Appetite-regulating hormones and peptides may be involved in the neurobiology of alcohol craving

Defined as a powerful urge to drink, or intense thoughts about alcohol, is an important contributor to the development and maintenance of alcoholism.

Recent research suggests that appetite-regulating hormones and peptides may be involved in the neurobiology of alcohol craving. A new study has confirmed that appetite-regulating peptides leptin and ghrelin do indeed influence alcohol craving, but especially among certain subtypes of alcoholics.

Results are published in the June issue of Alcoholism: Clinical & Experimental Research .

"We chose to examine leptin and ghrelin because both peptides are of high importance in appetite regulation and both have already been subject to former investigations," said Thomas Hillemacher, assistant professor in the department of psychiatry and psychotherapy at the University Hospital of Erlangen, Germany. "However, these former investigations have shown contradictory results which may have been due to their use of samples of alcoholics without specifying subgroups. This raised the idea of investigating these peptides in specific subtypes of alcohol dependence." Hillemacher is also the corresponding author for the study.

"There exist four different mechanisms of craving, which can lead to relapse," explained Otto Lesch, professor of psychiatry at the University of Vienna. "We know that these four different mechanisms are caused by different biological mechanisms. They have different long-term courses and they profit significantly differently from different pharmaceutical compounds. Therefore, it is very important to define basic workings of these different craving mechanisms in order to develop better models to proof new medications."

These four mechanisms of craving correspond to Lesch's typology of alcoholics according to different psychological, social and somatic characteristics. Type 1 refers to patients with heavy alcohol withdrawals who tend to use alcohol to weaken withdrawal symptoms. Type 2 patients use alcohol as self-medication because of its anxiolytic effects. In patients of Type 3 , the main characteristic is an affective disorder as origin for alcohol abuse. Type 4 patients show pre-morbid cerebral defects, behavioral disorders and a high social burden.

Researchers analyzed data gathered as part of a larger examination of different neurobiological aspects of alcohol dependence. Of the original sample of 200 patients, 188 (155 males, 33 females) provided leptin serum levels, and 117 (96 males, 21 females) provided ghrelin serum levels. Study authors measured craving through use of the Obsessive Compulsive Drinking Scale, and further classified patients according to Lesch's typology of alcohol dependence, as well as their preferred type of alcoholic beverage.

"The study showed that the involvement of appetite-regulating peptides in the neurobiology of alcohol craving is of different importance in specific subgroups," said Hillemacher. More specifically, results showed a positive association between leptin and craving among patients of Lesch's Type 1 and 2, and between leptin and craving among patients consuming beer or wine; but a negative trend between ghrelin and craving among patients of Lesch's Type 1.

"In alcohol dependence," added Lesch, "88 different methods are used to decrease relapse rates. Most of them are not effective, some of them increase relapse rates, some of them are really effective in subgroups of alcohol-dependent patients, but there is no one method which has only positive results." This study's results, he said, are of great importance to alcohol research because they help to clarify that other studies, results may be due to different selection criteria leading to different rates among subgroups.

Both Hillemacher and Lesch said that recognizing subgroups of alcoholics is imperative for future research as well as clinical applications.

"Our findings show that there exist important differences between alcohol-dependent patients, not only regarding psychosocial but also regarding neurobiological influences," said Hillemacher.

"Transmitter systems interact with peptides, and genetic research has to be aware that this interaction influences brain activities and therefore different mechanisms of craving," added Lesch. "To explain addiction, we need mechanisms of different types of craving. Addiction is not caused by the drug, but is caused by biological and psychological vulnerabilities leading to different types of craving."

source: University of Vienna Research

Speaking of genes...

Alcoholism is a chronic disease that can last a lifetime. One question that people have asked about alcoholism is whether or not it runs in families. Although there is no definite proof that alcoholism is entirely a matter of genetics there are clear patterns of inheritance that indicates it can and does run in families. It has been determined that there is a genetic predisposition to alcoholism.

There are many factors that determine whether a person may develop a tendency toward alcoholism. They include genetic heredity, lifestyle and environment. Stress can play a role toward developing the habit as well as friends and other peers. Those who have a history of depression may be more likely to suffer from alcohol addiction.

Some people who suffer from alcoholism are prone to outward behavior problems while others suffer from inner disturbances. For example, some people may become more aggressive and argumentative whereas others withdraw into themselves and become depressed. Problem drinkers may even be prone to violence.

A person can suffer from distorted vision, hearing and lack of coordination while under the influence of alcohol. It causes impaired judgment as well. Alcohol can also alter a person's perception and affect emotions. Alcoholism can cause long-term health problems such as liver and kidney damage, stomach disorders, memory loss and even heart damage.

Some people suffer from alcohol abuse while others suffer from alcohol dependency. What's the difference? Alcohol abuse describes dangerous drinking habits such as drinking every day and/or drinking too much at a time. Alcohol abuse can lead to dependency. People who suffer from alcohol abuse may miss a lot of work or school due to being up all night drinking and feeling the effects of a hangover. They may drive under the influence of alcohol and continue to abuse alcohol even though such abuse has caused them problems in the past such as losing a job or their driver's license.

People that are alcohol dependent drink large amounts of alcohol often. They built a tolerance to the alcohol and have to drink more in order to get the same effect. They suffer from withdrawal symptoms, have difficulty sleeping and may sweat or shake when not drinking.

There is no cure for alcoholism. Most alcoholics that try to quit usually suffer a relapse. They often feel as though they can't function without the alcohol and need it to cope with life. Alcoholism can be treated with counseling and medication. Most alcoholics do not seek treatment on their own. How do you know if someone is an alcoholic? There are symptoms. They have a strong craving or urge to drink. They may not be able to stop drinking once they start. They will suffer withdrawal symptoms when not drinking due to their physical dependence on the alcohol.

How can you help? If someone you know is an alcoholic remove the temptation and help him or her to get support. If you suffer from alcoholism admitting that you have an alcohol problem is the first step on the road to recovery. Don't keep alcohol in your home. Say no to others when they offer you a drink and seek the help and support you need.

author: Darlene Zagata, Uniontown, PA

Drug / alcohol treatment program

Another weapon against the evil forces of drug and alcohol abuse may find its way to far western North Carolina.

The program follows a treatment model called the Matrix Model, said Dr. James Kowalski, who is a licensed professional counselor and a Master Addiction counselor for Murphy Counseling Services.

A possible client would be evaluated and if the intensive outpatient program is indicated, he would go for treatment three times a week - three hours for each session. Treatment includes individual, group and family counseling, supplemented by attendance at a 12th step program such as Alcoholics Anonymous or Narcotics Anonymous.

Getting the program is a matter of funding, staffing and finding transportation for clients. Kowalski pointed out that if a person is asked to come in three times a week for a total of nine hours, there will be transportation costs for gasoline and cost of someone to watch kids. Murphy Counseling is pursuing grants or state funding to help get the program started.

"California got this started," Kowalski said. "They say it is the best thing available for treatment."

Murphy Counseling Services treats a range of disorders, including substance abuse, depression, sexual offenses and anger management through a variety of programs. Substance Abuse is presently addressed primarily through DWI (Driving While Impaired) services.

North Carolina law provides for five different levels of DWI substance abuse treatment, depending on a variety of factors, including how many DWIs a person has received.

"We have three groups running and we treat anyone who wants help or who is court ordered," Kowalski said. "We do an evaluation to determine what level (of treatment) is appropriate for the individual."

DWI programs involve group participation but individual counseling is offered if needed.

The DWI program recently received 100 percent in a MH/DD/SAS Programmatic Review evaluation.

"I have been doing the group for six months and we have only had one repeat offender," Kowalski said. (About 75 people have entered the DWI treatment to this point).

The DWI program is helping people get their driver's licenses back.

"We hammer to them not to get behind the wheel of an automobile, golf cart, scooter or boat," Kowalski said. "I saw a video that showed that a person can drive 2,000 times (intoxicated) before he is caught. The risky hours are 10 p.m. to 2 a.m. on weekends. I tell them that if they are on the road during those hours, they are fair game."

Kowalski pointed out that not everyone who gets a DWI is an alcoholic. Most people who get their first DWI will realize the problem and won't do it again.

Kowalski has counseled substance abusers in large, metropolitan areas and he sees a difference in this region in that people, in general, are poorer and more isolated and don't seek treatment as readily as those in the big cities. He also sees a generational substance abuse pattern where kids of alcoholics become alcoholics themselves.

The main drug of abuse in this area is still alcohol. But methamphetamine, prescription drugs (such as oxycontin and anti-anxiety medications) are also abused.

Alcohol depresses part of the brain that affects judgement and motor skills. Meth causes the body to be in a high state of arousal and improves energy. The brain is flooded with certain chemicals. When the euphoria runs out, the meth user needs more of the drug to get back to feeling better. Meth involves all kinds of physical risks, Kowalski said.

The meth addict is the hardest to treat because it is more addictive. A person normally becomes an alcoholic over a period of time. However, a person can get hooked on meth after the first use.

"They say that once you use meth, it can change your brain forever," he said. "It can take years for the brain to get back to where it was."

Kowalski said the government has cut back on funding for substance abuse treatment. A treatment facility in Black Mountain, North Carolina cut its in-patient treatment program from 28 to 14 days. If a person needs in-patient treatment, presently they can be directed to Christian Love Ministries in Murphy or to the Black Mountain facility.

"It seems like in North Carolina and Georgia, (substance abuse treatment) is not a priority," he said. "The government is spending money on other things and cutting back on what they spend on their own people."

Kowalski pointed out that it costs more than $20,000 a year to support an inmate in the prison system and those locked up could be treated for much less than that.

He said that two of the biggest cop-outs or excuses for using drugs and not seeking help are the statement "There is nothing to do around here" so they get into drugs and "I can do it (recover from drugs) by myself". People need support from family, spiritual support, a sponsor and others.

However, there is hope for the terrible drug abuse problem. Treatment is available and the intensive outpatient program will hopefully become a reality.

"I have worked in the field for 18 years and I like helping people make changes in their lives," Kowalski said.

source: Cherokee Sentinel

Teenagers And Alcohol

Even though they cite the wrong reasons, Tuscaloosa leaders are right to maintain that minors shouldn’t be jailed for simple alcohol possession.

They say jailing the youngsters on misdemeanor charges creates bad publicity and has a temporary negative effect on business.

The real concern should be about the jailed youths. In many cases, throwing them into jail for a misdemeanor offense is almost certain to produce lasting negative attitudes and mindsets.

We don’t downplay the importance of curbing underage drinking. But in most cases, it would be much better to issue a citation to minors in possession of alcohol and channel those who need it into treatment and education programs.

City police officers now give citations that order minors in possession of alcohol to appear in municipal court. The minor is jailed only if he or she is intoxicated.

Unfortunately, the state Alcoholic Beverage Control Board has chosen to take a harder approach. State ABC board administrator Emory Folmar, the former gun-toting, tough-talking mayor of Montgomery, is adamant that the only responsible option for dealing with people under 21 in possession of alcohol is to put them in jail, regardless of their level of intoxication.

Folmar says public safety is an issue because the youngsters could be involved in an accident. He also accuses the city of dumping the problem in ABC’s lap “so they don’t get blamed for something that happens to Junior out on the Strip."

Folmar’s hard-nosed tactics are likely to breed nothing but fear and resentment. There’s a much more intelligent, effective way to handle the problem.

source: Tuscaloosa News

I've Seen The Needle...

Twenty-one years after the first needle exchange
services were set up in response to the rise of
HIV, there is now a generation of injecting drug
users who are taking drugs differently and more
dangerously. It seems they are too young to
remember the HIV awareness campaigns of the
1980s and are at high risk from life-threatening
blood borne viruses such as Hepatitis and HIV.

The statistics are startling, with half of injecting
drug users estimated to have Hepatitis C, and a
total of 6,000 new infections per year. Current or
ex-injecting drug users make up nearly 90% of all
Hepatitis C infections in the UK (HPA, 2006). HIV
rates are at their highest levels since 1993 among
injectors, with anonymous surveys indicating that
one in 50 current users has HIV (HPA, 2006a).
With 25 needle exchanges across England and
Wales, Turning Point is coming into contact
with more and more people facing damage to
their health caused by risky injection practices.
We believe this is a public health issue and
there is an overwhelming case for improving
service provision for this vulnerable group.
Current drug policy is failing to protect people
from the risks of blood borne virus infection, at
huge cost to drug users, the community and the
taxpayer. Access to testing and treatment for
blood borne viruses is poor, with too many
people living in ignorance of their illness.

16 page .pdf file

source: Turning Point

We're SO Small...

Once Upon A Time...

My name's XXXXXX. I'm an addict. And this is what addicts do.
You cannot nor will not change my behavior.
You cannot make me treat you better, let alone with any respect.
All I care about, all I think about, is my needs and how to go about fufilling them.
You are a tool to me, something to use. When I say I love you I am lying through my teeth,
because love is impossible for someone in active addiction.
I wouldn't be using if I loved myself, and since I don't, I cannot love you.

My feelings are so pushed down and numbed by my drugs that I could be considered sociopathic.
I have no empathy for you or anyone else.
It doesn't faze me that I hurt you, leave you hungry, lie to you, cheat on you and steal from you.

My behavior cannot and will not change until I make a decison to stop using/drinking
and then follow it up with a plan of action.

And until I make that decision, I will hurt you again and again and again.

Stop being surprised.

I am an addict. And that's what addicts do.

__________

When I first read the above, which had been posted on a message board, I thought to myself: 'Boy, can I ever relate to that person...'. Over the years since, I've come to regard those words and sentences in different ways; a quick explanation of addiction behavior, a mea culpa, a back door exit...
I can't wait to read the conclusion.

Something over yonder

I started reading I'll Sleep When I'm Dead: The Dirty Life and Times of Warren Zevon, and I questioned last night whether I could get through it.

I think now I can. He was one of us, no doubt about it. He was one of us.

I wrote about it over yonder at the Shack.

The Futility of Random Drug Testing

Though touted by the Bush administration as the "silver bullet" that will force teenagers to "just say no," random drug testing is of questionable effectiveness. It is also costly, counterproductive and violates basic American values. That's why the million-member California State PTA, the American Academy of Pediatrics, the National Education Association, the National Council on Alcoholism and Drug Dependence, and the majority of the nation's school districts oppose school-based drug testing.

According to the Academy of Pediatrics, "There is little evidence of the effectiveness of school-based drug testing in the scientific literature." In fact, the only federally funded, peer-reviewed study, which compared 94,000 students in 900 U.S. schools, found no difference in illegal drug use between schools with and without a testing program.

Before subjecting secondary school students to a policy as invasive as random drug testing, evidence of its efficacy should be more conclusive than anecdotes offered by a few enthusiastic proponents and a drug testing industry that stands to reap billions.

Drug testing is costly. With federal grants, individual schools, many of them strapped for funds, spend between $10,000 and $40,000 per year for testing. This money could be used more productively for sports, arts, drama, music and other extracurricular activities that keep teens engaged between3 and 6 p.m., when they are bored and unsupervised. The funds could also be used to hire credentialed counselors who could focus full-time on substance abuse and related mental health issues.

Drug testing, regardless of how it's packaged, is an invasive diagnostic procedure. Like other health issues, alcohol and other drug use should first and foremost be the domain of parents and physicians. If parents want to drug-test their own children, they can easily buy over-the-counter kits at their local pharmacies or see their family doctors, leaving schools out of it.

There is no quick fix for the complex issue of substance abuse. Quality drug education and after-school programs that help students thrive will best result in the kind of responsible decision-making that endures beyond the teen years and into adulthood.

author: Marsha Rosenbaum, PhD
Director of the San Francisco office of the Drug Policy Alliance.
She is the author of "Safety First: A Reality-Based Approach to Teens, Drugs and Drug Education".

Alcohol A Teen's Problem

Recovering alcoholic at 19 recalls the fall.

By the time she went outside to smoke that early November morning in 2001, Katie had already downed about five or six shots of mixed liquor.

"I fell on my face, and that’s the last thing I remember. They said after that, I kept drinking and that I drank a half a bottle of vodka. My friend and I drank the bottle of vodka between us."

The 15-year-old Columbia junior high student was 5 feet, 8 inches tall and 105 pounds. Her blood alcohol limit soared to 0.2 percent - two-and-a-half times the legal limit.

She’d been drinking every weekend for more than a year. Had it not been for a trip to the emergency room, the night would have been just like any other Friday night for Katie and her friends.

Binge drinking among teens is a tricky problem, said Becky Markt, coordinator of the Youth Community Coalition in Columbia. Many see getting drunk as a rite of passage.

But binge drinking isn’t confined to college campuses, she said. Every year, the age of the drinker goes down and the amount of alcohol consumed goes up. "It’s never safe for kids to use alcohol, but they’re drinking enough to be harmful to their bodies, possibly leading to alcohol poisoning."

A drug and alcohol survey of students last year in Columbia Public Schools indicated 20 percent had tried binge drinking at least once - consuming five or more alcoholic beverages in one sitting.

Markt urges parents to attend a town hall meeting on binge drinking Wednesday night at Gentry Middle School. The program features Chris and Toren Volkmann, a mother and son from Olympia, Wash., who authored a book about their battle with teen alcoholism.

You don’t have to look beyond Columbia’s boundaries to find similar stories. Katie, a recovering alcoholic at age 19, and her mother shared their story on the condition of anonymity in hopes of helping other teens recognize and conquer self-destructive behavior. Their names have been changed for this report.

Katie’s substance abuse problem started at 13, when a friend pressured her to smoke marijuana. Aching from her parents’ divorce, the promise of a good time outweighed the fear of drugs that Katie’s elementary school D.A.R.E. class had instilled in her.

"At first I didn’t really feel anything. Then I tried again," she recalled. "And one time, it hit me. There was no real reality. It was a completely different world where I didn’t have to worry about anything."

Then an eighth-grader at Oakland Junior High School, Katie continued to get high on weekends and added alcohol to the mix shortly thereafter.

Katie’s mom, Susan, was well-versed in alcoholism. Her ex-husband’s drinking problem prompted her to join Al-Anon support classes when Katie was just 4. But she didn’t know that her only child was following her father’s footsteps until Katie’s binge caught up with her.

Susan gets emotional when she thinks of that Saturday in November, when she got a call at 2 a.m. to drive Katie to the emergency room. She remembers her daughter’s promise to seek help.

By Sunday, Katie was in an Alcoholics Anonymous session. By the following weekend, she was drunk again. And by the time she started attending Hickman High School, Katie was smoking pot daily, using her allowance and lunch money to buy it.

"It became an obsession. If I wasn’t doing it, all I could think about was when I could do it next, how would I get the money, how would I get away with it," she said. "I would get suicidal if I thought I couldn’t do it anymore."

To help cover her tracks, Katie would shoplift at the mall, picking up lip balm and T-shirts to show her mom what her allowance was being spent on. She got caught just before summer of her sophomore year.

The trip to the Columbia Police Department was a breaking point for Susan. "You want to believe your child when they tell you, ‘I quit.’ But then you find out they’re lying. That’s tough."

She immediately enrolled Katie in Crossroads, an outpatient drug treatment program in St. Louis. Seven weeks after starting the program, Katie was ready to stay clean.

Mostly, Katie said, the program worked because the counselors were recovering addicts who could relate to her struggles. They knew she relied on drugs whenever faced with a problem, and they provided alternative ways to cope. She also found a support network and continues to meet weekly with other recovering teens.

When she returned from the Crossroads program, Katie transferred to Rock Bridge High School to avoid the old crowd. Although Rock Bridge had its share of addicts, she opted to seek out friends who didn’t use drugs or alcohol. Katie focused on schoolwork and became an honor roll student.

As she pursues a degree in computer science at the University of Missouri-Columbia, Katie knows her limits. Drinking isn’t unusual on the MU campus, but Katie knows she can’t enjoy a social drink without potentially plummeting back into addiction.

On the other hand, when she thinks of the path she might have traveled, "I’m grateful. I got to start over."

source: Columbia Daily Tribune
author: JANESE HEAVIN

Dual Diagnosis

Dual disorders refers to the presence of both a severe mental illness and a substance use disorder. Integrated dual disorders treatment has been shown to work effectively for consumers with both disorders. In this treatment model, one clinician or treatment team provides both mental health and substance abuse treatment services.

How can people with dual disorders achieve recovery from both mental illness and substance abuse?

* Most people with dual disorders are able to achieve recovery. The chance of recovery improves when people receive integrated dual disorders treatment, which means combined mental health and substance abuse treatment from the same clinician or treatment team.
* Relapses do happen, but most people are able to recover from relapses relatively quickly and get back to where they were before they relapsed.
* Families and clinicians cannot force people to give up alcohol and drugs. Family and other supporters can help by providing support and hope, but recovery must be a person's own choice. It may take a long time for some people to achieve recovery.
* People with dual disorders can learn from peers who are in recovery. Some may benefit from self-help groups like Alcoholics Anonymous, Narcotics Anonymous, and Dual Recovery Anonymous. It is a matter of personal preference.

What is integrated dual disorders treatment?

Integrated Dual Disorders Treatment occurs when a person receives combined treatment for mental illness and substance use from the same clinician or treatment team.

It helps people develop hope, knowledge, skills, and the support they need to manage their problems and to pursue meaningful life goals.

You will know if you are receiving integrated treatment because your clinician or treatment team will do several things at the same time, including:

* Help you think about the role that alcohol and other drugs play in your life. This should be done confidentially, without any negative consequences. People feel free to discuss these issues when the discussion is confidential, nonjudgmental, and not tied to legal consequences.
* Offer you a chance to learn more about alcohol and drugs, to learn about how they interact with mental illnesses and with medications, and to discuss your own use of alcohol and drugs.
* Help you become involved with supported employment and other services that may help your process of recovery.
* Help you identify and develop your own recovery goals. If you decide that your use of alcohol or drugs may be a problem, a counselor trained in integrated dual disorders treatment can help you identify and develop your own recovery goals. This process includes learning about steps toward recovery from both illnesses.
* Provide special counseling specifically designed for people with dual disorders. If you decide that your use of alcohol or drugs may be a problem, a trained counselor can provide special counseling specifically designed for people with dual disorders. This can be done individually, with a group of peers, with your family, or with a combination of these.

source: http://www.samhsa.gov
link: Dual Recovery Anonymous

How an oldtimer greets a newcomer

His name is Bill. He has wild hair, wears a T-shirt with holes in it, jeans, and no shoes. This was literally his wardrobe for the past four years of life He is brilliant. Kind of profound and very, very bright. He became a alcoholic while attending college. Things have only gone downhill since.

Across the street from the campus is a well-dressed, very conservative A.A. club. They want to develop a meeting for the students but are not sure how to go about it.

One day Bill decides to go there. He walks in with no shoes, jeans, his
T-shirt, and wild hair.
The meeting has already started and so Bill starts looking around the room for a seat.

The room is completely packed and he can't find a seat. By now, the well dressed people are really looking a bit uncomfortable, but no one says anything.

Bill gets closer and closer and closer to the front of the room, and when he realizes there are no seats, he just squats down right on the carpet.

By now the people are really uptight, and the tension in the air is thick.
About this time, the evening's speaker realizes that from way at the back of the meeting, an "old timer" is slowly making his way toward Bill.

Now the "old timer" is in his eighties, and has silver-gray hair, and a
three-piece suit. A spiritual man, very elegant, very dignified, very
courtly. He walks with a cane and, as he starts walking toward this boy,
everyone is saying to themselves that you can't blame him for what he's going to do.

How can you expect a man of his age and of his background to understand some college kid on the floor?

It takes a long time for the man to reach the boy.
The meeting is utterly silent except for the clicking of the old man's cane. All eyes are focused on him.
You can't even hear anyone breathing. The speaker can't even continue the meeting until the "old timer" does what he has to do.
And now they see this elderly man drop his cane on the floor. With great difficulty, he lowers himself and sits down next to Bill and welcomes him so he doesn't feel outcast and alone.
Everyone chokes up with emotion. When the speaker gains control, he says,

"What I'm about to say, you will never remember.
What you have just seen, you will never forget."
"Be careful how you live. You may be the only Big Book some people will ever read".

forwarded to me by my friend gwen at Twelve Beads

The Guy In The Glass

When you get what you want in your struggle for pelf,
And the world makes you King for a day,
Then go to the mirror and look at yourself,
And see what that guy has to say.

For it isn't your Father, or Mother, or Wife,
Who judgement upon you must pass.
The feller whose verdict counts most in your life

Is the guy staring back from the glass.
He's the feller to please, never mind all the rest,
For he's with you clear up to the end,
And you've passed your most dangerous, difficult test
If the guy in the glass is your friend.

You may be like Jack Horner and "chisel" a plum,
And think you're a wonderful guy,
But the man in the glass says you're only a bum
If you can't look him straight in the eye.

You can fool the whole world down the pathway of years,
And get pats on the back as you pass,
But your final reward will be heartaches and tears
If you've cheated the guy in the glass.

Dale Wimbrow 1895-1954

I'm grateful to Peter Dale Wimbrow for allowing me to post his dad's poem.

Predatory Bleeding Deaconry

bleeding deacon: n. a person who believes himself indispensible to a group, esp. a person who becomes so over-involved in a group’s internal management, policies, or politics as to lose sight of its larger goals; (hence) a person with a negative, moralizing character, who acts like the sole source of wisdom.

Predatory (prěd'ə-tôr'ē, -tōr'ē)
adj.
1. Living by preying on other organisms: a predatory mammal; a predatory insect.
2. Of, relating to, or characterized by plundering, pillaging, or marauding.
3. Living by or given to exploiting or destroying others for one's own gain.

A Struggle Inside AA...

I suppose the various and sundry nefarious and unconscionable behaviors and events reported about The Midtown Alcoholics Anonymous group in Washington D.C must include, for now, the convenient and safe prefix alleged.

I'm reminded of one big book thumper I crossed paths with when I was still an active member of the online debating morons... He used to love calling A.A a "secret society". This man was also fond of sponsoring females, by his own admission. And as chance would have it, I also crossed paths with one of his, um, intended targets with whom he wished to spread the message...

So, yeah, cool and all that. The rule of law, etc...
Alleged.
But it wasn't a mind bending proposition for me, and for many others I'm sure, to feel the veracity of many of the elements in this sordid story from D.C.

Helping out a helping hand

Detroiter leads program that once rescued her

Addicted for at least a third of her life to alcohol, and continuing to battle a bipolar disorder, Shirley Cockrell readily admits she remains an addict.

"This whole thing became my new addiction, but it's a good one," she said.

The "whole thing" is the Go-Getters Program, which gives homeless and mentally ill people a place to spend their days doing arts and crafts, taking field trips, participating in support groups and getting counseling or referrals for other services.

Posted on a wall of the center at 1253 Green St. in southwest Detroit, a sign spells out what Go-Getters stands for: Gently Offers-Getting Everybody Thinking Together Eventually Reserving Sanity.
The center, a part of Southwest Solutions, is open Monday through Friday, from 7 a.m. to 2:30 p.m.
"We're always on the go," she said.
As the director of Go-Getters, Cockrell, 64, spends her days helping clients get to doctor's appointments, get prescriptions, apply for Bridge cards and pay their bills. Or she's making lunch or grocery shopping for the center.

"At times it surprises me to see myself doing this when I think where I came from, " Cockrell said.
Cockrell, who grew up in Levering, said she always drank, but says she was a highly functional alcoholic.
In the 1960s, she moved to Brighton and Howell, before settling in Detroit with a former husband in the 1970s.

The couple ran a bar. It was her first taste of entrepreneurship, but it also encouraged her taste for alcohol.
Eventually Cockrell said the marriage ended, but the mother of four opened an arts and crafts store, the What-Not Shop.
"I was really good for many, many years at hiding it," she said of her alcoholism.
When her sister was murdered in 1988, "then my depression came really, really hard. ... It started getting a real hold on me," Cockrell said.

A chance meeting with Cathy Hess, the founder of Go-Getters, introduced Cockrell to therapy and the center. She began volunteering and stopped drinking in 1996.
But when she had a heart attack in 1998, she briefly returned to drinking. And, again, her volunteer work with Go-Getters "was like my salvation."

"It's giving me back my life. ... It keeps me sober," Cockrell said.

Cockrell's not the only former Go-Getters client giving back to the center. Her daughter, Lee Ann Norris, 40, of River Rouge is the Go-Getters assistant director. Another former client drives the center's van.

"If it needs to be done, we do it," she said.

Her dedication to the agency was tested when funding cuts loomed years ago. Go-Getters operates on roughly $175,000 a year with grants, fund-raising and donations.
After getting paid to work 40 hours per week with Go-Getters, she said, she officially cut her hours and salary to part time "to keep the doors open and keep the stuff that we need."

source: Detroit Free Press
author: NAOMI R. PATTON at 313-223-4485 or npatton@freepress.com

They say that...

... life's a shit sandwich and every day is another bite.
Just for today, I'll side with the elusive and opaque 'they'.

Canadian soldiers walk fine line on Afghanistan's poppy crops

Nearly a century since the humble poppy first blossomed as an enduring symbol of military sacrifice, Canada's soldiers find themselves shoulder-deep in flowers of a very different colour, striking a delicate diplomatic balance between policy and practicality.

The opium poppies that blanket Afghanistan in spring are far different and a great deal more treacherous than the red Remembrance Day variety that bloom on city streets in November.

As Canadian soldiers patrol the vibrant pink opium fields of southern Afghanistan, they walk a narrow bridge of neutral territory that divides the Afghan government's U.S.-backed program to rid the country of poppies from the interests of dirt-poor growers whose help keeps coalition soldiers alive.

"We walk through fields all the time; every time we were patrolling through the towns, we'd walk through all kinds of (opium) poppy fields, everywhere," said Maj. Steve Graham, a squadron commander with the Royal Canadian Dragoons, just back from two months in the volatile Zhari district west of Kandahar.

Graham and his soldiers took pains to distance themselves from the poppy-eradication teams of President Hamid Karzai, even as they worked alongside members of the Afghan National Police - the same agency that provides security for the crews tasked with destroying the crops.

"Our line is we have nothing to do with poppy eradication," Graham said Tuesday in an interview. "But even though we want nothing to do with it and we stay away from it, it can't help but have an impact on us."

For Graham, it's simple self-preservation. Local farmers who depend on the poppy crop for their livelihood are a critical source of invaluable intelligence, such as the movements of local Taliban insurgents and where improvised explosive devices - or IEDs - are planted.

"They were telling me where the IEDs were, they were telling me when guys were moving through there that they didn't recognize, and they were pointing out a lot of good information for us," Graham said.

"Anything that damages that relationship is detrimental to what we're doing, and there's no doubt that poppy eradication damages that relationship."

It gets even stickier when poppy-eradication teams come under attack from the Taliban. No less an authority than Brig.-Gen. Tim Grant, the commander of Canadian forces in Afghanistan, decides whether to intervene if a request for help comes in, Graham said.

For the Canadian government and NATO, the equilibrium is more subtle.

Though Canadian soldiers play no role in poppy eradication, Canada supports the program as one of the pillars of the Afghan national drug-control strategy, said Gavin Buchan, the political director of the provincial reconstruction base in Kandahar.

Other pillars of the strategy include programs to encourage farmers to grow different commodity crops, developing alternative sources of income for locals, treatment for opium addicts and improved interdiction and law enforcement.

source: Canadian Press
authors: James Mccarten And A.R. Khan

Honey, I shrunk my brain...

Would that crisp Chardonnay or cool refreshing lager go down as guiltlessly if you knew that every sip contributed, imperceptibly, to the shrinkage of your brain?

A new study has found that over time, drinking alcohol, whether moderately or heavily, was associated with decreased brain volume.

And while heavy drinkers had significantly less brain volume than light or moderate drinkers, only abstainers were found to have no alcohol-related brain atrophy. The effect was the greatest in women.

Whether the loss of brain volume actually was caused by alcohol, and whether it contributed to any decreased cognitive function, remains to be seen.

But the study is the latest cautionary note in the perplexing issue of whether moderate alcohol consumption is good for one's health. It raises the question of whether drinking may be good for the heart but not so good for the brain.

"That's the big question," said lead author Carol Ann Paul, a researcher with Wellesley College. "I would be reluctant to tell people not to enjoy their drink a day. But that is something to think about."

The research, which included MRI brain scans of 1,839 people who are part of a Framingham study, was presented Wednesday at the American Academy of Neurology annual meeting.

Based on their drinking habits, the people, who ranged in age from 34 to 88, were divided into five groups: non-drinkers; former drinkers; low drinkers (one to seven drinks a week); moderate drinkers (eight to 14 drinks a week); and heavy drinkers (more than 14 drinks). Their average age was 61.
More drink, more shrink

Compared with the non-drinkers, all of the groups had progressively greater amounts of decreased brain volume, with the biggest decrease in the heavy drinkers. The heavy drinking group had a 1.25% decrease in brain volume.

Brain volume decreases somewhat as people age. A loss of 1.25% is approximately equivalent to one to two years of normal aging, Paul said.

A subgroup of people in the study who had a 12-year history of heavy drinking had an average 1.6% reduction in brain volume.

While, in general, decreased brain volume is associated with decreased cognitive function, the study did not measure that, said Ann Helms, an assistant professor of neurology at the Medical College of Wisconsin.

"It (the study) is a valuable observation," said Helms, who was not a part of the study. "But we need to say, 'what is the cognitive effect of this?' "

Helms said the study raises an interesting question about the role of alcohol in health.

One the one hand, a great deal of research suggests that moderate alcohol consumption may be good for the heart and may also help prevent strokes. But alcohol also may be toxic to brain cells, Helms said.

"There is no safe level of alcohol when it comes to loss of brain volume," she said. "If you are worried about cognitive function, you shouldn't drink anything."
How much is too much?

Helms said she would not recommend that anyone start or stop drinking moderately for health reasons.

However, she said it is reasonable for people to base their drinking habits on individual risk.

For instance, a person with a family history of heart disease or stroke might want to drink moderately. But a person with a family history of dementia or Alzheimer's disease might want to avoid alcohol, she said.

"Too much is not good," Helms said. "Unfortunately, it's not clear what that point is for any person."

The effect can be especially pronounced for women. Their rate of brain volume decline was roughly 50% more than men across the various drinking categories.

Women tend to be affected by alcohol more than men, because they metabolize and absorb it differently. As a result, they achieve higher levels of alcohol in their blood and become more impaired from the same amount consumed by men of the same body weight.

Heavy drinking among men and women is known to be bad for both the heart and the brain, said Bhupendra Khatri, director of the Center for Neurological Disorders at Aurora St. Luke's Medical Center in Milwaukee. Some of that likely is due directly to the alcohol and some of it probably is caused by the poor nutrition often found in heavy drinkers, he said.

What is interesting about the study is that it showed for both women and men that alcohol consumption was associated with a linear decline in brain volume from light drinking to heavy drinking, he said.

"The more you drink, the more it (the brain) atrophies," said Khatri, who was not part of the study. "There is a fine balance in life. You need to look at your own risk factors."

source: Milwaukee Journal Sentinel
author: JOHN FAUBER

Why Big Alcohol Fears Regulation

If you’ve ever wondered why the alcohol industry lobbies so hard against laws that might hinder its bottom line, a new study might shed some light. A comparative analysis of alcohol control policies in 30 countries found a clear link between alcohol policy and public health.

The study’s authors gauged the strength of each country’s alcohol control policies, such as limiting availability, price controls, and advertising. Using an index, each nation was given a policy score. The analysis revealed a strong negative correlation between score and consumption; in other words, the stricter the policy, the less alcohol was consumed. And while this should come as no surprise, it is disappointing to see how the US compares to the rest of the developed world. We ranked 15th out of 30, falling below Australia, Japan, Canada and most of Scandinavia.

analysis is by T. Eve Greenaway, Marin Institute

The personal dope on medical marijuana

The pot smokers came to a downtown hotel on a recent afternoon to hear the speeches, to meet others and to talk. Who, me? I attended the Cannabis Awareness Forum, not because I am unaware, nor because I inhale, but because I tend to favour legalization.
I sat up front, next to Erin Maloughney. By way of making conversation, I asked if she was a medical user of marijuana. Erin smiled amiably, dug into her wallet, showed me her licence and said, "I can grow 25 plants. I can transport 1,125 grams, and Ican possess 150 grams. I have to renew my licence annually. Which is funny, because the pain never goes away."

The pain?

"I broke my back twice. The first time, I was 13 years old. I was asleep in the car with my lap belt in place. My friend's father didn't turn on the highway where it bends. The car jumped a creek bed and it crumpled. A doctor found us and pulled us out. We were taken to Sick Kids Hospital. My friend didn't walk again. I did.
"The second time I broke my back, I was riding my bike to work. I was hit by a car. The car didn't have its turn signal on." Erin had been a career receptionist. She can no longer work. She smiled enigmatically and said, "In my last job, I was on the joint health and safety committee."
It took me a moment to catch on.

Joint health.

What is not funny is that she is in constant pain; several of her vertebrae are fused, and she has other annoying chronic problems. How bad is the pain?

"I'm always at four out of ten. I can turn my head and ... oh, I just jumped to a seven. It's never-ending. It gets worse with the rain, with humidity, with menses. I can't walk with my groceries. That's life."

The dope keeps the pain at a manageable level.

"I started smoking after the first accident. It was a teenage thing; someone's brother was a dealer. One day we lit up. The other girls got giggly. I didn't.

"Normally, if I'm sitting on the ground, I get stiff and it's hard to get up. I can't walk uphill. I can't run. But after smoking the joint I got up easily. The other girls asked me why wasn't I shaking my stiff leg."

She said, "I felt good."

Let's be clear: good is relative. Let's be clear about something else. Regular painkillers do not work for her, and they are hard on her body, nor are they meant to be taken in the dosage she needs. And even though the grass helps her get around, she is not now and will never be as mobile as she'd like to be.

She got an insurance settlement a few years after she broke her back the second time. She said, "I've been living in a condo downtown. I've made adaptations. I have grab bars, a raised toilet seat, cork floors. I wear better shoes. I get cortisone shots."

She also gets her nerves zapped with microwaves. "They place a needle in my spine, and they test to find the nerve that's hurting and they zap it; the nerve cooks inside me. Eventually it re-grows and the pain comes back."

So, um, how does she use grass? Is she a smoker? Is she a baker? Does she make tea with her tea? "I take bong hits and I make marijuana butter."
I am familiar, in an academic way, with the uses of the bong; the butter was new to me.

Erin said, "I take a crock pot, add a pound of butter, add my marijuana and some water. I leave it overnight. I stir it once in a while. The butter turns green. I don't clarify it." And with her magic butter she bakes cookies and makes chocolates, and dresses her pasta.

She has recently turned part of her apartment into a modest garden for some two dozen marijuana plants. And she is being pursued by the other residents of her condo, who think she's running some sort of grow-op.

Oh, kids.
If you think two dozen plants are a problem, you have never seen a real grow-op. In any case, she's legal.

Erin twisted in her chair and stretched her back and winced, and then she smiled. I said she seemed pretty chipper, all things considered, and I asked if her mood was a function of the herb. She said, "No, it's a quirk of character. Live long. Sing out loud. Dance even if no one is watching." Words to live by.

How often does she use?

"I smoke every hour on the hour. I'll just nip out into the alley now. If anyone gives me lip, I'm feisty. I don't see asthma sufferers going into the alley to inhale. What I'm doing is legal."
And, frankly, it is necessary for her health. She is not a product of reefer madness. She is the girl next door. She is also one of some 1,800 medical users of marijuana in Canada.

source: The Toronto Star
author: Joe Fiorito

Drugs pose challenge for doctors

By CHRIS MERRILL
Star-Tribune correspondent Wednesday, May 02, 2007

LANDER -- Medical professionals call it “narcotic-seeking behavior.” ER doctors see it almost every shift they work. It’s just one of the many manifestations of drug dependency.

A person comes into the emergency room with the chronic side-effects from addiction to methamphetamine, for example. He's suffering pain from dental deterioration. Or he's at the tail end of his “high” -- “tweaking,” physically exhausted, but anxious and unable to sleep, maybe feeling a little psychotic, and looking for something to help him “even out” so he can relax and finally get some rest.

Others are simply addicted to narcotics, legal or otherwise. They come to the ER with one goal in mind: Get some hydrocodone, oxycodone, some sort of opiate like those found in the brand name drugs Percoset and Vicodan.

It puts doctors in a tough spot. They have to learn to distinguish between the addicts and the rest. They have to become adept at differentiating between the side-effects of drug addiction, non-drug-related problems, and lies.

An analgesic that might be of great help to a normal patient might instead aid in furthering the problems of a chemically dependent person. This is why it is essential that an emergency doctor learn to identify the addicts.

“Obviously, we don’t want to feed their addiction -- we want to help people,” said Dr. Greg Clifford, head of emergency medicine at Lander Valley Medical Center.

The best way for a doctor -- in the context of the ER -- to help a drug addict is to refuse to prescribe narcotics, Clifford said. The physician must then try to explain to the individual about the risks associated with his or her drug dependency, give the patient information about treatment options, and hope that someday soon the person will decide to “get clean.”

More likely than taking the physician’s advice, the individual will probably just try another ER, or some other avenue for obtaining the drugs.

Until a chemically dependent patient desires to get clean, or until the individual is arrested, doctors must simply treat the side-effects of his or her addiction, and give the patient the medical information he or she needs in order to make an informed decision. The idea is that you never want to discourage people from seeking medical care, but if doctors were asked to “play cop” with drug users, the net effect would be to do exactly that.

“I don’t think it’s our job to be the law -- it’s our job to educate,” Clifford said.
The rest of the story here...

source: Jackson Hole Star Tribune

If you think you have a problem, you probably do...

Alcoholism as a disease process affects the individual, family, and society as a whole. The devastating impact of the disease can be seen in alcohol-related health problems, child and spouse abuse, divorce, job loss, accidents, crime, homelessness, and other losses. Currently, the concept that alcoholism is a disease and an addiction is widely accepted by professionals in the field.

When does drinking alcohol become a problem? The key appears to be a loss of control. Clinically, a person is considered an alcoholic if he/she continues to drink even though alcohol is causing emotional, family, physical, social, and occupational problems.

Alcoholism does not discriminate. It is found in all socioeconomic classes and cultures. The risk is also very high that children of alcoholic families will become alcoholic themselves.

Although alcohol is considered a depressant among drug classes, it has a stimulating effect. This effect is due to a lessening of inhibitions rather than to true physical stimulation. As the dose is increased, progressive depression of brain function occurs. The dose needed to produce the depressant effect depends on such variables as age, weight, sex, level of tolerance, and physical condition. For several reasons, alcohol can damage every cell in the body. First, it is found in all body fluids. Second, used repeatedly it is toxic to body tissues. Third, it is converted to a substance that is even more toxic to the body than its original form.

After ingestion, absorption primarily occurs in the stomach. A certain percentage is eliminated through the lungs and kidneys, and the remainder is broken down in the liver. This is part of the normal process that occurs when a person drinks alcohol. The metabolism of someone who is alcoholic is dramatically different.

Alcohol-related medical problems include liver disease, stomach and intestine damage, gallbladder disease, pancreatitis, high blood pressure, damage to the heart muscle, and disorders of essential body elements including low sodium, potassium and blood sugar as well as disorders of the thyroid gland. Alcohol virtually affects every organ.

Alcohol also affects the immune system, or the body's ability to fight infection. Because alcohol affects our inhibitions, it puts people at extremely high risk for participating in activities that can lead to AIDS, and chronic hepatitis. Alcohol also causes breakdown in the bones and muscles of the body. Kidney disease, numerous skin conditions, decreases in the production of all types of blood cells, cancer of the mouth; as well as voice box, tongue, esophagus, liver, lung, head, and neck problems are possible. As a depressant, excess alcohol intake acts on a variety of brain structures and can be associated with psychosis and dementia. Alcohol contains no nutritional value and excess intake causes vital loss of essential nutrients the body requires for cell repair and function. In addition, Fetal Alcohol Syndrome may occur because during pregnancy, alcohol crosses the placenta to the developing baby, which can result in physical abnormalities and developmental retardation.

Treatment of alcoholism incorporates both short-term and long-term goals. Short-term goals include safe detoxification, control of behavior and suppression of signs of delirium without endangering the person. Long-term goals may include involvement in a drug treatment program and community support groups and lifestyle changes in areas of socialization, leisure-time use, exercise, and nutrition. Some people may need a short term of anti-depressant therapy based upon significant clinical findings.

source: Reno Gazette Journal
article submitted by:
Lyon Council on Alcohol & Other Drugs
2475 Fort Churchill Road
Silver Springs NV 89429
Phone: (775) 577-4633
John Malek, PhD
Board Certified Family Nurse Practitioner