Foreword from Dr. Rick Barnett
The Center for Addiction Recognition Treatment Education and Recovery official newsletter, The CARTER Report, presents Issue #2 and focuses on overlapping addictions. Articles contain info on two or more substances and/or behavioral addictions. The online version of this piece can be found at cartervermont.org contact us directly at cartervermont@gmail.com, follow Dr. Rick on twitter @drrickbarnett
We’ve a fascinating article on a possible unified theory of all addictions, research on the connection between sugar and gambling, nicotine cessation in drug and alcohol treatment, and the dangers of combining opioids and benzodiazepines. The final article points to a great blog about sex addiction which is definitely worth a read. Addiction is a complex phenomenon. It requires in-depth and detailed consideration of every cause or reported cure as well as a broad understanding of the cultural and philosophical issues it invokes.
There’s something here for everyone. Read through this newsletter. Share it with others. Together we can raise our collective addiction intelligence to help ourselves and help each other!
Healthcare providers are in the business of expertise: expert diagnosis, expert planning, and expert treatment. This requires a specialized approach to treatment of individual addictions – but this could soon change. This article seeks to map the neurobiological underpinnings of all major addictions including food, sex, gambling, and alcohol and drugs. It validates the focus of CARTER, Inc. as it encompasses these prominent addictions. You’ll see that there’s significant overlap across addictions. And, it describes important distinctions between addictions at the level of diverse neuronal systems. This may explain why specialized knowledge and treatment of specific addictions is so important.
Smoking tobacco has always occupied a unique place within the addiction sphere. While the negative impact on health from smoking far exceeds all other addictions, smoking (and nicotine addiction) is often seen as a ‘secondary concern’ in treatment while other addictions are addressed. This research addresses a longstanding debate in chemical dependency treatment AND it strikes to the core of my own addiction recovery.
I quit a 7 year pack-a-day habit when I entered treatment of alcohol and drug addiction at age 20. I attribute my long-term sobriety to making that change early in sobriety. From teens to older adults, all smokers (including e-cigarette users) who enter drug and alcohol treatment who quit nicotine at the same time as their drug of choice are more likely to achieve lasting sobriety. While this article is the latest addition to this research, this has been confirmed in tons of research.
Here’s another review worth reading: Smoking Cessation and Alcohol Consumption in Individuals in Treatment for Alcohol Use Disorders
OPIOID ADDICTION AND OTHER DRUG USE
The best treatment has the best resources. The reality of availability of such resources (and the health providers to provide them) often means a diagnosis and treatment plan is based not on outcomes but efficiency. As this piece well argues, too often we seek to treat when “we know less about the context and life circumstances of the people who experience these events”. Opioid overdoses often include benzodiazepines (and/or alcohol).
Overdoses from benzodiazepines has been on the increase in recent years, outpaces prescriptions written, and disproportionately affects women. These charts show disturbing trends. Opioid addiction treatment is complex and a number of risk factors must be consistently and frequently reviewed in order to reduce the number of ever-increasing overdose deaths. Polypharmacy, other mental health conditions, other alcohol and drug use, and unstable social factors contribute dramatically to overdose deaths. This is an excellent overview article.
Let’s talk about a form of cross-addiction you probably never heard of: Sugar/Fat consumption and problem gambling! These two fields may at first seem to have little in common. But actually, gambling and compulsive overeating share a number of links that can prove a real challenge in treating either (or both together). In an article entitled “Calorie Intake and Gambling: Is Fat and Sugar Consumption ‘Impulsive’?”, researchers found a strong correlation between sugar and fat intake and gambling.
Subjects in the study who were found to have high sugar/fat intake also had more severe gambling pathology and higher anxiety scores. They were also more likely to be depressed and drink more alcohol. Treatment for problem gambling might be more successful when dietary modifications are included to reduce sugar/fat intake.
Sex and Porn Addictions: Misconceptions and Bias
Admitting to an addiction to sex or pornography can often feel particularly difficult for an individual. This needs to change. A huge part of bringing about this change shall depend upon growing a wider understanding of the nature of sex/porn addictions, and the environment in which an addiction can exist. Shame reduction is essential. This fact is often overlooked. A variety of views exist in our society about sexuality. Due to technological advances, access to pornography is unprecedented. We are in the midst of a new sexual revolution.
While the exact size of the porno graphy industry is difficult to ascertain, a recent estimate put annual revenue at $97 billion. With online porn ubiquitous, these are very different times from the days of simple Playboy magazines. Understanding this new dynamic is the foundation of finding the best way to treat those with a sex or porn addiction. A healthy approach towards sexuality is good, but like any addiction when such a need becomes overwhelming and uncontrollable – so often to the detriment of people’s lives and happiness – the need for treatment is vital. This article is a must-read and serves as an important contribution to creating a positive climate for those seeking help.