Bipolar Disorder Increases Substance Use Disorder Risk

It is well understood that it is of the utmost importance to treat the whole patient in the field of addiction medicine. A significant number of people seeking help for a substance use disorder, also have other mental health issues to contend with; it is common occurrence which can complicate one’s ability to work a program of recovery. Many people will actually develop a problem with drugs and alcohol as a result of using the substance to help cope with untreated mental illness; if substance abuse counselors fail to address a client's co-occurring disorder while in treatment, then there is an increased risk of relapse down the road.

Over the years there has been a plethora of research conducted which indicates that people with a mental illness, such as depression, are at an increased risk of addiction. It might even be fair to say that a mental illness begets mental illness, in some cases. Studies also point out that a person with a co-occurring disorder, otherwise known as dual diagnosis, has a much better chance of long term recovery, if they are treated for the addiction and co-occurring disorder at the same time.

The most common co-occurring mental health disorders that addiction patients have, include:

• Anxiety Disorder
• Bipolar Disorder
• Depression
• Post-Traumatic Stress Disorder (PTSD)

As was mentioned earlier, people with mental illness are often far more likely to have addiction problems, compared to the general public. This was the results of a new study conducted recently that found that adolescents with bipolar disorder are more likely to abuse drugs and alcohol, and develop a substance use disorder later in life, HealthDay reports. The findings were published in the Journal of Clinical Psychiatry.

The study involved 105 adolescents (average age 14) with bipolar disorder and 98 teens without the disorder, according to the article. Of which, 34 percent of the teens that were bipolar also had substance use disorder, compared to only 4 percent in the control group. The researchers followed up five years later with 68 of the participants with bipolar patients and 81 of the control group. The findings revealed that half a decade later, nearly half of those who were bipolar also had substance use disorder, compared to 26 percent of the control group.

Treating Cocaine Addiction

Despite the fact that the main focus regarding addiction these days is centered upon opioid use disorder, a form of addiction involving prescription painkillers and heroin, many Americans continue to regularly abuse cocaine. It is often the case that both opioids and cocaine are used in conjunction, as addicts attempt to maintain a delicate balance between the downing effects of opioids and the upper effects of cocaine. A practice commonly referred to as “speedballing.” You may be aware of the fact that a number of notable celebrities have lost their lives due to speedballs, such as John Belushi.

When cocaine is used on its own, the chances of an overdose are significantly less than that of opioids. Drugs in the opioid family cause severe respiratory depression which can easily lead to death. Part the reason that opioid addiction has garnered the attention of mainstream media to the degree that it has is the result of how deadly that form of drug can be. But rest assured, cocaine addiction can severely impact the course of one’s life, and without treatment it can be extremely difficult to find recovery.

Unlike opioid addiction, there are currently no accepted drugs to help people get off, and stay off, of cocaine. There isn’t a Food and Drug Administration (FDA) drug to treat cocaine addiction. However, new research suggests that blocking certain brain-cell receptors, specifically a receptor referred to as the TrkB, could reverse signs of cocaine dependency, ScienceDaily reports. The findings were published in the Journal of Neuroscience.

"I think this study could help revive the idea of targeting TrkB signaling to treat addiction," said The Scripps Research Institute (TSRI) biologist Candice Contet, senior author of the study. 

While blocking the TrkB has not been tested on humans, the technique showed great promise in rat models, according to the article. The researchers found that rats that learned to self-administer cocaine infusions, reduced their use of cocaine markedly when the TrkB blocker was given to them—exhibiting decreased signs of dependence. The findings are extremely important, especially when you consider that over 2 million Americans abuse cocaine.

People struggling with addiction may not be able to admit their need for help. If your cocaine problem is affecting your marriage, parenting, employment, friendships, finances, and spirituality, it’s time to call Celebrate Hope’s Christian addiction treatment center.

Genetic Underpinnings of Alcoholism

Addiction is a complex disease that few understand, and one that no one may ever understand completely. What is well understood is what can happen if the disease of addiction is left untreated—jails, institutions and death. Alcohol continues to be the most commonly abused mind altering substance, and is the fourth leading preventable cause of death in the United States, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

People often muse over why do some people become addicted to alcohol, while others do not? Naturally, the answer to that question involves a number of different factors, from genetics, brain chemistry and environment.

The science behind addiction is complicated, but research teams around the globe continue to shed light on the disease—a disorder which affects tens of millions of people. In fact, researchers at Purdue and Indiana University have identified 930 genes associated with alcoholism, as well as neurological pathways which could potentially serve as targets for treating the disorder, according to a Purdue University press release. The findings of the study were published in PLOS: Genetics.

The research teams compared the genomes of rats, that exhibited compulsive drinking behavior, to rats that abstained from alcohol use, according to the report. The researchers point out that it took decades to breed rats to consume alcohol. Scientifically, it was important to do so when you consider that rats are mammals that humans share a majority of genes. While the research is promising, the scope of factors at play may make it hard for pharmaceutical treatments to be created.

"It's not one gene, one problem," said William Muir, a professor of genetics. "This trait is controlled by vast numbers of genes and networks. This probably dashes water on the idea of treating alcoholism with a single pill."

Research will continue and at Celebrate Hope our Christian alcohol rehab program continues to be  offered in conjunction with advanced medical treatments from Hope by the Sea. This allows clients to have access to fellowship, physical fitness, and faith-building activities. Each program empowers addicts to reconcile with God and loved ones. In treating alcohol abuse, our counselors recognize that every addict’s struggle is unique.

The Pain of Opioid Withdrawal

It is easy to blame the American opioid epidemic on doctors, pharmaceutical companies and our over reliance on prescription drugs. While all of those played a huge role in the issue becoming a full blown national crisis, the fact remains that opioid narcotics are extremely difficult to stop using for many people—especially those who experience legitimate chronic pain. Those of you in recovery for an opioid use disorder, whether prescription painkillers or heroin, know all too well just how difficult it was to break the cycle of opioid addiction.

It often takes people suffering from opioid addiction a number of attempts at abstinence to finally succeed. And those who do manage to find recovery from such drugs typically need assistance via medical detox, inpatient treatment and regular attendance at 12-Step recovery meetings.

Those who have known alcoholics who managed to sober up using Alcoholics Anonymous, may find themselves asking why opioid addicts are unable to do the same? The answer to that question usually lies in the nature of opioid withdrawal. The early days of abstinence from opioids is by all accounts an extremely painful, uncomfortable experience. Typically characterized by:

• Anxiety
• Depression
• Diarrhea
• Cramping
• Insomnia
• Irritability
• Nausea
• Pain
• Restlessness

While it is true that opioid withdrawal is painful, those who actually have a chronic pain condition which led to the use of opioids in the first place, are met with even more pain as the drugs leave their system. What’s more, it can take some time for the brain to start producing painkilling endorphins after being idle for extended periods of time. Those who cannot tolerate the pain experienced during that interim period are at great risk of relapse, HealthDay reports. Kelly Dunn, an addiction specialist who researches opioids at Johns Hopkins University School of Medicine, in Baltimore, points out that:

"When you stop taking opioids it takes time for your body to regenerate its own 'painkiller' system," she explained. "Generally, four to five days. The severity varies per patient, and it's not predictable who will react how -- but withdrawal is real." 

It for the reasons mentioned above that many prescription opioid addicts require inpatient treatment. Being in a monitored environment, closed off from the medicine cabinet at home and aided by addiction withdrawal medicines are vital to the success of recovery.

Prescription Opioid Diversion

When most people are given a prescription for an opioid painkiller, they take the medication until the pain dissipates. It is quite common for there to be leftover tablets sitting in the medicine cabinet. Patients usually forget the pills are even there and continue living their life.

The prescription opioid epidemic that has been raging since 1999 has prompted a number of actions that were previously deemed unnecessary. Leftover opioid painkillers pose a serious threat, and often end up in the wrong hands. That is why prescription drug take-back programs have become more and more common in recent years. Opioid addicts will scavenge other people's medicine cabinets for drugs like oxycodone and Percocet. More importantly, teens will also raid their parents' medication bottles as well.

Such drugs are highly addictive and carry a large risk of overdose. It is vital that those with leftover medication dispose of them properly. Many pharmacies will actually take back unused medications. Another common trend of concern is medication diversion. People with a prescription for opioids giving the drugs away to friends, family or peers. A new study sought to find out how often painkiller sharing occurs.

A team of researchers from the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, found that 50 percent of patients with prescribed opioids have leftover tablets and 20 percent share the drugs, MNT reports. The findings were published in JAMA Internal Medicine.


"The fact that people are sharing their leftover prescription painkillers at such high rates is a big concern,” said Prof. Colleen L. Barry, Ph.D., senior study author. “It's fine to give a friend a Tylenol if they're having pain, but it's not fine to give your OxyContin to someone without a prescription." 

There were some other findings of note, including:

• 14 percent of respondents said they would share with family.
• 8 percent said they would share the pills with a friend.
• Less than 50 percent were not given safe storage or proper disposal information.

Fentanyl Salesmen Arrested for Kickback to Doctors

An aspect of the prescription opioid epidemic that is often ignored is the role of pharmaceutical salesmen. These are people who are employed by pharmaceutical companies to travel around the country enticing doctors to prescribe their medical product. Now, it stands to reason that a physician's willingness to prescribe a drug should be based off of the drug's effectiveness at treating a specific condition—and in a perfect world that may be the case. However, doctors are often times given huge incentives to prescribe one medication over another, a practice which surely had a hand in the rampant over prescribing of drugs like OxyContin (oxycodone).

In the wake of the beloved pop star Prince’s death, attention has been redirected back to the powerful opioid analgesic fentanyl. Many Americans may have never heard of fentanyl as the drug is not commonly used outside of hospital settings. Those who had heard of the drug before may have been unaware that fentanyl is 100 time more potent than morphine. Fentanyl, while fast acting and highly effective, can cause severe respiratory depression that can be fatal; this is why it should be scarcely used except under the close supervision of doctors and nurses.

In an attempt to stem the tide of irresponsible prescribing practices, law enforcement has begun to set their sights on pharmaceutical salesmen. Recently, two former pharmaceutical salesmen were arrested from charges stemming from paying doctors to prescribe a form of fentanyl, USA Today reports. The two salesmen, who worked for Insys Therapeutics, allegedly paid two doctors in the New York-area $259,000 in kickbacks to prescribe Subsys.

Most fentanyl prescribed for take home use comes in the form a transdermal patch. The patches are adhered to one’s skin—slowly releasing the drug throughout the course of the day. Subsys, on the other hand, is sprayed under the tongue, according to the article. The spray version of fentanyl works quickly, relieving pain in just five minutes.

"You have this hyper-powerful drug marketed intensely, aggressively and shamelessly without any sense of the addictive and lethal power of what is being sold," said Arthur Caplan, the director of medical ethics at NYU Langone Medical Center in New York.

We will continue to follow the fentanyl story. Stay tuned. 

Naloxone Without a Prescription

In the United States, we face a grave and serious situation with regard to both prescription opioids and heroin use. For far too long an unprecedented number of Americans have been able to access prescription opioids, even in situations where an alternative treatment could be utilized. In the wake of widespread over prescribing, an old drug reemerged on the scene—heroin.

Historically, heroin was thought to be a drug found only in heavily populated urban environments—used primarily among the poor and those of ethnic descent. While there may have been some truth to that idea in the past, it is far from reality today; Americans affected the most by illicit heroin and prescription opioid abuse reside in rural parts of the country—the Appalachian region strongly considered to be the epicenter of the American opioid epidemic.

If you have been following the media reports on this subject, it is likely that you have read about the efforts being made to mitigate the crisis. Efforts include:

• Expanding Access to Addiction Treatment
• Offering Treatment Instead of Jail Time
• Utilizing Prescription Drug Monitoring Programs
• Making It Easier to Acquire Naloxone

By and large, there has been widespread support on both sides of the political spectrum for expanding access to the lifesaving opioid overdose reversal drug naloxone—sold under the brand name Narcan. Thousands of American lives have been saved by the miracle drug, prompting lawmakers, health experts and those who work in the field of addiction to call for legislation which would make it easier for the friends and families of addicts to acquire naloxone.

If you think about it, it makes perfect sense. Time is of the utmost importance when it comes to an opioid overdose. Friends and family are, more often than not, the ones who are present—having naloxone on hand can better ensure a positive outcome. The good news is that states are jumping on board, and now practically every state has some form of legislation allowing people to buy naloxone without a prescription, Fox News reports.

"This saves lives, doesn't seem to have any negative impact that we can identify, therefore it should be available," said Dr. Corey Waller of the American Society of Addiction Medicine.