the place of an unknowable and uncontrollable unconscious most therapy and counseling looks at very visible processes like learning and cognitive distortions. The emphasis is on things you think and believe, that are unhelpful, not on things your unconscious mind is making you do.

Most of the cognitive interventions, like reframing and challenging faulty assumptions are relatively straightforward. Interpreting dreams is far more subjective and less certain. While interpreting dreams and exploring your unconscious can be personally rewarding it is not the sort of brief, medically necessary, intervention a lot of insurance companies will pay for.

Personally, I have some dreams. Some of those are a bit disturbing and others are happy memories, so yes I may look at them. I find I need to be careful in interpreting my dreams and feel you should be careful with anyone who offers you a quick interpretation of your dreams. Especially be suspicious of those popular books that list a whole lot of things and if you dream of a lake it means one thing and if you dream of a river it means something else.

One thing does not always have one definite meaning for everyone. I am told that Freud, that believer in all things sexual, once replied that sometimes a cigar is just a cigar. He was, according to some reports, highly addicted to tobacco, so dreaming of cigars makes sense in a drug-using context.

Dream meanings are very personal.

Your past life experiences, in real life, and vicariously in movies and books can color your dreams. For example, back in High School, I raised some birds, Pigeons, and parakeets, if I dream about those birds it may have one meaning for me and quite another one for a person who was bitten by a bird and as a result is frightened of birds. The important thing is what does this dream mean to you?

Most of us have far more dreams than we remember. Even people who say they do not dream seem to enter dream states when hooked up to machines during sleep studies. Ever had a dream, awakened, and ran for the bathroom and when you got back to bed could not remember that dream? The majority of us forget more dreams than we remember. Some people forget almost all of their dreams.

It is the very unusual or frightening dreams that get remembered. If you keep a pad by the bed and write the dream down upon awakening you will discover you are having and remembering a lot more dreams.

From a cognitive perspective, we think that during dreams memories are taken out, processed, and then restored. There are opportunities for memories to undergo some alteration as in Lucid dreaming an intervention proposed to help with dreams that maintain PTSD symptoms. 

Things that happen in dreams do not have to follow logic or even the laws of time and space. So you may, in your dream, step out a door and be in another country. So you saw something in your dream, someone did something or something happened to you or a person close to you what does that mean?

Dreams have layers of interpretation.

Recently I read a book on dream interpretation by Jeremy Taylor, Where water runs up hill; he suggests that dreams have many layers of meaning. So the dreams about the parakeets many just be about a fond memory of childhood but it might also have to do with existential things like living, having children, and eventually dying, or it might have another meaning altogether.

What he suggests we should do is look at the dream, talk with others you trust about the dream, and then look at possible interpretations. What do you think it means at a superficial level, what it could mean at a deeper level, and so on. Some of these meanings will not make much sense and some will really speak to you.

So if you comment or use the “contact me” form, I can offer you a possible meaning to two for what you ask about, but I make no pretense that mine is the “correct” interpretation. If when someone tells you that your dream might mean a particular thing and you feel in your gut, your felt-sense, intuition, that this is correct, that meaning is probably part of your truth.

Hope this brief explanation of dreams from purely my perspective might be helpful.

Enjoy your dreams but seek help for disturbing nightmares.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What do you do if you are allergic to smoke?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Allergic to cigarette smoke?
Photo courtesy of pixabay.

How do you work around smokers if you are allergic to smoke?

This question originally came to me as an email from a counselor who is allergic to smoke. While they love the work if it’s difficult being around people who are heavy smokers. This problem also applies to those who have allergies to perfume or other strong scents. I thought I would pass this along for whatever it is worth. If any of you out there have other ideas feel free to leave a comment or contact me.

This is an extra problem, I believe, for anyone who works in mental health or substance abuse treatment areas. The comments also apply to those who work with the homeless or in social service agencies.

Smoke also affects the family members and children of smokers. When there are children involved we suggest that the smoker refrain from smoking not only when the children are around but also suggest that they not smoke in areas that their children will be.

See the post on Third Hand Smoke to find out more about the lingering effects of having a smoker in a room where others later go.

As an ex-smoker, this is less of an issue for me. I often do not notice the scent of smoke but others may. I am not suggesting anyone take up smoking to reduce the issues they have with being around others who smoke.

I have written previously about how tobacco (nicotine) is the drug of choice among the homeless. See: What is the Drug of choice among the homeless?

Smoking and mental illness.

Heavy smoking is common among those with serious and persistent mental illnesses, substance abusers, and the homeless. Smoking is not the only reason that these clients may have a strong odor. Lack of hygiene facilities makes the problems worse and so do illnesses like depression that make it overwhelming for many people to do their activities of daily life.

The conventional wisdom used to be that smoking calmed down people with psychosis or emotional issues. So if you were trying to treat someone hearing voices or abusing street drugs, why make then give up tobacco at the same time?

Today, more and more places, treatment facilities, and self-help meetings are going smokeless. What we have found is that helping people give up tobacco does not hamper their recovery from other substances and may help improve their mental health symptoms.

Increasingly stop smoking programs are finding their place in the treatment of people with mental illness and substance use disorders.

Here are some thoughts to help those of you who find yourself around smokers who are triggering your allergies.

What do you do if you are allergic to smoke?

This is a serious challenge. I would hate to think that anyone would need to give up their profession because of allergies.  This is a severe challenge for people with allergies since so many clients are heavy smokers and the smoke smell lingers long after they have put that cigarette out. Heavy smoking is common in people with psychosis, schizophrenia, substance use disorders, and so on. I did have a colleague who had severe allergies and even someone wearing perfume or having flowers in their office set off their attacks.

Six suggestions for coping with smoke:

  1. See your doctor, especially an allergist. Untreated this is only likely to get worse. Taking medication may help prevent the allergies from getting worse.
  2. Consider a fan or air purifier for your office
  3. Try to work in larger offices or rooms where the smell may be less overwhelming.
  4. See if you can do some distance counseling work. We have a law here (California) that helps people who are in rural areas, shut-in’s, etc. see their therapist via the internet. Other professionals may be able to do more of their contacts via phone.
  5. See if you can get assigned to a school-based program or work with children. Their parents may smoke but you will have less smell on your clients.
  6. See if you can work in an inpatient facility that has a no smoking policy

Not sure if those suggestions will help you but that is the ones I have thought of so far.

If any of you readers come up with any other solutions let me know.  Let’s see what blog readers can come up with.

Is being around smokers or strong odors an issue for you?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is selective tolerance?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is selective tolerance?
Photo courtesy of Pixabay.

Not all tolerance is created equal

What is tolerance?

Tolerance, as it applies to medications and drugs, is having less and less of a reaction to a drug the more it is used or having to use increasing amounts of the drug to get the same result. Tolerance, in the sense in which I am using the term here, is the way in which repeated exposures to something produce less and less of a reaction. People get used to things and so does your physical body.

When it comes to substances, whether they are legal, prescribed or street drugs, tolerance is that characteristic of the body to learn to resist things. The body develops an “immunity” or reacts less and less strongly the more times it experiences something.

Over time the drug addict uses more and more of their particular drug of choice. The person taking prescribed medications may also develop a tolerance resulting in needing a larger dose to achieve the same result or eventually they may need to be switched to a different drug.

Tolerance used to be one of the two symptoms that were used to define addiction. Withdrawal was the other one. Because tolerance and withdrawal are characteristics of many substances, not just drugs of abuse, we have had to look at other symptoms to define a problematic use of substances. We now call that problematic use a “substance use disorder.”

What is selective tolerance?

Selective tolerance is those times when someone develops a tolerance to one effect of the drug but not another. The body “selects” one action to develop tolerance to and not another.

A simple example of selective tolerance.

Coffee contains caffeine, a stimulant drug. Many people drink it first thing in the morning to help them wake up and get going. It is also common to find that consuming a caffeinated beverage to late in the evening results in not being able to sleep well that night. It is recommended that you not consume caffeine in the afternoon or evening so that you will get a full night’s sleep.

Have you ever known someone who could drink a lot of coffee or caffeinated soda just before bedtime and still sleep like a rock? Most of us have. That person has “built up a tolerance” to caffeine’s sleep interfering characteristic.

That same person will have some caffeine, probably a lot of it, the next morning, and report that the caffeine helps them wake up and get going.

How can this be? Did they develop a tolerance to caffeine or not?

It appears that they have developed a tolerance to one action of the caffeine but not the other. That is the thing we call selective tolerance.

It is quite possible that psychological factors play a role here, but there are lots of other times when someone develops a tolerance to one of a drug’s effects and not another.

There have been some divided opinions on whether drinking coffee is good or bad. My belief is that for most people, most of the time, coffee has more positive than negatives. The choices it up to you.

Could you develop selective tolerance to the effects of alcohol?

The research says that many people do just that. This may be why we see very inconsistent results in research on some of alcohol’s effects. I am not being an apologist for alcohol by saying this, just trying to get the story right. Despite the problems, alcohol causes our society another round of prohibition is unlikely.

My view is that those countries that have a total ban on alcohol often have high levels of problems with another drug. Many countries with a total ban on alcohol have a worse problem than the U. S. does when it comes to Heroin. The solution, such as it is, seems to be better educated on the effects of drugs on the mind and the body. Hence this blog.

Heavy alcohol drinkers develop tolerance to alcohol’s motor coordination effects.

Those who drink a lot find ways to hide the fact that they are under the influence. More concentration on walking straight may keep the drunk out of jail.  Research shows that many heavy drinkers do develop a tolerance to the motor coordination effects.

Heavy drinkers do not develop a tolerance to the bad decision-making effects

One key result of alcohol’s effects on the brain is disinhibiting the drinker. Under the influence, people say and do things that they would not do when sober. One study reported that they found no tolerance developing to alcohol’s disinhibiting effects in heavy drinkers (Miller, M., et al, 2012, no relation to me I know of.)

This study also notes that recent drinking patterns are predictive of tolerance. You do not need to be an alcoholic, a chronic drinker, or even a heavy lifetime user of alcohol to show tolerance to some of its effects.

So we conclude that people do develop selective tolerance to the effects of alcohol and probably most other drugs. Drinking a lot of alcohol is still not a good idea. While your liver may develop tolerance with repeated doses of alcohol, it can also develop Fatty liver, alcoholic hepatitis, and cirrhosis.

Use all medications and drugs with caution and be aware that while you may be developing some tolerance, getting used to using this drug, there are probably other effects the drug is having on your body and your mind that you are unaware of.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Alcohol, Drugs and Mental Illnesses

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

How are alcohol and other drugs connected to mental and emotional problems?

There are clearly a large number of connections between drug and alcohol use and abuse and mental, emotional, and behavioral illness. The recognition of these connections has resulted in a growing emphasis on the relationships between drugs and alcohol and those conditions that we call Mental Illnesses.

This overlap, those times when someone has both a substance use disorder and a mental illness, was called first dual-diagnosis and more recently co-occurring disorders. The overlap is common but not total.

There are people with a mental illness that do not have a substance use disorder. There are also those with a substance use disorder that do not have a mental illness. Over time we have come to see that the overlap is so large that it is more common to see someone with both of these problems than not. The professionals in the field have come to think of co-occurring disorders as an expectation and not an exception.

This understanding that there are reasons for the overlap, or co-occurrence, of these two different disorders has spawned a lot of efforts to find effective treatments for people with multiple disorders. The advances in brain studies have resulted in a lot of research studies on the effects of various drugs and the brain. We now know more than ever before about how drugs and alcohol are affecting people’s thinking, feeling, and behavior.

Alcohol, the drinkable kind, has been around and in use longer than any other drug. We know more about this particular substance and its effect on the brain than probably any other chemical. I recently did a literature search for current scientific articles on the effects of alcohol on the brain and the search returned 28,834 articles. Other searches would, of course, have returned even more.

Given this huge and growing body of research, I thought I should spend some time and some blog posts reviewing some of this new knowledge. While I can’t read every study and surely will only be able to report on a few highlights, I want to tell you about some of the things we know and some of the things I think about the effects of drugs on the brain and on those things we call mental illness.

There are several sources of this new knowledge. These studies, beginning with the ones focused on alcohol come from the following areas.

1. Fetal Alcohol Spectrum Disorders.

Studies of children who have been exposed to Alcohol before birth show changes in the body, brain, learning, and behavior of those children. We used to think that only those children who were exposed to large amounts of alcohol developed problems. The more the research progressed the more we have concluded that any amount of alcohol consumed during pregnancy increased the risks to the child.

Just because a woman drank during pregnancy does not automatically mean that any problems her child has are the result of her drinking. Still, the link is so strong that most authorities now believe that there is no safe level of alcohol consumption for a woman who is or may become pregnant.

One result of the large overlap between substance use disorders and other mental illnesses is that a lot of people with a diagnosed disorder are at extra risk for risky sexual behavior and unplanned pregnancy. Parents with a disorder or two are more likely than others to produce an unplanned child.

2. Binge drinking.

The amount of damage drinking does to the body is correlated with the blood alcohol level. As a society, we have been looking at how much alcohol in the bloodstream is a safe level for someone to have and still drive.

Studies of the effects of various levels of alcohol on brain function have taught us a lot about the way in which increasing the level affects the person.

It looks certain that the higher the blood alcohol content the more the damage to the body and the brain. One drink a day all month may be theoretically safe but 30 drinks on one day is a very hazardous way to drink.

3. Alcohol affects the structure and functioning of the brain.

We have known for a long time that chronic alcoholics have a reduced brain volume. We are now seeing studies of the effects of alcohol on brain regions and on the production of neurotransmitters. One treatment for depression is to increase the levels of serotonin in the brain. This is done by slowing the natural breakdown of serotonin which is one way many antidepressants work.

We know that alcohol is altering these neurochemicals and so may be increasing the risk of developing a mental illness, may make one worse, or may mimic a disorder.

4. Chronic Alcoholics.

Studies of chronic alcoholics, how their brain works, and the changes that the brain undergoes have added to our understandings of what the alcohol may be doing to the other parts of the body and brain. Because alcohol totally mixes with water, and blood contains a lot of water, no part of the body avoids being damaged by drinking.

5. Developmental studies.

Studies of teens have suggested ways in which alcohol consumption may be affecting the development of the brain. The correlations between the amount that a teen drinks and the results of the rest of their lives, while not a proof of cause and effect, makes us think there are more connections than we previously realized.

We know that “F” students typically drink at least twice as much per week as the “A” students.

We also know that heavy drinkers take longer to heal from injuries than nondrinkers.

6. Brain scans and mice studies on the effects of alcohol.

Brain scans typically capture only a moment in time. Mice studies are not proof that what we see in mice is what is happening in humans. But when the two agree it lends credence to the concept that alcohol is fundamentally altering the way in which brains and the nervous systems function.

7. Learning studies and functional studies.

There have been a lot of studies on how alcohol and other drugs have been affecting people’s memory, behavior, visual and special recognition, learning, and other specific brain functions.

Now that you know where the information is coming from let’s begin in future posts to look at why we think mental illness and substance use disorders so often occur together and then what are some of the specific effects of alcohol and other drugs on the body and the brain.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Meth, Cocaine and Ecstasy really do cook your brain

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

egg cooking

Drugs can fry your brain.
Photo courtesy of Pixabay.com

Stimulant drugs cause overheating of the brain.

Your brain’s temperature does vary. The temperature in your brain can fluctuate a whole lot. Some things cause your brain to heat way up and other things cause it to cool down a lot.

Most of what we know about brain temperatures comes from studies of rats but it looks like the human brain runs at a temperature very close to the rat’s brain.

When Mr. Rat is sleeping his brains temperature cools down to about 95 (35C.) During the day Rat’s brain will mostly be around 98.6 (37C) which is what we expect the human brain and body to be.

When drugs are introduced into a mammals system, as they are metabolized, the brain’s temperature will shift to reflect that metabolism. Physical exercise and emotions alter this brain temperature also.

The way that a drug affects the brain’s temperature is, as are many other effects of drugs, very dependent on the dose of drugs and the route of administration.

Mr. Rat’s max brain temperature reaches an extreme high of 103 (39.5) during extremely vigorous rat sex.

That was his top brain temp without drugs. But let Mr. Rat, and presumably, humans, start tweaking on Meth and his brain temp cranks up to an over-the-top level of 104 (40C.)

At that point, the brain temp has begun to damage Mr. Rat and his larger human cousin’s brain. From here on as the brain temperature rises, the blood-brain barrier, the thing that protects your brain from infection and other damage, begins to leak. At this temperature, the very structure of the brain begins to “cook” as in there are structural changes.

I am not making this stuff up. I found this is in Kiyatkin’s article “The hidden side of drug action: brain temperature changes induced by neuroactive drugs,” from Psychopharmacology (2013) 225:765–780

Kiyatkin also points out that while the human brain only contains 2% of your body weight it uses up to 20% of the energy you use every day. This may explain why since T. V. came on the scene humans are thinking less and weighing more, but that is a topic for another blog post. (The T. V. part is my theory, not Kiyatkin’s.)

He does point out that the brain holds heat and the temperature there is likely to run hotter than the body temp, the center of the brain runs hotter yet as it takes a lot of blood flow to cool that part of your brain down. So if someone is doing (abusing) a drug like meth, ecstasy, or molly, the temperature in their brain center is likely to be higher than the rest of them.

The hotter the temperature of the brain the more severe any brain injury is likely to be.

This same study looked at rats trained to press a lever to get Cocaine and those rats who just had to wait around for an injection. The rats who self-injected or were drug-seeking – guess what? The temperature in the brains of addicted rats goes up when they are looking for cocaine. This suggests, at least the way I read this study, that the stimulant drug had changed the way the brain utilizes neurotransmitters and regulates temperature.

Both Meth and MDMA (Ecstasy or Molly) induce strong peripheral vasoconstriction. So while they increase the temperature in the brain they reduce the ability of the body to get rid of this heat.

In male rats when the room temperature went up to 29C (84.4) and they had social interactions with female rats, something that would normally raise the temperature of their brain slightly, Meth raised their brain temperature to dangerous levels (42C, 107.6F.) and within 6 hours 5 out of 6 rats died.

This brain cooking phenomenon may well explain the reports of deaths at human social events from dehydration despite efforts to drink water and stay cool.

Humans can tolerate Meth and other stimulant drug doses better than rates and we humans are better at regulating temperature. Still, above 104F (40C) high brain temperatures are implicated in permanent damage to the brain. (See (Chen et al. 2003; Iwagami1996; Oifa and Kleshchnov 1985; Lepock 2003; Sharma and Hoopes 2003; Yamamoto and Zhu 1998) quoted by Kiyatkin,)

So when people tell you that Meth, Ecstasy, or Molly is cooking your brain, they are telling it right.

Staying connected with David Joel Miller

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Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

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What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

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