Retirement: New Beginning

I just retired after 24 years at Loyola University Maryland as the Director of Alcohol and Drug Education and Support Services. I have mixed feelings, of course; going to miss my colleagues, but feel privileged to have had the opportunity to help many young men and women over the years to address their drug and alcohol concerns. I started my professional career in the addictions field when I was two years sober and now have over 36 years of continuous abstinence and recovery. Reflecting on this new change, I am grateful. When I began my recovery journey in 1977, I was in despair of ever doing anything worthwhile again in my life. With the gift of spiritual strength that comes with 12 Step recovery, I have been able to "give it away to keep it" through active 12 Step meeting participation, and to make a difference in the lives of individuals hurt by addiction through my professional career.

Although I will continue my private addictions counseling practice, in person (for those near Baltimore) and online (Skype, email, telephone), I will no longer be going to work every day. So, this is a new beginning for me, and I have committed myself to attending a 12 Step meeting most every day, daily exercise, and being available to help out my wife. I look forward to new opportunities for spiritual growth during this new phase of my life.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 12/29/2013.

A Way To Prevent Craving in Recovery from Addiction?

In recovery from addictions such as cocaine addiction, craving can be a major cause of relapse. Researchers are exploring the possibility of modifying the ability of the brain to develop specialized nerve cells that cause powerful drug cravings. ScienceDaily for December 17, 2013, reported on a recent rat study wherein the researchers examined how the synapses (signal relays) in nerve cells in a portion of the brain responsible for reward, emotions, motivation, and addiction (the nucleus accumbens) react to cocaine. Use of cocaine stimulates the brain to create synapses specific to cocaine that are silent (called "immature" by the researchers) in terms of activity, until the individual stops use of cocaine. At that point, these "silent" cocaine synapses mature and develop the ability to send signals resulting in the characteristic craving for cocaine when the individual is exposed to environmental triggers, such as being in the presence of the drug or seeing paraphernalia used to take cocaine.

The researchers' goal in the study was to see if they could intervene to change the matured nerve cells capable of causing cocaine cravings back to "immature" cells with no signaling capability. So, in the study, the scientists removed a portion of the nerve cell that is needed in growth of the nerve synapses, and found that doing so caused the mature cocaine craving cells to revert to their previous immature or inactive state. Without the mature cocaine craving cells, the theory goes, cocaine craving will not occur.

So, we have another attempt through science to find "biological and pharmacological strategies" (words of an author of the study) to improve recovery from addiction. Please note that these strategies do not address the emotional and spiritual aspects of addictive disease.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 12/19/2013.

More on Dangers of Alcohol Use during Pregnancy

In ScienceDaily of December 03, 2013, there is yet another scientific study suggesting that alcohol use during pregnancy can have adverse effects especially on the frontal cortex of the brain which regulates motor skill learning, decision-making, planning, judgment, executive function and sociality. The study, which was published in the November 27, 2013 issue of the Journal of Neuroscience, was of the effects of alcohol in pregnant mice whose mammalian brain is similar to the human brain.

The lead author of the study, Kelly Huffman, assistant professor of psychology at UC Riverside, stated: "If you consume alcohol when you are pregnant you can disrupt the development of your baby's brain ... This research helps us understand how substances like alcohol impact brain development and change behavior," Huffman explained. "It also shows how prenatal alcohol exposure generates dramatic change in the brain that leads to changes in behavior. ... Based on her earlier research, Huffman said, she expected to find some disruption of intraneocortical circuitry, but thought it would be subtle. "I was surprised that the result of alcohol exposure was quite dramatic," she said. "We found elevated levels of anxiety, disengaged behavior, and difficulty with fine motor coordination tasks. These are the kinds of things you see in children with FASD [Fetal Alcohol Spectrum Disorders].... The bottom line, Huffman said, is that women who are pregnant or who are trying to get pregnant should abstain from drinking alcohol."

So, to be safe, a pregnant woman should probably abstain completely from alcohol use.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 12/11/2013.

Recovery Tips for the Holidays

Persons in recovery from addictive disorders such as drug or alcohol addiction, gambling addiction, internet/gaming addictions, as well as those recovering from the effects of a relationship with an addicted individual, tend to be especially vulnerable to emotional upsets during the holiday season beginning with Thanksgiving, and continuing through Christmas, Hannukah, and the New Year observances. These emotionally trying times can lead to relapse into active addiction, if not prepared for. Here are some ideas that may be helpful:

1) A holiday need have only the emotional impact that you allow it to have. In other words, the individual has a lot of control over how he/she thinks about the holiday and the resulting emotions. Begin thinking about the particular day, for example, New Years Eve, as just another 24 hours of recovery during which you need to stay abstinent, sober, or emotionally balanced.

2) The recovery tool that I believe to be very helpful here is living one day at a time or just for today. There is no need to give a day that hasn't yet arrived any control over your thoughts or actions. You can, as I said in Item 1), think of upcoming holiday events as just another 24 hour segment that you do not drink, use, gamble, or fret.

3) In regard to attending events where there may be alcohol or other drugs or emotionally stressful situations, remember that you always have the choice to not go to the event. In early recovery (six months to a year), it may be advisable to put distance between you and the first drink drug, or other addictive behavior, and not attend the event.

4) If you choose to attend an event that may be a trigger for your addiction, prepare yourself emotionally, remind yourself that there is no valid excuse to pick up a drink or drug or engage in any other relapse behavior, give yourself permission to leave at any time that you begin to feel your recovery is at risk, and have your own transport or an individual willing to transport you at any time.

5) Increase your recovery supports such as 12 Step meetings attendance, communication with recovery sponsors (mentors), hanging out with recovering individuals and those supportive of your recovery, recovery coaching, and therapy, and rededicate yourself to other recovery tools such as prayer and meditation, church or other religious institution.

6) Remember that regardless of any emotion (loneliness and alienation are big ones), happening, or behavior by others, you do not have to take a drink, drug, or engage in any addictive behavior.

These are only a few recovery tips for the holidays. As always, I invite comments from others. Jan Edward Williams, www.alcoholdrugsos.com, 12/02/2013.

It's Never Too Late To Benefit from Stopping Smoking

Just a brief research note. According to a report inReuters for November 20, 2013, even seniors 65 years of age and older, who quit smoking cigarettes will experience a reduction in risks of death from heart related maladies, much faster than previously thought.

Previous research had shown that older former smokers who were heavy smokers could reduce their risk of dying from heart disease to the level of lifelong nonsmokers after 15 years.

The current research study found that a significant percentage of the older former smokers had a reduction in heart related problems within eight years after smoking cessation.

So, it's never too late to benefit from stopping smoking.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 11/22/2013.

Recovery Guidelines for the Person with Alcohol or Other Drug (AOD) Addiction

Here are some basic guidelines that I have developed to help the individual seeking to recover from alcohol or other drug (AOD) addiction through complete abstinence and use of support from attendance of 12 Step meetings:

Avoid Access to AOD

1. Avoid AOD and AOD users completely.
2. Do not stay in the same room or at a party, while someone is preparing to use or is using AOD.
3. Do not help friends find AOD or go along to watch.
4. Do not touch or handle AOD at any time.
5. Do not accept or fill any prescription without verifying the substance to be free of abuse potential. Do not rely upon the physician for this information; ask an addictions expert.
6. Read labels of over-the-counter medications; avoid liquids, such as cough and cold preparations, with alcohol in them, and choose "non-drowsiness" formulations.
7. Do not go to a place you know will result in access or put you in an environment normally frequented by users.

Avoid Unstructured Time

1. Avoid boredom, long periods of time with nothing to do, and isolation from persons who support your recovery. Get a job; go to AA/NA meetings; make friends with recovering people; develop new, or brush off old, hobbies, which you do not associate with use.

2. Especially avoid empty, unplanned periods at those times when you used to do AOD. Plan positive activities for dangerous times, preferably with persons who support your recovery.

Avoid holding large sums of money. For example, on payday, arrange for direct deposit and go to an AA/NA meeting right after work.

Identify and Prepare for Craving Triggers

1. Identify your personal cues for AOD craving/hunger, relative to sights, smells, sounds, events, people, and avoid if possible. Some common examples are music, sex, after work, payday, weekends, when significant other is away for a period of time, etc. Develop a survival plan for those (unavoidable) situations in which triggers are present, or craving/hunger occurs.

2.Brand into your brain that obsessions(recurring thoughts) or compulsions (craving or drug hunger which seems physically based) are normal and need not be acted on! In other words, just because you want to get high does not mean that you have to or should!

Learn To Handle Emotions

1. Mood swings, anxiety, insomnia, depression, anhedonia (pleasurelessness; present especially in cocaine addict), loneliness, feelings of worthlessness, fear of impending doom, are all common in early recovery. Remember that feelings need not be acted on destructively, and will pass.

2. Learn new tools to deal with "negative" feelings, such as, calling someone in recovery, going to an AN/NA meeting, using spiritual tools (prayer, meditation).

3. Ask for help from professionals (if not already in treatment) if negative feeling states continue to the point where you feel on the verge of relapse or other destructive behavior.

4. Remember that your basic recovery tool is involvement with recovering, supportive persons. Substitute healthy reliance on people for AOD.

The above guidelines are simple, practical suggestions that can be helpful to the individual recovering from any addiction.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 11/11/2013.

Addicts and Alcoholics Continue To Use Not To Get High but Due To Fear of Withdrawal

A recent research study utilizing rats, summarized in ScienceDaily for November 07, 2013, concluded that the reason rats continue to use cocaine is not because they are chasing the cocaine high but to avoid the consequences of a reduction in their levels of cocaine; that is, they continue to use to avoid withdrawal and its negative physical and emotional consequences.

Addicts and alcoholics and those who strive to help them, would probably respond to this study’s conclusions with a loud: “Duh!” Even though the addict or alcoholic may in part be motivated to continue to use because he/she is trying to get “high”, the truth is that most addicts and alcoholics no longer achieve the “high” but use basically due to their fear of withdrawal.

Withdrawal in this context is defined to include the physical signs and symptoms of withdrawal usually associated with abrupt cessation of use of a substance such as cocaine (see below), after chronic use to the point of development of tolerance and tissue dependence, as well as the signs and symptoms of a more subjective nature associated with psychological dependence upon a substance.

Also included within the withdrawal definition is the apprehension felt by the addict or alcoholic facing abstinence and recovery that he/she will now have to face all of the pain and vicissitudes of life without the drug used as a primary coping mechanism for years. The individual will be aware of the fact that recovery will require facing the pain and consequences of active addiction (e.g., harm caused to loved ones), again without his/her drug. Fear of withdrawal as defined is an imposing obstacle to the willingness of an addict or alcoholic to choose abstinence and recovery, and is a powerful motivator to continue to use in the face of overwhelming consequences from such use.

Here is a summary of the phases of cocaine withdrawal, as an example:

Stage One

The “crash” is a part of early withdrawal/recovery. Lasts a week to up to 12 days. Symptoms are opposite of the drug’s stimulant effects: depression, lack of hope; extreme fatigue and lack of energy (anergia); tendency to sleep a lot; be very hungry. Cravings for cocaine occur which are usually not pursued due to the extreme fatigue and anergia.

Stage Two

Lasts 2 weeks to 3 months. Depression continues, with peaks of intense cravings for cocaine which are untriggered. Without support and strong motivation (internal or external), the cravings to use will win out.

Stage Three

Can last 3 months to two years, characterized by anhedonia, a profound pleasurelessness, lack of feelings, boredom, difficulty feeling excitement or pleasure. The anhedonia is caused by a combination of the psychological stress from loss of the use of cocaine (sometimes referred to as a grief reaction as strong as that from the death of a loved one) and the neurochemical dysfunction of the mechanisms in the brain relating to production of feel good chemicals such as dopamine.

Because most alcoholics and addicts will have experienced the extremely unpleasant signs and symptoms of withdrawal from their drug (most do not have 24/7 access to their drugs), the reason for ongoing use is primarily to avoid withdrawal as broadly defined here; it is a good thing to have science confirm this well known truth.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 11/07/2013.

Does Satisfying A Child's Sweet Tooth Pose A Risk for Development of Addiction?

Does Satisfying A Child's Sweet Tooth Pose A Risk for Development of Addiction?

A recent research study, summarized in ScienceDaily for October 31, 2013, suggests that early repetitive satisfaction of urges for rewards, such as sweets or video games, may set the stage for development of addiction. The researchers looked at the portion of the brain that responds to learning based on stimulus-response; that portion of the brain is called the striatum. The striatum seems to grow in size based upon the frequency of behaviors stimulating it, such as rewarding behavior. Thus, the suggested theory is that children who develop a routine or strategy of getting their desires satisfied (called “stimulus response strategies”) for sweets, or to play video games, or watch “Dora the Explorer” may be more at risk for development of addiction. The researcher found that individuals that had developed a reliance upon this type of strategy smoked more, drank twice as much alcohol, and were more likely to use marijuana.
In the words of the researcher: "The literature indicates that children engage in stimulus-response strategies from a very young age *** Reward-seeking behavior in childhood, especially for immediate rewards like candy or playing action video games, stimulates the striatum and encourages stimulus-response strategies *** This would predispose the child to drug seeking behaviour."
This study’s conclusions provide another glimpse into how changes in the brain may explain addiction and its development. Prior research, for example, has suggested that addiction may in part be driven by the changes in the brain resulting from chronic (ongoing) exposure to feel good chemicals such as dopamine that are produced by consumption of addictive drugs (cocaine, opiates, alcohol, etc.).
Regardless of all this science that seeks to explain addiction, the individual who seeks to recover from addiction cannot afford to excuse his/her addictive behaviors and harmful consequences as due to brain changes. Research and science may explain addiction; they do not excuse the individual behaviors of the addicted individual. He or she must own his/her behaviors while using, and experience the resulting pain to themselves and those close to them; doing so can help motivate the individual to abstinence and recovery. There are no valid excuses for an alcoholic or addict to continue to use.
As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 11/04/2013.

Marijuana and Cocaine Impair Ability to Make Decisions and Control Emotional Reactions

Prior research has found that new users of marijuana tend to be more impulsive in their behaviors under the influence of the drug, but had suggested that experienced marijuana users did not display the same impulsivity when under the influence. A recent research study, summarized in ScienceDaily for October 28, 2013, concluded that regular users of marijuana and cocaine respond to tasks with increased levels of impulsivity and lessened decision making skills.

Some background is necessary to understand this study. The significance of impulsivity in addiction relates to the tendency of impulsive impaired users to make poor decisions and possibly seek to use drugs. An impulsive individual would tend to make snap, poorly thought out, decisions. Impulsivity relates to the functioning of the limbic portion of the brain, which is the old or primitive brain in the back of the head. Addictive substances commonly disrupt the ability of the frontal cortex (new brain) to control impulsive, emotional reactions stemming from the limbic system of the old brain. In other words, an individual, unimpaired by drug use, confronted by peers (emotional response: “I want to fit in”) with the choice to use or not use a substance of abuse, would, hopefully, be able to use his/her critical thinking (frontal cortex) to override the emotional desire to fit in, and be able to decide that using the drug in the past has caused problems or is illegal and not worth the risk to use, or in some other way think through the issue of use or no use.

To elaborate, in the study under discussion, the subjects were healthy, regular users of cocaine and marijuana (61 of them), who, after use of these substances (controlled by a placebo (sugar pill)), were tested on their ability to reflect before making a decision, and on their ability to stop a behavior once started. The study also looked at the effects of drug use by these regular users of marijuana and cocaine on their executive functioning, that is, their ability to make reasoned decisions and to think critically, all functions of the frontal portion of the brain (prefrontal cortex).

The study concluded: “Both cannabis and cocaine increased impulsive responding, but in opposite ways. Under the influence of cannabis, subjects were slower, but made more errors. Cocaine administration caused the participants to react more quickly, but if participants had to control their impulses they made more errors. This increased impulsivity after drug use could increase the likelihood of developing addiction ***

***One hallmark of drug addiction is a disturbed relationship between the frontal cortex where decisions are made and the limbic system that organizes emotional responses and memory. These results indicate that cannabis could decrease the amount of control the frontal cortex exerts over behavior, while cocaine could increase impulsive responding from the limbic system.”

So, even an experienced user of marijuana or cocaine will, when under the influence of his/her drug, be more impulsive in behavior and will have difficulty accessing critical thinking skills to counteract emotional desires and impulses. This impulsivity and impaired judgment can have consequences beyond drug use, such as, impaired driving, impaired decisions in relationships, sexual decision making, to name a few.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 10/29/2013.

Guidelines for Newcomers to 12 Step Meetings

It has occurred to me that there is an art to listening at 12 Step meetings such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA); to put it another way, there are some ways of approaching a 12 Step meeting that I have found can help me to benefit from the hour I spend at the meeting. Here are some guidelines I have put together especially for newcomers to 12 Step meetings; but I think some of us "old-timers" might need a refresher as well:

Compare In, Not Out! Keep an open mind.

Remember that the 12 Step Programs, like all organizations, have their own language, their own customs, and their own ways of doing things. When you hear something that doesn’t sound right to you, that you disagree with, that even offends you, avoid an all or nothing reaction (for ex., “That’s it! This Program is not for me!”). Set aside those objections and listen with an open mind. Try to have the mindset that I will listen for statements that I can relate to, rather than for ones I cannot relate to. In other words, try to compare yourself in, rather than out.

Try To Be Non-judgmental.

Everyone, it seems, has a little judge in the head who comments on what others say, with silent observations such as: "that's ridiculous!", or, "he can't even speak with good grammar", "she's only newly sober, what does she know?", etc. Try to quiet that little judge in your brain and listen for ideas and concepts and for feelings (see below). Some of the most profound statements I have heard at 12 Step meetings have come from individuals with little formal education but a Ph.D. in addiction and recovery.

Listen for Feelings and Genuineness.

The first time I ever sensed that there may be something spiritual going on at a 12 Step meeting was when I heard (and felt) real people sharing genuinely, from the heart, real feelings. You may not be able to relate to some of the factual details of a person's story, but you will almost always be able to relate to the feelings and state of mind of the speaker during active addiction and recovery.

Here are some ideas for the 12 Step Program newcomer in particular:

Anonymity is critically important to the integrity and vitality of AA. Please respect this fact and respect the confidentiality of persons present at the meeting. The identity of persons and what is said at the meeting should be kept confidential.

Because 12 Step members strive to be supportive of newcomers, you may be approached before or after the meeting, and asked questions similar to these: “How long you have been in the Program”, or, “Are you new to the Program”, or other questions seeking to see if you need some help. Answer honestly, perhaps along these lines, as appropriate to your situation: “I’m new; just trying to figure things out about my drinking or drug use.”

Members may offer to give you their telephone numbers to call them if you need help. Just accept them graciously. You always have the choice of whether or not to call. It is up to you whether or not you choose to give out your own number. A general guideline is that you should choose to accept help one on one from someone of your own gender to avoid complications unneeded in early recovery.

You may be asked to read some of the material customarily read at the outset of the meeting, You may elect to do so, or decline by saying something like: “Not this time, thanks.”, or “I don’t feel comfortable doing that, thanks.” If you decide to do the reading, be aware that it is expected that you identify yourself by first name and that you are an alcoholic or addict: “My name is ----, and I’m an alcoholic, or addict”

If you are called on to speak during the meeting, you can choose to share, or not. If not, the best response is probably: “I’m just going to listen”, or “I pass”. As always, be aware that it is expected that you identify yourself by first name and that you are an alcoholic or addict: “My name is ----, and I’m an alcoholic, or addict”

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 10/28/2013.

Parenting in Recovery

I ran across an interesting article published in the October 8, 2013, issue of The Partnership at Drug Free.org/, written by Phyllis Gardner, PhD, that discusses issues that arise when recovering alcoholics or addicts raise their own children, specifically some ideas about how to avoid behaviors that may trigger addiction in these children. The author notes that while genetics explains a significant percentage of development of addiction, clearly environment plays a role. The author lists three recurring themes that seem to morph into the destructive patterns associated with high-risk behavior in children:

1) Awareness: Think of the sort of tunnel vision that a lot of people suffer – not just people in recovery. They fail to see how they affect others with their personal approach to living. For example, they might be great at listening to the concerns of another person struggling to stay sober or make some other dramatic change in life, but they rarely listen to their own spouses. They can sit for hours with friends talking about their hopes and dreams for their children – but never ask those children what they want for their own futures.

2) Discipline: For some parents, the consequences of misbehavior depend more on their mood than the nature of the offense. Sometimes parents choose to avoid confrontation, or in other cases, they completely overreact to their children’s bad choices. Often they take their children’s behavior personally – reacting as if the child’s behavior was “done” to the parent, personally.

3) Modeling: Finally, many parents forget that they are role models for their children. They talk about personal responsibility then turn around and blame their problems on others. “Old ideas” creep into their conversations and their actions – despite their recovering status. They talk to their children about not letting their emotions rule them and then they yell in traffic and practically wreck the car trying to cut off the offending driver.”

My own views, based on anecdotal information from my own experiences, are that a parent in recovery from addictive disease should provide honest, age appropriate information about the fact that addiction can be inherited, the increased risks associated with such a family history, information about addictive disease and treatment and recovery (perhaps inviting older children to attend 12 Step meetings with parents), and state clearly that use of alcohol or other drugs by their children is forbidden. When the children reach the age where their peers will be using alcohol and other drugs, again, an honest discussion of the children's increased risk of developing a problem should be presented, along with an explanation of specific indicators of a drug or alcohol problem (for example, high tolerance, blackouts, negative personality change, behavior against values). I know from sad experience that doing all (or most) of the “right” things in parenting does not prevent children from developing addiction, but perhaps the honest exchange of information may result in earlier identification of addiction and treatment thereof.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 10/19/2013.

Spiritual Strength Is a Key to Prevention of, and Recovery from, Addiction

The alcoholic, according to AA's basic text (Big Book, page 25), has but two choices, to “… go on to the bitter end, blotting out the consciousness of our intolerable situation …; the other, to accept spiritual help.” So, the solution for the alcoholic and the addict (“...we were in the grip of a hopeless dilemma, the solution of which is spiritual in nature (NA Basic Text, 5th ed., page xi)) is a spiritual one.

According to many research studies, a belief in a higher power or God provides protection from development of a drug or alcohol problem. I will just refer here to one recent study summarized inScienceDaily for October 03, 2013, published in theJournal of Substance Use & Misuse. The researchers looked at responses from over 5,000 young men in Switzerland who were Religious (believed in God), Spiritual (believed in a higher power), Unsure about their belief in God, Agnostics (assume no one can know whether there is a God), and Atheists (do not believe in God). Here is a summary of the results:

Among the 543 religious young men, 30% smoked cigarettes daily, 20% smoked pot more than once a week and less than 1% had consumed ecstasy or cocaine in the past year. Among the 1650 atheists, 51% smoked cigarettes, 36% smoked pot more than once a week, 6% had consumed ecstasy and 5% cocaine in the past year. The three groups that lay between these extremes were in the mid-range both regarding their religious beliefs and the consumption of addictive substances.”

This study suggests that belief in God or a Higher Power is a protective factor in regard to development of a drug or alcohol problem, and, of course, can be a way out for those who have developed a drug or alcohol addiction.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 10/09/2013.

Use of Drugs of Abuse Like Cocaine Can Make the User More Vulnerable to HIV Infection

Medical News Today for October 2, 2013, summarized a research study published in the Journal of Leukocyte Biology that found that use of cocaine alters cells in the body related to immune responses, making them not only more vulnerable to the HIV virus but also to the spread of the virus once one is infected.

The Medical New Today report stated: “To make this discovery, scientists collected blood from healthy human donors and isolated quiescent CD4 T cells, and exposed them to cocaine and subsequently infected them with HIV. Following infection, researchers monitored the progression of HIV's life cycle and compared this progression against that of untreated cells. They found that cocaine rendered this subset of CD4 T cells susceptible to HIV, resulting in significant infection and new virus production.”

The editor of the Journal of Leukocyte Biology emphasized the potential significance of this research: "The co-epidemics of illicit drug use and infectious disease [such as HIV infection]...are well documented, though typically this connection is thought to occur through lifestyle choices and increased exposure ... What often does not come to mind is that drugs such as cocaine may be helping to fuel infections in this high-risk population by altering the immune system. These new studies are an important advance documenting how cocaine use may increase a person's vulnerability to HIV and further highlighting the need for improved education for both HIV prevention and drug abstinence."

Thus, another negative consequence of drug addiction is that the drug user's body immune response systems can become compromised resulting in the user being more vulnerable to infections such as HIV and to the spread of that infection in the user. As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 10/02/2013.

Once an Addict, Always an Addict: Time Does Not Cure Addiction

In 12 Step programs and addiction treatment centers it has been an accepted tenet that once an individual has crossed the line into addiction, that individual cannot return to problem-free, controlled use of the addictive substance. There has been research suggesting that the reason underlying this principle lies in either the addict's inherent brain circuitry related to impulsivity, setting him/her up to develop addiction once use of an addictive substance is initiated, or is a result of changes in brain chemistry related to impulsivity caused by chronic use of the addictive substance.

Presumably, if the addiction is due to changes in brain chemistry from use of the drug, then perhaps over time abstinent from the drug the brain can heal, with cessation of impulses to use the drug. In a recent study summarized in ScienceDaily, researchers have found that there are changes in the brain chemistry of cocaine addicts that persist after long term abstinence from use of the drug, resulting in ongoing elevation in impulsivity measures.

Thus, in the words of one of the researchers, "The knowledge that some neural changes associated with addiction persist despite long periods of abstinence is important because it supports clinical wisdom that recovery from addiction is a lifelong process...”

So, once an addict, always an addict: time does not cure addiction! As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 09/24/2013.

Do You Have a Gambling Problem in Addition to Your Drug or Alcohol Problem?

In a recent study published in ISRN Addiction and summarized here, researchers highlighted the issue of gambling addiction in persons with alcohol or other substance addiction. Researchers stated that gambling addiction is a hidden problem in individuals with drug or alcohol problems that is rarely addressed in 12 Step Programs and treatment centers. Between 10 and 20 percent of individuals with substance addiction have a gambling problem.

Here are some resources for gambling problems:

Gamblers Anonymous 
Gam-Anon
National Council on Problem GamblingNational Problem Gambling Helpline Network 800-522-4700

Quick Screen to Identify a Gambling Problem
1. You have often gambled longer than you had planned.2. You have often gambled until your last dollar was gone.3. Thoughts of gambling have caused you to lose sleep.4. You have used your income or savings to gamble while letting bills go unpaid.5. You have made repeated, unsuccessful attempts to stop gambling.6. You have broken the law or considered breaking the law to finance your gambling.7. You have borrowed money to finance your gambling.8. You have felt depressed or suicidal because of your gambling losses.9. You have been remorseful after gambling.10. You have gambled to get money to meet your financial obligations.

A “Yes” to any of these questions, means you should consider seeking assistance from a professional regarding this gambling behavior by calling the National Problem Gambling HelpLine Network (800.522.4700) toll free and confidential throughout the U.S.

My favorite tool to see if you have a problem with any addiction is this: Does your gambling cause a pattern of negative consequences in any significant area of your life, such as, finances, relationships, work, health?

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 09/21/2013.

Significance of Hangovers

A recent study summarized in ScienceDaily of September 12, 2013, to be published in the September issue of Alcoholism: Clinical and Experimental Research, sheds some light on hangovers and how they differ in drinkers as they age. The researchers looked at alcohol use in a pool of over 50,000 individuals ages 18 to 94, and found that the incidence of hangovers in binge drinkers was greater in younger drinkers and decreased in older binge drinkers.

There was no attempt in this study to to see if there is a connection between hangover incidence and development of alcoholism. However, prior research has found that individuals who develop alcoholism often do not experience the physical ill effects of excessive drinking such as hangovers. The suggestion is, therefore, that drinkers at a young age who do not have severe hangovers after drinking to excess are more at risk for alcoholism.

My own experience of almost 25 years of working with young adults aged 18 to 21 is that individuals with a history of alcoholism in a blood relative, such as a parent or grandparent, almost invariably will have an inherently high tolerance for alcohol, rarely get sick no matter how much they drink, and have mild hangovers. These individuals probably have a genetic predisposition to develop alcoholism and are at a four to six times greater risk to develop alcoholism.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 09/14/2013.

Recovery and Reality

I remember in my recovery from addiction, and have remarked about this before in this blog, wondering if there would come a time when my spiritual progress would be such that I would have "made it" and could ride off into the sunset of recovery with an internalized assurance that all is not only well in the present but would always be well in the future regardless of life's happenings. I guess that type of thinking is due at least in part to the Hollywood model or paradigm of life whereby the protagonist in life's drama would reach such an awesome state of spiritual progress that there would be a magnificent swelling of trumpets, violins, and cymbals, and  the scene would slowly fade into darkness with the message that the hero woud live a problem-free life forever after.

Alas, recovery from addiction, no matter the duration or the spiritual progress, does not follow the traditional Hollywood model, and realities and problems do happen, followed by human reactions to them that are driven by self-centered emotions and thinking errors, such as fear, self-pity, plus accompanying physical and emotional pain. The cause for this reflection is my recent injury resulting in a broken ankle and disruption of my seemingly ordered world--I am now in a wheelchair, cannot drive, work, or do much of anything for a while.

But, hold on a minute! After some prayer and meditation, support from my wife and good friends in recovery, I am quickly back into a mindset in which I can truthfully say: "Fundamentally all is well." The reality of my life at this moment has not changed but my reaction to that reality has. Indeed, on further reflection, the spiritual tools of recovery  can and do offer a "Hollywood ending" except that the ending is really a series of spiritual adjustments to life's realities using recovery tools. Before finding a spiritual way out of addiction, I was controlled by life's problems and my self-centered and self-defeating reactions to them. Now, though it may take some time, I have the spiritual tools to be OK in the midst of reality problems.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 09/07/2013.

With Seconds to Live, Will Your Addiction Have the Last Word?

In a brief article in livescience, the question is raised as to whether a few seconds of consciousness remain in an individual after decapitation. The article's author referred to some data supporting ongoing brain activity after decapitation: “In 2011, Dutch scientists hooked an EEG (electroencephalography) machine to the brains of mice fated to decapitation. The results showed continued electrical activity in the severed brains, remaining at frequencies indicating conscious activity for nearly four seconds.”

This article reminded me of a humorous story my first recovery mentor (sponsor) used to tell to illustrate the relentless power of denial in addiction. He would say: “I understand that after the heart stops beating, there remain a few moments of consciousness, during which I am sure my head would say, “Now, Norb, (his name) Now, you can drink!”

As always, comments are invited. 09/01/2013. Jan Edward Williams, www.alcoholdrugsos.com.

Smoking and Addiction Recovery

William L. White, a well-respected addictions researcher, has published a good overview of addiction recovery and tobacco use. Here are some statistics from White's work: Between 70-80% of people entering addiction treatment smoke—nearly 4 times the rate for all adults. People treated for alcohol or drug dependence are more likely to subsequently die from smoking-related diseases than from alcohol or drugs other than nicotine. Leading figures within the American history of addiction recovery have died of smoking-related diseases, including Bill Wilson, Dr. Robert Holbrook Smith, Mrs. Marty Mann, Danny C., Jimmy K., Charles Dederich, Dr. Marie Nyswander and Senator Harold Hughes.

It used to be an accepted "truth" in the addictions field, based on anecdotal evidence probably in part supported by the fact that most of the recovering addictions counselors smoked themselves, that an individual in early recovery from alcoholism or other dug addiction should not focus on stopping smoking tobacco products because to do so might cause so much stress or lack of focus on the "primary" problem (alcohol or other drug abstinence) that the individual would be in danger of relapse. I can remember back in the day when, believe it or not, we counselors and patients would smoke cigarettes during group therapy in an addictions treatment program. The thinking then was that addressing smoking could wait until the advent of a stable recovery from alcoholism.

Indeed, the basic text (Big Book) of Alcoholics Anonymous suggests that it may be wrong to make a "burning issue" about smoking by a recovering alcoholic when "his more serious ailments [drinking] were being cured in AA (Alcoholics Anonymous, 4th Ed., page 135)."  I do not criticize this early AA view of smoking. The science showing the serious health effects of smoking was not available then and, of course, the AA program by definition is aimed at alcoholic drinking (though I think stopping smoking can be done using the 12 Steps of AA).

Research, has not confirmed the validity of the old approach of avoidance of addressing nicotine addiction in early recovery; in fact, evidence seems to suggest that continued smoking in recovery can slow healing of the brain damaged by alcoholic drinking and may interfere with recovery. Also, addressing nicotine addiction at the same time as alcoholism (or other drug addiction) does not adversely affect treatment outcomes. I'll provide a summary of some of the research here.

1) Active alcoholism interferes with the flow of blood to the brain, probably in part causing the difficulty drinking alcoholics, and those in recovery, have with memory and thinking. In early recovery from alcoholism, brain imaging studies (2009) have shown that the blood flow to the brain of non-smoking alcoholics returns to normal within five weeks of abstinence, while the same is not true of smoking recovering alcoholics.

2) In a 2004 review of 19 research studies looking at the effect on addiction (non-nicotine) recovery in addiction treatment programs that addressed nicotine addiction as part of treatment of the "primary" addictions, "smoking cessation interventions provided during addictions treatment were associated with a 25% increased likelihood of long-term abstinence from alcohol and illicit drugs." In other words, "Contrary to previous concerns, smoking cessation interventions during addictions treatment appeared to enhance rather than compromise long-term sobriety." According to William L. White in his 2011 review, "Smoking cessation in early recovery does not increase craving for or urges to drink alcohol. Continued smoking following treatment for alcohol and drug dependence is a risk factor for resumption of alcohol and other drug use."

3) According to a federal government supported review of research on alcohol abstinence and recovery, "the short-term effects of alcoholism may appear more dangerous than those of cigarette smoking. However, mortality statistics suggest that more people with alcoholism die from smoking-related diseases than from alcohol-related diseases ***. Comorbid smoking and alcoholism result in synergistic exacerbation of health risks (the two conditions work to worsen health risks)."

4) According to a review of addiction treatment facilities (2010), Direct treatment of nicotine addiction beyond just providing a nicotine replacement drug (e.g., nicotine patch, gum) is rare. "About 71% of publicly funded treatment programs and 65% of therapeutic communities did not offer a counseling-based smoking cessation program or any medications, such as over-the- counter nicotine replacement therapy (NRT) or prescription medications (e.g., varenicline, sustained-release bupropion). Programs that relied on private sources of funding, like insurance and self-paying clients, were more likely to offer services, but the predominant approach offered by 41% of private programs was smoking cessation medications without a formal counseling program."

Those of us in recovery from addiction seem to be attracted to any behavior that feels good, such as eating, sex, gambling, and nicotine use, to name a few, all of which can reach the stage of addiction and become destructive. My experience in the addiction field and in my own recovery, is that the recovering individual needs to be on guard for any replacement addiction that may be rearing its ugly head. Nicotine addiction is probably tougher to treat and recover from than many of the so-called primary addictions (alcohol, opiates, cocaine). Gambling on a regular basis, for example, may not result in a sufficient pattern of negative consequences to seriously interfere with the quality of one's life.  However, the known health effects of smoking, even a few cigarettes a day, are so clear that addressing smoking should come sooner rather than later in one's recovery journey.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 08/27/2013.

Genetic Risks for Alcoholism and Eating Disorders Are Present in Both Men and Women

Researchers in a study to be published in the September issue of the Journal of Studies on Alcohol and Drugs, summarized in ScienceDaily, have found that the same genes may be involved in both alcohol addiction and eating disorders in both men and women. Prior studies had found such a connection in the case of women. The study under discussion is the first to look for a genetic connection for alcoholism and eating disorders in men.

Per the ScienceDaily summary:

"The researchers reported that people with alcohol dependence may be more genetically susceptible to certain types of eating disorders and vice versa. *** "In clinical practice, it's been observed that individuals with eating disorders also have high rates of alcohol abuse and dependence," said Melissa A. Munn-Chernoff, PhD, the study's first author. "Other studies have focused on the genetic connections between alcohol dependence and eating disorders, but all of those studies looked only at women. Ours was the first to include men as well."*** "We found that some of the genes that influence alcohol dependence also influence binge eating in men and women."

It is commonly thought that eating disorders occur only in women, but the disorder also can be found in men. This research suggests that individuals with eating disorders, including men, may be at risk for alcoholism and vice versa, that is, both men and women with alcoholism may be at risk for eating disorders. Those involved in treating individuals of both genders with alcoholism and eating disorders should be alert to the presence of both disorders in their patients.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 08/22/2013.

Your Reaction to Pleasure May Put You at Risk for Addiction

Researchers in a study to be published in the January 2014 issue of the Journal Alcoholism: Clinical and Experimental Research, summarized here, have found that the way an individual responds to a drink of alcohol may indicate presence of a risk to develop an alcohol problem. By way of introduction to the topic of this research study, I'll give a quick summary of brain chemistry of addiction.

For a number of years now, science has revealed that most drugs of abuse, including alcohol, operate in large part by causing a feeling of pleasure, or a "high", because of the drug's ability to trigger a flood of dopamine, a feel good chemical, in the reward pathway of the human brain. Dopamine is the chemical, also called a neurotransmitter, that is produced when we humans engage in pleasurable behaviors such as sex or eating food, etc. The theory is that production of dopamine can reinforce behaviors essential to human survival such as eating and reproduction. The amount of the feel good chemical dopamine that is produced by using drugs such as cocaine or alcohol is far in excess of that produced normally through natural functions (sex, eating) and the intense pleasure or high produced forms the basis for wanting to get the feeling again by using the drug that triggered the feeling. Or, as stated in fancier language by one of the researchers in the study under discussion:

"For example, in both laboratory animals and people, increased dopamine transmission seems to enhance the ability of reward-related stimuli to grab attention and attract you. This effect likely contributes to why having one drink increases the probability of getting a second one - the alcohol-induced dopamine response makes the second drink look all the more desirable."  ***These DA [dopamine] systems appear to be especially important in determining the degree to which rewards become desired. So, if they are activated to an abnormal degree, this can result in pathological 'wanting' or 'craving' for associated rewards. This is what drugs of abuse are thought to do - they increase DA activity more than what is normal, and when taken repeatedly, the ability of drugs to activate DA [dopamine] systems is often further increased or 'sensitized.'"

The researchers studied a group of social drinkers who were at varying degrees of risk of developing an alcohol problem, and using brain imaging studies, "... found that people vulnerable to alcoholism might experience an unusually large response [to the dopamine feel good chemical] in the brain's reward-seeking pathway when they take a drink" *** "This finding is compelling", said the researchers. "For example, a large dopamine response might energize reward seeking and counteract the sedative effects that are the focus of the intoxication measure. Conversely, people who experience minimal dopamine release when they drink might find the sedative effects of alcohol especially pronounced."

So, we have in this small study another indicator of an area for more research that might result in the ability to find a marker (reaction to pleasure through dopamine) that may predict who is vulnerable to developing an alcohol problem.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 08/20/2013.

Women Seek Alcohol Treatment Sooner that Men

New research scheduled for publication in the January 2014 issue of Alcoholism: Clinical & Experimental Research, and summarized in a press release here, found that women seek alcohol treatment between an average of 4 to 5 years earlier than men. Prior research has suggested that women may develop serious alcohol problems needing treatment at a faster rate than men, that is, that they might experience a "telescoping" effect, wherein they progress more rapidly through various stages of the disease...of alcoholism. Anecdotally (non-scientific evidence), in the 12 Step Programs it has been noted that women progress to alcoholism at a faster rate (time frame) than men.

One of the authors of the research study stated:

*** "in a moderately large heterogeneous population of drinkers seeking treatment, a telescoping effect is observed. Women, on average, sought treatment between four to five years earlier than men; in other words, 10 years versus 15 years. Although the study does not specifically address why this is the case, it is important for primary physicians and first line health care workers to know that it takes, on average, approximately 10 years to progress from self-reported problems with alcohol to treatment for women, and approximately 15 years to progress from self reported problems with alcohol to treatment for men.

"The bottom line," said the researcher, "is that hopefully these results will raise awareness concerning the restricted time window between alcohol problems and the development of sufficient negative consequences to prompt seeking treatment among women. These findings emphasize the need for greater attention to women's issues, determining sex-specific risk factors, as well as identifying subgroups most likely to require treatment. Additionally, there must be a greater awareness of the importance of intervening when alcohol problems are first experienced. If we are able to develop appropriate interventions, we may mitigate the need for inpatient treatment for some of these women."

As always, comments are invited. Jan Edward Williams www.alcoholdrugsos.com. 08/15/2013.

36 Years of Continuous Sobriety Today!

36 years ago today, I began a recovery journey that has resulted in 36 years of continuous abstinence from alcohol and other addictive substances. I share this here not as a tribute to me but as evidence (even though anecdotal) of how use of simple recovery tools can result in long term recovery. Just briefly, my story is of an individual who, back in August of 1977, was a full blown alcoholic in the latter stages of the disease, but who had no idea there was anything called the disease of alcoholism and who, when offered the opportunity to get sober through the 12 Step Program known as AA, rejected that Program because of the emphasis on spirituality, God, or a Higher Power. After about seven attempts at sobriety in AA, with relapses shortly after intensive hospital treatments, I became willing to go to a long term residential treatment program and willing to seek help from a God I didn't believe in, and try to do the 12 Steps of recovery in AA. Where did the willingness come from after a year of resistance to a spiritually based recovery? I can only speculate that exposure to AA coupled with the ever increasing pain and suffering (loneliness, despair, fear of impending doom, plus physical illness from drinking, such as, seizures, cardiovascular disease, liver disease) caused by alcoholic drinking combined to lead to willingness to try a spiritual way out. These days I would describe the willingness as a spiritual gift.

I'll quote from the AA basic text:

"Most emphatically we wish to say that any alcoholic capable of honestly facing his problems in the light of our experience can recover, provided he does not close his mind to all spiritual concepts. He can only be defeated by an attitude of intolerance or belligerent denial. We find that no one need have difficulty with the spirituality of the program. Willingness, honesty and open mindedness are the essentials of recovery. But these are indispensable. 'There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance—that principle is contempt prior to investigation.' -—Herbert Spencer.' (Appendix II, Alcoholics Anonymous)."

As always, comments are invited. www.alcoholdrugsos.com. Jan Edward Williams, 08/12/2013.

Recovery Slogans: Live One Day at A Time

Let's begin to talk about recovery slogans often used in 12 Step Programs. These slogans are really tools that can be used to support one's recovery from drug or alcohol addiction. Perhaps one of the most important practical concepts for early recovery is the well-known, and therefore, perhaps not fully appreciated, idea of living one day at a time. For the individual beginning recovery, there are so many areas of stress that the individual can easily become overwhelmed at the seemingly insurmountable goal of staying abstinent from the use of alcohol or other drugs. Commonly the newly recovering person will worry about staying away from drug or alcohol use in many situations that will arise in life, such as, a wedding anniversary coming up in a few months, or New Years Eve (8 months away), or giving a toast at a child's wedding (child now 3 years old). Or, how will I eat crabs without a beer, go to a football or baseball game, go on a date, etc. Abstinence in recovery can become an achievable, manageable goal by reducing the task to just not picking the substance up TODAY. Today is truly the only day you have, and is the only day you have to stay clean and sober. You don't have to not use the rest of your life. You need only decide to not use for today. Whatever future situation you are concerned about is not happening today.

The Alcoholics Anonymous basic text (Big Book) states:

"We are not cured of alcoholism. What we really have is a daily reprieve contingent on the maintenance of our spiritual condition. Every day is a day when we must carry the vision of God’s will into all of our activities (page 85)."

Similarly, the Narcotics Anonymous basic text states:

"Stop using for today. Most of us can do for eight or twelve hours what seems impossible for a longer period of time. If the obsession or compulsion becomes too great, put yourself on a five-minute basis of not using. Minutes will grow to hours, and hours to days, so you will break the habit and gain some peace of mind."

Another way to think about living in the now is this: Today is your past of tomorrow. Facing each day's challenges without using drugs or alcohol will build a solid foundation for recovery that is based on your own personal experience. One day at a time, using all the recovery tools at your disposal, including attendance of 12 Step meetings, finding a source of spiritual strength, getting a sponsor (mentor) in recovery, seeing a counselor or a therapist, and, of course, not drinking or drugging, will not only result in days abstinent but also the evidence based on your own experience that your recovery tools work. Faith based on experience rather than the words of others can be truly powerful. I will end the subject of living one day at a time with a quote from the 12 Step literature that I love. "I will try to live through this day only, and not tackle my whole life problem at once. I can do something for twelve hours that would appall me if I felt that I had to keep it up for a lifetime (Al-Anon-Alateen, Just for Today)."

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 08/12/2013.

More Evidence that Marijuana Is Not A Benign Drug

University of Maryland researchers in a study funded by the Federal government's National Institute on Drug Abuse, have preliminary evidence that suggests that marijuana use by young individuals whose brains are in the process of maturing may develop adverse effects on their brains' ability to function that may last into adulthood. The study found that adult smokers did not experience the same thinking dysfunction. Thus, if the evidence is substantiated by further study, regular marijuana use during adolescence, but not adulthood, may permanently impair cognition [thinking] and increase the risk for psychiatric diseases, such as schizophrenia. In more technical language, the research study can be summarized as follows:

"NIDA-supported researchers at the University of Maryland School of Medicine have found further evidence that marijuana exposure during adolescence, when prefrontal areas of the brain are still maturing, can produce long-lasting cognitive impairment. Cortical oscillations, or the rhythm of neural firing across brain areas, play a role in cognitive functions like attention, integrating sensory information, and working memory, and they are known to be reduced also in schizophrenia and other diseases. The adolescent brain’s unique sensitivity to being modified by cannabinoids [marijuana] has been indicated in other human and animal studies, although this is the first study to directly link adolescent exposure to abnormal electrophysiological activity in the adult brain.”

So, the takeaway for this piece of research is that marijuana use by adolescents may cause damage to thinking processes in the brain that may last into adulthood. Marijuana is not a benign drug! As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 08/05/2013.

Powerlessness in a Relationship with an Alcoholic or Drug Addict

"Lack of power that was our dilemma (Alcoholics Anonymous, Big Book, page 45)" is language that underlies the foundation for recovery from alcoholism and from addiction: "When we admit our powerlessness and our inability to manage our own lives, we open the door to recovery (NA Basic Text, Pages 19-20)." But what of powerlessness when an individual loves an alcoholic or an addict? Here is what Al-Ateen says about the effects of alcoholism on loved ones of the alcoholic:

"Unlike diabetes, alcoholism not only exists inside the body of the alcoholic, but is a disease of relationships as well. Many of the symptoms of alcoholism are in the behavior of the alcoholic. The people who are involved with the alcoholic react to his behavior. They try to control it, make up for it, or hide it. They often blame themselves for it and are hurt by it. Eventually they become emotionally disturbed themselves” (from Alateen – Hope for Children of Alcoholics, page 6).

Similarly, Nar-Anon's Step One is based on powerlessness over the addict: "... we are not responsible for the drug addiction. We did not cause it, we cannot control it, and we cannot cure it. If we do not learn how to cope with drug addiction, we will contribute to the disease."

Being in charge, in control, and self-sufficient, sounds like a good thing, but can, for the person in a close relationship with an addict or alcoholic, result in isolation, frustration, and mental turmoil and confusion. What we can learn in recovery in Al-Anon and Nar-Anon is a balanced understanding of what we can control, and what we cannot control, that is, what we are powerless over. Clearly we cannot control our significant other's behavior, including whether he/she drinks or drugs. What we learn is that we can control, with the help of others in recovery and our Higher Power, how we react to whatever it is that we cannot control. It is a great freedom to realize that we need not control anyone else, only our own thoughts, actions, and reactions.

As I have said often in my posts here, the Serenity Prayer offers sound guidance to the persons in a relationship with an alcoholic or addict: God, grant me the serenity to accept the things I cannot change--OTHER PEOPLE; grant me the courage to change the things I can --ME AND HOW I REACT TO OTHERS; and the wisdom to now the difference.

As always, comments are invited. www.alcoholdrugsos.com. Jan Edward Williams, 08/01/2013.

Humility: An Essential Feature of Recovery

Humility is considered an essential trait for a person recovering from alcoholism or other addiction to have. It seems to be true that if you think you're humble, you're probably not. What is humility anyway? In early recovery I thought, wrongly, that humility was equivalent to the way I felt about myself, namely, that I wasn't worth much, that I was a bad person because of what my addiction had caused me to do, and that I was basically an unlovable person. I came to understand that all of that negativity had to do with the disease of addiction, and, indeed, did not reflect humility but a lot of self-centered fear and self-loathing that was the result of seeking power in the wrong places. Lack of power is the basic dilemma of the alcoholic or addict. Recognizing the need for, and finding, a source of spiritual strength leads the recovering individual to the beginning of a sense of humility. I suggest, humbly, I hope, that humility for the recovering person is gratefully recognizing, most of the time, that his/her recovery and the strength to live life with emotional balance come from reliance upon the help of a spiritual source, Higher Power, God, or whatever term one might use. As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 07/30/2013.

Personality and Behavior Styles Developed by Age 5 May Predict Teen Alcohol Use

Because there is a genetic component in risk for development of alcoholism, individuals with a family history (blood relatives) of alcoholism as well as those in alcoholism recovery themselves are naturally concerned about the risks of development of alcohol (or other drug) problems in their own children. In a recent study (Dick, D., et al. (2013). Adolescent alcohol use is predicted by childhood temperament factors before age 5, with mediation through personality and peers. Alcoholism:Clinical and Experimental Research. doi:10.1111/acer.12206), researchers identified personality and temperament factors that were apparent in children before the age of five that were correlated with their later use of alcohol by the age of 15. This study is is also relevant due to the fact that commencing alcohol use at a young age is shown by research to be strongly associated with development of alcohol use disorders at an older age.

Using data from over 12,000 children, ages 6 months through age 5, the researchers found:

1) "...temperament characteristics found in very early childhood are significantly associated with alcohol use more than 15 years later. ***Children who are rated as consistently sociable through age 5 and children who are rated as having consistent emotional and conduct difficulties through age 5 both show elevated rates of alcohol problems at age 15."

2) Children who were sociable had problems because of their being outgoing and sensation seeking. Those with emotional and conduct difficulties had problems because they were less concientious and emotionally stressed.

So, what is to be learned here? Basically this study merely adds some data to the effect that temperament and behavior causing problems even before the age of five can be significant in terms of future, potentially problematic behaviors such as early alcohol use.

What is a parent to do? A consistent, truthful, age appropriate message to children about their family histories of alcoholism and the risks they run should they drink can be helpful. Ensuring that children are involved in healthy positive activities (for ex., sports, clubs), have a positive, respectful relationship with parents and peers, are successful in school, and learn to be assertive and that it's OK to be themselves, have been shown to be useful in preventing destructive behaviors including early alcohol (and other drug) use. As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 07/24/2013.