Wednesday, January 4, 2017

New Targets for Gambling Addiction

gambling addiction
Last October we cited research from over a decade ago, that had drawn parallels between gambling addiction and substance use disorders. Psychiatrist Hans Breiter conducted magnetic resonance imaging (MRI) scans on people playing slot machines, like the ones you find in casinos. The MRIs showed a similar picture to the scans of people using cocaine. And, just like drug addiction, gambling has the power to take everything from you; in effect, reinforcing the importance of continued research on the subject.

Breiter’s research was conducted in 2001, and it is fair to say that scientists' ability to probe the inner workings of the brain has greatly improved since that time. Hopefully, such improvements will help guide efforts to increase the effectiveness of gambling addiction treatments moving forward. The need for evidence-based treatment methods is vital, considering that more and more “baby boomers” are cashing in their 401Ks and heading to the casinos, finding themselves caught in the cycle of addiction.

New Targets for Gambling Addiction

It is no secret that casinos have a certain allure, one could hardly find an equal comparison, short of mind altering substances. People who go to casinos regularly will spend hour after hour hoping to hit a jackpot. Even after their money runs out, they will still feel a need to continue playing, and a persistent urge to find a way to do so, despite realizing the futility of continued play.

New research conducted by scientists at Imperial College London, has revealed targets in the brain that could advance gambling addiction treatment, according to a ICL news release. The researchers conducted MRI scans on nearly 20 gambling addicts, indicating heightened activity in the insula and nucleus accumbens when the participants experienced cravings. The study was published in the journal Translational Psychiatry.

Previous studies on the insula and nucleus accumbens, located in what is often referred to as our primal brain, have linked the two areas to substance use disorders. The areas are believed to be responsible for decision-making, reward and impulse control, the article reports. In gambling addicts, the researchers observed a weak connection between the nucleus accumbens and the frontal lobe, an area of the brain which plays a large role in decision making. Weak connections that could explain the link between cravings and relapse. The authors report that the frontal lobe may act as a checks and balances mechanism for the insula, leading to impulse control in healthy brains. And lack thereof in gambling addicts.

"Weak connections between these regions have also been identified in drug addiction. The frontal lobe can help control impulsivity, therefore a weak link may contribute to people being unable to stop gambling, and ignoring the negative consequences of their actions. The connections may also be affected by mood -- and be further weakened by stress, which may be why gambling addicts relapse during difficult periods in their life."

Strengthening Connections In Recovery

While there is still a lot that scientists do not understand about the biology of gambling addiction, people can, and do recover from the disease. If you are an older adult who has been struggling with gambling, please contact Hemet Valley Recovery Center and Sage Retreat. We understand that the later years of life can be a risky time when a comes to addiction, the result of changes such as retirement or loss of a spouse. Please understand that you are not alone, and at our older adult addiction treatment program, we can help you find your way on the path of recovery.

Wednesday, December 14, 2016

Monitoring the Future Survey On Drug Use

drug use
Preventing teenage drug and alcohol use is, and should be, a top priority among lawmakers and health experts in the United States. It is no easy task, but the mental health community knows that the longer one can refrain from using mind altering substances during the developmental stage of life, the less risk they have of battling addiction down the road. Naturally, there are always exceptions. A person can make it to their later years without abusing drugs or alcohol; only to have an injury, be prescribed opioid painkillers and develop a dependence/addiction.

There isn’t a formula for determining how or when a person will develop an addiction. To be sure, research can show us who is at greatest risk giving an indication of targets for prevention efforts. However, it is well known that addiction has the propensity to shine on anyone, regardless of age, race or gender. And it is the young people who are the greatest risks of forming an unhealthy relationship with drugs and/or alcohol.

With America in the throes of an opioid epidemic, it is easy to become fearful about what young people are experimenting with, as many drugs can lead to an overdose. However, opioids are taking lives every day of the week, it would seem young people are responding to education and prevention efforts. Researchers at the University of Michigan have released this year’s survey on teen substance use, with some encouraging findings.

Monitoring the Future

Every year, about this time, the Monitoring the Future survey is published, effectively opening a window on the mindset of young people regarding drug and alcohol use. The findings this year indicate adolescent drug and alcohol use rates have dropped dramatically, numbers that have not been seen since the early 1990’s, The Washington Post reports. Teenage cigarette, alcohol and illicit drug use are at historic lows—unparalleled since the pinnacle of the 90’s “war on drugs.”

In 2016, only 28 percent of high school seniors reported using cigarettes in their lifetime, compared to 63 percent in 1991, according to the article. The findings regarding alcohol use were just as promising, with a little more than 36 percent of high school students drinking alcohol in the previous year, compared to 67 percent in 1991. Illicit drug use (excluding marijuana) this year was low as well, with:
  • 5 percent of 8th graders reporting use.
  • 10 percent of 10th graders.
  • 14 percent of high school seniors.



Americans against the changing tides of marijuana acceptance in this country have long argued that legalization would lead to increased teen use. Which, when you think about it, seems to make some sense. However, the Monitoring the Future survey paints a different picture than you might expect. The findings indicate that teen marijuana use has stayed fairly level, despite legalization efforts, the article reports. Naturally, some experts are scratching their heads.

“We had predicted based on the changes in legalization, culture in the U.S. as well as decreasing perceptions among teenagers that marijuana was harmful that [accessibility and use] would go up,” said Dr. Nora Volkow of the National Institute on Drug Abuse (NIDA). “But it hasn’t gone up.”


Moving Forward

The data mined by researchers this year is great sign. Hopefully, the mindset of the 50,000 students who were interviewed for the survey holds course. It is also important to keep in mind that many teenagers are already struggling with addiction, a mental illness that will follow them into adulthood. It is paramount that young people living with addiction seek treatment and find recovery.

If you have a young adult child who is addicted to drugs and/or alcohol, please contact Hemet Valley Recovery Center & Sage Retreat. Our young adult program is centered on the various need needs and sensitivities of the emerging adult.

Tuesday, December 13, 2016


aging and substance abuseBy Louise Stanger, Ed.D, LCSW, CIP and Roger Porter

Like the Snow White parable, sometimes we look in the mirror and hope to see the fairest of them all. Instead, aging takes its toll and we see a wrinkly face and lines around our eyes. I know inside I feel like 35, yet the clock hands tell an older story…

Even though scientists claim 60 is the new 40 in part because of healthy living and medical breakthroughs, aging turns us from a well-oiled Corvette to a Model T Ford with creaks and groans. According to the Census Bureau, the baby boomer population - 78 million strong - will be over the age of 65 by the middle of the century. This means that 1 in 5 Americans will be a senior citizen - the largest group of older citizens in American history. With such a turn in demographics, it poses a challenging question for policymakers and behavioral health care professionals: how to take care of the aging population. More importantly, this population of aging Americans in particular are experiencing upward trends in substance abuse disorders. Alcohol is the most widely abused substance for Americans over the age of 50 while illicit and prescription drug use has spiked in recent years. In fact, elderly adults are hospitalized for alcohol problems as often as they are for heart attacks, according to the Champion Center - a treatment center for the elderly. These two forces - the greying of baby boomers and an increase in alcohol and other drugs amongst this group - are merging together and creating one of the fastest growing problems in our country.

There are a number of cultural trends, human behaviors, and gaps in the healthcare system that have contributed to the rise of alcohol and other drug abuse amongst the greying population. Aging adults experience life changes (sudden and otherwise) such as children growing up and moving away, death and loss of loved ones, and physical health issues (chronic pain, hip/knee replacements, etc.) that compound over time. If movement and change are the precursors to growing old, it’s no surprise the aging population is vulnerable to addiction.

However, it must be noted that the majority of the aging baby boomers who are admitted to treatment centers for substance abuse have been using illicit substances since their 20s and 30s. Now that they are in their 50s and 60s, they can no longer physically and mentally handle the effects of the substances on their bodies and must seek out treatment. First responders noticed this trend during medical emergencies because up to 14% of elderly emergency room admissions are due to alcohol or drug issues. “I think there is a tremendous denial that life is impermanent and we’re not going to be here forever. So we [baby boomers] continue to live like we’re in our 40s when we’re definitely not,” writes Patrick Arbore, the founder and director of the Center for Elderly Suicide Prevention and Grief Related Services at the Institute on Aging based in San Francisco.

The effects of illicit drugs and alcohol on aging individuals are particularly harmful because they can interfere with other common ailments like diabetes and depression, injuries can be much more severe, and these substances can cause problems when taken with other medications. With such complications, healthcare providers may be less inclined to encourage treatment options. For example, an older patient who can no longer drive or walk up-stairs may not be encouraged to attend Alcoholics Anonymous meetings. These issues raise questions about proper methods of treatment and efficacy in this population. And with 50% of people in nursing homes having alcohol-related issues, this is clearly an issue that is not going away.

Another issue that has contributed to this emerging epidemic is misdiagnosis. There are many reasons misdiagnosis occurs in this population, but perhaps the root cause is ageism. Since research is still being done on this growing issue, doctors and health experts can sometimes overlook the signs that an aging person is experiencing a substance abuse disorder. After all, it is believed the patient just wants to get “well” and giving pain medication as they heal is appropriate. As we have learned with the opioid crisis, many overlook that the health care system helped facilitate dependency due to over prescribing medications and the older adult keeps taking more and more medication because “my doctor prescribed it for me.” When they do diagnose correctly and advise treatment, some doctors and even family members believe quality of life will remain poor for the older individual because of their age or see it as futile because “they won’t be around much longer anyway.” Ageism can also be seen in the interpersonal level - in the elderly person’s family and friends. Many assumptions are made, including the assumption that there is no urgency to seek care for an aging loved one because it’s not seen as a severe problem the same way it is in younger adults because many believe that’s “just the way grandma is.”

Shame and stigma play a role - relatives of aging individuals with a substance abuse disorder often times avoid the issue or dismiss it with a different quality of life standard for older individuals. “Grandmother’s cocktails are the only thing that makes her happy,” is a common way of explaining the problem according to the National Council on Alcoholism and Drug Dependence. These same assumptions and trends even affect elderly individuals who are experiencing death and loss, whether it be a spouse or friend or other close family member. In fact, widowers over the age of 75 have the highest rate of alcohol addiction in the United States. And some - clinicians and families alike - even see treatment for addiction in the aging population as a waste of resources. This issue has come forth in the treatment facility community. For instance, entering a quick search for treatment facilities in your area will yield very few results for services that specialize in treatment for an individual over the age of sixty.

Even though there is evidence showing upward trends of substance abuse in the aging population, the issue remains largely invisible and goes underdiagnosed and undertreated, according to the National Center for Biotechnology Information on Substance Abuse Among Older Adults. The issue remains invisible because of the aforementioned misdiagnoses and cultural assumptions, as well as a lack of awareness. For example, a patient with a knee or hip replacement will take prescription opioids and could potentially develop an addiction. What started as a genuine pain management plan - compounded by life changes, other bodily ailments, genetic predisposition, etc. - turns into a serious problem. Add in the spiking opioid addiction problem due to overprescribing - 30% of prescriptions are for people 65 years of age and older - and it becomes clear this is an issue affecting millions of aging Americans.

Lastly, social workers, doctors, behavioral health care professionals and caregivers may shy away from asking elderly patients if they use alcohol and illicit substances. “I don’t think service providers are used to asking someone age 65 if they’re using illicit drugs. We need to make sure they are trained to ask,” says Patrick Arbore. There’s an assumption that aging Americans have passed this stage in their life. However, the only way light is shed on this issue is when caregivers are properly trained in this area so that direct and honest care is given.

One of the key ways to highlight the issues surrounding the aging population and substance abuse is through teams of trained medical professionals. Social workers in particular with their person-in-environment ecological approach are well suited to take the lead in designing interdisciplinary multi-modal teams trained in reducing the risks associated with aging and substance abuse disorders. Additionally, social workers can educate patients and clients as well as provide guidance to care providers on a wide variety of treatment options to serve the growing need.

Treatment facilities, likewise, need to be visionary and vocal in the healthcare community about expanding resources and treatment options available to this population. If you or an elderly loved one is experiencing addiction, it starts with recognizing this as a problem and seeking out the proper help. Treatment centers offer general support groups for all ages as well as peer groups for age-specific treatment options tailored to address many of the issues discussed above with the aging population. There are also Self-Help and 12- Step age-specific groups available, which help prevent relapse and play an integral part in support for long-term recovery.

Dr. Louise Stanger received her Bachelor’s degree in English Literature from the University of Pittsburgh, her Masters in Social Work from San Diego State College and her Doctorate in Educational Leadership from the University of San Diego. Her book Falling Up: A Memoir of Renewal is available on Amazon and Learn to Thrive - An Intervention Guidebook is available on her website

Roger Porter has two Bachelor degrees, film and marketing, from the University of Texas at Austin. He works in the entertainment industry, writes screen plays and coverage.

Thursday, December 1, 2016

A Newcomers Road to Long Term Recovery

People who are new to the rooms of recovery, may at times feel like they are on a different planet than they were before. In a room with a group of people who share a common experience, stories of both their life in addiction and in recovery are revealed. For over 80 years, people have worked with each other to abstain from alcohol or any other mind altering substance that has the power to ruin lives.

If you are in your first thirty days of sobriety, hopefully you have gone to the front of the meeting room to collect a “newcomer” chip. The newcomer chip may seem unimportant when compared to yearly anniversary chips, and some people in early sobriety may opt out or walking to the front to get an under 30-day sober chip. However, some would argue, and they would be right in doing so, the newcomer chip is the most important as it could be considered one’s first introduction to humility.

It takes a lot of courage to stand in front of a group of relative strangers, and identify as a newcomer. It is an action that says you are willing to put ego and every other potential shortcoming aside, declaring that you are in fact an alcoholic and/or addict. It says that you are ready to surrender, that your way isn’t working and that you are ready to do whatever it takes to be free from the bondage of self.

Perhaps you have witnessed someone pick up an anniversary or sobriety birthday chip, and maybe they were given a chip that acknowledges decades of abstinence. If so, you may have found yourself in awe. With your inner voice saying, “How?” The answer to that question, to the puzzle of how someone can abstain from drink or drug for multiple decades, is simple; you just keep coming back and don’t use drugs or alcohol no matter what.

Recovery is a gift that is given freely, but one that requires continued vigilance against the snares of addiction to hold onto. One manages to work a successful program of recovery by following in the footsteps of those who have walked the road before you. Those who have managed to acquire significant time in the program are fully aware of the fact that they cannot keep what they have unless they give it away. If you don’t have a sponsor, find someone with significant “time,” a person whose words resonate with you.

Long term sobriety is possible, and by continuing to practice the principles of recovery in all your affairs, you too may one day find yourself walking to the front of your homegroup to collect a chip acknowledging decades of recovery. You may find yourself in front of newcomers who are thinking exactly what you were thinking all those years ago. Recovery has the power to take a fragile newcomer and turn them into an inspiration to a new generation of recovering addicts and alcoholics.

But for now, next time you are at a meeting take stock of all the years of collective recovery in the room. People with decades, like Jeanne McAlister who just celebrated 60 years of sobriety, taking her last drink in 1956, The CW6 reports. She, like many with significant time, chose to use her recovery to help others, founding an addiction treatment center in San Diego in 1977.

At Hemet Valley Recovery Center and Sage Retreat, we would like to honor Jeanne McAlister steadfast dedication to helping others find the gifts of recovery.

Friday, November 18, 2016

Facing Addiction in America

Addiction is a clinically accepted form of mental illness, a debilitating disease of the brain that can steal everything good from you—even your life. Certainly, people have been dying from alcohol and tobacco related complications for millennia, even though those substances are typically legal for adult consumption in today’s world. When that occurs, it is not uncommon for members of the general public to think that they died from a character flaw that they were unable to change. It is a line of thinking that could not be further from the truth, a veritably “flawed” line of reasoning, to be sure.

For nearly twenty years, Americans have been battling with opioid addiction. Rampant over-prescribing of opioid painkillers resulted in over two million people developing an opioid use disorder. Efforts to alter prescribing practices in America, via putting ceilings on the number of pills that can be prescribed and the duration of a prescription, did manage to reduce prescription opioid abuse in the United States. However, making it more difficult for Americans to acquire opioid painkillers, resulted in the creation of a vacuum, which in turn led to a scourge of heroin abuse and the importation of even more deadly opioids.

The Great Lengths of Addiction


Attempts at curbing the American opioid epidemic, in some ways, is analogous to playing a game of Whack-o-Mole—only with a darker outcome. Making it harder to get prescription opioids, only served to create a larger demand for heroin, fentanyl and other synthetic opioids. In many cases people with an opioid use disorder traded deadly drugs for even more deadly narcotics. Fentanyl is 100 times more potent than morphine and 80 times stronger than medical grade heroin. Law enforcement officials and medical professionals have seen a surge in fentanyl abuse and subsequent overdose deaths.

If fentanyl weren’t scary enough, it turns out that there are even more deadly opioid narcotics that can be acquired with ease and in some cases, legally over the Internet. The drug we are referring to is carfentanil, which is 10,000 times more potent than morphine and should only be used for sedating large animals, such as elephants. Yet, Americans are ordering the fentanyl-analog online to be used by humans.

The behaviors being exhibited is nothing short of mind-boggling. Just a pinhead sized amount of carfentanil touching the skin can be lethal, nevertheless people are still taking the risk. It just goes to show that you make it next to impossible for an addict to get their hands on a particular mind altering substance, and they will find a way to maintain their addiction. Risk of life is seemingly of little consequence. With such great stakes at risk, it is hard to view addiction as being a mere character flaw, rather than a mental illness or disease of the mind. People will go to extraordinary lengths to avoid opioid withdrawal symptoms. Which is why we need to put more emphasis on treating addiction, rather than making it harder to get drugs or punishing those who are afflicted by the disease.

Viewing Addiction Differently


Addiction is a disability that affects millions of Americans each year, thousands of which will not live to see the end of the year. Instead of looking at or talking about addiction as being a moral failing or a character flaw, we need to look at addiction the same way we would any potentially fatal disease. Just like a diabetic requires insulin maintenance to live, an addict requires treatment, followed by a lifelong course of spiritual maintenance.

The U.S. Surgeon General, Dr. Vivek Murthy, released a report on addiction: A call to action that demands we look at addiction as what it really is—a mental illness. In "Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health," Murthy points out that for every dollar spent on addiction treatment services, saves $4 in health care costs and $7 in criminal justice costs every year, according to USA Today. The Surgeon General's report calls for a paradigm shift regarding how society looks at addiction. Murthy would like to see the end of stigma and discrimination—seeing fewer prisoners and more patients.

“We have to recognize (addiction) isn't evidence of a character flaw or a moral failing,” Murthy said. “It’s a chronic disease of the brain that deserves the same compassion that any other chronic illness does, like diabetes or heart disease.” 

Please take a few minutes to watch the video below:

If you are having trouble watching the video clip, please click here.

At Hemet Valley Recovery Center & Sage Retreat, we offer a full continuum of care including: Acute Medical Detoxification, Rehabilitation, Residential, Partial Hospitalization and Recovery Residences.

Please contact Hemet Valley Recovery Center & Sage Retreat 866.273.0868 to begin the journey of recovery.