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.