Category Archives: Addiction Courses

Drug Abuse in South Africa at Alarming Levels

December 3, 2014

The Magnitude of Drug Abuse in South Africa

South Africa is experiencing a rise in drugs abuse. In recent years the trend in alcohol abuse as well as other drugs has been alarming. Alcohol is still the primary drug of abuse and use is rising every day. In 2011 the world health organization (WHO) reported that South Africa has the highest per capita consumption rates in the world of alcohol in the world and it is quite insane that the rate is continuing to rise. In South Africa the citizens consume in excess of 5 billion litres of alcohol annually but this figure is likely to be higher still if sorghum beer is included, and equates to 9 – 10 litres of pure alcohol per person. Despite alcohol being the primary drug of abuse there are other drugs that are used by the South Africans as well. These drugs include Methaqualone (Quaaludes), cocaine, marijuana popularly known as dagga in South Africa, and heroin are all drugs that are becoming increasingly popular in the cities of South Africa.

There have been drastic political changes in  South Africa  that have been accompanied by social transitioning, rapid modernization, high unemployment rates, and a decline in social, cultural, and family values. As a result, drug use has flourished and new environments, such as night clubs, that promote drug use have been created. These environments appear especially promising for adolescents and young adults looking for an escape. It is in these places that drugs look cool and casual sex is acceptable. Unfortunately, these places are a haven for heavy drug abuse and diseases; such as, HIV and AIDS. Needless to mention, South Africa has become a major country involved in international drug trafficking networks over the past decade. Experts have agreed that it is becoming harder and harder to deal with the explosion of the drug trade and it links are becoming increasingly complex to tame.

South Africa

Here are statistics of the most abused drugs in South Africa over the past years. These statistics are from the World Health Organization (WHO). However there might be some changes on the statistics as the use of drugs of abuse in South Africa is increasing at such a rapid rate.

South Africa drugs of abuse stats according to WHO

The World Health Organization (WHO) reports that drug consumption in South Africa is twice the world norm. It is saddening to note that 15% of South Africa’s population has a drug problem. The cost associated with drug abuse is crippling the South Africa’s economy. This is evident as the country spends R20-billion a year and could pose a bigger threat to the country’s future than the Aids pandemic. According to SAPS figures, 60 percent of crimes nationally were related to substance abuse, this shows the cost of drugs of abuse in relation to the social ills they cause. Just as it happens everywhere, addicts will go through all odds to afford the drugs they have become dependent on and crime is the immediate step the youths take to buy their daily dosage of these drugs. In the Western Cape, the figure was closer to 80 percent that shows that Western Cape is the most affected area.  The perpetrators of these crimes are either under the influence of substances, or trying to secure money for their next fix. The use of drugs has also increased prostitution as most of the prostitutes have to sleep with 10-15 men daily to find enough money to buy their drugs of abuse.

 SANAB disbanded

The use of drugs and related crimes have increased greatly, by 30% to be exact after the government disbanded   SA Narcotics Bureau (SANAB) which was  a dedicated drug-fighting unit within the SAPS that had achieved some notable successes. The SANAB was disbanded in 2004 and no other body has sprung to fill the vacuum.

Recently the United Nations World Drug Report had named South Africa as one of the drug capitals of the world. The abuse of alcohol and usage of dagga has led to the country to being one of the top ten narcotics and alcohol abusers in the world. The CDA also reports that one Rand in four in circulation in South Africa is linked to the substance abuse problem. CDA is a drug control organization. The increase in drugs use is also evident in the increase of number of drug arrests from a mere 300 in 2006 to a staggering 1500 in 2012 in Cape Town.

Teenagers are not left out

The CDA reports that alcohol use is common in school kids and most kids who are involved in alcohol abuse are involved in violent crimes 3 times more than kids that are not involved in drug abuse.

South Africa

It also points at the increase in drug use among teens.  As from 1992 – 95 the use of drugs among teenagers increased by 600%. But the figure is still increasing as evident in 2007 when it stood 1100%.  Most kids begin using drugs of abuse at the age of twelve, the CDA report of 2009 revealed that schools have become a target for drug dealers.

A part from alcohol drugs that are widely abused in SA include;

Methamphetamine (Tik)

  • Crack
  • Heroine
  • Cocaine
  • Mandrax
  • Dagga
  • Ecstasy

Finally, We at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts by availing some of the most integrative approaches to healing an addict. We advocate for natural healing to all kinds of addiction. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

The Magnitude of Drug Abuse in South Africa

 

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Substance Abuse and HIV/AIDS among Urban Minority Youth

December 2, 2014

How to Prevent Substance Abuse and HIV/AIDS among Urban Minority Youth

Substance abuse and HIV/AIDs are major problems that the urban minority youth have to face daily. Substance abuse among the urban minority youths has been linked to many societal ills including theft and robbery, the urban youth minority that are involved in substance abuse face some of the toughest life choices especially after becoming dependent on the drugs of abuse . once they have got dependent on the drugs of abuse they will find it hard to supplement most of their daily needs as in most cases drug addicts are avoided by employers, once jobless and the heightening cravings for the substances of abuse they will turn to some other ways of finding their daily supply of the drugs that they use. Turning to robbery has become one of the immediate choices that they bump into and hence they become a problem that the whole society suffers from. In most cases the youths may be felled by police bullets while escaping from crime scenes and some who are lucky will be sent to rehabilitation centers and that in itself affects the economy of a country as the country will spend more on these centers sometimes having to forego other expenses just to cater for the youths.

The biggest problem with the urban minority youths is their environment. Most of the people they interact with especially through the media lead lives of drug abuse, most of these youths are driven by their love for certain genres, they therefore idolize such artists so much that they will want to lead a life like theirs, this is a great problem having drug users as role models therefore there is need for educating the youths to stay away from drug use through the use of messages that may be sent through broadcast media such as radio and television. The urban minority youths needs to access relevant information that may help them stay away from drug abuse.

HIV and Youth Statistics

The urban minority youths are also involved in active sex. In most cases these youths do not get serious with their relationships, these relationships are sex based and having one night stands with different women is something that these youths take pride of. It is the involvement of these youths with multiple sexual partners that put them at high risk of contacting HIV/AIDS.  The urban minority youths need access to drug abuse and HIV/AIDS preventing messages in their immediate environment. Painting walls and having these messages artistically inscribed on the walls can be a good way to market this ideology and help the youths know of the dangers of drug abuse and involving oneself in risky sexual behaviors such us having multiple sexual partners. Other ways that can help these youths to stay away from drug abuse and HIV/AIDS may include:

Evidence-based prevention protocols

In a research study done to assess whether evidence-based prevention protocols could positively influence substance abuse and HIV/AIDS knowledge and reduce sexual risk-taking behaviors among urban minority youth by the by the U.S. Centers for Disease Control and Prevention (CDC) and the Center for Substance Abuse Prevention (CSAP) dubbed Be Proud! Be Responsible! CASASTART; Focus on Youth; and Street Smart. This research study that involved sessions comprised of six, 50-minute modules that incorporated role-plays, discussions, and multimedia formats to actively educate and engage youth in prevention activities.

This study used the National Minority Substance Abuse / HIV Prevention Initiative Cohort 7 Youth Questionnaire. The National Minority Substance Abuse / HIV Prevention Initiative Cohort 7 Youth Questionnaire was developed by CSAP as part of a national cross site evaluation of all Minority AIDS Initiative (MAI) funded programs throughout the United States. Sexual risk behavior served as the outcome variable, with the following ten predictors being assessed for the study: disapproval / alcohol use, school importance, delinquency/crime, disapproval / tobacco use, disapproval / marijuana use, illicit drug use, stress- related alcohol and drug use, HIV/AIDS knowledge, HIV/AIDS testing, and negative peer attitudes.

The findings of the study showed changes in pre and posttest measures which revealed that participants who were at heightened risk were also more inclined to get tested for HIV/AIDS after receiving the intervention (95% confidence level). At posttest, an increase in HIV/AIDS knowledge seemed to have a buffering effect against risky sexual behaviors. Additionally, participants who thought of school more favorably were less likely to engage in sexual risk taking behaviors at posttest (95% confidence level). This study therefore showed the importance of educating the urban minority youths and creating awareness of the dangers of drug abuse and HIV/AIDS as paramount to fighting these two vices in the urban minority youths.  The intervention used the pretest-posttest design and worked with four urban high schools and five summer camp programs located in the Northeastern United States having a total of 653 African American and Hispanic/Latino youth, ranging in ages from 13 to 18.

hiv

Promoting Talent

The youths have talents that need to be exploited in a bid to find avenues though which the drug abuse and HIV/AIDS prevention messages can be spread. Apart from using their talents as a media through which this message reach many people it also keeps them occupied and gives them a reason to focus more in their own developments other than indulging in drug abuse and risky sexual behaviors.

Finally, Dr. Dalal Akoury (MD) of AWAREmed Health and Wellness Resource Center is committed to availing help to addicts by availing some of the most integrative approaches to healing an addict chained to any behavior. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

How to Prevent Substance Abuse and HIV/AIDS among Urban Minority Youth

 

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Severe Mental Illness and Substance Abuse

December 1, 2014

Persons with Severe Mental Illness Are Prone To Substance Use

Severe Mental illnessPeople with severe mental illness (SMI) are more prone to substance abuse than those who are not suffering from severe mental illness. Both epidemiological and clinical studies that have been done on this have attested to this fact. The findings of these researches have also pointed out that Individuals diagnosed with SMI are also at greater risk of hospitalization, homelessness and suicide and experience more difficulty in different spheres of their lives. Most studies have shown that individuals with SMI are more prone to substance abuse. However other studies that have been done on the same issue have not linked the two phenomena. The substances used most frequently by persons with SMI are alcohol, followed by cannabis and stimulants. Sedatives and hallucinogens are used less frequently by those with SMI. Amphetamine use is greater in persons with psychotic disorders compared with the general population. Studies have shown that both cannabis and, to a greater extent, amphetamines can provoke psychosis. Because individuals do not use cannabis or amphetamines alone, but use them in combination with several other substances, examining the effects of the use of a specific substance on mental illness is particularly challenging. A review showed that substance use has adverse long-term effects on cognitive functions in persons with SMI. The substance that has been found to affect the individuals most negatively is alcohol while cannabis use has little influence on the cognitive functions of the individuals.

Several studies have shown that many people with SMI tend to achieve full remission of their substance use while others relapse frequently. Research from different treatment settings indicate that 30 per cent of those with less severe mental illness and heavy substance use attain sustained remission, while up to 60 per cent of those with SMI and less severe substance use attain sustained remission.

There is however a lack of studies on how persons with SMI experience abstaining from substance use. Nevertheless, research on substance use by clients without the comorbidity of mental illness indicates that social support is important to successful change in behavior of these people. Clients claim that they benefit from interventions that address their multiple recovery issues as opposed to ones that emphasize recovery strictly in sobriety terms. Another qualitative study has noted the participants’ view that highly structured programs and cognitive behavioral techniques are crucial to achieving abstinence. Not only is sobriety a lifelong struggle for many clients, but also is perceived as a challenging state because of the risk that the person becomes complacent after achieving sobriety. This may indicate a need for substitute dependency to maintain the abstinence.

It is of importance to examine how individuals with a psychotic disorder experience quitting substance use and to investigate reported experiences of former abstinence periods by participants still using substances. Two qualitative studies with a primary focus on how persons with SMI experience abstaining from substance use have reported that clients view substance use as one of many sources of difficulty over a troubled life course and that social support is critical to staying clean, lack of support in most cases makes it difficult for these individuals to quit using these drugs. One ethnographic study of clients’ perspectives showed that giving up substances was seen as a source of both pleasure and pain, and presupposed a certain level of rationality.

Study findings

In a study done by Henning Pettersen, Torleif Ruud, Edle Ravndal and Anne Landheim with an objective to find out experiences of abstaining from substances of persons diagnosed with SMI. They examined both the reasons given and the requirements and strategies used when abstaining. The main reasons for quitting substance use were social relationships and meaningful activities. It was found that the stated requirements and strategies used in the search for sobriety were detachment towards people and places, positive thinking, controlling feelings and emotions, and fear of dependency. A qualitative study with semi-structured interviews was conducted, and a descriptive and explorative design was applied. This study included a purposeful sample of 11 patients with SMI and substance use being treated by assertive community treatment teams. Henning et al concluded that the results from this study are consistent with those from other qualitative studies on the importance of social relationships and meaningful activities as expressed reasons for abstaining. The strategy of actively avoiding a former adverse milieu to reach sobriety is consistent with findings from one similar study. The strategies of fear of adverse consequences, positive thinking, and controlling feelings and emotions found in the present study have not been reported by other qualitative studies.

The study had eleven participants of which nine were men and two were women. The ages of the participants were between 27-63 years. Most of the participants had a diagnosis of schizophrenia or schizoaffective disorder, but persons diagnosed with bipolar disorder or an unspecified psychotic disorder also participated. For most participants, SMI had preceded their substance use. The treatment of the participants took duration of between 14-30 months after the first interview.

Severe Mental illnessCannabis and amphetamine were the main substances used in the study but alcohol and other prescription drugs were also used to a lesser extent. However most of the participants used a combination of the substances. At the time of the study four of the participants were abstaining from substance use. Their abstinence periods ranged from 3 to 18 month. At the time of the first interview seven of the participants were still using substances. By the second interview, the abstainers were still abstinent and the users had continued their use. The abstaining group and the group of users did not differ significantly in their psychiatric diagnosis or history of substance use. The 11 participants shared their experiences of shorter and longer periods of abstaining from substances. Some of them talked of their abstaining periods retrospectively, and some were abstaining at the time of the interview. From the findings of this study it is therefore safe to conclude that people suffering from SMI are more prone to substance abuse than people who don’t.

Finally, We at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts by availing some of the most integrative approaches to healing an addict. We advocate for natural healing to all kinds of addiction. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

Persons with Severe Mental Illness Are Prone To Substance Use

 

 

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Addictions and the Internet

December 1, 2014

The Potential of Web 2.0 Internet Technologies in Enhancing Treatment for Alcohol/Other Drug use Problems

Addiction and the internetOver the past decade there has been proliferation of e-health applications across disease categories. With the emergence of the next generation of Internet-based applications, Web 2.0, there are increasing opportunities for integrating these technologies into treatment approaches for alcohol/other drug use problems, in a way that engages and empowers like never before. No evidence currently exists to demonstrate the benefits of Web 2.0 applications, such as social networking and social media, on alcohol/other drug use problems. However, social learning and influence theories point to the possible mechanisms of action and effectiveness. More research is urgently required to examine the potential of Web 2.0 applications on alcohol/other drug use problems.

The internet has become very useful today. All information is sought online and medical information is no exception. As is evident the social platforms that came with the digital age are not only used to chat and catch up on social issues but have become a very valid platform through which professionals seek ideas and debate on crucial issues that are very important to their careers. The internet has become unequalled hub of information where professionals seek information and share ideas. Likewise patients have also found the internet a good place to air their concern and this has been boosted by the fact that you can be anonymous and still have your problems solved by professionals who may question and answer columns on their websites or blogs. The internet has the advantage of speed, unlike looking for information in a library full of books where you have to go through table of contents of many books to find what you want you just write the keywords on the search pane on the search engines like Google, Bing or Yandex and then the information will be brought within seconds. Even with many choices to select from you can still refine your search by keying in specific keywords that will make your search more local hence very effective. Today most internet users seek health information from the internet, it is estimated that 80% of internet users in America seek health information from the internet and 59% of them are adults.

The youth form the majority of the internet users, it is estimated that 71% of these youths seek health information online. Right now apart from email and search engines use, health information searching is the most popular activity for adults. There are also many forums that are created on online communities like Facebook and twitter that people use to access health information. On these sites people of like mind come together discuss their health problems and find solutions to their problems and drug addicts are no exception. The internet is a platform for seeking information but as it stands right now drug and alcohol addicts can get computerized treatments. Research testing the efficacy of computerized psychological treatments for alcohol and drugs addiction revealed that when coupled with weekly therapist support the computer-delivered alcohol and drugs treatment can be as effective as face to face treatment. With technology based for depression, it has been found that coupled with guidance it works twice better.

The web 2.0 technology

The emergence of web 2.0 technology may find the best solution that incorporates all the convenience and efficacy to the internet based treatment delivery while providing a platform for the development and maintenance of social connectedness and support which is key in achieving effectiveness in online computer-delivered treatments. However as stated earlier there is still little research reports that have been published on the subject of alcohol and other drug use and how they can be treated. But scientists opine that the web 2.0 has applications such as the social influence tool that can be useful in alcohol and other drugs use and treatment. This application allow individuals to learn in a more social context with changes in opinions, feelings , attitudes, thoughts and behavior as a result of group discussion. Interacting with like-minded individuals in the group helps in educating a person more on the issues of alcohol and other drugs abuse and how they can be treated.

internet
This application will help individuals to know more about drugs and alcohol before they begin using them. It is a known fact that most people who are now addicted to alcohol and other drugs of abuse were exposed to environments where these drugs were used, having a social forum where adolescents can seek information and learn about the dangers of alcohol and other drugs abuse they will stay away from the abuse of alcohol and other drugs. Many youths now stuck in the use of drugs began using the drugs when they were cajoled by friends who told them that using drugs of abuse is ‘cool’ and so they knew all the good things associated with drug abuse but no one ever told them the dangers of these drugs on friendly and in social context as they will learn on the web 2.0 applications. It is a known fact that adolescents listen to their peers more than they do to their parents and therefore the adolescents are led into using these drugs by their peers. The internet therefore presents an alternative interactive platform where these adolescents can seek information and guidance from health practitioners.

Finally, We at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts by availing some of the most integrative approaches to healing an addict. We advocate for natural healing to all kinds of addiction. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

The Potential of Web 2.0 Internet Technologies in Enhancing Treatment for Alcohol/Other Drug use Problems

 

 

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Dopamine and RDS

December 1, 2014

Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome

dopamineDopamine is crucial neurotransmitter and hormone in the body. This hormone serves many purposes. It plays a role in the pleasure and reward pathway of the brain as well as in memory and motor control. And any decline in this hormone presents the body with myriads of ill-health conditions. This hormone however is greatly affected by drugs of abuse, most drugs that are taken to produce induced euphoric feelings in a person works in such a manner that they increase the production of the dopamine neurotransmitter, when this neurotransmitter is produced up to certain levels it will get depleted in the long term and hence the problem sets in. Specifically, the euphoric properties of cocaine and other drugs of leisure lead to the development of chronic abuse, and appear to involve the acute activation of central dopamine (DA) neuronal systems. They proposed that DA depletion results from overstimulation of these neurons and excessive synaptic metabolism of the neurotransmitter. When this happens may suffer ill-health conditions. These may include; poor nutrition, stress, lack of sleep and the habitual use of antidepressants, symptoms such as depression, mood swings, poor attention and food cravings will also occur. Some of the major symptoms of dopamine deficiency are depression, chronic boredom, and a loss of satisfaction, apathy, chronic fatigue and low physical energy with no desire to exercise the body. To correct these problems, it is necessary for this hormone to be supplemented so that the normal levels are restored. In addicts the use of buprenorphine to treat opioid dependent individual is common and is approved by the FDA. While to many people it has been working well with many studies supporting its use has now been reported that using buprenorphine for a long time will jeopardize the life a person as cases of severe withdrawal symptoms have been common. Researchers have found it necessary to embrace genetic testing to reveal reward circuitry gene polymorphisms especially those related to dopaminergic pathways as well as opioid receptor(s) as a way of improving treatment outcomes.

Researchers have currently proposed the use of dopamine agonists instead of antagonists like buprenorphine that is mostly used with naloxone can offer long term solution to dopamine deficiency. While it is well established that dopamine deficiency or a hypodopaminergic trait leads to aberrant substance seeking behaviors (RDS) and intact mu opiate receptors are important for maintaining “dopamine homeostasis”, scientists have suspected that opioid-dopaminergic interaction must be involved in buprenorphine response. In this regard they have provided some evidence that a putative dopamine agonist, KB220Z shows long-term potential as an opioid replacement compound especially in subjects having a genetically determined hypodopaminergic trait like RDS.

In a research study done by Kenneth Blum, Marlene Oscar-Berman, William Jacobs, Thomas McLaughlin and Mark S. Gold, it was found that dopamine genes can affect clinical outcomes in reward deficiency syndrome and therefore it is safe to use less powerful dopamine agonist dopaminergic genes in helping patients with low dopamine levels on a long-term basis.

Dopamine agonist therapy

Based on these earlier studies both Blum et al has continued to propose dopamine agonist therapy rather than dopamine antagonistic therapy currently favored by the approved FDA drugs as medical assisted treatment. Specifically, they proposed that D2 receptor stimulation can be accomplished via the use of KB220Z which is a complex therapeutic nutraceutical formulation that potentially induces DA release, causing the same induction of D2-directed mRNA and thus proliferation of D2 receptors in the human. This proliferation of D2 receptors in turn will induce the attenuation of craving behavior. In fact, this model has been proven in research showing DNA-directed compensatory overexpression which is a form of gene therapy of the DRD2 receptors, resulting in a significant reduction in alcohol as well as cocaine craving behavior in alcohol and cocaine preferring rodents.

This research done by Blum and his team suggested that utilizing less powerful dopaminergic repletion therapy to promote long term dopaminergic activation will ultimately lead to a common, safe and effective modality to treat Reward Deficiency Syndrome (RDS) behaviors including Substance Use Disorders (SUD), Attention Deficit Hyperactivity Disorder (ADHD), Obesity and other reward deficient aberrant behaviors. This concept is further supported by the more comprehensive understanding of the role of dopamine in the NAc as a “wanting” messenger in the meso-limbic DA system. This team had a hypothesis that D2 receptor stimulation signals negative feedback mechanisms in the mesolimbic system to induce mRNA expression causing proliferation of D2 receptors.

dopamineAs revealed by the researchers stress and dopamine D2 receptor levels play a significant role in alcohol seeking behaviors. Another researcher Delis and his team observed that in the presence of a stressful environment, low DRD2 levels are associated with increased ethanol intake and preference and that under this condition, increased ethanol consumption could be used as a strategy to alleviate negative mood this also supports dopamine agonist therapy not antagonistic. It is therefore safe to use dopamine agonists instead of dopamine antagonists in treating those with low dopamine levels as they are much safer.

Finally, We at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts by availing some of the most integrative approaches to healing an addict. We advocate for natural healing to all kinds of addiction. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome

 

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