Private Outpatient for Opiates, Done Right

Prescription drug abuse, especially by young people, is on the rise, and opiates like Vicodin and Oxycontin rank high on the list.  People with chronic pain all too often end up addicted to their medications.  People who got into  heroin or other opiates for recreational use or to self-medicate some psychic hurt frequently find themselves in deeper waters than they ever intended.  We meet all these people, among others, in LifeRing meetings, and one of the big concerns for them is anti-addiction medications.  In the past, the most common medication to treat opiate addiction was methadone.  Methadone continues in use, but buprenorphine (byou-pruh-NOR-feen) is the new kid on the block, and both physicians and patients are picking up on it because it's easier to administer, has fewer side effects, and less potential for abuse than methadone.  Buprenorphine is being used both to detox the person addicted to opiates and in some instances as a maintenance regime.

It isn't easy for the person who wants to address an opiate addiction to find proper care.  Apart from a few outstanding practitioners like Dr. Howard Kornfeld in Mill Valley, the patient who is without Kaiser coverage may not find any place to go.

That's slowly changing, as both physicians and patients become educated about new addiction pharmacology.  One of the bright signs of change in the field is the opening of Reliance Center in San Francisco.  Located on the third floor of the beautiful old 450 Sutter Street building, a block north of Union Square, this new outpatient clinic brings together a very high powered medical and counseling staff in a comfortable, almost living room atmosphere.

Putting physician and counselor on the same team tells me that these folks really "get it."  You need both the medical doctor and the empathetic psychological advisor to deal with an addiction.  I had the opportunity to meet and to look up the resumes of the key staff.  Dr. Carrie Schuman, Medical Director, has treated people with opiate dependence for more than 25 years.  She's a leading member of the California Society of Addiction Medicine and a member of the national addiction medicine group.  This physician knows what she's talking about when it comes to opiate addiction, and she also projects a warm, caring, nonjudgmental attitude.  On the counseling side, there's Lubov Smith, a Licensed Marriage and Family Therapist, who comes to the Reliance Center from years as Executive Director of the Henry Ohloff Centers, one of the oldest addiction treatment programs in the area.  She's bright, funny, and very knowing.  If I had an opiate addiction issue, I'd put myself into the hands of this team without hesitation.  Check them out at http://reliancecenter.com.

Professionals who include pharmacological tools in their recovery approach are often pleasantly surprised to learn that abstinence support groups exist that are open to patients who are taking these medications.  More than ten years ago, the medical director of a local treatment facility complained to me about the "G**damn 12-step sponsors who interfere with my treatment plans."  Although AA co-founder Bill W. was personally very positive about anti-addiction medications, the organization he founded contains a strong streak of anti-medication Luddites, who in many instances tell the recovering person to throw away their anti-depressants and other prescription drugs, or they're not really considered "sober."  That hasn't changed in the past ten years, judging by recent stories I've heard.  And so, when a support group like LifeRing comes along, with a more evidence-based approach, physicians' interest perks up.

In the past few years, LifeRing has mounted exhibit tables at conferences of addiction counselor groups such as NAADAC and CAADAC and at APA events (American Psychological Association).  If we can raise the money -- it costs at least $1000 to exhibit at one of these events -- we hope to exhibit next year also at ASAM and CSAM -- the American and California Societies of Addiction Medicine.  With our evidence-based supportive approach to anti-addiction pharmacology, LifeRing should get a positive reception from these professional groupings.

Goodbye Genetics, Hello Epigenetics

For the first time in history, science now has tools that can definitively answer long-standing questions about the role of genetics as the cause of diseases.  So far, the results have been devastating for believers in genetic causality.  The better we can see, the less genetic causality we find.

I've previously summarized the minimalist findings of modern genetics research for a number of psychiatric disorders, including addiction, here and here in this blog, and in my book, Empowering Your Sober Self.

Now comes another blockbuster study, this time of schizophrenia, a disease commonly believed to have a strong genetic component.  According to the November issue of Scientific American, summarizing a recent report in Nature, "three crack teams of investigators pooled genomic data from 8,000 schizophrenics of European ancestry but could lay claim to only a handful of weak genetic risk markers."

By contrast, says the same article, epidemiologists have been able to find significant correlations between schizophrenia and environmental and cultural conditions.  Growing up as an immigrant or as a racial minority in a big city, particularly in densely populated and troubled neighborhoods, is a significant risk factor for the disease.

These studies have given a boost to the field of epigenetics -- the study of how environmental conditions evoke or overwrite genetic predispositions.  The primitive notion that our DNA is our destiny is giving way to the understanding that our genes do nothing until they are activated.  Environmental conditions (including not only the chemicals that enter our body but also the decisions we make, the people we hang with, and the stress we undergo) determine whether a gene gets turned on or off.  Our genetic array is like a keyboard, and our interaction with the world governs what melody gets played on it.

By coincidence, a recent issue of Counselor, the magazine for addiction professionals, features an article, "Epigenetics Has Come to the Addiction Field," by Mike Taleff, Ph.D.  Taleff's main point is that it's not genetics that makes a person an alcoholic or other addict.  It is the repeated consumption of alcohol and other drugs that programs a person's genetic material to crave the drug and prioritize its consumption.

This epigenetic understanding, says Taleff, can help a recovering person shed some common myths, such as the belief that "they are somehow morally, bad, defective, or otherwise flawed.  Often, this kind of thinking gets in the way of recovery."  Epigenetics teaches, by contrast, that becoming addicted "has little to do with your moral character."  Addiction is a result of the programming that addictive substances perform on your brain.

Many questions remain to be settled before science can claim that we have a comprehensive understanding of the causes of addiction.  But progress is being made.  For decades, addictionology was stuck in the belief that the alcoholic/addict's disorder was genetically programmed. Thanks to the enormous strides made by genetic science in the past decades, with the deciphering of the human genome and the subsequent advances, we can now say with considerable certainty that genetics supplies only a weak explanation at best. Now we need to turn our eyes toward the epigenetic factors:  environment, culture, and above all the neurochemical properties of the addictive substances themselves.

Cover story

The cover of my new book -- Empowering Your Sober Self -- is going to appear as a prop in the forthcoming made-for-TV movie "Sins of the Mother."  According to the synopsis, the heroine, Kim, postpones writing her Ph.D. thesis to go live with her mother, a recovering alcoholic.  To establish the mother's character, the camera scans the books on her coffee table, and lingers on "Empowering Your Sober Self."

Just so you know, this is not a paid product placement.  A member of the film staff ran across the book in a bookstore and asked my publisher for permission to feature it as a prop.  The movie will air on Lifetime Television. Date not yet known.  The producer is Mother Road Productions Ltd in Vancouver BC.

Oh, and a review of my book, by William L. White, will appear in the next issue of Alcoholism Treatment Quarterly.  White also wrote the preface for my book, and it is expected that the review will closely track the preface.  It will not mention the cover.

What If There Were LifeRing Treatment?

[I'm cross-posting this item both here and in my LifeRing Convenor blog. Lately I've been posting a lot more to the convenor blog than here.] 

Quite a few recovering people in various treatment programs have expressed the wish that LifeRing filled more than an hour in their week.  The desire for "more LifeRing" is especially strongly felt in programs where the other hours consist of heavy-duty 12-step lectures and meetings.

Of course, there is no such thing as a LifeRing treatment program, and there probably oughtn't to be.  We are a peer-to-peer support group, and should always remain that.  So much of our fundamental approach is premised on horizontal support dynamics that the introduction of vertical relationships -- inevitable in today's insurance-dominated treatment settings -- would bring about wrenching distortions.  Still, wouldn't it be liberating if today's treatment professionals saw their role as not only facilitating 12-step involvement but also facilitating LifeRing involvement?  Whatever works best for the client?

For treatment professionals in Northern California, an opportunity to learn the basics of LifeRing is coming on Saturday, Sept. 19.  Thanks to sponsorship by CAADAC, the California association of addiction professionals, I'll be presenting an all-day workshop at the LifeRing Service Center in downtown Oakland.  I'll be selecting material from Empowering Your Sober Self (my new book), from the Recovery by Choice workbook, from How Was Your Week (our convenor handbook) and from other sources.  This six-hour program is aimed at treatment professionals, and six hours of Continuing Education credit, plus an hour of Professional Development credit, are offered.  However, space permitting, any interested person, including of course any LifeRing participant, is welcome to take part.  It only costs $10.

Here's a page with details about the venue, parking, meals, etc.  Hope to see you there!

On the Air with Audrey Chapman

It was my great pleasure this morning to appear via telephone on the Audrey Chapman show, broadcast in the Washington DC area on WHUR-FM at 96.3 and via the Internet at http://www.whur.com. Audrey is a relationship specialist who has written several books on love and its problems. She's active as a writer and speaker and also maintains a busy counseling practice. She talks with radio listeners every Saturday morning from 8 - 10 am (5 -7 a.m. my time), and her show is said to have a huge morning audience up and down the East Coast.

From the first words, you can see why Audrey has such a following. She's calm, she's clear, she's relaxed; she projects empathy without judgment. You immediately feel comfortable talking to her, telling her your problems. She also sees right to the heart of an issue. She couldn't have had much time to read my new book, but she clearly understood the main points. Her questions were relevant and moved the conversation forward.

Audrey thrives on the freshness and urgency of listener calls. And her callers didn't disappoint. In just a few conversations, much of the huge panorama of addiction problems in the society was laid out before us. A grown up woman was concerned with the drinking of the auntie who raised her. A mother was troubled by her teenage son's drinking. A father worried that his own drinking was leading his son into alcoholism. And so on. Addiction is an enormous problem, and there are people everywhere struggling with it.

We don't yet have LifeRing meetings in the D.C. area, but I had the opportunity to tell listeners about www.lifering.org, our website. I was pleased that Audrey asked me to stay on into the second hour of her show. There was still much more that could have been said, and I had to bite my tongue once or twice when callers pushed concepts and solutions that have very limited utility. But I loved the live interaction, and I could see myself engaged in a longer and very interesting conversation with Audrey on some other occasion. She's smart and she has an open mind and a great way with people.

Check out her website at audreychapman.com.

Empowering Your Sober Self: The LifeRing Approach to Addiction Recovery

Jacqueline Foreman (right) interviews me on Your Mental Health Talk Radio about my new book, here:

Empowering Your Sober Self: The LifeRing Approach to Addiction Recovery

The program aired July 7 2009 at 5 pm Pacific Time.

Treatment promo research results

From the treatmentgap.org website:

Most Americans know someone personally who is addicted to alcohol or drugs and they are worried about access people have to affordable treatment. And, most people support including treatment in national health care reform. These opinions are shared across the board—regardless of race, age, income and geographic location.

Results of a new national poll conducted by Lake Research Partners for the Closing the Addiction Treatment Gap initiative confirm what we suspected: Most Americans know someone personally who is addicted to alcohol or drugs and they are worried about access people have to affordable treatment. And, most people support including treatment in national health care reform. These opinions are shared across the board—regardless of race, age, income and geographic location.

Among the key findings of the national poll, conducted by Lake Research Partners:

• Three-quarters of Americans (76%) know someone personally who has been addicted to alcohol or drugs. Personal experience with addiction spans all demographic groups.

• Half of Americans (49%) do not think they would be able to afford the costs of treatment if they or a family member needed it. This concern about affordability is highest among Americans with incomes under $50,000 (67% say they would not be able to afford treatment).

• Three-quarters (75%) of Americans are concerned that people who are addicted to alcohol or drugs may not be able to get treatment because they lack insurance coverage or cannot afford it.

• Nearly three-quarters (73%) support including alcohol and drug addition treatment as part of national health care reform to make it more accessible and affordable. This support cuts across all demographic groups.

• Two-thirds of Americans (68%) also support increasing federal and state funding for alcohol and drug prevention, treatment, and recovery services.

The finding that three quarters of Americans know someone personally who has been addicted to alcohol or drugs confirms what many recovering people find through personal experience: when you broach the subject, practically every person you talk to has a story about someone who is or was addicted.

Not researched in this study, which was funded by treatment industry interests, is how many Americans know someone for whom addiction treatment did not work. The industry not only has an affordability gap, it has a credibility gap.

They laughed at him

A little while ago, a gentleman -- let's call him "Guy" -- phoned to say that he had just read my book and wanted to start a LifeRing meeting. Guy said he is more than 20 years clean and sober in AA, and is one of the better known AA speakers in his region.

He happened to go to his favorite recovery bookstore, and this title, Empowering Your Sober Self, "jumped out at me." He bought it and over the next 24 hours read it straight through. He said he had been reading recovery literature for nearly 30 years and nothing had resonated with him enough to pick up the phone and call the author, until this book.

He said he liked AA enormously but after more than 20 years, he felt it was always the same thing, and it wasn't going anywhere, and he wanted the challenge of moving forward. The LifeRing concept really spoke to him.

He wanted to start a LifeRing meeting in his area, and he outlined a plan to go speak with some head people at a number of treatment programs with which he was familiar, having often spoken there, in order to get a room and referrals. Of course, I encouraged him, but at the same time I cautioned him that his enthusiasm might not be shared by some of his AA friends.

And so it was. At the first program where he spoke with the chief, he was told that the facility's board of directors was unlikely to go with anything other than 12 step.

He then took the book to his home group, and presented a share about the "A" and the "S" -- the addict self and the sober self. He said, "They laughed at me." They agreed about the "A" but they couldn't wrap their minds around the concept that there was an "S" -- a sober self -- inside the alcoholic's head. His talk met with sarcasm and ridicule.

It reminds me of Gandhi's famous saying:

"First they ignore you, then they ridicule you, then they fight you, then you win."

To his everlasting credit, Guy wasn't intimidated. He's going to speak to other treatment professionals. I shared with him that a number of senior people in 12-step programs have been expressing interest in the LifeRing option. He's now reading How Was Your Week in order to prepare for the convenor role. He's making plans to come visit Northern California in September so he can see LifeRing meetings first hand.

A Reader Writes With More Reading

One of the readers of this blog was kind enough to email me with the following information, which I pass on as received:

mr. nicolaus,

i'm a regular reader (& sometime commenter) of your "new recovery" blog. i'm writing to draw your attention to a few items i think might be of interest to you:

1 - the april/may 2009 issue of "Free Inquiry" magazine ran a great piece by Steven Mohr entitled "Exposing The Myth of Alcoholics Anonymous"; "Free Inquiry" is the first American publication to take AA head-on in a long, long time & the article is thorough & even-handed (unfortunately, you have to pick up a hard copy as the contents aren't available online)

2 - Dr. Harriet Hall (www.sciencebasedmedicine.org, www.skepdoc.info) ran a blog post on the above article & gave an MD's view of the article & the organization (http://www.sciencebasedmedicine.org/?p=490); i thought that might be of interest as well

3 - at my request, Dr. Hall visited & commented on a blog post at www.mentalhelp.net (http://www.mentalhelp.net/poc/view_doc.php?type=weblog&id=700&wlid=5&cn=14); the "editorial comment" to her post was -- putting it mildly -- elusive & openly condescending to any lay critique of AA; again, i was hoping this might be of interest of to you & that you might want to lend your voice to the discussion.

in any case, i thank you for your time & wish you all the best with your book. i'll be visiting the blog & www.unhooked.com regularly.

warmest regards,

peter [Name withheld]

donewithaa.wordpress.com

Choice Theory Conference

It was my privilege yesterday to attend the Choice Theory Education Conference at the Hilton in Sacramento. I staffed a LifeRing literature table there, met with LifeRing convenors and future convenors, attended some of the sessions, and met some of the leading figures in the choice movement.

Georgellen Hofine, one of the oldest students of Choice Theory founder Dr. William Glasser (photo), personally welcomed me to the gathering. LifeRing keynote speaker and DVD author Dr. B. J. Davis was the closing speaker on the conference program, and I much enjoyed listening to his presentation and chatting with him informally.

Choice Theory advocates Resa Stendel Brown and Jack Harnden spoke about the application of Choice Theory in education. Author Mike Rice gave a talk on addiction. B. J. Davis, in addition to his own discussion of Choice Theory in addiction treatment settings, introduced a DVD showing how Reality Therapy (an earlier name for Choice Theory) was applied in a prison setting.

I took time out to meet and chat with convenors of the LifeRing meetings in Placerville and one of the Sacramento locations. One of the conference participants expressed determination to start a LifeRing meeting in Lodi. Two of the treatment professionals in attendance spoke of plans to start LifeRing meetings at their centers in the Sacramento area.

It was a very positive crowd, including quite a few people with an interest in addiction recovery, and I should have brought more books, as Empowering Your Sober Self sold out by noon.

The only shadow over the event was the news that Dr. Glasser himself, who had been scheduled as keynote speaker, had been admitted to the hospital with a cardiac issue. There is as of this writing no further news on his condition.

LifeRing in New Living (NY)

An excerpt adapted from Chapter 2 of my new book (Empowering Your Sober Self) appears in the April issue of New Living, a free 20-p health and wellness newspaper published in Stony Brook NY and distributed in the New York City area and Long Island.

This chapter from my book contains a set of tips and exercises designed to help the person who wants to stop using addictive substances to move across the gap from contemplation to action. They include visualization, laughter, self-forgiveness, reframing, exercise, and other attitude-builders. I wrote a 900-word excerpt for the paper.

The editors took some minor liberties with the chapter. They took the sentence, "Becoming drug or alcohol-free can exhilarate you and enable you to accomplish great things in life," and added the phrase "... and perhaps, more importantly, give you gratitude and humility, two spiritual qualities hard to find in most people."

OK, I may not be the most original writer in the world. But I try not to stoop to moth-eaten cliches like "gratitude and humility." But it's good to have the article in the paper, with a plug for the book, and a plug for the two LifeRing meetings in Long Island; and I guess there's a small price to pay for that. I am humbly grateful.

Class war in California counseling

In California you need a license to fix cars, cut hair, paint fingernails, give massages, and much else. But not to provide addiction treatment. You can be a high school dropout with a history of petty crime and mental hospital stays, and you may find work as a counselor treating people who suffer from addiction. There are in fact a substantial number of high school dropouts working as front-line counselors in the field today.

Yet, at the same time, the addiction counseling industry insists, almost with one voice, that addiction is a disease. Just like diabetes, atherosclerosis, hypertension, and the rest. Now, if addiction is a disease, then addiction treatment must be a branch of medicine. No?

How many other branches of medicine do you know where the front-line treatment providers -- the physicians and RNs who hold the patient's recovery in their hands -- are high school dropouts? Or high school graduates, without more? Or have junior college degrees, only? There are none. Addiction treatment is way out of line, far, far below the standard of the rest of medicine -- if in fact it deserves the name "medicine" at all.

To be sure, there are quality treatment programs where addiction professionals are held to the same high standard as other providers. At the Kaiser Chemical Dependency Recovery Programs, for example, there is supervision by an MD, and each of the counselors has a professional license or certification as a Licensed Clinical Social Worker, Marriage and Family Therapist, Registered Nurse, or a similar qualification that requires graduate level education and thousands of hours of supervised training. But these islands of quality are, unfortunately, just islands.

Several organizations in California have been trying for years to pass legislation that would require standards of training, education, licensure and certification for addiction counselors comparable to those in other clinical professions. The current effort is Senate Bill 707. It is a complex piece of legislation and I won't try to analyze it here in detail. What's most interesting about it, really, is the controversy that surrounds it.

On the one hand, there are voices crying that it doesn't go far enough. Today's email, for example, brings a post from Dennis W., a member of the board of one of the counselors' organizations, complaining that the draft bill is so watered down as to be useless. It puts counselors with a GED and 350 hours of counseling experience on the same level as those who have a master's degree in addiction studies. He says that the bill in this form "will continue to keep the addiction service profession in California the sub-standard field that all other states in the US look down upon."

On the other hand, the bill has been the target of a barrage of attacks charging that it goes too far. If it passes, say these voices, program costs will rise, programs will go out of business, and counselors by the thousands will be out of jobs. What's that about?

The current newsletter of one of the other addiction professionals' organizations explains:

Simply put, associations representing program owners are attempting to defeat the measure by “scaring” counselors from supporting it. The truth is, they’ve opposed every bill put forward to recognize your professionalism. More than half of the states have licensure and none of their treatment systems were shut down due to licensure or certification. Standards for counselors improves salaries, raises treatment outcomes and reduces the strains on public sector treatment as addicts seek treatment from private practitioners.

So there you have it. It's class war. On one side, the counselors who aspire to professional status and to the salaries, benefits, and respect that come with it. On the other side, associations representing owners of treatment programs whose profit rate depends on filling their staff rosters with people who have little education, training, or other claims to professional advancement.

Now you can begin to understand a little more clearly why much of the addiction industry is so heavily invested in the 12-step approach. The 12-step approach does not require much in the way of professional education. If you've done the steps and you can repeat a basic set of slogans for any occasion, you're qualified to "carry the message" to others. Of course, you're not supposed to be getting paid for doing that, but you're being paid so little as a counselor that you might as well be doing it for free. If Karl Marx were looking at this, he might say that the 12-step organizations continuously generate a "reserve army of labor" for the treatment industry -- a flood of workers willing to work for substandard wages and under substandard conditions. And this "reserve army" necessarily depresses the wages and conditions of the whole labor force. No wonder, then, that the owners' associations oppose the counselors' campaign to pass laws that would upgrade professional standards.

Don't drink that marshmallow

The marshamallow experiments are famous by now, thanks in large part to Daniel Goleman's Emotional Intelligence books, and their relevance to addiction seems obvious.  In 1968, Stanford psychology prof Walter Mischel presented four-year olds with a marshmallow and the choice: Eat it now, or wait 15 minutes and get two.  The kids who could delay the gratification ended up, a decade and more later, with higher SAT scores, higher graduation rates, better jobs -- in short, twice as many of the marshmallows life had to offer.  

It was often believed that the kids who could delay gratification did so thanks to more "will power."  Mischel -- according to a helpful and informative summary in this week's New Yorker, by Jonah Lehrer -- analyzed what this "will power" really consisted of.  He paid very careful attention to what went through the delaying kids' minds as they resisted the bait.  They succeeded because they had methods of distracting their minds from the lure.  They covered their eyes, or played hide-and-seek under the desk, or sang songs.  "Their desire wasn't defeated -- it was merely forgotten."  The key, Mischel found, was not to resist the marshmallow -- that didn't work --- but to avoid thinking about it.  

In further experiments, Mischel found that children could be taught cognitive tricks that helped them distract themselves.  Even reducing the intensity of the temptation by pretending that the marshmallow was only a picture of a marshmallow or that the marshmallow was really a cloud worked for some children.   

Mischel and other researchers Lehrer quotes are skeptical of finding a genetic basis for the ability to delay gratification.  Too many genes are involved in even the simplest aspects of personality.  The cutting edge of research lies in classroom curricula that teach self-distraction, and in educating parents to cultivate simple cognitive skills in children.  Says Mischel:

"We should give mashmallows to every kindergartner... We should say, 'You see this marshmallow"  You don't have to eat it.  You can wait.  Here's how.'"

No Such Thing as a Bad Person Addicted to Alcohol

Had the pleasure today to hear and meet Charles D. Appelstein, author of No Such Thing as a Bad Kid and other works expounding the strength-based approach to working with at-risk youth.  

Charlie was keynoter  at the 12th annual Northern California Tobacco, Alcohol, Drug Educator and Youth Development Conference at UC Berkeley, where I staffed a LifeRing exhibit table.  He's a fun speaker, gets the audience laughing, chanting, and singing, all the time delivering key points of a message that is in many respects revolutionary.  

When a teacher or counselor begins work with troubled kids -- also "trouble kids" -- the key thing is attitude, Charlie began.  The successful attitude, he said, is "I believe in you.  You are a great kid.  You can do great things."  This attitude transfers to the kid; it makes the kids feel good about themselves, it gives them hope, and it inspires them to change for the better.

Afterward we chatted about addiction treatment, and I told him that LifeRing was one of the strength-based approaches in this field.  He expressed great interest.  We also exchanged books; he gave me his and I gave him mine.  

I also had the opportunity to chat with Tom Herman of the State Department of Education, Dr. Alex Stalcup of the New Leaf Treatment Center, Ralph Cantor of the local County Office of Education, and a number of substance abuse program administrators, teachers, cops, and others in and around K-12 education who are concerned with the drug issue.  The message that there's a secular, strength-based addiction recovery support network out there was welcome news to many ears.  

First call

Had the first telephone call today from an arms-length reader of Empowering Your Sober Self, my new book.  A counselor in San Diego called on the 800 line to say he had a number of clients who were not responding to 12-step and this looked like just the right approach for them.  Wanted to know were there local meetings (not yet) and how they could connect with us (online).  "Very glad to see you exist.  This is much needed."

Seattle police chief tapped as 'Drug Czar'

Rumors last month that Rep. Jim Ramstad was headed for the post of 'Drug Czar' proved unfounded, as Pres. Obama has reportedly nominated Seattle Police Chief Gil Kerlikowske for the post, instead.  Kerlikowske has earned generally positive reviews, but it's too early to say, if he's confirmed by the Senate, what he's likely to do as top commander of the 'war on drugs.'  Obama is on record that this 'war' has been a colossal failure.  There's grounds for hope that Kerlikowski will redirect the mission of this cabinet-level office more toward treatment, prevention, and a public health approach, rather than the nightstick-and-prison medicine that has prevailed.  For an eloquent statement advocating such a change in mission, read Victor Capoccia's op-ed in the Baltimore press, here.  Capoccia is head of the Closing the Addiction Treatment Gap initiative.  

Well said, in Washington

The Bush years, by wide consensus, were a dismal era for science.  But by a strange paradox, some bright stars emerged in what is normally a dismal field under any administration: addiction science.  

One is the brilliant Nora Volkow, who brings a rare mix of research experience, clear thinking, and leadership ability to the National Institute on Drug Abuse (NIDA).  

Another is Mark Willenbring, Director of the Division of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).  In a letter to the current New Yorker (the one with the cartoon of Obama as George Washington on the cover), Willenbring precisely skewers a piece that this normally astute mag published in its December 1 issue.  The article, titled "Special Treatment," by Amanda Fortini, featured a Los Angeles area deluxe treatment facility.  

After a string of well-worn 12-step platitudes about addiction and the difficulties of recovery, the owners of the facility claimed that in essence treatment could make no difference, everything depended on the addicted person's motivation.  So why bill the client for clinical services on top of the normal cost of luxury room and board? 

Willenbring's letter goes directly for the jugular.  He writes that the piece:

... shows the irony that paying more does not guarantee access to the most current therapies... The program that Fortini describes appears to base its services on a treatment model that is more than thirty years old .... Although clients may or may not receive some benefit, they are vulnerable to unnecessary relapse risk if more contemporary treatments are not also made available.  For example, research funded by the National Institutes of Health has identified several medications that reduce relapse in early recovery from alcohol dependence.  Newer behavioral approaches, such as cognitive-behavior therapy and motivational interviewing, also increase recovery and provide alternatives to the traditional Twelve Step approach (which in updated form is also effective).  This menu of services makes possible truly individualized treament and  increases client choice and engagement, but only if people have access to it.

The treatment program Fortini described in her article was so clinically clueless and bereft of ideas that the piece might have been a subliminal parody.  It isn't often that I get to cheer somebody in Washington for saying the right stuff.  Could this be the beginning of a change we can believe in?  

Congratulations to Barack Obama

As a college student at Wesleyan in '61 (or was it '62?) I joined with other white students to team with groups of black students from Howard University in an effort to integrate lunch counters in Glen Burnie, a suburb of Baltimore.  In some places we sat indefinitely without being served; in one, we were served coffee with salt in it; at another they locked the doors as we approached.  When we picketed the segregated local movie theatre, a mob of white men surrounded us as sheriffs watched.  A providential cloudburst scattered the crowd and allowed us to escape.  

On the night of election day in 1964, I arrived at the civil rights movement headquarters in Jackson, Mississippi, to begin a few months of volunteer work.  Nearly everyone was glued to the TV set to see whether the Democratic Party would seat the elected black delegates running under the banner of the Freedom Democratic Party.  The answer was, no.  

These and other memories came upwelling as I watched the inauguration of Barack Obama.   The party that wouldn't seat elected black delegates had nominated a black man for president.  A man whose father would not have been served at DC area restaurants 60 years ago was taking the oath of office.   Indeed, there has been some changes.

This morning's San Francisco Chronicle editorializes that Obama's new approach is "grounded in sobriety and hard work."  The "sobriety" that's meant here is, I assume, the metaphorical kind -- a pragmatic, realistic attitude -- and not the literal kind, meaning abstinence from alcoholic drink.  Yet there's a connection to reflect on, here.  

For me, personally, my time of active engagement in the civil rights movement was largely a time when my alcoholism (acquired in my freshman year in college) was in remission.  Engagement in life-changing work was hugely more interesting than drink.  My drinking habit only bloomed large during the years of reaction that followed, when it seemed that everything we had done was being undone.  Pessimism, despair, lack of hope were the atmosphere in which this illness flourished.  And I'm not the only one.  Is it an accident that the drug problem grew larger in rough proportion as conditions for the poor and middle class in America stagnated and deteriorated?  

Barack Obama's own history with alcohol and other drugs offers a refreshing contrast to that of his predecessor in office.  Obama has freely and openly admitted experimenting with drugs as a youth, but then stopped; he is trying to quit, or has quit, smoking.  What a contrast to the history of "W," whose claimed mid-life alcohol salvation story is widely believed to be a sham that covered up more than it revealed, notably a long history of cocaine use, some say.  

I've not yet seen anything in the way of Obama's statements so far that gives a clue to his specific policies on alcoholism and other addictions.  The federal government has many levers to pull and many dollars to spend in this area.  On general principles, I assume that Obama will support the recent extension of parity in the treatment of mental health and addiction treatment.  I assume that the federal agencies in this area will continue to be funded.  

The open questions in my mind are (a)  War on Drugs, and (b) Federal excise taxes on spirits and tobacco.  We need "change we can believe in" in the "war on drugs," a criminal exercise in hypocrisy and racial/economic persecution that is long overdue for radical reform.  An even more telling mark of Obama's mettle will be whether he supports Congressional action to raise the excise taxes on liquor and tobacco.  Public health advocates have long maintained that raising these taxes is the single most effective measure to reduce the social impact of these two most murderous addictive drugs.  Needless to say, the pillars of corporate greed stand deeply dug in on this issue.

The largest opening in the clouds under this new administration will be in the area of improving living standards and reducing inequities for the poor and middle class.  If the real and emotional environment of ordinary people in this country becomes infused with progress and hope, the problems of alcohol and other drugs will recede as if of their own accord.  It will take some time, but if the new administration succeeds in this largest and most difficult of goals, we will, in fact, see a new era of "sobriety" in both senses of the word.

Congratulations to President Barack Obama, and best wishes for the future.

P.S.  To date, the White House Office of National Drug Control Policy remains under an interim head, Patrick Ward, a Bush appointee who has held the post a bit over a year.  Obama's choice of Rep. Jim Ramstad to become the new Drug Czar has run into heavy fire for Ramstad's ties to abusive "faith-based" programs, his policy positions on prevention, and his ties to a massive investor fraud.  Read Maia Szalavitz's blog blast and the Drug Policy Alliance editorial.  Ramstad is not change, he's MOTSOS.  

End Stage

Is nothing sacred? Michael Shermer, Scientific American's Skeptic columnist, reports in the November issue that one of the icons of psychology, the five stages of grief, has been debunked.

Launched by Elizabeth Kubler-Ross in her book On Death and Dying (1969), the model of denial-anger-bargaining-depression-acceptance is one of the most widely known paradigms in modern psychology. But, according to Shermer's sources, there appears to be no evidence that most people most of the time go through most of those stages in that order, or any other order.

The five stages of grief, along with similar "stage" theories, Shermer says, satisfy people's craving for simplicity and predictability. Unfortunately, the scientific basis for them is just not there. And they can also impose feelings of guilt and shame on people who are not feeling what they think they should. And, in today's world, people who follow the simple "stages" narrative are the exception, while diversity and individual variation are the rule.

Good grief! What's next? Are we going to learn that there is no evidence that most people recovering from addiction go through a certain well known set of steps?

Genetics of mental illnesses: More is Less

Genetic research into psychiatic disorders appears to be undergoing a systemic deflation not unlike that in the financial markets. As I posted a couple of weeks ago, a survey article in the then-current Scientific American showed that genetic studies of human intelligence had labored mountainously and brought forth a 0.4 per cent mouse. Today comes a special issue of Nature Neuroscience dedicated to the neuropsychiatric diseases, and it's the same story. The initial radiant hope that today's mega-billion dollar genetic research apparatus would nail the culprit genes responsible for schizophrenia, autism, bipolar disorder, or depression, has dimmed to a faint glimmer. The more we can see, the less we find.

In the roundup article, Steven Hyman (Department of Neurobiology, Harvard) works hard at sounding upbeat, but has little to work with. Family studies, rich in anecdotal material, suggest that autism, schizophrenia, bipolar illness, and major depression must have major genetic components. Therefore it should be a simple matter to find the genes, and then to develop medications that target those genes.

Over the past two decades, however, efforts to identify risk-conferring alleles for the common forms of neuropsychiatric disorder have largely been unrewarding. Despite the significant role for genes highlighted by aggregate measures of their influence (Table 1), the underlying genetics of common neuropsychiatric disorders has proved highly complex, as attested by unpredictable patterns of segregation in families, lack of Mendelian ratios in twin studies and serious difficulties in replicating genetic linkage studies.

Anecdotes notwithstanding, the given illness frequently appears in people without the suspected genetic traits, fails to appear in people with the traits, and appears in people with other traits believed to be associated with an entirely disparate disorder. Current technology can easily identify "highly penetrant" genetic variations that cause a narrow subset of disorders, such as some types of Alzheimer's disease and macular degeneration, but the candidate genes involved with the most common psychiatric disorders make only a very slight dent in the etiology. It doesn't help that the clinical definitions of the psychiatric disorders tend to lack objective physiological markers, so that diagnosis rests ultimately on clinicians' opinions, which may vary widely.

Neither Hyman's article nor the remaining items in the special issue of Nature Neuroscience focus on addictive substance abuse, but you could substitute "alcoholism" into the paragraphs just quoted and come out with the same result. I've summarized the research on that topic in my forthcoming book. By April, when the book comes out, it should be amply clear that the deflation of the genetic myth in alcoholism is only part of a larger panorama of reassessment. The better our genetic research tools become, the more clearly we can see, the more obvious it becomes that we cannot blame our genes for our disorders, nor can we hope for a magic pill to set us right. It's just not going to be that easy.

Genetics: The more we see, the less there is

In the concluding chapter of my forthcoming book (link), I look at the evidence for an alcoholism gene.  My research showed that the more powerful our tools become, the less we find in the way of genetic causality.  Modern genetic research has wiped away any basis for the idea that alcoholism is a genetically transmitted disease.  The most that can be said is that some people appear to inherit a lower responsiveness to alcohol, so that if they drink, they must drink more to get the same high.  For details, see my book, due out in April.  

Now comes an article in Scientific American, by science journalist Carl Zimmer,  reporting on modern research into the genetics of intelligence.  Here too, the conventional wisdom has been that genes play a major role.  But when the most powerful computer-assisted research tools are turned on the human genome, the supposed genetic factor all but evaporates.  Intelligence turns out to depend very weakly on a diversity of genes. The most influential of these genes contributes just 0.4 per cent (less than one half of one per cent), and this gene is believed to influence also a variety of other cell functions -- so that it is not specific to intelligence as such.  

Much of the myth of genetic causality rests on twin studies.  This is true both in alcoholism and in intelligence research, as well as in other fields (for example, autism).   Zimmer cites research showing that twin studies involving affluent families show a strong apparent genetic influence, while similar studies involving twins from poorer families show virtually no genetic factor at work.  The modern molecular genetic studies suggest that the apparent genetic influence reported in some twin studies may be a chimera due to false methodological assumptions.   Twin studies have been severely criticized, and some scientists consider them junk.  The SciAm article is in the October 2008 issue at p. 68; a link is (temporarily) here.

Spirituality strikes out

Two controlled trials of the effect of spirituality on addiction recovery showed no improvement for the patients given spiritual guidance as part of the usual treatment regimen, either in their addiction recovery or in their spiritual practices.  In fact, in one trial, the patients provided with spiritual guidance made less progress in overcoming depression and anxiety than the patients not given spiritual treatment.

Details are in the Journal of Substance Abuse Treatment, July 25 2008.  The abstract is here.  Thanks to David Kaiser Ph.D. for flagging the item.  

Invitation to Guest Authors

Guest authors are invited to contribute to this blog. I have to take another break until the end of June. I'm working on a book with a June 30 deadline.

Confrontation Therapy, R.I.P.

Two of my favorite scholars have combined to write a powerhouse of an article that everyone interested in addiction treatment will want to read. William R. Miller, co-author of the Handbook of Alcoholism Treatment Approaches (reviewed here), and William L. White, author of the monumental history Slaying the Dragon (reviewed here), have written what hopefully will be an obituary for an era, entitled "Confrontation in Addiction Treatment." It's in Counselor Magazine. Here are a few snippets from this substantial, strongly researched and comprehensive treatment:

The use of confrontational strategies in individual, group and family substance abuse counseling emerged through a confluence of cultural factors in U.S. history, pre-dating the development of methods for reliably evaluating the effects of such treatment. Originally practiced within voluntary peer-based communities, confrontational approaches soon extended to authority-based professional relationships where the potential for abuse and harm greatly increased. Four decades of research have failed to yield a single clinical trial showing efficacy of confrontational counseling, whereas a number have documented harmful effects, particularly for more vulnerable populations. There are now numerous evidence-based alternatives to confrontational counseling, and clinical studies show that more effective substance abuse counselors are those who practice with an empathic, supportive style. It is time to accept that the harsh confrontational practices of the past are generally ineffective, potentially harmful, and professionally inappropriate.

....

Early claims of the superior effectiveness of confrontation and counterclaims that it was ineffective and potentially harmful relied primarily on statement of opinion buttressed by anecdotes. With the emergence of more science-grounded treatment approaches in the 1980s and 1990s came studies that began to tip the scales of this debate. Two recent reports, however, suggest that confrontation still has its proponents. A 2001 study on staff attitudes toward addiction treatment found that 46 percent of those surveyed agreed that “confrontation should be used more” (Forman, Bavasso & Woody, 2001); and a 2004 ethnographic survey of adolescent addiction treatment in the United States commonly encountered programs that were “explicitly designed to demean and humiliate” (Currie, 2004).

...

There never has been a scientific basis for believing that people with substance use disorders, let alone their family members, possess a unique personality or character disorder. Quite to the contrary, research on virtually any measure reflects wide diversity of personal characteristics among people with addictions, who are about as diverse as the general population, or as snowflakes. Studies of defense mechanisms among people in alcohol treatment have found no characteristic defensive structure, and higher denial was specifically found in a clinical sample to be associated not with worse, but with better treatment retention and outcomes (Donovan, Hague & O’Leary, 1975).

...

Reviewing four decades of treatment outcome research, we found no persuasive evidence for a therapeutic effect of confrontational interventions with substance use disorders. This was not for lack of studies. A large body of trials found no therapeutic effect relative to control or comparison treatment conditions, often contrary to the researchers’ expectations. Several have reported harmful effects including increased drop-out, elevated and more rapid relapse, and higher DWI recidivism. This pattern is consistent across a variety of confrontational techniques tested. In sum, there is not and never has been a scientific evidence base for the use of confrontational therapies.

If you've ever been exposed to confrontation therapy, or have a confrontational counselor now, by all means read this article, sure to be reprinted in textbooks and to become a classic.

If there's one defect in it, it's in glossing over the confrontational therapy element in AA itself. Dr. Harry Tiebout, whose psychiatric theorizing framed the confrontational approach, was hugely influential on Bill Wilson, and he was not alone. Dr. Silkworth echoed the theme, with his advice to Wilson to "give them the medical business, and give it to them hard." The "medical business" meant to convince the alcoholic that he was suffering from an incurable fatal illness. This revelation was designed to attack and to "shatter" the alcoholic's defenses, to "deflate" his ego, and render him hopelessly dependent on his "physician." The very first clause of step one, the foundation of the whole edifice, "powerless over alcohol," expresses a confrontational strategy, as thousands of counselors have found out in practice. To be fair, this is not the only element in AA; there are other strands that tend to counterbalance it. But the article is certainly wrong in claiming, as it does, that there is no attack therapy strand in AA at all. -- This cavil aside, the article is a masterful piece of work, by two giants in the field. Highly recommended.

Abstinence leads to rapid brain repair

Abstinence leads to rapid repair of gross brain damage seen in alcohol dependent persons, according to a review of neuroimaging studies by a group of Japanese researchers.

In uncomplicated alcoholic patients, a high incidence of cortical shrinkage and ventricular dilatation were reported using brain CT scans. In older alcoholics, prefrontal gray matter deficits were especially marked when compared with younger alcoholics. Reversibility of brain shrinkage is a common neuroimaging finding in patients with alcohol dependence.

Regrowth of shrunken brain areas was particularly vigorous during the first month of abstinence, the scans showed. Besides the gray matter, areas "with significantly greater recovery in abstainers were the temporal lobes, thalamus, brainstem, cerebellum, corpus callosum, anterior cingulate, insula, and subcortical white matter." Follow-up studies showed that the regrowth was not simply due to rehydration.

The study appeared in the Dec. 2007 issue of the Japanese Journal of Alcohol Studies and Drug Dependence. The abstract is here.

Brazil study: Does AA really work?

"Do Alcoholics Anonymous groups really work? Factors of adherence in a Brazilian sample of hospitalized alcohol dependents." -- That's the title of a study in the current issue of the American Journal of Addiction, published by a American Academy of Psychiatrists in Alcoholism and Addiction. A team of researchers headed by M.B. Terra followed 300 alcoholics committed to three hospitals in Puerto Allegre, Brazil. Results (from the abstract):

AA adherence was below 20%. The main factors reported by patients as reasons for non-adherence to AA were relapse, lack of identification with the method, lack of need, and lack of credibility. The factors reported by patients as reasons for adherence were identification with the method and a way to avoid relapse. Although AA is considered an effective intervention for alcoholism, its adherence rate was excessively low. The identification of these nonadherence factors could help health professionals in referring certain alcoholic patients to therapeutic interventions other than AA.

The result of this study is unsurprising; essentially the same finding was made in a meta-analysis almost two years ago reported in the Cochran Report (Source) What's noteworthy here is that patients were asked their reasons. It would be useful if the various threads in the responses (objections to the 12-step approach on the one hand, denial on the other) were explored in more depth and an attempt made to untangle them.

2007 Darwin Award Nominee: Alcohol Division

Michael was an alcoholic. And not an ordinary alcoholic, but an alcoholic who liked to take his liquor... well, rectally. His wife said he was "addicted to enemas" and often used alcohol in this manner. The result was the same: inebriation.

The machine shop owner couldn't imbibe alcohol by mouth due to a painful throat ailment, so he elected to receive his favourite beverage via enema. And tonight, Michael was in for one hell of a party. Two 1.5 litre bottles of sherry, more than 100 fluid ounces, right up the old address!

When the rest of us have had enough, we either stop drinking or pass out. When Michael had had enough (and subsequently passed out) the alcohol remaining in his rectal cavity continued to be absorbed. The next morning, Michael was dead.

The 58-year-old did a pretty good job of embalming himself. According to toxicology reports, his blood alcohol level was 0.47%.

In order to qualify for a Darwin Award, a person must remove himself from the gene pool via an "astounding misapplication of judgment." Three litres of sherry up the butt can only be described as astounding. Unsurprisingly, his neighbors said they were surprised to learn of the incident. Source. Thanks, John C. (Goathouse) for the item.

Humility R Us [NOT]

It's been six years since AA Trustee Dr. George Vaillant's article in the AA Grapevine, saying that "It doesn't hurt at the level of the GSO for AA to have humility and understand that 60 per cent do it without AA." Source. He was talking about the research finding that 60 per cent of alcoholics who achieve at least five years of abstinence do it without using AA.

It's been six years, and Vaillant's plea for humility has either not been heard or already forgotten. In this months' issue of Addiction Professional, columnist Carlton Erickson reports that "fourteen experts" recently met at a "consensus conference" in Rancho Mirage CA to define "recovery," and came up with a definition that includes an implied endorsement for "peer support groups such as AA and practices consistent with the 12 Steps and 12 Traditions."

In other words, judging by Erickson's column, if you're part of the majority that are staying sober without AA you're not considered in recovery. But if you're a chain-smoking Big-Book thumper whose entire social, moral, and intellectual life is wrapped up in AA meetings, then you're a model of recovery. The mind boggles.

The panel's full report, published in the Journal of Substance Abuse Treatment, is considerably more balanced than Erickson's column makes it seem. The report says that "the founders of AA recognized that there were many paths to the same position ... and did not suggest that their specific methods were the only means to attain the overall goal." (Thanks Jason Schwartz for forwarding the full article.) The panel considered but expressly rejected the definition of recovery as "abstinence attained through adherence to 12-step principles."

That's progress. But the plug for AA and the 12 steps is highlighted in the report, and Erickson's column picked up on that highlight, as most hurried readers will.

This endorsement is completely gratuitous. It comes in the absence of any evidence cited in the report showing either (a) superior efficacy of 12-step over other paths in reaching long-term sobriety, or (b) a positive association between long-term participation in 12-step groups and measures of "personal health and citizenship."

The report admits that no validated instrument for measuring "personal health and citizenship" exists. Then what scientific ground is there for making the claim?

The implied beneficial effect of AA participation on "personal health" is indefensible given the notorious prevalence of nicotine addiction among AA members. The report takes note of the nicotine problem, including "significant rates of emphysema, cancer, and other terminal health conditions associated with these products among those otherwise in recovery" (read: in AA). But come to the bottom line, the panel tucked tail between legs and "considered it best to remain silent on tobacco use within the sobriety component of the recovery definition."

The next line is lovely: "It is admitted that there is no clinical justification for this position."

The claim that long-term AA participation enhances "citizenship" is equally dubious. The cited ground for it is the AA homilies for doing service, "giving back." But this "service," to the limited extent people actually do it, is in the nature of recruiting for the AA organization. AA has no outward-directed community service component on the order of the Masons, Shriners, Rotarians, and many other groups. So where does "citizenship" come in?

Trying to come up with a definition of recovery is a laudable project. The panel notes that recovery science (as distinct from addiction science) is a poorly developed field, and that the lack of a validated definition of 'recovery' is a significant obstacle. But when you enter the gates of science, the motto is "lasciare ogni sospetto" -- here drop all hesitation, abandon all fear. So long as recovery scientists keep genuflecting to the sacred cow in the room, little progress and considerable dung is to be expected.

Alcohol Killed 'The Prophet'

The excellent New Yorker continues its literary war on the alcohol-as-muse delusion. In the Jan. 7 issue is a thumbnail bio of Kahlil Gibran, author of the huge bestseller, The Prophet. After the success of this book, Gibran took to drinking heavily. Eight years after The Prophet, having produced nothing further of note, he died of cirrhosis of the liver, at age 48.

Bankrupt Tobacco Firm Floats Whiskey-Flavored Cigs

Whiskey-flavored cigarettes and cigarette papers dosed with vanilla to disguise the stink of the smoke are among the "new technology" being marketed now in Quebec by JTI MacDonald, a Japan-based cigarette company that is in bankruptcy proceedings.

Public health advocates are up in arms. Read more here. Thanks, Michael W., for the item.

If liquor doesn't get you, nicotine will

Last week's New Yorker had a bio of Malcolm Lowry, a lauded writer whose alcoholism claimed him at age 47; see my blog note, "Alcoholocaust," below. This week's mag covers iconic short story writer Raymond Carver (What We Talk About When We Talk About Love), also an alcoholic, but one who got sober in 1977, and stayed that way. But he kept smoking. He once said that he was only "a cigarette with a body attached to it." Lung cancer claimed him at age 50.

The mag's Lowry story took the author down a notch or two by suggesting that his wife was actually responsible for much of the greatness in Under the Volcano. The mag continues on its debunking tear by demonstrating beyond reasonable doubt that the savage blue pencil of Carver's editor Gordon Lish was responsible for creating the terse, minimalist style that made Carver famous.

Score: New Yorker 2, theory that alcohol helps the creative juices flow, 0.

Oh, and don't miss the cartoon on p. 68. A bar patron drinking coffee to a neighbor with a cocktail: "Been there, drunk that." I'd copy it here but I worry about overstretching the boundaries of the "fair use" doctrine.

Let them drink Grand Marnier!

A proposal out of Tacoma to "treat" chronic street alcoholics by banning the sale of cheap wine caught the fancy of S.F. Chronicle columnist C.W. Nevius last week. The scheme is simple: in a defined "alcohol impact zone," stores are banned from stocking Thunderbird, Boone's Farm, Royal Gate, Takaa, and similar cheap rotgut.

If the homeless alkies want to buy Cabernet Sauvignon or Grey Goose, that's ok.

Public health authorities in Tacoma laud the idea, citing reduced emergency room admissions and other medical costs. That's not surprising. The same thing happened nationwide during Prohibition.

The logic by which Nevius calls this simple class-based Prohibition scheme "treatment" escapes me. It's just one more aspect of the ubiquitous economic bias that Prof. Merrill Singer describes so vividly in his recent book, "Drugging the Poor," reviewed here.

Back from Iraq with a monkey on their back

Jon Marshall's News Gems website writes:

"ABC News' investigative team, led by Brian Ross, worked with six graduate journalism students to discover whether troops returning home after serving in Iraq are facing the same battles with drug addiction as soldiers did when they came back from Vietnam. For their series, "Coming Home: Soldiers and Drugs," the students traveled across the country from Fort Carson in Colorado to Fort Bragg in North Carolina to examine the accuracy of the Army's assurances that drug abuse among ex-combatants isn't growing. Their findings:

Many of this country's bravest men and women who volunteered to defend America in a time of war have come home wounded -- physically and mentally -- and are turning to illicit drugs as they adjust to normal life, according to soldiers, health experts and advocates." Source.

The five programs are available online here.

Afghan farmers see through "drug war"

Recent U.S. initiatives to eradicate poppy fields in selected areas of Afghanistan, on the Colombian model, have met with growing resistance by Afghan farmers, according to a briefing paper by the Afghanistan Research and Evaluation Unit (link):

"The view that the government is willing to deepen the poverty of some of its rural population for the sake of a ban on opium poppy cultivation further alienates the rural population. The belief of many farmers that those enforcing the ban and eradicating their crop are themselves actively involved in the opium trade makes matters worse; so does the perception of widespread bribery and the sense that eradication targets the vulnerable and ignores the crops of those in positions of power and influence."

Afghan farmers are seeing that the eradication efforts are aimed mainly at growers or dealers who are competitors to the growers and dealers connected with the Afghan government and its sponsors. A secondary aim of eradication may be to reduce the over-all supply in order to maintain prices. The Afghan farmers are seeing firsthand what the "war on drugs" is all about and they're not buying into it. The study's authors caution that Afghan farmers will continue to grow the poppy until they're presented with a reasonable alternative -- and none is in sight.

Girl, 8, asks cops for help with drunken mom

"Help me. My mother is drunk, and she crashed her car," said an 8-year old Tampa FL girl to troopers last week who were checking on a car wreck.

With the girl inside, the mother had sideswiped two other vehicles before hitting a parked car head-on and coming to a stop. The girl got out of the wreck, unhurt, and approached the first officer on the scene.

"Ever time she drinks she gets like this," said the girl. The mother was booked for drunk driving, child abuse, and related charges. Source.

Sponsors rat on pigeon

Two Alcoholics Anonymous sponsors took the witness stand in federal court in Des Moines IA recently to denounce their former sponsee, Thomas Vasquez, as "a pathological liar" lacking "the capacity to be honest." Source.

Vasquez probably deserved the slams. He was a paid government informer trying to build a case of extortion against incumbent Democratic state senator Matt McCoy. A Bushie federal prosecutor brought the transparently political case. The jury threw it out after less than two hours of deliberation, including lunch.

But ... should AA sponsors be testifying as character witnesses against their former sponsee? Isn't that against some rule?

War of the drugged

From the Guardian (U.K.):

The army today admitted that cocaine was becoming the "drug of choice" for British service personnel.

Colonel John Donnelly, who has responsibility for army discipline, said a significant increase in drug taking by soldiers could be linked to stress induced by the demands of combat operations.

More on this topic.

Whine tasting

It had to come to this.

The California Republican Party issued two press releases attacking the California Democratic Party for spending campaign money on a wine tasting fundraiser.

The Democrats shot back, pointing out that the Republicans spent four times as much on wine for their events, plus sending untallied bottles of a rare vintage to major donors. Source.

Dual diagnoses have same root?

Substance abuse and mental illness very commonly go together. One hypothesis to explain the correlation is to see the patient using alcohol/drugs to medicate the mental disorder. Another view sees the mental disorders as the symptoms of excessive drug/alcohol ingestion. Now comes Dr. Andrew Chambers and his researchers at the U of Indiana Medical school with a study that suggests both theories are wrong. Based on experiments with adult rats, Chambers found that both substance abuse and mental disorders probably stem from a malfunction in the amygdala, a small region within the brain that plays a role in numerous processes, including the memory of emotionally charged events. Read details. Read blogger Jason Schwartz's piece on the same issue, here.

Don't wait till kids are in middle school

A study of underage drinking finds a big jump in alcohol use in children between the fifth and sixth grades, and suggests that waiting to deal with an alcohol issue in the home until the child is in middle school is too late. Source.

The researchers urge parents to "talk to their kids about alcohol" when the kids are ten or eleven, or earlier. But talking alone isn't going to cut it, if the parents themselves are setting bad models of alcohol use in the home. The research really suggests that if one or both of the parents have an alcohol problem, the time to deal with it (at the latest) is when the kid is still in primary school.

Marijuana smoke nastier than cigs

Dec. 14, 2007 -- New research from Canada shows that some toxins may be more abundant in marijuana cigarettes than tobacco cigarettes.

The researchers burned 30 marijuana cigarettes and 30 tobacco cigarettes on a machine in their lab, measuring levels of chemicals in the smoke.

Ammonia levels were up to 20 times higher in marijuana smoke than in tobacco smoke. Levels of hydrogen cyanide and nitrogen-related chemicals were three to five times higher in marijuana smoke than in tobacco smoke. Read more.

99 per cent wouldn't use drugs if legal

A recent poll of 1000 U.S. adults asked if they would use "hard" drugs such as cocaine or heroin if they were sold legally. More than 99 per cent said they would not. Source.

The numbers undercut the argument of "war on drugs" supporters that drug prohibition is a necessary dam against widespread drug use.

Quite the contrary, says David Borden, CEO of StopTheDrugWar.org. For example, rates of marijuana use in the Netherlands, where it's sold legally in "coffee shops," are only about half those in nearby France, where marijuana use is an arrestable offense.

Evolution at work

A drunk man in Thailand stopped to urinate and poked his member through a crack in a fence.

On the other side of the fence, a vigilant puppy spotted this invading one-eyed albino rat, and promptly sank its teeth into it.

Doctors at the hospital said the member "should still be useful" to the man in the future. Source.

A good question

A new policy in New Jersey allows cops to ask drinking drivers who served them their last drink. Source.

Some bar owners are upset because existing law already makes barkeepers liable for serving patients who are drunk.

Cops answer that the question helps them spot bars that ignore the law.

Surprising finding about youth drinking (NOT)

A study of 11,000 persons in London found that teens who drank to excess (4 drinks or more per session, once a week or more often) were twice as likely to snag a criminal conviction by age 30. They were also much more likely to become alcoholics, to use hard drugs, and to become homeless. Source.

The study is being used as fodder for an Australian provincial government campaign to crack down on youth drinking. A worthy cause, no doubt, but did the study control for factors such as family income, education, and environment?

College profs modeling alcoholism for students?

College students' drinking excesses continue to make news. A prof at R.Y.S. (wherever that may be) points out in his or her blog that the students may just be copying their profs.

"Can we acknowledge that there is a huge amount of alcoholism in academia? Not the cute Dudley Moore kind, but the kind that makes us less sharp and ends our lives early? I'd imagine every one of us knows a colleague who needs a mid-morning 'refresher' or who always smells slightly of drink. I remember seeing my supervisor trying to be inconspicuous checking all the (empty) wine bottles at a reception, hoping there was a glass left in one of them, and finally making a glass by combining all the remnants red and white wine that were left. I remember drinking with him at a local bar until well past midnight (having started at four). And is there any function in academia that doesn't involve alcohol?"

Read the whole thing. Good point. A college administration trying to cope with its students' alcohol excesses needs also to look in the mirror. It'll be hard to get a handle on student conduct if the faculty's drinking is out of control.

CIA up to its old tricks?

A tantalizing hint that the CIA is up to its old tricks (flying drugs from conflict zones) surfaced in the crash landing of a Gulfstream II business jet in Mexico Sept. 24.

The Florida-based craft carried somewhere between three and six tons of powder cocaine, and either no heroin or up to one ton of heroin, depending on which estimates one believes.

The flight originated in Colombia and was destined for Florida with a stopover in Cancun.

Blogger FrostFireZoo.com reports that the serial number of the craft matches those of a plane used by the CIA on at least three occasions in the rendition of terrorism suspects from Guantanamo to other countries to be tortured.

A Mexican journal accused Mexican and U.S. political authorities of hypocrisy for waging a so-called "war on drugs" on the one hand, and being heavily invested in the lucrative drug trade, on the other.

Foxfire.com observes that the amount of drugs said to be on the plane diminished with every official Mexican press release on the incident, and speculates that the subtracted amounts disappeared back into the market.

The photos of the crash scene, above, originated with Mexican press sources. For a video with commentary on EVTV, click.

P.S. Aug. 26 '08: Someone has removed the photos of the crash scene from this blog, and from the original source website as well. However, a video containing the same or similar still photos is still available online here: http://www.evtv1.com/player.aspx?itemnum=10106 -- See them before they're gone.

Alcoholocaust

If you have illusions about the role of alcohol in creativity, read "Day of the Dead" by D.T. Max on p. 76 of the Dec. 17th issue of the New Yorker. It's a thumbnail bio of Malcom Lowry, author of "Under the Volcano" (1947), hailed as one of the top twelve English novels of all time; he was considered the heir of James Joyce. He died ten years afterward, after passing out from massive quantities of alcohol and barbiturates. He was 47.

The chronicle of his marriage and collaboration with Margerie Bonner is a tortuous, gruesome story of love, hate, help, hurt, rescue and revenge. Bonner, who edited and rewrote Lowry's texts daily, almost certainly contributed the discipline and warmth that raised "Under the Volcano" above the rambling, two-dimensional symbolism that was Lowry's best unassisted effort. He was consumed with rage at everything and everyone; his violent tirades drove all their friends away.

She tried for years to get him to cut down or stop his drinking, but ended up matching him bottle for bottle, and when he finally found a doctor who got him to take a break (using aversion therapy), she refused to stop, and dragged him down again.

Much of the article deals with the theory that she murdered him, for which many women acquaintances and critics applauded her. It's a thin case. British local authorities, who conducted the inquest, pinpointed asphyxiation by aspiration of vomit as the cause of death. That's not murder. But it hardly matters. Lowry was bent on death by alcohol sooner or later. During one of his few lucid moments, he described his own life as an "alcoholocaust."

If a movie is ever made of this marriage, it should be on a double bill with "Pollock," and made required viewing for young artists considering careers in alcoholism and addiction: don't go there.

Cartoon of the week

From the Nov. 12 New Yorker (which consistently, over time, has published the best addiction cartoons, to my knowledge):

Well said

Sometimes fiction writers (but aren't we all?) say it better than authors of solemn research monographs. In the Fiction section of the current New Yorker, writer Alice Mattison describes a character, Jerry, who, at dinner with his ex-wife and his daughter, shook his head when they suggested a glass of wine:

"... he so enjoyed being exactly as he was that he didn't want even the mild alteration in mood brought on by a glass of Chardonnay."

Well said! "So enjoyed being exactly as he was"!

On this topic, see also Katharine Hepburn, and (much more obliquely) Stereo Sue, or the Quale of Sobriety, both below. Thank you, writer Alice Mattison, for this brilliant little gem, one of several in her story.

Triggers in your ear

Recovering people trying to minimize environmental cues about drinking and drugging should consider staying away from rap music and country music. Rock music, once believed the major gateway to drug abuse, is relatively safe.

Researchers who looked at the bestselling songs in several genres from 2005 found that 37 percent of top country songs featured references to drugs or alcohol, compared to just 14 percent of rock songs. Rap was worst with 77 percent. Source.

A short list of songs about drinking/drugging and NOT drinking/drugging is here, and a long collection of the same is here.

Researchers didn't, but should, look at classical music also. Item No. 1 for my mute-button list is Mahler's Das Lied von der Erde -- an operetta that celebrates being drunk and depressed. Oh, and what about that line in Beethoven's Ninth about being "drunk with fire"? LOL.

Choice Philosophy Gets a Boost

A new publication by William L. White and Ernest Kurtz gives a boost to the principle that persons in recovery deserve a choice (a LifeRing motto, see the top of the start page of www.unhooked.com). Read about it in the LifeRing Convenor blog, here.

Mile wide and an inch deep

Someone said Baptism in the South is a mile wide and an inch deep. Here's an example:

The cleaned-up version:

JOHNSON CITY – A Bristol Virginia Baptist preacher arrested in Johnson City in July pleaded guilty Thursday to driving under the influence.

Tommy Tester, 58, of 17425 Hobbs Road, Bristol, Va., was sentenced to 11 months and 29 days, suspended to 24 hours in jail, 16 hours of which he has already served. He will also have to spend 24 hours picking up litter.

Tester, the minister of Gospel Baptist Church, also entered a “best interest” plea to a charge of indecent exposure and was sentenced to five months and 29 days, suspended to probation.

Police said Tester, who was wearing a skirt, pulled up in his vehicle to Belmont Carwash, got out and urinated in a wash bay in view of children. Source.

The unexpurgated version here. -- Thanks, Kelly C., for the tip

Gender-specific response even in rats

As if to illustrate again what Women for Sobriety founder Jean Kirkpatrick preached decades ago about people, a recent study found different responses to alcohol in female v. male rats. A group of rats selectively bred to be heavy drinkers were exposed to changes in their lights-on v. lights-off schedule, like employees who work rotating shifts, to test the effect of this stress on their drinking. The male rats subjected to the shifting schedule decreased their alcohol intake; the female rats slightly increased theirs. Details.

Recovery of Cognitive Abilities

A study of sober alcoholics in their sixties or later, who had been abstinent for an average of about 15 years, found no cognitive impairment or other brain functioning defect. Details in Alcoholism: Clinical and Experimental Research, November '07. -- Thanks, Deena B., for the tip.

Rays of hope from Recovery Summit

A Recovery Summit under the auspices of the federal Substance Abuse and Mental Health Services Administration (SAMHSA) convened with little fanfare in the winter of 2005, and its report has now been released. Among the "Guiding Principles":

• There are many pathways to recovery. Individuals are unique with specific needs, strengths, goals, health attitudes, behaviors and expectations for recovery. Pathways to recovery are highly personal, and generally involve a redefinition of identity in the face of crisis or a process of progressive change. Furthermore, pathways are often social, grounded in cultural beliefs or traditions and involve informal community resources, which provide support for sobriety. The pathway to recovery may include one or more episodes of psychosocial and/or pharmacological treatment. For some, recovery involves neither treatment nor involvement with mutual aid groups. Recovery is a process of change that permits an individual to make healthy choices and improve the quality of his or her life.
• Recovery is self-directed and empowering. While the pathway to recovery may involve one or more periods of time when activities are directed or guided to a substantial degree by others, recovery is fundamentally a self-directed process. The person in recovery is the “agent of recovery” and has the authority to exercise choices and make decisions based on his or her recovery goals that have an impact on the process. The process of recovery leads individuals toward the highest level of autonomy of which they are capable. Through self-empowerment, individuals become optimistic about life goals.
• Recovery involves a personal recognition of the need for change and transformation. Individuals must accept that a problem exists and be willing to take steps to address it; these steps usually involve seeking help for a substance use disorder. The process of change can involve physical, emotional, intellectual and spiritual aspects of the person’s life.
• Recovery is holistic. Recovery is a process through which one gradually achieves greater balance of mind, body and spirit in relation to other aspects of one’s life, including family, work and community.
• Recovery has cultural dimensions. Each person’s recovery process is unique and impacted by cultural beliefs and traditions. A person’s cultural experience often shapes the recovery path that is right for him or her.
• Recovery exists on a continuum of improved health and wellness. Recovery is not a linear process. It is based on continual growth and improved functioning. It may involve relapse and other setbacks, which are a natural part of the continuum but not inevitable outcomes. Wellness is the result of improved care and balance of mind, body and spirit. It is a product of the recovery process.
• Recovery emerges from hope and gratitude. Individuals in or seeking recovery often gain hope from those who share their search for or experience of recovery. They see that people can and do overcome the obstacles that confront them and they cultivate gratitude for the opportunities that each day of recovery offers.
• Recovery involves a process of healing and self-redefinition. Recovery is a holistic healing process in which one develops a positive and meaningful sense of identity.
• Recovery involves addressing discrimination and transcending shame and stigma. Recovery is a process by which people confront and strive to overcome stigma.
• Recovery is supported by peers and allies. A common denominator in the recovery process is the presence and involvement of people who contribute hope and support and suggest strategies and resources for change. Peers, as well as family members and other allies, form vital support networks for people in recovery. Providing service to others and experiencing mutual healing help create a community of support among those in recovery.
• Recovery involves (re)joining and (re)building a life in the community. Recovery involves a process of building or rebuilding what a person has lost or never had due to his or her condition and its consequences. Recovery involves creating a life within the limitation imposed by that condition. Recovery is building or rebuilding healthy family, social and personal relationships. Those in recovery often achieve improvements in the quality of their life, such as obtaining education, employment and housing. They also increasingly become involved in constructive roles in the community through helping others, productive acts and other contributions.
• Recovery is a reality. It can, will, and does happen.

That's a far better synopsis than one could have expected. Particularly laudable is the recognition, at the top of the list, that "there are many pathways to recovery." Equally enlightened is the acknowledgment that recovery is, at bottom, self-directed and empowering. LifeRing has been making those fundamental points as loud and clear as we are able. It's heartening to hear a gathering of recovery mavens at the national level articulate the same liberating concepts. Even though author William L. White wasn't listed as an author in the report's preface, it sounds a lot like White's New Recovery Movement advocacy. -- Thanks Don Phillips for the tip.

Why some alcoholics find it hard to quit smoking

Joe P. from New Jersey said in an email to unhooked.com:

"The reason most Alcoholics find it so hard (to quit smoking) is because they get NO support from AA members, they tell them not to worry, just don't drink. That way of AA (Majority members, mostly Nicotine Addicts, even though there are a lot of others who say the same thing) is the way of Death!"

Joe should know, he is a long time member of AA who supports Nicotine Anonymous.

Another Court Rules that AA/NA are Religious

A recent court case ruled that a parolee can sue a parole officer for damages if the parole officer requires the parolee to attend 12-step groups such as Alcoholics Anonymous or Narcotics Anonymous when this violates the parolee's religious or non-religious beliefs.

The case is titled Inouye v. Kemna, issued Sept. 7, 2007. The full text of the opinion is here. The court that issued the decision is the Ninth Circuit of the United States Courts of Appeal. The court's ruling is the law in California, Oregon, Washington, Arizona, Montana, Idaho, Nevada, Alaska, Hawaii, Guam, and the Northern Mariana Islands.

Ricky Inouye was imprisoned in Hawaii after conviction on drug charges, and served his time. As a Buddhist, he objected to participating in 12-step treatment programs because of their religious nature. After his release, he sued his parole officer, Nanamori, for giving him the "choice" of AA/NA meetings or prison.

When that case came to trial in the federal court in Hawaii, Nanamori argued that he, a parole officer, could not have known whether AA/NA are "religious" because the law on that issue was foggy at the time he ordered Inouye to participate (2001). If the issue was unclear, Nanamori was immune from suit. Nanamori won on that issue in the lower federal court in Hawaii. Inouye (or rather his son Zenn, Ricky having meanwhile died) appealed to the Ninth Circuit.

The Ninth Circuit's opinion makes short work of the claim that the law was fuzzy on the religious nature of AA/NA. The court points to virtually identical cases decided before 2001 by the federal courts of appeal for the Seventh Circuit (Illinois, Indiana, Wisconsin) and the Second Circuit (New York, Connecticut, Vermont), in addition to a string of similar cases in lower federal courts and in state courts, all with the same result. The "unanimous conclusion" of these courts was that coercing a person into AA/NA or into AA/NA based treatment programs was unconstitutional because of their religious nature. Because the law on this issue was "uncommonly well settled," Nanamori cannot claim immunity.

Accordingly, the Ninth Circuit sent the case back to the lower federal court in Hawaii to decide how much, if anything, Nanamori has to pay Inouye's estate in monetary damages.

The court's ruling means that criminal justice officers -- or, arguably, any agents of the state, local, or federal government within the bounds of the Ninth Circuit -- can be sued for damages if they ignore a client's religious or anti-religious objections and coerce the person to attend 12-step meetings or 12-step based treatment programs.

What should prisoners, parolees, and criminal justice officers do in response to this ruling?

(1) Prisoners and parolees who have problems with the religious content of 12-step programs should stand up for their beliefs and make their objections heard, loud, clear, early, and on paper. In this case, Ricky Inouye won in part because he wrote letters and filed suit promptly after he was coerced into 12-step programs. He held to his position consistently, and enlisted legal help as soon as possible. Prisoners and parolees need to make it clear both in words and deeds that they earnestly want to remain clean and sober, that they are willing to participate in alcohol and other drug treatment programs and to attend support groups, but that the religious content in the 12-step programs violates their constitutionally protected beliefs and interferes with their recovery. Prisoners and parolees can match these words with actions by demanding referral to non-religious (secular) treatment options, if they exist, and by taking the initiative to organize secular support groups, such as LifeRing, on their own.

(2) Officials in the criminal justice system (and other government officials with coercive powers over addiction offenders) need to offer their clients a choice between religious and secular treatment programs and support groups. The "choice" between AA/NA or prison offends the constitution, and officers who insist on it need to check their professional liability insurance. Government officials can help themselves as well as their clients by sending the message to treatment programs that the programs must embody a secular track along with the 12-step track, or risk losing referrals. Officials need to inform themselves and their clients about the availability of secular support group alternatives, such as LifeRing. Where clients take the initiative to organize such support groups, officials need to be cooperative and provide a level playing field when it comes to rooms, publicity, literature, referrals, and other resources. In an appropriate case, officials may take the lead in initiating secular support groups themselves.

The Ninth Circuit decision ruffles some feathers because it contradicts the belief of many AA/NA members that the 12-step approach is "spiritual not religious." Of course, these words can have many meanings. But as far as the First Amendment of the US Constitution is concerned, the 12-step approach is clearly religious, and the Ninth Circuit only joins a "march of unanimity" of other courts who have come to the same conclusion.

The basic thrust of this line of cases is that the constitutional guarantee of freedom of and from religion extends over the whole of the United States, including the ever-expanding areas enclosed by prison walls. Since such a large proportion of prisoners are there because of drug and/or alcohol abuse, this recent ruling serves as an important refresher. Jails and prisons, notoriously in California, are overcrowded and in deplorable condition. The Ninth Circuit's decision says that the freedom of religious belief or disbelief must not go down the drain along with so many other elements of civilized penal treatment.

[On Spring Break]

Sometimes life overwhelms blogging. These past few weeks my days and nights have been so filled with work, love, and remodeling -- not necessarily in that order -- that there hasn't been time to keep up with the blog. I haven't even had time to watch the 14-part HBO addiction marathon. I'll be back when things settle down. -- Marty N.

Canada prof surprised by 12-step religious content

Prof. Larry Moran in the Department of Biochemistry at the University of Toronto (photo) wrote in his blog that he read the articles about Alcoholics Anonymous in the March issue of Readers Digest (Canada) and then read the text of the twelve steps, and was "surprised at how religious AA must be. They must think that most alcoholics are Christians." This led to a lively exchange of comments, which see.

Reviews Pan Bill W bio-drama

March 6, 2007, N.Y. Post:

Who would have guessed a drama about the founders of Alcoholics Anonymous would be the laugh riot of the year? But that's the unfortunate result of "Bill W. and Dr. Bob," the well-intentioned but haplessly executed effort written by novelist Stephen Bergman and clinical psychologist Janet Surrey that opened last night.

What should have been a powerful and inspirational story plays instead like a drunken road-show version of "The Producers."

Read full review

Broadway World.Com's reviewer writes:

A program note for Stephen Bergman and Janet Surrey's Bill W. and Dr. Bob advises us that performance of the work does not imply affiliation with nor approval or endorsement from Alcoholics Anonymous World Services, Inc.

Smart move, A.A.

Doing for alcoholism what Reefer Madness did for drug abuse (or at least what its New World Stages neighbor Sealed For Freshness does for Tupperware), Bill W. and Dr. Bob is a frightfully melodramatic bio-drama which uses the same kind of character-probing sensitivity one might find in a driver ed movie to tell the story of two men who, in dealing with their own demons, developed the treatment techniques that would birth Alcoholics Anonymous.

... The authors turn their heroes and everyone around them into cardboard cutouts ... while I can't imagine anyone feeling inspired or enriched by this misdirected corn, I know a few more evenings like this could have me swearing off theatre for a while.

Source.

Belgium ups the ante with cig warnings

Cigarette packs sold in Belgium will soon have vivid pictures of the harm that smoking does, along with text warnings.

The pictures are not for the faint-hearted. One shows a man with a swollen-red tumour protruding from his neck. "Smoking can lead to a slow and painful death," reads the advice underneath. Another shows a smoker in a prison cell clutching bars made of cigarettes. The moral of the story? "Smoking is addictive. Don't start." Other pictures the Belgian government plans to rotate over the next three years show toothless gums, blackened lungs and open-heart surgery.

Canada already uses pictorial warnings along with text. Other European countries are expected to follow suit.

EU Health Commissioner Markos Kyprianou, introducing the new policy, said: "Pictorial warnings are a cost effective public health measure, which not only serve as a prominent source of health information, but are also likely to reduce tobacco use in the population." More.

Drug problem in Afghanistan getting worse, UN says

NEW YORK: Despite efforts by the Afghan government and the international community, the drug control situation in the country is worsening, the International Narcotics Control Board (INCB) said in its annual report.

The production of illicit opium poppy in Afghanistan reached a record 6,100 tons in 2006, up almost 50 percent from the previous year, the report said.

Due to a rising level of Afghan opiate trafficking, the Vienna-based UN drug control watchdog added, the neighbouring countries are now faced with a wide range of problems, "such as organized crime, corruption and relatively high illicit demand for opiates."

Moreover, the drug abuse by injection is increasingly becoming one of the main factors behind the widely spread of HIV/AIDS in some areas of the region. Source.

Prisoners take hostage for nicotine

JOHNSON CITY, Tennessee -- Two inmates housed in a smoke-free prison took a guard hostage and then released him and returned to their cells when given cigarettes.

Billy Grubb, 32, and Bradley Johnson, 25, attacked the guard Monday night, said Howard Carlton, warden of the Northeast Correctional Complex. Both are in prison for murder.

Prisons across the state are instituting no-smoking policies after the Legislature passed a law banning smoking in state buildings. -- Source

Anonymity is only for the anonymous

Once again Alcoholics Anonymous has lent its name to the publicity thirst of another bratty celebrity. This time it's Britney Spears, whose publicist let the world know that she was given a pass from her upscale Malibu treatment program to attend an AA meeting. E.g. Source. Millions of 7-year old girls will now make a mental note to become alcoholics and get their names in the paper by going into rehab and to AA. It's great promotion for AA and for the celebs. But it reinforces the two-class system in AA. If you're in the celebrity class, your AA membership glitters like a glass pebble in a brightly lit goldfish bowl. If you're not a "name," you're in the dark. Anonymity is only for the anonymous. What would Bill W. say?

Bhutan: South Asia's alcoholism capital

Bhutan has the highest per capital alcohol consumption of any country in South Asia, says a World Health Organization report, and alcoholism is becoming one of the leading causes of death there. Source.

State Dept drug report plays politics

The U.S. State Department report on the worldwide illegal drugs trade issued March 1 reads like a political propaganda bulletin more than a real research report. Regimes that have Bush administration support, such as Colombia and Afghanistan, get patted on the head for their alleged drug control efforts, while heads of state that give Bush hell (as in Venezuela, Bolivia, and others) get blasted for alleged complicity in the dirty business.

The facts remain -- and the report admits -- that Colombia produces 90 per cent of the world supply of cocaine, and Afghanistan supplies more than 90 per cent of the heroin, and both are close allies of the Bush administration. Neither Colombia nor Afghanistan could achieve anything remotely near this kind of market domination without at least the active benevolence of their respective governments.

The report, which runs to 9 megabytes in PDF online (Vol. 1 here and Vol. 2 here), shows its political bias most transparently in the summary on Afghanistan. While admitting that Afghan opium production increased 25 per cent last year, the report claims that heroin stemming from Afghan opium is distributed almost exclusively in Europe, Russia, the Middle East and Asia. It claims that most of the heroin sold in the U.S. comes from poppies grown in Colombia and Mexico, which together account for only four per cent of the world supply.

The State Department strains credulity when it asks us to believe that the huge U.S. heroin demand is fed by this relative trickle of supply. The report says in one passing sentence that "Heroin produced from Afghan opium also finds its way to the United States" (Vol. 1, p. 19) but makes no effort to quantify this grudging admission.

The presence of Afghan heroin in the United States is a political landmine for the Bush administration. The bumper crops of opium recorded in Afghanistan since the invasion are unmistakably the administration's baby. To protect the administration, the State Department, the U.S. Drug Enforcement Administration and the White House Office of National Drug Control Policy all repeat the fairy tale that Afghan heroin in the U.S. is insignificant. But local police and treatment staff in many parts of the U.S. know better. Search this blog under "Afghanistan" for a selection of local news stories, many of them from the heartland, about heroin addiction and overdose deaths due to the high-potency white powder heroin made in Afghanistan under the protection of American troops by a regime propped up with American taxpayer dollars.

WHAT war on drugs?" As Gandhi reportedly said about Western civilization, "I think it would be a good idea."

New drug turns meth to almond extract

A newly discovered drug with the catchy name YX1-40H10 can convert methamphetamine to benzaldehyde, a common food additive with an almond flavor, scientists at the Scripps Research Institute in California claim. If it passes a series of safety and efficacy tests, the new compound could be administered to people who have taken methamphetamine to neutralize the drug in the body. Source.

Research: impulsive rats quicker to do cocaine

Rats who rank high in impulsivity -- the abstract doesn't make clear how that was measured -- are more likely to self-administer intravenous cocaine than their less impulsive peers, a group of scientists at Cambridge University has found. The study, led by Jeffrey W. Dalley, is significant because it found that the impulsive rats had a substandard set of dopamine receptors before being exposed to cocaine, thus supporting the hypothesis that dopamine receptor deficiency is a precondition, rather than a result, of chronic stimulant consumption. The study appears in the March 2 issue of Science. Abstract.

While the study sheds light on stimulant use, this model will not transfer so easily to other drug use profiles, particularly opiates and depressants such as alcohol.

IndyCar racer busted for DUI

IndyCar Series driver A.J. Foyt is facing charges for driving under the influence of alcohol in Mecklenburg County, North Carolina.

The 22-year-old, who lives in Huntersville, N.C., was arrested on December 10 after running a stop light. He was released after posting a $1,000 bond, and will have to appear in court on April 9 to answer to the DUI charges. Source.

New Recovery blog reader Taylor M., who contributed this item, writes:

It will be interesting to see how the IRL handles this- especially given how backwards they are about tobacco and how much alcohol sponsorship is worth to the racing industry in general. It is interesting to note that drinking alcohol at all is generally considered a no-no in pro racing, most drivers only drink on the podium. There are some notable exceptions (Kimi Raikkonen ) but mostly it's frowned upon even if alcohol sponsorship isn't.

Brief skills training is effective to curb college drinking

A study in Swedish colleges, where over-use of alcohol is widespread, showed that a Brief Skills Training Program was effective in reducing alcohol consumption over a two-year period.

Students were randomly assigned to a brief skills training program (BSTP) with interactive lectures and discussions, a twelve-step–influenced (TSI) program with didactic lectures by therapists trained in the 12-step approach, and a control group. More than three quarters of the students were rated "high risk" on an alcohol consumption score.

At follow-up two years later, the high-risk students who had received the BSTP program showed significantly better outcomes than high-risk students who had undergone TSI. The TSI students did no better than the control group.

The study results are in the March issue of Alcoholism: Clinical and Experimental Research. Abstract.

UK: "Restricted" report urges Rx heroin

The government should consider providing free heroin to hard-core addicts through the National Health Service as a way to reduce crime, says a top-level report by the UK Home Office.

Marked "restricted" because of its controversial recommendations, the document was leaked to The Independent.

There is mounting evidence that trying to restrict the supply of drugs is impossible, says the document. Even if partially successful, supply restriction merely drives up the price of drugs and drives addicts to commit more crimes.

The report comes in a setting where cheap and potent Afghan heroin in unprecedented volume has been flooding into the UK from all ports of entry.

"There is a strong argument that prohibition has caused or created many of the problems associated with the use or misuse of drugs. One option for the future would be to regulate drugs differently, through either over-the-counter sales, licensed sales or doctor's prescription." Source.

For a historical review of similar policy recommendations, see the Transform Drug Policy web site.

Methadone abuse a growing killer

When given in small, controlled doses, methadone is a well-documented treatment for heroin addiction. But taken in larger doses, without adequate medical supervision, and in combination with other drugs, methadone can be a drug of abuse, addiction, and death.

A federal government study found that nationwide methadone-related deaths climbed to more than 3,800 in 2004 from about 780 in 1999. Among all narcotic-related deaths in 2004, only cocaine killed more people in the United States than methadone. More from the Baltimore Sun.

Canada Readers Digest publishes "12 Steps to Nowhere"

The Canada edition of Readers Digest has published an abbreviated version of award-winning journalist J. Timothy Hunt's article "Twelve Steps to Nowhere," which originally appeared in Toronto's Saturday Night magazine (offprint here). The piece is the author's personal story of recovery from severe alcoholism -- a recovery in which the author thoroughly investigated but strongly rejected the 12-step approach. Although some 60 per cent of successful recoveries from alcoholism occur outside of and without AA (Source), few and far between are the published personal narratives of non-AA recoveries. Readers Digest's publication of Hunt's compelling autobiographical essay hopefully signals a more evenhanded attitude toward all recovery pathways (at least north of the border). Read the piece in Readers Digest.

Drug dealers high on Bush pardon list

"George W. Bush Likes Those Drug Dealers When It Comes To Pardons," says the Eye on Washington blog. Citing a complete listing of pardons in Wikipedia, the blog says that 14 of 113 Bush presidential pardons were for convicted dealers of marijuana, hashish, cocaine, methamphetamine and other drugs. Source.

Monkeys demonstrate nicotine reward

Squirrel monkeys in cages will press a lever up to 600 times to get a shot of nicotine, researchers at the National Institute on Drug Abuse (NIDA) have found. The study demonstrates that nicotine has the same rewarding effect in nonhuman primates as other drugs of addiction. Source.

Moderation group said to be booze industry front

The organization DrinkWise Australia, which was established to promote responsible drinking, claims to be independent, despite receiving millions of dollars from the alcohol industry whose representatives make up half its 12-member board.

The organisation received $5 million in Federal Government funding last year to raise awareness of alcohol misuse and "change the drinking culture in Australia". However, DrinkWise's credibility is now being questioned following the resignation of the chairman of its research advisory committee and accusations it is a front for the alcohol industry. More.

Nicotine, cocaine, heroin lead to similar brain damage

A study of the brain tissue of deceased former smokers has found chemical alterations similar to the brain damage that cocaine and opiates cause in laboratory rats, according to researchers at the National Institute on Drug Abuse (NIDA). Abstract. Discussion.

U.S. docs more likely to warn minorities about drinking

American doctors are twice as likely to warn African-American and Hispanic patients about drinking and drug use than white patients, a study by Harvard professor Kenneth Mukamal, M.D. (photo) has found.

"Yet blacks are less likely to be binge drinkers than whites," he said.

"It would be naive to disregard the possibility of racial bias or stereotype toward blacks and Hispanics in medical settings and assume that the difference in who gets counseling about alcohol use is coincidental," said one commentator.

Doctors should be asking about alcohol use, but should be asking about it across the board, Mukamal said. Details.

Ban all booze ads, top UK doc says

London: A leading doctor says all advertising of alcohol must be banned in a bid to curb Britain's growing drink problem.

The comments by the head of the Royal College of Physicians come as latest data show alcohol-related deaths in the UK have doubled in the past 15 years.

Professor Ian Gilmore said the measure was necessary to protect children who were influenced by sporting heroes wearing branded clothing. -- More

Colombia: Minister resigns over drug gang scandal

The foreign minister of Colombia resigned Monday as the government of President Álvaro Uribe, the Bush administration's closest ally in South America, struggled with a scandal that has disclosed ties between paramilitary cocaine-trafficking squads and some of Mr. Uribe's most prominent political supporters.

The scandal (which surprised nobody) comes at a time when the U.S. Congress is considering extension of the so-called "free trade" agreement with the Colombian government. Blogger Jonathan Tasini (Huffington Post) writes that "free trade" has meant flooding Colombia with cheap imported grains from highly subsidized U.S. agribusiness corporations. This drives local farmers out of business and forces them to switch to growing coca for the well-connected drug gangs. Source.

Alcoholics have trouble reading facial expressions

Alcoholics are poor at reading facial expressions that signal emotions, and this deficit predicts relapse, researchers in Belgium have found.

The researchers presented alcoholics in a treatment program and a matched control group with a series of photographs showing emotional facial expressions (EFE) and asked them to identify the emotion displayed and its degree of intensity. Alcoholics consistently lagged on this test. Moreover, individuals who were at the bottom of the scale in this skill were very liable to drop out of treatment and relapse.

Skill at recognizing emotional expressions did not improve after only three months of abstinence, the researchers found.

Marie-Line Foisy, a researcher at the Universite Libre de Bruxelles and corresponding author for the study, said, "It may be that alcoholics with more severe difficulties in recognizing EFE also have more difficulties in dealing with the conventional detoxification process," said Foisy. "They may also benefit from specific training programs aimed at improving EFE recognition, or more general interpersonal skills." Source.

Comment: This research suggests that alcoholics may benefit from a support environment that provides peer feedback, a key element in improving recognition of other people's feelings and in raising one's interpersonal skills. Meetings that incorporate feedback ("crosstalk") appear to have a distinct clinical advantage along this dimension.

Hotel chain goes smoke-free

SILVER SPRING, MD.—Choice Hotels International has announced that its 433 Comfort Suites hotels in the United States will go 100 percent nonsmoking as of May 1. The 433 properties represent 34,000 rooms. According to Kimberly Shells, Senior Director, Brand Strategy for Choice, the decision to go smoke free was driven by research.

“We conducted research among guests and franchisees,” Shells says. “The vast majority of them supported it. It really is for our guests. We found that the vast majority of guests prefer a smoke-free environment.”

Ten percent of U.S. Comfort Suites hotels already are 100 percent nonsmoking. The other properties will transition to that status by the end of April.

“We are extremely excited about this opportunity to increase guest satisfaction,” Shells says. “It is an opportunity to differentiate ourselves and attract new guests to the brand.” Source.

The move follows similar decisions by Westin and Marriott. Source.

Denver pot advocate shot and killed in his home

CBS4) DENVER A Denver man well-known in Colorado's medical marijuana community was shot and killed Saturday night after his house was broken into.

Ken Gorman, an outspoken advocate for legalizing marijuana, grew pot in his home on the 1,000 block of South Decatur Street, and allowed reporters to film the plants.

Denver police said they are investigating the shooting, but were releasing few details Sunday afternoon. Family members told CBS4 Gorman was the victim in the crime. More.

Take alcoholic parents' kids away, Scot says

ALCOHOLIC parents should have their kids taken from them in the same way as heroin addicts, one of Scotland's top addiction experts has claimed.

Professor Neil McKeganey, a former government adviser, has accused social services of double standards when dealing with heroin and alcohol addiction.

The respected academic has said children of parents who refuse to give up drink are suffering neglect as serious as those of drug addicts.

McKeganey, director of the Centre for Drug Misuse Research at Glasgow University, has warned the Scottish moralistic attitude to drugs means well-meaning social workers are failing thousands of Scots youngsters.

Social workers are often reluctant to remove children from the homes of alcoholics while the use of illegal drugs such as heroin is seen as far more serious. More.

Wyoming: More than half of arrests due to alcohol

Casper, WY: When the Wyoming Sheriffs and Chiefs Association surveyed jails in 2005, the results were astonishing: alcohol played a role in about 55 percent of arrests for all crimes, and people brought in for driving under the influence were more intoxicated than suspected.

But, reporting from detention centers was spotty enough to prompt a new round of data collection, with researchers hoping for a more solid picture of alcohol’s role.

The new findings presented to the Governor’s Substance Abuse and Violent Crime Advisory Board, showed that alcohol is a factor in 62 percent of all arrests. And, when alcohol is involved, people arrested for crimes ranging from domestic violence and underage drinking to assaults and warrants were far worse than legally intoxicated, with an average blood alcohol content of 0.159, nearly twice the legal limit of .08.

The new data was collected in every county during a six-month period in 2006 through survey forms completed by law enforcement officers in detention centers, said Ernie Johnson, a management consultant to the sheriffs and chiefs association and the study organizer.

“It really opened our eyes,” Johnson said, adding that the data clearly indicates alcohol is Wyoming’s top substance abuse issue. More.

Kids turn tables on parents

Hartford, CT: Every spring, when prom and graduation season arrives, parents and teachers warn teens about the dangers of using drugs or drinking alcohol. This spring, a group of civic-minded teens at Haddam-Killingworth High School is turning the tables on the adults.

The Youth In Action group is creating a 30-second television ad that urges parents to stop allowing children to hold drinking parties in their homes. The "Where do you draw the line?" ad will run on the local cable-access channel this spring.

"House parties are a big thing around here," senior Shalyn Carey said. "Where are the kids getting the alcohol? From their parents. Parents play just as big a role in their kids' partying as the kids do. We're saying, `Be a friend to your kid, but be a parent, as well.'" More.

Epidemic of child alcoholism in Britain

London: Children as young as 12 are being diagnosed as alcoholics amid growing concerns about binge-drinking in Britain, an investigation by The Independent on Sunday reveals today.

Record numbers of pre-teens and teenagers now require hospital treatment for drink-related disorders, the exclusive nationwide survey shows.

The findings prove there is a hidden epidemic of child alcoholism, resulting in thousands of youngsters being treated in hospital each year for alcohol poisoning, liver disease and drink-related psychiatric illnesses.

Doctors warn that conditions such as cirrhosis of the liver are now starting to appear in people who are still in their teens, prompting calls for special detoxification clinics to be set up around the country for teenage drinkers.

Dr Claire Casey, head of a new youth detox unit at the private Priory Group, said: "We have children presenting with all the adult symptoms of alcoholism. Some are so addicted that it is actually dangerous to get them to stop drinking straight away.''

New figures reveal that Britain's teenagers are drinking twice as much as they did a decade ago, with half of all 13-year-olds consuming more than 10 units a week. The amount being consumed by 11- to 13-year-olds has gone up almost threefold in the same period, with doctors citing the cultural shift towards 24-hour drinking.

They are also worried that the drinks industry is deliberately targeting the young, promoting alcopops - heavily sweetened, attractively packaged alcoholic drinks - and offering alcohol at historically low prices. Source.

Drunk dad lets boy, 11, drive car

Florence County, SC: A local man has been arrested on charges he allowed his 11-year-old son to drive the family car while the father was drunk in the passenger seat, sheriff’s Capt. Todd Tucker said.

The boy’s 9- and 4-year-old siblings were also in the car Friday morning, Tucker said. A deputy dropping his child off at Coward Elementary School said he saw the 11-year-old boy driving the car. The boy’s father, Joddy Deam Morris, was drunk in the vehicle, Tucker said. Source.

Girl sets drunk woman on fire

Saskatchewan, Canada: A 12-year old girl, part of a group of kids of similar age, set fire to a woman who had passed out drunk outside a bar. The victim required several weeks of treatment in a burn unit. The girl was found guilty of aggravated assault. At sentencing, she expressed regret. Source

New Mexico tries talking urinals

RIO RANCHO, New Mexico (AP) - New Mexico is hoping to keep drunks off the road by lecturing them at the last place they usually stop before getting behind the wheel: the urinal.

The state recently paid US$21 each for about 500 talking urinal-deodorizer cakes and put them in men's rooms in bars and restaurants. When a man steps up, the motion-sensitive plastic device says, in a woman's voice that is flirty, then stern: "Hey, big guy. Having a few drinks? Think you had one too many? Then it's time to call a cab or call a sobre friend for a ride home."

The recorded message ends: "Remember, your future is in your hand."

The talking urinal is the latest effort to fight drunken driving in New Mexico, which has long had one of the highest rates of alcohol-related traffic deaths in the United States. (Men account for 78 per cent of all drunk-driving-related convictions in the state.)

Scalia daughter arrested on DUI charge

WHEATON, Illinois (AP) -- Supreme Court Justice Antonin Scalia's daughter was arrested this week and charged with driving under the influence of alcohol and child endangerment, officials said Wednesday.

Ann S. Banaszewski (mug shot photo) 45, of Wheaton, was arrested Monday evening while driving away from a fast-food restaurant in the suburb 20 miles west of Chicago, police said.

Three children were inside Banaszewski's van when someone called police to report a suspected intoxicated driver, said Deputy Chief Tom Meloni. More.

Scalia, who has nine children, is a leader of the neoconservative wing on the U.S. Supreme Court.

Director: Restore treatment budget cuts

The Central Texas Treatment Center has gone from 60 to over a hundred beds. It's at its capacity right now, and there's a waiting list.

Several years ago, the state cut funding to drug treatment. Now directors say the state needs that back.

"If you want your folks working and paying taxes and raising their families, then by all means, they need to come to treatment," said Kay Baker, Director, Central Texas Treatment Center. "If you want them in prison watching TV, wasting taxpayer dollars, then don't send them to treatment." More.

Fed brief backs "sober houses"

Boca Raton, FL: Federal prosecutors here filed a brief opposing a city zoning rule that would bar "sober houses" from residential neighborhoods.

Filed on behalf of the owner of two large "sober house" apartment buildings, the brief says the facilities are housing for the disabled and therefore clearly exempt from the city's zoning jurisdiction.

Opponents argue that the facilities provide treatment and are commercial in nature, and therefore should be confined to commercial districts.

Read details here. Another angle on sober houses, here.

A likely story

Baton Rouge LA: After backing her car into a government vehicle in the Attorney General's parking lot, Assistant Attorney General Debbie Baer told police that she was driving a fellow Alcoholics Anonymous member who had begun drinking again and left a strong odor of alcohol in her car.

The Louisiana Attorney General's Office says Mrs. Baer has been placed on administrative leave while they investigate the matter.

Afghan war and suburban heroin deaths: Putting it all together

At least one blogger has begun to put the pieces together: Young suburban white kids in the Midwest dying of powder heroin overdoses and suburban Midwest Republican politicians -- more or less the parents of these same kids -- rabidly supporting the wars in Afghanistan and Iraq:

It seems almost scary, but is it possible that the wealthy in this country have in effect sold their children to the Afghanistan drug lords through their greed, blind patriotism and hatred?

See more reflections along this line in Crawford's Take.

Great success in war on drugs: Teens turning to Rx drugs instead

The White House Office of National Drug Control Policy issued a report Feb. 15 citing great successes in the war to reduce teen use of illicit drugs ... but an alarming upswing in teen use of prescription drugs such as Oxycontin to get high. Details.

Congratulations Drug Czar John P. Walters on this great achievement in national drug policy.

New study confirms dopamine depletion

A researcher at the University of Buffalo's Research Institute on Addictions (RIA) has found a change in the brain that occurs after drug use and that may contribute to drug addiction.

The finding, reported in the January issue of Biological Psychiatry, demonstrates that repeated exposure to different types of drugs of abuse, such as cocaine, nicotine, amphetamine and alcohol, lead to a persistent or long-term reduction in the electrical activity of dopamine neurons in the brain.

Dopamine neurons are the origin of the reward pathway responsible for the "feel good" experience that is such a strong component of drug use and abuse.

"A persistent reduction in dopamine neuron electrical activity after repeated exposure to different types of drugs appears to be the result of excessive excitation of dopamine neurons," according to Roh-Yu Shen (photo), a neuroscientist and the lead investigator on the study. "This represents a new and potentially critical neural mechanism for addiction and provides a working model that suggests how the reward pathway function is altered and how these changes can be responsible for triggering intense craving and compulsive drug-seeking." Source.

Annapolis: New rules decimate drinking

Donny Bailey, manager of a bar and restaurant popular with students at the Naval Academy in Annapolis says "Drinking has declined so much, it's scary. They can't drink 20 shots like they used to. Ever since the rape last year, it's gone down. They just get in too much trouble."

Following a series of sexual crimes linked with alcohol last fall, the Academy adopted new rules that prohibit all underage drinking. Students over 21 are limited to one drink per hour and three drinks on any given evening, not to exceed 0.08 blood-alcohol content, the legal standard for drunken driving in Maryland and many other states.

Those who fail random breath tests are counseled the first time, but those caught twice, or with higher than a 0.15 blood-alcohol content, can be disciplined with restriction to the dorm, 5 a.m. marches and even expulsion. Academy authorities said that enforcement has been strict and effective.

In a recent memo, the student drug and alcohol coordinator warned of infractions and urged students to take the policy to heart. Source.

Parental ATOD use leads to behavior problems in children

Children whose parents used alcohol, tobacco or other drugs including cocaine while pregnant or in their infancy exhibit greater behavior problems through age 7 than other children, a study published in the February issue of Pediatrics has found.

"Our findings highlight not only a need for continued prevention and treatment programs that are directed toward illegal drug use but also a call for increased effort toward prevention of tobacco and alcohol use, which is a more prevalent problem and has as great an impact on childhood behavior problems as prenatal cocaine exposure," the study's authors write.

Source.

Two more go smoke-free

The Merritt-Peralta Institute (MPI), the oldest adult residential addiction treatment facility on the West Coast, went smoke-free in January, its clinical coordinator Terry Arnold announced.

The MPI program is located in the Alta Bates-Summit-Providence Hospital complex in midtown Oakland, CA. The smoking ban ends a long-standing anomaly where the only location in the block-long complex that permitted patients to smoke was the addiction treatment center.

Meanwhile the Kaiser hospital complex in Vallejo CA declared a smoke-free policy covering the entire campus, including parking lots and sidewalks. The "smokers' huts" that previously enabled smokers were dismantled. Source.

Afghanistan: Whole villages addicted

Elizabeth Bayer, formerly of the U.N. Office on Drugs and Crime (UNODC) in Afghanistan, reports:

"There are villages in the north of Afghanistan where the entire population is addicted to opium. Mothers in carpet weaving districts take opium to ease muscle aches earned from spending long days at the loom, and give it to their children to keep them quiet."

Says Bayer: "There is no education, no awareness of the harm that opium causes. People here have been traumatized. If they can find something to relieve the pain, they will take it." From Time magazine 2/14/07.

South Carolina bill would require treatment for all DUI offenses

Durham, S.C.: Convicted drunken drivers would have to participate in alcohol treatment programs — even if they didn’t want their driver’s licenses reinstated — under a bill introduced Tuesday that would rewrite the state’s DUI laws.

The mandated treatment is needed because many convicted offenders choose to drive on suspended licenses rather than pay to go through treatment programs to get their licenses back, supporters say.

Such drivers conservatively total in the thousands annually, said Lee Dutton, spokesman for the S.C. Department of Alcohol and Other Drug Abuse Services. Source.

No mention so far in the coverage of this controversial bill whether the mandated treatment will be secular, or include a secular option, as required by federal appellate decisions.

NET for heroin gets boost in Scotland

Jack McConnell, Scotland's First Minister, has called for a radical shake-up in Scotland's drug rehabilitation policy after witnessing a controversial new heroin addiction treatment in action.

He said that Scotland must seek to abandon the methadone programme and look instead for new, drug-free methods of kicking heroin.

His comments came after he visited a trial of neuro-electric therapy (Net, promo photo from website), a drug-free addiction treatment, invented by a Scottish neurosurgeon, Dr Meg Patterson.

At the trial, Mr McConnell met six female heroin users who are undergoing a seven-day course of Net. The treatment involves a weak electric current being applied to the brain.

Laura, 28, a mother of two, has been a heroin user for seven years, but has failed to quit using methadone. She told the First Minister she had been "amazed" by how quickly her cravings for heroin had disappeared while undergoing Net.

Afterwards the First Minister spoke of his desire to see Net given a full clinical trial, with a view to making it available on the NHS.

He said, "I'm very keen that we find a way of progressing to a proper research proposal so that Net can be tested in the conditions that will meet the standards of the National Health Service.

"If this is successful, then this treatment could operate on a scale that can make a huge difference to people's lives." Source.

New "Science of Addiction" booklet by NIDA

The "Science of Addiction" booklet published by the National Institute on Drug Abuse (NIDA) on Feb. 13 breaks new ground. It's the first government publication that tries to summarize current scientific knowledge about addiction and addiction treatment in a format accessible to the literate lay person.

The 36-page booklet can be downloaded as a web file here or as a PDF file here. Free paper copies can be ordered online. It should be quite useful to persons trying to get a grip on their own experience with addictive substances, to persons in relationships where addiction is an issue, and to educators, people in the media, and treatment professionals.

Mom sues frat, college over boy's alcohol death

Boulder, CO: The mother of Gordy Bailey (photo), a Colorado University freshman who died of alcohol poisoning at a fraternity initiation in 2004, is suing the fraternity and the university for negligence and reckless misconduct.

A superior court judge has ruled that the lawsuit can go ahead and has set a March 2008 trial date. Source.

A coroner revealed that after Bailey had passed out, his fraternity brothers marked up his arms, legs and trunk with racial and sexual slurs, said the young man's father, Lynn Gordon Bailey.

"This reinforces the nearly unbearable pain of the whole thing," Bailey said. "Was he dying while they were writing that?"

When it became apparent that the 18-year-old was not breathing, and police were going to be called in to investigate, someone tried to wipe off the slurs that were written on his face with a felt-tip marker, police said. Source.

Bailey's death has similarities to the fate of Phanta "Jack" Phoumarrath at the University of Texas, Austin. Link.

People underestimate power of addictive cravings

People systematically underestimate the power of cravings for addictive drugs, says a new study sponsored by the Carnegie-Mellon Institute. The study measured what people addicted to heroin would give for a dose of the medication buprenorphine, a heroin blocker, when their cravings were highest v. when they had just received the drug and their cravings were at their lowest.

People play around with addictive drugs because they don't believe that they will become hooked, says Professor George Loewenstein, lead author of the study. Similarly, people without personal experience of addiction have no clue to the compelling force of the addict's craving, once addiction is established. Source.

Even low levels of second-hand smoke cause heart risk

Even low-level indirect exposure to cigarette smoke is associated with a significant rise in heart disease risk in new research conducted by researchers from the U.K.'s University of Nottingham.

The study is the first to directly measure secondhand smoke exposure through levels of a nicotine byproduct in the blood. Previous studies have relied on participants' recall of exposure.

Compared with people in the study with no detectable exposures to nicotine, those with low- and high exposure levels also had significantly higher levels of two important markers of heart disease risk.

"These findings suggest that secondhand smoke exposure has a clinically important effect on susceptibility to heart disease, even at relatively low levels of exposure, and they highlight the importance of minimizing the public's exposure to secondhand smoke," researcher Andrea Venn, PhD, stated. Source.

Catch-22 for mandated treatment in UK

Britain's drugs problem should be treated predominantly as a medical rather than a criminal issue, says a major upcoming report by a group of law enforcement and medical authorities.

The report says that drug users are typically sent to treatment only after they have been caught for committing a crime, a time when they are frequently not ready for treatment and do not benefit from it. Meanwhile drug users who have not committed crimes but wish to have treatment for their addiction are unable to get it because the programs are full. Details.

Full Nelson: Teacher snorts coke in front of class

A retired elementary school teacher working as a substitute snorted cocaine through a pen cap in front of her 4th-grade class -- and some of the students (aged 10) recognized what she was doing and reported her. Joan M. Donatelli, 59, was charged with criminal possession of a controlled substance and two counts of endangering the welfare of a child. Details.

UK soldiers snorting cocaine on video

GLASGOW, Scotland (UPI) -- The British military is conducting an internal investigation over video of troops in Scotland allegedly snorting cocaine in their Glasgow barracks.

The video was taken by a soldier in the Royal Regiment of Scotland with a cell phone, and given to The Daily Record newspaper, which contacted military authorities. Source.

Afghanistan: "The poppy will eradicate us"

From a World Politics Watch article by freelancer Jason Motlagh:

As the Taliban makes headway in the south and east, the largest-ever opinion survey shows one-fifth fewer Afghans believe the country is moving in the right direction compared to the eve of 2004 elections. Contempt mounts each day against President Hamid Karzai for failing to hold members of his government accountable. According to Crisis Group, his Anti-Corruption and Bribery Office has a staff of some 140 and has been operating for over two years but has yet to obtain a conviction. U.S. Defense Department and European officials say at least half of all Western aid does not reach those who need it. Drug-related corruption is most problematic at the local-regional level, though a number of state employees told me the trail leads all the way back to Kabul, where suspiciously lavish homes interrupt otherwise drab neighborhoods. Perhaps no one has defined the situation better than the embattled president himself: "If we fail to eradicate poppy, the poppy will eradicate us."

Read the full article.

More light on genetic basis of nicotine addiction

Two studies in the January 2007 issue of Human Molecular Genetics confirm previously suspected genetic linkages to nicotine addiction and identify an additional gene, Neurexin, that appears to play a significant role in determining whether a smoker becomes hooked.

Laura Jean Bierut, M.D., associate professor of psychiatry and principal investigator of both studies, says that a large number of genes are probably involved in nicotine dependence, and understanding how they work may make it possible to develop new treatments for smoking cessation. Source.

More ex-smokers than smokers in US now

SEATTLE--(BUSINESS WIRE)--Last year marked the tipping point in the fight against tobacco addiction according to Free & Clear®, a national leader in coaching-based tobacco dependence treatment. The United States now has more former smokers than current smokers. Further, over half of Americans now live in a city or state that is smoke-free. In 2006, seven states and 116 cities, including Washington, DC, enacted local smoke-free laws, bringing the total up to 22 states and 577 municipalities.

Still, the struggle to quit remains a formidable challenge. Recent studies demonstrated nicotine levels in cigarettes actually increased over the past ten years. Even more troubling, recently published surveys indicate the decline in smoking prevalence in the United States leveled out in 2004 at 21%. While the vast majority of smokers want to quit, over 45 million adults still use tobacco in the United States despite significant adverse consequences to themselves and their family members, friends, and employers. Source.

Chinese herbs better than nicotine patches?

Darlington, UK: A patch containing Chinese herbs is more effective at helping smokers quit than the conventional nicotine patches, according to Dr Philip Cheung, former director of Durham University's Centre for Comparative Public Health. Dr. Cheung says the herbal treatment has helped six million Chinese quit, and works more quickly at less cost than the nicotine patches. Source.

Upscale treatment centers chafing at 12-step

The Betty Ford treatment center, once the very icon of celebrity rehab, is being upstaged by a slew of newer and tonier facilities, many of them dumping Ford's you-can-have-any-program-you-want-so-long-as-it's-12-step model.

So says a survey of upscale inpatient facilities in the Feb. 19 Newsweek. Ford, which at last report charges $38,000 for a 28-day stay, is now on the low margin of the upmarket segment. There are programs that charge up to $100,000 for the same stretch. They include Malibu sunsets, equine encounters, Native American talk circles, gourmet cuisine, and -- more important -- elements of cognitive behavioral therapy, Motivational Interviewing, pharmacological treatments and other modern therapeutic approaches.

Newsweek's article quotes Chris Prentiss of Passages Malibu, an upscale facility that has dumped AA altogether. Prentiss says that AA's "emphasis on helplessness in the face of addiction makes people feel stupid and ashamed." Other providers talk in more guarded terms, but the trend away from exclusive reliance on the 12-step model is remarkable. What the high-priced celebrity showcases offer today, the K-mart treatment shops will be trying to copy tomorrow. Without the hot tubs, the sunsets, or the horses.

For a listing of non-step or steps-plus treatment facilities, click here.

Half of sexual assault victims had been drinking

According to national statistics, about 50 percent of all women were under the influence of alcohol when they were victims of a sexual assault. Source.

Stores sell liquor to white teen using black ID

Carson City, NV: A 16-year-old white boy using the identification of a 31-year-old black man was served alcohol by two out of 15 businesses visited during an alcohol compliance check conducted by the Carson City Sheriff's Department recently. Source.

Australia: Alcohol kills indigenous person every 38 hours

ALCOHOL kills one indigenous Australian every 38 hours, landmark research has found.

The average age of those dying from alcohol-attributable causes - mostly suicide for men, or alcoholic liver cirrhosis for women - is about 35 years.

National Drug Research Institute (NDRI) Indigenous Australian Research team leader Dennis Gray said these were conservative estimates from a first-of-its-kind study of the problem which showed alcohol killed 1145 indigenous Australians between 2000 and 2004.

"If we are serious about addressing this disparity and reducing death rates among indigenous Australians, we need to focus on the underlying social causes of that ill health," Professor Gray said. "For instance, suicide is the most frequent alcohol-caused death among indigenous men, which reflects the despair that many indigenous people feel."

Senior Research Fellow Tanya Chikritzhs said she was shocked to discover indigenous women as young as 25 years were dying of haemorrhagic stroke due to heavy drinking. Source.

Addiction has many subtypes

"Dr. Peter Banys, head of the addiction treatment program at the San Francisco Veterans Affairs Medical Center, said addiction needs to be considered a disease of many subtypes, similar to leukemia, each linked to a different set of genes or environmental factors. Some people may be hardwired thrill-seekers, he said, while others may fall prey because of depression or 'cognitive processing' disorders. Each subtype might respond to a different medication or counseling approach.

'You've got to be thinking about it as multiple disorders that look the same but are not,' Banys said. 'They're not genetically the same. We already know that there are at least six different chromosomal locations heavily implicated, and many more are turning up.' -- From a San Francisco Chronicle addiction story by its science writer Carl T. Hall, Feb. 11. Source.

Forced naltrexone implant for opiate addicts?

A proposal to implant persons arrested on opiate abuse charges with a timed-release naltrexone device has raised a medical ethics debate. A critical comment by R.G. Newman MD, MPH, appears in this blog.

From one narco-state to another

President Bush has nominated William Wood, the current U.S. ambassador to Colombia, to the same post in Afghanistan. Gen. Peter Pace, chairman of the Joint Chiefs of Staff, told the press that the President's intent was to transfer the Colombian model to Afghanistan.

Among the numerous voices questioning the wisdom of this judgment was the New York Times, which editorialized on Feb. 6:

The limited gains Colombia has achieved in recent years have been offset by an overly generous amnesty program for right-wing paramilitary leaders and drug traffickers, which has seriously compromised the rule of law. And American aid has been disproportionately directed into military and police programs, leaving far too little to promote alternative livelihoods for Colombia’s farmers. Despite all the money spent, the amount of land planted with coca crops has risen and the net harvest has been reduced only slightly. Afghanistan’s problems will not be solved by copying these mistakes.

Source. It sounds like, apart from the language barrier, Wood will feel right at home in Colombistan.

A long, insightful piece on the Colombia/Afghanistan parallel by Simon Jenkins in the Sunday Times (London) makes a similar point. In Afghanistan, he says:

Here, too, the West is intervening in a narco-economy that is destabilising a pro-western government. Here, too, quantities of aid have been dedicated to security yet have fed corruption. Here, too, intervention has boosted drug production and stacked the cards against law and order. This year’s Afghan poppy crop is predicted to be the largest on record. European demand has boosted the price paid for Afghan poppies to nine times that of wheat. At this differential a policy of crop substitution is absurd. ...
Some 40,000 Nato troops from more than 30 different countries are gathered in Kabul. Since many of them refuse to fight, the city has become a holiday camp for the world’s military elite. Outside the capital, military occupation acts as a recruiting sergeant for insurgency, leaving Nato bases constantly on the defensive. ...

Jenkins' piece, titled "America is doped up in Colombia for a bad trip in Afghanistan," observes that in Helmand province, a major poppy area, "drug lords are the only counterweight to the Taliban." Source.

Citizen: Alcohol industry runs Texas legislature

AUSTIN — A citizen member of the state's Sunset Advisory Commission wants the Legislature to dismantle what he calls the "corrupt system" of alcoholic beverage regulation that he says protects wholesale distributors at the expense of retailers and consumers, and blocks any effort to raise taxes on liquor.

Austin attorney Howard Wolf (photo), in a scathing position paper, criticized the relationships among lawmakers, wholesale distributors and the Texas Alcoholic Beverage Commission.

Wolf, who also served on the Tax Reform Commission, said that the alcoholic beverage industry has a controlling influence with the Legislature, and has blocked any moves to increase the tax on liquor, which has not been raised since 1984. Source.

Woman drives SUV into church

CLAYMONT, DE. Dawn Johnson, 36, drove her Chevy Trailblazer at speed across oncoming traffic, off the road, and through the wall of the Discipleship of Christ Baptist Church at 1:15 a.m. Her SUV went about 25 feet into the church. Police arrested her and charged her with driving under the influence. Source.

Driver ed teacher busted on DUI

Williamsport, PA: Stanley E. Burke 3rd, the driver education teacher at Montoursville Area High School, has been charged with drunk driving after he crashed his mini van into a parked pickup truck on Broad Street in Montoursville, according to borough police.

Burke, who also is the school’s health instructor and the girls’ varsity track coach, had a blood-alcohol content level of .28 when his van hit the truck in the 300 block of Broad Street about 11:15 p.m. on Jan. 26, Patrolman Jason Scott Bentley said in an affidavit. Source.

Star USC kicker falls off cliff drunk

Los Angeles: University of Southern California star field goal kicker Mario Danelo was drunk when he plunged over a cliff to his death, the coroner's office said Jan. 9. His blood-alcohol level was 0.23, nearly three times the legal limit in California.

Danelo, 21, was found Jan. 6 more than 100 feet down a rocky cliff in San Pedro.

Danelo made 15 of 16 field goals this season and led the Trojans in scoring with 89 points. He made two field goals in the Rose Bowl on New Year's Day to help USC beat Michigan 32-18. Source.

Captain Al Cohol: Arctic superhero

A 1973 comic featuring Captain Al Cohol, a superhero of the Arctic north who had one fatal weakness -- guess -- has been republished, complete, on the web. Source. The comic shows alcoholism as something that even the strongest men can fall into, and it makes an effort to localize its message to the Inuit culture.

All quiet on the Walters front

John P. Walters, head of the Office of National Drug Control Policy (ONDCP), told the press last December 9 that Afghanistan would become a "narco-state" unless a major campaign of spraying the poppy fields with herbicide were initiated. Walters, in fact, announced that such a campaign had been decided on. Source.

Six weeks later, the Karzai regime in Kabul announced that spraying the poppy fields would not happen, either from the air or from the ground. See earlier blog item here. Instead of expressing dismay, the White House pledged additional funds and troops, and Pres. Bush sent personal well-wishes to Karzai.

The effect was to hang Walters out to dry. The "giant steps" toward poppy eradication that he said were needed to prevent Afghanistan from becoming a narco-state are not going to happen. The "scourge of corruption" that troubles Afghanistan's institutions, according to his Dec. 9 statement, is unchecked and reinforced, with the blessings of the Bush administration.

If Walters had any backbone, he'd resign.

$1.2 billion later: National Youth Anti-Drug Media campaign ineffective, harmful

The biggest national anti-drug media campaign ever launched in the U.S. spent more than $1.2 billion from 1998 through 2004 without measurable effect on youth drug use, according to a report to Congress by the Government Accounting Office (GAO). Source.

In some subgroups, notably young teens (12-13 year olds) and girls of any age who had not been using drugs, the campaign appears to have increased the initiation of drug use because it made drug use by peers seem more familiar and acceptable, the GAO concluded.

A major aim of the campaign, motivating parents to monitor their children's drug use, the GAO found, met with no significant results, and even when the campaign affected parental behavior, there was no evidence of corresponding changes in the attitudes or behavior of children.

Although alcohol, tobacco and other drug use among teens has been declining, the GAO report found no causal relationship between the decline and the media campaign.

The campaign is conducted by the Office of National Drug Control Policy (ONDCP), a branch of the Bush White House. Despite (or because?) of the campaign's negative results, President Bush has asked Congress for $120 million for the campaign for 2007, an increase of $21 million over last year. ONDCP criticized the GAO report's methods and conclusions.

(Thanks for the lead to this item to the Kujan blog.)

Obama trying to quit smoking

WASHINGTON — Sen. Barack Obama is trying to snuff out a habit before it hurts his run for president: He's trying to quit smoking.

The Illinois Democrat, who will formally launch his campaign Saturday, said his wife, Michelle (photo), persuaded him to quit.

"My wife wisely indicated that this is a potentially stressful situation, running for president," he said Tuesday. "She wanted to lay down a very clear marker that she wants me healthy."

The stakes are high for Obama not just because of the health hazards but because voters might be wary of a presidential candidate hooked on cigarettes. More.

Nursing mom kills baby with cocaine in breast milk

A nursing mother in West Branch MI killed her 5-month old baby with breast milk containing cocaine, medical examiners ruled. The mother had been using cocaine two or three times a day while nursing the infant girl, Karie Lee Bowman. The woman was sentenced to nine months in prison. Source.

Man steals AA basket money

Everett, WA: An unidentified man stole an envelope containing $37 in dues collected at an Alcoholics Anonymous meeting in the 1700 block of Baker Avenue. Members unsuccessfully chased the thief. Source.

Drinking dulls sense of humor

You suspected this all along? Heavy drinking dulls the sense of humor. It's official. A study in the journal Addiction found that people with an alcohol problem had a harder time matching punch lines with their jokes than a sober control group. Jokes with more complex or subtle humor especially escaped the alcoholic group. Source.

Actor Ben Affleck quits smoking

Ben Affleck's new film 'Smokin' Aces' made him quit smoking.

The actor plays chain-smoking bondsman Jack Dupree in the new action film and admits the amount of cigarettes he had to puff on for the role have put him off nicotine for good.

He told People magazine: "The whole week that I shot, I smoked, like, five packs a day. By the time the movie was over, I was so sick of smoking, I just didn't want to do it anymore, and I quit." Source.

View from Pakistan: Afghanistan is narco-state

Afghanistan has become a narco-state, says Rasul Bakhsh Rais, a professor of Political Science at the Lahore University of Management Sciences, in a commentary in the Pakistan Daily Times.

The twin strategy of war and reconstruction in Afghanistan has failed to achieve any remarkable success. The country is sliding fast into chaos and disorder, particularly on its southern and eastern periphery. If other areas are calm, it is not because the state has extended its writ to them, but because it has surrendered its authority to the local warlords. There is general despondency and frustration among the population.

Their grief and anger is widely shared by the international community and by friends of Afghanistan throughout the world. After three bouts of deadly war, the Afghans thought they would have a better, peaceful future and economic opportunities to reconstruct their individual and collective lives.

The Taliban have re-emerged as a formidable force, against the hope that international intervention and political reconstruction would end the war. The warlords continue to stay put and strong, forcing President Hamid Karzai to make compromises. The Pashtun regions remain unstable and out of the government’s control.

Local farmers and international drug-traffickers have found the absence of the Afghan state and weak political and security arrangements auspicious for reviving poppy cultivation on a scale never known before in the history of the country. Afghanistan unfortunately has become a narcotics state — a development that has taken place in the presence of NATO, ISAF and US forces.

The U.S. under the Bush administration has allied itself with the warlords, the worst and least popular elements of Afghan society:

The warlords humiliated, coerced and murdered tens of thousands of Afghans, and most of them had a narrow support base in their immediate ethnic or tribal communities. The United States, by co-opting them as allies against the Taliban, rehabilitated them, empowered them with money and weapons and gave them a dignified space in the new political structure.

Most of them have committed untellable atrocities against their political and ethnic rivals and could be put before an international criminal tribunal for their crimes against humanity. All of them have been spared for the ‘good’ work they have done for the US and ISAF forces.

Read the full commentary.

Charity says spike in abortions due to drink binges

London: The family planning service Marie Stopes International said today that it performed a record number of UK abortions last month.

The charity carried out nearly 6,000 abortions at its nine centres across the UK in January, the highest number in its 32-year history. This was a rise of 13% on January last year.

The charity's UK director, Liz Davies, blamed the surge in abortions on excess drinking over the Christmas season. Source.

(Thanks, Owen P., for this item.)

Recovering folks face "Sober House" scams

Recovering folks just emerging from residential treatment may find themselves vulnerable to unscrupulous "Sober House" operators, according to recent stories in the Minneapolis-St.Paul Star Tribune by staff writers Tony Kennedy and Terry Fiedler.

Julie Coverdale was steered to a sober house by her counselor after a month at a 12-step treatment program. The house was billed as "Phase II" of her recovery, but there was no therapeutic component to it, other than the requirement that she attend two outside AA meetings a week. She was turned out of the house without legal process when she was found smoking cigarettes in her room. She had to fight to get her deposit and her personal belongings back. She said most clients who get evicted just walk away. Source.

Sober house operators in Minnesota get around the state's tenant protection laws by classifying the facility as "disabled housing." Clients are made to sign waivers of tenant rights and are called "guests" or "program participants" paying "program fees" instead of rent. Many find that they can be evicted on 15 minutes' notice. Some operators profit from frequent evictions of their vulnerable clients, too insecure to demand return of their deposits or belongings. Says the paper:

HEART, a Minneapolis nonprofit, spent about half of its $275,000 grant budget last year to cover the first month's rent for financially needy clients who moved into sober houses. More than a year ago, however, the agency stopped paying security deposits because so many landlords failed to return the money.

"It's hard to tell who is starting in it for an honest reason and who is starting it as a quick way to make a buck," said Anne Germain Beauclaire, HEART's executive director.

Despite abuses, sober houses are proliferating in Minnesota due to cutbacks in public funding for treatment and tougher insurance regulations. They can be highly profitable for the owners. Says the paper:

Sober houses exist in a legal netherworld: Landlords say they are exempt from local tenant laws because their clients are disabled. Yet the owners don't have to provide tenants with counseling or other services because the homes are not licensed treatment centers. The program is whatever the landlord says it is, and tenants who violate the rules are often immediately thrown out.

Read the full story.

Myth: Small-town girl goes bad in Big City

Media mogul Donald Trump's explanation for beauty queen Tara Conner's tale of addiction -- small-town girl goes bad in Big City -- didn't wash with the editors of the Lexington (KY) Leader-Journal.

Alcoholism and drugs are big time problems all over the small towns of eastern Kentucky, write the editors. Conner was drinking and doing drugs long before she hit the Big Apple.

What Conner's story really shows, says the paper, is the big gap between celebrities and ordinary folks in access to treatment. Conner got into an upscale residential 30-day program the day she asked for help. In the drug-saturated small towns where the newspaper's readers live, there's one treatment bed for every ten people who need it, and the average wait is four to six weeks -- if you can afford it at all. Source.

Newsom: Another Politico Pleads Alcohol

The parade of public figures "taking the fifth" -- pleading alcohol abuse -- swelled last week with the addition of Mayor Gavin Newsom (photo right) of San Francisco.

After admitting to a sexual affair two years ago with his former appointments secretary, (photo middle) a woman married to his campaign manager (photo left), Newsom said that although "my problems with alcohol are not an excuse for my personal lapses in judgment," he had stopped drinking and wanted professional help staying sober.

"Upon reflection with friends and family this weekend, I have come to the conclusion that I will be a better person without alcohol in my life," Newsom said in a statement.

Newsom said Monday that he would get treatment from Mimi Silbert, the founder and director of the Delancey Street Foundation in San Francisco, and that it would not affect his duties as mayor.

Delancey Street provides a residential program for hard-core addicts, including ex-convicts and prostitutes. Although the mayor plans to work with her on an outpatient basis, the program will not be easy, said Silbert, who met with Newsom over the weekend.

"The good thing, to me, is that he came and asked for help from a place he knows would not be light," Silbert said.

Delancey Street, which she founded in 1971, does not rely on the 12-step philosophy of Alcoholics Anonymous but works to address the underlying reasons for excessive drinking, she said.

Citing privacy reasons, Silbert would not elaborate on how specifically she planned to help Newsom, whom she described as "very serious" about getting help. More.

Sources said that Ruby Rippey-Tourk, 34, Newsom's partner in the 2005 affair, has an alcohol issue of her own and revealed the affair to her husband as part of the ninth step of the Alcoholics Anonymous program, which requires the person to "make amends." Source. Discussion. Her husband, Alex Tourk, then confronted Newsom with the affair and resigned his post as campaign manager.

Newsom is up for re-election in November. Commentators say that Tourk commands a loyal following of volunteers who won't be working for Newsom this fall. More.

Colorado lecturer dies drunk in snow

A University of Northern Colorado sociology lecturer who was found dead in a snow bank at the Foothills Unitarian Church in Fort Collins died of hypothermia due to acute alcohol intoxication, the Larimer County Coroner’s Office ruled today.

She was reported missing on Jan. 2 by her husband after having last been seen New Year’s Eve.

Four children playing at the church before services almost a month later saw her body partially covered by snow. They called a parent, who notified police.

Family members said Wilkins-Wells was believed to have been headed to church the day she went missing. The family belongs to Foothills Unitarian, which is about two miles from their home.

Wilkins-Wells had been a sociology lecturer at UNC since August 1992, specializing in minority relations and community planning.

Katie Wilkins-Wells said that her mother had started having problems with alcoholism two years ago and had joined Alcoholics Anonymous. Source.

UK: Labour MP Fiona Jones dead of alcoholism

London: Fiona Jones, until recently a rising star in the Labour Party mentioned as a possible cabinet minister, died from liver disease due to alcoholism last week. She was 49. Her husband, a local radio DJ, was quick to point to a culture of heavy drinking at the House of Commons and an extraordinary court battle over her election expenses as being to blame. Details.

Man charged with stalking actress at AA meeting (not Lohan)

A Brooklyn man has been charged with stalking an actress at an AA meeting, putting flyers about her under car windshields in the parking lot outside the meeting, and yelling at her in the meeting lobby. Source. The actress is NOT Lindsey Lohan.

Boston: Politicos dragging feet on heroin problem

"Our public officials and elected representatives continue to drag their feet on increased funding for, and accessibility to, aggressive rehabilitation and educational programs" to meet the heroin problem, says a letter to the Boston Globe by Jody Price of Brockton.

Ms. Price is one of the parents in the suburban Boston area whose family has been hit by heroin addiction.

She says of the local politicos: "Their inaction abandons families to be destroyed by the gut-wrenching fear and life-changing grief they suffer, struggling to save their children, then losing them to overdose. " More.