Monday, February 4, 2013

Commentary: Addressing Fetal Alcohol Spectrum Disorders in Addiction Treatment

Addiction treatment professionals can play a vital role in preventing the leading known cause of intellectual disabilities, birth defects and neurobehavioral disorders in the world, Fetal Alcohol Spectrum Disorders (FASD).
Each year 125,000 American newborns are prenatally exposed to heavy or binge alcohol consumption, 20 times the number exposed to methamphetamine and inhalants. Alcohol is a teratogen—a substance known to be toxic to developing babies. Of the most common substances of abuse, including marijuana, cocaine and heroin, alcohol produces by far the most serious neurobehavioral effects in the offspring of substance-using women.
FASD is not typically included in addiction treatment curriculum. One problem is that there is not a code for it in the DSM manual of mental health disorders, and as a result, psychiatrists and psychologists are not informed about FASD.
FASD may also be an unexamined cause for high recidivism in addiction treatment. There are several reasons why this may be:
•    Women may have used alcohol and drugs while pregnant and be afraid to discuss in group;
•    Women may have children with undiagnosed FASD, and may not be educated on appropriate parenting techniques; and
•    Clients themselves may have been prenatally exposed to alcohol and have unidentified learning and behavioral disorders as a result.
Preventing FASD in Addiction Treatment
If a woman drinks while she is pregnant, there is a risk for having a child with FASD regardless of ethnicity, education or socio-economic status. A woman does not have to be an alcoholic to have a child with effects; however, women that suffer with alcoholism are at the highest risk. Women who use other drugs are also at high risk for having a child with FASD, since many use alcohol as well. Women who drink should be counseled about using effective contraception to avoid pregnancy.
Since FASD is preventable, all clients and their families receiving addiction treatment should be educated on the hazards of drinking while pregnant. Men may not cause FASD directly, but they have a very important role in prevention. They can encourage and support women not to drink while pregnant, or at risk for pregnancy.
Treatment is an appropriate time to learn about FASD. If clients realize that some of their children may have effects from prenatal alcohol exposure, a counselor is there to provide them with support and resources. Treatment professionals should provide opportunities for women to discuss many of the difficult issues around mothering and parenting. They can provide women with language to talk to their pediatricians and other health care providers about possible exposures to ensure that the children are receiving assessments and appropriate services.
Recognizing FASD in Clients
People with FASD often go unnoticed as having a brain disorder because the majority of individuals have borderline intelligence or above. This is a lifelong disability and the cognitive, behavioral, emotional and social difficulties can each appear across a continuum of severity, from mild to profound. They may experience a daily fluctuation of attention and focus. Many will struggle with understanding cause and effect relationships or the ability to predict future behaviors. Individuals are typically naïve and are easily led into situations. They may have problems in judgment, memory and social skills, but because they have strong expressive language skills they appear higher functioning than they are. It is not uncommon for a client with FASD to be unsuccessful and sometimes terminated from treatment. These individuals need structure, support and understanding. If counselors better understood the typical behavioral profile of a client with FASD, and how to modify treatment, treatment outcomes could improve.
Recognizing that a person “can’t” perform, rather than “won’t” perform, immediately changes the dynamic in a service relationship. By recognizing the disability of FASD and modifying systems of care, we can improve outcomes for clients. Adults often need lifelong transitional and behavioral support.
Below are suggestions for improving treatment for individuals with FASD: 
•    Train staff to modify treatment plans and treatment;
•    Plan for long-term treatment and aftercare options;
•    Include the entire family in treatment;
•    Assist clients with housing, vocational, educational, day-care, respite, recreational and other services;
•    Assist clients with Supplemental Security Income, public assistance, food stamps, Medicaid/Medicare and other disability programs;
•    Counselors should consider the possibility of past victimization in these clients;
•    Counselors should know best treatment practices and recommendations for clients with FASD; and
•    Addiction treatment agencies should pursue assessments and diagnosis for clients (and/or children of clients) when they suspect a person has FASD.
There is much that can be done to address FASD in addiction treatment. The National Organization on Fetal Alcohol Syndrome (NOFAS), founded in 1990 as a voice for individuals, families and caregivers living with FASD, disseminates information and resources, provides referrals to specialists, and offers a 22-unit certification program for addiction professionals (www.nofas.org).
Kathleen Tavenner Mitchell, MHS, LCADC
Kathleen T. Mitchell is currently the Vice President and International Spokesperson for the National Organization on Fetal Alcohol Syndrome and a noted speaker/author on Fetal Alcohol Spectrum Disorders (FASD) and Women and Addictions. She founded the Circle of Hope (COH), an international peer mentoring network for women who have used substances while pregnant.

Sunday, February 3, 2013

Injection Drug Users With Hepatitis C Are “Super-Spreaders” of the Virus

People who inject drugs and have hepatitis C are “super-spreaders” of the virus, who are likely to infect 20 other people, a new study finds. Half of hepatitis C virus transmissions take place in the first two years after a person is initially infected.
Researchers from the University of Oxford in England say early diagnosis and treatment of hepatitis C in people who inject drugs could help prevent the spread of the virus, HealthDay reports.
Hepatitis C, which can be spread through contact with infected blood, may lead to scarring of the liver, or liver cancer. There is no vaccine for the disease, the article notes. Many people with hepatitis C are unaware they have the disease, and go undiagnosed for more than a decade.
“For the first time we show that super-spreading in hepatitis C is led by intravenous drug users early in their infection,” study author Gkikas Magiorkinis said in a university news release. “Using this information, we can hopefully soon make a solid argument to support the scaling-up of early diagnosis and antiviral treatment in drug users. Helping these people and stopping the spread of hepatitis C is our ultimate target.”
The study appears in the journal PLoS Computational Biology.

Thieves Steal Prescription Drugs From Medicine Cabinets in Open Houses

Prescription drug thieves are stealing from medicine cabinets during open houses, ABC News reports.
Home sellers usually lock up valuables such as jewelry, electronics and personal information, but often don’t think of securing their medicine cabinets. A San Diego realtors’ group is warning homeowners about these thefts. “The take away here is common sense,” Anthony Manolatos of the Greater San Diego Association of Realtors told ABC News. “When an agent is showing your home and you’re not there, take your valuables with you or lock them in a safe.”
The Drug Enforcement Administration (DEA) has observed this trend. “Stealing drugs from open houses is indeed a technique drug thieves use to obtain controlled substance prescription drugs,” said the DEA’s Barbara Carreno. She said drugs stolen during open houses include opioid painkillers, anti-anxiety drugs, ADHD drugs, Xanax and Valium.
DEA enforcement groups, called tactical diversion squads, have found drugs on the black market that have been stolen during open houses, Carreno added.

Friday, February 1, 2013

The Hope Share: A Live Storytelling Event

85 million people in the U.S. have been affected by addiction and over 20 million are in long-term recovery. Imagine if each of them came forward to share a story of recovery or a message of support.
The Hope Share, a new story-sharing portal created by The Partnership at Drugfree.org, is designed to elevate stories of recovery and inspire others to speak out and help break the stigma and discrimination surrounding addiction.
We’ve teamed up with proud partners of this project, InTheRooms.com and Faces & Voices of Recovery, to host a unique upcoming virtual experience – The Hope Share: A Live Storytelling Event.
Taking place on Wednesday, February 6th at 9 p.m. EST, participants are encouraged to share their video stories of hope using their webcam during this 90-minute LIVE event to help inspire others and spark meaningful conversation around alcohol and other drug problems and addiction.
To participate in this event, visit Meeting Room 1 here at 9:00 p.m. EST on February 6th.
The event will be moderated by InTheRooms.com and will feature Pat Taylor, Executive Director, Faces and Voices of Recovery, and Jerry Otero, a Parent Support Specialist and clinical social worker from The Partnership at Drugfee.org.
Share your powerful story and help encourage families who are struggling with a young person’s addiction, and let them know that there is hope, and that recovery is possible.
To participate in this event, visit Meeting Room 1 here at 9:00 p.m. EST on February 6th.

Gene Mutations Linked With Increased Risk of Dying From Cocaine Abuse

New research suggests people with common genetic mutations have an almost eightfold increased risk of dying from cocaine abuse. The mutations affect the chemical messenger dopamine in the brain.
Dopamine is vital to the functioning of the central nervous system. Cocaine blocks transporters in the brain from absorbing dopamine, HealthDay reports.
The mutations are found on two genes. The Ohio State University researchers found about one in three white people who died of cocaine abuse had these genetic mutations. A different combination of mutations affects the risk of dying from cocaine abuse in black people, the researchers noted in a news release.
The study appears in the journal Translational Psychiatry.

Prepaid Card Designed to Help Those in Recovery From Addiction Manage Money

Three men who met while in recovery have developed a prepaid card designed to help others who are recovering from addiction manage their money, the New York Daily News reports.
They have launched the Next Step Prepaid MasterCard, a reloadable card designed for people in recovery, and for those who are financially supporting them. The card gives family members and guardians control over funds, while teaching people in recovery how to manage their money, the article notes.
“When I left treatment, I spent hundreds of dollars on stupid things like Starbucks, just to fill a void,” said company co-founder Eric Dresdale, who started drinking in high school.
The primary account holder of the Next Step card is the parent or caregiver. The person in recovery receives a companion card, which can be used to make purchases. The card cannot be used at an ATM machine, or to get cash back at a store. It is not accepted at bars, casinos or liquor stores. “The truth is, if someone wants to buy drugs they will find a way,” Dresdale told the newspaper. “But we act as a hurdle from achieving that goal.”
Addiction specialist Dr. Paul Hokemeyer thinks the card can be a useful tool in recovery. “I think it’s a great tool to teach patients boundaries and limits,” he said.
The card’s activation fee is $9.95, and has a monthly maintenance fee of $14.95, compared with $3 to $5 for many other prepaid cards.