Wednesday, June 27, 2012

Understanding Recovery from Marijuana

Basic Facts About Marijuana

Marijuana is the most commonly abused illicit drug in the United States. It is a dry, shredded green and brown mix of flowers, stems, seeds, and leaves derived from the hemp plant Cannabis sativa. The main active chemical in marijuana is delta-9-tetrahydrocannabinol, or THC for short.

How is Marijuana Abused?

Marijuana is usually smoked as a cigarette (joint) or in a pipe. It is also smoked in blunts, which are cigars that have been emptied of tobacco and refilled with a mixture of marijuana and tobacco. This mode of delivery combines marijuana's active ingredients with nicotine and other harmful chemicals. Marijuana can also be mixed in food or brewed as a tea. As a more concentrated, resinous form, it is called hashish; and as a sticky black liquid, hash oil. Marijuana smoke has a pungent and distinctive, usually sweet-and-sour odor.

How Does Marijuana Affect the Brain?

Scientists have learned a great deal about how THC acts in the brain to produce its many effects. When someone smokes marijuana, THC rapidly passes from the lungs into the bloodstream, which carries the chemical to the brain and other organs throughout the body.

THC acts upon specific sites in the brain, called cannabinoid receptors, kicking off a series of cellular reactions that ultimately lead to the "high" that users experience when they smoke marijuana. Some brain areas have many cannabinoid receptors; others have few or none. The highest density of cannabinoid receptors are found in parts of the brain that influence pleasure, memory, thinking, concentrating, sensory and time perception, and coordinated movement.

Not surprisingly, marijuana intoxication can cause distorted perceptions, impaired coordination, difficulty with thinking and problem solving, and problems with learning and memory. Research has shown that, in chronic users, marijuana's adverse impact on learning and memory can last for days or weeks after the acute effects of the drug wear off. As a result, someone who smokes marijuana every day may be functioning at a suboptimal intellectual level all of the time.

Research into the effects of long-term cannabis use on the structure of the brain has yielded inconsistent results. It may be that the effects are too subtle for reliable detection by current techniques. A similar challenge arises in studies of the effects of chronic marijuana use on brain function. Brain imaging studies in chronic users tend to show some consistent alterations, but their connection to impaired cognitive functioning is far from clear. This uncertainty may stem from confounding factors such as other drug use, residual drug effects, or withdrawal symptoms in long-term chronic users.

Addictive Potential

Long-term marijuana abuse can lead to addiction; that is, compulsive drug seeking and abuse despite the known harmful effects upon functioning in the context of family, school, work, and recreational activities. Estimates from research suggest that about 9 percent of users become addicted to marijuana; this number increases among those who start young (to about 17 percent) and among daily users (25-50 percent).

Long-term marijuana abusers trying to quit report withdrawal symptoms including: irritability, sleeplessness, decreased appetite, anxiety, and drug craving, all of which can make it difficult to remain abstinent. These symptoms begin within about 1 day following abstinence, peak at 2-3 days, and subside within 1 or 2 weeks following drug cessation.

Marijuana and Mental Health

A number of studies have shown an association between chronic marijuana use and increased rates of anxiety, depression, and schizophrenia. Some of these studies have shown age at first use to be an important risk factor, where early use is a marker of increased vulnerability to later problems. However, at this time, it is not clear whether marijuana use causes mental problems, exacerbates them, or reflects an attempt to self-medicate symptoms already in existence.

Chronic marijuana use, especially in a very young person, may also be a marker of risk for mental illnesses - including addiction - stemming from genetic or environmental vulnerabilities, such as early exposure to stress or violence. Currently, the strongest evidence links marijuana use and schizophrenia and/or related disorders.4 High doses of marijuana can produce an acute psychotic reaction; in addition, use of the drug may trigger the onset or relapse of schizophrenia in vulnerable individuals.

Addictive Potential

Long-term marijuana abuse can lead to addiction; that is, compulsive drug seeking and abuse despite the known harmful effects upon functioning in the context of family, school, work, and recreational activities. Estimates from research suggest that about 9 percent of users become addicted to marijuana; this number increases among those who start young (to about 17 percent) and among daily users (25-50 percent).

Long-term marijuana abusers trying to quit report withdrawal symptoms including: irritability, sleeplessness, decreased appetite, anxiety, and drug craving, all of which can make it difficult to remain abstinent. These symptoms begin within about 1 day following abstinence, peak at 2-3 days, and subside within 1 or 2 weeks following drug cessation.

Marijuana and Mental Health

A number of studies have shown an association between chronic marijuana use and increased rates of anxiety, depression, and schizophrenia. Some of these studies have shown age at first use to be an important risk factor, where early use is a marker of increased vulnerability to later problems. However, at this time, it is not clear whether marijuana use causes mental problems, exacerbates them, or reflects an attempt to self-medicate symptoms already in existence.

Chronic marijuana use, especially in a very young person, may also be a marker of risk for mental illnesses - including addiction - stemming from genetic or environmental vulnerabilities, such as early exposure to stress or violence. Currently, the strongest evidence links marijuana use and schizophrenia and/or related disorders. High doses of marijuana can produce an acute psychotic reaction; in addition, use of the drug may trigger the onset or relapse of schizophrenia in vulnerable individuals.

What Treatment Options Exist?

Behavioral interventions, including cognitive-behavioral therapy and motivational incentives (i.e., providing vouchers for goods or services to patients who remain abstinent) have shown efficacy in treating marijuana dependence. Although no medications are currently available, recent discoveries about the workings of the cannabinoid system offer promise for the development of medications to ease withdrawal, block the intoxicating effects of marijuana, and prevent relapse.

The latest treatment data indicate that in 2008 marijuana accounted for 17 percent of admissions (322,000) to treatment facilities in the United States, second only to opiates among illicit substances. Marijuana admissions were primarily male (74 percent), White (49 percent), and young (30 percent were in the 12-17 age range). Those in treatment for primary marijuana abuse had begun use at an early age: 56 percent by age 14.

Sunday, June 3, 2012

Relapse Prevention Techniques Used for Drug Rehab


Recovery from cocaine addiction: "My counselor gave me a reality check."

"Barbara" is recovering from a cocaine addiction. Counseling is very helpful to her. (This story is based on the experiences of real people whose names have been changed.)

I began my recovery from cocaine addiction November 24th last year. I got into cocaine at parties. At first it was for fun. Then I kept taking it because it gave me energy and made me feel strong and confident. It gave me good feelings inside, but it made me act like a real jerk to everyone else, and I didn't see it. I started to get edgy and impatient, and got into fights with friends for no good reason. I ended two relationships and lost my best friend that way.
Losing that friend finally made me stop and look at what a mess my life had become. I called a crisis hotline, and they got me an appointment at a women's counseling center in town.

The center gave me a lot of help. They introduced me to a Narcotics Anonymous meeting. They talked me through withdrawal symptoms when I was first getting off cocaine. They got me to a doctor's checkup to make sure my body was working OK after the cocaine abuse and withdrawal. They introduced me to a drug counselor who ran support groups and met with people one-on-one.

One-on-one counseling was the most helpful for me. For a few months, I saw my counselor once or twice a week. Now I check in twice a month, to tell her how I'm doing.

Counseling let me see myself in a new way. I realized that feeling bad about myself made me want to use. When I was sad or angry, I'd try to erase those feelings with cocaine. My counselor helped me learn to recognize when I'm stressed out, and do things to help myself feel better. She taught me the initials "HALT": "H" for "hungry, "A" for "angry," "L" for "lonely," and "T" for "tired." When you're feeling any of those things, you're more in danger of slipping up and using drugs to try to feel better. So the best thing to do is "halt": stop what you're doing and take care of yourself right away—get something to eat, blow off some steam, find someone to talk to, or get some rest.

Once, I relapsed after I ran into my old dealer. "It was just an accident," I told my counselor. "I ran into him on the way to the store." But my counselor saw my denial and gave me a reality check. "Why the store in his neighborhood?" she asked me. I realized that I went there to tempt myself into using. Now I know not to go to that neighborhood anymore.

Young woman sitting outside

Learn more: After recovery, Barbara's life is different. Read more about her new life.

Learning Relapse Prevention is important, learn how.