Substance Abuse and Addiction

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    Many people believe that the use of snuff and other forms of smokeless tobacco is safer than smoking. However, potent human carcinogens (N-nitrosamines) are also present in high concentrations in smokeless tobacco. These carcinogens have been clearly linked to cancers of the lung, esophagus, liver, pancreas, bladder, cervix, nasal and oral cavities. There simply is no safe way to use tobacco products. 
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    Having addictions in your family is considered a risk factor for developing addictions. Patients who receive a prescription for opioids to treat pain can also be at risk of developing an addiction to this medication if they have the following risk factors: 
    • Depression, anxiety or other psychiatric issues present at the time of opioid treatment or in their past history. 
    • Ongoing substance abuse with alcohol or other drugs.
    • Poor coping skills and a tendency to imagine “worst possible outcomes” in difficult situations. An individual with these traits may be primed to become addicted to these powerful drugs. 
    It’s always a good idea to have a conversation with your doctor about the pros and cons of taking any medication, especially an opioid that falls within the Schedule III classification of controlled substances.
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    A , Addiction Medicine, answered
    There are numerous options for opiate users looking for help. The long-standing standard of non-abstinence treatment for this group used to be methadone treatment, although buprenorphine treatment (Suboxone, Subutex) has gradually been gaining favor for being easier to administer in an office setting as well as having some abuse-protection built in.

    Some anecdotal evidence even supports replacement of opiate use with marijuana use, although research on the success of such options is limited.

    Most importantly, individuals seeking help with a heroin addiction should take into account factors such as access to the medication, ability to pay, as well as their individual reaction to the medication when considering the best option.
    Finally, most of these therapies are meant as short-term methods to replace heroin and then gradually reduce the medication, with the ultimate goal being abstinence. While some individuals use them as maintenance drugs, that initial aim should be kept in mind if a person is seeking to become opiate-free.
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    A , Family Medicine, answered
    While several research studies have demonstrated a correlation between marijuana use and schizophrenia, scientists aren't certain if the drug actually causes the illness. Experts question whether people who are already at risk for developing schizophrenia are more likely to use marijuana at a younger age. Because early life stress is a possible risk factor for schizophrenia,  those exposed to stress early in life may also be more likely to use marijuana. Using large amounts of marijuana can trigger psychotic symptoms, such hallucinations and paranoia, in some people. Marijuana may also cause some people to have a relapse of symptoms of schizophrenia even while they are receiving treatment.
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    A , Addiction Medicine, answered
    Studies suggest that some people experience withdrawal symptoms when stopping marijuana. These symptom patterns include craving for marijuana, reduced appetite, sleep difficulty, weight loss, and—in some cases—anger, aggression, irritability, and restlessness.
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    A , Internal Medicine, answered
    Some people think that marijuana -- by far the most popular illegal drug -- is harmless. Unfortunately, that's simply not true. While it may be less immediately dangerous or addictive than other drugs, it can still take a toll on your health, making your RealAge (physiologic age) older. Marijuana contains 50 percent more carcinogens and four times as much tar as cigarettes. Studies show that the heavy use of marijuana can cause residual neurologic effects that decrease cognitive (the learning, thought process part of mental) functioning. Heavy users actually experience aging less from the drug itself than from the behaviors it tends to induce, most notably a lack of motivation. For example, users are less likely to exercise, eat a healthy diet, or maintain the kinds of social networks that help protect against stress. They are also more likely to engage in risky behaviors, such as unsafe sex or driving under the influence of drugs or alcohol.
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    Acetaldehyde is a chemical that is produced when sugar is burned. Internal studies conducted by cigarette maker Phillip Morris revealed that adding acetaldehyde to nicotine significantly increases the desire to smoke.

    While patches and gum may help to stave off a craving for nicotine, they don't touch the acetaldehyde.

    It is no coincidence that it is harder to resist smoking when you are drinking a beer: once the acetaldehyde in your system is activated by the beer, you will crave more, in the form of a cigarette.

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    A , Internal Medicine, answered

    Nicotine is the addictive drug in tobacco products, so there's a simple way to prevent nicotine addiction: don't use tobacco in any form. Most tobacco users start when they're teenagers - and about three thousand teens start smoking every day. School-based programs that teach about the dangers of tobacco have been shown to be very effective in keeping kids from starting. 

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    A , Internal Medicine, answered
    Like all addictive drugs, nicotine affects your brain, making you feel good and wanting more of it. Nicotine has an upside: It can improve your concentration and alertness, boost your mood, and suppress your appetite. Of course, the downside, like the risk of lung and heart disease, far outweighs the upside, but try telling that to your addicted brain. When your brain doesn't get nicotine for even a few hours, you'll probably find yourself pacing around, feeling irritable and depressed, having a headache, and unable to concentrate.
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    A , Psychology, answered

    Here are a few ways to talk to your kids about steroids as well as a few strategies from my book, The Big Book of Parenting Solutions, to help you navigate yet another worrisome subject with our children.

    Open up the steroid dialogue–don’t wait for your kids to come to you. “Hey Mom, can we talk about steroids?” probably isn’t going to be reality. Open up that conversation with your child at least by fourth grade. Remember, kids as young as fifth grade are now indulging, so get a year start. Just tailor your talk to their level. Remember, one talk isn’t going to do it. Repeat. Repeat. Repeat.

    Use real world events. Cut out an article about Mark McGwire and use it as your conversation opener: “Do you think he knows what the long-term damage could be on his body?”  “What are your friends saying?” Use the issue as a bridge and cover the next few tips. Or go back to Barry Bonds: “Do you think he should make the Hall of Fame if they find out he took steroids?” “Do you think it’s fair to the other players who aren’t using steroids?”

    Discuss the health dangers. There are clear health risks that your child needs to know. Here are just a few: severe acne, loss of hair, liver abnormalities (including peliosis hepatitis or blood-filled cysts), increase in the harmful kind of cholesterol, rage, angry outbursts or uncontrolled aggressive behavior, increase in blood clots, and high blood pressure. The results really aren’t back yet on real long-term effects of steroid use—especially on young bodies.

    Share your views. Many kids actually feel their parents are accepting of steroids. Why? Well, it seems one of the biggest reasons kids take steroids is to please their parents. If you’ve been stressing that college scholarship, winning at any cost, how proud you are that he or she’s such an athlete (“Olympic are right around the corner, darling”), then bite your tongue. Your child needs to know (and pronto) why you think steroids are wrong (think this one through carefully so you do create a strong, powerful case), and what your family values are (push that this is also cheating, lying and deception).