The Heart of a Parent

Just a couple of weeks ago, JTNN and a number of our partners held a press conference at Reno City Hall featuring Mayor Bob Cashell, his wife, and his son, Pat who is openly in recovery from an addiction problem. The purpose of the press conference was to raise awareness and money for a heroin prevention campaign that we are putting on early in 2011.

During the event, Mayor Cashell faced the media, who were there in force, and said, "When my son Pat had an addiction problem, his mother and I didn't know what to do." Here is one of the most influential people in the Reno community saying, "I didn't know what to do." With tears in his eyes, the Mayor went on to talk about how his son had a problem for many years but now is sober and doing well.

There's a lot we could talk about in that story but what really reaches out to me is the heart of a parent.

When a child, whether grown or not, has an addiction problem, so much goes through the parent's mind. Some of these thoughts include, "I'm a terrible parent," "What did I do wrong?" "What happened to my little one that used to play with toys and watch cartoons and was so excited about birthdays and Christmas?"

When a child becomes addicted, a parent's heart breaks. It may look like anger or disappointment or depression or any number of things but it's all about a broken heart.

I've talked to many parents and they all say something similar: "I didn't know what to do but I would do anything that I could." A parent's heart may be broken, but that heart still hopes and prays and wants and works for the best outcome for his or her child.

Some parents get their child back and some don't. Some of these children get into recovery and all is well. Some die. Others keep using drugs. And others may quit but they are never the same again. I remember one mother telling me that after her daughter used methamphetamine for a number of years, she finally received treatment and is doing well, "But," the mother added, "She's not the same person that she was...I miss that part of her." That mother still loved her child and was thrilled that she made it out to the other side but she grieved for the child she lost to
the addiction.

There's more on my mind but what I've also learned about a parent's heart is that most want to help. We are excited about the number of parents that have come forward during our heroin campaign. We hope more parents come forward for support from other parents, to volunteer, and to share their stories. I look forward to meeting each an every one of you.

Much Ado About Nothing?

There has long been controversy about women who drink alcohol during pregnancy. In fact, the problem of birth defects and other problems caused by maternal drinking has become such an issue that the advice now given (at least officially) is, "No level of alcohol is safe for the unborn baby during pregnancy."

This abstinence advice has been challenged by the findings of a study reported this fall in The Journal of Epidemiology and Community Health. According to one source, "Using data from the Millennium Cohort Study in Britain, a data-rich look at 11,500 children born in the U.K. 2000 and 2001, researchers at University College in London concluded that the children of women who drank 'lightly' — meaning up to one to two drinks a week — during pregnancy did no worse on cognitive tests at age 5 than children of mothers who did not drink at all. Actually, they did slightly better on the tests, which included things like 'naming vocabulary,' 'picture similarities' and 'pattern construction.'”

According to the study, the children of mothers who went beyond “light drinking,” however, had noticeably lower scores.

This could be great news for women who would like to imbibe a little while pregnant but there are some troubling issues still.

This reminds me of a study published by the Rand Corporation in the late 1970s that proclaimed some alcoholics who were sober could possibly return to social drinking without ill effect. Regardless of the soundness of that science the real issue here is that every alcoholic I knew back then said, "I'm one of those. I can return to social drinking!" Disastrous thinking for a person who has the disease of alcoholism.

So, I see the same thing here. As many of the bloggers on the pregnant women and alcohol issue said, my mom drank alcohol (moderately I presume) during pregnancy and I'm pretty sure that I turned out OK in terms of thinking abilities and related items. But the point of telling women that no alcohol is safe isn't about answering the question, "Is one drink safe? Is two safe? How about three?"

The point really is about what how close to the cliff do you want to go without falling off? For instance, what is one drink? I have known people who think that one drink was an 8 to 12 ounce martini. For another instance, the answer from an alcoholic when asked, "How much did you drink when you were arrested for drunk driving (for example)?" the answer is often, "I just had a couple." As that elusive number is pursued, it often turns into 4 or 7 or 12 drinks. In other words, a
pregnant woman, especially one with a drinking problem, may THINK she's drinking one drink but is actually drinking more.

For a final instance, what's the big deal about not doing something for 9 months, especially when the potential for harm is so great?

Many of the blogs written in response to the research article talked about how scared we make women in America about being pregnant and they were full of testimonies (like mine) that "my mom drank and I'm OK." But if we are going to err, let's err on the side of safety.

I don't want to scare anyone and I don't want to oppress pregnant women with rules and regulations and do's and dont's that make them feel persecuted for being pregnant. But I have to say that I have known many women who have given birth to children with Fetal Alcohol Spectrum Disorder (FASD). While these are lovely and loved children, that condition can be devastating to the child and the whole family (not to mention the price tag to society). In addition, FASD is totally preventable.

Why shouldn't we warn and encourage women to do everything they can to have the healthiest baby possible? A human life and preventable disabilities that last a lifetime are worth the conversation and the effort.

Different Day, Same Story (Sort of)

I was in high school in the late 1960s when the news began to report on soldiers from the war in Vietnam coming home addicted to heroin. Now, most troops didn't take heroin but there was enough to make it something to talk about. This may have been the beginning of America's modern day awareness of heroin addiction.

I remember those days and how the drug seemed so awful, especially because it was associated with injection, crime, and a lifestyle that most of us can't relate to in the least. Then Hollywood took over and showed us a sometimes realistic and sometimes exaggerated view of heroin use. I'd say we had a very negative view of heroin and everything related to it. I'd also say that I was afraid of the drug and would never have tried it. My reaction then was kind of like the reaction of many kids today with methamphetamine. I saw it as a "dirty" drug.

But times change and people sometimes forget. Heroin addiction and related problems have never gone away but our general consciousness about the drug waned for a number of years. I remember when I first moved to northern Nevada 25 years ago, the prevailing wisdom was that there were very few heroin addicts in the area. Not true.

Fast forward to a year or two ago. Painkilling, opiate based prescription drugs are becoming a much talked about issue. At the same time, we begin to notice that youth coming to treatment are showing up more and more for heroin. Adults, too. But this is a smokable heroin. The old fashioned heroin "junkie" of the 60s and 70s seems gone.

But what happened that heroin just seemed to jump back on the drug scene? First of all, it never left. But I will say that I think today it's reaching a wider audience and, like the heroin epidemic of the 60s, we're noticing it more because it's affecting younger people and even teens. And for some, injection is still part of the culture of use.

What's different now is that we are seeing a pattern of use that seems to start (for many) with prescription painkiller use. Then, for some, abuse. Finally, for some of those that abuse, heroin. So far we've been seeing and hearing about smokable heroin. But now treatment providers and others are noticing more injection use of the drug, as well.

I bring this up because while we've been focusing on methamphetamine and more recently on prescription drugs, heroin has been making a major comeback. JTNN is looking into the reasons and will be reporting more as we learn more from the data. But for now, we are looking at the fact that heroin use and addiction is still with us. More to come later.

Uncle Bob

Everyone has a story about a person in their life who has a drinking or drug problem but can never seem to get better, despite the best efforts of those around them. Unfortunately, this person's story is often used to prove that treatment for substance use disorders doesn't work and that recovery from said disorders rarely happens. "My Uncle Bob has been to treatment 12 times and he never lasts more than a week after he gets out." "My Uncle Bob quits from time to time but he just can't quite get on track." "Uncle Bob just Bob just doesn't seem to care about staying sober even though he has been given SOOOO many chances. I guess he just doesn't care."

Everyone has an Uncle Bob. It may really be an aunt or a dad or a sister or a best friend or a co-worker or a next door neighbor. But we all have at least one person in our life that seems to symbolize the fact that chemical addiction is a hopeless disorder from which very few get better or recover. You're probably think I'm going to launch into a sermon on how effective treatment is and "Shame on you for believing in the Uncle Bob Myth!"

Actually, I won't do any of that but I will make a statement and then I'll tell you a story. The statement is this: "For every Uncle Bob you tell me about, I can counter with a story about someone who was a 'hopeless' alcoholic or drug addict and who is fine today." In fact, I challenge you!

Now, here's the story: Lori is a 37 year old female with a 21 year history of alcohol and drug addiction that started with alcohol and marijuana but over the years included methamphetamine addiction and prescription pill abuse. She was pretty functional until she tried methamphetamine at 24 when she was a young mom with two young children and a marriage that started off well enough but now was facing some trouble. There's not enough room here to tell you all the details but through her drug use Lori lost her marriage and custody of her children. In fact, it got so bad that she actually chose drugs over raising her children.

Over the years Lori managed to scratch out a marginal living doing various jobs and living in a small apartment or sometimes with a man that would take care of her. But her life mainly consisted of using alcohol and drugs and just surviving the best way she could. She often thought about quitting but would always remember her Uncle Bob (Remember, everybody has one!) who seemed to try and try but never could quite help himself.

Then Lori really got into trouble. She was arrested for a drug related charge and was looking at serving some time in prison. Life had never been so bad. Lori was convicted of the crime but was given a chance to attend something called drug court and treatment instead of one to five years in prison. She thought about treatment and how it sounded kind of useless but she visited her counselor and group sessions each week, as required. She also went to self help meetings (Alcoholics Anonymous and Narcotics Anonymous).

She began to keep track of how long she was drug free and she began to think that maybe there was hope after all. She met people who were sober, just like her with stories a lot like hers. Life still was hard but as the weeks and months passed, she began to realize that with some effort on her part, some honesty and integrity, and a strong support system, life might be OK after all without alcohol and drugs.

Fast forward 10 years. Looking back at that day that she went into drug court (with some misgiving, at that), Lori decides that it's been worth it. All has not been perfect. She had a relapse about 6 months into her recovery. Then she had some health problems about 5 years ago. She and her kids talk now and spend time together, although she knows that she could of spent more time being part of their lives but she can't undo that. She has to deal with the remorse but she also works on that by forgiving herself and making "amends" whenever and wherever possible. Now she lives in the day but also looks to sunny days ahead. She has a grandbaby who she adores. Her Uncle Bob died last year and he never did get sober....but Lori did. She mourns him but she celebrates her own recovery.

Not everyone gets sober but many do. Recovery happens all the time not just occasionally. September is Recovery Month. You'll be hearing more from me about that later. Let's celebrate and remember the thousands and the millions in recovery from a substance use disorder. In the meantime, remember Lori.

Responsible Drinking is Safe and Legal

Consider the four following situations and ask yourself, "What do these have in common?"

1. Last year a national study named Reno as one of the heaviest drinking cities in the nation. This statistic was based on something like how many people drank two or more drinks at one sitting. The local media had a heyday with that statistic by going around to local bars and polling patrons on their thoughts while they hoisted a drink or two. The study and its findings dissolved into a haze of misinformation and laughter.

2. More recently, an article was published in the Reno Gazette Journal that talked about how local law enforcement works with local retailers to insure that underage youth don't have access to alcohol. The online article was met with derision and scorn by many readers who said, "Doesn't law enforcement have anything better to do than to harass kids who are trying to have a good time?"

3. I was recently with friends and noticed that a pregnant woman in the group was holding a glass of wine. I didn't see her drink any but I asked someone in the group later about it. The response I got was, "What does it matter if she drank a glass of wine or two? What harm could it do?"

4. In the last few years, most alcohol commercials on TV end their 30 seconds with, "And remember to drink responsibly."

OK, if you asked the question, "What do these four have in common?" you may have come up with, "Alcohol." That's true but I'm asking for something a little deeper than that. So, what is it? I'm thinking that the common denominator is that we, as a society, have a very ambivalent attitude about alcohol in general, toward abusive drinking, and even toward underage drinking.

Even though the science has shown us that underage drinking (under age 21) and heavy drinking over a certain amount at any age is bad for your health and puts you at greater risk for addiction, we still have that attitude of "kids will be kids," "let them sow their wild oats (they'll get over it soon enough)," or "a man's gotta do what a man's gotta do" (or a woman, for that matter). In addition, even though there is no known level of alcohol that is safe for a pregnant mom to drink in relation to the effects it could have on her unborn child, maybe just a sip or two won't hurt anything.

But the great salve on all of this is, "And remember to drink responsibly." That sounds so...so...so... responsible. When I first heard it I thought, "Those alcohol manufacturers are really swell. They get it." Then it occurred to me and to many of my colleagues that we don't know what the word "responsible" means in the context of drinking.

Is it, "Don't get too drunk?" Is it, "Don't drink too much and drive?" Is it, "Don't drink so much that you get in bed with the wrong person?" Is it, "Don't make a major life decision while drinking?" Is it, "Don't drink more than a sip when you're pregnant?" Trying to figure out what it means to drink responsibly is almost imponderable because it could mean so much to so many.

Considering that there are many definitions as well as many interpretations of that word, our underage drinking prevention group (Environmental Strategies Coalition) dared to actually plumb the depths of responsible drinking. After much conversation and doing our best to be objective and non judgmental, we came up with this... Are you ready?

"Responsible drinking is safe and legal."

We said "safe" because alcohol, when used to excess, can cause unsafe situations in driving, work, recreation, and even relationships. In addition, the most preventable disability in children is related to Fetal Alcohol Spectrum Disorder (FASD). It's 100% preventable because if a woman doesn't drink when pregnant, it's impossible for her unborn child to get FASD.

We said "legal" because the most current science informs us that if we can keep youth from drinking or trying drugs until age 21, then very few people become addicted later in life. Oh, and it's the law. There's also the matter of following the current laws such as not drinking and driving. We said "safe" because alcohol, when used to excess, can cause unsafe situations in driving, work, recreation, and even relationships.

Our definition of responsible drinking really isn't all that complicated but it also counters much of the laughter and scorn heaped upon efforts to get our fellow citizens in northern Nevada to think about how to prevent so many alcohol related problems in our communities. My sense is that those that laugh are the minority but are heard more because they make more noise. I would encourage you to speak up (respectfully, of course) the next time someone says, "Who cares if a 17 year old drinks?" or "What does it hurt if a pregnant woman drinks one drink?" Maybe we can turn this around.

I Don't Need Help

What would you say if I told you that 90% of babies with asthma don't get the medical care that they need? What would you say if I told you that 90% of children with cancer don't get treated? What would you say if I told you that 90% of women with breast cancer can't find a doctor to see them until they have progressed to a more serious stage of the disease.

OK, take a deep breath. None of that is true. But what would you say if I told you that 90% of the 23 million people with substance use disorders in America don't receive treatment? That statistic is true but it may not upset you or make you feel so uncomfortable as untreated babies with breathing problems.

So why do 10% (actually a little less than that) of those with a chemical addiction problem get the help they desperately need? Here are a few thoughts for you to ponder on that one:

1. There isn't enough help to be had. There is not one publicly funded treatment bed for adolescents in Washoe County, Nevada. That's for starters. Whether you are adolescent or adult, if you were to call around for help in our county or any part of Nevada for that matter, unless you have money down or insurance you will most likely face a wait time to see someone of days or even weeks. The problem is that addiction won't wait. It continues to progress and untreated alcoholics and drug addicts continue to use.

2. Stigma. There is no other disease or health condition that has more stigma than addiction. No one blames a child for having asthma because it's not their fault but the 28 year old with the methamphetamine problem or the 50 year old alcoholic is seen as weak, lacking will power, and responsible for their condition. I understand that and I understand why many feel that way but it has to be said that addiction is best understood as a chronic, relapsing disease that responds best to treatment. As for responsibility, I not only hold the addicted person responsible to manage their disease I also hold the diabetic to do the same thing. By the way, studies have overwhelmingly shown that addicted people have about the same compliance rate in treatment as those with diabetes, high blood pressure, and asthma have in following medical advice.

3. The last reason why so many don't get the help they need is that most people with addiction problems think they don't have a problem. In the treatment and recovery field we call this "denial." Denial isn't just denying you have a problem, it's not understanding you have a problem. Remember when you started a diet and then two days later you ate like you weren't on a diet? What did you tell yourself before you broke that diet? I bet I know. It was something like, "I can eat this...it won't hurt me...that one candy bar won't make me gain weight!" That's denial. It sounds like a lie but for just a minute you BELIEVE that you can do that thing that a minute ago you knew you couldn't do. That's what addicted people go through every minute, every day. They can't connect their problem with their substance use. Hence, they can't connect the need to get help with a life threatening illness. "I don't need help," is often the refrain.

Bottom line is that addicted people need to be informed that they have a problem and they need to be directed to treatment. Then someone needs to advocate for that person to get help. I know, I just said that there's not enough treatment out there but the effort can be made and treatment can eventually be found. And by the way, who ever said, "They have to want to change in order to get treatment," is uninformed. But I'll talk about that another time.

A Prescription for a Safer Community

Prescription drugs are certainly on JTNN's radar and have been for the last year. In fact I've already written about this topic twice in the JTNN blog. But there's more to be said.

On Saturday, JTNN along with the Reno PD and a number of other partners are hosting the second Prescription Drug Round Up in which we invite people to bring their unused and unwanted prescription and over the counter drugs. A law enforcement officer and volunteers will collect and catalog the items that people bring in. Then the Reno PD will incinerate the drugs. These are drugs that will no longer be in circulation and that will no longer have the ability to be used in a way that they weren't intended.

As part of a grant that the Reno PD has obtained, prescription lock boxes will be given away at the Round Up sites, as long as supplies last. This will provide the ability for people with potentially dangerous prescriptions to lock those pills and substances away and make them less likely to fall into the wrong hands.

Now, you may ask, "What's all of the hoopla about here? They're just pills and there can't be that many out there." Here are some statistics for you:

· Nevada's rate of prescription drug distribution for the opiate based pain killers Oxcodone and for Methadone is about double the national average.

· Nevada's rate of prescription drug distribution for the opiate based pain killers Hydrocordone (Vicoden) and for Morphine is about triple the national average.

· Nationally, there have never been more overdose deaths from prescription drugs than now and Nevada's rate per capita is about 5th or 6th highest in the nation.

It makes sense to do all that we can to take unused and/or unwanted prescription drugs off the street and get rid of them. Many people are concerned about these drugs going into the water system and I share that concern. But the bigger concern is that people are dying more often and at greater frequency from prescription drug overdoses.

If you'd like to be part of the effort here are the places we'll be holding the Drug Round Up on Saturday April 24th from 9 am to 3 pm:

· The Family Resource Center, 115 West 6th Avenue in Sun Valley

· Sak 'N Save, 1000 Plumb Lane, Reno

· Scolari's Market, 8165 South Virginia Street, Reno

· Scolari's Market, 200 Lemmon Valley Road, Reno

· Scolari's Market, 1300 Disc Drive, Sparks

Please come and bring your unwanted drugs. No questions will be asked and you can just drop off and go! We'll look forward to seeing you.

The Extreme Drinking Games People Play

Extreme drinking games -- when I was 16 that might have sounded kind of fun. There are games such as Beer Pong, Drink 'Til You Pee, Dicey, Fuzzy Duck and maybe hundreds more. There's even a drinking game related to the family card game Uno. In fact, when I Googled "extreme drinking games," I got hundreds of links and web sites. I'll let you do your own research on extreme drinking games, but basically they are designed for the participants to drink as much as they can in as short of time as possible. What's the goal? Extreme intoxication, of course.

But back to what I would have thought when I was 16. Back then I would have seen in extreme drinking games the opportunity to not only engage in out of control intoxication with my friends but I would have seen the unlimited possibilities of seeing who could drink the most, who had the best stories in the morning, and so on. Fortunately, my drinking career was short lived and nothing really bad happened to me. But looking back over almost 40 years, the thought of "What was I thinking?" occurs to me.

Obviously, that kind of insight is available to a 55-year-old with a career, a wife, grown kids, grandkids, things to lose, and so on. But a 16-year-old doesn't think that way. In fact, the so called "executive decision making" part of the brain isn't even fully developed in men until they are 25 and women sometime in the late teens or early twenties. So, of course, drinking as much as you can to get as wasted as you can usually sounds better to a teenager than to an aging baby boomer.

Now that I've officially established my credentials as a rapidly aging old guy who actually remembers being a teenager, let me say that there are lots of reasons why extreme drinking games are a terrible idea.

First, there is the potential for addiction. One way to get addicted is to use something like alcohol in large quantities over a period of time. Extreme drinking games are a form of binging and put a person at risk for future addiction. And the research shows us that the younger a person engages in that kind of activity, the better chance he/she has to develop a problem later.

Second, it's not safe. The body and brain aren't always on the same wavelength which means that when a person drinks a lot of alcohol at one time, the body will often accept it but then when that alcohol hits the brain, there can be an overdose which can be anything from becoming more intoxicated than intended, to losing memory (blackout) for minutes or even hours, to shut down of vital body systems resulting in coma and/or death. There's also the issue of medications. Many people don't realize that certain drugs, even prescription drugs, can multiply the effect of alcohol in the body, causing an overdose, as well.

Third, depending on the person and what's already in their stomach, the drinker may not feel the effect of the alcohol right away, thinking he/she is OK, when actually the opposite is true. This could result in not taking care in terms of making a decision about driving a car or some other activity that could be dangerous.

Finally, there's the issue of what we call social norms. We have many social norms such as "say please and thank you," "don't cut in line," and more. We even have social norms that help us understand that out of control drinking is not an appropriate or safe activity, especially in public. But extreme drinking games sponsored by casinos and bars that normally include younger drinkers creates a whole new social norm that says, "It's OK to get as drunk as you like, in fact, it's expected." That may sound a little on the prudish side but I have an 11-year-old daughter and a 5-year-old grandchild. I don't want them growing up in a society that glamorizes and glorifies out of control, falling down drunk behavior.

April is Alcohol Awareness Month. Let's put the brakes on this one and think better or ourselves not only as individuals but as a community. Is extreme drinking what we want to be known for?

Inhalant and Poison Awareness

I remember when I was about 10 years old, I tried to buy some airplane glue from a local hobby shop in Sacramento, where I grew up. "You have to have your mom or dad's permission," said the clerk. I couldn't figure out what that was all about. It wasn't like I was trying to buy cigarettes or beer. But it turns out that even back in 1964 we knew that there were some things that don't seem like drugs that could have dangerous effects when not used as intended.

But it's not just airplane glue. There are number of common household items that can be inhaled to achieve a certain euphoria. Some of these "inhalants" are "white out," computer dust off spray, gasoline, certain paints, some solvents, propane, the propellant in some aerosols (e.g.whipping cream cans in the dairy section), nitrous oxide, and the list goes on. These are all substances that can produce intoxication that lasts anywhere from a few seconds to much, much longer.

You may ask, "Why would anyone want to do that kind of a thing?" Good question. Often it's a younger child or teen or cannot afford or cannot find another harder to get drug or alcohol. It could be a homeless person who finds it cheaper and more efficient to get high off of paint or something else. It could be a college student thrill seeking just to see what happens.

You may also ask, "Is this addictive?" The answer is, "Yes." Inhalants can become habit forming and cause people who are addicted to them to seek them out in a compulsive way, much like an alcoholic who can't do without a drink or a heroin addict who needs that drug.

Another question might be, "What's so dangerous about inhalants?" Inhalants are one class of intoxicants that can begin to cause brain and/or physical damage to body organs right away. In addition, think about how a person uses this type of drug. The user essentially breathes in a volatile or poisonous substance into their lungs, depriving themselves of a full dose of oxygen or maybe depriving themselves of oxygen at all. That sounds dangerous to me!

What about treatment for inhalant abuse? I don't know of any inhalant abuse specific treatment center in Nevada but I do know that most treatment centers are equipped to handle a variety of issues and problems, which means that most inhalant abusers can access help through the treatment system in our state.

At JTNN we'd like to make you more aware of the potential dangers that can be found in some of the most mundane household items. For more info, you can go to
http://www.inhalants.org/about.htm.

The Science of Prevention

Substance abuse prevention seems like a simple idea. You prevent substance abuse. Of course I was taught in third grade never to define something using the same word (i.e. prevention is preventing something) because it doesn't add to the conversation and doesn't help us understand what that word really means. So, what does substance abuse prevention really mean? What are we trying to prevent?

The most obvious answer is that we are trying to prevent first use of a chemical substance. In fact, that's a great goal. But then does that mean we forget about the kids that have already tried something? And why do we care about preventing some 14 year old kid from trying beer or marijuana? After all you might say, "I did that and I turned out just fine."

The answer to why we want to keep that young person away from alcohol and other drugs is simple. We now know that children who try or use alcohol, tobacco, or marijuana before the age of 21 increase their chances of becoming addicted by many times over compared to the young person that we hold off from trying anything before he or she turns 21. In fact, people that don't try any alcohol or drug before age 21 rarely become addicted.

That doesn't solve the problem, though, because chemical addiction is a very complex issue and has many, many causes. Only one of those causes and contributing factors is an early initiation to use of an addictive substance. But it is key to emphasize, especially in a place like Nevada, that early drinking, smoking, or drug use is not a rite of passage and not a prerequisite for growing up properly.

Consider this: When JTNN compared the information provided by middle and high school students in school based surveys in 2005 we found that over 30% of 17 year olds that tried alcohol at age 8 or less had tried methamphetamine by the time they were 17. Those who tried alcohol at older ages had less involvement with methamphetamine. The numbers double for those who tried marijuana by age 8 with over 61% who did so also using meth by the time they were 17. This alone is huge in that much of our prevention efforts need to be spent in helping young children learn the value of and make the decision not to try even the so called "gateway" drugs of alcohol, tobacco, and marijuana.

But there's more. This doesn't mean that a child who has tried something is destined to a life of addiction. Our prevention efforts should still be geared to help that child make healthy decisions and to help him or her decide not to use again. We may even need to offer some of our youth strong education, sanctions, and even treatment, when the situation calls for it.

What are we trying to prevent? I think the picture is clear that we need to work toward preventing the decision to use a chemical substance. But we also need to help those who have started to make a decision to stop. The real prevention item here can be stated in a more positive way which is that we want to help youth make the best decisions that will ensure a life that is not impacted or destroyed by chemical substances.

Fetal Alcohol Syndrome

When my mom was having kids (3 of us), her standard for prenatal care came from a book written by Johns Hopkins University in 1949, entitled, "Expectant Motherhood." This book stipulates "safe" levels of cigarette smoking and alcohol consumption during pregnancy. Sixty plus years ago the prevailing medical wisdom was that a pregnant woman shouldn't smoke more than 10 cigarettes a day (remember these were non filtered in the late '40s) and she shouldn't drink more than two alcoholic drinks per day.

I'm sure that my mom smoked a little and she drank in moderation during all of her pregnancies, although I did ask her once about her level of use and she replied that she cut down from her usual moderate levels during pregnancy, just to make sure. Anyway, my brother, sister, and I are in our 50s and so far it appears that we are doing OK. So, what's all the buzz about women smoking, drinking, and using certain drugs during pregnancy?

Since the 1940s, our knowledge about what is safe and unsafe for an unborn child has increased exponentially. We've known for a long time that pregnant women shouldn't smoke cigarettes at all. And the standard for drinking is, "There are no safe levels of alcohol during pregnancy."

That last statement is a little puzzling because I'm sure my mom drank a little during all of her pregnancies. Is there something missing here? Can't a pregnant woman just drink a little and not worry about it?

Answering that question requires an understanding of what alcohol does and when it does it during the pregnancy. You see, the unborn child is affected by the alcohol in relation to the precise development that he/she is going through at the time the alcohol is ingested. So, if a woman drinks a few drinks a night during the time that certain organs are being formed, then it is possible that those organs may be impacted by that drinking. Related to that is the fact that no one really knows how much alcohol is too much during pregnancy so it's proper and safe to say, "Don't drink at all during pregnancy."

Another issue is the woman who is addicted. What should she do? Well, I hope that everyone that is addicted gets help and gets into recovery. In the case of an addicted woman who is pregnant, the best advise is, "Quit immediately, get help for your addiction problem, and seek prenatal care!"

This cannot be stated plainly enough. Fetal Alcohol Syndrome and all of the Fetal Alcohol Spectrum Disorders are totally preventable if a woman doesn't use alcohol or other drugs while pregnant. If she uses a chemical substance and finds out she's pregnant, then quitting immediately is the next best thing.

There's a lot to say on this topic and I'll return to it later in the year. But suffice it to say that often pregnant women don't get the help they need because they are embarrassed, ashamed, or just don't understand. We need to take time to engage these women in any way we can for their sake and for the sake of their children.

Children of Alcoholics Week

What do you think it's like growing up in a home in which one or both parents have an alcohol or other drug problem? These are homes that may look fine from an outsider's perspective but for those children living in it that home can be a living inferno.

Alcohol andor other drug abuse adds a dimension to a family in which the mom, the dad, the kids, and anyone else living there learns to live by certain rules. These "dysfunctional" rules have been written about and analyzed by a number of authors but none so succinctly (in my opinion) as by therapist and author Claudia Black.

Dr. Black says that the rules of an addicted household boil down to three. These are 1) don't talk, 2) don't trust, 3) don't feel.

"Don't talk" means, "Don't talk about the problem." Don't bring up anything that might make the family look bad or that might divulge the family secret. So, the children carry on the charade that everything is just fine and dandy when it's not. Mom gets drunk while you're all out to dinner one night and the kids know not to talk about it, not to describe it, not to ask about it. "What was wrong with Mom last night?" is not a permissible question. Keep the family secret!

"Don't trust" means that you learn not to trust what you see, hear, and experience. For example,when Dad is intoxicated, he promises his son a fishing and camping trip but when sober, he either doesn't remember or just breaks the promise. The son learns over time to disengage from Dad's empty promises and sees his father as an unreliable person not worthy of trust. Over time, this lack of trust is really about learning not to depend on anyone, not to share, not to feel safe. It can be very isolating.

"Don't feel" means that you learn to deny or shut off your feelings in the midst of turmoil and trouble. A 12 year old girl drives her intoxicated mother home from the bar every Saturday night. When the girl protests, her mother says, "Do it and just get over it." In time, the girl learns to "stuff" her feelings so she can accommodate her mother's unreasonable requirement. Over time this rule of "don't feel" can develop to the point that this person may not even know how she feels when hurt,angered, or even joyous.

Don't talk, don't trust, don't feel are rules that evolve in an addicted household. These rules can be debilitating and damaging to those children that live under them. But they can be countered. Just like the addicted person, the people living with that person can benefit from counseling and treatment.

February is Children of Alcoholic's Month in recognition of the fact that those that grow up in an addicted family are at risk for being harmed in many ways,especially emotionally. This month is also a celebration of the fact that children that grow up in an addicted family need help and will benefit from help. If you'd like to know more, contact us at JTNN at 775-324-7557 or call the Crisis Call Center at 775-825-HELP.

What's So Funny About That?

As the 2009 Holiday Season wraps up we are reminded of many wonderful things: family, friendship, community, giving, faith, and more. But we are also reminded of the role that alcohol plays in our society. Even if you don't drink, could you imagine Christmas and New Years without the mention of alcohol? There's the football games with all of the beer commercials. There are the alcohol industry sponsored television ads exhorting us to enjoy the holidays and to drink responsibly. There are numerous events and get togethers that would seem not quite "right" if there wasn't a little (or a lot of) alcohol included in the festivities. Of course, locally, there is the Santa Crawl that includes people dressed like Santa going from bar to bar in downtown Reno spreading as well as imbibing Christmas Cheer. In fact, the picture of thousands of Santas "crawling" drunk around Reno in a snowstorm even strikes many as kind of humorous. I have to admit that it strikes me as a little funny.

So what's so funny about a drunk Santa? What's so funny about a drunk person in any situation? Is it that we enjoy someone else acting a fool? Is it that we enjoy seeing someone falling down, getting up and then falling down again? Is it we think that if a person is foolish enough to be in that condition they deserve to be the object of laughter and scorn? Or maybe we just chalk it up to a good time and wish we could be doing what that person is doing.

Not to spoil anyone's good mood at the outset of the good year, but whether you find the intoxicated person funny or not, there's a whole lot to take the edge off of the laughter that drunk person may provide.

First, alcohol is a toxic (i.e. poisonous) substance and while most people can drink safely and without harming themselves, intoxication is technically an overdose from consuming too much alcohol. That means that what was a safe activity in moderation could turn into alcohol poisoning that could range anywhere from throwing up to even death by lethal overdose.

Second, most people can drink safely and without incident but one of 10 drinkers become addicted to alcohol. There are many factors that contribute to this, including genetic, peer group, and more. Estimates are that there are somewhere between 18 and 22 million alcohol dependent people in America.

Third, even at small levels of alcohol, most people are impaired. Impairment begins with the higher brain functions such as reasoning, judgment, and memory. Then impairments continues to fine motor skills such as writing with a pen or typing. Next, impairment continues to gross motor skills such as walking. Finally, if a person drinks enough, basic functions such as breathing and heart beat can be suppressed by the alcohol, resulting in serious medical complications and even death. So many issues such as drunk driving, many family problems, fights, and more are related to over drinking.

Drunk people often say and do funny, even hilarious things. But, for me, it's not all that entertaining because of the wreckage that intoxication can cause in all of our lives. I wish everyone a happy, prosperous, and sober New Year!