Falling Dominoes: Or, Why You Can't Have "Just One"

Search the Internet or type in "falling dominoes" on YouTube and you will be deluged with opportunities to watch videos, often set to music, of vast numbers of colorful rectangles knocking one another over. These productions are extravagant examples of the original "domino effect." They show domino tiles arranged in both straight lines and intricate patterns, each tile balanced on a narrow end with its rear flat facing the front flat of the next. As long as the distances between the tiles are shorter than their length, once the first domino is toppled, all the rest must fall. Or more accurately, all the rest usually fall; once in a while a chain reaction jams, the audience sighs, and the videographer cuts to dominoes that are falling. The middle and last dominoes in these arrangements fall because they are subject to laws of nature. Physics and gravity may not yield the...
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Bath Salts: Devastation from Addictive "Thinking"

The phenomenon of "bath salts" abuse and dependence is hard to believe. Nevertheless, since late 2010 young people and adults have been swallowing, smoking, sniffing, and injecting dangerous white or colored powders that they purchase from head shops, convenience stores, or the Internet.[ NIDA Message] Colorful packages with catchy names such as Arctic Blast, Cloud 9, Ivory Wave, Snow Leopard, Vanilla Sky, and White Lightning may contain 50 milligrams or more of powder and sell for $25-50. They are labeled as bath additives (or glass cleaner or plant food) that are "not intended for human consumption." How this can be happening? Neurobiology helps explain it. Basically, addiction doesn't make sense : people with addiction pursue their relationship with a mood-changing chemical even when it ruins their body and other relationships. This happens because: (1) addictive substances provide reward and escape that condition the user to seek the substances over and...
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Alcohol and Bodily Harm to Women

Popular belief does not expect women to "hold their liquor" as well as men, and this is one of those instances when science agrees with popular belief. If a man and a woman drink the same amount of alcohol, even if they are equal weight, the woman will have a higher concentration of alcohol in her blood. That's because a greater proportion of the man's body weight is water, which dilutes the alcohol; and also because the stomach walls of women compared to men contain less alcohol dehydrogenase, an enzyme that breaks down alcohol. Therefore, repeatedly drinking the same quantity of alcohol is likely to damage a woman's organs—liver, heart muscle, brain—more quickly than a man's. ( Alcohol Metabolism ) Published dietary guidelines reflect these differences and, for example, define moderate drinking as up to 1 drink per day for women and up to 2 drinks per day for men....
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Recovery: Can You Have It Your Way?

Many individuals with a personal or professional stake in addiction recovery consider recovery a spiritual process and diligently defend the right of everyone in need of recovery to practice spirituality in whatever non-hurtful ways are meaningful for them. When it comes to how these people in need practice "recovery" itself, there is no such unanimity among stakeholders—except for possible agreement that the process won't go very well if everyone pursues their recoveries with the same diversity as their spiritualities. Decades of accumulated practical wisdom and medical-scientific knowledge inform how various stakeholders think about addiction and recovery. But their individual knowledge bases and points of view differ as well as overlap. They debate definitions of recovery and what the willing person must do or not do to achieve recovery. For a generous sample of discourse on these matters, look at the consensus document from the Betty Ford Institute Consensus Panel, the...
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Reduce the Demand!

Misuse of prescription opioids is the fastest growing drug problem in the United States. And it will only get worse unless the population, especially youth, realizes that nonmedical use of these potent pain relievers is un cool and dangerous. A common misconception is that these substances are safe because they are prescribed by physicians and dispensed through pharmacies. Drug buyers can indeed be more confident of the "product" when it's a trademarked tablet rather than white powder in a plastic bag. A 26-year-old said, "My drug of choice is pharmaceutica l heroin." But, just like heroin, these trademarked substances present the same deadly dangers of overdose and addiction. And buying, selling, or giving away these substances is against the law—even if they were prescribed for you.   The Centers for Disease Control and Prevention (CDC) reports 100 people die from drug overdoses every day in the United States. The CDC...
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Intervening on Alcohol? Style Matters!

As we commemorate Alcohol Awareness Month, we are reprinting the Addiction Medicine Update, "Intervening on Alcohol? Style Matters!," originally published in April 2012. The World Health Organization identifies "The harmful use of alcohol [as] a global problem which compromises both individual and social development. It results in 2.5 million deaths each year. Alcohol is the world's third largest risk factor for premature mortality, disability, and loss of health." ( WHO ) Yet, perhaps because of our collective affection for beverage alcohol, we don't get alarmed. As Frank Bruni points out in his commentary on the death of Whitney Houston, it's other drugs that make the headlines. ( New York Times ) But some of us are too close to the dangers of alcohol to be complacent—perhaps because we witness alcohol problems as a family member or treat addiction as a clinician. Fortunately, our roles give us opportunities to help people...
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Reduce the Supply!

Epidemic misuse of prescription pain medication in the United States is partly due to the availability of opioid analgesics (medication in pills, patches, injections, nasal sprays, and even lollipops that contain natural or synthetic substances that cause pain relief and euphoria by stimulating endorphin receptors in the brain). Can individuals and communities possibly do anything to reduce or reverse this deadly problem? The answer is yes . Specific actions by individuals, healthcare professionals, and others can r educe the supply of opioids available for misuse and addiction without denying pain relief to those in need. National surveys show 60 to 70 percent of people who used opioids nonmedically obtained them from a friend or relative. About 11 percent took them without asking. At home, securely lock up any prescription opioids you may need and get rid of any you don't need.Visitors who are drug-experimenters or opioid-addicted—these could be relatives, teenage...
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Too Many Painkillers?

United States data for 2009 showed that more individuals died from unintentional drug overdoses (37,485) than from motor vehicle crashes (36,284). These casualties included individuals with histories of extensive drug use as well as drug-naïve experimenters, partly because overdoses are often "mixed," and anyone consuming a combination of sedating substances, such as alcohol plus medications originally prescribed for pain, sleep, or anxiety, can't predict their maximum effect or the timing of it. The rise in overdose deaths is linked to increases in availability and misuse of prescription opioid pain medications (such as oxycodone, hydrocodone, morphine, and methadone), which caused more overdose deaths than heroin and cocaine combined Prescription opioids became more available because societal expectations of physicians and other practitioners altered opioid prescribing patterns. In the past, medicines such as morphine were used sparingly, mostly for treatment of brief pain, like after major surgery. Opioids were also used to relieve...
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Facing Addiction and The National Council on Alcoholism and Drug Dependence (NCADD) are proud to announce the merger of our organizations – creating a national leader in turning the tide on the addiction epidemic.
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