Until recently, treatment professionals addressing disorders such as anxiety, depression, and substance abuse have tended to defer treatment of nicotine addiction until after the so-called primary disorder (anxiety, depression, substance abuse) has been stabilized. The thinking was that attempting to arrest nicotine use (smoking) would distract the patient from focusing on treatment of the more immediate problem of depression, anxiety, or substance abuse. In a study summarized in ScienceDaily on February 11, 2014, researchers at Washington University School of Medicine in St. Louis have concluded that “ ***that quitting or significantly cutting back on cigarette smoking was linked to improved mental health outcomes. Quitting altogether or reducing by half the number of cigarettes smoked daily was associated with lower risk for mood disorders like depression, as well as a lower likelihood of alcohol and drug problems.”

The lead researcher of the study “***believes the serious health risks associated with smoking make it important for doctors to work with their patients to quit, regardless of other psychiatric problems."

"About half of all smokers die from emphysema, cancer or other problems related to smoking, so we need to remember that as complicated as it can be to treat mental health issues, smoking cigarettes also causes very serious illnesses that can lead to death. *** We really need to spread the word and encourage doctors and patients to tackle these problems. When a patient is ready to focus on other mental health issues, it may be an ideal time to address smoking cessation, too."

There is abundant research that the benefits of smoking cessation not only result in improved mental health, as suggested in the study under discussion here, but also in almost immediate reduction of adverse effects associated with smoking, such as some forms of cardiovascular disease. So, this study perhaps removes an excuse recovering addicts or alcoholics may use to delay looking at addressing a serious, life-threatening addiction, namely, smoking.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 03/03/2014.

The 12 Step programs (Alcoholics Anonymous, Narcotics Anonymous, Gamblers Anonymous, Marijuana Anonymous, etc.) are a free resource available almost 24/7 to those seeking recovery from the disease of addiction. Even though much is made of the fact that the 12 Steps are only "suggested", it is clear from a reading of the AA basic text (called the "Big Book"), Alcoholics Anonymous, and the literature from the other 12 Step fellowships, that in order to recover an alcoholic (or addict) "... must find a spiritual basis of life..." (Big Book, p. 44). For many, the mention of spirituality triggers an emotionally violent, all or nothing, reaction that can effectively close the door to the recovery support available in the 12 Step programs. These individuals often have legitimate reasons for their automatic opposition to anything that smacks of God or organized religion. Indeed, there are a number of commercial treatment centers that appeal to those who have been harmed by experiences with organized religions by touting their programs as not being 12 Step based.

In my experience working with addicted individuals for over 36 years, regardless of the reasons for one's aversion to God and religion, any individual can, over time, come to believe in a Higher Power or other source of spiritual strength.

Willingness seem to be an essential key to beginning one's spiritual journey. Spirituality in the Twelve Step programs is a reality based approach, with simple, practical suggested steps an individual can take to arrive at his or her own personal brand of spirituality. In order to begin one’s spiritual journey in the 12 Step programs, one need only be willing to be open to the possibility that such a source of strength may be found and then begin to seek such a source. Belief in the existence of a spiritual source of strength is not a prerequisite to beginning one's spiritual journey. All one need do is to, of course, not drink or drug, attend 12 Step meetings, and reach out on a daily basis through prayer or meditation to a source of spiritual strength regardless of what that source may be or may be called. Over time, the individual will discover through his/her own experience that this regimen of prayer, meditation, and meeting attendance has produced a spiritual strength he/she has never before had, one which has become a solid spiritual foundation for recovery.

Where, you may ask, does one find the willingness to begin the spiritual journey I just described. I do not have a definitive answer to this question but will offer a few thoughts. Willingness often comes from the pain of loss and consequences resulting from alcohol or other drug use, as well as the opportunity to see the evidence, or reality, of spirituality in the other members of the 12 step programs who model in the meetings the result of applying spiritual principles in their lives.

There are a number of stories that may help newcomers to recovery to understand the reality based spirituality of the Twelve Step Programs. One is known as the "Eskimo story."

Two men were sitting alone waiting for a bus. One of the men wore the collar of a Catholic priest. The other man turned to the priest and said "I once prayed to your God to save my life and he failed me!" The priest smiled and said, "Tell me, my son, of your prayer." The man went on to tell how he had been lost in the arctic cold of Alaska, he had no food or shelter and was certain he was going to die. In his last breath, he begged God to save him from death. The priest smiled and said, "But son, God did not fail you. You are alive." The man replied, "God didn't do anything. Some Eskimos showed me the way out."

Basic to the concept of a higher power, God, or other source of spiritual strength, in the Twelve Step programs is the principle that this source works through people and that most people have "Eskimos" in their lives who have helped them. An intervention which may work to bring this point home to people new to spiritual recovery is to suggest they think about the "Eskimos" or people who have been helpful in their lives before they began recovery, making the point that, after all, they have lived long enough to have an opportunity to recover.

Another way of saying that God works through other people is: “We can do together what I can't do alone.” The Twelve Steps are phrased in terms of “We”: Thus, “We admitted we were powerless” (Step 1); “We came to believe that a power greater than ourselves could restore us to sanity” (Step 2) “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs” (Step 12).

Persons attending Twelve Step meetings can see and hear real people who have had spiritual awakenings and turned their lives around. They can see in these people concrete evidence of the spiritual power of the Twelve Step Program. They can feel the strength that comes from real people sharing real feelings with one another, with no ulterior motives other than self-help, that is, to help themselves through helping others—hence the description of 12 Step spirituality as “reality based.”

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 02/15/2014.

As we see more and more states legalizing marijuana (Cannabis) use and a growing consensus among Americans that marijuana use is not a bad or dangerous practice, it is important to note that regardless of the fact that the drug may not be as toxic as alcohol, marijuana is not a benign drug. It is common knowledge that alcohol use during pregnancy can cause serious adverse effects on the fetus. The science is not as definitive on the effects on the fetus of marijuana use by a pregnant woman. But there is some evidence that THC, the main ingredient in marijuana, has a less than benign effect on the brain development of the fetus.

ScienceDaily for 01/27/2014, provides a summary of a study on mice (ethics prevent studies on humans; but results of mice studies are scientifically relevant) that suggests that marijuana use during pregnancy can have serious enduring adverse effects on brain development of the fetus, especially in the cerebral cortex which is the seat of judgment, thinking, and memory. Using language from ScienceDaily:

"The study highlights that consuming Cannabis during pregnancy clearly results in defective development of nerve cells of the cerebral cortex, the part of the brain that orchestrates higher cognitive functions and drives memory formation. In particular, THC negatively impacts if and how the structural platform and conduit for communication between nerve cells, the synapses and axons, will develop and function. *** … these developmental deficits may evoke life-long modifications to the brain function of those affected."

The lead author of the study stated: "Even though not all children who have been exposed to Cannabis will suffer immediate and obvious deficits, … relatively subtle damage can significantly increase the risk of delayed neuropsychiatric diseases. Even if THC only would cause small changes its effect may well be sufficient to sensitize the brain to later stressors or diseases to provoke neuropsychiatric illnesses in those affected in the future."

Thus, regardless of legality and the widely accepted myth that marijuana use is “no big deal”, the drug does have negative effects that will become more widespread as its use increases (and I have not even mentioned its addiction potential).

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 01/30/2014.

I ran across a new website, Recovery Stories, that I think worthy of mention in this blog. The aim of the site "...is to empower individuals and families to recover from addiction and its consequences. We do this by providing hope, understanding and a sense of belonging. We connect recovering people so that they can inspire, learn from, and support each other. We create empathic environments in which recovery can flourish.”

The creators of the site believe “...that storytelling has an important role to play in the recovery field. At the end of the day, addiction recovery is about people’s journeys into and out of addiction. It’s about a personal transformation. Solutions to serious substance use problems are manifested in the lives of people in long-term recovery. These lived solutions provide insights into principles and practices that underlie recovery from addiction.”

The site developers go on to state that “...[s]adly, little of this information is circulated to people in need of help. The site authors seek to “... change this situation. People suffering from addiction and its consequences have the right to easily access information that will help them recover.”

The site has a number of Recovery Stories with titles such as Adam's Story: A moment of Clarity; Brad's Story: A life beyond my wildest dreams; and Tim's Story: A doctor in recovery.

The website is rich in its articles on important recovery topics such as Factors that Facilitate Recovery. This article lists and describes factors in recovery such as: hope, a sense of belonging, acceptance—being supported by others, role models of recovery, involvement in meaningful activities (giving back and helping others), and spirituality.

So, I recommend you check out this Recovery Stories website.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 01/19/2014.

Although there is in the 21st Century much science and research defining alcoholism (addiction) in scientific and cognitive behavioral terms that can be useful, in my view, researchers and scientists often ignore the spiritual aspect of addiction and recovery. In addition to the mental-emotional and physical-medical-neurological-aspects of addiction, the spiritual effects of the disease of addiction must be addressed. Alcoholism is a "spiritual malady" per the basic text of AA (Alcoholics Anonymous, p. 64). There is a growing body of research examining the role of spirituality and religion in the development (or not) and treatment of addiction. This blog post, however, will just briefly look at the anecdotal (based on experience, not scientific research) evidence suggesting that the alcoholic or addict may have an innate spiritual deficit disorder.

Abraham Twerski, a noted psychiatrist and researcher in the addiction and mental health field has said: “When a person is not feeding his spirit properly, it’s not like an iron deficiency or a Vitamin A deficiency. They suffer from SDS — spirituality deficiency syndrome. *** Spirituality means being the best human being you can be. *** My work with alcoholics and drug addicts has convinced me they can’t recover without spirituality...” (speech, 11/02/2009, Saint Peter's University).

Based on my years of counseling alcoholics and addicts and participating in 12 Step meetings, it is clear to me that most alcoholics and addicts trace feelings of personal alienation and emptiness to times in their lives that predate their use of alcohol or other drugs. Indeed, many seem to have felt they “were on the outside looking in” from their earliest memories. Some of the other words used to describe this spiritual deficit include these: “hole in the soul”; “soul sickness”; “alienated”; “numb”; “empty”; “fear-filled hopelessness”; “fear of impending doom.” If I were a philosopher, I might say that all human beings have an emptiness or existential pain (angst) that they strive to fill with activity (jobs, careers, hobbies), sex, relationships, and the like. Fortunate individuals are able to develop a personal relationship with a God, Higher Power, or other source of spiritual strength early in life and the willingness to nurture that relationship throughout their lives.

Some individuals, however, fill their spiritual vacuum with alcohol or other drugs, or other addictive behaviors. These individuals describe their early reactions to use of alcohol or other drugs something like this: “For perhaps the first time in my life, I felt normal, unafraid, beautiful/handsome, smart, able to be social and interact with others.” This reaction to drugs or alcohol can be overwhelmingly attractive for someone who had spent life in fear of being crushed by a cosmic rock at any moment, resulting in an ongoing effort to achieve that reaction through drug or alcohol use, ending in addictive disease. In a loose sense, the alcoholic or addict has found a reason for being through use of alcohol and other drugs. As is well known, seeking meaning in life through addiction leads to spiritual bankruptcy and, for some, actual death. In my experience and the experience of many in the addiction field and in the 12 Step communities, addressing the spiritual aspects of addiction is essential to long term recovery.

So, perhaps it may be helpful to look at the alcoholic or addict (or potential alcoholic or addict) as an individual who has a spiritual deficit disorder.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 01/09/2014.