Category: Addiction

Treatments Now Available For Disordered Gaming

00Addiction, Environment, Featured news, Mental Health, Mindfulness, Parenting, Personality Change, Social Life, Video Game Addiction February, 20

Source: pozaristul at Flickr, Creative Commons, some rights reserved

In June of 2018, The World Health Organization released the 11th version of the International Classification of Diseases (ICD-11). For the first time, Gaming Disorder would be included as a mental health condition that is characterized by physical, social, and psychological impairments due to excessive video gaming.

Like most things, gaming can be healthy in moderation, but some gamers play excessively. Yonah Budd is the Director, Co-Founder and Chief Therapy Officer of The Farm – a private rehab center in Stouffville, Ontario. He has over three decades of experience with youth who are struggling with behaviour- and drug-related addictions. According to Budd, those he considers addicted to gaming often play to escape some form of stress in their lives and do not seek help until they have lost a relationship, a home, a business, or all three.

In an interview with the Trauma and Mental Health Report, Yonah explained that treatment for a gaming disorder utilizes similar steps to a typical drug-use program; one in which the first step for every new client is a complete detox. At The Farm, detoxing begins with a minimum of a 30-day stay without internet access to reduce dysfunctional behaviours. Older clients are typically given a flip phone without data while younger clients are provided with colouring books or building blocks. Being in an outdoor environment also provides a ‘wilderness’ experience in therapy. Being in a natural environment, there are fewer distractions from electronic devices.

Social integration is a very important goal of rehabilitation. People with disordered gaming behavior often experience significant withdrawal from social activities with friends and family. According to Yonah, many teens can become isolated, playing for 8-10 hours per day, sometimes even all night long.  It can be especially difficult to withdraw from a routine when playing with online friends. Yonah thinks the rise of online communities has only made it easier to fall into dangerous habits. However, face-to-face social interactions can be beneficial in treating a gaming disorder. Yonah described how social integration helped one of his clients:

“I know a boy now in his 20s. For most of his teenage years he was a gaming junkie… Now as an adult, he can’t spend all his time sitting in front of a computer because in your twenties you don’t do that anymore if you want to be social. Working with him, I said OK, why don’t we look at some board gaming… so now he’s is out 2-3 nights a week playing board games. It’s still gaming, but it’s social gaming…”

Parents and caregivers can play a key role in helping find alternatives to gaming that encourage a healthier lifestyle. Playing video games with a son or daughter can be a great first step to better understand their behavior and build parent-child rapport. As Yonah states:

“Rapport is what it’s all about. Adults have to come to the kids. Dad needs to sit down with Billy and play games with him… If a kid likes racing games, try engaging them in something more social, like go-karting.”

In order to prevent relapse, an important final step is re-integration back into the home environment and the family unit. One program, Venture Academy, places troubled teens from across Canada in “host-home environments.” At the end of the week, each of their teens gets a chance to practice problem-solving skills and daily responsibilities in small, family-sized units. Re-introducing clients to a more familiar setting before returning them home is intended to make it easier to transition from treatment into a normal routine. Chris Madsen, one of the counsellors at Venture Academy, says:

“Change is best retained in the environment in which it is learned. I’ve worked in wilderness programs and there are a lot of positive things about that, so don’t take this as a knock, but a lot of them are recognizing that once the child has “woken up”… teens are relapsing at home because parents are not going to be able to replicate a wilderness program.”

As the issues and technologies continue to evolve, treatment will have to evolve with it and what we learn over the coming decades will determine what methods help most.

– David Remisch, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Opioid Addiction a Battle Between Parents and the Law

00Addiction, Education, Featured news, Law and Crime, Mental Health, Parenting, Trauma Psychotherapy January, 20

Source: rafabordes at Pixabay, Creative Commons

In 2017, a father from Victoria, British Columbia, pleaded for his 15-year-old daughter to seek rehabilitation for an opioid addiction. He was terrified that by the time she realized she required treatment, it would be too late—a reality for many parents with children battling addictions.

Opioid addiction has reached epidemic levels among youth and adults in North America. In 2016, roughly 64,000 Americans died from this class of substances, which includes illegal drugs like heroin, and prescription drugs such as fentanyl, which constitute the majority of opioid-related deaths. In 2015, approximately 10% of youth ages 15 to 24 were using prescription opiates in Canada.

In Canada, health care is managed provincially. According to lawyer Lisa Feldstein, an expert in the field of children’s mental

Current Canadian laws are deemed highly problematic by parents of drug-addicted children who believe the laws impact their ability to protect their children from danger, leaving many feeling hopeless and afraid. The Trauma and Mental Health Report (TMHR) interviewed numerous parents with drug-addicted children and many believe the very nature of drug addiction impairs an individual’s ability to think rationally and recognize they have a severe problem warranting immediate treatment. This concern was reiterated by the father of the opioid-addicted child from Victoria, British Columbia:

“She’s a child. Her brain is not completely developed. She’s already suffering emotional issues and now the drugs are doing the talking for her. She’s not thinking rationally.”

Parents’ concerns are partially supported by research. According to one study, the reason many individuals with opioid addictions do not seek treatment may be due to dysfunctional neurocircuitry resulting in an impaired ability to recognize their drug addiction.

If it is believed their child lacks mental capacity, parents can obtain an official form, authorized by a physician, allowing their child to be involuntarily admitted to treatment. However, the period of time in which treatment facilities can involuntarily confine children is often short. For example, in British Columbia, Form 4 allows an individual to be involuntarily admitted for 48 hours. To be held longer, a second form must be completed within that 48-hour period, upon which an individual can be held up to 30 days.

In an interview, Brenda Doherty, a parent of a 14-year old opioid-addicted child, expresses the frustration and heartbreak caused by the current mental health system. Doherty was successful in obtaining Form 4, however, her daughter was released from the hospital she was admitted to within one hour of arriving:

“I didn’t even have time to get down there and they discharged her… They let her go and she died a day and a half later.”

While the National Institute on Drug Abuse states that involuntary treatment can be effective, Micheal Vonn, policy director for the British Columbia Civil Liberties Association, argues that involuntary treatment may place children at greater risk once discharged:

“The question then becomes, once they are released, are they actually more inclined or set up for an overdose because they don’t have a structured program to go into to support them in recovery?”

However, according to Families for Addiction Recovery, while voluntary treatment is always preferred, if obtaining consent is not possible, the risks of untreated addiction must be considered, which can include homelessness, juvenile detention and severe medical problems.

In an interview with the TMHR, Kaelan Lanie, a 20-year old from Minnesota who battled an opioid addiction throughout her youth appreciates both sides of the debate:

“Although I think in many cases forced intervention is necessary, I believe the addict has to want the help in order for treatment to actually work, and unfortunately you can’t force someone into wanting to get better.”

When asked what the primary motivating factor was that allowed Lanie to recover from addiction, she said:

“I just had enough. I became willing to do whatever it took to recover and God lined up the right people to believe in me until I could believe in myself.”

Lanie offers advice to parents of drug-addicted children:

“I believe the best thing a parent can do for their child with a drug addiction is to seek help themselves. Talk about things—whether by joining support groups or confiding in friends and family. Addiction is a family disease and everyone must recover from it.”

The balance between respecting children’s autonomy and the duty of a parent to protect their child is complex. However, a case can be made that allowing parents to consent to treatment on behalf of their child, although inadequate to solve the current opioid crisis, can potentially save the lives of opioid-addicted children. For now, all parents can do is support their child as affirmed by the father of the 15-year old from British Columbia:

“I tell her that I love her and to be careful and to take care. And when I get a response, I just know that she’s alive. And that’s all I can ask right now.”

—Julia Martini, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

health law, there is no minimum age for medical consent in most Canadian provinces, including British Columbia. If an opioid-addicted child is deemed to have mental capacity by a physician, they are capable of deciding whether or not they will receive treatment. Exceptions are only granted during medical emergencies in which case a physician decides on the most appropriate action. In contrast, parents in the majority of US states can make medical decisions on behalf of children under the age of 18, with a few US states even allowing parents to send adult children into involuntary treatment.

This article was originally published on Psychology Today

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Does Pornography Impact Romantic Relationships?

00Addiction, Featured news, Porn Addiction, Pornography, Sex, Sex Addiction November, 18

Source: Davidcure at DeviantArt, Creative Commons

As pornography consumption has increased in the past few decades, so has fear surrounding its potential harm on relationships. But, does pornography have a negative impact on human intimacy?

An initial study in 1989 by researcher Douglas Kenrick claimed that men found their wives less attractive after viewing pornographic images. This finding created controversy around the health of watching pornography, and how its use might put female partners at a disadvantage.

Since then, however, concerns have arisen about the validity of the original study. The effects were present in a scientific laboratory, where men were exposed to photos of a Playboy centerfold, rather than in a real-world environment. These effects were also short-lived and disappeared quickly.

In July 2016, a group of researchers from the University of Western Ontario in Canada tried three times to replicate Kenrick’s study and failed to find similar results. This failure has prompted questions regarding the impact of pornography on men’s perceptions of their partners and on relationships as a whole.

It’s possible, though, that the replication studies may not have obtained similar findings due to sexual advertising becoming so prevalent in Western culture. The impact of viewing lewd images might be imperceptible now that under-clothed women are regularly displayed in popular media.

A March 2017 analysis by researchers from Indiana University examined the effects of pornography on sexual and relationship satisfaction in both men and women. The researchers examined results from 50 separate studies and determined that the impact on men and women is different. When women viewed pornography, their relationship satisfaction did not change. But when men viewed pornography, lower satisfaction did exist.

“…There appears to be no overall or global association between women’s pornography consumption and the elements of satisfaction studied by researchers to date… Men as a group, on the other hand, do demonstrate lower sexual and relational satisfaction as a function of their pornography consumption.”

These researchers raise the possibility that the men who experienced lower sexual and relationship satisfaction with their partner could be more likely to consume pornography because of their lower satisfaction—rather than pornography being the cause.

Another analysis conducted by researchers from the Universities of California, Copenhagen, and New York investigated whether viewing violent or non-violent pornography affected attitudes of violence towards women. The researchers found that both violent and non-violent pornography consumption was associated with attitudes that support this type of violence.

Researchers from Texas A&M and the University of Texas challenged these claims, proposing that pornography may be a means to alleviate sexual aggression. Looking at crime statistics, they point to evidence that, as access to and prevalence of pornography has increased, instances of sexual assault have not.

Clearly, finding a conclusive answer as to whether pornography use has negative effects on relationships is challenging. In addition, adverse effects on relationships may not be the direct result of pornography use, but rather caused by the motive behind viewing pornography or by underlying issues that lead to its consumption. In other words, it may be problems in a relationship that lead to viewing pornography.

Perhaps that is what it comes down to—the individual relationship.

In an opinion piece in The Guardian newspaper, one anonymous writer said about her husband’s pornography use:

“Porn ruined you. Ruined us… It was your love of porn that slowly diminished my love and respect for you and destroyed my self-confidence.”

If one partner has negative views towards pornography, that partner may feel betrayed upon discovering that the other partner consumes it. The partner consuming the pornography may feel guilt knowing that the other partner does not condone the behavior. These varying effects on different individuals may explain why some studies find that pornography is damaging to relationships, while others find the opposite.

– Andrei Nistor, Contributing Writer. The Trauma and Mental Health Report

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller

This article was originally published on Psychology Today

Robert T Muller - Toronto Psychologist

Workplace Alcohol Tests: Where Do We Draw the Line?

40Addiction, Alcoholism, Career, Featured news, Law and Crime, Mental Health, Work February, 18

Source: Bousure at flickr, Creative Commons

Keeping our personal and professional lives separate is something many of us strive for. But, as Johnene Canfield recently discovered, we only have so much control over this process. In the spring of 2015, Canfield was fired from her six-figure position as a Minnesota Lottery official after a DUI conviction and a stint in rehab for alcohol abuse. The following October, she filed a lawsuit to reclaim her job.

Canfield’s former employers say the reason they dismissed her was to ensure the safety of other employees and clients, as well as to preserve employee productivity at the Minnesota Lottery. But these reasons reveal how problem drinkers are viewed as incapable of workplace competence.

According to Linda Horrocks, a former health care aide at Flin Flon’s Northern Lights Manor, a long-term care home for seniors, “Employers often act based on what they think they know about addiction and alcohol addicts”—but not necessarily on the reality of living with addiction. Horrocks, like Canfield, was fired for alcohol addiction.

She was eventually re-hired by the Northern Regional Health Authority, the health-governing body in northern Manitoba that oversees employment at Northern Lights Manor. But her employer required her to sign an agreement to abstain from drinking on and off the job, and to undergo random drug and alcohol testing.

In an interview with the Trauma and Mental Health Report, Horrocks said:

“I didn’t object to the testing, but I didn’t want to commit to never drink again on my own time. My union even advised me against signing this agreement, because I would just be setting myself up for failure—I hadn’t gone through treatment yet. And so, I was fired again.”

Horrocks maintains that the employers’ offer to help her abstain from alcohol completely was based on misconceptions about alcoholism and treatment.

“The managers knew a little bit about alcoholism, as family and acquaintances had gone through treatment. They just decided that the counselling that I was going through with Addictions Foundation of Manitoba was not enough because it is a harm-reduction program, not a direct path to complete abstinence.”

Horrocks understands why some may think that abstinence is the only way:

“After all, if you’re a recovering alcoholic, alcohol is deemed ‘your enemy.’”

Proponents for abstinence-based treatments argue that periods of abstinence can repair brain and central nervous system functions that were impaired. Having problem drinkers self-moderate alcohol intake has had variable success in the past. For some, the temptation of having “just one drink” can be a precursor to relapse. And for them, total abstinence may be a better approach.

But Horrocks explains, abstinence may not be the best approach for everyone. The harm reduction model accepts that some use of mind-altering substances is inevitable, and that a minimal level of drug use is normal. This approach also recognizes research showing experimental and controlled use to be the norm for most individuals who try any substance with abuse potential.

Harm reduction seeks to reduce the more immediate and tangible harms of substance use rather than embrace a vague, abstract goal, such as a substance-free society. During intervention talk sessions, therapists explore and attempt to modify drinking patterns or behaviours with the client. The clinicians support autonomous decision-making and independent goal setting related to drinking.

Evidence published in the Canadian Medical Association Journal shows that these programs aim to reduce the short- and long-term harm to substance users and improve the health and functioning of these individuals. There are also benefits to the entire community through reduced crime and public disorder, in addition to the benefits that accrue from the inclusion into mainstream life of those previously marginalized.

Benjamin Henwood and colleagues from the University of Southern California also show that those who work on the front-line of severe mental illness and addiction prefer the harm-reduction approach to complete abstinence. Yet few employers have taken this approach into account when deciding the fate of employees with proven substance abuse problems outside of the workplace.

Horrocks’s and Canfield’s experience begs the question, where do we draw the line? How much say do employers have over their employees’ personal lives? It may just be that employers need to better respect the privacy of workers, so long as workplace productivity is not affected. And if employers maintain substance abuse policies that bleed over into the personal lives of staff, consideration of a harm-reduction approach is key.

–Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller. 

This article was originally published on Psychology Today

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Medical Marijuana for PTSD?

80Addiction, Featured news, Post-Traumatic Stress Disorder, Stress, Trauma, Trauma Psychotherapy December, 17

Source: Sinclair Terrasidius at flickr, Creative Commons

On October 1st, 2016, a Canadian medical marijuana company called Marijuana for Trauma opened a location in Edmonton, Alberta to treat PTSD in military veterans. It’s owned and operated by Fabian Henry, who uses marijuana to treat combat-related PTSD, resulting from his second tour of duty in Afghanistan. He claims that conventional medicine does not allow people struggling with PTSD to process their trauma, while marijuana does.

Although the use of medical marijuana for the treatment of physical and psychological disorders is controversial, medical marijuana is currently legal in Canada.

The Washington Post reports that therapeutic use of marijuana was banned in the U.S. in 1970, and marijuana is still categorized as an illicit drug despite its potential medicinal benefits. Given its controversial nature and association with stereotypes, cannabis research for treatment of mental disorders has been limited. But scientific interest is intensifying.

A recent study published in Molecular Psychiatry showed that treatment using particular compounds found in marijuana may benefit those with PTSD, and that “…plant-derived cannabinoids [psychoactive chemicals] such as marijuana may possess some benefits in individuals with PTSD by helping relieve haunting nightmares and other symptoms of PTSD.”

Research published in Science Daily also looked at symptom reduction in patients with PTSD. As a result of taking medical marijuana, participants reported a decrease in re-experiencing the trauma, less avoidance of situations that reminded them of the trauma, and a decline in hyper-arousal.

There is also anecdotal evidence. In an interview with the Trauma and Mental Health Report, Dianna Donnelly, a counselor and patient at the Canadian Cannabis Clinics, described her experience:

“I am a patient who legally uses cannabis for depression. The cannabis helps mute or lower my negative chatter, which allows for good thoughts and feelings to arise. One Veteran, a friend of mine, who recently started using marijuana instead of prescription medication for PTSD, said that with the cannabis, he can feel his emotions, and experience them properly and safely. Before, he just felt numb.”

Medical marijuana is not usually used on its own for the treatment of PTSD. Shelley Franklin, the Veteran Program Coordinator for the Canadian Cannabis Clinics, explained that:

“Medical cannabis is used in conjunction with other therapies. Peer support groups are a highly supported therapy for patients suffering an Operational Stress Injury [another term for PTSD]. Medical cannabis strains with the right CBD and THC [psychoactive chemicals in cannabis] levels are assisting veterans with chronic physical pain, as well anxiety and insomnia issues. I believe that medical cannabis will continue to work in conjunction with many other therapies.”

Conversely, former Canadian Member of Parliament Peter Stoffer believes that soldiers have too much access to medical marijuana. Although not opposed to the use of medical marijuana in certain cases, Stoffer believes that current legislation, which compensates veterans for up to 10 grams of cannabis per day, promotes overuse and could potentially lead to negative effects. In an interview with the CBC, Stoffer said:

“Ten grams a day is an awful lot of marijuana to give one person. It is an incredible amount. That’s simply not the way to go. You’re not helping that person at all. You’re not giving them any chance of recovery. All you’re really doing is masking the pain that they’re suffering.”

The research is still in its infancy and likely to explode in the near future, as the Canadian government prepares to remove restrictions on marijuana in 2017. This movement will make it much easier for researchers to study the effects cannabis has on psychological disorders and to form conclusions on its efficacy.

As for Fabian Henry and his cannabis dispensary Marijuana for Trauma, he continues to work with physicians to tailor the amounts dispensed to individuals and has no plans himself to stop using the drug.

–Andrei Nistor, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Medical Marijuana for PTSD?

00Addiction, Featured news, Post-Traumatic Stress Disorder, Stress, Trauma, Trauma Psychotherapy December, 17

Source: Sinclair Terrasidius at flickr, Creative Commons

On October 1, 2016, a Canadian medical marijuana company called Marijuana for Trauma opened a location in Edmonton, Alberta to treat PTSD in military veterans. It’s owned and operated by Fabian Henry, who uses marijuana to treat combat-related PTSD, resulting from his second tour of duty in Afghanistan. He claims that conventional medicine does not allow people struggling with PTSD to process their trauma, while marijuana does.

Although the use of medical marijuana for the treatment of physical and psychological disorders is controversial, medical marijuana is currently legal in Canada.

The Washington Post reported that therapeutic use of marijuana was banned in the U.S. in 1970, and marijuana is still categorized as an illicit drug despite its potential medicinal benefits. Given its controversial nature and association with stereotypes, cannabis research for treatment of mental disorders has been limited. But scientific interest is intensifying.

A recent study published in Molecular Psychiatry showed that treatment using particular compounds found in marijuana may benefit those with PTSD, and that “plant-derived cannabinoids [psychoactive chemicals] such as marijuana may possess some benefits in individuals with PTSD by helping relieve haunting nightmares and other symptoms of PTSD.”

Research published on Science Daily also looked at symptom reduction in patients with PTSD. As a result of taking medical marijuana, participants reported a decrease in re-experiencing the trauma, less avoidance of situations that reminded them of the trauma, and a decline in hyper-arousal.

There is also anecdotal evidence. In an interview with the Trauma and Mental Health Report, Dianna Donnelly, a counselor and patient at the Canadian Cannabis Clinics, described her experience:

“I am a patient who legally uses cannabis for depression. The cannabis helps mute or lower my negative chatter, which allows for good thoughts and feelings to arise. One Veteran, a friend of mine, who recently started using marijuana instead of prescription medication for PTSD, said that with the cannabis, he can feel his emotions, and experience them properly and safely. Before, he just felt numb.”

Medical marijuana is not usually used on its own for the treatment of PTSD. Shelley Franklin, the Veteran Program Coordinator for the Canadian Cannabis Clinics, explained:

“Medical cannabis is used in conjunction with other therapies. Peer support groups are a highly supported therapy for patients suffering an Operational Stress Injury [another term for PTSD]. Medical cannabis strains with the right CBD and THC [psychoactive chemicals in cannabis] levels are assisting veterans with chronic physical pain, as well anxiety and insomnia issues. I believe that medical cannabis will continue to work in conjunction with many other therapies.”

Conversely, former Canadian Member of Parliament Peter Stoffer believes that soldiers have too much access to medical marijuana. Although not opposed to the use of medical marijuana in certain cases, Stoffer believes that current legislation, which compensates veterans for up to 10 grams of cannabis per day, promotes overuse and could potentially lead to negative effects. In an interview with the CBC, Stoffer said:

“Ten grams a day is an awful lot of marijuana to give one person. It is an incredible amount. That’s simply not the way to go. You’re not helping that person at all. You’re not giving them any chance of recovery. All you’re really doing is masking the pain that they’re suffering.”

The research is still in its infancy and likely to explode in the near future, as the Canadian government prepares to remove restrictions on marijuana in 2017. This movement will make it much easier for researchers to study the effects cannabis has on psychological disorders and to form conclusions on its efficacy.

As for Fabian Henry and his cannabis dispensary Marijuana for Trauma, he continues to work with physicians to tailor the amounts dispensed to individuals and has no plans himself to stop using the drug.

This article was originally published on Psychology Today

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Using Mindfulness with Opioid Addicted Chronic Pain Patients

00Addiction, Chronic Pain, Featured news, Mental Health, Mindfulness, Therapy News, Trauma Psychotherapy August, 17

Source: frankieleon at flickr, Creative Commons

In March 2016, legislative bodies in Maine put a bill forward to combat the state’s rising opioid addiction problem. New restrictions on opioids for chronic pain require doctors to limit prescriptions to just 15 days, and to encourage doctors to consider non-medicinal forms of treatment.

Treatment of chronic pain involves a delicate balance between managing pain relief and risk of drug addiction or abuse. Opiates have been used for centuries to treat acute and chronic pain. There is little debate over the short-term benefits of medication, but their use for chronic, non-malignant pain is controversial.

Chronic pain is a debilitating lifelong illness, affecting more than six million Canadians. The National Institute of Health defines chronic pain as lasting for at least six months, and creating both physical and mental strain on the victim’s quality of life. Patients may experience fear, depression, hopelessness, and anxiety in coping with their pain.

At the annual 2013 American Psychiatric Association meeting, pain specialists debated how to properly treat chronic pain and explored new forms of non-medicinal treatment.

Jennifer Potter from the Department of Psychiatry at the University of Texas advocates continued use of opioid prescriptions, but cautions doctors to examine potential risk factors for substance abuse.

“The vast majority of people with chronic pain do not go on to develop an opioid addiction, so it’s important for patients to understand that if this medication benefits you, it’s not necessarily a concern. We can’t let our response to the rise in prescription drug abuse to be denying access to all people in pain who can benefit from opioids.”

But a 2015 study by Kevin Vowles and colleagues from the University of New Mexico found that, on average, 25% of chronic pain patients experience opioid misuse and 10% have an opioid addiction. So, we also need non-medicinal treatment options to care for lifelong pain.

“Patients with substance abuse issues can be treated for pain in a variety of ways that don’t involve opioids,” says Sean Mackey, Chief of the Pain Management Division at Stanford University and Associate Professor of Anaesthesia and Pain Management.

One alternative way to approach chronic pain is through mindfulness, described as the process of paying active, open attention to the present moment. When a person is mindful, they observe their own thoughts and feelings from a distance, without judging them as good or bad.

Mindfulness is based on acceptance of one’s current state, and is becoming increasingly popular among patients as a way to help with pain symptoms.

Jon Kabat-Zinn, founding Executive Director of the Center for Mindfulness at the University of Massachusetts, advocates for mindfulness-based strategies to be incorporated into chronic pain treatment programs.

Kabat-Zinn created the popular Mindfulness Based Stress Reduction approach designed to treat chronically ill patients responding poorly to medication. The eight-week stress reduction program involves both mindfulness practice and yoga, and is effective in alleviating pain and in decreasing mood disturbance and stress.

A study by Natalia Morone and colleagues at the VA Pittsburgh Healthcare System showed the benefits of mindfulness in older adults with chronic low back pain by looking at diary entries of participants throughout an eight-week mindfulness treatment program. They found that treatment improved attention, sleep, pain coping, and pain reduction through meditation.

Some participants gained better awareness of their body throughout treatment:

“It felt good to realize [through mindfulness] that I can co-exist with my pain. Being mindful helped me realize that in my angry reaction to my back pain, I was neglecting my whole body. I saw my body only through my pain, which caused me to hate my body over time. I can now see myself outside of my body, and am working day by day with my meditation to become a happier person living with chronic pain.”

The authors also found that practicing mindfulness helped participants create vivid imagery to enhance their mood and decrease pain. One patient noted:

“I hear a sound in the distance and felt it was bearing my pain away, replacing it with a joyful ‘lifting’ of my spirits.”

While no miracle treatment exists, mindfulness can help improve patient quality of life.

–Lauren Goldberg, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report. 

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Using Mindfulness with Opioid Addicted Chronic Pain Patients

00Addiction, Chronic Pain, Featured news, Mental Health, Mindfulness, Trauma Psychotherapy August, 17

Source: frankieleon at flickr, Creative Commons

In March 2016, legislative bodies in Maine put a bill forward to combat the state’s rising opioid addiction problem. New restrictions on opioids for chronic pain require doctors to limit prescriptions to just 15 days, and to encourage doctors to consider non-medicinal forms of treatment.

Treatment of chronic pain involves a delicate balance between managing pain relief and risking drug addiction or abuse. Opiates have been used for centuries to treat acute and chronic pain, and there is little debate over the short-term benefits of medication, but their use for chronic, non-malignant pain is controversial.

Chronic pain is a debilitating lifelong illness. The National Institute of Health defines chronic pain as lasting for at least six months, and creating both physical and mental strain on the victim’s quality of life. Patients may experience fear, depression, hopelessness, and anxiety in coping with their pain.

At the annual 2013 American Psychiatric Association meeting, pain specialists debated how to properly treat chronic pain and explored new forms of non-medicinal treatment.

Jennifer Potter from the Department of Psychiatry at the University of Texas advocates continued use of opioid prescriptions, but cautions doctors to examine potential risk factors for substance abuse.

“The vast majority of people with chronic pain do not go on to develop an opioid addiction, so it’s important for patients to understand that if this medication benefits you, it’s not necessarily a concern. We can’t let our response to the rise in prescription drug abuse to be denying access to all people in pain who can benefit from opioids.”

But a 2015 study by Kevin Vowles and colleagues from the University of New Mexico found that, on average, 25 percent of chronic pain patients experience opioid misuse and 10 percent have an opioid addiction. So, we also need non-medicinal treatment options to care for lifelong pain.

“Patients with substance abuse issues can be treated for pain in a variety of ways that don’t involve opioids,” says Sean Mackey, Chief of the Pain Management Division at Stanford University and Associate Professor of Anaesthesia and Pain Management.

One alternative way to approach chronic pain is through mindfulness, described as the process of paying active, open attention to the present moment. When a person is mindful, they observe their own thoughts and feelings from a distance, without judging them as good or bad.

Mindfulness is based on acceptance of one’s current state, and is becoming increasingly popular among patients as a way to help with pain symptoms.

Jon Kabat-Zinn, founding Executive Director of the Center for Mindfulness at the University of Massachusetts, advocates for mindfulness-based strategies to be incorporated into chronic pain treatment programs.

Kabat-Zinn created the popular Mindfulness Based Stress Reduction approach designed to treat chronically ill patients responding poorly to medication. The eight-week stress reduction program involves both mindfulness practice and yoga, and is effective in alleviating pain and in decreasing mood disturbance and stress.

A study by Natalia Morone and colleagues at the VA Pittsburgh Healthcare System showed the benefits of mindfulness in older adults with chronic low back pain by looking at diary entries of participants throughout an eight-week mindfulness treatment program. They found that treatment improved attention, sleep, pain coping, and pain reduction through meditation.

Some participants gained better awareness of their body throughout treatment:

“It felt good to realize [through mindfulness] that I can co-exist with my pain. Being mindful helped me realize that in my angry reaction to my back pain, I was neglecting my whole body. I saw my body only through my pain, which caused me to hate my body over time. I can now see myself outside of my body, and am working day by day with my meditation to become a happier person living with chronic pain.”

The authors also found that practicing mindfulness helped participants create vivid imagery to enhance their mood and decrease pain. One patient noted:

“I hear a sound in the distance and felt it was bearing my pain away, replacing it with a joyful ‘lifting’ of my spirits.”

While no miracle treatment exists, mindfulness can help improve patient quality of life.

–Lauren Goldberg, Contributing Writer, The Trauma and Mental Health Report. 

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report. 

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Biased Publication Standards Hinder Schizophrenia Research

00Addiction, Bias, Deception, Education, Ethics and Morality, Featured news, Psychopharmacology, Trauma Psychotherapy September, 16

Source: Erin on Flickr

The effects of schizophrenia are profound. Characterized by delusions, hallucinations, and social withdrawal, the disorder has no known cure. The introduction of antipsychotic medications in the 1950s has helped many sufferers cope. Following diagnosis, patients usually take antipsychotics for the rest of their lives.

But recently, a 20-year study by professor emeritus Martin Harrow and colleagues at the University of Illinois found evidence to support alternative treatment methods. In fact, non-medicated patients in the study reported better community functioning and fewer hospitalizations than patients who stayed on antipsychotics.

So why do medications continue to be the most commonly prescribed treatment for schizophrenia?

Antipsychotic drugs are the largest grossing category of prescription medication in the United States, with a revenue of over $16 billion in 2010. And much of the research that exists on treatment of schizophrenia is directly funded by pharmaceutical companies, making it challenging for independent researchers like Harrow and his team to get studies published. A bias exists towards silencing unfavourable research.

An analysis looking into possible publications biases surrounding antipsychotic drug trials in the U.S. found that, of the trials that did not get published, 75% were negative, meaning that the drug was no better than placebo. On the other hand, 75% of the trials that did get published found positive results for the antipsychotics being tested.

The Washington Post wrote an article in 2012 claiming that four different studies conducted on a new antipsychotic drug called Iloperidone were never published. Each of the studies pointed to the ineffectiveness of the drug, finding that it was no more effective than a sugar pill for the treatment of schizophrenia. A publication bias like this is worrisome.

Research has also shown that staying on antipsychotic drugs for long periods of time negatively impacts brain functioning and could potentially lead to a worsening of some of the initial symptoms of the illness, including social withdrawal and flat affect.

A growing body of research is focusing on cognitive therapy and community based treatments for schizophrenia, as either a replacement for or in combination with traditional pharmacological treatments. So far, outcomes have been promising.

A study by Anthony Morrison, a professor at the University of Manchester found that patients undergoing cognitive therapy showed the same reduction in psychotic symptoms as patients receiving drug treatment. Likewise, research by psychiatristLoren Mosher, an advocate for non-drug treatments for schizophrenia, showed that antipsychotic medication is often far less effective without added psychotherapy. Onestudy by Mosher showed that patients receiving alternative community based treatment had far fewer symptoms of schizophrenia than patients who received traditional treatment in a hospital setting.

When antipsychotic medication was introduced, many hoped it would represent themagic pill for an illness previously thought to be incurable. But little was known about the long-term effects, and even today, many claims of medication efficacy or lack of side effects remain questionable.

Research in schizophrenia is burgeoning and whether a safer, more effective treatment can be developed remains to be seen. Yet for such developments to be possible, it is important for the scientific and medical communities to open themselves up to the possibility of alternative treatments instead of limiting research that challenges the status quo. While antipsychotic medications offer great benefits in terms of reducing acute positive symptoms like hallucinations or delusions, they are by no means a cure.

–Essi Numminen, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Semicolon Punctuates Mental Health Awareness

00Addiction, Featured news, Mental Health, Resilience, Self-Harm, Suicide, Trauma September, 16

Source: Brittany Inskeep on Flickr

Sure, writers dismiss it. But the semicolon—the otherwise underwhelming punctuation mark—has had its share of fans like American physician and poet Lewis Thomas, who said the semicolon leaves “a pleasant little feeling of expectancy; there is more to come; read on; it will get clearer.”

Amy Bleuel echoed this sentiment when she founded Project Semicolon on April 16, 2013. This global non-profit movement is dedicated to providing support for those struggling with mental illness, suicide, addiction, and self-injury.

In a recent interview with the Trauma and Mental Health Report, Amy shared the meaning behind the semicolon:

“It represents continuance. Authors usually use the semicolon when they choose not to end the sentence. You are the author and the sentence is your life, and you’re choosing to continue.”

In 2003, Amy lost her father to suicide.

“I’m kind of continuing his story by telling it to raise awareness. It took 10 years for me to do it but I was able to use his story to bring hope to others and that was my inspiration.”

Since the project’s humble beginnings, the semicolon has evolved into something much bigger. After one of Amy’s blog posts went viral, many decided to get inked with the symbol. What’s more: they started sharing their stories online and creating awareness around mental illness.

But according to Amy, Project Semicolon was not intended to become a tattoo phenomenon:

“It was not meant at all to be a tattoo campaign. It was just picked up as that. I got a tattoo. People started getting a tattoo. It became something people apparently wanted to say.”

It also became something people were willing to stand behind. As a registered charity, Project Semicolon raises funds to help fight stigma and present hope and love to those in need. Dusk Till Dawn Ink, a tattoo shop in Calgary, even donates a portion of the proceeds from semicolon tattoos to the Canadian Mental Health Association.

But the semicolon isn’t the only mental health tattoo out there. Casidhe Gardiner, 20, has an eating disorder recovery symbol tattooed on the inside of her arm, alongside the words “take care.” To her, the tattoo serves as a reminder to look after herself and to avoid relapse:

“If I branded myself with a recovery symbol in a place that I could see all the time, it would remind me in a hard time when I’m spiraling down again that I’ve recovered. I’ve done all this hard work to get there. Why go through the negative parts of the disorder when I have all these amazing parts of recovery?”

What is it about mental health tattoos that help in the healing process?

According to Casidhe, the tattoo works as a conversation piece—sparking discussion when it might not happen otherwise. When asked about the role the semicolon tattoo plays in her healing process, Amy felt the concept was more opaque:

“You know I’m not really sure how that works. I have a lot of people say they look at the semicolon and it gives them inspiration. It’s a reminder that says you get to keep writing. Yeah it sucks sometimes but you get to keep going and choosing how you write that story.”

Supporters of the project have declared April 16th ‘National Semicolon Day.’ On this day, everyone is invited to post their semicolon tattoo on social media platforms like Twitter and Pinterest with the hashtag #ProjectSemicolon, raising awareness and celebrating the network of people who believe in moving forward despite their challenges.

On their website, the project states that they are not a helpline, nor are they trained mental health professionals. But what makes Project Semicolon special, according to Amy, is that it emphasizes the importance of community and non-judgmental support in recovery:

“These people need somebody who cares, who understands them. Not just people who say everything will get better. I wanna be open and honest about my own struggles, I don’t want them to think I’m a person who doesn’t struggle. I want people to be able to come up and say, ‘I struggle too.’ Why do we need to hide?”

A simple punctuation mark; a tattoo; a network of support. Perhaps by wearing a symbol that represents the struggles and victories of the human spirit, the invisible becomes visible. And visibility is important when striving for universal acceptance.

 “Stay strong; love endlessly; change lives.” The phrase appears on the mission statement on the project’s website. It was borne of a phrase close to Amy’s heart:

“I use the phrase “love endlessly” and I truly believe that it’s love that can save a life. And my father showed me that in the short time I had with him.”

–Marjan Khanjani, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today