If only I had an extra seven grand to toss about

I would have the best computer ever...


I will have some discussion about the boys - including an hour stuck at a rest area in the middle of nowhere, while I disassembled my steering column to start the van later.  I will also post about ignorant fucking morons and the implications of a paper (PDF) that shockingly reveals that the metric to test whether employment screens are biased, turns out to be fatally flawed. But first, a bit of my fantasy life. 

It would start with this, set into this.  It would have two sets of these, cooled by this.  It would also contain one of these and six of these.  It's primary drives, would be two of these though.  It would live right here in this pretty case, assuming I can make the stupid blue light go away.  It would use this power supply.  It would be controlled with this mouse and keyboard set, though sometimes might be controlled by a handy little remote keyboard with trackball.  I would use this lovely thing for a monitor, while also piping a split to the tee vee in the living room - which, since we are dreaming, is a sixty some inch flat panel, hidden behind bookshelves on sliders most of the time (thus the need for the wee remote keyboard).  I would use these speakers in my home office, but would totally go with Bose in the living room.  I honestly don't see a need for optical drives, since with twelve TB of storage and the ability to use this desktop as a server, I am not sure what the point would be. 

I would, however, need one of these, these and this + a hell of a badass internets connection.

We won't even begin to talk about my five odd thousand dollar laptop.

I am building a new addiction site

Having found a very good deal on hosting services, I have taken the step of getting a new domain (a couple actually) and am in the process of building an addiction web site with forums. The domain is talkingaddiction.org and I have rather ambitious plans for the site. I would like to utilize the main page as a clearing house for information and have (ideally original) articles by addiction professionals, doctors and researchers posted a couple times a week.

I will also be creating a forum for people whose lives are affected by substance use disorders and people who suspect their lives are affected by substance use disorders - their own or someone else's. This is where I could possibly use a little help. I am committed to making this a space that is completely safe for people who are afraid of others finding out they are spending time at an addiction forum. This means that rather than just making it possible for users to post anon to the outside world, I want to provide assurance that administrators and moderator don't even have access to information that could identify forum members. This means not only providing means for creating accounts that hide all personal identifiers from everyone, but also hides their ip address and such.

I am honestly not to sure about how to make that happen, though I will be talking to the tech people who work for the host about it. I am using Drupal content manager, running on an apache server. I will also need to be able to keep track of the amount of traffic, even if I cannot keep track of any identifying information about the traffic.

The other thing that I am hoping to accomplish is the development of a forum for addiction professionals, researchers who study substances of abuse and MDs. Possibly even creating a whole different front page - or at least a feed (possibly keyword filtered for user preference) that identifies recent items. I know that this is less likely to come together - at the very least I expect it to be rather difficult to get people who are as busy as everyone who fits the requirements to actually take the time to make it happen. But I have long felt that communication between people doing relevant research and the people who actually deal with people with substance use disorders could be exceedingly valuable. And I think that MDs - especially those who work ERs, could also get a lot out of communication with addiction professionals. For that matter, it might be appropriate to invite emergency service providers into the discussion.

The other thing I am hoping someone might be able to help me with - or even possibly just create, is a news feeder for picking up addiction related news. Something that can be set to filter content from sites that turn out to provide inaccurate information.

Finally, I am also looking for people who have a bit of spare time, who could help as moderators. I have the tentative commitment of one person and would like to shore things up rather solidly. As the site isn't even up yet, I don't expect to need much help initially. But I am hoping to build things up rather quickly and would like to make sure that everything is covered. It really shouldn't be all that complicated. There are few enough restrictions that there really shouldn't be too much trouble. I am trying to set things up so that users can kill file other forum members if they run into conflict and also will be asking users to self flag posts that contain profanity, so that users who wish to avoid that can do so easily. Basically moderators would mainly deal with posts that should have been self flagged and weren't and personal threats. The only other issue that may be very complicated is users who set up multiple accounts so as to continue harassing users who have killfiled them - or who have been banned for refusing to respect the very few rules that will be in place.

Other than that, I expect to open the site within the next ten days. It will probably need some tweaking here and there - I have never set up a site before and have little help. But we will be ready to start talking by May 2nd at the latest. And unlike my last, rather blundered attempt at creating an addiction community (for smokers), I think this will work out much better. I think the biggest problem with that was the attempt to create what should have been a forum in a blog format.

I will also note that there will be no advertising on the site - I am rather up in the air about a donation button. I would like to recoup my costs if possible, but I am not terribly comfortable with creating any pressure for anyone who wants to use the site. I am going to keep the site as politically neutral as possible, not offering any "official" Talking Addiction position on anything except for the advocacy for more humane treatment of people dealing with addiction or addictive behaviors and people with other mental problems. I want this site to be a very comfortable and safe place for people to come and talk - including people who have yet to admit or who aren't really sure if they really have a problem.

Finally - a couple more important points; Sobriety is not a requirement for membership - or even for posting. And membership is not restricted to substance based addictions. There are all manner of behaviors that qualify as addictions and Talking Addiction will not discriminate. This is to be a site for people who are suffering from addictions and/or substance use disorders and anyone who either has (or thinks they might) those sorts of problems or knows someone who does will be welcome.

BikeMonkey and Equivalence of Oppression (update)

A certain lovely someone made the point to me that I wasn't particularly clear on a point that I am quite definitely not trying to claim that the bigotry aimed at atheists is like the persecution of the Jews. I am not at all. My entire point was that I have had to deal with some very intense feelings regarding this particular issue. Feelings that are completely valid.

PalMD wrote a rather upsetting post the other day, one that resonated with me on one level and made me spitting fucking angry on another. He finally felt the need to respond to Garrison Keillor's vile diatribe in Salon, trying to put non-Christians in their place in regards to celebrating x-mas. Pal comes from a very different perspective on this than I do, one that I cannot possibly understand, not being Jewish myself. His feelings on this resonated with me not because my experience is the same as his, but because Keillor's sentiments have been thrown in my face as well - sometimes by people who were once my friends and who despite my anger towards them and their bigotry, people I still care about. But that was not my first comment there - my first comment there was an expression of all out rage at something besides Christmas that Keillor ripped from Pal.

I am a musician and a midwesterner raised in Michigan - the same state that Pal hails from. I am not and never have been primarily into bluegrass, but bluegrass and hybrid mountain folk are nevertheless a part of my musical experience - a rather big part. Some of the best times I have had playing music, have been as part of a relatively large crowd of people hanging out and playing bluegrass and folk. Because of Michigan's automotive history and the importation of a hell of a lot of workers from parts of Appalachia, Tennessee and Kentucky, there is a huge presence of this sort of music here. There are professional and semiprofessional bluegrass and hybrid folk players, as well as dulcimer makers who can build instruments to rival the best instrument makers from the aforementioned areas. And I have had the pleasure of playing with a lot of these folks, as often as not, while sitting around a fire.

Here is the thing about bluegrass and folk - no one gives two shits what labels someone wears. If you want to listen and enjoy, you are more than welcome any time. If you want to join in, most folks don't care if you can't carry a tune to save your life, much less care what labels you wear. What matters is that you love music, love the community being fostered right then and there and want to take part - whether by listening or joining right in. That is what bluegrass and mountain music is all about - that is the point of it. Traditionally, folk music of any sort in most cultures has been a great leveler - a chance for everyone in a village or group to be equalized and enjoy themselves freely.

So when I read Pal's heartfelt sorrow at feeling that was taken from him, I got fucking angry as hell - far more angry than I did about Keillor's overt x-mas commentary. And I expressed my indignant anger at the notion that some motherfucker could take something so fundamentally open and inclusive away from anyone, much less someone I like. I was not invalidating Pal's feelings, I was expressing my own - and to some extent expressing my anger and refusal to let motherfuckers like Keillor "put me in my place" as well. Nowhere was I suggesting that Pal's feeling weren't valid or that he should just be able to ignore the bigotry and pretend it doesn't matter. Hell, I wasn't even suggesting that I can do that. Not letting not only people like Keillor or right wing blowhards or people who used to be my friend "put me in my place" doesn't mean it doesn't matter or effect me - obviously it does, rather fundamentally even. I just happen to have a different attitude than Pal does about how to handle it from there - in large part because I have a very different experience from Pal's.

But BikeMonkey, in his infinite wisdom decided that I needed to be put in my place, much like Keillor does - though in a different context. BM doesn't think that my feelings about this topic are valid, because my experience isn't Pal's and my overwhelming privilege means I should just shut the fuck up and pretend it doesn't matter. BM decided that there was some sort of equivalence being made, rather than what actually was happening and assumed he knows all about my great fucking privilege in the face of religious expression. I am going to address this idiot notion of equivalence first, then talk a little about my extreme privilege and experience with bigotry.

There is no equivalence between my experience and Pal's. None. Because I don't actually have a window into Pal's head, I cannot say for sure what he feels, but I do have his words to go by and can assume that this whole situation had a rather profound affect on him. Pal has a lifetime history of being Jewish that feeds his experience of Keillor's diatribe that I do not have and he has feelings that have nothing to do with Keillor that impact what he is feeling about it now. And we have to add to that that he was raised by people who are Jewish and who probably faced even more antisemitic bigotry than he has faced - something that probably had a pretty profound effect on his worldview. There is absolutely no equivalence to our experience, because his is not mine - I didn't grow up with the anything like what he grew up with.

That does not mean that my feelings are somehow less valid than Pal's. They are different - very different. They may not even have the depth of his own, though that is impossible for anyone to judge, because no one has a window into anyone else's head. I don't know what Pal's feelings are or what feeds them - I only know my own and what feeds them.

I am an atheist. I am not an atheist because I wanted to be an atheist, I am an atheist because I finally was unable to perpetuate my faith in the face of so very much evidence to contradict everything I Believed. I feel free now, like a huge burden has gone from me - do not get me wrong - in many ways I feel much better for finally shedding my faith. But that has come only after a nearly twenty year struggle to cling desperately to that faith. I described a great deal of that experience and the abusive nature of my brainwashing here, here, here and a bit here, so I am not going to really go into the abusive nature of my relationship with my faith now - suffice to say, if you do not want to click the links, that like a lot of people I spent a very long time in a very abusive relationship with religion. I will highlight one aspect of that abuse though, because it speaks well to my immense privilege.

Before I do, I do want to be clear that I am pretty cognizant of my privilege. I am privileged and I have benefited from it my whole life. But privilege is relative - it is always relative.

One of the worst abuses my relationship with religion fostered, was my attitude about my neurological issues. At an early age I was taught that I did not have neurological problems - or if I did, it was totally a matter of demonic activity being at the heart of it. I was taught by my fundie mother that it was totally a matter of wholly surrendering myself to her god and following his plan for my life. That if I just believed enough - prayed enough - figured out and accepted her god's plan for my life, I would no longer have any of these problems. On the other hand, I was told by my atheist father that these neurological issues are just as excuse others were making for me and that if I just damned well did as I was told - if I buckled down, I would be ok.

Being a hardcore little fundamentalist myself, this god person was the obvious choice. Not that it mattered, whether my faith was too weak or my will to weak, my inability to overcome my neurological issues without help was entirely my seven year old responsibility. There was therapy in there when I was in middle school, but with a therapist ill equipped to help me, especially given that I was truly convinced by my parents that it was all on my head. Faith or will, it was all up to me and me alone. It wasn't until my entire world shattered around me as a teen, that I changed my view on that - unfortunately it only changed for the worse.

I decided then to embrace my mental illness and in exactly those words. I decided that just as my god obviously wanted me to have sex and use drugs - else he wouldn't have sent the opportunities for both my way so often - I became convinced that this is the way I was made, the way my brain was made and I should just accept it as it was. I decided that the only way I could ever be successful, was if I truly accepted who and what I was, because when my world shattered I didn't stop believing. My beliefs changed to be sure - they changed quite fundamentally. But the Faith was still there - the absolute Belief was still there. Not only that, but it was something that I described as Christian, though I explored all sorts of other beliefs.

I no longer denied that I had atypical neurology, but I didn't believe that I should try to change it - in spite of using a hell of a lot of drugs that did just that. As I learned more and understood more about the world around me and even myself, my feelings about my brain evolved. I accepted eventually that I really would probably do better with help, but help wasn't available and recreational drugs were. But still there was that faith - though even that had evolved further and further.

I should note that I was quite often subject to bigotry from other Christians, because I was not the right sort of Christian and as a rather serious substance abuser and horrendous slut, I obviously did not live their version of a Christian lifestyle. My advocacy for glt rights also counted hard against me, as did my acceptance of evolution.

There were times when I might have let it go, but for the simple stark terror I had of hell and the possibility of hell. That, combined with this belief that there were otherwise unexplainable interventions in my life - the biggest being that I was still alive and relatively coherent. And it was a great comfort when I moved to a new city where I literally had two friends before I moved there. My partner and I had split and I was pretty much bereft of anything approaching the support network that I had developed and fostered back in Lansing. I went to the church that my two friends in Portland were attending and was embraced into a wonderful new family.

Until it all fell apart - until I could no longer reconcile or justify any of it. Then I was rejected by this family I had been part of. I was rejected by people who were an important part of my life and the life of my eldest child - not just in the context of faith, but in a very holistic fashion. I was rejected and my child faced rejection for things he had no comprehension of, by people who were as important to him as they were to me. And ever since, I have either endured rejection from these people or pressure to just read this book or listen to that speaker - and it would all make sense again. Comments that they are still praying for me and have every confidence I will one day return to their god's grace.

And while it is certainly not all, many people I care about find it downright offensive that I would infringe on their holidays and any other aspect of their culture.

Being back in the midwest has brought on other problems. Friends who were my friends in spite of my identifying as a Christian - friends who had been rejected by most people who carry that label, but accepted me because I did not have come to reject me for rejecting any spiritual or religious beliefs altogether. To be sure, I still have many friends - including many gay and transgendered friends. But I have lost as many as I still have.

And I still have to make a lot of decisions about whether or not to admit to being an atheist to whom. There is a very common theme in the midwest (and many places) that people don't care what your spiritual or religious beliefs might be - they just take exception to people who don't believe in any sort of higher power.

I have been soundly rejected by most of my community of friends and loved ones. Was rejected at a time when I was dealing with the trauma of finally getting free of my struggle with religion. As abusive as it was, like many such relationships it was nevertheless a fundamentally important part of my life. It is over and I am free of it, but I am not free of it's influence. I am not only dealing with the hole left by faith, I am dealing with the hole left by many people I love - exacerbated by the bigotry of people I love, the bigotry of strangers aside. And while people can't just look at me and see that I am an atheist, I sometimes have to sit quiet and pretend I am not.

And it is only in the last year, while dealing with this rejection and pain, that I am finally actually getting help for my neurological issues and managing to repair the severe damage those problems have created in my life and in the lives of my children. At thirty three, I am finally getting an education in hopes of pulling myself and my children out of the poverty and near poverty that has been their lot in life.

So no, my experience is not PalMD's experience. His experience may even plumb greater depths than my own, I can only speak for myself on that count. All I can say is that my experience with religious bigotry has had a very painful and profound affect on not only myself, but my eldest son as well. There is no equivalency because Pal's experience and mine are very different and because neither of us could begin to know the depth of suffering the other feels to compare. But just because there is no equivalence, does not make either of our experiences or the feelings fostered by those experiences less valid than the other.

Adolescents and Addiction

This is my paper on adolescents and addiction. The paper in format with bibliography is available here. I will try to get the next post about talking to kids about drugs up over the next few days. I will also be posting my communications paper on genderism and homophobia, probably tomorrow.

According to the 2008 National Survey of Drug Use and Health, a full 9.3% of youths between the ages of 12 and 17 were current illicit drug users (SAMSHA, 2009). According to the same report the rate of binge drinking in the same age group, was 8.8%, a rate that climbs to 17.2% of 16 and 17 year olds (SAMSHA, 2009). This rate of current illicit drug use indicates a very serious problem in youth today, especially when taken in the context that there is an increasing problem with drug use initiation starting as young as ten years old. Binge drinking is generally considered substance abuse, regular binge drinking is a sign that a given individual is very likely addicted to alcohol.

Substance use in this age group may be correlated with an orientation towards risk taking, arrests, less education, pregnancy and long term substance abuse problems. Even worse, substance use at this age increases the likelihood of psychopathology and stunted neurological development (Lopez, Schwartz, Campo & Pantin, 2008). Although not all adolescent substance use will qualify as addiction, it very often leads to addiction later in life. Regular adolescent substance use often does qualify as addiction.

Defining Addiction

Put very basically, addiction is the habitual use of a substance or engaging in a behavior that causes a certain level of harm and which the addict cannot control. That is not a very satisfactory definition however, because it is very vague and ultimately fails to address the understanding that not all addiction is the same (Denning, Little & Glickman, 2004; Dodes, 2003; Khantzian & Albanese, 2008). Although this paper is focusing on substance abuse and addiction, some addictions are not substance based. Some addictions result from unrelated neurological disorders, such as bipolar disorder, schizophrenia, depression and quite commonly attention deficit disorders. Other addictions are the result of a neurochemical propensity for addiction. Still others are simply the result of crisis. This is just a small number of reasons addictions happen. With all of these different causes, it is unreasonable to assume that there is one solution.

Dr. Dodes notes that “Addictions are in the mainstream of the human condition (Dodes, 2003, p. 185). Indeed Dr. Dodes asserts that the major difference between addictions and normal human compulsions is the harm and degree of harm caused by the compulsion. Dr. Khantzian and Dr. Albanese assert that the core of most addictions is a desire to self-medicate. They make a very strong case to support the notion that people use substances to compensate for unpleasant feelings, emotions or life situations (Khantzian & Albanese, 2008). Harm reduction pioneer, Dr. Denning with Little and Glickman asserts that there are many reasons people develop what they prefer to call “substance use problems.” They understand that not all substance use is the same and not all of it is abuse or addiction. Most importantly, they believe that the necessary approach is largely determined by the individual (Denning et al.,2004).

Adolescence involves many other factors that have a significant effect on addiction and substance abuse and treatment. With youth comes the developing brain and a lot more mental plasticity. This age range is also the time when many neurological disorders tend to surface. Finally, adolescence is also a time of hormonal changes
that often result in a great deal of emotional and physical distress. When the general life changes of being a teenager are factored in, adolescence significantly complicates an already complicated mental illness (Griswold, Aranoff, Kernan & Khan, 2008).

Adolescent Substance Abuse

Normative Use
According to the detailed tables of the 2008 National Survey on Drug Use and Health, 39% of adolescents will have used an illicit drug and 60% will have used alcohol (SAMHSA, 2008). It is clear that not all youth who try illicit drugs and alcohol become regular users or substance abusers. Most adolescents who use substances either use it once or rarely. While no substance use among children and adolescents is safe, it is important to recognize that most youth who try illicit drugs or alcohol will not become habitual substance
users.

There are many dangers to non-regular drug use among children and adolescents. Intoxication often leads to impaired judgment and increased risk taking. The most common risks include attempting to drive under the influence and unsafe sexual behavior which in turn can lead to pregnancy and/or sexually transmitted infections (Wood, Drolet, Fertro, Synovitz & Wood, 2002). Another risk is that youth who use drugs infrequently will increase substance use either during adolescents or in adulthood (Lopez et al., 2008). There is also a significant risk that their substance use will escalate into increasingly risky substances. Finally, there is also the risk of death through overdose, allergic reaction or in the case of single
standard doses of MDMA, by mechanisms we simply don't understand at this time (Kaye, Darke & Duflou, 2009).

Dangerous Use and Abuse
By age 17, 4.6% of youths will have a substance use disorder involving illicit drugs, while 4.9% will have a substance abuse disorder involving alcohol. A full 60-75% of child and adolescent substance abusers will also be diagnosed with another mental disorder (Griswald et al., 2008; SAMHSA, 2008). It is also important to note
that while there is some crossover between illicit drug addiction and alcohol addiction, it is minimal. When the crossover is taken out of the equation 7.6% of youth, 17 and under have or have had substance use disorders (SAMHSA, 2008). To put this in context, in a group of 500 17 year old adolescents, it is very likely that 38 of those kids have experience with substance abuse disorders.

Although figures have gone down significantly since the late 1990s, they have gone down from a significant spike that started in the 1980s (SAMHSA, 2009). There is little indication that there will be a significant drop in substance abuse among youth any time soon. More importantly, the most recent fad in illicit drug use among
children and adolescents is the use of pharmaceuticals (Wood et al., 2002). The use of pharmaceuticals is particularly dangerous, because even youth who have expressed a refusal to use other illicit drugs are often willing to try pharmaceuticals in a recreational context (SAMHSA, 2009). Another serious problem is heroin use, which saw a spike in use from .5% in 1995, to steady out at 1.6% in 2001 (Hopfer, Kurhi, Crowley & Hooks, 2002) and changing little with a rate of 1.5% in 2007 and 2008(SAMHSA, 2008).

Both heroin and recreational pharmaceutical use are particularly dangerous. The potency of heroin is extremely unreliable, which creates an elevated risk of overdose leading hospitalization and death (Merscham, Leeuwen & McGuire, 2009; Hopfer et al., 2002). The danger of pharmaceutical use and abuse, is that pharmaceuticals are usually mixed with other pharmaceuticals and sometimes alcohol
(SAMHSA, 2009). This is particularly dangerous because even if it is a child's first time, the wrong combination can cause serious injury and death. Another significant problem with pharmaceuticals, is that their use is likely more prevalent among children who are not considered “at risk” than any other drug except for alcohol (Johnston, O'Malley, Bachman & Schulenberg, 2009).

Risk Factors

There are many factors that can determine whether a child is at an elevated
risk for substance use disorders. The primary factor is often described as peer pressure, but this is not an accurate description of the actual social pressures involved in initiating substance use. For most substances, the actual peer pressure is to stay away from drugs (Johnston et al., 2009; NIDA, 2003; Wood et al., 2002). Other factors that significantly elevate the risk of substance use and abuse among children and adolescents include socioeconomic status, parental involvement, parental substance use issues, parental abuse, early aggressive behavior and comorbidity (Callaghan, Tavares, Taylor & Veldhuizen, 2007; NIDA, 2003).

Social Pressure
Although general peer pressure seems to be moving in the direction of pressure not to use illicit drugs and even alcohol, it is important to explore the role that social pressures play in child and adolescent drug use. Because the general direction of peer pressure actively discourages illicit drug use, it may be causing some backlash among kids who feel they have been alienated from their general peer group (Griswald et al,, 2008; Dodes, 2003). Adolescents often feel a compulsion to rebel against not only their parents, but against people who ignore them, harass them or whom they perceive are against them in some way (Denning et al., 2004). This creates an inverse sort of peer pressure, directly countering the general
pressure not to use illicit drugs and/or alcohol. While this alone may not initiate substance use, there is more to the equation of social pressure.

Young people who feel like outcasts, tend to congregate with other kids who are like them. Many of the reasons that kids become outcast are factors that also put them at an elevated risk for substance use disorders (Denning et al., 2004; Khantzian & Albanese, 2008), creating a conjunction of elevated risk and inverse social pressure. Thus in an of itself, being a social outcast becomes a significant
risk factor. Kids who have no other elevated risk factors, who become social outcasts are at an elevated risk for that reason alone.

There are other social pressures that come into play. As kids get older, whether they have elevating risk factors or not, become increasingly likely to use alcohol. It is highly available and many children and adolescents witness their parents drinking alcohol, whether the parents drink a lot or are moderate drinkers. Thus while there may still be a general pressure to avoid illicit drugs, as children age the general peer pressure to avoid alcohol fades and often reverses into pressure to drink (Johnston et al,. 2009; SAMHSA, 2008; SAMHSA, 2009).

There is also often peer pressure involved in the abuse of pharmaceutical medications. This is complicated by many children not really perceiving recreational pharmaceutical drug use as being similar to other recreational drug use and abuse (Johnston et al,. 2009). Children and adolescents who sincerely believe that recreational drug use is bad, have no compunctions against the recreational use of pharmaceuticals. Worse, the younger a child is, the more likely it becomes that their initial drug use will be pharmaceuticals. In 2008, more than 5.4% of children ages 12-13 reported having engaged in the recreational use of pharmaceuticals.
Breaking the drug classes down, 5.4% reported using psychotheraputic drugs, 4.5% reported using pain relievers and almost 1% reported using stimulants (SAMHSA, 2008).

C0m0rbidity
There is a great deal of evidence to support the assertion that people with attention deficit disorders are significantly more likely to become substance abusers, than the general population. The comorbidity of ADHD and substance abuse is estimated between 30% and 50% (Gordon, Trulak & Troncale, 2004). While there is no significant difference in the rates of alcohol abuse, persons with ADHD are at significantly higher risk for abusing other drugs and other drugs plus alcohol. The rates of lifetime substance use disorders among persons with ADHD is 52%, compared to persons without ADHD at 27% (Biederman et al, 1995).

The comorbidity of substance use disorders and mood disorders is also very common. About 70% of people diagnosed with bipolar, for example, are tobacco users (NIDA, 2008). An National Institute on Alcohol Abuse and Alcoholism sponsored study found a 40% comorbidity of mood disorders, among people who sought treatment for a substance use disorder (Grant et al., 2004). Though there are still a lot of
questions to be answered about the relationship between substance use disorders and mood disorders, there is no question that mood disorders significantly increase the risk of substance abuse and addiction.

In aggregate, it is estimated that there is somewhere between a 60% and 70% comorbidity between adolescent substance use disorders and other mental illness (Griswold, 2008). While there are some questions about potential misdiagnosis due to comorbidity, the statistics are too significant to be ignored. There is no doubt that there is an extremely significant correlation between substance abuse disorders and other mental disorders.

Family
Parents and family play a very important role in determining whether a child or adolescent will develop a substance use disorder. Parents have a profound impact on their children. Many neurological disorders have a very strong familial connection, especially ADHD (Biederman et al., 2008), which is a major risk factor. The children
of parents with substance use disorders often develop substance use disorders themselves (SAMHSA, 2008). Children and adolescents from families that are economically disadvantaged have an elevated risk for substance use disorders (NIDA, 2003). Children and adolescents who do not have much interaction with their parents also have an elevated risk for substance use disorders (Denning et al., 2004;
Dodes, 2003; Johnston et al., 2009; Khantzian & Albanese, 2008; NIDA, 2003).

Prevention

There are many ideas about preventing juvenile substance use disorders. Public service announcements, parental education, peer counseling, large scale local and national government programs in public schools, school assemblies, “scared straight” programs that introduce at risk youth to prisoners, and myriad after school programs. A significant problem with all of these measures, is that there is little evidence to support the efficacy of most of these preventative measures. The studies that have been done would suggest that certain changes to current approaches might be warranted.

Nixon, Mansfield and Thoms did a study of public service announcements that suggested that providing instructional materials for in class activities following the viewing of videos would likely increase the efficacy. While their study was limited in scope, it was more intensive than many studies into the efficacy of substance use prevention measures. They also suggested that targeting youth with specific risk factors and public service announcements that were culturally specific would likely increase the effectiveness of such materials (Nixon, Mansfield & Thoms, 2008).

There is evidence that would suggest that culture specific substance use prevention measures might reduce the incidence of substance use disorders. Developing and implementing prevention programs for the classroom that are specified for the cultures represented, would expose children and adolescents to a variety of programs, while also responding to culturally specific substance use trends (NIDA, 2003).

There is also evidence that peer counseling programs can be an effective preventative tool. Programs that include mentoring are likely to be even more effective, as they discourage adolescent mentors from engaging in behaviors that they are trying to discourage younger children from engaging in. Evidence would suggest that adolescents are significantly more likely to listen to information
about substance use and sexuality that comes from their peers, than when it comes from teachers (Whiston & Sexton, 1998).

Intervention

Parents are an extremely important component to the treatment of juvenile substance use disorders. Children and adolescents with substance use problems are especially vulnerable and need a lot of support from their family and community. Family counseling is especially important, as is parental sobriety. The development of a
substance use free peer group is also very important (Griswold, 2008). It is also important to approach the situation realistically and understand that while sobriety is the ultimate goal, a harm reduction approach is not inappropriate. Complete sobriety may not happen overnight, especially if acute dependence is a factor.
Substance use disorders are often a chronic condition and in recognizing that, an implicit goal of reduction (Ie. Using only at specific times) and management may be the best short term goal (Bukstein et al., 2005; Denning et al., 2004).

Given the significant level of comorbidity, an intensive psychological assessment should be done as early in the intervention process as possible (Dodes, 2003; Griswold, 2008; Khantzian & Albanese, 2008). There is an elevated risk for suicide or other extreme responses to the intervention process (Denning et al., 2004). There is also the possibility that medication will be indicated and with certain disorders, such as bipolar type one. Abstinence from the substance of abuse may trigger an acute response without a pharmaceutical alternative (Khantzian & Albanese, 2008). In such cases there may be very little time in which to make an assessment and determine whether psychopharmacology may be appropriate (Griswald, 2008).

Unfortunately, there are many different types of addiction and substance abuse, each presenting its own unique challenges. Once the intervention has been initiated it is up to the juvenile's doctor, therapist and family to decide on the best course of action (Denning et al., 2004). It is up the the parent's, the child or adolescent
and the professionals to develop a set of goals that the child must stick to. Failure to meet specific goals must be explained by the child or adolescent and appropriate actions must be taken (Dodes, 2002; Khantzian & Albanese, 2008). If the juvenile is on medication, the medication must be closely monitored by parents (Griswald, 2008).

The most important consideration for dealing with an addict or substance abuser, is that they are still a human being. Compassion and empathy are a critical component to recovery. Disrespect and dehumanizing will not help recovery progress. Recovery does not happen because of concepts such as “tough love,”it sometimes happens in spite of those methods (Denning et al., 2004; Dodes, 2002; Khantzian & Albanese, 2008). It is important to remember that a child or adolescent with a substance use disorder is still a child.

Talking to Kids about Substance Use and Abuse: Who and When

After mentioning some very disturbing statistics a couple posts ago, I would like to address ways that discussion might go and when it might be a good time to have it. Contrary to comments on that post, I am not suggesting you have it with the infants. But depending on various risk factors, I would suggest that it is hard to start too early. I have discussed this before and will probably do so again. The big difference between the last time I discussed this and now, is not the content of the discussion but that I now have evidence to support assertions I will make. I am only going to start this now, because I would like to post the paper I just wrote before I go into too much depth and I am waiting until I know it was graded to do that.

I think the first and most important issue to discuss, is that of what it is appropriate to talk about, with whom and when. I will start with who.

There are a remarkable number of parents out there who believe that they don't need to have this discussion with their child, because their child would never dream of using drugs. I am not engaging in hyperbole when I suggest that there are a lot of parents out there who have buried children they thought would never use drugs. While there are factors that elevate the risk that specific children are more likely to engage in substance use at a rather young age, that doesn't mean children who do not have those risk factors are immune. More importantly, there are risk factors you may not be aware your child has.

There are a lot of neurological issues that come up, that you may not be aware your child has. Your child may have friends who use drugs that you aren't aware of - your child might not even be aware of yet. A particular substance may be making the rounds at you child's school - this happens from time to time. A drug becomes particularly prevalent and is available at a very low price. It is there and because so many kids are using it, it becomes vogue to do so. It is also quite possible that your child is not nearly as open with you as you think s/he is. Your child may be something of a social outcast and you don't even know it - and that is a significant risk factor.

More importantly, as I mentioned in my last drug use post, there are substances that transcend normative risk factors. Pharmaceuticals are huge these days and kids don't necessarily have to raid the medicine cabinet at home. With a lot of children on psych meds (most commonly abused, more than a percentage point or two over pain killers) they can just quit taking their pills, save them up and trade some with another kid who has done the same and take some of both - or more, if they let another kids or so join the fun. I will grant that they usually get a little older before they add alcohol to the mix, but this is behavior that more than 5% of children age 12-13 have at least tried. At least 3% of kids in that age range are abusing pharmaceuticals. What the National Survey on Drug use and Health doesn't say, is that a significant percentage of 9-10 year olds are also trying this. By the time they are old enough that they are more likely to use alcohol, the percentage of kids playing with pharmaceuticals is above the 40% mark.

To be totally clear and rather harsh about it, it is critically important that you discuss pharmaceuticals with your kids. The wrong combination can cause serious problems, even death. Throw some alcohol into the mix and there is an even stronger likelihood that you will go to wake up your child, only to find them stiff and cold and very, very dead. I doubt the thought that this child was a very good kid is going to be much comfort at that point. And no, the fact that your child might well engage in really stupid drug use doesn't make them any less a good kid. It just might make them dead though...

The next question, now that I hope we are clear that all kids should have this conversation with their parents, is when. My own attitude is to start young and never stop. Latch onto opportunities as they present themselves. Don't be preachy and don't be too intense or regular with it. When they are very small, just use their own insatiable curiosity. If you are a drinker, tell them about what you are doing. See something on tee vee, use that as a starting point. As they get a little older, make a point of sitting down with them once in a while, specifically to talk about drugs and drug use. When they get towards 11, 12, 13 - ask them about it. Let them guide the conversation. Talk about it a little bit more often, but not too often.

Most importantly, make sure they know that they can ask you anything they want to know about. Make it clear to them that you would be happy to honestly and openly discuss topics that are important to them - sex, drugs, relationships. Encourage them to develop a habit of talking to you about things that are bothering them when they are young, because that will make it infinitely more likely that when they are confronted with choices like using drugs, they will be inclined to talk to you about it. Also keep in mind that the best time to talk about drugs initially, is before they ever start. Don't assume that they will wait to talk to you - make it clear that there are dangers and that they need to understand those dangers. Also, accept that they may come to you and tell you someone offered them something or another - you can ask, but don't push them for a name. Yes, it would be ideal to know - but they aren't going to tell you if they aren't going to tell you and pushing them will be a detriment to the development of that trust.

As they become teens, make sure you have laid the groundwork already. If you have done your part early on, trust them to come to you with questions. Make sure that you have discussed the specifics - the dangers of various substances and the like - I am going to write another post about how those discussions might sound. If they seem to be depressed, ask them how they are feeling - is there anything wrong that they might want to talk about. If not with you, then with someone else that you trust and they trust. It may well be that they aren't going to be as interested or comfortable talking to you at that point - let it go and encourage them to talk to someone who is trustworthy. About the best you can do is to make it clear you are available and open to them.

Whatever you do, do not lie - we will go into this more tomorrow, but this one is important. Never. Never ever lie to them. If they ask you something about your past that you aren't comfortable talking about (assuming it is age appropriate), my first suggestion would be to get over it and just tell them what they want to know. But shy of that, if you aren't willing to answer, then honestly tell them that. Don't tell them you never did something you did - just tell them that you aren't comfortable talking about that.

Unless of course you have or have had a substance use disorder. At that point all bets are off. Your child has a major risk factor and you absolutely have to make that clear to them. Forget about your pride and all that bullshit. Suck it up and spill it, because your child absolutely must know that you have a problem and that because of that, they are far more likely to have similar problems if they engage in drug use. The thing is, you have an almost magical power at your disposal, one that makes it exponentially less likely your child will have this problem. You tell them they have an elevated risk and you tell them why. Do that and it is exponentially less likely that your child will initiate drug use. This applies to most risk factors, but is considerably more poignant when it comes to owning up to your own issues with substance use.

I am not just pushing shit in your general direction, that I am afraid to do myself. I have had myriad substance abuse problems and will be dealing with them until the day I die. My oldest son has a lot of very significant risk factors besides the substance abuse issues of his dad. My youngest will probably not be too far off his brother's risk factors. We have talked about it before and we will continue to talk about it, my soon to be eight year old son and I.

No, it isn't easy. It is just critically necessary, because I love my boys.

Time for that chat with the kids about drugs...

Here are some statistics to scare the crap out of the parents out there. These are statistics for kids between the ages of 12 and 17. The figures come from the 2008 National Survey of Drug Use and Health. If you read nothing else of this post, please read the last couple of paragraphs. And please consider having a talk with your kids about drugs.

Seriously, this is critically important.

More than 60% have tried alcohol.
More than 47% have tries illicit drugs.
4.9% have experienced substance abuse problems with alcohol.
4.6% have experienced substance abuse problems with illicit drugs.
There is only a 1.9% crossover, so a full 7.6% of these kids have experienced substance abuse issues altogether.

In regards to the illicit drug use, there is a lot of crossover.
3.4% = Cannabis, 1.2% (est.) = other traditional illicit drugs.

The more frightening statistic is the abuse of pharmaceuticals, which is becoming one of the most serious youth drug problems today. An estimated 3% have abuse issues with pharmaceuticals. But that is just abuse, the estimates for kids in that age group to have tried/sometimes use pharmaceuticals are more than 40%. In context with other sources I have been reading, this is often in combination with alcohol and almost always includes mixing pharmaceuticals.

It doesn't matter if it is the first time a kid has tried this out. The right combination of pharmaceuticals, or mix of pharmaceuticals and alcohol = a dead kid.

I would also point out that initiation is getting younger and younger. We're talking 10 or 11 years old, sometimes younger. And the younger the child, the more likely it is that they will be trying pharmaceuticals. The other thing that is important about this pharmaceutical problem, is that there is far less correlation with traditional risk factors. Poverty, drug abusing parents and even an expressed distaste for illicit "street" drugs are not nearly as relevant with pharmaceuticals as they are with street drugs and alcohol.

A good time for that talk, would be when you next see your kids. Don't wait until they are preteens or teens - that could well be too late. If you are feeling a bit overwhelmed by the prospect, this is a great resource and I am going to post a longer discussion about this when I actually finish my paper.

The National Survey on Drug Use and Health: finally found it and damn it is scary

Linked in my top post now, in case you wanted to check it out...

I could really use some help from some of my addiction friends. I have tried search string after search string, trying to find the statistics for older children and adolescents (ages 12-17) who have tried illicit drugs, alcohol or tobacco, but who don't or didn't use them. I know that is part of the damned survey, but I cannot find figures anydamnedwhere.

The Stigma of Addiction and other Mental Issues

The topic of stigma and mental problems has been coming up a lot for me lately, especially (of course) in relation to addiction.  So it was rather fortuitous to discover another great blog this morning and this post...

Sometimes I find it easy to forget about, because I have a lot of supportive, loving people in my life who just don't go in for stigma.  Couple that with having even less of a social life than usual this summer and I found myself in that comfortable place - the place where I just don't have to think about the destructive force of words - words that perpetuate shame.  It is that shame that really gets me fucking angry as hell.  I get enraged at the notion that a whole lot of people - some of whom I know - are so terribly ashamed of their own fucking brain.

To me, it is so obvious now...Feeling ashamed of the way one's brain works, is a lot like feeling ashamed of having brown eyes instead of blue, or red hair instead of blond.  It's obvious enough to me, that I forget sometimes that it is not so obvious to others.  It's obvious enough to me now, that I even forget sometimes that it wasn't always so obvious to me.  And even as obvious as it is, it is still easy enough to feel shame about who I have been and how I have behaved - because it is impossible to sort out where my neurochemical issues end and just plain old bad decision making begins.  It is especially hard, because everything I have done, all the bad decisions that I have made - all of it was at least influenced by the way my brain works.

How then, does one separate what one should be ashamed of, from what they should just accept as part of having neurological issues?

My short answer; one can't.  Trying to do so requires sorting through every factor that influences our decision making.  As a thought exercise, I would ask you to think for a moment, about the last book you read (or article).  I want you to consider everything that went into the decision to read it - don't just scratch the surface - dig deep into your motivations.  Follow the chain that brought you to the point where you wanted to read that book or article.  Where did your interest in the subject of that piece come from?  Where did the interest in whatever influenced you to get into that subject arise?  What else did you read, that indicated you might like to read this piece?  What influenced you to read that?  In short, try to untangle the skein of influences and motivations that brought you to the simple decision to read that book.  If it was a friend who recommended it, why do you trust their judgment?

If you just did as I asked, you probably got stuck rather close to the decision you made to read whatever it is you recently read.  Unless you took quite a bit of time and really went at it, you barely touched on a small fraction of everything that went into that very basic decision.  And even if you did take the time and focused, you quite likely still only scratched the surface - just a little deeper than some people would scratch.  Now think about this - we're just talking about the decision to read something.  How then does one sort out the decision to wander the country, sleeping outside as often as not?  How does one sort out the decisions to use virtually every mind altering substance set in front of them?  How does one sort out the decisions to have sex with virtually every woman and some men, who were willing and willing to use protection?  How does one sort the decisions that leaves one virtually homeless for more than five fucking years?  How does one sort the decisions to sell drugs, so one has drugs and sometimes a little money (and sometimes a lot of money)?  How does one sort the decisions to buy dope, instead of buying shoes that aren't literally falling apart at the seems?  How does one sort all the decisions that led to losing the roof over not only one's own head, but that of their family?

How does one sort the decisions that paint a picture of a reprehensible excuse for a human being?  How can such a person not be brutally ashamed of their own fucking brain - regardless of what actually influenced those decisions and how?

I wish there were a simple answer.  I really, really do, because it is hard being that person - hard not to be ashamed to the point of incapacitation.  It's hard not to extrapolate thirty some years of bad decisions into an inherent failure.  It is hard not to take those stigmas that are attatched to being mentally ill and accepting them as absolute truth.  But there is an excellent place to start - a place that not only helps the person who has made these decisions, but helps others as well.

Fighting these vile fucking stigmas is a very important place to start.  Being loud and proud of who and what one is, because as reprehensible as many of my decisions have been, I am also a good person on a great many levels.  And what makes me a good person, what fosters the positive - these factors are just as influenced by the way my brain works.  Just as the bad - the things that can foster shame - are influenced by the way my brain works, so are the positives.  The same chemistry that has seen me getting high on all manner of stupidity, has also seen me fostering my children's native intellect - communicating, reading and providing them with the absolute security of my absolute love for them.  The same chemistry that has seen me sleeping under bridges and in all manner of flops, has also seen me work feats of extreme beauty and grace in multi-million dollar homes.  The same chemistry that sees me lashing out in extremely harsh words, has also seen me develop a love for a wonderful women that transcends anything I ever thought anyone could feel in that context, let alone me.

Stigma is a trap.  Stigma is a prison of invisible bars that hold some people far more firmly than steel and concrete could ever manage.  Stigma does nothing but destroy and break further, people who are already broken and in need of healing.  Not broken because our brains are atypical, but because we haven't the tools to integrate our neurochemistry with the society in which we exist.  We are broken, because our society doesn't have a place for us - though that is slowly changing.  But regardless of what makes us broken, stigmas just exacerbate the problem - the brokeness - the shame.

Because I love you all, I wanted to mention...

...that I am becoming increasingly busy, as the end of the summer semester approaches. I have a shitton of work to get finished and a week from today, I am picking up my boys from TN. I will still have two finals to take after they are here and lots of important, fun things to do with my kids - whom I only get for a very short, less than two week stretch. Then I will have a few days to take care of non-school type business (Like the job I have managed to somehow basically take over), before the absolute greatest women ever is coming to see me, for about a week.

So blogging is going to be lite - or should be. If it's not, please feel free to naggingly ask me if I have gotten ahead of the mountain of shit I have left to do. Not that I expect you to, it is after all my responsibility to put my work ahead of my infesting conversations with my big blue meanieness (really, really, mean and nasty, big blue meanieness)...But if you have the urge and notice I am being a little more obsessed with a argument than someone who has too many other things should be, feel free to point out my stupidity in being so obsessed right now....

See you all on the other side...

I love to be loved...

Not sure exactly who is sending it - it may even be the company that makes them, but I am extremely grateful to whoever decided that I should have the newer generation e-cigarette. I got an email from the company a couple days ago, confirming the order to my address. Kind of freaked at first, because the order is for the E9 with several cartridges - an order totaling about $100 including shipping, thinking there was a mistake that I was going to get charged for.

There wasn't. I emailed them and was simply told that it was not charged to my account. They didn't say that they actually sent it, but given the language issues and that they use a third party for "help" questions, that doesn't rule it out. And I had mentioned to them that I have been writing about their E9m, which is a very different model, they may have decided they wanted me to write about the new generation nicotine vaporizer.

In any case, I will have the opportunity to write about the E9 within the week.

But if one of my readers decided I should have one, I would like to say thank you ever so much. And just in case anyone was wondering, I really love books. I am all about the books really. Especially books by people who want to send them to me and find out what I think about their books. In fact, if anyone sends me their book to review - I would be all about reading and reviewing it.

I almost forgot to give an update on the smoking, while I am on the topic...

I am still smoking, having steadied at about 3-5 cigarettes a day, sometimes only two. I had a couple of days that went to six, but have been doing less far more than more. I do seem rather stuck on the last few, but that is far better (and cheaper) than the average of 20+ I was on before. Mine does seem to be a common experience with the e-cig, though there are plenty of folks who manage to quit tobacco altogether rather quickly.

Juxtaposition 235: Cthuluh, Jack Chick and Child Abuse

Update: Dan J, in his total awesomeness, managed to find a link to a PDF of the Cthuluh tract at the artist's web site... Thanks Dan. I would also like to heartily recommend giving his latest post a read - I can't help but be terribly pleased to find that someone else came up with a rather more "profane" rant than I did - and a very good one at that. He makes several points that I will delve into at some point in the relatively near future - I am more than a little fucking tired of this bullshit notion that we should accept dangerous behaviors and decision making from people, that we wouldn't accept under any other circumstances, simply because there is religion involved.

As Dan so eloquently puts it; Fuck Them!!!

It is terribly amusing to me, that at the same time I managed to get into an argument with someone about Tiamat and the fact that Cthuluh is really cause for far more concern, because frankly Cthuluh wouldn't kick Tiamat's ass - h'd jst fckng eat hr, I also noted this delicious little tidbit posted at Pharyngula. I found it while perusing a few blogs that were involved in the crushing of my hopes for Canadian healthcare. I have a rather dark sense of humor, so I thought it was more than a little amusing. But when I was talking about it with my dearest Juniper, I realized that there is an element to the humor that one is likely to miss, if they never experienced Chick Tracts when they were a child. In a most unfortunate turn, it seems that the old tracts aren't available online and the new ones aren't quite on a par with the ones I was exposed to as a child, but I did find a couple that provide a decent taste. "The Beast" shows a common theme that runs through many of these tracts, providing up with a glimpse of what we can expect in these "end times." There were a lot of scenes that showed us what hell was like, showed Satan as a deceiver and even several that talked about specific demons and types of demons.

Juniper just didn't find the Cthuluh tract nearly so amusing at the end - it is, I will grant, rather disturbing. But honestly, it is not the least bit more disturbing than a lot of the Chick tracts are and were even moreso when I was growing up. And when I was four, five and six, I read Chick tracts all the time. There were scads of them at church and I happened to be rather adept at ferreting about in the sorts of places they got stored. They were comics, which are just lovely fun for a child and no one thought anything of seeing any of us kids reading these abominations. Never mind the demons and souls and brutal destruction of life and property - it was all for the greater biblical good of raising good Christian children. It was also a hell of a indoctrination tool. And it is ever so useful for a small child to get a headstart in understanding demonology.

During this same conversation, Juniper and I got to discussing my parochial school experience - it actually came up when I casually mentioned being paddled by the principle fairly regular like. It occurred to her that this was a very good expression of this concept of arationality that I have been on about, since I first noted it's use by that albino gorilla, John Wilkins. Because I think it's important to recognize that a great deal of creationist and general religious thinking falls outside the purview of the rational/irrational dichotomy - though my opinion about the value of that understanding would probably differ fairly significantly from John's. So picture a bit of my life, if you will and see just how irrational my thinking was as a child and how irrational much of my adult life has been...

Fast forward to the third grade - I have been steeped in such brilliance as those older Chick Tracts. I am firmly entrenched in the terrorizing Belief that my dad and other people I love quite dearly are bound for eternal torment in hell, unless they accept my god in their lives. I am already a "Royal Ranger," the scout group that is part of the Pentecostal, fundamentalist church my mom and I are attending. And now I am getting set to start school at the same church. Without five days a week of elementary school, I am spending the vast majority of my time in this church. I'm in the choir, I am there on Weds for Royal Rangers, I am often there on Sat, for events involving both and there are a lot of activities happening throughout the summer. And now I am going to be there for school. Where I will learn some academics - and a whole lot more of the religious nonsense - six, often seven days a fucking week.

I was rather cleverer than the average bear, no question. But all the cleverness in the world is for naught, when all that is going in is filtered through rather extreme dogma. I was, at one point, taught that intellectualism was another religion - much like evolution - a tool of Satan. I was taught that I needed to focus all of that intellectual acuity on things that fostered my faith and the faith of others. My dad ran a strong counterpoint to the notion that focusing much of my intellectual acumen on anything not within the purview of my faith was wrong. But that didn't stop me from developing some rather deep seated shame - shame that would ease up from the recesses of my mind, to make me rather frustrated with myself - possibly even ashamed of myself, whenever I allowed my intellect to be wasted on anything that didn't bring glory to my god. After all, God had given me this intellect - how dare I ever waste it on the world...

Chris Mooney wonders, in his reply to me, why the realm of moderate faith isn't a reasonable place for fundies like I was to end up - at least for a while. Why I shouldn't, in spite of my anger, recognize that this is better for that person than being a fundie. Well here's the problem with that...

I have always been an insatiably curious person - I was curious before my infant eyes could clearly view the world around me, I was curious when my brother taught me to read at two, I was curious and I was clever. I was also pervasively lied to for many years - lies made no less egregious because those inundating me with them believed the lies themselves. I was taught to be ashamed of too much curiosity, unless that curiosity was firmly focused on the dogma I was constantly and consistently hammered with - day in and day out. I was taught that the majority of the humanity that I was commanded to love, were going to suffer for all of eternity in hell, because they didn't worship the right god, didn't worship the right god properly or didn't worship any god at all. I spent subsequent decades trying to make reality fit within the confines of dogma - tried to shift the dogma to accommodate reality - became increasingly desperate to find some way to hold onto my Faith, because that was right and critically important.

Please, if you don't see it as such - please explain to me how that experience of mine wasn't child abuse that led to decades of hell. Drug abuse, self-loathing and unrelenting depths of despair, masked by extremes of sensory overload from sex, drugs, writing and music.

More importantly, why should I sit back and pretend that this moderation that Chris speaks so highly of is any better for some of those people, than it was for me. At least when I was a fundie, I was somewhat content. I wasn't desperate to make it all make sense, because it made sense - I didn't need to question, because the answers were there and beyond those answers was minutia that I could parse easily, through prayer and study. Yes, I was occasionally angry and ashamed by my inability to focus everything on my god - but it was unquestionably easier than the suffering of the last eighteen to twenty years of my life.

I am certain that there are many people who are more than happy to live in that realm of moderate faith - I don't really care. Because for many people, that moderate faith is merely fundamentalism tainted and broken by doubts. A desperate place where the reality is an increasingly desperate need to make the absolutely incompatible weave into the fresh whole cloth of a coherent worldview.

I am for helping them, helping people like me - period. If some moderates and fundies get hurt, angry or offended along the way - well honestly, I'm not even really sorry about it. Both groups and those in between and outside on the fringes foster an environment of absolutely hellish agony.

That is what I am combating and will continue to combat. And I am not going to apologize for it - no one who fostered my personal hell has, or has even shown any remorse for my experience there.

Cannabis is Magical!!1!11!!!!

Context. And more context.

Or at least seems to induce a fair amount of magical thinking.  And that would be magical thinking not a hell of a lot different than claims of magical gods, psychic phenomena or the belief that vaccines, cancer drugs and many other medicines are actually poisons being peddled to unwitting consumers by the evile of Big Pharma.  People who rightly mock conspiracy theories about 9/11 and new world order, secret governments, turn around and make the base assumption that none of the evidence showing that cannabis has more than negligible deleterious effects can be true, because there's a government conspiracy to hide the truth and scare the masses.

There is fairly exhaustive evidence that indicates the legal status of cannabis is absolutely absurd and that the scare tactics engaged by most public agencies is vastly overblown.  That is not to say that there isn't risk and evidence for harm stemming from cannabis use, on many different levels. 

There is no question that smoking anything causes respiratory damage and damages cilia in the upper throat.  Anyone who has ever cleaned a pot pipe knows that the tar left behind is impossible to clean off with water alone, unless it's boiling - this same tar mattes the cilia in the esophagus and like tobacco, coats the lungs.  While the average cannabis smoker, smokes less than the average tobacco smoker, thus lessening the overall damage of smoking it, the tar that is formed is actually worse weight to weight, than the tar from tobacco.  There is a great deal of evidence indicating that cannabis smokers who do not smoke tobacco have a higher incidence of  bronchitis and chronic bronchitis, than non-smoking populations.

No links have been found between cannabis smoking and lung cancer or emphysema - though there is evidence of proteins that are thought to be precursors to cancer in cannabis smokers, there is also evidence that cannabis use may inhibit the development of those proteins into cancer.  It is important to note however, that there is no evidence that it impacts the incidence of cancer in concurrent tobacco smokers.

Reproduced studies have indicated that the incidence of cannabis addiction in cannabis smoking populations is around fifteen percent.  Addiction being defined by the DSM IV criteria, a conjunction of pervasive use, in spite of significant personal harm.  Cut that by a third to be certain you've weeded out biased diagnosis - cannabis is magical you know - and you still have one out of every twenty cannabis smokers addicted at some point in their life.  When we look at populations that use cannabis and also have concurrent neurological issues, the percentage skyrockets.  And it is very common for people with neurological issues such as ADHD, bipolar, schizophrenia and other psychotic disorders to use tobacco, use cannabis and other illicit drugs. 

I could go on and on, but here are some articles that do a much better job than I.  I am way too busy at the moment and will get to more evidence - recent studies and the like, when I can.  These peer reviewed journal articles and reports are not protected by pay walls and easier to throw out there, because you can read them and I don't have to summarize anything.  I don't have the time to summarize material that is paywall protected, I'll get to it asap, but I am trying to get through a lot of credits this summer and it's more than a little stressful.

A Lancet Seminar.

The 2001 Australian study on the health effects of cannabis use.  I suggest looking at the summaries of each section and then looking at the body of each section, if you have questions.

The British Journal of Anesthesia. 

The British Journal of Psychiatry. 

This wasn't hard to find folks.  And this is just what I looked for to throw something up that isn't paywalled.  Are we to believe that there is some conspiracy that is trying to toe the usual line of most public agencies in the U.S.  Oh shit, I'm sorry but are we to believe that there is some government conspiracy to contradict the usual line of said public agencies?

Of course there is, because I just keep forgetting that cannabis is fucking magical.  Sorry, I'll try better to keep that in mind from now on.

DuWayne's New Addiction

A friend has loaned me most of the "new" Battlestar Galactica with the rest to be loaned as I finish the first seasons. I may be in trouble now - blogging could suffer (because school can't) as might my socialization. The sure sign of an addict - when they spend time alone with their addiction, instead of with friends and loved ones.

So if you'll excuse me, I need to be alone with my new crack...At least until the most wonderful women to ever grace my life calls.

Ya Think (bloody damned morons)

I needed a little break from my final paper, so I thought I would take the moment to share this little nugget of wisdom I found in The Cognitive Therapy of Substance Abuse. Keeping in mind that this is in the context of the first session with a new client:

For example, the cognitive therapist would be ill-advised to speak in the following manner:

"We're going to be examining your thinking processes, to understand the kinds of cognitive distortions that lead you to engage in maladaptive behaviors such as drug abuse and antisocial behaviors."

I'm sorry, but if you are honestly stupid enough that it would ever cross your mind that saying anything at all like this to any patient would be reasonable, you really need to find a career that doesn't involve cognitive therapy of any kind. And if you are stupid enough that you would consider saying that to an addict you would actually like to see get help, you really need to consider a career that doesn't put you in a position to be a risk to others - like pressing buttons that go bing.

What irritates me about this example, is not simply that it's so completely absurd, it's that there are a host of more subtle mistakes that a therapist could make that aren't shown. For example, I could see a therapist saying the following, especially if said therapist was new to this and rather nervous:

"So John, what I'd like to do is explain a little bit about how cognitive therapy. I'd like you to feel free to ask me any questions you might have about this type of treatment, so don't be shy. We're going to try to understand how you see things, how you feel about your life, who you are - about using drugs. This is important, because it can give me a good idea of where your coming from and where things went wrong. This will also start to help you understand yourself a little better and help you turn your life around in a direction you would be more satisfied with."

Do you see the problem ? It's subtle and could actually turn out to be language use that the client will be comfortable with. But there is no way that the therapist can know that in the very first conversation with a client - especially a client who is a substance abuser. Even when they were the one to initiate contact, drug abusers are notoriously reticent about help seeking. Quite often the first session is going to be the only session - even if the therapist does everything right. So this first session is walking in eggshells - you will not get a second chance to fix any mistakes you make.

"...where things went wrong." is the problem statement. Yes, they are there because something is very wrong and presumably things went wrong somewhere. Odds are pretty damned good that if they're in your office, they even know that things went wrong somewhere and assume that you know this too. The problem is that verbalizing this smacks of judgment. The client may well decide you believe that they are wrong as a person. Even if they don't go to that extreme, it is likely to both anger them and flare up their shame response. One simple word like that can easily cut the chances that the client will return in half.

I don't want to give the impression that this book is horrible. Actually I think it does a fairly admirable job, though I disagree rather strongly with some of the base assumptions of the authors. It is a book intended to be supplemental material for the practicing cognitive therapist who is getting involved in treating substance abusers and addicts. Ultimately, this is really my problem with the aforementioned scenario - while the example they give should be absolutely obvious to anyone who was able to become an accredited cognitive therapist, the example I provide might not be as obvious. And while making a "wrong" statement to any patient should be avoided in initial sessions (with most clients, at all), it is especially critical when dealing with addicts. If an example of what not to say under the circumstances were necessary, it would make far more sense to use one that is more subtle - a reminder to reinforce what the cognitive therapist has already learned, probably repeatedly, over the years they've spent in school.

As a complete aside, I will note that under pressure and feeling rather crappy, I have managed to smoke only three cigarettes thus far today. Although my Joni Mitchell station on Pandora is helping an awful lot. That and my e-cig...

Wherein DuWayne Rants About the #$@&ing Drug Laws

Before I start, I would really like to recommend that you take a listen to Gabriela Montero. I recently discovered her whilst listening to one of my Pandora stations and her playing made me weep for the beauty and the passion with which she throws herself into her variations and compositions. Gabriela is a wholly remarkable pianist, a child prodigy who has matured into brilliant and nuanced composer. And she is also great stress relief...

I have had a not so grand day today. It started well enough, though not as productively as I might have wished. And I had a fantastic visit with the doctor, where we discussed my meds and how the new regimen has been working out. We decided to double my dose of Wellbutrin, from 100mg in the morning to 100mg in the morning and another at lunch (something I was going to do a couple weeks ago, but chose to wait because he wanted to see me to add the extra dose). I was actually feeling pretty damned good when I left the doctor's office - almost three and I had only smoked two cigarettes all day.

How quickly things can change. Today I discovered just how fragile a thing, this thing that is my calm and collect self.

More...

The fucking war on drugs put me on the verge of a nervous fucking breakdown today. Though I was heading that way when I went to get my scripts filled in the first place.

My fucking Wellbutrin costs eighty-six fucking dollars as a fucking generic. Eighty-six dollars!!! And the version I am taking is not available much cheaper anywhere - including mail order. I very nearly started crying in the fucking store when they told me that. I'm working on getting help with my scripts through the state, but the wheels turn slowly. My folks are helping out some, but that just stresses me out more, because I don't want to be a fucking burden on them at thirty-two years old. I was frustrated and angry and decided to hold off on that one to see if I could find to cheaper elsewhere, or if there might be another option for finding Bupropion for less, but in the same dose as I've been taking.

No such luck, this time around.

So I decide to get it filled and owe my parents even more. Fucking yeah for me!!! I headed back to Wal-Mart and handed the women at the window the script, having completely forgotten that I had been told earlier (when I dropped off the others) that they were out of that one anyways. The women at the window punched it all into the computer and told me it would be about twenty minutes, so I sat down to wait. After about half an hour, the women who had originally taken my scripts came out to remind me that they were out of that particular dosage of Wellbutrin. Mind you, the women who had taken the script had seen me sitting there several times, while helping other fucking customers - never once occurred to her to let me know that I couldn't get my fucking drug. Nor did they consider just fucking calling me to tell me - if they hadn't noticed (they are usually really good about calling for stuff like that and they weren't very busy).

What the fuck does this have to do with the war in drugs, you ask?

I had a check with me, written for the total cost of all three of my scripts. And even though another Wal-Mart has the Welbutrin, I couldn't pay for it at the one I was in. So I had to transfer the other two to the other fucking pharmacy as well. The only problem being that Clonidine and Ritalin are controlled fucking substances and they can't be called in. They can't be faxed over and apparently, they can't even get them ready in anticipation of the fucking paper script being brought in. Nor can they be refilled - every month, my doctor has to write another script for me.

Of course I had wasted nearly half an hour sitting in fucking Wal-Mart before I became aware that I would have to go to another store - about half an hour across town. And not only would I have to run over there to get them, I would have to fucking wait there while they filled my other two scripts - because we have the most ridiculous fucking drug laws ever. Mind you, it was close to dinner time and a friend of mine was joining us. I was about fifteen minutes late when it was all over with. (Though I did get a text from the most beautiful and brilliant women in the world, who just seems to know when a text from her is going to take the edge off of stressful situations - thanks Juniper)

My problems today and with getting more than thirty days worth of my meds at a time, are far from the only egregious intrusion that our draconian drug laws have thrust into medicine. Because of course, there is also the war on pain management to be considered. You know, the war in which not only patients who doctor shop and fraudulently acquire multiple scripts for the same pain killers (often times to sell them) got to jail, but even doctors who appear to be over prescribing and patients who are engaged in a good faith pain management regimen with their (only) prescribing doctor.

I am so fucking tired of this paternalistic fucking bullshit! This has gotten beyond fucking ridiculous - went beyond that point fucking years ago. The war on drugs interferes with the ability of doctors to care for patients, therapists to freely help drug addicts and substance abusers and patients to have reasonably simple and rather less costly access to their medications.

Fuck You drug warriors - Every MotherFucking One of You!!!

First Report on the E-Cigarette - And Seeking Contributors

Yes, I really am writing about it just six hours since I arrived home to find my e-cig had arrived - there's a very good reason. By this point in the evening, I am usually going on my - oh probably fourth by now - maybe my fifth (the time is going by quickly). I usually smoke about half a cigarette at a time.

I have smoked a few hits off my second cigarette since I got home. That would be, well, considerably less than usual and I just got the damned thing.

It is definitely different, kind of like a cross between smoking a light cigarette and hitting a slightly clogged pinch-hitter (cannabis smoking implement (yup, I won't define alexythemia, but a pinch hitter...)). This thing really rules, even if it is not all that much like actually smoking - which I suspect I will find to be a good thing in the future - similar enough to help me off the smokes, different enough that I think it will be easier to get off of.

The vaporizing liquid, is flavoring, propylene glycol, water and, of course, nicotine. The nicotine is actually synthesized from tobacco, but (they claim) that what is left is just nicotine. But even assuming that some of the other elements are left, it's vaporized, not smoked.

While I definitely think it is too soon to say for sure how it will work for me, I am now comfortable with the idea of advertising it on my personal blog. I have heard enough people talk this particular one up now, that I am very confident that I can provide you with an honest assessment of how it's working for me and tell you how it's worked out for the folks I've talked to about it. Any questions are totally welcome at any point.

I will get a small amount from sales, five percent for most, ten percent with less expensive, maintenance supplies (disposable parts, mostly cartridges). I just want to disclose that, before anyone accuses me of being a shill - because frankly I am really excited thus far. But keep in mind that it's not much in the general scheme and if I sell anything at all, it will likely only defray a fraction of what I am spending on it (which is a lot less than smokes).

I will not however, be advertising this on the Quitters Blog. I did not start that blog to sell stuff, rather it's a side-effect of deciding to quit smoking. I am interested in starting a community there, not make a profit.

So we are up and running over there, but I am needing your help - whether you smoke or not, work in that field or not. If you have a blog, please link to Quitters Blog and let your readers know that we are looking for people to contribute. And if you have the urge to throw it in, I am also interested in hearing from anyone with other substance abuse/addiction problems, who would be interested in joining a similar venture - on another collective project. I have been considering ways to do this for a while and am realizing that I am simply not likely to have time to start a full on forum, any time soon.

If anyone would be interested, it is not a problem to remain entirely anonymous and post. I will be happy to offer anonamail-in posting - whatever it takes to make folks comfortable writing about their experience. I would prefer, as much as possible to just make people team members - and folks can still hide their blogger profile, while front page posting as a team member. I just don't have a lot of time to put into it, though I will certainly post on all the blogs (mostly cross-posts from this blog)....

I got my E-Cigarette!!! - Calling For Smokers Ex and those who want to be be Ex...

Addendum - I am looking for contributors - I am setting up a quitters blog, see below. No longer considering it - doing it. Email me or leave a comment.

And it's up over here - please leave a comment there or email me if you are interested in contributing...

Just came in this afternoon, while I was at school and it rocks. It will take some getting used to, but I think this is definitely going to make a huge difference in my run to quit smoking.

And while I'm on the topic, a visit from one of my favorite commenters at Dispatches, Abby Normal, got me thinking. Abby posted a really kick-ass comment, describing his experience with quitting smoking. Would there be any interest from my ex-smoking readers, as well as those who are trying to or who are planning on quitting, in a blog project for you (and me) to post about our experience? I would love to throw up another blog around here and allow you all to post - with team posting privileges for those who want them.

I would also be really happy to add medical, sciencey types and addiction counselors to the mix, should they wish to contribute posts as well.

I think that this could be of immense benefit to all of us, especially those of us who are still smoking. If there is interest and it works out, I would love to add blogs for other addiction issues - or possibly a forum. Though if the latter was developed, it would require volunteers to moderate. And keep in mind that I really can't devote much time to making this go, which is partly why I would just prefer to give those who want it, team posting privileges. This would not be something to abuse and there would have to be some rules - number one being to keep it topical. But I think this could be pretty rocking big fun, as well as built in support for us quitters.

Please let me know what you think.

And actually, I should also note that though I've gotten out of the habit since I resurrected this blog, I am all about having guest posters. I will be somewhat selective about what I post and will admit that my reasons may be pretty arbitrary, but I am all about hearing from you, if you want to post. I do recommend that you ask me before you write the post, so you don't end up writing something that I don't really want - but I really do like the idea of getting some other voices up around here and outside of comments. Finally, please don't assume that because you disagree with me on something, that I won't be willing to post your views - there are some things that I just won't, but that is not a common restriction for me.