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Scott Crawford's Journey to Sobriety Guides His Vision for a Healthier Industry - INDY Week

Steve and Mickey Bakst founded Ben’s Friends, an industry support group for those struggling with addiction. I started a chapter in Raleigh, which quickly grew. A year later, I was hosting Ben’s Friends meetings at Crawford and Son, where we’d share our stories, tackling topics like how to handle wine tastings or how to maintain a group of friends, sober. We started to create that blueprint of success that had never existed.  One day, it occurred to me that here I was talking with people about how to navigate the industry sober, and yet, I was still rewarding a good shift from my own staff with alcohol. When I started Crawford and Son, I didn’t want to seem anti-alcohol. I was scared to be “that guy” who just eliminated alcohol altogether. If you’re the sober guy in the room, people already start to feel uncomfortable around you. So, I tried to take an approach that would create a healthy culture around alcohol by keeping a close eye on it. We allowed a beer at the end of the night or a glass of wine while cleaning up. I didn’t think there was anything wrong with that.

Online Intergroup of Alcoholics Anonymous | Building an AA fellowship anytime, from anywhere, for everyone

The first AA meetings online used Bulletin Boards and were around 1986. Email groups started forming in the early nineties and the development of the worldwide internet rapidly fueled the growth and variety of groups. The first online AA group, Lamp-lighters, was formed in 1990, and has met by email continuously since then. Now there are hundreds of AA groups with thousands of members, connected together through this Online Intergroup. Using various mechanisms such as video conferencing, phone conferencing, message boards, email listserve, and chatrooms; the AA community is constantly connecting and finding new, creative ways to communicate the experience, strength and hope of recovery in Alcoholics Anonymous.

Juggling My Children, Their Alcoholic Sitter and My Own Sobriety - The New York Times

Vodka. I’d like seven vodka tonics. I’d like to slip inside a bottle of vodka, to bathe in it, to slosh, just for the night, just for a little while. That’s how I know my addiction is still there, still lurking, still hungry. After 18 years it’s probably ravenous, but it’s not starving. Starvation is something you die of, and addiction cannot be killed. You can’t excise or eradicate it. You have to contain it. Dam it. Barricade it. Even then, it whispers. Through whatever levees you erect, it gurgles. It splashes out a Morse code of desire. You become a certain kind of deaf, a certain level of numb, all the time, every day. That’s the work. That is how you progress from drunk, to dry drunk, to sober human. You’ll never be just human. You’ll always be a sober human — a person almost, but not quite.

More than half of people using cannabis for pain experience multiple withdrawal symptoms: Minority experience worsening of symptoms over time, especially younger people -- ScienceDaily

In addition to a general craving to use cannabis, withdrawal symptoms can include anxiety, sleep difficulties, decreased appetite, restlessness, depressed mood, aggression, irritability, nausea, sweating, headache, stomach pain, strange dreams, increased anger and shakiness. Previous research has shown that the more symptoms and greater severity of symptoms a person has, the less likely they are to be able to reduce their use of cannabis, quit using it or stay away from it once they quit. They may mistakenly think that the symptoms happen because of their underlying medical conditions, and may even increase the amount or frequency of their cannabis use to try to counteract the effect -- leading to a cycle of increasing use and increasing withdrawal.

Increase in pleasurable effects of alcohol over time can predict alcohol use disorder: New research challenges existing dogma that higher tolerance for stimulating and rewarding effects of alcohol leads to addiction -- ScienceDaily

"These pleasurable alcohol effects grow in intensity over time, and do not dissipate, in people progressing in excessive drinking," said King. "This tells us that having a higher sensitivity to the rewarding effects of alcohol in the brain puts such individuals at higher risk for developing addiction. It all fits a picture of persistent pleasure-seeking that increases the likelihood of habitual excessive drinking over time. Alcoholics were thought to need to drink more to finally get their desired effect when they drink, but these well-controlled data do not support that contention. They get the desirable alcohol effect early in the drinking bout and that seems to fuel wanting more alcohol." While it may seem relatively intuitive that individuals who experience alcohol's pleasurable effects most intensely are at the greatest risk for developing drinking problems, King's findings run counter to current prominent addiction theories. "Our results support a theory called incentive-sensitization," said King. "In response to a standard intoxicating dose of alcohol in the laboratory, ratings of wanting more alcohol increased substantially over the decade among the individuals who developed more severe AUD. Additionally, the hedonic response -- essentially, how much a person liked the effects -- remained elevated over this interval and didn't go down at all. This has traditionally been the crux of the lore of addiction -- that addicts don't like the drug (alcohol) but can't stop using it."

Ritalin and similar medications cause brain to focus on benefits of work, not costs -- ScienceDaily

The results largely matched Westbrook's computer-modeled predictions. Those with lower dopamine levels made decisions that indicated they were more focused on avoiding difficult cognitive work -- in other words, they were more sensitive to the potential costs of completing the task. Those with higher dopamine levels, on the other hand, made decisions that showed they were more sensitive to differences in the amount of money they could earn by choosing the harder test -- in other words, they focused more on the potential benefits. Westbrook said the latter held true whether the subjects' dopamine levels were naturally higher or whether they had been artificially elevated by medications.

How many of 1829 antidepressant users report withdrawal effects or addiction? - PubMed - NCBI

A total of 1829 New Zealanders who had been prescribed antidepressants completed an online survey; 44% had been taking antidepressants for more than 3 years and were still taking them. Withdrawal effects when stopping medication were reported by 55%, and addiction by 27%. Paroxetine had particularly high rates of withdrawal symptoms.

QuarterWatch™ (includes new data from Quarter 2, 2019) Methotrexate Errors, Trends Among Addictive Drugs, and Underreporting of Serious Events | Institute For Safe Medication Practices

While therapeutic opioid use declined between 2013 and 2017, we observed a substantial increase in prescriptions for amphetamine and methylphenidate products, the other major Schedule II drugs. These potent stimulants of the central nervous system (CNS) increase the release of multiple neurotransmitters, including dopamine and norepinephrine. Despite well documented risks of dependence and addiction, an estimated 7.8 million persons, about 2.4% of the US population, reported taking amphetamine products in 2017. Overall, reported use of amphetamine and methylphenidate products increased by 37% from 2013 to 2017, with the most rapid growth among adults (66% increase) rather than children (14% increase). The changes in exposure are shown in Table 1.

What Does It Mean to Have a Serious Drinking Problem? - The New York Times

I didn’t join A.A., though I don’t rule it out. I sought support from my husband, daughter and friends — those I’d offended, those surprised I even had a problem. I devoured others’ stories, watching movies about alcoholics, reading memoirs, lurking in sub-Reddits for people struggling to quit. But what really kept me on the path was the remarkable difference between the drinking and not drinking me. I hadn’t grasped the degree to which a sense of shame had insidiously undergirded my life. Now it was gone, replaced by an unaccustomed pride. The longer I abstained, the better I felt, in ways that spilled into marriage, work, parenting, friendships. Recently, someone unaware I’d quit told me I looked years younger. I’m more patient. My headaches are infrequent, my energy up. Those results fit with a study published in the Canadian Medical Association Journal, among the first focused on moderate drinkers’ mental health. Researchers studying cohorts of people in Hong Kong and the United States found even “safe” drinkers, women in particular, showed improved well-being if they stopped. Today, I can label myself. I had moderate alcohol use disorder, a “chronic relapsing brain disease” marked by loss of control over alcohol. The National Institute on Alcoholism and Alcohol Abuse says 6.2 percent of American adults, more than 15 million people, are on the alcohol use disorder spectrum. (Other research puts the numbers higher.) I’d guess many, like me, drink modestly enough that they don’t believe they have a problem. I feel lucky I quit before anything worse happened.

In mice, alcohol dependence results in brain-wide remodeling of functional architecture -- ScienceDaily

"The neuroscience of addiction has made tremendous progress, but the focus has always been on a limited number of brain circuits and neurotransmitters, primarily dopaminergic neurons, the amygdala and the prefrontal cortex," said senior author Olivier George, PhD, associate professor in the Department of Psychiatry at UC San Diego School of Medicine. "Research groups have been fighting for years about whether 'their' brain circuit is the key to addiction. Our results confirm these regions are important, but the fact that we see such a massive remodeling of the functional brain architecture was a real shock. It's like studying the solar system and then discovering that there is an entire universe behind it. It shows that if you really want to understand the neurobiological mechanisms leading to addiction, you can't just look at a handful of brain regions, you need to look at the entire brain, you need to take a step back and consider the whole organ." George said the findings further undermine the idea that addiction is simply a psychological condition or consequence of lifestyle. "You would be surprised at how prevalent this view remains," he said. "The brain-wide remodeling of the functional architecture observed here is not 'normal.' It is not observed in a naïve animal. It is not observed in an animal that drinks recreationally. It is only observed in animals with a history of alcohol dependence and it is massive. Such a decrease in brain modularity has been observed in numerous brain disorders, including Alzheimer's disease, traumatic brain injury and seizure disorders." Brain modularity is the theory that there are functionally specialized regions in the brain responsible for different, specific cognitive processes. For example, the frontal lobes of the human brain are involved in executive functions, such as reasoning and planning, while the fusiform face area located in the lower rear of the brain is involved in recognizing faces. Reduced modularity, said George, likely interferes with "normal neuronal activity and information processing and contributes to cognitive impairment, emotional distress and intense craving observed in mice during abstinence from alcohol." Due to the format of the testing, George said it was not clear if the reduced modularity was permanent. "So far, we only know that it lasts at least one week into abstinence. We have not tested longer durations of abstinence, but it's one of our goals."

The Art of Dying | The New Yorker

I was climbing stairs and paused, too exhausted for another step. I harbored a nebulous conviction that I could tolerate only so much pain, short of a red zone in which I would go mad or die or something terrible would happen. And that anyone should see as much and want me to do anything—have a drink or a drug, for starters—to make it stop. I thought, They say one day at a time. How about one second? I stared at my ticking watch. A black abyss opened. I was numbly aware that I wasn’t insane. I wasn’t dying. Reality was droning on as usual, with impartial sunlight streaming through a nearby window and picking out swirls of dust motes. A perfectly demented thought blazed up. Roughly: What if they find out I’m not really an alcoholic and throw me out of here? I need this place! I believe it was the last, deepest rootlet of my denial, expelled. Not an alcoholic?

The Art of Dying | The New Yorker

See, Brooke is a child of alcoholics, as I’m not. I grew up and became one. She grew up and married one. She knew I was a mess but thought the drinking part was normal, until she got wise and kicked me out of the house. (Note to anyone who knows an active alcoholic: never, ever sympathize. If you suspect you’re going to, shut your eyes, plug your ears, and hum.)

The Art of Dying | The New Yorker

I remember, in rehab, on the Upper East Side in 1992, an alum of the place, a tough guy from Queens, addressing the nightly A.A. meeting. He told us of once showing up at some clinic, drunk and filthy and soiled with his own diarrhea, and throwing a fit because the doctor was ten minutes late. “If you’re a real alcoholic,” the guy said to us, “no matter how low you go, you will have an attitude.” He added, “If you’re a real alcoholic, you will never feel quite right. Whatever you want will be a little bit out of reach. Can’t handle that? Get the fuck out of here and get drunk.” I went up to him afterward, in tears, to thank him. He said, “You heard me?” I said yes. “Good,” he said, turning and walking away as if from some crap on a sidewalk. Saved my life.

What Chris said

I figuratively put all the chemicals in a funnel, and they came out bourbon. Jack Daniel’s-on-the-rocks, with a splash, except when scarce funds reduced me to Heaven Hill. Alcohol was liberating for me at first. A standard progression: great, good, fair, poor, bad, very bad, and then a phase for which any word but “Hell” fails. Halfway through the second drink, there may be a flicker of the old euphoria, quickly snuffed. You chase it in vain for the rest of a wretched night. It’s over for you. A line has been crossed. Yet you cannot imagine yourself not drinking. The obsession is at one with your core sense of self.

Cycles of reward: New insight into ADHD treatment: Neural processes involved in ADHD -- ScienceDaily

Neurons release dopamine in different ways: phasic release is characterized by quick, high intensity spikes in the neurotransmitter, often in response to motivational stimuli like drugs or sugary treats. Tonic release, on the other hand, refers to slower, more regular firings of dopamine neurons, and is involved in muscle and joint movements. Wickens and his collaborators initially thought that, since methylphenidate blocks the reuptake of dopamine by receptors in the brain, that the drug should increase the phasic dopamine signal. Rather, after analyzing their data, the researchers found the opposite: methylphenidate did not increase phasic dopamine. To explain this finding, Wickens suspects that the brain has a remarkably powerful feedback mechanism to keep the brain's dopamine levels in check, even when reuptake is blocked by methyphenidate. "When you use methylphenidate in the intact brain there's a neural regulation mechanism to compensate for the direct effects of the drug," said Wickens. "Methylphenidate's therapeutic effects could be indirect consequences of this feedback loop." The computer modeling suggests that methylphenidate primarily impacts the tonic dopamine signal. Shifts in tonic dopamine signaling may activate dopamine receptors in ways that improve the symptoms of ADHD.

Consuming alcohol leads to epigenetic changes in brain memory centers -- ScienceDaily

n, in mouse models, how acetate -- a byproduct of the alcohol breakdown produced mostly in the liver -- travels to the brain's learning system and directly alters proteins that regulate DNA function. This impacts how some genes are expressed and ultimately affects how mice behave when given environmental cues to consume alcohol. Their findings were published today in Nature. "It was a huge surprise to us that metabolized alcohol is directly used by the body to add chemicals called acetyl groups to the proteins that package DNA, called histones," said the study's senior author Shelley Berger, PhD, the Daniel S. Och University Professor in the departments Cell and Developmental Biology and Biology, and director of the Penn Epigenetics Institute. "To our knowledge, this data provides the first empirical evidence indicating that a portion of acetate derived from alcohol metabolism directly influences epigenetic regulation in the brain."

Hub linking movement and motivation in brain identified -- ScienceDaily

lateral septum (LS), a region considered integral to modulating behavior and implicated in many psychiatric disorders, directly encodes information about the speed and acceleration of an animal as it navigates and learns how to obtain a reward in an environment. "Completing a simple task, such as acquiring food for dinner, requires the participation and coordination of a large number of regions of the brain, and the weighing of a number of factors: for example, how much effort is it to get food from the fridge versus a restaurant," said Hannah Wirtshafter, the study's lead author. "We have discovered that the LS may be aiding you in making some of those decisions. That the LS represents place, movement, and motivational information may enable the LS to help you integrate or optimize performance across considerations of place, speed, and other environmental signals."

How relapse happens: Opiates reduce the brain's ability to form, maintain synapses: Preclinical research was focused on revealing the molecular mechanisms behind addiction and relapse -- ScienceDaily

In experiments with rodents, the UB team determined that exposure to heroin and morphine reduced drebrin levels in the nucleus accumbens, a key part of the brain's reward pathway. Synaptic rewiring The researchers found that opiate exposure causes synaptic rewiring in this part of the brain, as well as a decrease in drenditic spines, the protrusions on neurons that play key roles in neuronal transmission, learning and memory. "Opiates fundamentally change how the brain communicates with itself," Dietz said.

Prizes for sobriety: As Washington meth use rises, this treatment is one of few that works | The Seattle Times

Here’s how the treatment works: You come in a few times a week, complete a urine test, and if it’s negative, you draw for a prize — at a trial McDonell is running in Wallingford, there are “small” prizes like shampoo or a toothbrush, “big” prizes like a coffeemaker, or rare “jumbo” prizes like a DVD player. The longer you’re sober, the more draws you get, but if the test comes back positive, the clinician says “see you next time.”

Mindful body awareness training during treatment for drug addiction helps prevent relapse -- ScienceDaily

The intervention is called Mindful Awareness in Body-oriented Therapy (MABT) and combines manual, mindfulness and psycho-educational approaches to teach interoceptive awareness and related self-care skills. Interoceptive awareness is the ability to access and process sensory information from the body. Researchers studied 187 women at three Seattle-area locations. The cohort, all women in treatment for substance use disorder (SUD), was split into three relatively equal groups. Every group continued with their regular SUD treatment. One group received SUD treatment only, another group was taught the mindfulness technique in addition to treatment, and the third group received a women's education curriculum in addition to treatment in order to test whether the additional time and attention explained any positive study outcomes. Women were tested at the beginning, and at three, six and 12 months on a number of factors including substance use, distress craving, emotion regulation (self-report and psychophysiology), mindfulness skills and interoceptive awareness. There were lasting improvements in these areas for those who received the MABT intervention, but not for the other two study groups. "Those who received MABT relapsed less," Price said. "By learning to attend to their bodies, they learned important skills for better self-care."

Want to quit smoking? Partner up: Couples who attempt to stop smoking together have a sixfold chance of success -- ScienceDaily

At the end of the programme, 64% of patients and 75% of partners were abstinent -- compared to none and 55% at the start, respectively. The odds of quitting smoking at 16 weeks were significantly higher (5.83-fold) in couples who tried to quit together compared to patients who attempted it alone. "Previous research has shown that ex-smokers can also positively influence their spouse's attempts to quit, but in this study the effect was not statistically significant," said Ms Lampridou. "As for non-smoking partners, there is a strong risk that they will adopt their spouse's habit." Ms Lampridou noted that research is needed to confirm the findings in smokers who are otherwise healthy.

ADHD drug Ritalin has no effect on primate prefrontal cortex -- ScienceDaily

Julio Martinez-Trujillo and colleagues refute their hypothesis the caudal prefrontal cortex -- a brain region critical for attention -- is Ritalin's main site of action in the brain. To arrive at this conclusion, the researchers recorded large populations of neurons in this brain region as two male macaque monkeys performed a demanding visual attention task. The team did not observe any differences in neuronal activity after administration of the drug compared to a placebo, even at doses that improved the monkeys' performance on the task.

Heavy drinking may change DNA, leading to increased craving for alcohol: Genetic vicious cycle may reinforce risky drinking behavior -- ScienceDaily

Scientists at Rutgers and Yale University School of Medicine focused on two genes implicated in the control of drinking behavior: PER2, which influences the body's biological clock, and POMC, which regulates our stress-response system. By comparing groups of moderate, binge and heavy drinkers, the researchers found that the two genes had changed in the binge and heavy drinkers through an alcohol-influenced gene modification process called methylation. The binge and heavy drinkers also showed reductions in gene expression, or the rate at which these genes create proteins. These changes increased with greater alcohol intake. Additionally, in an experiment, the drinkers viewed stress-related, neutral or alcohol-related images. They also were shown containers of beer and subsequently tasted beer, and their motivation to drink was evaluated. The result: alcohol-fueled changes in the genes of binge and heavy drinkers were associated with a greater desire for alcohol.

Exercise and memory mechanisms

Mice were given cocaine injections over four days in special chambers with a distinctive floor texture to produce a drug association with that environment. The animals were then housed for 30 days in cages, some of which included a running wheel. The researchers found that mice that exercised on these wheels had lower levels of brain peptides related to myelin, a substance that is thought to help fix memories in place. Re-exposure to the cocaine-associated environment affected running and sedentary mice differently: Compared with sedentary mice, the animals with running wheels showed a reduced preference for the cocaine-associated environment. In addition, the brains of re-exposed runners contained higher levels of hemoglobin-derived peptides, some of which are involved in cell signaling in the brain. Meanwhile, peptides derived from actin decreased in the brains of re-exposed sedentary mice. Actin is involved in learning and memory and is implicated in drug seeking. The researchers say these findings related to peptide changes will help to identify biomarkers for drug dependence and relapse.

Dopamine Drives Early Addiction to Heroin - Neuroscience News

To prove that increased dopamine directly causes drug reinforcement, the team looked at the effects of silencing dopamine in mice with a well-established heroin addiction and were consistently self-administering the drug using a lever. They found that when they silenced the dopamine neurons, the mice were much less likely to self-administer heroin. Crucially, when they did this early in the addiction phase, the mice were less likely to develop the habit of self-administering heroin. This showed that activation of dopamine neurons in the nucleus accumbens is required for the early positive reinforcing effects of opioid drugs.

Just a few drinks can change how memories are formed -- ScienceDaily

One of the downstream dominos in the signaling pathway affected by alcohol is a gene called dopamine-2-like receptor, which makes a protein on neurons that recognizes dopamine, the "feel-good" neurotransmitter. "The dopamine-2-like receptor is known to be involved in encoding whether a memory is pleasing or aversive," Petruccelli said. And alcohol hijacks this conserved memory pathway to form cravings. In the case of the alcohol reward pathway studied, the signaling cascade didn't turn the dopamine receptor gene on or off, or increase or decrease the amount of protein made, Kaun said. Instead, it had a subtler effect -- it changed the version of the protein made by a single amino acid "letter" in an important area. "We don't know what the biological consequences of that small change are, but one of the important findings from this study is that scientists need to look not only at which genes are being turned on and off, but which forms of each gene are getting turned on and off," Kaun said. "We think these results are highly likely to translate to other forms of addiction, but nobody has investigated that."