Thursday, February 28, 2008

Time to re-assess attitude to alcohol

Prime Minister Kevin Rudd was right when he said recently that alcohol abuse was a growing problem and that the "epidemic of binge drinking" he had witnessed was "not good".

Interestingly, our Prime Minister's remarks make for a fascinating juxtaposition with those of someone in the alcohol service industry. The owner of the Normanby Hotel (in Queensland), defending his hotel's record on public safety, was recently quoted as saying: "If we're so bad, why are we so popular?"

It's not rocket science to realise that popularity is not necessarily an indication of whether something is good. All it shows is that it is popular. After all, smoking is popular. So is junk food. But neither of them is "good".

Furthermore, being good doesn't always guarantee popularity – if that was the case, carrots and celery would be in much higher demand. And why do we tend to lean towards popular – even when we know that, sadly, carrots are better for us than chocolate.

One thing our society is generally good at, supported by underlying philosophies such as individualism and materialism, is elevating short-term pleasure over long-term benefits. Hence, a smoker will tell you that they know cigarettes are bad for them but they still smoke.

It's why I choose a chocolate bar instead of an apple for a mid-afternoon snack, or sleep in instead of getting up and exercising. I know what is good, but the good is not always popular. And being popular does not make it good – no matter what the owner of the Normanby may hope.

And so we find that alcohol abuse and binge drinking have become popular, and is a fast-growing problem for Australian society.

Figures recently quoted in The Courier-Mail, and sourced from the National Health and Medical Research Council, suggest there are staggeringly high levels of binge drinking occurring in young Australians. More than 40 per cent of 16 to 17-year-old drinkers consume alcohol at hazardous levels.

Some dismiss those who are warning of the dangers of youth drinking patterns, and argue that young people have been drinking illicitly for generations. There is a level of truth to that, however, the nature and environment in which alcohol consumption is taking place now is fundamentally different from even five years ago.

So what can we do? Part of the problem lies in the fact that the nature of alcohol being consumed by young drinkers has changed drastically. Young drinkers are not experimenting with beer or wine. They are choosing spirits and mixers, and the pre-mixed drinks such as UDLs and Vodka Cruisers are hugely popular. When alcohol doesn't taste like alcohol, such as with drinks like these targeting the teenage market, you get young people underestimating the effect of what they are drinking. It's a recipe for disaster.

Of course, during the teenage years, and early 20s, many people are also struggling with issues of identity, insecurity, peer pressure and fear of rejection. A substance, which promises – even temporarily – to remove inhibitions, embolden the drinker and include them in a socially popular activity, is one that is difficult to resist.

Further complexities arise when you consider the social environment in which young people are being raised. Over-arching community ideas, such as short-term gratification, throwing off restraint and self-determination all combine to create a cocktail of impending disaster.

If we care about reducing the binge drinking happening among our young people, we should consider carefully the words of Geoff Munro, spokesman for the Australian Drug Foundation. He said: "The whole culture impels people into believing that drinking is important, that it should be a part of every social occasion."

We know this to be true – so how do we expect young people to "just say no" if the rest of society is saying yes. What can we do? Well, in a recent interview, Munro encourages us to "re-assess the role alcohol plays or should play in society".

That is something that Rudd and Health Minister Nicola Roxon can take a governmental approach to. But it's also something we can all do – as individuals.

After all, I could think about how my implicit assumptions regarding alcohol create the shared community experience we have and how I could help bring about a change personally. When you think about it, that's a really good idea – and perhaps, we could even help make it a popular one.


Monday, February 25, 2008

Seattle offers a place for homeless to call home - even to drink

The 75 tenants at 1811 Eastlake were once chronic drunks, living and boozing on Seattle's streets. Two years ago, outreach workers rounded them up and gave them their own place to live - and drink.

Despite an initial furor about taxpayers' supporting chronic alcoholics - "bunks for drunks," some critics have called it - Seattle Mayor Gregory J. Nickels announced last month that the program was succeeding.

Nickels said 1811 Eastlake and a second facility, Plymouth on Stewart, had saved taxpayers $3.2 million in emergency social and health services formerly spent on homeless people. Tenants have also reported a one-third reduction in the number of days they get drunk.

Built with $11.2 million in government funding, 1811 Eastlake costs taxpayers $13,000 a year for each tenant. That's a fraction of the $50,000 Seattle says it would spend on jails, emergency hospitalization and treatment for each homeless person on the street.

But 1811 Eastlake is not a glorified flophouse.

It has two staffers on duty around the clock. And with the help of 14 other full-time staff and counselors, tenants get two hot meals a day, trips to a local food bank, medication monitoring, and health services through Medicaid. They also receive housewares, clothing and other supplies.

The theory behind 1811 Eastlake is "Housing First," developed 15 years ago by Sam Tsemberis, an advocate for the homeless in New York City. About 150 cities, including Philadelphia, have adopted variations that are less radical than Seattle's.

After years of working with homeless people, Tsemberis decided the traditional ways did not work. He turned the model on its head: First get the homeless into housing, then provide services to keep them off the streets.

In 2005, the Robert Wood Johnson Foundation, the Princeton health-care research organization, awarded $400,000 to researchers at the University of Washington who are studying the Eastlake approach. The three-year study ends in July.

New York City expects to open its version of 1811 Eastlake within a year. Rob Hess, who ran Philadelphia's homeless services for five years before accepting the same job in New York in 2006, said he was not surprised that chronic alcoholics did less drinking once they were in their own apartments.

"They have . . . a safe environment as opposed to having to sleep on the streets," he said.

"Nobody really wants to live on the streets."
source: The Philadelphia Inquirer

Friday, February 22, 2008

The half-hearted war on drugs—in prisons

Getting drugs into Canadian prisons is deceptively simple. So are the solutions.

"It is not surprising that drug abuse and trafficking is an issue within the penitentiary walls," the Correctional Service of Canada Review Panel wrote in its largely ignored December report to Public Safety Minister Stockwell Day. It is "unacceptable," they stressed. It "destroys hope of providing a safe and secure environment where offenders can focus on rehabilitation." But not, somehow, surprising.

The panel, which was chaired by former Ontario Cabinet minister Rob Sampson, is probably right. Drugs in prisons are a worldwide phenomenon, and by no means a new one. But that doesn't make the statement any less remarkable. The facilities to which we send society's most dangerous elements to keep them away from us—in hopes they'll reemerge, at the very least, less dangerous and, ideally, as productive members of society—are themselves criminal environments. And not just a little criminal, either. Fully 10.5 per cent of random urinalysis tests conducted in Canadian prisons in 2005-2006 came back positive. Meanwhile, 12.4 per cent of tests were refused (they cannot be administered without inmates' consent). A suspicious mind might assume a fair proportion of those would have come back positive, had they been administered.

How do drugs get into such supposedly secure environments? On the demand side, "[a]bout 4 out of 5 offenders arrive [in prison] with a serious substance abuse problem," the CSC Review Panel wrote. As the gang-affiliated population in prison grows—by a third in the past decade, according to CSC Commissioner Keith Coulter—the number of inmates with on-the-job experience in the drug trade exacerbates the problem. And, famously, there isn't much else to do in there.

The supply side, meanwhile, is limited only by the gag reflex and human ingenuity. Putting contraband inside tennis balls and hurling them onto prison grounds is a tried and true method. The CSC Review Panel also mentioned bows and arrows. And it suggested, quite reasonably, that the decision at some facilities to stop manning guard towers had made the over-and-in technique a bit of a gimme. In New Zealand, the Christchurch Press reported last year that people had taken to stuffing methamphetamines inside dead birds and sending them on their last flight over the perimeter fence. A Corrections department spokeswoman referred to the technique as "wacky."

Visitors, who are at least theoretically subject to screening by drug dogs and ion scanners, are another huge point of vulnerability. But during its first-hand inspections of Canadian prisons, the CSC Review Panel noted that some gained access after a "no more than cursory" inspection. "Ion scanners are used inconsistently," says the report, "and in some penitentiaries, the Panel was told by staff that they could not properly use the technology because they had not been fully trained." And while drug-sniffing dogs have been proven effective, the Panel noted significant "service gaps." "[R]esources are insufficient to maintain a comprehensive search program," it stated bluntly, even recommending a national registry of prison visitors be established to monitor positive drug tests and screen out potential smugglers.

In its submission to the Panel, the Canadian Centre for Abuse Awareness suggested "any visitor convicted of attempting to transport illegal drugs or narcotics into institutions be banned for life from entry upon CSC premises." If anything, it seems astounding that they aren't already. After all, once drugs get past the visiting room, it's no small feat to recover them.

In one case chronicled by University of British Columbia law professor Michael Jackson in his 2002 book, Justice Behind the Walls, an inmate was observed stuffing something down his pants during a visitation. A strip search having revealed nothing, policy dictated he be placed in a so-called "dry cell"—i.e., no plumbing—on the theory that the contraband would have to reappear eventually. After officers witnessed him again rummaging around in his pants, they again strip-searched him, forcefully bent him over and spread his buttocks, revealing a balloon full of marijuana. But in the ensuing legal battle over whether searching protocols had been correctly followed, the officers' differing accounts of the event came into play—some said the balloon had been "removed" from the inmate's buttocks; others said it had simply "appeared." The inmate's account was considerably more violent. The guidelines allow guards to compel an inmate to bend over, Jackson wrote—even if it raises serious "ethical and constitutional issues"—but they say nothing about the spreading of buttocks. In the end, the case against the inmate was dismissed due to a faulty chain of custody of the balloon in question. But had it gone further, he might well have escaped punishment despite all acknowledging he had smuggled marijuana into a prison in a balloon in his rectum.

Staff who heard about the acquittal, Jackson wrote, unsurprisingly "saw it as yet another example of the Independent Chairperson leaning over backwards to protect prisoners from the consequences of wrong-doing." And it's not surprising that rank and file union members remain the loudest voices calling for change on the inside. Their inherently dangerous workplaces are compounded by policies such as voluntary, not mandatory, testing of inmates for HIV and Hepatitis B and C upon admission to a CSC facility. "This means that when correctional officers are pricked with dirty needles or showered with offenders' feces," the CSC Panel wrote, "they literally fear for their lives."

But depending on whom you talk to, staff can also be part of the problem. In 2005, Alice English was charged with smuggling fully 2.8 kilograms of marijuana, as well as crack, cocaine, hashish, cellphones and pornography into the Bordeaux jail. She copped to it in videotaped testimony this week, but said she only did it once, and only because inmates had threatened her children—and she added that other guards must have been complicit in the arrangement, since there was no other way inmates could have known such details. Pierre-Arold Agnant, a guard at the Montreal Detention Centre, was nabbed last year for allegedly accepting bribes to allow a gang-controlled smuggling ring to bring drugs into the facility. It's impossible to know for sure, but Jackson said recently he suspected as much contraband entered prisons via staff as via visitors.

Despite that, at least one CSC facility did not "routinely" search staff members at all as they entered in 2006, according to a heavily censored report on drug interdiction activities from the CSC's Audit Branch. Its report noted that ion scanners and sniffer dogs were rarely used on any CSC staff. These "would mitigate a significant risk," the report read, noting that "the rise in organized crime may increase attempts to compromise staff."

Stockwell Day's office pledges a commitment "to ensuring a fair and effective corrections system with a priority to protect Canadians." Which, ultimately, is the point. It's easy not to care about what people put up with behind bars—but as one inmate told Insight magazine for its exhaustive look of drugs in American prisons, "They should understand that these guys are going to get out some day. They are going to be your neighbors, cutting your grass." Cracking down on visitation rights—or cutting them off entirely, as the CSC Review Panel suggested if the situation worsens—would demoralize prisoners and jeopardize rehabilitation efforts. But most studies have concluded that drugs are the single biggest factor in creating a criminal, disrespectful atmosphere in prisons. Cracking down on staff screening, meanwhile, would be sure to create strife with the unions. But the overwhelming impression, given the ingenious yet simple ways in which drugs arrive in prison, is that the problem could be solved if the political will existed to do so. The platitudes emanating from Day's office don't exactly reek of urgency.

Thursday, February 21, 2008

Islander brings scientific awareness to the epidemic of alcoholism

Psychologist Santi Meunier has spent most of her adult life exploring the ravages of substance abuse. In her new book, "Dying for A Drink: the Hidden Epidemic of Alcoholism," Meunier presents hard evidence that proves alcoholism is not simply a bad choice, but a disease resulting from a combination of genetic, physical, and psychological factors. Environmental, social and spiritual factors also play a strong role in alcohol addiction, according to the book.

Citing references to a variety of medical and scientific periodicals, Meunier packs a systematic punch into her book. "I want to dispel the myths about alcoholism," Meunier notes. She brings to light that alcoholism is no longer thought of as a subjective diagnosis, but as a medical diagnosis of a brain disorder. "There's so much stigma and judgment in our society related to alcoholism. I want to clarify why it is a disease."

Research of alcohol dependency has become more sophisticated, Meunier continues. Scientists are working to isolate the alcohol gene. In the next few years, an actual test will be able to prove alcohol is chemically connected. "We are basically chemistry," she points out.

Meunier has worked in the field of recovery for over 20 years, holding a long track record of private practice with troubled families. She points out that alcoholism ruins families, friendships, jobs and health. "Alcoholism is a three-fold disease. There is a physical addiction, an emotional dependency and a soul sickness, or spiritual dependency," she says.

As part of her scientific approach, Meunier has developed a series of practical concepts and solutions she presents through speaking engagements and private practice. Her methods show how society stays emotionally blackmailed through addiction.

"Three outcomes are imminent for the alcoholic: finding success in a recovery program, being institutionalized or jailed, or facing an early death," she says. Her own step by step guide called the Holographic Treatment Program helps people who want more than "okay" sobriety, Meunier explains.

Meunier has moved from her personal experience of witnessing the devastating effects of alcohol in her own family to pioneering her three-level outpatient recovery program for adult children of alcoholics. She has helped troubled adolescents through developing abuse and addiction recovery programs for several residential schools.

Meunier has found through her research that relapse of alcohol abuse is very high, and has pushed on to research why. "We are not dealing with the problem holistically," she notes. Meunier recalls the 'Just Say No' program from the 1980s, saying, "It was a good start, but it did not look at why children start drinking." The average age that boys start drinking, she adds, is 11. "If the brain chemistry is low, that group will try to selfmedicate," she explains. "They take the drink, and the chemical level goes up. For the first time, they have a feel-good chemistry." But over time, the chemistry level drops lower, creating more imbalance.

Those already familiar with Meunier's work have witnessed how her program, "Practical Spirituality for Fearless Living," uses ground-breaking tools for personal and professional growth. She notes that fear is the ultimate robber that keeps us from fulfilling our life purpose. "The world needs us to be a success," she adds.

Meunier is planning a series of speaking engagements geared toward high school- and middle school-aged children. She also plans corporate seminars that address addiction in the workplace. "The amount it costs us as a society is huge," she says. "I am becoming a spokesperson for the reality and solutions in an addicted society."

Meunier's book is now available online at the publisher's Web site,, and also can be ordered through Amazon Books or any Barnes and Noble outlet. Jamestowners may order signed copies directly from the author by calling her at 667-7399, or visiting her new Web site, www., which is expected to be online in March.

Monday, February 18, 2008

Diary of a functioning alcoholic

They're smart, successful professionals who never miss a day's work - the very opposite of the image of the problem drinker. Natasha Courtenay-Smith meets three upright young women who thought alcoholism would never happen to them

Before she fell pregnant in 2000 Olivia McMahon had a reputation as a bit of a party girl. On a night out she was always the first to the bar and the last to leave, and was proud of her ability to throw back more tequila shots than any of her peers.

'I was always up for getting really drunk - I had been since my teens,' says Olivia, now 37, a successful food photographer. 'I didn't think I was any different to my friends or my husband. We all liked socialising and having a good time, and I wouldn't have even considered that any of us was drinking too much. Yes, I did throw up from time to time, and suffered from memory loss after a big night out, but doesn't everyone? I could still drag myself into work in the morning, even if I did have a stinking headache, so I couldn't see what the problem was.'

Even when, following the birth of her daughter Chloe, Olivia began to drink during the day, too, she wasn't concerned about the amount of alcohol she was consuming. 'I had a few friends with babies of the same age, and we'd all get together for lunch, during which I'd inevitably crack open a bottle of wine,' she recalls. 'I'd end up plastered by 3pm, and would open another bottle of wine in the evening when my husband got back from work. The last thing on my mind was that I had a problem - I was just making the most of my maternity leave. I'd stopped breast-feeding by then, so I wasn't worried about my daughter.'

Olivia's case may be extreme but these days she is far from alone. According to the Office for National Statistics, almost a quarter of adult women report drinking five days or more per week, and recent NHS figures state that a fifth of women drink more than the recommended number of units at least once a week. Even those of us who have grown out of excessive bouts of binge drinking seem to have a bottle of wine permanently chilling in our fridges and think nothing of pouring ourselves a large glass to accompany our dinner.

Yet how many of us realise that alcohol affects women's bodies differently to men's, and can increase our risk of cancer, digestive problems and coronary heart disease? The number of women in Britain dying from drinking has almost doubled since 1991 to just under 3,000 in 2005, with women aged between 35 and 54 the fastest-growing group of victims. High-profile deaths related to alcohol include Sally Clark, the solicitor wrongly jailed for murdering her two sons, and the ex-MP Fiona Jones, who died last year aged 49. She turned to drink to deal with the stress of working in the House of Commons and slid into full-blown alcoholism after losing her seat in 2001.

For Olivia, returning to work meant that her drinking escalated. 'I was being pulled in so many different directions that I couldn't do anything properly, and alcohol was the only way I knew to relieve the stress,' she says. 'We'd often have bottles of wine and champagne on photo-shoots, and I'd have a glass while I was working. No one said anything as they all thought I was just game for a laugh. At home I drank more than ever, too. I could easily polish off a bottle of wine on my own, and would frequently have a third of a second bottle as well.'

By the time Chloe was two Olivia was out every night drinking heavily with friends, while her husband looked after their daughter. He eventually kicked her out of the family home. Still, when he insisted she had a problem she wouldn't listen. 'In my mind I didn't fit the mould of the alcoholic. I didn't keep vodka in my sock drawer and I didn't drink first thing in the morning.'

So how much alcohol is too much? The Department of Health recommends that women drink no more than 14 units of alcohol a week, and no more than three units in any one day (a 175ml glass of wine at 13 per cent is 2.3 units; a measure of spirits is one unit). After an episode of heavy drinking it is advised that you refrain from drinking for 48 hours to allow the body to recover. But William Shanahan, the medical director at the Capio Nightingale clinic, which offers treatment for addiction problems, says such guidelines are confusing.

It is not possible to state, he says, a single tipping point at which heavy drinking can be called alcoholism. 'It's important to remember that all alcohol is a poison, and that our bodies are only able to metabolise one unit an hour,' he says. 'Anything over that will damage your body. Most people hate the term "alcoholic" because they don't see themselves sitting on Hungerford Bridge with a brown paper bag. It's much more helpful to think of it in terms of "harmful drinking" and "dependent drinking" rather than simply as alcoholism. Drinking is harmful if it causes a problem in any area of your life. If, for example, your character changes for the worse after a few glasses of wine, you might not be dependent on alcohol but there is a problem and you do need to look at the way you drink. If it affects your work, leads you to have unsafe sex or results in mental problems such as depression, you definitely need help. Dependent drinkers find that life is not possible without a drink, and they also experience withdrawal symptoms or cravings for alcohol. This is equally a problem that needs medical help.'

For Olivia McMahon help came in 2004 when she finally went into rehab at the Life Works treatment centre, after her husband stopped her seeing her daughter. 'I hadn't been able to accept I was an alcoholic, but the truth finally hit home when tests showed my liver function was seriously impaired,' she says. 'By the time I came out I was not only clean but was also determined never to drink again. My marriage was beyond repair, so my husband and I sold our house and I was able to buy myself a small flat. He insisted on Chloe continuing to live with him until I'd proved I was fully recovered,' she says, 'and 18 months ago Chloe finally moved back in with me.'

According to Frank Soodeen, a spokesman for Alcohol Concern, it is women in professional households who are the most likely to drink regularly and to excess. 'Studies have shown that professional women use alcohol as a prop to cope with exhaustion, anxiety, isolation within a family setting and possibly feelings of "loss of role" when children leave home,' he says. 'Women also drink to deal with the stress created by having to balance home obligations and intense competition at work.'

That is certainly the case for Georgina Lucas, an advertising executive who insists that within her work environment it is normal to manage stress using alcohol. 'My job involves flying back and forth across the Atlantic up to four times a month,' says Georgina, 34. 'I negotiate deals that are worth millions to my firm. I live in a state of permanent jet-lag, dealing with international clients who call me on my mobile any time, day or night. Even when I'm at home I'm up at 6am, in the office by 7am and spending all day in and out of incredibly stressful meetings.

'I drink to help me cope with the demands of my job, and to put me to sleep at night. Because I'm constantly changing time zones I end up drinking around the clock and spend a lot of my time mildly drunk. I can't see when I'll stop drinking as I'm single and not about to settle down any time soon. Alcohol and my job come hand in hand. I need to drink in order to cope, and to sleep. I don't even think about what effect alcohol could have on me in the long term; I don't see the point in worrying about the future when I've still got the now to get through.'

Although not surrounded by the stress of a corporate environment, 28-year-old Ruby Holmes also has a troubled relationship with alcohol. She began drinking heavily at university to mask the insecurities she felt about her body and looks. 'As a teenager I suffered from bulimia, and just looking at my reflection in the mirror would make me burst into tears,' says Ruby. 'I discovered alcohol when I got to university in Cardiff, and as soon as I had my first drink all my low self-esteem melted away. From then on I started drinking every night - I could easily polish off a bottle and a half of wine in one sitting. I also used to go to the student union to have a pint at lunchtime.

'I began to use drink to be liked and to boost my confidence. It was as though I'd started living a double life. Sober, I was quiet, introverted and frumpy. Drunk, I was fun-loving, extrovert and wore skinny jeans, miniskirts, vest tops and strappy dresses. I was able to flirt with men, which I could never do sober.'

Although Ruby found work after university, as an independent documentary-maker, her drinking slowly began to catch up with her. By the beginning of 2006 she'd sunk into a chronic depression. 'By this point I'd taken to drinking cheap vodka as well as wine at night, and in the mornings I'd wake up full of anxiety and self-loathing, with a sense of dread in my stomach,' she says. 'I could hardly work at all because I constantly had a hangover, and what with having to pay rent on my flat I was mounting up huge debts. By last summer I was drinking in the daytime, too - usually cheap vodka. Everything good about my life had fallen away and alcohol was the only thing I had to keep me going.'

Last year, realising she had a problem, Ruby attempted to go cold turkey. After experiencing severe withdrawal symptoms, including hallucinations and the shakes, she called an ambulance and was admitted to hospital with severe liver necrosis caused by alcohol abuse. She stayed in hospital for a week and was told that unless she stopped drinking she would die.

Recovery has been far from easy. 'I've been given anti-depressants and had counselling, but staying away from booze initially felt like a constant battle,' she says. 'None the less, I've managed to stay sober ever since, and it's as though a mist has cleared from in front of my eyes. My depression has vanished and, thanks to counselling, my body image has improved.

'Without alcohol I am ambitious and look to the future. I now look at all my friends, who still drink heavily alongside holding down full-time jobs, and wonder if they know the damage they could potentially be causing themselves. I'm just grateful I managed to stop drinking before it was too late.'

source: Telegraph

Wednesday, February 13, 2008

Opiate And Nicotine Addiction Shown To Have Additional Similarities

"That was good!" "Do it again."

This is what the brain says when people use tobacco, as well as 'hard drugs' such as heroin. New research published in the February 13 issue of The Journal of Neuroscience indicates that the effects of nicotine and opiates on the brain's reward system are equally strong in a key pleasure-sensing areas of the brain - the nucleus accumbens.

"Testing rat brain tissue, we found remarkable overlap between the effects of nicotine and opiates on dopamine signaling within the brain's reward centers," says Daniel McGehee, Associate Professor in Anesthesia & Critical Care at the University of Chicago Medical Center.

McGehee and colleagues are exploring the control of dopamine, a key neurotransmitter in reward and addiction. Dopamine is released in areas such as the nucleus accumbens by naturally rewarding experiences such as food, sex, some drugs, and the neutral stimuli or 'cues' that become associated with them.

Nicotine and opiates are very different drugs, but the endpoint, with respect to the control of dopamine signaling, is almost identical. "There is a specific part of the nucleus accumbens where opiates have been shown to affect behavior, and when we tested nicotine in that area, the effects on dopamine are almost identical," says McGehee.

This research is important to scientists because it demonstrates overlap in the way the two drugs work, complementing previous studies that showed overlapping effects on physiology of the ventral tegmenal area, another key part of the brain's reward circuitry. The hope is that this study will help identify new methods for treating addiction - and not just for one drug type.

"It also demonstrates the seriousness of tobacco addiction, equating its grip on the individual to that of heroin. It reinforces the fact that these addictions are very physiological in nature and that breaking away from the habit is certainly more than just mind over matter," says McGehee.

This work is supported by grants from the National Institutes of Health, T32GM07839 and F31DA023340 to JPB, DA015918 and DA019695 to DSM.

Source: Scot Roskelley
University of Chicago Medical Center

Monday, February 11, 2008

Much can be done to help children of alcoholics

Alcoholism in the home has long-lasting effects. Children of alcoholics often learn to cope with an unhappy childhood in ways that cause problems for them later in life. Learning about how alcoholism affected your past can help you build a better future.

Children of alcoholics often act in one of the following ways:

* They become super-responsible, like a miniature adult.

* They become a trouble maker.

* They become able to adjust to any change, without noise or fuss.

* They become a family clown or peacemaker, smoothing over troubles.

Children of alcoholics often believe they are all alone, that no other families have these problems or that it is up to them to cure the parent. A child may take the blame for a parent's alcoholism — or the parent may blame the child.

As a result, many children of alcoholics not only feel unloved, but unlovable. Some of them suffer physical or sexual abuse, which reinforces this feeling. And because life at home is full of disappointments, broken promises and lies, the child learns not to trust, not to get too close to anyone and not to communicate in healthy ways.

Adult children of alcoholics often retain their childhood patterns. The super-responsible child may grow into an adult who demands perfectionism. The child who is the family's scapegoat may have legal or financial troubles throughout life. The child who used to adjust to anything may be passive and withdrawn as an adult. And the family clown may grow up to be entertaining, but irresponsible.

An adult child of an alcoholic may be anxious, may try to control events and relationships, may have trouble being intimate, may be chronically depressed or have stress-related health problems.

Tragically, many children of alcoholics either become chemically dependent themselves or marry alcoholics.

If you know a child living in an alcoholic home, try these things:

* Gently encourage the child to talk about life and listen to what they say.

* Invite the child to an outing or offer a quiet place to do homework.

* Encourage the child to think of people who would be understanding and helpful in hard times — perhaps a teacher, friend, relative or neighbor.

* If the parent drinks and drives, give the child your phone number and offer to come pick him/her up.

* Suggest resources for the child, such as Alateen.

* Tell the child that he or she cannot cause, control or cure the parent's drinking.

* Tell the child that alcoholism is a disease and it's OK to love the parent but hate the disease.

Finally, if yougrew up with an alcoholic parent, find out more about alcoholism and its effects on family members of alcoholics.

Talk about your feelings and experiences with friends, relatives, people in 12-step programs, health professionals.

Remember you didn't cause your parent's drinking and no one but the parent had any chance of controlling or curing it.

source: Great Falls Tribune

Sunday, February 10, 2008

Students & alcohol — Coast to coast

Stories from campuses in South Carolina, California shed light on dangers of drinking

Here's hoping college faculty in Kansas and across the nation take good notes about something 40 professors at Fresno State have started doing in their classrooms.

Or, more accurately, something the professors aren't doing.

As part of a campaign by the university to combat irresponsible drinking, the Fresno State instructors have taken a pledge to watch what they say to students about drinking.

No more jokes during Monday morning labs about weekend hangovers. No more TGIF talk during the last lecture of the week.

Michael Caldwell, an associate music professor who organized professors to take the pledge, said he took the initiative partly in reaction to the alcohol-poisoning death of a 19-year-old Fresno State student in January 2006.

In taking the pledge, Caldwell and 39 of his colleagues agreed to become familiar with laws and campus policies about alcohol, and become aware of programs and services for students seeking help for alcohol problems. They agreed to promote responsible attitudes toward alcohol in classroom discussions, and they further pledged not to make comments suggesting that all college students drink to excess. Caldwell said students have told him their instructors have made comments to the effect of, "Everybody enjoy partying this weekend," and, "OK, it's the weekend. Let's go party."

"It's easy to make flippant comments about alcohol, and bring your own life or the college atmosphere into the classroom," Caldwell said. "It's usually very innocent and unintentional."

Although Caldwell said the pledge isn't designed to blacklist anyone or make faculty uncomfortable, the initiative has caught on with only a tiny fraction of the university's 1,300 part-time and full-time faculty. One faculty member said the pledge was a restriction on speech and raised questions about academic freedom.

What a sad reaction.

It's hard to see how taking a voluntary pledge would cause any harm.

What's not so hard to see is that excessive drinking is a problem on college campuses.

The same day The Associated Press distributed a story about the pledge, the AP also circulated a story saying three fraternity members at Clemson University were charged in connection with the alcohol-related death of a freshman during an off-campus party.

The fraternity members' activities weren't directly connected to the student's death, a prosecutor said, but the three were charged with transferring beer and liquor to a minor and using fake identification to buy alcohol. The students facing charges are 19, 20 and 21 years old.

The deaths at Clemson and Fresno State happened a nation apart, but they're not isolated incidents. Alcohol abuse has led to medical problems and fatalities on campuses elsewhere.

In reaction, college administrators are taking steps to curb excessive drinking.

The pledge at Fresno State is a grassroots step in that direction, and it's worth pursuing on other campuses.

source: Topeka Capital-Journal

Saturday, February 9, 2008

Methadone Deaths Gain Attention Of Medical Examiners

Formerly a drug used only to treat heroin addiction, methadone is becoming more popular in recent years to treat pain.

As the use of the drug increases, so too do the deaths at an "alarming rate," according the National Drug Intelligence Center. Florida has become one of the leading states for methadone overdose deaths, according to the Center for Disease Control.

Now, authorities are wondering if methadone may be fatal even in therapeutic doses.
"I would never let anybody in my family take methadone unless they were a heroin addict to begin with," said Hillsborough County Medical Examiner Vernard Adams.

The chairman of the Florida Medical Examiners Commission on Friday distributed a study to other commissioners citing increased instances of sudden deaths among methadone users.

Researchers in Oregon reported in the study published last month that methadone has been implicated as a likely cause of sudden death at therapeutic doses. In the study published in the American Journal of Medicine, the researchers recommended clinical safeguards and further studies designed to enhance the safety of the drug.

Adams said he's also noticed some methadone-associated deaths that are different from other deaths attributed to drug overdoses.

In addition to the fact that deaths are occurring at therapeutic doses, Adams said some methadone deaths involve heart issues. Most drug overdoses involve respiratory failure, Adams said.

But Adams said he has no statistics and cannot cite specific cases related to this possible phenomenon. He said he just has a general sense that this is something that should be examined.

"The fact that these people are dying from methadone at therapeutic concentrations, this is anecdotal," Adams said. "We haven't studied it the way these people in Oregon have."

In Hillsborough County, methadone was listed as a contributing cause in 37 deaths in the first six months of last year. Methadone was listed as the only cause in five deaths. In 2006, methadone was listed as a cause in 49 deaths, according to medical examiner data. In ten deaths, methadone was listed as the sole cause. In 2005, methadone was listed as a cause in 30 deaths in the county and as the sole cause in 10 more.

The numbers reflect a trend in Florida, where methadone was listed as a cause in 392 deaths in the first six months of 2007 and in 716 cases in all of 2006, compared with 2005 when the drug was a cause in 620 deaths.

Stephen J. Nelson, the chairman of the state Medical Examiners Commission, distributed the Oregon study at the commission's regular meeting. Nelson said he wanted medical examiners to be aware of the potential problem and to be on the lookout. It's possible, he said, that the commission may attempt to track methadone levels in the deceased.

In November, the National Drug Intelligence Center published a study titled, "Methadone Diversion, Abuse and Misuse: Deaths increasing at Alarming Rate." According to the report, the quantity of methadone dispensed nationwide more than tripled between 2001 and 2006.

The report described methadone as "safe and effective when used as prescribed," but said the drug has increasingly been misused and abused.

Methadone has been used in addiction treatment for the past 50 years, according to the report, which noted that the drug's use in pain management has increased steadily since the late 1990s. Physicians turned to methadone as an alternative to oxycodone and hydrocodone, which were being increasingly abused. It also can be used less frequently and is less expensive than other drugs, the report states.


Friday, February 8, 2008

Demand makes war on drugs daunting

Sgt. J. Centeno spends his days trying to get drug dealers off local streets, but he knows that act alone won’t stop the deadly cycle of addiction that will bring a new one in the next day.

That’s a daunting realization for the 16-year West Virginia State Police officer and commander of the Southern Regional Drug and Violent Crime Task Force.

“We are realizing something really sad about the war on drugs,” he told Princeton Rotarians Friday. “It seems almost like drugs can take a permanent stand ... It seems like we take five steps forward and six steps back.”

The cycle is as simple as the basic rules of supply and demand. As long as there are people in the area willing to pay for drugs, Centeno said there will be people willing to break the law and risk their lives to supply them. That’s why, in his estimation, the only way to win the war on drugs is to take many big steps forward before addiction has a chance to take hold.

Beating drugs and their dealers must start with prevention, and the younger efforts start, the better, Centeno said.

“We can always put a lot of drug dealers in jail and spend all of your tax money to keep them in jails,” he said, but preventing the next generation of drug users would be the best way to put drug dealers out of business.

And, there are plenty of those businesses alive and well in the region.

The six undercover officers in the drug task force investigate drug-related crime in Mercer, McDowell and Wyoming counties. In January alone, those six officers opened 50 separate investigations.

“We’re realizing we’re very good at reacting, but very few times do we see prevention,” he said.

Prevention tactics to keep kids off drugs should start early, he recommended, particularly in light of the disturbing results of Pride Surveys conducted in West Virginia 2003-05. Designed to measure students’ perceptions and activities regarding tobacco, alcohol and other illegal drugs, the studies involved students in middle and high school grades.

In 2002, 33.2 percent of West Virginia eighth-graders and 41.9 percent of 11th-graders surveyed reported using cigarettes within the last year. Approximately 42.8 percent of eighth-graders and 61 percent of high school juniors reported consuming alcohol within the year.

Those percentages dropped slightly in the 2004 survey, but not enough to create any comfort, according to Centeno, who said tobacco and alcohol use pave the way for more explicit drug use as teens age.

In 2004, 33.4 percent of West Virginia juniors surveyed reported using marijuana in the last year, while 8.4 percent reportedly used cocaine.

“This is the bad news,” Centeno said.

Part of the good news appeared to indicate students who were busy with school, family, church and community obligations weren’t the ones doing drugs. It was the juveniles at home or a friend’s house on the weekends who reported consuming the most.

“When they have things to do, when they have a lot of responsibilities, they don’t use a lot of alcohol or tobacco,” he said.

Solutions lie, Centeno said, in finding and providing safe, productive activities among positive peer groups and breaking the cycle of young generations simply falling into drug addiction because it’s a cycle they can’t escape.

“Drug users are like water. They seek the path of least resistance,” he said.

If communities, schools, families, churches and other positive organizations provide resistance, he predicted the war on drugs would be a fairer fight.

“We are in trouble with drugs. We’re fighting as hard as we can and as fast as we can,” he said.

In addition to community activities, Centeno said vigilant, educated citizens are essential to stopping dangerous drug patterns.

To report suspected drug activity in your community or learn more about the drug task force, call 327-DRUGS.

For more information on the Pride Surveys, visit

— Contact Tammie Toler at

source: Bluefield Daily Telegraph

Tuesday, February 5, 2008

Translating Steps 6-12 of Alanon

Alanon members say they get a lot out of working the steps of the program which are pretty much the same for Alcoholics Anonymous (AA) only they apply the principles to how alcoholism affects their own lives.

  • Step 6 states "Were entirely ready to have God remove all these defects of character." This is about not imposing one's will on others. For Alanons, this means relinquishing control freak behaviors over the alcoholic. (Source: Southwest Group). Your entire focus and obsession throughout the day is no longer on the alcoholic and you can actually have a conversation with friends without it being about "what he did today to me."

  • Step 7 says "Humbly asked Him to Remove Our Shortcomings." Alanon also has a workbook that goes into extensive detail regarding working the steps of the program. Some say it is in this step that Alanon members get some kind of peace and it is a relief to "not be trying to run the world in our household." In Alanon the name of the game is detachment as you will notice on any online support groups you find for the program.

  • Step 8 reads "Made a List of All Persons We Had Harmed and Became Willing to Make Amends to Them All." Many Alanon members are surprised to learn that the first person on their list is the alcoholic, according to Anger is common for Alanons who are typically referred to by old-timers in Alanon as "untreated Alanons." What that term means is that this is a person who has not worked the steps of Alanon and can only talk about the problems instead of the solution.

  • Step 9 reveals "Made Direct Amends to Such People Wherever Possible Except When to Do So Would Injure Them or Others." One Alanon member writes that this step is a "Put your money where your mouth is step" with no expectations. It has been said that living with an alcoholic is like living in a "half-world" and you can't count on anything.

  • In Step 10 you "Continued to Take Personal Inventory and When You Were Wrong, Promptly Admitted It." Newcomers in Alanon typically see themselves as saints at first before ever getting a sponsor, attending their first meeting, or doing an inventory, according to a few Alanon members. But as they grow they begin to see "where they themselves start the ball rolling." Some people just coming to Alanon might say that their husband just smokes pot, nothing major and that it never bothered them until recently. Some might say this is "hitting a bottom in Alanon" when you realize that you need help dealing with your emotions surrounding your spouse's addiction.

  • Step 11 says "Sought Through Prayer and Meditation to Improve Our Conscious Contact with God as We Understood Him, Praying Only for Knowledge of His Will for Us and the Power to Carry That Out." What this means is you discover the plan your Higher Power has for you. A lot of times the recovering alcoholic is in denial about what went on when she drank - what it did to her family, kids, husband; etc.

  • Lastly, in Step 12 Alanon members "Having had a Spiritual Awakening as the Result of These Steps, We Tried to Carry the Message to Others and to Practice These Principles in All Our Affairs." This is the only step of Steps 1-12 of Alanon where the wording is different than AA. In AA the word "others" is substituted for "the alcoholic who still suffers" in Step 12.

All of the steps of Alanon result in a changed attitude toward the alcoholic. You see him or her as a sick person on an emotional level, not just an intellectual one.

source: Associated Content

Monday, February 4, 2008

Acculturation In The Texas-Mexico Border Region: Effects On Drinking Differ By Gender

Previous research has shown that immigrant groups that acculturate to mainstream American culture tend to have more alcohol-related problems. Most of this research, however, has been conducted among Hispanic populations living in U.S. metropolitan areas. A study of Hispanic populations along the Texas-Mexico border has found that acculturation appears to have different effects on drinking by men and women.

"As immigrant groups acculturate to mainstream America, at least in the case of alcohol, because U.S. norms regulating alcohol use are more liberal than those of other countries, especially regarding drinking by women, as women acculturate they drink more," explained Raul Caetano, professor of epidemiology and regional dean (Dallas) at The University of Texas School of Public Health as well as the study's corresponding author. "With men it may be the fact that acculturated men have higher incomes and may have more disposable income to buy alcohol."

Although the factor of acculturation may be different, the consequences are all too familiar: problems with family, work, drinking and driving, alcohol dependence, etc.

Caetano and his colleagues chose to focus on the Texas-Mexico border for several reasons. "Texas has the largest part of the border, and most of the population living on the border," he said. "Also, the previous research was fragmented and not very conclusive."

"The border is a unique, complex and rich environment," added Hector Balcazar, regional dean of the El Paso Regional Campus, University of Texas School of Public Health, "both regarding acculturation, and the role that acculturation plays in affecting drinking behavior. This is also the first study of this nature in the border area."

Researchers analyzed data gathered from a 2002-2003 survey conducted in El Paso, the Rio Grande Valley, and an unspecified number of colonias (border settlements, often poverty stricken). Of the 1,200 face-to-face interviews that were conducted, a total of 472 male and 484 female Hispanic adults were included in an analysis to investigate their degree of acculturation, drinking patterns, and applicability of diagnostic criteria for alcohol abuse and dependence. Respondents were coded into four acculturation categories: very Mexican oriented, bicultural-Mexican, bicultural-Anglo, or very Anglo/Anglicized.

"There is a clear differential effect of acculturation by gender," said Caetano. "While this was shown in previous research, the effects on the border seem to be more accentuated. Men drank less as they acculturated, and had a lower prevalence of alcohol-use disorders. Women drank more with acculturation, but this did not seem to lead to a higher rate of alcohol use disorders."

Caetano said these findings help to clarify that the border population of mostly Mexican Americans and their alcohol use is different from that of the rest of the country. "It is not possible to assume that acculturation will have the same effect on drinking across gender, age or ethnic groups in the United States," he said. "Furthermore, readers should understand that drinking is a product of personality characteristics and the environment. As these change, drinking will change as well."

Balcazar recommended that future research develop methods to better understand biculturalism, as well as the environment and ecology of the border region. This study, he said, has helped to highlight the phenomenon of acculturation, especially in places like El Paso-Juarez, where two cultures can come together to interact in many different ways.

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


Sunday, February 3, 2008

Misuse of 'bupe' is found to be on rise

In a report to federal regulators, the manufacturer of buprenorphine has provided the starkest evidence to date that misuse of the drug is growing in parts of the country where it is most widely prescribed as an addiction treatment.

Reckitt Benckiser Pharmaceuticals Inc. outlines problems such as a rise in the number of children sickened by accidentally ingesting the pills; an increase, in some areas, of people taking the drug to get high; and commonplace street sales in some cities for as little as $2 per tablet.

The U.S. Food and Drug Administration received the report Jan. 8. A spokesman for the agency said it is under review but declined to comment further. If federal officials conclude that abuse of the drug has become a problem, they can seek further controls over its distribution.

The report linked misuse and illicit sales to the federally sanctioned practice of allowing doctors to prescribe large quantities of the drug for patients to take at home. "It was the patients in treatment for opioid abuse - no doubt selling or trading their own supply of buprenorphine - who were seen as major contributors to the street supply," the report stated.

Federal officials didn't anticipate such abuses when they spent $26 million to develop the drug and help Reckitt Benckiser bring it to market. Congress considered buprenorphine, sold mainly in the U.S. as Suboxone, the centerpiece of its plan to broaden access to addiction treatment.

The latest report closely parallels the findings of a series published in December in The Sun, which revealed that while buprenorphine has been shown to be highly effective as an addiction treatment, its misuse is increasing. The newspaper also identified patterns of illegal sales as well as several deaths caused by taking the drug in combination with other substances.

Many specialists in addiction medicine believe that in the five years the drug has been on the market, its benefits have outweighed any problems. That's also the view of Baltimore's health commissioner, Dr. Joshua M. Sharfstein, who has asked the General Assembly for $5 million to expand buprenorphine treatment for heroin addicts.

Reckitt Benckiser submits the reports as part of a "post marketing surveillance" system as a condition of the FDA's 2002 approval of the drug. The surveillance, conducted by a consultant hired by the company, is intended to alert U.S. regulators to any abuse. A copy of the document was obtained by The Sun.

The report, covering the period from July through September 2007, is based largely on questionnaires to patients seeking drug treatment and to doctors and workers at drug clinics, including three in Baltimore. The consultant also conducts "street-level" interviews, analyzes poisoning and injury data, and reviews postings on Internet sites frequented by drug abusers.

The surveillance revealed:

• There was a substantial increase in the numbers of patients entering drug treatment who were aware of abuse and illegal sales of buprenorphine - on par with methadone for the first time. They described street sales in a number of places, including Chicago's West Side, where the drug was "easy to purchase" for $2 to $5 per tablet. Most addicts reported using it on the street to avoid withdrawal sickness.

• At poison control centers across the nation, more than a quarter of 1,876 buprenorphine exposures involved children under 6 years of age from Jan. 1, 2006, to Sept. 30, 2007, the company said. The rate of buprenorphine exposures in children was higher than the rates for methadone and oxycodone, which are far more commonly prescribed, the report said. The children who ingested buprenorphine, whose names and locations were not stated, all recovered.

The levels have been mirrored in Maryland, according to the Maryland Poison Center at the University of Maryland School of Pharmacy. Over the past three years, 35 children were exposed to buprenorphine, amounting to 28 percent of the total of 121 exposures. By comparison, 27 children were exposed to methadone, or 9 percent of the 293 cases for that medication, and 75 were exposed to oxycodone, or 14 percent of the 501 exposures to that medication.

• A major source of illegal Suboxone, according to 17 percent of doctors surveyed, was "lax or inappropriate" prescribing of the drug by their peers. More than half the doctors questioned in New England, where Suboxone is most widely available as an addiction treatment, said they believed it was just as easy to buy illegally as methadone and other widely abused narcotics. Drug abusers who were interviewed generally agreed.

• Interviews with drug treatment clients in Lynn, Mass., suggested that growing numbers of drug abusers might be turning to Suboxone to get high. In past reports, company officials have said 90 percent of people abusing Suboxone buy it on the street to ward off symptoms of narcotics withdrawal. But a third of the drug abusers questioned in Massachusetts said they used the drug to get high.

In Vermont, a researcher reported that 14 percent of prescription opioid abusers reported that buprenorphine was their "primary opioid of abuse."

"There is evidence that there is experimental use and illegal diversion of buprenorphine, especially the most frequently prescribed product - Suboxone," the report said.

Harriet Ullman, a spokeswoman for Richmond, Va.-based Reckitt Benckiser, said that no one at the company was available to comment and referred questions to the company's consultant, Dr. Charles R. Schuster, managing member of CRS Associates LLC. Schuster said in an interview that "a small percentage" of drug abusers have been experimenting with the drug. He said the company is working to help train doctors how to reduce abuse of the drug.

Dr. Sidney H. Schnoll, a Connecticut physician and a member of an eight-member advisory group established to review the quarterly surveillance reports, conceded that the company faces "issues" with abuse of the drug.

But he said that all drugs have risks. "You have to balance the benefits with the risks," Schnoll said. "Right now [the balance is] in favor of this drug."

Suboxone, which is dissolved under the tongue, relieves addicts' cravings for narcotics and the sickness that comes on when they stop using them abruptly. Some patients say the pills free them from the need to obtain street drugs, allowing them to focus on seeking jobs or taking other steps to turn their lives around.

Unlike methadone, which is distributed by clinics that often require patients to show up every day to receive their doses, Suboxone is designed to be taken unsupervised. Take-home policies in the United States, where doctors are permitted to prescribe a month's supply with up to five refills, are more lenient than those in many other countries.

Baltimore health officials said they hope to avoid some of the illegal diversion by starting addicts in clinic settings and stabilizing them before referring them to private doctors. These clinics are also providing extensive counseling services, which many private doctors are unable or unwilling to provide across the country.

Sharfstein and state health officials recently told Maryland lawmakers they were taking steps to minimize misuse as they expand treatment with the drug.

City officials conceded that "bupe" can be purchased illegally on Baltimore streets, just like heroin and other narcotics. Schuster said that the company has plans to step up surveillance in Baltimore by conducting more "street" interviews but that details were still being worked out.

source: The Baltimore Sun

Saturday, February 2, 2008

Paying the Tab: The Costs and Benefits of Alcohol Control

What drug provides Americans with the greatest pleasure and the greatest pain? The answer, hands down, is alcohol. The pain comes not only from drunk driving and lost lives but also addiction, family strife, crime, violence, poor health, and squandered human potential. Young and old, drinkers and abstainers alike, all are affected. Every American is paying for alcohol abuse.

Paying the Tab, the first comprehensive analysis of this complex policy issue, calls for broadening our approach to curbing destructive drinking. Over the last few decades, efforts to reduce the societal costs--curbing youth drinking and cracking down on drunk driving--have been somewhat effective, but woefully incomplete. In fact, American policymakers have ignored the influence of the supply side of the equation. Beer and liquor are far cheaper and more readily available today than in the 1950s and 1960s.

Philip Cook's well-researched and engaging account chronicles the history of our attempts to "legislate morality," the overlooked lessons from Prohibition, and the rise of Alcoholics Anonymous. He provides a thorough account of the scientific evidence that has accumulated over the last twenty-five years of economic and public-health research, which demonstrates that higher alcohol excise taxes and other supply restrictions are effective and underutilized policy tools that can cut abuse while preserving the pleasures of moderate consumption. Paying the Tab makes a powerful case for a policy course correction. Alcohol is too cheap, and it's costing all of us.

Philip J. Cook is professor of public policy and economics at Duke University and former director of the university's Sanford Institute of Public Policy. His books include Gun Violence, The Winner-Take-All Society, and Selling Hope.


"A wonderful little book...Draws on history, political philosophy and straight economics to point out that higher alcohol taxes would fit squarely in the American tradition."--David Leonhardt, New York Times

"As laws against smoking and drugs become more draconian, the relative regulatory neglect of alcohol remains a mystery. Much of this mystery--at least in the US context--has recently been dispelled in Paying the Tab, a gem of social science by the Duke University economist Philip Cook.... Mr. Cook's original and very literary book shows how certain principles of markets and regulation break down when a cherished commodity happens to be a mind-altering (and judgment-impairing) drug."--Christopher Caldwell, Financial Times


"There is a vast literature on the illicit drugs, a large literature on nicotine, and nothing up-to-date and authoritative on the second most deadly, and arguably the most damaging, alcohol. Phil Cook, with a modesty and understatement that inspire trust, explores the options for reducing the harms, allowing the benefits, and respecting personal liberty. This is a masterly combination of analysis and evidence. It is also beautifully written."--Thomas C. Schelling, Nobel Prize-winning economist

"The war on tobacco was won: the harms were recognized and measures taken to reduce them. In this compelling book, Philip Cook shows that the war on alcohol, too, can be won if policymakers act on the overwhelming and converging evidence that simple measures can reduce the short-term and long-term harms caused by drinking. He brings order to a highly complicated set of causal issues by telling us what may be true, what is probably true, and what is indisputably true; and he shows how large gains can be made simply by taking account of the last set of facts."--Jon Elster, Columbia University

source: Princeton University Press

Friday, February 1, 2008

Drug court graduates commence addiction-free journeys

PRINCETON — Instead of sentences, Mercer County Circuit Court Judge William Sadler handed down diplomas and new leases on life Monday.

The judge and a crowded courtroom of supporters gathered to wish seven graduates of the Southern Regional Drug Court well on their way into new, drug-free journeys, and two of the special speakers know what it’s like to travel the same roads.

Melissa Tedder was one of the first to complete the Mercer County program designed to provide alternative sentencing designed to help drug offenders overcome addiction and escape time behind bars. At the time she entered the program, Tedder didn’t have much to smile about and even fewer opportunities in her outlook.

“I was a menace to society. My life had fallen apart as a result of my drug addiction,” she said Monday.

This week, she couldn’t stop the smile from spreading across her face as she told the audience how her life had turned around since she entered the program and graduated in June 2007. In fact, she’s getting married soon. She’s held a job for 18 months straight, and she’s worked hard to repair relationships with her children and her mother.

Though she did the recovery work herself, she said it never would have been possible without the court’s strict supervision and the support of the drug court treatment team.

“I’ll always be grateful for this program,” she said.

Kenneth Shrader, another graduate, said he carries many titles. He’s a father, a husband, an employee and more. A couple of years ago, there were some other names he called himself.

“I was hopeless. I was an addict,” he said.

Shrader said his family and everyone who cared about him had given up, but there was one chance left. He was referred and accepted to the drug court docket, and today, he’s sober and once more surrounded by a family who knows he is strong enough to beat addiction.

Holding his new baby and watching his daughter in the audience, he said those relationships showcase the biggest differences in his life.

“Today, I remember a 4-year-old who didn’t want to leave her mommy’s leg, and now comes running to her daddy at the door,” he said.

Magistrate Mike Flanigan, who oversees the misdemeanor segment of the Southern Regional Drug Court along with Magistrate Rick Fowler, hosted Monday’s ceremony and reminded the seven graduates that the celebration was not a conclusion.

“It’s not the end, only the beginning,” he said.

Though Sadler said he was a skeptic when Circuit Court Judge Derek Swope approached him about a drug court, he said he became a believer as a team of community corrections officials began touring similar courts and making plans for their own in late 2004 and early 2005.

“We saw what drug court was truly about ... It was truly about helping people with addiction problems,” he said, along with relieving the court system of non-violent drug offenders and the expenses associated with incarcerating non-violent offenders.

It costs approximately $25,000 a year to incarcerate someone, and Mercer County has struggled to tame its bills to the Southern Regional Jail in Beaver. Participants in Monday’s graduation said the drug court not only saves money in jail fees; they said it spends treatment dollars more wisely.

In addition, drug court participants are expected to submit to drug testing, complete treatment goals, hold down jobs and give back to the communities in which they were once burdens.

Drug Court Coordinator Laura Helton said the 78 participants accepted so far have completed more than 15,000 hours of community services, performing tasks that would have cost the county an estimated $92,000 if community corrections clients had not performed them.

West Virginia Supreme Court of Appeals Justice Brent Benjamin, has attended all three of the local drug court graduation and said he was proud to see seven graduates Monday, a sure sign the program is picking up momentum. While speed of completion and statistics were to be commended, he said they were not the most important things to recognize during the graduation ceremony.

“The lives changed are what matter,” he said.

To the grads, he said, “Get out there, and start the rest of your lives.”

The keynote speaker for the day, West Virginia Supreme Court of Appeals Chief Justice Elliott “Spike” Maynard, changed his address after hearing the previous graduates speak.

“I don’t know anything I could say that would be as powerful as what Melissa Tedder and Kenneth Shrader had to say,” he said.

There are five drug courts in operation in West Virginia — three for adults and two for juveniles. Maynard said their successes prove to judges and observers alike that putting people behind bars isn’t always the answer.

“This works. This saves lives and saves families,” he said.

Though he said words would never be enough to express his pride in the treatment team and graduates, he said he still had two special ones to deliver: “Thank you.”

“Thank you for making changes in your lives,” he said. “God bless you, and thank you for being such a success and for making the program such a success.”

As the seven new graduates were called to accept their diplomas, Flanigan and Sadler touted their accomplishments in the program and tallied their drug-free days, and all announcements were met with broad smiles and a room full of applause.

At the conclusion, Flanigan announced, “To our graduates, congratulations. To our participants, you’re next.”

source: Bluefield Daily Telegraph