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PEOPLE USE DRUGS FOR REASONS blog

Stigma Busting

by Barry Lessin

December 9th, 2010

The stigma associated with addiction and mental health problems in our country is very disheartening. It's pervasive, existing at all levels of our culture and society.

As a provider of counseling and treatment services for these problems, it feels to me like an invisible wall or barrier that my clients and I are often trying to climb over to get to the other side. Then there are the people who are not yet in treatment, who experience stigma as an Everest-sized mountain, too high to begin to even think about climbing.

Dr. Harold Koplewicz, one of the nation’s leading child and adolescent psychiatrists and strong advocate for child mental health, recently posted and article on Huffington Post about the divisiveness associated with children's mental health. His writings are a welcome voice of reason and information in the struggle to lower the stigma associated with mental illness and addiction in our culture.

Some of the same extreme reactions to mental health treatment are seen in other areas such as racial/religious/political differences. Differences between "us" and "other" trigger fear in us as human beings. This fear is a natural physiological survival response otherwise known as the "fight/flight" response that we humans share with other mammals.

Accurate information usually reduces fear: when we turn a light on in a dark room after hearing a noise and see that there's nothing in the room to hurt us, we quickly calm down.

We've made some progress in the addiction field in lowering the stigma barriers to make addiction treatment more accessible to those who need it. We have a long way to go with mental illness, and this dialogue can only help.

Read Dr Koplewicz's article here: Why are People so Divided When It Comes to Children's Mental Health?

A great resource about all things related to mental illness, including an extensive grassroots effort to "bust" stigma at its roots, is the National Alliance on Mental Illness (NAMI).

How Do I Know If It's A Problem?

by Barry Lessin

December 8th, 2010

People come for help with a substance abuse problem at varying levels of motivation. However, almost all my clients want to know very early on, usually in the first session, if their use or their family member’s use of a substance is really a problem.

A full evaluation of a potential addiction generally requires a thorough evaluation, but I’ll often use a tool in the first session that will quickly give the person some measuring sticks to help begin to explore their use in more detail. It’s really a quick screening tool, but it almost always opens the door for opportunity to explore their behavior in more detail.

They’re easy to remember, because they all begin with the letter “C”:

1) Control

People without an abuse problem always have control over the amount they drink or use; if they say they're going to have 2 drinks, that's all they ever have.

People with a problem will often go over a self-imposed limit, often with consequences (see #2 below). This is often a "Russian-roulette" pattern: you can stay under a limit for many months, and then "boom", you go over (and you're not happy about it).

2) Consequences

People without an abuse problem rarely will experience negative consequences. If they do, they will make an adjustment in their behavior or lifestyle and the consequence won't occur again.

People with an abuse problem, when experiencing a negative consequence, will often make an adjustment, which is short-lived. In fact their attempts to make adjustments often fail, and consequences continue and often get worse.

Consequences can be related to:

  • physical health
  • legal situations
  • emotional well-being (feelings of guilt, remorse, lowered self-esteem, depression)
  • anger management
  • family conflicts
  • interpersonal conflicts
  • job performance

3) Compulsivity

Compulsivity refers to behaviors that are repetitive and feel driven to be performed. The behaviors are disruptive to a person's productivity or well-being.

People without an abuse problem, when thinking about drinking or getting high, can take it or leave it. Their daily lives move forward without much thought about whether getting high is in the picture.

People with an abuse problem spend a lot of time thinking about and planning activities where they can drink or get high. Many of their life activities are focused on whether getting high will occur. And if there is beer in the refrigerator, it will be hard to let it sit there unused.

The "Three C's" is not just a handy screening tool. It's a great way for my clients to begin to explore some of the specific issues related to their substance abuse behavior and to help them make their own mind up about the issue. 

My Participation in ADHD Expert Roundtable

by Barry Lessin

November 29th, 2010

I recently had the opportunity to participate as an expert contributor to an online "roundtable discussion" of ADHD at Everydayhealth.com, the major website of Everyday Health, Inc., a leading online health company.

The bewildering array of information available about ADHD combined with the confusing set of symptoms and behaviors that are often seen in children with ADHD make it difficult for parents to decide what direction to take when there's concern that your child may have ADHD.

The multidisciplinary panel I was a part of had a chance to answer some important questions that will help you make better decisions about getting help for your child.

Here's a link to the Everydayhealth.com roundtable.

No More Four Loko: A Great Opportunity for Parents?

by Barry Lessin

November 24th, 2010

The recent news about the Food and Drug Administration’s decision to pull caffeinated alcohol drinks such as Four Loko off the market triggers a mixed reaction for me.

Part of me gets annoyed at how the media approaches issues relating to the dangers of drinking or drug use among our children. There is often a focus on fanning the fears of parents about the various “dangers lurking out there” for our kids. It’s scary, but the reality is that if a teenager really wants to get high or drunk, they will often find a way to do so.

A bigger part of me is glad the media hypes it because it’s an excellent opportunity to hear what our kid’s have to say about the issue. Given the opportunity, they’ll express their (often strong) opinions about the various aspects of the issue—the government involvement angle, the beverage-marketing angle, how the beverage does or doesn’t impair people, etc.

Research suggests that when we talk openly with our children about drugs and drinking, they are more likely to have better self-control and develop more negative perceptions about these risky behaviors.

The caffeinated-alcohol drink issue is a great opportunity to let our kids express their opinions about these drinks. When we’re able to put aside (for the moment at least!) our parental fears and judgments and just listen, there’s a greater likelihood that we’ll get a glimpse into the thoughts and lives of our teen, an opportunity to make a positive connection with our them, and to possibly help them reduce their risky behavior.

Get more info: US News and World Report article on FDA ban of caffeinated alcohol drinks.

Mental Health and Primary Care Medicine

by Barry Lessin

November 20th, 2010

Since my practice is located within a family medical practice where I act as a behavioral health consultant, I read with interest, and posted a comment on the article's website, about the following article:

Health Highlights: Nov. 19, 2010 - US News and World Report

What's very encouraging is that primary care medicine has begun to recognize the value of integrating mental health consultants into their practices. On-site psychologists in primary care practices, serving as behavioral health consultants/resources, when added to traditional medical staff/team helps to ease patient access to oft-needed counseling or psychotherapy.

As a psychologist located within a family medical practice, I see first-hand how the stigma associated with seeking mental health is reduced by my presence in the practice, and how the coordination of care between mental and physical health increases the likelihood of improvement in physical health.

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