Research on Marijuana’s Role in Car Crashes Expands as Drug Availability Grows
/By Join Together Staff
June 10th, 2014/



As marijuana becomes more readily available, a growing number of researchers are studying the possible link between marijuana and fatal car crashes, USA Today reports.

A study published earlier this year by Columbia University researchers found marijuana contributed to 12 percent of traffic deaths in 2010. The study of almost 24,000 fatal car accidents found marijuana was linked to three times as many traffic deaths compared with a decade earlier.

According to a 2010 survey by the National Highway Traffic Safety Administration (NHTSA), one in eight high school seniors said they drove after smoking marijuana. Almost one-quarter of drivers killed in drug-related crashes were younger than 25, the article notes. In addition, almost half of fatally injured drivers who tested positive for marijuana were under age 25.

The National Institute on Drug Abuse (NIDA) and NHTSA have been conducting a three-year study to determine how inhaled marijuana impacts driving performance.

NIDA notes on its website, “Considerable evidence from both real and simulated driving studies indicates that marijuana can negatively affect a driver’s attentiveness, perception of time and speed, and ability to draw on information obtained from past experiences. Research shows that impairment increases significantly when marijuana use is combined with alcohol.”

NIDA notes it is difficult to measure the exact contribution of drug intoxication to driving accidents, because blood tests for drugs other than alcohol are inconsistently performed, and many drivers who cause accidents are found to have both drugs and alcohol in their system, making it hard to determine which substance had the greater effect.

Lawmakers in Washington state, where recreational marijuana use is now legal, are trying to determine how police officers can identify drivers impaired by marijuana use. There is no consensus on what blood level of THC, the active ingredient in marijuana, impairs driving, the newspaper notes. Breathalyzers cannot be used for marijuana.

Some Massachusetts Doctors Resign from Marijuana Companies After Visit from DEA
/By Join Together Staff
June 10th, 2014/

Some Massachusetts physicians have resigned from marijuana companies after being told by U.S. Drug Enforcement Administration (DEA) investigators they must do so or be faced with relinquishing federal licenses to prescribe certain medications, The Boston Globe reports.

The agents have visited the homes and offices of doctors involved with medical marijuana dispensaries, according to the newspaper. The doctors said they were told the DEA wants them to resign from the companies because of a conflict between federal law, which bans use of any marijuana, and Massachusetts state law, which allows use of medical marijuana.

At least three doctors were contacted by DEA investigators, the article notes, and at least two have resigned their positions with dispensaries.

“Here are your options,” Dr. Samuel Mazza said he was told by Gregory Kelly, a DEA investigator from the agency’s New England Division office. “You either give up your [DEA] license or give up your position on the board . . . or you challenge it in court.” Mazza is Chief Executive of Debilitating Medical Conditions Treatment Centers.

The DEA’s actions may delay new medical marijuana dispensaries from opening, the newspaper noted.

A measure passed by the U.S. House of Representatives recently would end federal interference in state medical marijuana laws. Under the measure, the federal government could not spend funds to stop states from implementing their own medical marijuana laws. The amendment passed as part of a bipartisan funding bill. It now moves to the Senate for consideration.

    

	Sat., June 21: COA Open House
	This year, it's all about adjuncts: what are these tools, how do they work and how can (or should?) they be used? Come find out. Come to the Dwier Center (392 Church Street, Groveville, NJ) between 12:00 and 5:00 pm for a full afternoon of speakers talking about Narcan, Ibogaine and other medications, the Overdose Prevention Act and more.    The outdoor vendor park will include representatives from The Retreat, Daytop, Compass Health, Footprints to Recovery, Destination Hope, Christian Life Prison & Recovery Ministries, Nar-Anon, NA, AA, Addiction Treatment Services International (ATSI), Ibogalite, Advanced Health & Education, and Parents of Addicted Children, among others.   We'll also be showing THREE recovery films throughout the afternoon and serving refreshments from Family Nest Italian Restaurant.    There will be some important announcements as well as a few surprises......   As with all major COA events, COA Recovery Radio (www.coaradio.com) will be broadcasting live - stop by the station and meet some of our infamous show hosts. Hang out and listen or share your thoughts on the air.   For details, including speaker bios, click here. To be a vendor (no charge), contact cityofangelsnj@hotmail.com.

	Wed., June 11: Invitation to a Live COARR Show
	Let's Talk About Recovery!   With 10 original shows, COARR plays Recovery Talk 24/7/365....past shows are available online at www.coaradio.com/pastshows.html and in each show's online archive.  Tune in thru the smartphone app (free in the iphone/droid stores) or on www.coaradio.com to hear what's playing now.....   This Wednesday (tomorrow!) the COARR station will be open for Wil B. Kleen's live broadcast of "Laughter and Recovery". Join the audience at the Dwier Center from 8:30 to 9:30 pm for this hilarious show featuring all new, original material....including a boxing match between a champ from AA and a challenger from NA.... it's classic WBK: clever, witty and darkly real.... Check out past episodes of "Laughter and Recovery" at www.coaradio.com/WBK        Listen to past COARR shows any time: For "Women & Addiction" with Terri Thomas, click here. For "Hope Fiend" with Minister Rich Mollica, click here. For "Emotional Sobriety" with Andy Finley MFT, click here. For "Journey Thru the 12 Steps with the Life Recovery Bible," click here. For "Share Your Scars" with Vicki, click here. For "Wings Over Water: Creativity in Recovery" with recovery musician Kathy Moser,  click here. For "Laughter & Recovery" with stand up comic Wil B. Kleen, click here. For "Relationships in Recovery" with Alexa, click here. For "Saving Lives" with COA Director of Interventions Tom Redneck Clark, click here. For "Nar-Anon Families of Addiction Information Line" click here .

	Recovery Walk Update
	At COA, we think Recovery should be available to everyone. It shouldn't only be for those with the best insurance. So we will work with anyone who reaches out to us, regardless of their treatment history, insurance status or other details*. We never turn anyone away. You can learn more about COA scholarships in the video below. Our Recovery Walk on September 14, 2014 in Mercer County Park will support continued scholarships for recovery.     This is what a COA scholarship can do Please click here for details and help us if you can. Make a donation, register to walk or run, share this link, and/or volunteer. This will be an uplifting event with live music, vendors, food, testimonials from recoverees, live broadcast on COA Recovery Radio (www.coaradio.com) and much, much more!    * COA is a service organization: all COA services are completely free of charge and everyone who works for COA is a volunteer. That means we can be completely objective and impartial, recommending the best options for our clients, based upon their individual situations. For help with a drug problem, call COA at 609-910-4942 or visit us online at www.cityofangelsnj.org.

The Council of Southeast Pennsylvania, Inc.                                                   and           Pennsylvania Recovery Organization --      Achieving Community Together (PRO-ACT)
Recovery in Our Communities June 10, 2014      Like us on Facebook                                   www.councilsepa.org                       Follow us on Twitter Information and Recovery Support Line 24/7: 800-221-6333        We are products of our past, but we don't have to be prisoners          of it.      Rick Warren PERSONAL PROFILE Stacie Leap, CRS, FPS:  "A New Normal, and a New Me"  "Throughout my childhood, I was faced with many traumatic challenges...  I lost hope and assumed that this lifestyle was the norm... Then I saw an internet advertisement for "Recovery Coaches at PRO-ACT" in Philadelphia... I never dreamed that an advertisement for Recovery Coaches would lead to all this, but I am glad it did." Read more of  Stacie's Story.     THE MAYOR'S DINNER AND A MOVIE And A Recovery Transformation On June 4th PRO-ACT Philadelphia's staff attended The Mayor's Drug and Alcohol Executive Commission's "Making A Difference Recognition Dinner."  At this event, Dr. Arthur Evans, Jr, Commissioner of DBHIDS, reported that creation of the Philadelphia Recovery Community Center (PRCC) was one of the three most important developments in transforming the behavioral healthcare system in Philadelphia. Earlier that same day, PRO-ACT staff and our Executive Director, Ms. Beverly Haberle, were interviewed and videotaped about the tremendous work being done at PRCC. The Centers for Medicare and Medicaid Services, or CMS, is producing the video to support the integration of peer support staff into larger behavioral health provider organizations. Filming took place at the PRCC.  The Council and PRO-ACT are working to help our communities prevent illness and coordinate better healthcare. Our mission is accomplished through prevention, intervention, recovery supports, advocacy and education.  WILL SCHOOLS AND COLLEGES SUPPORT RECOVERY? Ask Your School To Do Some Homework Colleges began addressing students' recovery support decades ago, providing sober dorms and support meetings on campus. One recovery-support model, the Collegiate Recovery Program (CRP), is designed to create a "recovery friendly" space and supportive community. There were four CRPs in 2000 and an estimated forty today. Lack of data is often cited by academic institutions as an obstacle. To fill that evidence gap, CRPs are now the focus of several studies. Help your alma mater, alumni groups and parent-teacher organizations to better understand the needs of their community. Share this website with them, and ask your school to examine their approach to prevention and recovery support.  Change your school, and we change the culture.  Some Upcoming Events June 11, 2014: 7-8:30pm Free Pizza and Recovery Tool Kit on "Family Coping Strategies" at our SBRCC in Bristol.  To register contact Karen Burke at 215-788-3738 x 100 or click here. June 18, 2014: Meet The Council Open House, 8 - 9 am at 252 West Swamp Road, Bailiwick Office Campus, Unit 12, Doylestown, PA 18901 September 12, 2014: 7:05 pm. Recovery Night at the Baseball Game, Phillies vs. Marlins, Citizens Bank Park. Click here for tickets.  September 20, 2014: PRO-ACT Recovery Walks! 2014, Great Plaza, Penn's Landing, Philadelphia. Click here to register and get more information. Employment Opportunities: Please click here

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JUNE 10 v 18 TWELVE STEPPING WITH POWER IN THE PROVERB

Hiding hatred makes you a liar;

slandering others makes you a fool.

STEP 9 - Made direct amends to such people wherever possible, except when to do so would injure them or others

Hiding hatred is very stressful and overtime it can develop itself into a trigger called jealousy . I was always considered the Black sheep of the family .At a very young age my sister was always at the top and in my parents eyes she could do no wrong. My jealousy developed into anger , hate , and then resentment . I would loose sleep over all the hateful thoughts of how could I get her into trouble and knock her off her pedestal . When we were in our teens , I made up a story and a friend of mine at the time started a rumor and my sisters last few years of high School were a living hell . You can only hide hatred , anger , jealousy , , and resentment so long before it rears its ugly head . If you don't deal with it through step nine it will hurt you and others in the long run . I am not sure if my sister will truly ever let the hurt I caused go . 

James 3 : 16

For where jealousy and selfish ambition exist, there will be disorder and every vile practice.

By Joseph Dickerson

Instant Gratification As A Way Out of Addiction? 

Yes!

Seeking instant gratification instead of waiting for a more valuable prize can get people into addiction, but this "delay discounting" mentality can be used to break free of addiction as well.

Shutterstock

By Dana Smith

06/09/14

What if I told you you could have $10 today or $20 next week, which would you choose? What about $100 today or $110 in six months? Rationally, we should always opt for the larger amount, no matter what the wait. But our brains process these two rewards differently, under-valuing the later option and preferring an immediate satisfaction far more than a delayed prize. 

This inability to defer gratification is a type of impulsivity called “delay discounting,” and it is considered to be a hallmark of addiction. While the tendency to live in the moment is prized in self-help articles, numerous studies have linked this type of “myopia for the future” to an increased risk for drug dependence—users preferring the immediate rush of a high over the delayed benefit of a long and healthy life. 

However, new research has emerged showing that while this type of “irrational” decision-making can contribute to someone developing an addiction, it may also help get them out of it.

Discounting and Drug Abuse

Dr. Warren Bickel has been researching drug addiction for the last 20 years, and he thinks that this trait is “part and parcel” with the addictive experience. “Data suggests discounting is predictive of who becomes addicted versus not,” he says. “If you compare addicts versus non-addicts on [this trait], addicts discount substantially more. [Moreover,] it seems proportional with their drug use—the more they use, the more they discount.”

Additionally, discounting has been linked to treatment outcomes, with higher rates of impulsivity associated with a greater risk for relapse after rehab. This predictive ability is true regardless of the drug being used, be it heroin or nicotine—the longer you can wait for any type of reward, the longer you are likely to go without using.

In the lab, delay discounting is assessed by giving people a series of “smaller sooner” versus “larger later” choices, like the ones above. The point at which you switch from preferring the future to the present reward determines your discounting rate and is thought to reflect your capacity for self-control. 

This ability to delay gratification is linked to activation in a specific part of your brain—the dorsal (top) lateral (outside) prefrontal cortex, located near your hairline and above your eyebrows. This region is associated with planning and decision-making, and typically the more activation you have in this area, the better you are at self-control. However, the prefrontal cortex is known to be abnormal in dependent drug users, and numerous studies have shown that addicted individuals have less brain volume in this region than non-drug users. This decrease in size seems to be directly related to drug use itself, with severity and length of use linked to a greater decrease in volume and activity. Losing brain cells is never a good idea, but in the prefrontal cortex it can be especially detrimental, impacting the ability for self-control and making someone even more impulsive than they already were. But all is not lost, andstudies have shown that our brains can bounce back once off drugs, the cells regenerating like leaves growing back on the trees after a long winter.

A New Type of Treatment

Which brings us back to Dr. Bickel’s work. Reanalyzing five previous studies, the researchers looked at how different treatment options affected this trait of discounting, and how this may in turn relate to abstinence efforts. Remarkably, this time it was the users who had the highest rates of discounting that improved the most with treatment. That is, those who were initially the most impulsive in their decision-making became less impulsive over time. Notably, this was not the case in the control arms of the experiments, suggesting there was an important effect of the treatment program itself on discounting. Even more remarkable, this improvement in discounting was linked to abstinence success, with the individuals who had the largest decreases in discounting also having the lowest number of positive drug screens. 

This result is particularly surprising as it is in direct contrast with previous studies showing that high impulsivity, particularly in regards to future discounting, is typically linked to worse treatment outcomes. One possible explanation is that this discrepancy is due to the type of treatment used across the different studies. For example, in one of the original trials, multiple types of treatments were used, effectively “throwing the kitchen sink” at the patients. As a result, abstinence levels were an impressive 80-90%, roughly double the success rates for the current standard treatment options. 

Dr. Bickel thinks that it is this difference in the effectiveness of the treatments that resulted in the conflicting discounting trends. “It looks like the predictive ability of discounting for a therapeutic outcome occurs with moderately effective treatment. But when you have highly effective treatment, which is where we found these changes in discounting, that’s the difference…The efficacy of the treatment determines whether discounting is a predictor or if discounting changes.”

Improving Memory and Self-Control

Perhaps the most exciting finding of the new research is the link between working memory and improvements in discounting. One of the trials that was re-analyzed involved training participants on a working memory task, trying to improve their abilities in this domain. However, the researchers discovered an unexpected link between improvements in working memory and an increase in self-control. While at first this result was surprising, discounting and working memory being separate cognitive processes, the two functions overlap in the brain, both linked to activation in the dorsal lateral prefrontal cortex. Thus, it appears that improving working memory can strengthen activation in this area, which can subsequently enhance other behaviors (like self-control) that tap into it. 

Working memory is also thought to be related to abstinence success, for in order to achieve your goals, you have to be able to keep them in mind first. Indeed, more and more, future planning is being thought of as a type of working memory, remembering how you acted in the past and keeping in mind how you’d like to change your behaviors in the future. 

Dr. Bickel explains, “Remembering an event in the past and thinking about the future are really tied processes. And working memory, being able to hold ideas and concepts or facts in our heads for a certain period of time, may be necessary for us to think about and value things that occur in the future.” 

Together, these findings suggest there may be a way to improve decision-making in drug users, which could then result in an increase in treatment efficacy. As the current options for rehab are often less than perfect, improving any chance for success, particularly in those who are most likely to fail, seems like a worthwhile endeavor.

Regression to the Mean

However, before we get too excited about the possibility, it’s important to keep in mind a small statistical effect that may be having a large impact on the current findings. 

One alternative explanation for the results is that those who have lost the most have the most to gain. This is true both mathematically in the idea of “regression to the mean,” where outliers on both ends of a spectrum have a tendency to pull in towards the center, as well as more colloquially in the idea that the lower one starts off, the more potential there is for growth. Also, rather than looking at the trait of discounting itself, these findings can be viewed more abstractly, in that individuals who are able to significantly improve in any arena might be the ones who are most readily helped by treatment. 

Additionally, while the current analysis had a dataset of over 200 participants to work with, another 300 individuals dropped out during the initial studies. Considering that drug users who are highest in impulsivity also have the highest likelihood for relapse, this loss could have skewed the data, not taking into account the most extreme cases. Unfortunately, this is a problem that almost all studies on addiction treatment encounter, in that they are largely made up of a self-selecting group of individuals who want to get clean and are willing and able to stick with it. However, it is often those who drop out who might need the most help and who would be able to shed light on what doesn’t work and why in terms of treatment.

At the end of the day, though, any opportunities to advance treatment success rates should be taken, and the current findings do provide a promising new avenue for improving self-control, and subsequently abstinence efforts. Dr. Bickel says, “I think often in addiction we deal with either the symptoms of addiction or the demographics of the participants, but it could be that decision making processes are really key in understanding how addiction operates and perhaps how to treat it.”

Dana Smith has written for The Guardian, The Atlantic and Scientific American: Mind, among other publications.