Tobacco: The Number One Killer

400,000 Americans die each year as the direct result of tobacco use. Canada has a similar rate even though there are large printed warnings on each cigarette package and the industry is highly regulated in terms of advertising and conditions under which the product can be sold. The US governmnent is currently considering ways that they can strengthen their regulations.

Nicotine is one the most highly addicted substances ingested by mankind and many experts see it as the “gateway” drug leading to expermentation with other substances. Judging by what I see around our elementary and high schools with kids puffing away, this seems to be borne out in fact. What I do know is that thirty odd years ago I was an up to two large packs a day smoker convinced that I would never be able to stop. But somebody gave me a plan and I grabbed onto and have not looked back. Oh I every once in a while I yearn for a good cigar but I get over it.

Back then the recovery home I was in did not attempt to even look at this addiction, There was no patch, gum or other medically assistance out side of cold turkey. In fact the prevailing thinking at that time was that you could not treat tobacco addiction at the same time as alcoholism and other drug use. Today we know differently.

Just thinking back, when I was fortunate enough to go to the non smoking session and grab on, a good friend of mine in recovery attended with me. I was able to stop he wasn’t. He died a few years back of lung cancer. I miss him.

So, what is your experience as a clinician, as a smoker or former smoker? Is tobacco the gateway drug? Can we treat all addictions at the same time? Do traditional methods for other drugs work for those addicted to nicotine? Why do severe media warnings not work as effectively as we would hope? Could it be that our youth just rebel against such messages? Why is it that more boys than girls start smoking? What about “spit tobacco”, how prevelant is its use?

For current stats please go to Health Canada’s Canadian Tobacco Use Monitoring Survey at www.hc-sc.gc.ca

I expect this week’s subject to have a fairly heavy response which will just absolutely delight me. I look forward to your comments but don’t write a book rather make multiple submissions if you like.

Jeff

P.S. It is so good not to have yellow fingers any more.

Addiction: Illness or Personal Choice?

Addiction: New research suggests it’s not an illness it’s a choice . This is the title of the front page article of the current MACLEANS newsweek magazine (Canadian). You can access the article by going to www.2macleans.ca . Go down to the Health section and click on the article.

The article is an interview with Harvard psychologist Gene Heyman. Doctor Heyman’s comments states his position that “… drug or alcohol addictin is not a disease, but a matter of personal choice. He suggests that the reason we have called it an Addiction is that we want to be humane.

I don;t know if Dr. Heyman is familiiar with the current research on addiction as a brain disease or not. What I do know is that I desperately fought alcohol and somehow could not resist the obsession of picking up that first drink. It is correct that nobody poured it down my throut, I did make a choice, But, I had reached that point where I had no mental defense.

This article, in my view, is a dangerous one. it gives one person’s opinion and reseach which may very well be flawed. Its danger lies in the possibility of policy makers and funders taking this view at face value and providing an excuse to reduce resources to much needed programs.

I am hoping that you wil take the time to read the article and submit your comments to the Blog. I look forward to your comments.

Jeff

What Is Best For Our Clients?

I am back from England and I do apologize for the delay of this week’s posting. We have been having some computer challenges.

I have asked you for your suggestions on the topics and issues you want to discuss. One of our colleagues has suggested that we have a dialogue on faith based and harm reduction approaches to addictions. For example, are they mutually exclusive? Can we be overly zealous in our clinical biases? What about the client’s rights and matching to the appropriate intervention? What does the research say?

I suspect we will have some interesting opinions. Just click on comments read, type in your thoughts and submit. I look forward to your insights.

The Future of Rehap

I am just leaving for the UKESAD conference in England. I am co-presenting on the subject of the future of residential treatment. Many of you have communicated with me directly on the subject. Thanks.

I think we can be fairly sure they will exist but will there more beds or less. I also wonder if there might be changes over the next few years in terms of client populations and treatment approaches.

As a non clinician, I would suggest that for goverment funded programs the beds should be reserved for the most acute cases. I mean by acute those with concurrent disorders or lack of social and financial supports.

Another question is the future of the private pay for service residential programs. One American commentor has suggested that they are getting too expensive.

What does your crystal ball say?

I have set this blog up for you to share and discuss the issues. So please let me know what subject matters you want to address.

Jeff

Should Drug Possession Be Decriminalized?

The April 26, 2009 edition of  Time magazine had an article Drugs In Portugal: Did Decriminalization Work?

Portugal has changed its focus from jailing people to one of therapy.

A report five years after decriminalization claims a lower rate of drug use among Portugese youth as well as lower HIV rates. The report claims the lowest drug use among the fifteen European Union nations.

In North America Senator Jim Webb of Virginia has called for a commission simillar to Portugal’s to ponder the issue. The discussion is also alive in Canada including a recent pro pot rally in Toronto.

What about you on the front line? What is your opinion? What would be the benefits? What are the dangers? How would you implement such a plan?

I look forward to your views. Simply click on Comments, read the submissions, type your comments and submit.

Jeff

To Medicate Or Not to Medicate: That Is The Question

The first week of our blog was a success. 45 of you submiitted your comments. Web Master Steve says that is a good start. If you did not submit last week, why not do so this week. Please enter this in your favorites and tell your friends and colleagues about our blog. If you are just coming on, welcome.

This week’s discussion and debate has a fair bit of controversy around it.

Medication Assisted Treatment.

When I first  entered recovery Antabuse was being used. I was never on it but I knew many who were. Methadone, and more recently buprenorphine, has been quite accepted to assist opiate dependency. Naltrexone is now being administered for alcohol dependency.

Now I know there are strong opinions on  both sides of the question. So let’s have a healthy debate. Should we assist those suffering from addictions with medications? Why or Why Not? When is it appropriate? When is it not?

Simply click on Comments, read the submissions, type yours and submit.

I look forward to your opinions and experiences.

Jeff

Addictions: A Gateway to a New Life

Most speakers usually present addictions as a negative.  And goodness knows there is a lot negative about addictions. But, there is another side to it. That is recovery. So many of us have reached a turning point in our lives, made a turn around and went on to not only have a good life but also provide valued services to society and our fellows.

I have known many cases over my years of recovery. The young man who went from the streets to the Order of Canada .  The drunken doctor who become the head of his professional college. Or how about the biker chick who is now a tenured professor at a major university.  I am sure you also have similar stories.  Won’t you please share those stories with me and the readers of this Blog. Simply click on No Comment.

Jeff