DENIAL MANAGEMENT WORKBOOK

March 26, 2014

Denial is a normal and natural response for coping with painful and overwhelming problems. This workbook describes the twelve most common denial patterns and guides the reader through a series of exercises that help them identify and more effectively manage their own denial.

This workbook is Designed to help people overcome denial, recognize their addiction, and make a personal commitment to recovery.

The structured exercises contained in this workbook teach the reader how to recognize and more effectively manage their denial when it occurs.

Other exercises invite the client to put these new skills to use by identifying and clarifying the problems that caused them to seek help, their life and addiction history, and their personal symptoms of addiction. Clients are then guided through the process of making a firm and deep commitment to taking a next step in recovery.
Denial Management – A Cognitive Restructuring Approach


The Minnesota Starvation Study

March 26, 2014

Here us what happens when you don’t eat. Scientists in Minnesota carefully documented a group if subjects over a period if long-term starvation. It’s not a pretty picture and has direct implications for understanding anorexia and extreme dieting.
http://m.bbc.com/news/magazine-25782294


The 2010 National Survey on Drug Use and Health: Summary of Findings

March 25, 2014

This report presents the first information from the 2010 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Unless otherwise noted, all comparisons in this report described using terms such as “increased,” “decreased,” or “more than” are statistically significant at the .05 level.

Illicit Drug Use

  • In 2010, an estimated 22.6 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 8.9 percent of the population aged 12 or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically.
  • The rate of current illicit drug use among persons aged 12 or older in 2010 (8.9 percent) was similar to the rate in 2009 (8.7 percent), but higher than the rate in 2008 (8.0 percent).
  • Marijuana was the most commonly used illicit drug. In 2010, there were 17.4 million past month users. Between 2007 and 2010, the rate of use increased from 5.8 to 6.9 percent, and the number of users increased from 14.4 million to 17.4 million.
  • In 2010, there were 1.5 million current cocaine users aged 12 or older, comprising 0.6 percent of the population. These estimates were similar to the number and rate in 2009 (1.6 million or 0.7 percent), but were lower than the estimates in 2006 (2.4 million or 1.0 percent).
  • Hallucinogens were used in the past month by 1.2 million persons (0.5 percent) aged 12 or older in 2010, including 695,000 (0.3 percent) who had used Ecstasy. These estimates were similar to estimates in 2009.
  • In 2010, there were 7.0 million (2.7 percent) persons aged 12 or older who used prescription- type psychotherapeutic drugs nonmedically in the past month. These estimates were similar to estimates in 2009 (7.0 million or 2.8 percent) and to estimates in 2002 (6.3 million or 2.7 percent).
  • The number of past month methamphetamine users decreased between 2006 and 2010, from 731,000 (0.3 percent) to 353,000 (0.1 percent).
  • Among youths aged 12 to 17, the current illicit drug use rate was similar in 2009 (10.0 percent) and 2010 (10.1 percent), but higher than the rate in 2008 (9.3 percent). Between 2002 and 2008, the rate declined from 11.6 to 9.3 percent.
  • The rate of current marijuana use among youths aged 12 to 17 decreased from 8.2 percent in 2002 to 6.7 percent in 2006, remained unchanged at 6.7 percent in 2007 and 2008, then increased to 7.3 percent in 2009 and 7.4 percent in 2010.
  • Among youths aged 12 to 17, the rate of current nonmedical use of prescription-type drugs declined from 4.0 percent in 2002 to 3.0 percent in 2010.
  • The rate of current Ecstasy use among youths aged 12 to 17 declined from 0.5 percent in 2002 to 0.3 percent in 2004, remained at that level through 2007, then increased to 0.5 percent in 2009 and 2010.
  • The rate of current use of illicit drugs among young adults aged 18 to 25 increased from 19.6 percent in 2008 to 21.2 percent in 2009 and 21.5 percent in 2010, driven largely by an increase in marijuana use (from 16.5 percent in 2008 to 18.1 percent in 2009 and 18.5 percent in 2010).
  • Among young adults aged 18 to 25, the rate of current nonmedical use of prescription-type drugs in 2010 was 5.9 percent, similar to the rate in the years from 2002 to 2009. There were decreases from 2002 to 2010 in the use of cocaine (from 2.0 to 1.5 percent) and methamphetamine (from 0.6 to 0.2 percent).
  • Among those aged 50 to 59, the rate of past month illicit drug use increased from 2.7 percent in 2002 to 5.8 percent in 2010. This trend partially reflects the aging into this age group of the baby boom cohort (i.e., persons born between 1946 and 1964), whose lifetime rate of illicit drug use has been higher than those of older cohorts.
  • Among persons aged 12 or older in 2009-2010 who used pain relievers nonmedically in the past 12 months, 55.0 percent got the drug they most recently used from a friend or relative for free. Another 17.3 percent reported they got the drug from one doctor. Only 4.4 percent got pain relievers from a drug dealer or other stranger, and 0.4 percent bought them on the Internet. Among those who reported getting the pain reliever from a friend or relative for free, 79.4 percent reported in a follow-up question that the friend or relative had obtained the drugs from just one doctor.
  • Among unemployed adults aged 18 or older in 2010, 17.5 percent were current illicit drug users, which was higher than the 8.4 percent of those employed full time and 11.2 percent of those employed part time. However, most illicit drug users were employed. Of the 20.2 million current illicit drug users aged 18 or older in 2010, 13.3 million (65.9 percent) were employed either full or part time.
  • In 2010, 10.6 million persons aged 12 or older reported driving under the influence of illicit drugs during the past year. This corresponds to 4.2 percent of the population aged 12 or older, which was the same as the rate in 2009 and lower than the rate in 2002 (4.7 percent). In 2010, the rate was highest among young adults aged 18 to 25 (12.7 percent).

Alcohol Use

  • Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2010 survey (51.8 percent). This translates to an estimated 131.3 million people, which was similar to the 2009 estimate of 130.6 million people (51.9 percent).
  • In 2010, nearly one quarter (23.1 percent) of persons aged 12 or older participated in binge drinking. This translates to about 58.6 million people. The rate in 2010 was similar to the estimate in 2009 (23.7 percent). Binge drinking is defined as having five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey.
  • In 2010, heavy drinking was reported by 6.7 percent of the population aged 12 or older, or 16.9 million people. This rate was similar to the rate of heavy drinking in 2009 (6.8 percent). Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days.
  • Among young adults aged 18 to 25 in 2010, the rate of binge drinking was 40.6 percent, and the rate of heavy drinking was 13.6 percent. These rates were similar to the rates in 2009.
  • The rate of current alcohol use among youths aged 12 to 17 was 13.6 percent in 2010, which was lower than the 2009 rate (14.7 percent). Youth binge and heavy drinking rates in 2010 (7.8 and 1.7 percent) were also lower than rates in 2009 (8.8 and 2.1 percent).
  • There were an estimated 10.0 million underage (aged 12 to 20) drinkers in 2010, including 6.5 million binge drinkers and 2.0 million heavy drinkers.
  • Past month and binge drinking rates among underage persons declined between 2002 and 2010. Past month use declined from 28.8 to 26.3 percent, while binge drinking declined from 19.3 to 17.0 percent.
  • In 2010, 55.3 percent of current drinkers aged 12 to 20 reported that their last use of alcohol in the past month occurred in someone else’s home, and 29.9 percent reported that it had occurred in their own home. About one third (30.6 percent) paid for the alcohol the last time they drank, including 8.8 percent who purchased the alcohol themselves and 21.6 percent who gave money to someone else to purchase it. Among those who did not pay for the alcohol they last drank, 38.9 percent got it from an unrelated person aged 21 or older, 16.6 percent from another person younger than 21 years old, and 21.6 percent from a parent, guardian, or other adult family member.
  • In 2010, an estimated 11.4 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. This percentage had dropped since 2002, when it was 14.2 percent. The rate of driving under the influence of alcohol was highest among persons aged 21 to 25 (23.4 percent).

Tobacco Use

  • In 2010, an estimated 69.6 million Americans aged 12 or older were current (past month) users of a tobacco product. This represents 27.4 percent of the population in that age range. In addition, 58.3 million persons (23.0 percent of the population) were current cigarette smokers; 13.2 million (5.2 percent) smoked cigars; 8.9 million (3.5 percent) used smokeless tobacco; and 2.2 million (0.8 percent) smoked tobacco in pipes.
  • Between 2002 and 2010, past month use of any tobacco product decreased from 30.4 to 27.4 percent, and past month cigarette use declined from 26.0 to 23.0 percent. Rates of past month use of cigars, smokeless tobacco, and pipe tobacco in 2010 were similar to corresponding rates in 2002.
  • The rate of past month tobacco use among 12 to 17 year olds declined from 15.2 percent in 2002 to 10.7 percent in 2010, including a decline from 2009 (11.6 percent) to 2010. The rate of past month cigarette use among 12 to 17 year olds also declined between 2002 and 2010, from 13.0 to 8.3 percent, including a decline between 2008 (9.1 percent) and 2010. Cigar use among youths declined between 2009 and 2010, from 4.0 to 3.2 percent.

    Initiation of Substance Use (Incidence, or First-Time Use) within the Past 12 Months

  • In 2010, an estimated 3.0 million persons aged 12 or older used an illicit drug for the first time within the past 12 months. This averages to about 8,100 initiates per day and was similar to the estimate for 2009 (3.1 million). A majority of these past year illicit drug initiates reported that their first drug was marijuana (61.8 percent). About one quarter initiated with psychotherapeutics (26.2 percent, including 17.3 percent with pain relievers, 4.6 percent with tranquilizers, 2.5 percent with stimulants, and 1.9 percent with sedatives). A sizable proportion reported inhalants (9.0 percent) as their first illicit drug, and a small proportion used hallucinogens as their first drug (3.0 percent).
  • In 2010, the illicit drug categories with the largest number of past year initiates among persons aged 12 or older were marijuana use (2.4 million) and nonmedical use of pain relievers (2.0 million). These estimates were not significantly different from the numbers in 2009. However, the number of marijuana initiates increased between 2007 (2.1 million) and 2010 (2.4 million).
  • In 2010, the average age of marijuana initiates among persons aged 12 to 49 was 18.4 years, significantly higher than the average age of marijuana initiates in 2002 (17.0 years).
  • The number of past year initiates of methamphetamine among persons aged 12 or older was 105,000 in 2010. This estimate was significantly lower than the estimate in 2007 (157,000) and only about one third of the estimate in 2002 (299,000).
  • The number of past year initiates of Ecstasy aged 12 or older was similar in 2009 (1.1 million) and 2010 (937,000), but these estimates were an increase from 2005 (615,000).
  • The number of past year cocaine initiates aged 12 or older declined from 1.0 million in 2002 to 637,000 in 2010. The number of initiates of crack cocaine declined during this period from 337,000 to 83,000.
  • In 2010, there were 140,000 persons aged 12 or older who used heroin for the first time within the past year, not significantly different from the estimates from 2002 to 2009. Estimates during those years ranged from 91,000 to 180,000 per year.
  • Most (82.4 percent) of the 4.7 million past year alcohol initiates were younger than 21 at the time of initiation.
  • The number of persons aged 12 or older who smoked cigarettes for the first time within the past 12 months was 2.4 million in 2010, similar to the estimate in 2009 (2.5 million), but significantly higher than the estimate for 2002 (1.9 million). Most new smokers in 2010 were younger than 18 when they first smoked cigarettes (58.8 percent or 1.4 million).
  • The number of persons aged 12 or older who used smokeless tobacco for the first time within the past year increased from 928,000 in 2003 to 1.4 million in 2010.

Youth Prevention-Related Measures

  • Perceived risk is measured by NSDUH as the percentage reporting that there is great risk in the substance use behavior. The percentage of youths aged 12 to 17 perceiving great risk in smoking marijuana once or twice a week decreased from 54.7 percent in 2007 to 47.5 percent in 2010. Between 2002 and 2008, the percentages who reported great risk in smoking one or more packs of cigarettes per day increased from 63.1 to 69.7 percent, but the percentage dropped to 65.8 percent in 2009 and remained steady at 65.5 percent in 2010.
  • Almost half (48.6 percent) of youths aged 12 to 17 reported in 2010 that it would be “fairly easy” or “very easy” for them to obtain marijuana if they wanted some. Approximately one in five reported it would be easy to get cocaine (19.0 percent). About one in seven (12.9 percent) indicated that LSD would be “fairly” or “very” easily available, and 11.6 percent reported easy availability for heroin. Between 2002 and 2010, there were declines in the perceived availability for all four drugs.
  • A majority of youths aged 12 to 17 (89.6 percent) in 2010 reported that their parents would strongly disapprove of their trying marijuana or hashish once or twice. Current marijuana use was much less prevalent among youths who perceived strong parental disapproval for trying marijuana or hashish once or twice than for those who did not (4.4 vs. 32.8 percent).
  • In 2010, three quarters (75.9 percent) of youths aged 12 to 17 reported having seen or heard drug or alcohol prevention messages from sources outside of school, lower than in 2002 (83.2 percent). The percentage of school-enrolled youths reporting that they had seen or heard prevention messages at school also declined during this period, from 78.8 to 75.4 percent.page17image25360

Substance Dependence, Abuse, and Treatment

  • In 2010, an estimated 22.1 million persons (8.7 percent of the population aged 12 or older) were classified with substance dependence or abuse in the past year based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM- IV).
    • Substance Dependence or Abuse, Alcohol and/or  Other Drug: 8.7%, of these:
      •  Both Alcohol and Illicit Drugs: 2.9 million (about 13%)
      • Illicit Drugs but Not Alcohol: 4.2 million (about 19%)
      • Alcohol But Not Illicit Drug: 15.0 million (about 67%)
  • Between 2002 and 2010, the number of persons with substance dependence or abuse was stable (22.0 million in 2002 and 22.1 million in 2010).
  • The specific illicit drugs that had the highest levels of past year dependence or abuse in 2010 were marijuana (4.5 million), pain relievers (1.9 million), and cocaine (1.0 million). The number of persons with marijuana dependence or abuse did not change between 2002 and 2010, but the number with pain reliever dependence or abuse increased (from 1.5 million to 1.9 million) and the number with cocaine dependence or abuse declined (from 1.5 million to 1.0 million).
  • In 2010, adults aged 21 or older who had first used alcohol at age 14 or younger were more than 5 times as likely to be classified with alcohol dependence or abuse than adults who had their first drink at age 21 or older (15.1 vs. 2.7 percent).
  • Between 2002 and 2010, the percentage of youths aged 12 to 17 with substance dependence or abuse declined from 8.9 to 7.3 percent.
  • Treatment need is defined as having a substance use disorder or receiving treatment at a specialty facility (hospital inpatient, drug or alcohol rehabilitation, or mental health centers) within the past 12 months.
  • In 2010, 23.1 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem (9.1 percent of persons aged 12 or older). Of these,
    • 2.6 million (1.0 percent of persons aged 12 or older and 11.2 percent of those who needed treatment) received treatment at a specialty facility.
    • Thus, 20.5 million persons (8.1 percent of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive treatment at a specialty facility in the past year.
  • Of the 20.5 million persons aged 12 or older in 2010 who were classified as needing substance use treatment but did not receive treatment at a specialty facility in the past year, 1.0 million persons (5.0 percent) reported that they felt they needed treatment for their illicit drug or alcohol use problem. Of these 1.0 million persons who felt they needed treatment, 341,000 (33.3 percent) reported that they made an effort to get treatment, and 683,000 (66.7 percent) reported making no effort to get treatment.
  • The number of people receiving specialty treatment in the past year in 2010 (2.6 million) was similar to the number in 2002 (2.3 million). However, the number receiving specialty treatment for a problem with nonmedical pain reliever use more than doubled during this period, from 199,000 to 406,000.

ON THE INTERNET IN PDF


The Up Side of Down

March 23, 2014

FEBRUARY 25, 2014

Book Discussion on The Up Side of Down

Megan McArdle talked about her book, The Up Side of Down: Why Failing Well Is the Key to Success, in which she argues that the U.S. is unique in its willingness to let its citizens and businesses fail and says that this is what has made the country successful. During this event, hosted by the American Enterprise Institute in Washington, DC, Ms. McArdle spoke with George Mason University professor Tyler Cowen.

Watch The Discussion: The Up Side of Down


Public Health and Drug Use

March 23, 2014

Public Health and Drug Use
March 20, 2014

White House National Drug Control Policy Acting Dir. Michael Botticelli talked to the National Lt. Governors Association about prescription drug abuse and opiate overdoses, their impact on public health and safety, and government efforts to address the issue.

Watch the presentation


Language Is Important

March 20, 2014

THE LACK OF UNIFORM LANGUAGE for addiction and psychology has hindered the development of the field substantially.

We spend more time arguing about what a word should mean than we do about what is wrong with the patient and what treatment is being used.

This is more than a superficial problem of semantics. It causes serious problems in diagnosing addiction and related problems. It also makes accurate charting and evaluation of treatment for the purpose of reimbursement unreliable.

This lack of uniform language cuts to the core of behavioral health care credibility. Here are a few examples;

– Is it alcoholism, addiction, substance use disorders, substance dependence, substance abuse, compulsive use, or problem use?

– If we can’t agree on what the disorder/disease etc. should be called how can we actually expect get paid for the treatment of “whatever-it-is?

Establishing uniform language really makes a lot of difference:
– Are we treating the right thing or the wrong thing?
– Does the treatment help patients get well, do nothing, or make them sicker.
– What professionals, in what settings should be providing treatment?

The time spent continuously arguing about the meaning of basic terms would be better spent discussing the nature of a problem, and the best approaches for treating it

There are still serious and very STUPID debates about whether the people who have “it” should be called patients, clients, or consumers; and if those who believe that that they have overcome “It” should be called cured, in remission, in recovery, etc.

This problem has driven me crazy for over forty years and there is no solution insight.

http://www.relapsewww.relapse.com.org
www.terrygorski.com


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