Medical Issues

Ambien Not Just A Mild Sleeping Aid

A new report shows that the number of emergency department visits involving adverse reactions to the sleep medication zolpidem rose nearly 220 percent from 6,111 visits in 2005 to 19,487 visits in 2010….

…Zolpidem is an FDA-approved medication used for the short-term treatment of insomnia and is the active ingredient in drugs such as Ambien, Ambien CR, Edluar and Zolpimist.

Read More at Science Daily

Potential Malnutrition In Pregnancy

Researchers have found that women of childbearing age who drink are less likely to take multivitamin supplements, and risk malnutrition in pregnancy.

No big surprise there.  However, it's important to remember that alcohol consumption prevents the body's proper absorption and utilization of nutrients, even if they are present in the diet.  So if pregnancy occurs, the baby gets a double-whammy: exposure to alcohol and a mom who could be suffering from malnutrition.  Not good.

Women Who Drink Before Pregnancy Less Likely to Take Multivitamins

Vitamins In Recovery — A Personal Opinion

2013-03-19 16.44.57It isn’t uncommon for me to get questions about nutrition, particularly the role of vitamins in recovery. Let me say at the outset that I have no desire to get into a debate about it. There are huge industries with a vested interest in promoting vitamin therapies, and they use extremely effective advertising to attract people to their products. Many of those folks swear by their various courses of nutritional supplements, and that’s okay. I’m not going to buck the current of billions of dollars worth of merchandising, nor am I interested in changing anyone’s mind.

In most respects, however, I disagree with the concept of vitamin therapy.  In fact, I hold a pretty conservative viewpoint on vitamins, in recovery and otherwise. We evolved to get them in certain quantities, and it's difficult for me to imagine how messing with basic body chemistry is beneficial.  Most experts who are not connected with the vitamin industry agree that there is no point in supplementing heavily unless blood tests have indicated an insufficiency of a particular vitamin, such as vitamin D.

Of course, those who do have an ax to grind, either because of ties to the industry or their own endeavors (books, websites, health food stores, etc.) take an entirely different view. The information here is based on good medical advice, and that’s all I have to say about it.  Most nutritionists agree that we require vitamins and minerals only in tiny quantities, and that what isn’t absorbed literally goes down the drain. I once read a nutritionist’s summation: “Americans have the most expensive urine in the world.”

As addicts, we love the idea of some magical pill that will make us “all better,” but it doesn’t exist. The repairs necessary to recover from addiction will take place with abstinence, a good diet, exercise, rest, and — important to a remarkable degree — fun and relaxation. And it takes time; physical recovery from addiction, including alcoholism, can take up to two years. We feel better long before that, thank goodness, but it can take that long for our brains and the rest of our bodies to get back to something like normal.

However, we addicts are used to getting results fast. It’s no accident that the drugs that are most rapidly addictive are the ones that work the fastest. We think in the short term, and we don’t like to wait — for anything. Good nutrition, exercise and so forth take attention and work, and there’s no instant payoff. That’s our biggest hangup in recovery: wanting the magic pill.

That said, all alcoholics (and most other addicts) suffer from malnutrition to one degree or another. Alcohol prevents the small intestine from absorbing nutrients properly, and interferes with the intestinal bacteria that produce many of the nutrients we need. As a general rule, I believe that absent a doctor’s recommendation most of us do fine with a multivitamin every day with a meal (I take mine with breakfast). Because I have also been diagnosed with a vitamin D deficiency, I take supplements of that as well along with certain mineral supplements prescribed by my physician.

In the case of early recovery, no harm — and much good — can come from taking a high-quality multivitamin in the morning and one in the evening — always with a meal. Vitamins are food, not medicine, and must be digested with other food in order to be properly absorbed.

My personal opinion is that after the first year or so in recovery, people who eat properly and get a bit of sunshine and some exercise along with proper medical care probably don’t require more than a multi a day, and perhaps a mineral supplement if the multivitamin doesn’t provide them.  This obviously doesn't apply to folks who have been told to take certain supplements by a physician.

Of course your mileage may vary.  If it works for you, great! Whether it’s vitamins or the placebo effect, the whole point of recovery is to feel better and get on with our lives.

The Dangerous New Disease in Needle Park

From The Fix:

Since the start of the AIDS epidemic in the early 1980s, public health professionals have made impressive progress in developing prevention programs that stop HIV and hepatitis C in injection drug users; thousands of lives have been saved. But there’s a less recognized—and growing—danger with the potential to wreak havoc on the bodies of drug users and to burden the healthcare system with steep financial costs…

Read More Here

Could The Sandy Hook Tragedy Have Been Avoided?

We at Sunrise wish to express our heartfelt sorrow and sympathy to the families and friends of the victims, and to the community of Newtown. Tragedies like this defy expression, and only time can lessen the pain. Along with the rest of the world, we try our best to convey our shock, sadness, prayers and good wishes to all.

There are lessons to be learned from tragedy.  We do not know if Adam Lanza's path could have been changed at some point by the observation of an alert practitioner, or if the freedoms inherent in our way of life would have permitted any sort of intervention, but it is possible.  We do not know if he was a substance abuser or addict.  Nonetheless, these events should stand as a reminder to all addiction professionals that we need to remain alert for the co-occurring conditions that so frequently accompany our specialty.

The Meth Vaccine And Others Will Never Be The Whole Answer To Addiction

Every so often I read about a possible new vaccine for some form of addiction. The latest is a successful trial — in rats — of a meth vaccine. Leaving aside the fact that rats and humans are both millions of generations from our common ancestor of 160 million years ago, and that there is no reason to assume that things that work on them will work on us (only about 1 in 1000 drugs do), I have other reservations.

First of all, let me say that I totally agree that anything that will reduce the craving for drugs or the pursuit of addictive behavior has got to be a plus. My worry is that remedies such as meth vaccine will be touted by some as a cure-all, and I don’t think that will ever be the case. Personally, I know that I wasn’t right for years after I got clean and sober. A variety of changes in my physical and emotional condition were necessary, along with a readjustment to society, before I was back to normal (whatever that is).

It is said that if you sober up a horse thief, you end up with a more efficient horse thief.

True, that.

There is nothing intrinsic in the fact of getting clean and sober that makes us able to again function in our lives, family or society. We first have to unlearn the ways of thinking that developed due to our addiction(s). Additionally, and particularly in the case of those who began using as preteens or teens, there will always be brain development issues to deal with and try to overcome, along with the need to learn to live in a world of sober people with different goals and different ways of approaching them.

That’s why we have programs of recovery.

Even those of us who came to addiction later in life, when we had already developed some life skills, have a lot of catching up to do. My using affected my ways of thinking about the world, the ways I related to other people, and myriad other parts of my life. In many of those, the changes became habits that I needed to set aside in sobriety.

Put simply, if I’d been able to take a pill or a shot and walk away, I’d still be pretty-much the a**hole I was when I was active in my addictions. I needed a program. I still need reality checks from time to time, even after 20-plus years.

This, BTW, is part of my objection to methadone and Suboxone maintenance: no remedial treatment.  On the program side, I have a problem with the recovery snobs who refuse to accept folks on maintenance in the rooms (not, thankfully, all folks in all programs).  How else are they going to learn about alternatives?  But I digress…

I applaud the researchers for their concern, their advances in understanding addiction and how it affects us physically, and their dedication to improving the overall knowledge in the field. But I don’t think there will be an instant cure for addiction until they are able to put us in a tank, hook us up, and totally reprogram our brains and bodies.

And I sincerely hope that time never comes, for a lot of reasons.

Why Is Addiction A Physical, Mental and Spiritual Condition?

Why do they say that alcoholism and other addictions are a physical, mental and spiritual condition? 

Not to seem like a wise guy, but it's because they are.  Addiction affects us in many ways.  Let's look at some.

Most of us can understand the physical part.  We get sick, we feel shaky when we need our drugs.  We suffer withdrawal when we stop after using too much.  A hangover is simply short-term withdrawal, for example, and the fun increases the longer we use.  After prolonged use of alcohol and/or other drugs our health may start to deteriorate.  We may lose or gain weight, develop digestive problems, the shakes, liver problems, and a variety of other symptoms of physical decline.  Clearly the disease of addiction affects us physically.

It's not too hard to discern some mental effects, either.  When we're using, our minds obviously don't work in the same fashion as when we're straight, and over time the dysfunction begins to predominate.  As we reach the point of chronic use and addiction we may develop mental issues that can range from paranoia to mania, depression, and just about anything in between.

Even the various forms of denial that allow us to continue to fool ourselves that we're okay are a form of mental aberration.  As we progress in our addiction, our thinking and reasoning ability may begin to deteriorate.  In some cases, this can lead to various forms of dementia that are usually permanent.

However, spiritual deterioration is sneaky. 

Before I get into just how sneaky, I need to explain that by “spirituality” I mean the qualities of the human spirit that relate to the people and things around us.  No metaphysical or religious connection need be involved, although the qualities of spirituality are certainly necessary for those things to flower.

One of the first things to go is honesty. 

We begin to lie to ourselves and others about matters related to our drug use.  We tell ourselves that we can stop whenever we like — we just don't want to. 

We lie to our families about when and how much we have used. 

We call in to work with the “stomach flu,” when in fact we have a bad hangover. 

We steal time and services from our families and employers, and lie about our reasons.  When we've done that long enough, it becomes habitual. 

We are no longer the honest people we once were, even though we may console ourselves that we haven't stolen anything or harmed anyone by our neglect of the facts.

Compassion goes out the window.  We armor ourselves against the concerns, needs and pain of others, because to acknowledge them would be to admit our own part.  As our lives center more and more around getting and using our drugs, we reach a point where we're immune to any feelings but our own.  Those, we try to squash with drugs, because the reality is too painful to consider.  Relationships and family ties deteriorate.

We are quick to create resentments that justify our actions, and to forget what we may have known about forgiveness.  If I can hold your behavior against you, then I don't need to worry about how you feel, or about your opinions.  You're the bad guy, and forgettable, even though you may be right.

Love and the idea of joy either disappear, or become so distorted that we have no idea what they used to mean.

And so on, and so on.

Most of us draw away from our religious beliefs as well.  It becomes apparent to us that we are falling short of our convictions, and so we change those to accommodate our current lifestyle.  Morality may be an issue, if we have been promiscuous or dishonest.  We fear the consequences of those things predicted by our religion, and thus we can't afford to believe any longer.  We may cling to some beliefs that fit our situation, reject religion altogether, or become convinced that we are terrible people who are doomed.

So addictive disease is, indeed, a physical, mental and spiritual issue.  If we don't address all three equally in our attempts at recovery, we will almost certainly fail to gain the true benefits of a sober life, even though we may fool ourselves that we're okay, simply because we aren't using drugs.

But are we really okay?  Think about it.