While you may not have heard about synthetic cathinones or synthetic cannaboids, many teenagers and young adults have, and it's become a growing issue for their health and well-being. In fact, nearly one in nine high school seniors have gotten high on synthetic drugs, such as “K2” or “Spice,” second only to the number of teens who have used marijuana.
“Monitoring the Future,” the nation’s most comprehensive survey of teenage drug use, found 11.4% of the high school seniors questioned had used the synthetic substances, often packed as potpourri or herbal incense and sold in convenience stores, which mimic the effects of marijuana.
At convenience stores, smoke shops, and similar type establishments, synthetic cathinones are often sold as “bath salts” or “jewelry cleaner.” On the packages, these substances are labeled “not for human consumption” to hide their intended purpose and avoid Food and Drug Administration (FDA) regulatory oversight. However, these dangerous substances are steadily growing in abuse by teens and young adults.
Synthetic marijuana is a designer drug whose purpose is to imitate cannabis. The cannabinoid compounds present in synthetic marijuana act on the same cell receptors as those affected by THC in natural marijuana, however the similarities often end there. Manufacturers take herbs, incense, or other materials that mimic leaves and spray them with lab-synthesized liquid chemicals.
The U.S. Substance Abuse and Mental Health Services administration indicates that the chemicals used in synthetic pot offer no medical benefit to users and these substances actually have a higher potential for abuse among users.
Bath salts are crystalline powders, typically taking the form of a white or brown powder, similar in appearance to Epsom salts, thus the name. These powders, which are sold in small plastic or foil packages, have similar effects to stimulants like cocaine, meth, or MDMA.
Research has shown that synthetic cathinones, such as bath salts, have an extremely high abuse and addiction potential. Compounding the situation even further, bath salts contain chemical compounds that were never developed for human consumption that can create their own dangerous effects as well. Very little is known how the body processes these chemicals and what the long term effects will be.
According to the Office of National Drug Control Policy, the contents and effects of synthetic cannabinoids and cathinones are unpredictable due to a constantly changing variety of chemicals used in manufacturing processes devoid of quality controls and government regulatory oversight.
Health warnings have been issued by numerous public health authorities and poison control centers describing the adverse health effects associated with the use of synthetic drugs.
Similar to the adverse effects of cocaine, LSD, and methamphetamine, synthetic cathinone use is associated with a variety of health issues such as:
Synthetic cannabinoid side effects meanwhile can include:
Reports of severe intoxication and the dangerous health effects associated with synthetic drugs make this a growing public safety and health issue. How these substances react with other drugs, whether prescribed or illegal, make the side effects even more serious and difficult to treat.
Alarmingly, these drugs are shown to be popular with young people. Research from the National Institute on Drug Abuse indicated that, of the 11,406 ER visits associated with synthetic pot, 75% were between the age of 12 and 29.
These substances appear to be popular with teens and young adults due to their accessibility. Synthetic substances do not require stealing prescriptions, or the risks associated with purchasing illegal substances from a drug dealer.
Also readily available for Internet purchase, synthetic drugs represent a dangerous trend in substance abuse. Despite recent temporary bans of selected ingredients by the U.S. Drug Enforcement administration (DEA), many synthetic drugs remain legal due to the hundreds of formulas in existence. And because they are often legal, many young adults may not perceive these substances as dangerous.
Synthetic drugs are especially problematic for those who already have addiction issues and/or other mental health conditions. These substances are extremely addictive, and the effect of the comedown and/or withdraw, especially in the case of bath salts; can be dangerous for the user as well.
If you or someone you know needs help with addiction, please contact The Meadows at 800-244-4949. If you are a young adult struggling with these substance abuse problems, please visit Dawn at The Meadows or call 855-333-6075 to learn more.
By Wally P.
On pages 13-14 of the "Big Book" of Alcoholics Anonymous, we read that Bill W., while in detox at Towns Hospital in New York City, took the Steps in one day, recovered, and never drank again. In the chapter titled, "A Vision for You," we learn that Dr. Bob relapsed after a couple of weeks on the program because he had not made his amends. He made them in one day and never drank again. Later in this chapter, we find that Bill D. is taken through the steps in a couple of days while in detox at Akron City Hospital. He too never drank again. In the story, "He Sold Himself Short," Dr. Bob took Earl T. through the Steps in "three or four hours." The pioneers repeated this simple and straightforward process hundreds of thousands of times during the "early days" with remarkable success.
In a talk Bill W. gave in Hollywood, CA in 1951, he said, "Don't make a project out of working your steps. Go through your day being the sort of person you would like to be, trying to help someone else, and making sure you don't hurt anyone. And when you get to the end of your day, review the Twelve Steps and you'll find that you've worked them all."
I know there are those who are skeptical that the Steps are simple and meant to be taken quickly and often. At one time, so was I. Then someone pointed out to me that the words used in the "Big Book" to describe taking Steps One through Nine are "next," "at once" "immediately," and "we waste no time."
Recently, a friend told me the reason he takes newcomers through the Steps quickly. He described it in terms of"the window of opportunity." He explained this "window" something like this:
When a newcomer enters the Twelve-step community, whether from a treatment center, detox, or the street, he or she passes through a "window of opportunity" - a time when he or she is most "teachable." How long does a person remain in this state? In other words, how much time does it take a newcomer to realize the pain he or she is experiencing in recovery is greater than the pain he or she remembers when using? How much time do we have to alleviate this pain?
Do we have a year? Absolutely not! Do we have a month? Sometimes we do, sometimes we don't. Do we have a week? For many, that may be pushing it. What if we only have today? What if we assume the newcomer is going to relapse tomorrow (and in many cases this is true). Why not take him or her through the Steps today in order to prevent that relapse tomorrow?
I personally experienced this "window of opportunity" on September 11, 2001. I had conducted a seminar in Austin, TX the previous weekend and was to speak at two treatment centers in the Texas foothills that day. I had not seen any television, but over the radio I did hear about the Twin Towers coming down and the Pentagon being attacked.
At the second facility, as I started into my scheduled history presentation, a young man in the back of the room raised his hand. I asked if I could help him and he said, "Wally, we are in a lot of pain here today. We don't know what's going on, but we do know it is bad. We need some relief. We know you take people through the Steps. Can you take us through the Steps right now?"
I could have said, "Wait until you get out of treatment. There are Beginner's Meetings in Kerrville. There you can take the Steps in a month or so."
Instead, I turned to one of the counselors and asked, "What do you think?" He answered my question with one of his own. "How many times have you done this?" To which I replied, "This would be the first." "Then go for it," he said.
I matched everyone up as sharing partners and took them through the first three steps in about 10 minutes. Then I explained the Fourth Step inventory and asked each of them to share with their partners, for the next 10 minutes, what was bothering them. They spread out to do their one-on-one, mini Fifth Steps.
I reconvened the group and took them through the next four steps. I then explained the Eleventh Step, had them get quiet for five minutes, and asked them to share what had come to them during their "quiet time."
I finished up with the Twelfth Step question. After the residents acknowledged they would carry this simple message to others, I looked at my watch. I had taken everyone in the room through all Twelve Steps in 52 minutes.
How thorough was this "Introduction to the Twelve Steps?" It was thorough enough to demonstrate the simplicity of the process. It was thorough enough to move people out of the problem and into the solution. It was thorough enough to give them the confidence to go through the Steps again and again.
Since that monumental day, I have made this "Introduction to the Twelve Steps" hundreds of times at treatment centers, correctional facilities, and recovery workshops and conferences around the world. Many thousands have had their lives changed as the direct result of this "keep it simple" approach to recovery.
About the Author
Wally P. is an archivist, historian and author who, for more than twenty-three years, has been studying the origins and growth of the Twelve-step movement. He is the caretaker for the personal archives of Dr. Bob and Anne Smith. Wally conducts history presentations and recovery workshops, including "Back to the Basics of Recovery" in which he takes attendees through all Twelve Steps in four, one-hour sessions. More than 500,000 have taken the Steps using this powerful, time-tested, and highly successful "original" program of action.
Wally P. will be the featured presenter at the 2013 Alumni Retreat on Friday on January 25.
The Meadows will host Recovery Comedy with Kurtis Matthews on December 31 at The Meadows to entertain patients and staff. This event is not open to the public. Using his struggles with infidelity, alcohol and drugs to enrich his material, Matthews makes audiences laugh while inspiring them to be better people.
In 1984, Matthews began his stand-up career at the Improv in Hollywood. That same year, he also embarked upon his own journey in recovery from alcoholism after an automobile accident that resulted in his second DUI and jail time. Touring alongside such renowned comedy veterans as Bill Hicks and Sam Kinison, Matthews learned the joys of making people laugh, as well as the challenges of staying sober while doing so.
"We know being in treatment during the holidays can be difficult and the holidays overall can often be a challenge to those in recovery," said Sean Walsh, The Meadows Executive Director. "At The Meadows we not only want to assist our patients and family members to ensure this will be the first of many healing and healthy holiday seasons, but also to remember the power of laughter and learning to incorporate fun into recovery."
The Meadows is an industry leader in treating trauma and addiction through its inpatient and workshop programs. To learn more about The Meadows' work with trauma and addiction contact an intake coordinator at (866) 856-1279 or visit www.themeadows.com.
For over 35 years, The Meadows has been a leading trauma and addiction treatment center. In that time, they have helped more than 20,000 patients in one of their three inpatient centers and 25,000 attendees in national workshops. The Meadows world-class team of Senior Fellows, Psychiatrists, Therapists and Counselors treat the symptoms of addiction and the underlying issues that cause lifelong patterns of self-destructive behavior. The Meadows, with 24 hour nursing and on-site physicians and psychiatrists, is a Level 1 psychiatric hospital that is accredited by the Joint Commission.
When Adolescence Doesn't End at the Same Time Adulthood Arrives: REHAB Treatment for Young Adults
Bonnie A. DenDooven, MC, LAC
Ad·o·les·cence is defined as a period or stage of development, preceding maturity. But what happens when chronologically your son or daughter becomes an adult and emotionally they are still locked in immature, self-destructive patterns that you thought they would out grow?
For a therapist working with young adults and their families, REHAB is a process of untangling the mystery of maturation gone wrong. Getting young adults sober from drugs and alcohol is just the tip of the iceberg. Unless the underlying issues are addressed, the young adults are precariously at risk to return to the immature habits that put them at risk to start with.
Karen Horney, pioneer psychotherapist who focused on the struggle toward self-realization, held that basic anxiety brought about by insecurities in childhood was fundamental to later "character development". (Footnote 1) In other words, some anxiety and some insecurity are needed to produce maturity, much like the baby chick in an egg needs to press against the adversity of the hard egg shell in order to emerge strong and capable from the hatching process.
In 1969, a publication changed how we treated children. The "Self-Esteem Movement" was birthed when psychologist Nathaniel Brandon published a widely received and highly acclaimed paper called "The Psychology of Self-Esteem" and argued that "feelings of self-esteem were the key to success in life". (footnote 2) A 40-year craze of self-esteem building began then. This craze changed how parents and teachers treated anxiety and insecurity in children. The "Self-Esteem Movement" encouraged parents and teachers to remove as much anxiety as possible from the lives of children. Suddenly it was NOT okay to give 1st, 2nd, and 3rd place trophies for fear that some child would feel less than others. Teachers put away red markers previously used to grade papers because it might make students "feel bad". Parents began a chorus of constant praise and admiration such as "You're so smart!", and "You're so pretty!";, and the killer, You've got so much potential". Research now shows that by age 12, children no longer believe these overworked compliments and see these compliments as an attempt by adults to manipulate them. (Footnote 3) Worse, the self-esteem movement created children who may have high self-esteem but who cannot tolerate any form of anxiety or insecurity. Without tolerating basic anxiety and insecurity they cannot produce character in themselves. Teenage use of drugs and alcohol to medicate the anxiety and insecurity is leaving us with a generation of addicts who live by the cognitive distortion, "I should never feel bad."
In the therapy room, when working with immature young adults (ages 18-29), it is easy to detect patterns. The newest research on addiction indicates that attachment disorders underscore addiction, but what does that mean? Karen Horney wrote about how the authentic self emerges. She described three classifications of how we relate to others. It is in our relationships with others where authenticity or the lack thereof shows up. To see attachment disorders in action, therapists watch how young adults: (1) Move toward people, (2) Move against people, or (3) Move away from people.
In essence, it is a simple and brilliant way to look at this thing called attachment disorder and to prepare therapeutic interventions that are effective. In the close conformity of the REHAB environment, these reactive positions of relating to others become visible, and set patterns readily emerge in the day-to-day required activities. Following are the three categories and ten patterns
Attachment style of Moving toward People:
Pattern 1: The need for affection and approval; pleasing others and being liked by them. The feelings of peer pressure are too powerful to resist and results in CODEPENDENCY and trauma bonding to unhealthy "friends" Young people can become just as addicted to "the lifestyle" of the drug world as they are to the chemicals.
Pattern 2: The need for a partner; one to love and who will solve all problems - the emphasis is that "love will solve all problems". This results in love addiction and sexual promiscuity with either an inability to disengage from abusive relationships or the inability to be without a relationship. These are the REHAB residents who strike up romantic or sexual liaisons in treatment.
Attachment style of Moving against People:
Pattern 3: The need for power; the irresistible urge to bend the rules and achieve control over others. While most people seek strength, an immature young adult may be desperate for it.
Pattern 4: The need to exploit others; to get the better of them. To manipulate, operating from the underlying belief that people are there simply to be used staff splitting and using humor to control a room (they are just an audience). People become objects and the immature adult operates without empathy.
Pattern 5: The need for social recognition; and limelight. The immature young adult manifests as desperate for recognition; they posture before staff, lie, cheat, and steal in order to be the center of attention, or become the clown and the butt of their own joking, never taken seriously. This need is an act of moving against people because it connotes beating others out for attention.
Pattern 6: The need for self respect; an exaggerated need to be valued can result in an overly inflated ego and a young person who is not in touch with their own limitations and unable to see their own character defects. This pattern forms Narcissism and self-blindness.
Pattern 7: The need for achievement; though virtually all persons wish to make achievements, some are desperate for it. Some are so driven for success, that they sacrifice relationships, health, and sometimes integrity for it. The paradox is that achievement is an elusive line that seems to move just as soon as a goal is met. The success never satisfies.
Attachment styles of Moving away from People:
Pattern 8: The need for self-sufficiency; taken to the extreme, some are independent to the point of becoming "needless and want-less". ISOLATION and LONELINESS ensue, along with an inability to live among others interdependently.
Pattern 9: The need for perfection; while many are driven to do things well, some young adults display an overriding fear of being even slightly flawed. This perfectionism causes "Fear of Shame" to become a driving force in their life, causing them to quit tasks they enjoy if they can't be the BEST.
Pattern 10: The need to contain; some find a need to restrict life to within narrow borders - to live as inconspicuous as possible. The ultimate result of an extreme of this pattern are ANOREXIA and DEPRIVATION. We find young people who have gravitated toward living alone and homeless. They find it difficult to rejoin others in the REHAB community.
In a REHAB environment, a young adult is forced to display every coping skill they have ever engineered. For many, it is the first time they are in close quarters with so many people 24-hours a day. If their tendency is to move toward and enmesh and give away their soul in order to deal with the anxiety, we see it in the friendships they form and as a failure to confront others out of fear of rejection. If the tendency is to move against others to cope, peers will react to them- against postures are offensive and conflicts with ensue.A tendency to move away from others manifests as depression, rage and laziness.
The best REHAB treatment centers are those that know how to manage, not eliminate, the anxiety and insecurity, in fact many activities are designed to increase the anxiety. Activities are planned to strategically intervene on the coping defenses above. As the defenses are exposed and the resident is taught to tolerate anxiety and feelings of inferiority, gradually the immature self begins to grow more confident and merges into a whole and complete self. This new self has character and is capable of navigating the adult world. The alternative is to stay immature, without a confident self, and to medicate with drugs and alcohol or other self-defeating behaviors.
Bonnie A. DenDooven
Bonnie A. DenDooven, MC, LAC is a former business owner-turned-therapist. The author of the MAWASI© for therapy and healing of financial disorders and work disorders. She is a former primary and family counselor and assistant clinical director for Dr. Patrick Carnes at The Meadows. Bonnie was schooled in Gestalt therapy and is a member of Silvan Tomkins Institute of Affect Script Psychology, an advocate of Martin Seligman Positive Psychology, and a champion for the initiative for VIA Classification of Strengths and Virtues (jokingly referred to as the "un-DSM").
Footnote 1: Neurosis and Human Growth: The struggle toward self-realization, 1950
Footnote 2: http://www.chabad.org/blogs/blog_cdo/aid/1073778/jewish/Why-Hasnt-the-Self-Esteem-Movement-Given-Us-Self-Esteem.htm
Parents of young addicts suffer the aftershocks of trauma long after the addict has entered REHAB and begun recovery. The Family Member PTSD Scale © Note1 which assesses family members of drug addicts for SHOCK, ISOLATION, VICTIMIZATION, SHAME, OVER-RESPONSIBILITY, LACK OF HOPE, and GRIEF, as well as for other symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex Post-Traumatic Stress Disorder (C-PTSD), is the first tool to use when starting to work with families of addicts. The scale was designed to determine the degree of trauma and the residual effects that trauma has had on parents and siblings. There are stages of unresolved trauma which must be known before beginning family reconciliation.
Examples of some of the typical SHOCK questions on the scale that parents of addicts endorse include: "I am numb from dealing with the crisis of addiction" or "I am shut down emotionally and do not respond like I used to" or "I have flashbacks of incidents that happened in our family when we were dealing with active addiction" or "When the phone rings late at night, I sometimes still experience startle, fear and vivid memories."
Most families have some form of PTSD. A parent who found their child collapsed in the bed or bath nearly dead from an overdose, who experienced a surge of adrenalin to handle the emergency, and never processed the crisis, is frequently haunted by vivid recollection, and nightmares. The nightmares can last for years. For many parents, the long battle with trying to save their teenager's life has resulted in C-PTSD. C-PTSD was first described in 1992 by Judith Herman in her book Trauma & Recovery. It is a psychological injury that results from protracted exposure to prolonged interpersonal trauma with "loss of feeling in control", "disempowerment", or "feeling trapped," which parents suffer knowing they are responsible for underage children in grave danger. The key difference between PTSD and C-PTSD is the concept of "protracted exposure."
All previous family models for working with addiction have approached the family system from the point of view as if addiction began with adults and was passed down generationally. Today we are seeing a very high percentage of first-generation addicts, and the devastation to relatively normal parents when their children turn to drugs is incomprehensible. We have begun to work with families using a different model from the traditional model of family systems theorists of 20 years ago. Once the addict is admitted to REHAB, an immediate assessment for Post Traumatic Stress (PTS) of parents and siblings of these young addicts is begun. Some form of relief from the PTS symptoms is the most immediate need of family members. For some parents, the admonition to just "start working on your own issues" feels like a slap in the face. When the very first advice parents get from treatment center staff are things like "look at your enabling" or "look at your codependency" or "go find an ALANON group and work on your own stuff", some are offended and further traumatized by the lack of empathy for their current state of SHOCK.
"The most painful thing that we see parents dealing with," says April Lain, M.Ed, L.L.S.A.C, who has facilitated over 360 family workshop sessions integrating young adults back into their family of origin, "is the confusion of being told to disengage and leave the addict on their own - the concept of ALANON of "detach with love" is healthy but can be confusing. Parents are sometimes even made to feel guilty for continuing to seek help for their adult children who are caught in the grip of addiction, when intervention is required." She goes on to say, "I tell these parents not to feel guilty for seeking help. If you saw a stranger standing out on the ledge of a 14-story building about to jump off, wouldn't you at least call 911 and try to save their life? If you would do that for a stranger, why not for your own son or daughter who is standing on the proverbial window ledge and their life is in great danger from drug and alcohol use?" For parents who are in the trenches strategizing interventions, they are still on the battle ground. The adrenalin is still pumping. Lives are at stake.
The PTSD/C-PTSD approach to dealing with families is cutting-edge and compassionate. Without fail, along the way, the family members have suffered severe abuse from the addict. Abuse comes in several forms: Overt, Covert, Stealth, Structured, and Impulsive.
Overt abuse is clear-cut and easily recognizable and easy to describe. Cursing, name-calling, fighting, and verbal threats are overt and obvious. If your beloved son or daughter is standing in your kitchen threatening you with a knife, it is obviously abuse and is easily describable to others. If your teenager is throwing things or kicking holes in doors, you have evident visible damage. If you have bruises, broken lamps and you've started to put locks on your bedroom door out of fear, you are dealing with overt, tangible abuse.
On the other hand, covert abuse by an addict revolves around the addict's need to assert and maintain control over his/her parents or brothers and sisters. Covert abuse may not be visible to others such as to the non-custodial parent in divorced families, or with grandparents or schools and even police or coaches who continue to see the addict as charming. These "outsiders" will say, "Oh, you are making a big deal out of nothing." Or, "They will grow out of it, quit nagging them." Covert abuse is emotional and manipulative. It takes advantage of trust and costs parents their self esteem and confidence. Covert abuse is made all the more painful because others do not see the emotional damage - they only see a seemingly "crazy person" who is dealing with the aftermath of addiction.
Stealth abuse such as gaslighting is a form of abuse where the truth gets denied so often and so convincingly that the parent starts to believe they are going crazy. It is the deliberate use of false information to make others doubt his or her own reality, doubt their own memory, and not trust their own perceptions. (The term gaslighting comes from a 1944 film called "Gaslight" starring Ingrid Bergman. Her charming new husband deliberately attempts to drive her crazy, i.e., gaslighting.) Many parents report a feeling "like I was losing my mind".
Sometimes addicts manifest what is known as a patterned (or structured) abuse. That is someone who abuses everyone around them, not just parents but other children, friends, authority figures. The abuse is predictable- everyone gets a fair share. Other addicts are more unpredictable and impulsive with their abuse - they are nice at times and then they strike "out of the blue" in a flurry of chaos. One never knows when the rage fit will hit.
Bessel van der Kolk, in his "Assessing and Treatment of Complex PTSD" identified depression, lack of self worth, problems with intimacy, inability to experience pleasure, satisfaction, or to have fun, as symptoms of C-PTSD. There are no reliable statistics of the number of marriages that do not survive dealing with a child addict, but it appears it could be as high as 20 percent. It is complicated because other factors might have impacted the marriages. The emotional toll is very high on the family.
Drugs and alcohol have taken a foothold on our younger generations on an epidemic scale. Validating the stress that the families have endured is the first step for starting to work with the family. Helping the family to recognize the PTSD characteristics of their reactions, helping them to heal and finally, helping the addict to feel and show empathy for how the trauma has impacted those who love them- that is the work of a REHAB Family Counselor.
Bonnie A. DenDooven
Bonnie A. DenDooven, MC, LAC, a family workshop therapist at Gatehouse Academy, is a former business owner-turned-therapist. The author of the MAWASI© for therapy and healing of financial disorders and work behaviors. She is a former primary and family counselor and assistant clinical director for Dr. Patrick Carnes at The Meadows. Bonnie was schooled in Gestalt therapy and is a member of Silvan Tomkins Institute of Affect Script Psychology, an advocate of Martin Seligman Positive Psychology, and a champion for the initiative for VIA Classification of Strengths and Virtues (jokingly referred to as the "un-DSM").