Category Archives: substance use disorders

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

Effects of Alcohol last long after you sober up

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

Alcoholic beverages.
Photo courtesy of Pixabay.com

Alcohol continues to affect you after it has left your bloodstream.

Researchers are finding that the effects of alcohol are not limited to what we see or experience while the alcohol is present in the bloodstream. Those effects continue long after the liver has removed the alcohol from the bloodstream. Here are some of the things researchers are reporting about the effects alcohol leaves behind after it has done its work.

One of these lingering effects increases the risk that alcoholics or those with an alcohol use disorder will drink again.

1. Hangovers impair your driving skills.

One study measured attention, coordination, and vigilance in college students the night after they had consumed enough alcohol to become legally intoxicated. Students were tested one day and then again the next. Some students were instructed to not drink alcohol overnight, others were allowed to drink to intoxication. The following week the groups switched. This allowed a comparison of how students did on the various tests after a night of drinking or no drinking.

This study was done in the college dorm to avoid increasing the number of drunk people out on the roads. I did not do this research, just reporting what I read.

The results?

Students who had drunk to intoxication, that would be enough alcohol to reach a point one zero blood alcohol content (.10), were just as impaired the next morning when their blood alcohol content had returned to zero as they had been the night before.

You are just as impaired with a hangover as when you are legally drunk!

Actually, many of the subjects in this experiment were in worse shape with a hangover than when they were legally drunk. Memory, attention, motor coordination even the ability to plan were all significantly affected.

2. Alcohol causes the blood-brain barrier to “leak.”

The purpose of the blood-brain barrier is to keep things out of the head that does not belong there. It also has to let things in that the brain needs. This functioning as the brain’s border patrol is hard work for that blood-brain barrier. When that Blood-Brain Barrier is under attack, under the influence of alcohol, it has trouble doing its job.

One thing that gets kept out of the brain when you have alcohol in your system is glucose. Your brain may only be 2% of your body but it uses 20% of the energy, so a shortage of fuel develops quickly while all those alien Alcohol molecules are storming the brain’s border.

This is why so many hangover remedies include sweet ingredients. Without energy, the brain can’t work efficiently.

3. Impaired coordination lasts a long time.

At some point, and that precise level is still debatable, high levels of alcohol in the bloodstream alter or damage the part of the brain that controls coordination. Evidence of this comes from several sources.

Chronic alcoholics exhibit unsteady gates even when they have undergone detox and their blood alcohol levels are at zero.

Children born with fetal alcohol syndrome, the most severe form of damage to a child as a result of the mother’s alcohol consumption, exhibit a particular form of uncoordination. When moving their arms they move them much more rapidly when close to the body than when farther away. There is also a decided jerkiness to their arm movements. All of this points to Alcohol causing impairment in the brain’s ability to regulate motion long after there has been any physical presence of alcohol.

This impairment in coordination lasts into adulthood.

4. Alcohol shrinks the brain’s size and volume.

The prefrontal lobes of the brain shrink about 11% in those who have abused alcohol over some period of time. Other parts of the brain shrink also, resulting in an expansion of those blood-filled spaces called Lateral Ventricles by as much as 42%.

I have not found a source that quantifies this as to how much alcohol over how long a time this takes to happen. What has been established, at least tentatively, is how much of the damage to the brain can be repaired.

The size of the lateral ventricles seems to shrink with sustained abstinence. The ventricles shrink and the surrounding brain tissue expands and or grows back a little but not all the way.  The damage to the prefrontal lobes does not seem to be repaired.

This results in many people in alcohol recovery having impaired executive functions. They need to learn or relearn planning, scheduling, and decision-making skills.

Combine the changes in the brain with the loss of coordination and the result is 33% to 50% of all those with an alcohol use disorder will have cognitive or motor disorders in addition to difficulty controlling their consumption of alcohol.

5. Alcohol lowers inhibitions long after it has exited the body.

Most of us know that alcohol lowers inhibitions and allows people to do and say things that they would not otherwise do. What has been discovered recently is that a pattern of recent heavy drinking increases that disinhibited behavior. The result is that drinking heavily even if only for a while increases the risk of your making poor decisions even during times when you are not drinking.

One researcher observed that this residual loss of control is one more reason that people with alcohol use disorders are at high risk of drinking again even when they are trying to stay sober.  The brain really has rewired itself and the part of the brain that says “do not do that” is off-line for an extended period of time after a recent episode of heavy drinking.

There are other long-term consequences of drinking alcohol but let’s leave that for a future post.

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 you get drunk and they don’t

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

Inebriated people.

Alcoholism.
Photo courtesy of Pixabay.

Some people get higher blood alcohol concentrations (BAC) than others.

If a group of people all drink the same number of drinks, even if they are all drinking exactly the same amount of alcohol in those drinks, one person will end up with a higher blood alcohol content than others.

This unequal blood alcohol level is not about tolerance

We are not talking about the subjective feeling of being more or less drunk here. Some people feel it more than others. Some people have practiced drinking so much they have built up tolerance. They don’t look or act drunk even at high blood alcohol concentrations. But if we test them on a machine, that person with the high tolerance, the one that thinks they can hold their liquor, they will be just as uncoordinated and incoherent as anyone else.

The number of drinks is not the only thing that affects how high your blood alcohol content goes.

Here are some of the factors that affect how drunk you actually get as measured by blood alcohol content.

1. More drinks equals a higher BAC.

The more alcohol you consume the drunker you get. But not everyone gets to the same number. Drink an extra drink or a stronger one and you get more alcohol in your bloodstream.

2. Bodyweight influences blood alcohol.

Alcohol mixes very rapidly in water. Most of the body is water. The bigger you are the more that one drink gets diluted and the lower your blood alcohol level will be. A 200-pound person can drink more alcohol than a 100-pound person before they reach that legally drunk point. That big person cannot drink twice as much, by the way, but they can consume slightly more.

3. Gender influences how much you can drink.

Men’s stomach produces more of the enzyme that breaks down alcohol. One book reported that men’s stomachs neutralize 10% of the alcohol before it ever leaves the stomach. This means that women get a higher blood alcohol level than a man even if they are the same weight. Guys have known about this for years but ladies now you know.

4. Older people get higher blood alcohol levels.

As we get older our livers slow down even if it is low mileage and you rarely abused it. One drink per day may be OK for a thirty-something but past age seventy 4 drinks a week will be too much.

4. A damaged liver can’t metabolize alcohol like it used to.

Excessive alcohol consumption is one way to damage a liver, there are others. Viral infections, over the counter and prescribed medications when used in excess can also damage that liver. Add alcohol, a non-prescription pain reliever used in excess, and a viral infection and your liver may go on strike.

5. Just because you stop drinking does not lower your blood alcohol.

This is a common mistake. You feel a bit woozy. You stop drinking alcohol and start drinking coffee. Now feeling fully awake you feel safe to drive. You have not had a drink for an hour or more, it should be safe to drive right?

Most alcohol is absorbed in the small intestine. You stop drinking but the alcohol keeps moving from the stomach to the intestines to the bloodstream. The result? For the next 30 to 90 minutes your blood alcohol content will continue to go up.

An hour and a half after you stopped drinking your blood alcohol content is higher than when you stopped.

This does not mean you should knock down that last one and then drive home as fast as possible before it hits you. What it should tell you is that a whole lot of physical features will conspire to take your blood alcohol level above where you think it is.

One other Alcohol factor can get you.

Drinking energy drinks, strong coffee, and a little eye-opener. People do stimulants, legal and illegal kinds. And then they feel that they are alert enough to drive. Just like the person who has developed tolerance you may feel OK but given a test of reaction time or judgment you will probably fail. Missing a point in a video game is no big deal. Feeling OK and then driving and hurting yourself or others, that is a really big deal.

So there are some reasons why you may be drunker than you think you are and why one person can drink more than you and dot get drunk but you may need to drink less or not at all to avoid the consequences of high blood alcohol contents.

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 binge drinking?

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

Drinking

Binge drinking.
Photo courtesy of Pixabay.com

Why binge drinking matters.

Binge drinking is a pattern of drinking that has been linked to a host of physical, mental, and behavioral problems.

In the binge drinking pattern, the drinker consumes a large quantity of alcohol on one drinking occasion. Anyone might experience an occasional episode of heavy drinking but with consistently heavy drinkers or binge drinkers, their typical pattern of consumption is that when they drink the get drunk.

The concept of binge drinking relates more to how high the level of alcohol in the bloodstream goes rather than when or how much the drinker consumed over a unit of time.

So if someone chooses to drink a lot one night why is this of any concern to others? Why should it matter to the drinker if their pattern of drinking is a binge-drinking pattern? First the concerns and then some more precise definitions of what qualifies as binge drinking.

There are two principal concerns with binge drinking.

1. Alcohol damages the drinker’s brain and body.

The higher the blood alcohol content (BAC) the more damage to the body. Alcohol and its primary breakdown product, Acetaldehyde, are highly toxic to the body. In small amounts, the body can cope with this foreign substance. Above a certain point, there is damage to the body. A single episode of binge drinking is likely to leave minimal long-term damage. Repeated binge drinking will leave more long-term damage.

At high enough levels many substances can cause death. For alcohol, that point is a blood alcohol content around .60 (point six zero.)

Have one drink per day and it may be healthy, or non-harmful anyway. Save those drinks up and consume them all on one night and the damage may be permanent.

Blood alcohol level is also related to repeated head trauma (Winquist et al., 2008.) Long-term high levels of alcohol damages brain cells in the prefrontal cortex which may decrease by 10% or more. Binge drinking also causes cells surrounding the lateral vertices to shrink resulting in an expansion of this fluid-filled cavity in your brain by about 42%. Alcohol and especially heavy or binge drinking cause these cells in your brain to shrink resulting in more empty, blood-filled spaces in the brain (Wolerock, 2009.)

High blood alcohol levels also result in memory loss and the creation of false memories, a process called confabulation.

2. Intoxicated people hurt themselves and others.

At high blood alcohol levels, there is an increased risk of harming self and others. Most places set strict limits on the legal level of alcohol in the bloodstream you may have and still drive. Those limits are admittedly imprecise. Two people with the same blood alcohol content may not be equally impaired, but the higher the level goes for any given individual the more impaired they become.

Increasing blood alcohol levels reduce coordination, lower inhibitions, and impair judgment and memory. Intoxicated people, those who have binge drank on this occasion are 55 times more likely to attempt suicide. They are the major source of serious and fatal car accidents. They are more likely to commit crimes and harm others.

There are exceptions, sober people can do bad things, many intoxicated people do not commit crimes, but the higher the blood alcohol content the more the risks.

There is also a severe risk if the person binge drinking is or becomes pregnant. The unborn fetus does not have a developed liver. So mom-to-be needs to have her liver do the alcohol detox for this unborn child. We used to think a drink or two each day was OK. Now we are convinced that any alcohol during pregnancy is a bad idea and binge drinking is especially risky for mom and unborn child.

What is the definition of binge drinking?

Most definitions of Binge drinking are common sense approximations. Using blood alcohol content would be more precise but all that blood drawing is inconvenient.

The definition of binge drinking we use here in the United States is five or more standard drinks for a man, 4 or more for a woman on any particular drinking occasion. This is roughly the amount of alcohol that will make you legally too drunk to drive.

Standard drinks are calculated so that regardless of what you are drinking you can estimate how much alcohol is in your drink.

Despite what many people think, the alcohol in any alcoholic beverage is the same substance, ethanol. So this “I only drink Beer” I can’t have a drinking problem is nonsense. All those other statements about why one beverage is better than others, nothing to do with the alcohol.

When it comes to blood alcohol content, alcohol is alcohol.

In the U. S. a twelve-ounce beer is one standard drink. A four or five-ounce glass of wine is also a standard drink. If you are drinking whiskey, scotch, vodka, etc., then one ounce of a 90 to 100 proof beverage is a standard drink.

No cheating here

People will try to fool themselves. You know that drinking a tall can or 40-ounce beer is not one standard drink. Right? Neither is drinking 151 (a beverage with 75 ½ % alcohol.)

Alcohol content can vary from state to state or country to country. Outside the U. S., tell me the alcohol content of beers is higher. Pouring more of a beverage in a glass does not let you count it as one standard drink either.

The amount of alcohol it takes to make one person’s blood alcohol content reach .08 or .10 may vary. Some tell me it’s not fair that others can drink a lot and not get arrested for driving drunk and they ended up in jail after only a few. Why this happens is a subject for another blog post.

Binge drinking is not a moral thing.

Some people have argued that telling people to not binge drink is making a moral judgment. They should be able to tie one on if they choose. Choosing to binge drink, drink till you get legally drunk (or illegally drunk if you prefer that term) does not necessarily make you a bad person.

If you drive 60 miles per hour in a 25 mile per hour school zone and a child runs out, your braking distance is a lot longer than if you were driving the prescribed 25.  There is more likelihood that you will harm a person’s crossing the street and if you hit them you could mess up the rest of your life also.

Similar case with binge drinking. If you binge drink this can increase the risk that you will damage yourself health-wise or harm others if you drive or are around them. We are just saying there is a warning out on this behavior.

Now if this is your typical pattern of behavior, when you drink you always binge and end up drunk this is a worry. If having developed some problems due to your excessive drinking in the past you continue to binge drink then this is a bigger problem.

If your drinking, binge, or otherwise is interfering with your life, consider changing your drinking pattern. If when you try to control your drinking you find you keep losing control, it is time for some professional help.

This blog is largely devoted to the topics of mental health and substance use disorders. Especially those times when people have both issues, which is called co-occurring disorders. Alcohol is one of the top problems in this area. Stay tuned for more on alcohol’s effect on your body, brain, and your mental health.

Past posts on this topic you may want to look at include:

Dangers of Binge Drinking

Alcohol prevents healing

6 Myths about alcoholism

Blackouts – common or rare?

What is confabulation? Relationship to false memories and Wernicke-Korsakoff’s syndrome 

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

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

The link between Smoking and Depression

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

Full ashtray

Smoking cigarettes.
Photo courtesy of Pixabay.com

Smoking may be the cause not the result of depression.

People who smoke are far more likely to become depressed than nonsmokers. About 40% of smokers suffer from a mood disorder, largely depression, while the rate in the whole population is typically in the range of 2% to 10% in any one year.

The connections between tobacco smoking and mental health issues may be even more severe than was previously thought. The connections are not limited to depression or related mood disorders.

One recent study took another look at the National Epidemiologic Study on Alcohol and Related Conditions, a large nationwide survey of mental health and addiction issues.  (P. A. Cavazos-Rehg, N. Breslau, D. Hatsukami, M. J. Krauss, E. L. Spitznagel, R. A. Grucza, P. Salyer, S. M. Hartz, L. J. Bierut. Smoking cessation is associated with lower rates of mood/anxiety and alcohol use disorders. Psychological Medicine, 2014; 1 DOI: 10.1017/S0033291713003206)

This study surveyed 35,000 people; about 4,800 of those were daily smokers. The study participants were resurveyed 3 years later. Smokers in this study appear to have significantly higher rates of mental health issues.

Half of all smokers reported having “Alcohol problems” While 24% reported some form of drug use problem.

Over the course of the three-year period between studies, some people quit smoking. Among those who quit smoking the rates of mental health and substance abuse problems declined, while those who continued to smoke continued to have higher rates of mental health and substance use disorders.

This challenges the conventional wisdom that in treating serious mental health or substance abuse issues the issue of tobacco smoking can be left for a later time.

Chemical use of many kinds is known to impact mental health. Excessive alcohol use results in depression. Many practitioners have been reluctant to treat someone for depression while they are still drinking alcohol.

Recently professionals in the mental health and substance abuse field have moved to thinking that substance use issues and mental health issues so thoroughly interact that both problems need to be treated simultaneously.

The evidence continues to mount that there is a connection between tobacco use and both mental health issues and substance use disorders. It is becoming clear that ending tobacco use might have a significant impact on mental health.

Recently I have been hearing of studies in which the seriously mentally ill were taught smoking cessation and the results of their recovery from both issues were essentially the same as the general population.

If you are a smoker, quitting may well improve your mood and your mental health. If you are struggling with a mental health or substance use disorder there is no reason to put off quitting smoking and there are a growing number of reasons to think that quitting will make your other problems easier to manage.

Have you seen a connection between your smoking and other life problems?

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

Drug kills your mental health before it kills your body.

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

Full ashtray

Smoking cigarettes.
Photo courtesy of Pixabay.com

Nicotine  – The killer drug.

Of all the drugs out there, legal or illegal one drug alone accounts for the bulk of the drug-related deaths each year. That drug is Nicotine and the predominant ways it gets into your body is by smoking or second-hand smoke.

We have known for 50 years or more that Tobacco and smoking were harmful to our physical health but we are only now seeing the extent of the connection between smoking and other societal problems such as mental illness and homelessness.

For every one person that dies of an illegal drug Nicotine kills 200 people. That is not an argument for legalizing other drugs. We have seen highly publicized drug deaths recently from illegal drugs. Heroin and prescribed Opiates can kill quickly and with alcohol in the bloodstream the overdose death rate sores.

Deaths from tobacco happen far more slowly. There is a gradual progression of a variety of diseases before the final death.

What we have been overlooking in all of this is the significant connection between mental illness, other drug addiction, and smoking. Mental health treatment providers have been slow to recognize the connection and slower yet to attempt any form of smoking cessation treatment with the mentally ill clients.

While in withdrawal from Nicotine clients can become agitated, restless, and harder to manage. Providers have suggested that they needed to work on the “bigger” issues of drug withdrawal, alcoholism, depression, and other mental disorders.

What has been missing from this approach is a clear view of the ways in which Nicotine may be causing and maintaining a mental illness.

Research studies have suggested that between 44% and 50% of all the cigarettes consumed in America are smoked by those with a mental, emotional, or behavioral health diagnosis (a DSM diagnosable condition.)  Researchers have detailed the efforts of the Tobacco companies to market to the mentally ill (Prochaska, Hall, & Bero, 2008; Lasser et al., 2000; Apollonio & Malone, 2005, cited in Wigand, 2009.)

One consequence of the heavy smoking by the mentally ill is that they commonly live twenty years less than those without a long-term mental illness.

Despite the apparent connection between Nicotine and the creation and maintenance of mental illness most providers have been reluctant to include smoking cessation in their programs.

This connection between smoking and mental health issues is particularly problematic among women. Jessup Et al. on their study of women smokers reported “Smokers had significantly higher rates of Post Traumatic Stress Disorder (PTSD), past year depression and anxiety, suicidality, past year substance abuse, and co-occurring disorders.

Jessup further reports that women who smoke two packs per day are more than twice as likely to suffer from Major Depression. Those with Post Traumatic Stress Disorder were 4-5 times more likely to be heavy smokers. In this study, smoking women were much more likely to be unemployed than nonsmokers and even if they lived with a partner the smokers were more likely to not have enough money to meet their basic needs.

The connection between smoking, drug, and alcohol use disorders, and mental illness has been reported in study after study.

Those disorders that seem to be highly correlated include substance use disorders, PTSD, Depression, Anxiety disorders, and Psychosis. There have been some suggestions that smoking has helped those with serious mental illness manage their symptoms, even though this is at the cost of a shortened lifespan. The research seems to report that smokers report more, not fewer, symptoms of mental illness. The “smoking solution” is making symptoms worse, not better.

This connection between smoking, mental illness, and a substance use disorder also resulted in increased rates of unemployment, no medical insurance, and a high need for treatment. Those at the highest need of physical health services were the least likely to be receiving those services other than through free programs or hospital emergency rooms.

Studies have also reported that smokers are twice as likely to have had recent thoughts of suicide as non-smokers.

One difficulty with adding smoking cessation treatment to substance abuse, mental health, and co-occurring treatment programs is that the majority of people in treatment are in the stage of change we call “precontemplative” meaning they had not even thought about quitting. For this group, the most effective intervention may be education about the connection between smoking and their other co-occurring issues.

We are hopeful that the expansion of health care will result in more services for those who have co-occurring disorders and that smoking cessation treatment may be included in those services.

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 he Internet addicted?

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

Computer

Internet.
Photo courtesy of Pixabay.com

Is this just having fun or is it internet addiction?

How much internet usage is a problem?

When it comes to behaviors how can you tell when enough is too much?

We know that behaviors can become problems. Some like pathological gambling can destroy lives and families but when is a behavior an addiction?

Is internet addiction a real addiction?

It would appear so. Brain scan studies show that in both drug-addicted individuals and people with problematic internet usage the same areas of the brain light up when they think about their preferred activity. The brain has changed in response to their habit and has resulted in characteristic symptoms of addiction.

The hallmarks of addiction are; building up a tolerance, withdrawal symptoms, excessive involvement with the drug or activity, and continued participation in the activity despite negative consequences. We should also mention here that cravings for the drug or activity are the factor that maintains the addiction.

Let’s look at how these characteristics will manifest in someone with an internet addiction. We think there is a difference between high levels of computer usage and a true internet addiction. Computers and the internet have become parts of modern life. They can have good and bad aspects. Many jobs now require the use of the computer, often for many hours per day. We use computers and the internet for business, person, and social applications. Some usages have more risk of becoming a problem than others.

Internet addiction is one of these “behavioral addictions” or compulsions that are poorly understood and little researched.

First, the 4 characteristics of addiction applied to excessive internet usage. Then some information on possible psychiatric connections.

1. Tolerance.

People who become addicted to the internet need more and bigger computers, more software, and the time they spend on the computer continues to increase. They may spend excessive (for their income) amounts of money and time on their computer activates.

2. Withdrawal.

When unable to do their usual activities the internet addict will become angry, fearful, anxious, or depressed. Should their connection fail they are unable to do other activities in the place of their internet routine.

3. Excessive usage.

What is excessive is a matter of perspective. Most addicts can’t see that their activity has become excessive until it has become too late. Neglect of other areas of life is a good sign this activity is becoming excessive.

Does the internet user stay up too late and then are they tired all the next day. Does this time online interfere with their job, school work, or family life? Is this person neglecting their role responsibilities?

All of these are signs that the use of the internet has become excessive.

4. Continued use despite negative consequences.

The internet addict will begin to lie to others around them about their usage and the nature of their online activities. We have talked elsewhere, or will soon about how this lying may be a sign that the person is using the internet in the service of another addiction, like an affair, gambling, or a sexual addiction. The lying we are talking about here is not about covering up the why of their usage but this lie is about covering up the extent of their usage.

Poor school work or job performance are common results of excessive internet usage. Chronic fatigue with a loss of motivation and interest in other activities occurs. Social isolation, with few friends and few offline activities, also occur.

Psychiatric considerations and co-morbidity.

So why should we be concerned about an internet addiction? They could be addicted to books (an incurable condition for a writer.) As long as they do not lose their job or family, what’s the harm?

Internet addiction may be a symptom of other disorders rather than a primary disorder. Internet addiction coexists with several other serious mental health problems. Those with internet addiction often have depression from mild all the way to serious. Anxiety is a common co-morbidity and may be of the generalized, over-anxious, variety, or the social phobia type.

Among those with excessive internet usage, alcohol and marijuana abuse is common. Addictions travel in flocks and switching one addiction for another is commonly reported in recovery circles.

Internet addiction is not yet a recognized disorder in the DSM. One variation, Internet Gaming Disorder has been proposed for further study. The mental health community is still not quite sure how to understand this internet addiction thing.

Some authors have proposed that this may be a variant of Obsessive-Compulsive Disorder (OCD.) The use of the internet may be a way of reducing anxiety in those with OCD. Other authors have noted that the anxiety in Internet addiction is more like that in drug addiction, the addict becomes anxious when they are unable to get the thing that is the object of their addiction.

Internet addiction may be another of those catch-all groups that are really a set of similar symptoms that represent several distinct disorders. A cough can be a symptom of many illnesses and what if excessive internet usage is really a symptom of many different mental health disorders?

Three variations of internet addiction appear likely

1. Internet Gaming.

This variant is the need for the repetitive playing of games and racking up points. They may be playing against others online or this may be a solitary activity. Research currently distinguishes this from internet gambling. Gambling Disorder (formerly called Pathological Gambling) seems the same online and offline and pathological gamblers move between various settings and games of chance.

2. Cyber Sex.

This appears to fit in with other sexual issues. It is distinguished from the use of the internet to facilitate affairs or other crimes. This can vary from sex chat and sexting all the way to a pornography addiction. In a cybersex addiction, the goal is to get sexual gratification online rather than the goal of meeting a real person offline.

3. Obsessive use of the internet for social contact.

This includes frequent usage of emails, text messages, and social media sites. The internet addict may become obsessed with how many friends they have on a particular site, what others are saying, and so on. This reliance on the internet for human contact may lead to a lack of social skills and few friends when in offline situations.

One serious concern with excessive reliance on the internet for social contact is the risk of pain caused by online stalking and cyberbullying which can result in suicide or other emotional crises.

Hope this brief summary of the problem of internet addiction and the link to other behavioral disorders may be helpful to someone. As always appropriate comments are welcome.

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