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Basic InformationMore Information"I have benefited from AA and the 12 Steps... Very much so!"A Better MeetingAA Is To Shame As A Hot Knife Is To ButterAging and Alcohol UseAlcoholic's Anonymous, Outcomes and New Research on AlcoholismAlcoholics Anonymous (AA) is a Cult ?An Alternative to PowerlessnessAttachment to OutcomesAwakeningConcerning Problems Within AADefining and Understanding the Concept of Denial, Addictions and OtherwiseGauging the Effectiveness of One Component of Alcoholics AnonymousHow Drugs Affect The BrainHuffing: Parents and Kids BewareIts Never Too LateLike Phoenix Risen from the Ashes of Addiction, A New Addiction Recovery ProgramNIDA InfoFacts: Drug Abuse and AIDSNIDA InfoFacts: Drug Addiction Treatment MethodsNIDA InfoFacts: Drugged DrivingNIDA InfoFacts: Pregnancy and Drug Use TrendsNIDA InfoFacts: Understanding Drug Abuse and AddictionOn the Question of Medical MarijuanaPain Pills, A Real PainPerverse MotivationRandom Thoughts About Addiction, Delusions and HallucinationsRecoverySelf-EfficacyStaying Sober: Dealing With TemptationsSteering Versus DriftingThe Author of Your FateThe Enlightened PathThe Impeccable PathThe Mentality of ChildhoodThe OPEN PathThe Paradoxical Sinclair Method For Treating Alcohol DependenceTwo MindsWise Counsel Interview Transcript: An Interview with Annie Fahy, MSW on Motivational InterviewingWise Counsel Interview Transcript: An Interview with John C. Fleming, MD on Preventing AddictionWise Counsel Interview Transcript: An Interview with Laurence Westreich, MD on Helping Families Help Addicted MembersWise Counsel Interview Transcript: An Interview with Marc Kern, Ph.D. on Rational Alternatives to Alcoholics AnonymousWise Counsel Interview Transcript: An interview with Morteza Khaleghi, Ph.D. on the Importance of Treating Emotional Trauma in Addiction Wise Counsel Interview Transcript: An Interview with Patt Denning, Ph.D. on Harm Reduction Psychotherapy for Substance Abuse and AddictionWise Counsel Interview Transcript: An Interview with Stefanie Goldstein, Ph.D. on Mindfulness and Addiction TestsLatest NewsComputer-Based Screening May Reduce Teen Substance AbuseTeen Impulsiveness Has Different Sources in ADHD, Substance UseAccelerated Aging Evident in Cocaine-Dependent IndividualsMany Who First Misuse Prescription Pills Get Them From Friends, Family: ReportCocaine Habit Might Speed Brain AgingUse of Ecstasy, Speed by Teens Tied to Later DepressionHalf of Young Cigarette Smokers Also Smoke Pot: Survey12-Step Meetings May Help Teens Beat Alcohol, Drug AbuseAlcohol Use With Opioids Common Even Without Abuse PastSubstance Abusers, Even Recovering Ones, May Face StigmaDrug, Alcohol Abuse Common Among U.S. Teens, Study FindsAlcohol Effects on Brain Activity Vary With Blackout HistoryPrenatal Meth Exposure Linked to Behavioral ProblemsExcessive Drinking Costs U.S. Colleges Millions AnnuallyKids Using Synthetic Pot a Growing Public Health ConcernSpring Break Boozing May Put Young Brains at RiskMany Alcoholics Suffered Childhood Trauma: StudyGenes Play a Role in Drug Abuse Risk Among Adopted Kids: StudyNarcotic Painkillers Another Threat to Traumatized War Vets: StudyDrinking Scenes in Movies May Spur Teens to Do the SameStrict Underage Drinking Laws May Deter Delinquency in TeensEcstasy Use During Pregnancy May Harm Fetus: StudySupport for Tougher Liquor Laws Rises When Booze, Crime LinkedBooze in Movies May Fuel Teenage Drinking1 in 10 U.S. Kids Lives With Parent Who Has Abused Alcohol: ReportStop-Smoking Drug May Also Curb Problem DrinkingIllicit Drugs Bought Off Internet May Be Poisons, Experts WarnHard Drug Use in Middle Age Could Prove Fatal, Study FindsDrinking Late in First Trimester May Be Most HazardousAlcohol Targets Brain 'Reward Centers' in Heavy DrinkersOne in Six Americans Binge Drink: CDCMeth Users Much More Likely to Try SuicideFor Some Couples, Binge Drinking Is RoutineStates Crack Down on Drunk Drivers This Holiday SeasonDrug Overdoses Kill More Americans Than Car Accidents: CDCAlcohol Use Down, Pot Use Up Among U.S. TeensDrunk Driving-Related Deaths Surge During the Holidays'Ecstasy' May Cause Long-Term Changes in Brain ChemistryToo Much Alcohol Linked to Unsafe Sex, Study ConfirmsIf Parents Drink and Drive, Their Kids May Too: StudySmart Kids More Likely to Try Illicit Drugs as Young AdultsHelping Others Helps Teens Beat Substance AbuseDrugs Slipped Into Drinks Sending Many to ER: ReportHeavy Meth Use Linked to Schizophrenia'Fake Marijuana' May Trigger Heart Trouble in TeensMore Than a Third of Teens Turning to Alcohol, Drugs: StudyMore People Landing in the ER After Abusing Muscle Relaxant: ReportDeaths From Abuse of Painkillers Triple in a Decade: CDCNational Drug Take-Back Day Scheduled for SaturdayPot Can Mimic Brain Changes Seen in Schizophrenia Questions and AnswersLinksBook ReviewsSelf-Help Groups |
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Alcohol and Substance Abuse - Cannabis and Opioid Specific ConcernsMark Dombeck, Ph.D.Cannabis - Since marijuana may be one of many drugs abused, total abstinence from all psychoactive substances should be the goal of therapy. Periodic urine testing should be used to monitor abstinence. Cannabinoids can be detected in the urine up to 21 days after abstinence in chronic abusers due to fat redistribution; however, one to five days is the normal urine positive period. Thus, beginning drug monitoring needs to be interpreted accordingly.
- If a user is to remain drug-free, follow-up treatment, usually with psychiatric help and resort to community resources, is vital. Life-style changes such as avoiding people, places, and things related to cannabis use should be encouraged. Initial psychosocial treatment should focus on confronting denial, teaching the disease concept of addictions, fostering an identification as a recovering person, recognition of the negative consequences of cannabis abuse, avoiding situational and intrapsychic cues that stimulate craving, and formulation of support plans. Drug urine tests should be used to ensure compliance.
- It is likely that some heavy cannabis users, like other heavy drug users, suffer from chronic anxiety, depression, or feelings of inadequacy. In these cases, the drug abuse is a symptom rather than the central problem. These cases can benefit from psychotherapy and psychiatric medications.
- Psychotherapy is useful when it focuses on the reasons for the patient's drug abuse. The drug abuse itself - past, present, and future consequences - must be given firm emphasis. Involving an interested and cooperative parent or spouse in conjoint therapy is often very beneficial. In the adolescent, cannabis dependence often hides poor self-esteem, depression, severe family problems, and learning disorders. These issues must be addressed in therapy. Generally, a nonjudgmental, honest, steady, and firm approach is needed with adolescents.
Opioids As described for previous drugs, with one important additional note: - Like all addictions, opioid addiction is difficult to kick. In some cases, it is recommended that patients addicted to opioids get on to a Methadone or LAAM maintenance program via a maintenance clinic. Patients on such maintenance programs go to the clinic each day and receive medication in the form of Methadone or LAAM. These medicines are themselves opioids, and so keep the opioid addicted patient from experiencing withdrawal symptoms so long as they continue to use the Methadone or LAAM. The advantages of having patients on Methadone (versus Heroin) are many: Methadone can be given in one daily dose and provides a long lasting effect without any spiked-'high' states. This allows the addicted person to have the rest of their day free to pursue more socially useful endeavors than simply finding the next fix. It can be administered orally, and is thus much safer than IV injected Heroin. Although it is not easier for people to come off of Methadone than it is to come off of heroin, the process can be done very gradually in measured doses, so that it is safe and more likely to actually work than any cold-turkey complete abstinence approach.
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