Substance Abuse Disorder in Young Adults

Complexities in Practice and Understanding Theory

The above topic is a training I attended last Friday at Brynn Mawr College Graduate School of Social Work & Research. In order to keep my license to practice in the state of Pennsylvania, I must complete 45 hours of training every two years. In order to keep my job at Fairmount, I must complete 25 hours of training because that is what's required for DDAP. It is safe to say, I will be in a classroom as long as I want to keep my license and since it took a hell of a lot of work to get that license in the first place (besides sitting for state boards) I intend to make sure I keep it.

I work with a lot of patients between the ages of 18 to 30 years old and given that the average heroin addict is a white male between the ages of 18 to 30 years old from the suburbs, I chosen a class to address this population. I would rate this training as no more than adequate. Though, I did learn some new information most of the information I was already aware of. I wanted to learn more about prevention as well as more therapeutic interventions. There was very little information about prevention and the interventions spoken about such as Motivational Interviewing and Cognitive Behavioral Therapy are techniques I already use. I guess I wanted something more.

What I did learn;

Chester, Delaware and Lancaster Counties have the highest addiction rates especially as it pertains to opiates. It is not Philadelphia.

Most kids start taking pills right out of their parent's medicine cabinets right in the home. The message I received appeared "common sense", lock up the medications.

Environmental concerns around the pharmaceutical age and the minimization of the use of marijuana fuels the addiction process.

When raising your children "Explain not blame". We live in a time of "Prescription Explosion, Minimization of Marijuana, An Opiate Epidemic, College Age Drinking". One crushed 30 mg Percocet equals 5 bags of heroin. Kids ages 18 to 25 years old are the biggest abusers of prescription opioid pain relievers (right out of their parent's medicine cabinets), ADHD stimulants and anti-anxiety drugs such as Ativan, Xanax, ect. More than 3,000 young adults die yearly from prescription drug overdoses. Notice this number does not include heroin addicts. Today, drug overdose is the leading cause of death in young adults.

75% of opioid addiction patients switch over to heroin. More than 300 million opioid pain medication prescriptions are written every year which equals one bottle of pills per adult in America. I will add that this is one of my "pet peeves". I will never understand why doctors/dentists feel it is necessary to write opioid prescriptions for every little pain/procedure. One in twenty high school students has abused Vicodin, and one in thirty high school students  has abused Oxycontin. Guess what? Over 50% of them started at age 12 years old.

Then there is the myth surrounding today's marijuana and its addictive substance known as THC. In the 1970's and 1980's marijuana contained lower than 4 to 5 % of the addictive substance THC compared to today's marijuana which contains an average of 80 to 90 % of the addictive substance of THC. Because of the popularity of medical marijuana and the perception that marijuana is not dangerous has lead to a culture of acceptance. The problem is the concentration of THC in today's marijuana is a catalyst to mental health problems in our youth. Our brain does not even fully develop until age 25 years old so using a substance high in THC on an undeveloped brain creates problems with the brain. especially when it comes to impulse control, decision making and problem solving.

There was also a lot of discussion around process addictions and substituting one addiction for another. Many folks with substance addictions also have process addictions or those who become sober from the substances turn to process addictions such as gambling, codependency, internet, food, sex, pornography, gaming, body image and obsessive dieting and exercise, shopping, clothes, clutter, work, cutting, kleptomania, depressive cycles and being attracted to chaos.

Fact;

38% of us cannot go more than 10 minutes without checking our cell phones, or email.

There is a whole new generation growing up in the technology age which fragments language and leads to fragmented relationships. Of course if we do not know how to form healthy relationships than we automatically decrease our much needed social interaction and supports. The most important thing adults can do is model behavior. Put the cell phones away at the dinner table and limited internet use.

Fact:

82% of substance abuse and/or process addicts also have a mental health diagnosis. It does not matter which came first but it does matter that both are treated at the same time.

Counselors need to understand both addiction and mental health and learn to bridge the gap.

As a society we must remove the stigma of those with addictions and mental health diagnosis in order for proper treatment to occur. There are so many people who suffer in silence for fear of being an outcast in society. It is a disgrace how society treats those who suffer whether it be the individual or family.

"Remember if you do not heal from both you may not heal from either".

What can we do to help? EDUCATE EDUCATE EDUCATE

The important thing we can do to help our children as they enter into young adulthood is to build resiliency.  Kids who are resilient do better than kids who are not resilient. It can be developed over time because it is learned. Pay attention to your kids. Listen intend of preach. Nurture. Make your home a safe place. Model the behavior you want from your kids. Do not be inconsistent. Watch your unrealistic expectation of your children. Children who do not feel so good inside feel isolated and will look for external things to feel better. And remember that even the healthiest family framework can produce a child who wonders externally however if they were given a solid foundation, and they do not die prematurely as a result of the external instant gratification with help and support, they can come back and live healthy productive life.

(Michael Blanche MSS LCSW)

Integrity and Honesty

I have had my second cup of coffee on this early Sunday morning as I get ready to go to work. It is my weekend to be the onsite counselor and to teach classes in the Addicted Brain as well as Family education. The weekends can be exhausting as there is so much to do. I never minded working hard as I believe it is in my nature to do so and I do not mind the weekends so much as we (counselors) take turns rotating as the onsite counselor on the weekend responsible for every other counselor's patients in the event of crisis. There is much to be said for loving your profession no matter how taxing. This weekend I have been training a newly hired counselor. Since I am the one who developed the Family education program as well as the senior counselor, I generally train the newly hired counselors. I am a "rule follower" and very "organized" so I guess that helps as well.

Anyway, I like this new counselor. Naimah seems authentically sweet and kind hearted. I think I am a good judge of character and have the ability to conceptualize a person. I believe that is one reason I am a good therapist. I look beyond the surface of a person. Naimah seems to be a person of integrity and God knows we need more people in this world of integrity. There are so many dishonest people in the world who lack integrity and the sad thing is those same people think that others around them do not recognize that dishonesty. As far myself, I do not confront the dishonesty anymore as I believe it is a waste of my energy and my energy is sacred to me these days. I still believe most people are good however miss-directed they maybe on their journey in life. People are dishonest in a variety of ways be it a direct bold lie-in-the-face or an avoidance of following through.

I am unsure why I am thinking of integrity this morning. Maybe it is because of the political nonsense currently in the news or maybe it is my own experiences that I have lived through. I really do not know.

Let this be a Sunday of personal honesty and integrity.

Week in Pictures

I guess we will start with the shoes.

 

 

 Followed by our Pre-Thanksgiving Eve Flower Power Concert Event out in Royersford.

 

 Thanksgiving 2013

 

It was my weekend to be on-call and on-site. I teach the Addicted Brain Science Class so I had copied hand-outs from NIDA to share with the class of 26.

Relapse Prevention and More

I went to an excellent training on Relapse Prevention in King of Prussia yesterday. I really love the classroom. I feel like such a nerd because I love the entire learning experience and it awakes a personal energy from within. I wrote several notes and once I compile them I will share them here on the site. Though I did discover a frightening statistic that was a little close to home. Before I write about statistics I just want to add that I am a person who loves science as much as I love history so research based evidence and numbers are definitely "me".

Anyway,

I especially love genetics.

There are 40 genetic markers according to the latest research that pre-disposed us to addiction. Science states it is probably more than 40 markers but thus far 40 markers have been found. What does this mean in numbers? If a child is born to one or two parents with an addiction (substance and/or a process addiction like porn, gambling, shopping) whether they are active users or in recovery, the child has a 50 to 80% chance of acquiring an addiction. Scary? Yeah! If a child is born to parents without an addiction but who have one or more grandparents with an addiction, there is a 50% chance of that child acquiring an addiction. The way to look at this 50% is the same as having a 50% chance of a child being born a male or female. These numbers were a bit overwhelming to me evident by my expression in the classroom that prompted the instructor to point me out and ask me what I thought.

This is just based on genetics without the environmental factor included.

I wish I knew this 30 odd years ago. Of course, science was not that advanced. So what can one do when the children are already here and have this genetic predisposition? Well, there are protective factors that should be in place for anyone who has a small child born with this genetic make-up. What are these protective factors? Some of these factors include postponement of experimental alcohol and drug use in adolescent. Kids are smoking pot and drinking alcohol at age 10, 12, 14 years old and some have already moved onto other drugs such as pills, heroin, PCP and cocaine. Then there are children born to mothers who are actively using. The light to the genetic fuse box is lit at birth which increases their chances even more.

Have you ever wondered why some kids raised in the same family use and others do not? Or some kids use and can walk away but others become addicted? Kids raised in a home where neither parent uses and one or more developed addiction? You would expect that in a family were one or both parents have or had an active addiction. How many people really know their family history? Maybe, grandpop was never spoken about or grandmom was hidden. How much do people really know? What about the porn addict or the shopping addict? Are these people ever spoken about? I doubt it. Maybe some people cannot wrap their head around genetics and are still believers in the moral model? Some may say that genetics is an excuse. Well, the numbers, research and methods do not lie.

I know. It is a lot. One maybe thinking what does this have to do with relapse prevention? Well. It means a ton and more. You need to see where it all began to come up with a plan to arrest it and place it in remission and if one thinks there is some magical cure, well, wake up! There are a few things that really stand out to me as a result of this training. First, it is the statement "addiction is based on a fear of living". A fear of being uncomfortable. You cannot talk someone out of addiction because he or she must feel it. A whole lotta words with very little sense you maybe thinking. I will get my notes together and write more about it in depth. The best model to use in addiction is the Recovery Model based on a Public Health Model with three specific hallmarks.

In this field, we are required to have 25 credit hours of education per year mandated by the state and to keep our licenses to practice. Once upon a time, all one needed was recovery to be a counselor. Those days are long gone. You must have a graduate degree and a license to practice whether one is in recovery or not. If you work with a co-occurring population (mental health + addiction) you need further training. It is a horse and pony show at times. There is even an international license to practice in all states and every country. Amazing!

Going off topic. Sorry.

To sum it all up, I will be back with a look into the Recovery Model. Some will agree. Some will not agree. It is ok. Whatever road one travels can lead to the same destination. 

Today

Biology and Psychopharmacology of Behavioral Health; Addiction and the Central Nervous System is the name of the class and I love love love it!

And if you take a class at Bryn Mawr College, you can expect to drink your coffee from these cups as oppose to Styrofoam cups.

Shoes and Shoes

Ok. I must really be running out of things to write about, since this is my third post on shoes. Let's talk about this pair, shall we. I love shoes. I love shoes that are timeless and classic, as well as different and funky. These are a pair of great flats that go great with a pair of grey slacks, white sweater and pearl jewelry. Ok, so now you know how I went to work today. I like flats, because they are comfortable and easy to get around in. However, I like different with a taste of unusual and funky. The interesting thing about my taste in shoes is that it does not resemble to my taste in clothes. I wear clothes that are timeless and classic without frills. I work in a professional environment, so Fall/Winter = Suits with skirts, tights and boots to the knee. Spring/Summer = dresses without hose.
I am as comfortable in a suit, as I am in a pair of jeans and sneakers. Of course, I wear pants to work with heels, flats or ankle boots, but I stick with basic colors like black, brown, khaki and grey. In the winter, I may wear a sweater or blouse. In summer I may wear a tank with an overlay. I am fond of jeans and sweatshirts, or sweaters on the weekends. Hot Summer months = crop pants in the basic colors already stated adding a white pair.

My taste has never really changed. I always wore timeless and classic styles. I like to buy good clothes that last years. Pearls are my favorite gem stone, though I do wear gold and silver. I am not much into costume jewelry. I rather have a few good pieces of gold and silver, than a ton of costume jewelry. I shop at a few stores. Kohl's, Macy's and DSW. If I am in another city and see something interesting in a shop, I will purchase it. However, I never buy unless there is a sale. The only time I would buy something that is not on sale is if I really needed it for an occasion, or it blew me out of this world, which is seldom.

For twenty years, I wore scrubs and lab coats. When I went back to school, I traded that look for a more professional look. I still have those scrubs packed away somewhere. I keep telling myself, I need to give them away. I love science, but I figured a way to use it in my new field. I teach the Addictive Brain and Co-occurring Disorders. Neurobiology is fascinating as well as Genetics.

OK, you can wake up now:)