Category Archives: Addiction

Addiction, Gateway Drug

Mathematics Proves Correlation to Marijuana as Gateway Drug

Two Studies Show Cannabis-Gateway Effect

by Pamela McColl, SAM Canada

The 25-year Christchurch Longitudinal Study demonstrated that in 86% of cases of those who had taken two or more illegal drugs, marijuana had been the drug the study subjects had taken first. The correlation is in the mathematics and can’t be denied.

The researchers concluded that the use of marijuana in late adolescence and early adulthood had emerged as the strongest risk factor for later involvement in other illicit drug use.

New research has been released that adds to these findings. Researchers at the University of Bristol in the UK has found regular and occasional cannabis use as a teen is associated with a greater risk of other illicit drug taking in early adulthood.

The study by Bristol’s Population Health Science Institute, published online in the Journal of Epidemiology and Community Health in 2017, caught the attention of most major newspapers in the UK.  It was reviewed in the British Medical Journal and Science Daily in June of 2017.    But, once again, the news was under-reported in the North American media.

Cannabis Use Predicts Many Forms of Problematic Substance Use in Adulthood

Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), the researchers looked at levels of cannabis use during adolescence to determine whether these  might predict other problematic substance misuse in early childhood – by the age of 21.

In addition to the findings on pot and illicit drug use, the study found that early cannabis use was associated with harmful drinking and smoking.

The lead author of the study, Dr. Michelle Taylor from the School of Social and Community Medicine told the UK media: “I think the most important findings from this study are that one in five adolescents follow a pattern of occasional or regular cannabis use and that those individuals are more likely to be tobacco-dependent, have harmful levels of alcohol consumption or use other, illicit drugs in early adulthood.”

Spearman’s Rank Correlation Coefficient:

Now for all those that are still question the Gateway Theory or are willing to dismiss the evidence from these studies here is the Statistical Mathematical Evidence of Correlation:

A survey that was conducted in Canada and 9 other countries was used to determine the percentage of teenagers who had used marijuana and other drugs.

Using Spearman’s Rank Correlation Coefficient to test the correlation between the two variables as extracted from the population as pairs of sets of data, it was mathematically demonstrated that there is a positive correlation between the two variables.

The claim that there is a positive correlation between smoking marijuana and doing other drugs is made with at least a 95% level of confidence by mathematical calculation.

If after this evidence you still cling to the position that the Gateway Theory is old-school and can be cast aside, you are being asked for your evidence, your proof and your calculations.

Follow Pamela McColl in Facebook at The Marijuana Victims Association

“Legalization would result only in more cannabis users and thus a higher secondary demand for and entanglement within the remaining illegal drug market,” wrote David Sergeant of The Bow Group, London, England.

Addiction

Be Ready for the Long Term if Your Teen Needs Rehab

Leave a comment

3 Tips for Finding a Rehab for Your Teenager       

by Julie Knight  

If you think your teen’s pot use is no big deal, you may be very wrong.  You may need to prepare yourself for the long-term recovery from drugs.

Over the past three years, I’ve struggled to find a rehab with counselors who could convince my teenage son that using marijuana two or three times a day is damaging his developing brain.

“It’s just marijuana,” he told me when he was 15-years-old. By the time he turned 16, he’d escalated to dabs, one of the most intense concentrates of marijuana, OxyContin and cocaine. He would drink alcohol until he blacked out.

A friend his age died after ingesting the same lethal mix of OxyContin and alcohol that my son was experimenting with.

I’ve sent my son to five residential rehabs for drug addiction. He’s relapsed after each rehab within a few weeks. When he turned 18, I offered to send him to sober living or said he’d have to live on his own. He’s living on his own now. I know he’s still using marijuana and alcohol. I’m not sure what else.

I’ve been asked to share some of my lessons learned. Here are my top three tips.

  1. Understand that the best program is probably going to be a long-term solution: short-term residential rehab followed by a long-term boarding school or after care program. As hard as it is to fathom giving up your child for up to a year, it’s so much easier than trying to stay two steps ahead of a drug- or alcohol-addicted child who is a mastermind of deceit.

The purpose of a short-term (30- to 90-day) residential rehab is just to get your child to wake up to the fact that drug or alcohol use might not be leading him or her on a path to success or wellness. The goal is to uncover the factors driving their use and offering tools to cope with those issues.

Prepare for sticker shock. That program can cost anywhere from $2K or $3K up to $50K+ for just one month.

The catch? After you spend that boat load of money for residential rehab, you’re not done. Then they tell you, “Oh, by the way, now you need to send your child to an ‘after’ program and that program has to be at least 6-12 months, so mortgage your house again because that will cost you at least $80K for a good program.”

What? You don’t have a house or an extra $80K stuffed in your mattress? Good luck.

  1. Get over the cost. Find any way you can to pay because that “after” program is the key to your child’s success. Don’t make the mistake I did by skipping it.

It should be a program where your child has no access to outside influences. Bringing a child home and trying to manage the process with outpatient counseling doesn’t work. At least not for my son.

My son fooled us all with his “miracle” recovery in his first wilderness program. He seemed transformed while safely tucked away in the mountains of Southern Utah. But he relapsed within a week of returning home, though it took me several months to discover this.

When my son came home the first time, I signed him up for outpatient counseling and sent him to a presumably “drug free” private school to get him away from his drug friends. I tested him for drugs but he figured out how to cheat the urine test. He also started using alcohol heavily since that didn’t show up in the urine test.

He met a boy at the “drug free” private school who introduced him to OxyContin, the pill form of heroin.

I didn’t think I could afford a 10-month boarding school / after program for my son because it was so expensive. Where was I going to get $80K? But turns out I went on to spend more than that with various other, shorter-term rehabs that didn’t work.

  1. Find an expert to help you find an appropriate rehab for your child. I used David Heckenlively in Walnut Creek. He did a great job of counseling me to find the best rehab for my son, a program called Open Sky Wilderness. Even though my son relapsed soon after returning from wilderness, I truly believe he learned valuable lessons there that influence him today in positive ways. It was one of the better programs my son went to, and it taught me a lot about how to parent a drug-addicted child.

In retrospect, I wish I’d listened to the advice that a longer-term boarding school is recommended after residential rehab. Not all teenagers will relapse and get into harder drugs like my son did but many will.

I was a single mom paying for all this myself. I didn’t have a house or relatives to help. I didn’t think I could afford a more expensive after program. But I later learned I could use my retirement money since this was a health-related expense. I could also borrow against my 401(k).

I also used Denials Management, which helped recover a portion of the cost of the wilderness program. A refund of about $10K came to me after about eight months of fighting the system. That was the best Christmas gift ever.

I believe all the counseling my son has received has helped him understand a few key concepts. He knows he can’t try meth, even once. He knows he can’t mix drugs and alcohol.

When I kicked him out, he could have moved to be closer to his drug-using friends but didn’t. He’s living 30 minutes from me in Sacramento. Thanks to all the counseling, he knows how much I love him. He visits often.

I think he’s using more moderately now because he’s able to work full-time and he’s finishing school. But I know it’s a progressive disease. I have to enjoy every hug I get while I can.

The cost of the five residential rehabs totaled more than a year’s salary. I drained my retirement fund to save my son. I’d do it again. For all I know, my son might be dead now or in jail if I hadn’t intervened.

In my next blog post, I’ll feature tips from other parents weighing in on “How to find the best rehab for your teenager.”

The author, Julie Knight, is a single mother living in Davis, California with her sixteen-year-old daughter.

Addiction, Mental Health

Psychiatry at Crossroads: Learn from Addiction Medicine

Practicing psychiatry is very tricky.  Heavy-duty pills have serious side effects.  To some observers, psychiatric medications are prescribed only to make money and psychiatrists are seen as evil witches casting spells. The world is not so simple, as there are psychiatrists working to get patients off medications.

A number of websites such as Mad in America and Beyond Meds channel gripes against Psychiatry and its medications.  At the same time, there’s been a flood of people suffering from mental health and addiction problems in need of treatment.  Forbes Magazine recently reported that there’s a shortage of psychiatrists in the USA.

Politics of Mental Health Treatment

We suspect that veterans with PTSD* and marijuana use are promoting the increased demand for psychiatrists.  Back in 2005, SAMSHA and ONDCP tried to warn Americans that teen marijuana use can introduce mental health problems in those with no previous issues. The DSM manual, which is like a Bible for Psychiatry, gives guidelines for diagnosing and treating symptoms.

Parents Opposed to Pot recommends staying free from marijuana and other drug abuse as the best defense against having a psychiatric condition.  The turbo-charged marijuana of today puts a far greater number of people at risk than the weaker pot of the ‘70s.  In Colorado and Washington, dispensaries sell marijuana that averages 22 to 28% THC, compared to 1-4% back in hippy days.

Providence St. Peter’s Hospital in Olympia, Washington reports of 1-2 new psychotic patients every day because of “dabbing” mariju- ana extracts.  A standard treatment is to give an anti-psychotic medication, Risperdal, and then release the patients.  However, if there is underlying addiction, the brain needs to be off mind-altering drugs before a mental health assessment.

Changes in HIPAA Law could put more checks and balances on Psychiatry.  Because of HIPAA Law, families are not allowed to know enough.  An ideal system of mental health treatment would pull together families and psychiatrists and patients. When Representative Murphy introduced a mental health care reform bill two years ago, many people supported it because it promised to change HIPAA.   However, the ACLU and patients’ rights groups fought this provision and a bill passed the House without making this crucial change.

If the Affordable Health Care Act is revised, Congress should not  cut insurance coverage for mental health care or addiction treatment.

Psychiatric Practices and System Called into Question

Often insurance will not pay for optimal addiction treatment unless there is an underlying mental health diagnosis.  Even when there is a mental health diagnosis, treatment also fails if patients are released from hospitals prematurely.

The Washington Post reports of a Maryland mother who suffocated two children after she was released from a psychiatric hospital too soon.  This unfortunate woman, Sonya Spoon, had suffered from abandonment at four months age, lived in orphanages and suffered from a head injury at age 18.  Her adoptive mother had warned the doctors against releasing her from the hospital too early, before an antidepressant could take effect.

Despite complete failure in the mental health care system, the criminal justice system sentenced her to 45 years in prison.   It is tragedy on so many levels for both her and the two toddlers she killed.  Unfortunately, the prison system is filled with both addicts and those suffering from untreated mental health disorders.

Beginning in the Kennedy Administration, a movement to de-institutionalize mental health patients began.  Psychiatry hoped that medications could replace institutions.  Pharmaceutical companies jumped at the opportunity, produced new drugs and marketed them vigorously.  It would be nice if “magic pills” really did work all the time, but they often cause additional problems and outlive their usefulness.

Everyone admits there are failures in the mental health care system, and many of Psychiatry’s critics want to eliminate all pills and forced treatments. However, plenty of people believe psychiatric pills help them. (Please see comments below by Jane Thompson whose medications bring relief to Bipolar Disorder.)  To think all psychiatric medications are worthless is like thinking all mental illness develops because the parents are evil.   Amateurs should never tell others not to take their psychiatric meds.

Psychiatry Lags Behind Other Branches of Medicine

Some branches of medicine, such as those that treat cancer and heart disease, have made great strides in the past century. Unfortunately, Psychiatry has not.  Many doctors besides psychiatrists are known to .  Books by Robert Whitaker, Joanna Moncrieff, MD and others call into question the overuse of psychiatric drugs.   Whitaker’s Anatomy of an Epidemic, 2010, won the IRE award for investigative journalism.  Whitaker is not totally anti-psychiatry as some people maintain. He has stated: … “It (Psychiatry) has a duty to develop selective-use protocols, which seek to minimize long-term use of antipsychotics (and other psychiatric medications). I also believe that our society should provide the resources to enable this rethinking of the drugs.”

No doubt Bipolar Disorder has been overdiagnosed.  Some individuals and professionals have classified drug and alcohol abuse as “medicating an underlying bipolar disorder.”  This interpretation excuses and dismisses the serious consequences of substance abuse.  At the same time, it may be hooking some people into taking pills, without getting them off substances of abuse.

The “chemical imbalance” theory of mental illness has never been proven.  In fact, this theory was never accepted by Psychiatry.  Some people conclude that psychiatrists and pharmaceutical companies have pushed this notion in order to make money and sell pills.  Today the marijuana industry is pushing marijuana for most mental health conditions, including depression, bipolar autism and ADHD in children.  Unfortunately, many with schizophrenia use pot, although it makes their problems worse.

The brain isn’t understood as well as other organs, and many times mind-body solutions are called for, instead of “medications.”

In Saving Psychiatry, Addictions Psychiatry Can Help

If Psychiatry became better at distinguishing the underlying roots of mental health issues, our treatments could be better.  British journalist Patrick Cockburn writes eloquently as to why he believes his son, Henry, became schizophrenic.  The diagnosis was precipitated by heavy marijuana use between the ages of 14 and 19.  After years of trial and error, and Henry’s refusal to take medication, the son has been stabilized with Clozapine.

Perhaps, because of a focus on pills for insurance purposes, Psychiatry often falters, despite the DSM Manual.  There needs to be better discernment of root causes.  Which illnesses are a result of substance use,** or trauma, and/or a combination of both?***  Treating trauma and Adverse Childhood Experiences (ACEs) before people resort to substance abuse would bring down the number of people needing psychiatrists. However, the most adverse cases of trauma or extreme psychosis may need to be medicated, including foster children whose parents suffered from drug abuse.   Even when psychiatric pills cause side effects, the alternative can be worse.

Addictions Psychiatry can help the psychiatric field when the “biological” model fails.  Addictions psychiatrists are trained to think more holistically, addressing the mind, body and spirit of a person.  If Psychiatry certifies more doctors in Addictions Treatment, it can make a difference and become a force for much good.

As for epidemic of Heroin, Fentanyl and opioid pill overdoses, policies focused on harm reduction have failed to stem the number of deaths by overdose.  Most states have passed making it easier for doctors and law enforcement to stop the overdoses.   Yet, this policy doesn’t treat the underlying addiction. Cost and insurance companies should not determine matters of mental health, or life and death.

Notes

*  PTSD is very real but only professionals should diagnose it.  At times, “bipolar disorder” and ADHD were also used too loosely and over-diagnosed.

**A NAMI (National Alliance for Mental Illness) Minnesota publication gives special attention to marijuana among the drugs that can cause psychosis, as well as legal drugs such as steroids and ADHD drugs. Epidemiological research of nearly 19,000 drug abusing Finnish subjects showed that marijuana most consistently led to a diagnosis of long term schizophrenia (Niemi-Pynttäri JA, Sund R, Putkonen H, Vorma H, Wahlbeck K, Pirkola SP. Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. J Clin Psychiatry. 2013 74(1):e94-9).

*** Victims of PTSD who turned to marijuana with deadly results:  Cascade Mall shooter Arcan Cetin, an early marijuana user with PTSD killed five people at a Macy’s in Washington.  Stephen Bourgoin who recently killed five teens in a wrong way crash also suffered from childhood trauma, too.  Eddie Routh was a veteran with PTSD who smoked marijuana before killing Chris Kyle and Chad Littlefield.  NBC Nightly reported that Richard Rojas, the veteran who rammed into several people and killed a teen in Times Square, used marijuana before driving into the crowds.

Addiction, Driving, Mental Health

Legal Marijuana Imperils Traffic Safety, Adds Mental Health Burden

By Dean Whitlock, a freelance writer from Thetford, Vermont, writes about safety as it relates to marijuana.  The article appeared in Vermont Digger on May 2, 2017.

The discussions of H.170, which would legalize possession and home-growing of small quantities of marijuana, have focused a lot on the danger to teenagers, which is appropriate since adolescents are in a stage of neural development that makes them much more likely to become addicted, develop mental health conditions, and suffer decreases in cognitive processing and memory retention. The problem with this focus is that people over 21, particularly up to the age of 25 or 26, are still susceptible to all of these effects, just at a lower level of risk.

That point aside, the area where every age runs the same risk is on the highway. Again, teens and young adults are more at risk because they tend to take more risks in the first place. They are also less experienced with driving and with the use of alcohol and drugs. But adults do make the same stupid mistake of driving under the influence.

According to the best data we have available, drinking alcohol before driving increases the risk of accident five-fold at the still-legal .08 blood level. Driving under the influence of marijuana doubles your risk. That being the case, we would expect to find considerably more people dying on the roads because of alcohol then because of marijuana. The data on traffic accident fatalities that we have from the Vermont Department of Safety tell a somewhat different story:

This data is based on blood tests that measure active THC, so we can be reasonably sure that the drivers had used marijuana recently enough to still be DUI.

Driving Under the Influence of Marijuana Imperils Safety

Note the small difference between the number of deaths due to alcohol and the number due to marijuana. The most likely reason for this is that many marijuana users think it’s OK to drive after using. For teenagers, we have clear evidence for that from our Youth Risk Behavior Survey.

Here’s the 2015 data:

Reports from both Colorado and Washington indicate that the same must be happening there. While accidents and fatalities involving drunk drivers went down in recent years, the numbers involving marijuana went up.

Why is this happening? Because we are not teaching people – young or old – that marijuana impairs your ability to drive. At a well-attended forum on marijuana effects held in Burlington last month, one attendee stood up and insisted that marijuana helps people drive more carefully, and this message pervades the popular websites that cater to people interested in learning more about marijuana from sources “untainted” by officials like police officers and scientists.

It’s important to note that the traffic fatality data shown above only includes deaths in accidents. It does not include the five Harwood teenagers killed on I-89 last October. The driver of the car that hit theirs, Steve Bourgoin (36, hardly a teen), has been charged with second-degree murder, so their deaths are not considered to be due to a traffic accident.

Addiction is Not a Crime

Addiction is not a crime, it is a mental health issue, and the behavior of users who suffer acute or chronic psychotic episodes goes far beyond the usual definition of addiction.

When Bourgoin’s blood toxicology report was completed, authorities withheld the contents pending trial; however, Vermont investigative reporter Mike Donoghue, writing for Vermont News First, quoted several sources in saying that there was active THC in Bourgoin’s blood at the time of the accident. Since then, Vermont Rep. Ben Joseph, D-Grand Isle-Chittenden, a retired judge, has reported being told the same thing by contacts of his in the state legal apparatus.

As reported on VTDigger, Bourgoin told friends that he suffered from anxiety and PTSD due to childhood trauma, and his former girlfriend told detectives that he self-treated with marijuana for “mood spells.” Court documents quote her saying, “It was always very evident when he was out [of marijuana], as he would be more angry and violent during those times.”

Anger is one of marijuana’s withdrawal symptoms, and it is a more addictive drug than most people think. A review of several studies of treatment methods for marijuana addiction found that one-year abstinence rates for adults, even under the most effective treatments, ranged only from 19 to 29 percent.

In a 20-year study involving more than 2000 U.S. war veterans being treated for PTSD, the vets who used medical marijuana along with the standard therapy reported more violent behaviors and worse outcomes after treatment than vets who didn’t use marijuana. The heaviest users showed the strongest effects. Another study found that marijuana use resulted in increased suicidal ideation among marijuana users.

Marijuana and Mental Health Problems

There are other correlations between marijuana and serious mental health problems. Since 2002, a series of studies in Europe have reported that individuals who use cannabis have a greater risk of developing psychotic symptoms. Not only does marijuana bring on symptoms earlier and make them worse, it is a causative factor.

A Finnish study published this past November compared sets of twins where one used marijuana heavily and the other did not. Heavy use increased the risk of developing psychosis by a factor of 3.5. Again, the data indicated that, in many cases, marijuana abuse caused the psychosis, not the other way around. The newly released report on marijuana from the U.S. National Academies of Sciences agrees with these findings.

Addiction is not a crime, it is a mental health issue, and the behavior of users who suffer acute or chronic psychotic episodes goes far beyond the usual definition of addiction. These sufferers needs effective treatment far more than jail time. And these new research findings, combined with Vermont’s recent traffic fatality data, highlight the fact that marijuana is not harmless. Legalizing recreational marijuana in Vermont would not be a simple matter.

Vermont has already decriminalized marijuana use. What we haven’t done is provide a mental health system that can deal with the thousands of cases of addiction, psychosis, and other mental illnesses that we already have in our state, nor have we done nearly enough to educate Vermonters about marijuana’s harms, in order to prevent tragedies from happening.

Legalizing marijuana – whether like alcohol or tobacco – will only make our mental health burden worse, while it makes our highways far less safe.

A former supporter of legalization, Whitlock is now opposed. He is a member of Smart Approaches to Marijuana (SAM-VT)