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24 June 2010

Drug Overdoses and the Environments in Which They Occur: Is There a Relationship?

Shepherd Siegle at McMaster University in Canada has conducted interesting research into the phenomenon of “drug overdoses.” Although first reported more than 20 years ago, it is only now entering the mainstream of applied social science.

Siegle and his colleagues have postulated that as drug users--his research has centered on opiates--continually use in a familiar environment, the body's tendency to anticipate the drug and prepare to counter its effects are conditioned by that environment. As a result, when using a typical dose in an unfamiliar environment the individual overdoses. In essence he argues that people do not so much "overdose" as "under prepare" to handle their usual dose in a strange environment. In other words, Pavlovian or “Classical Conditioning” impacts the way an individual is affected by the heroin (other drugs, including alcohol?) consumed based upon the environment in which the drug was consumed.

This research has far reaching implications for many areas of substance use disorder prevention and treatment. Not only may Siegle's research hold some meaning as regards the recent rise of "overdoses" on prescription medication, it will be interesting to consider its implications regarding collegiate alcohol "overdose." As high school students used to drinking in a familiar environment attempt to transplant their drinking behaviors to an alien collegiate environment, this could help social scientists understand the phenomenon of collegiate alcohol poisoning.

To read more, visit:

General overview of the theory - http://www.druglibrary.org/schaffer/heroin/heroin2.htm or http://www.psywww.com/intropsych/ch05_conditioning/conditioning_and_drug_tolerance.html

A more detailed and referenced review of the theory - http://serendip.brynmawr.edu/bb/neuro/neuro03/web1/crichards.html

A 1986 paper by Siegle explaining the phenomenon - http://www1.appstate.edu/~kms/classes/psy5150/Documents/Siegel_CaseHistory.pdf

Another Siegle paper on the topic - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1469825/pdf/envhper00327-0117.pdf

PowerPoint on Classical/Pavlovian Conditioning - http://dogsbody.psych.mun.ca/~bmckim/2800/Chapter3.ppt See slides 32 – 40 for an explanation of Siegle’s findings.

15 June 2010

What Causes a Problem is a Problem Because it Causes a Problem

We are all familiar with the types of problems associated with AOD use, the type that make the headlines in the local paper or are related to the crime reported on News Radio. Although important, these are not typical of the issues we all face with unfortunate regularity.

Interestingly, most who choose to consume alcohol do so moderately and without problem. Beer, wine, and spirits are a regular part of many ethnic and cultural celebrations and observances and an integral part of many religious ceremonies, my own Christian faith being a ready example. As a matter of fact, in both the New and Old Testaments there are in excess of 300 references to alcohol...actually “wine” and “strong drink”...equally split between cautions against the use of such beverages—LEVITICUS 10:9 (King James): Do not drink wine nor strong drink, thou, nor thy sons with thee, when ye go into the tabernacle of the congregation, lest ye die: it shall be a statute for ever throughout your generations—and exhortations regarding its use—1 TIMOTHY 5:23 (King James): Drink no longer water, but use a little wine for thy stomach's sake and thine often infirmities. Alcohol is legal for those of age and a source of revenue in the form of taxes for local, state, and federal governments, and enjoyed by many.

So if alcohol is a drug and if it is used by many without problem, how do we recognize drinking as a problem before it becomes obvious to everyone? The answer is actually quite simple, but in its simplicity it escapes serious consideration by most who inadvertently step over the invisible line that separates “social” consumption from its more challenging counterpart, problem drinking. The simple “rule of thumb” is, What causes a problem is a problem, because it causes a problem. It is when my consumption is responsible, directly or indirectly, for a more obvious problem that I must consider the consumption of alcohol itself to be a problem as well. Allow me to illustrate with a couple metaphors.

Imagine you ordered the “Blue Plate Special” at the local diner and 30-minutes later you became ill. Would you ever eat at that diner again? Most of us would say yes as it was probably coincidence that we became ill after eating. Two weeks later you once again eat at the same dinner and become ill within an hour of eating...would you return? Chances are many of us would think twice before doing so. Yet how many of us might have “too much to drink” on a social occasion experience a hangover if not become ill only to dismiss this as part of the price paid for having a good time and drink in much the same way two-weeks later, experiencing similar consequences and think nothing of it, other than, "it is part of the price paid to have a good time?"

Those familiar with treating alcohol problems suggest that problems resulting from the consumption of alcohol, e.g., employment issues - attendance, job performance, productivity; health issues – hangover, vomiting, medical conditions caused by or exacerbated by drinking; family issues – arguments, verbal or physical violence, infidelity, inconsistent parenting; legal issues – DUI, assault, civil suits related to negligence, fraud; interpersonal relationships – estrangement from friends, arguments, embarrassment of self or significant others, suggest that the consumption itself is a problem if not the problem.

Here is a simple test to see if one’s drinking is becoming an issue in need of attention—and this does not necessarily mean alcoholism, but simply “something” I need to consider changing. It consists of two simple questions: (1) When was the last time I wondered if drinking milk was becoming a problem? Next: (2) When was the last time I wondered if alcohol, i.e., “my drinking,” was becoming a problem? Chances are most of us do not think twice about milk, at least beyond whether we care for it or not. I will bet at least one someone reading this has wondered about his or her drinking, however. The variation on these questions is, “When was the last time my (family, wife, girlfriend, son, etc.) wondered if my drinking was becoming a problem?"

There are other online and anonymous questionnaires that can shed light on the nature of one’s drinking and a couple are listed at the end, but suffice it to say that “what causes a problem is a problem when it causes problems." If you are not sure, find someone who understands alcohol related problems and discuss it.

Online Screening Resources:
http://www.alcoholscreening.org/Home.aspx
http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=1860&cn=14

What to do if you want to change:
http://rethinkingdrinking.niaaa.nih.gov/ToolsResources/DrinkRefusalSkills.asp
http://helpguide.org/mental/alcohol_abuse_alcoholism_help_treatment_prevention.htm

What do you think?
Robert

04 June 2010

Motivational Writing: Increasing the likelihood that your views will be considered

Sharing personal opinion is by no means a new endeavor. Since Eve suggested to Adam that the fruit of the tree of knowledge was sweeter and more desirable than all others in the garden, we humans have been trying to persuade each others to consider our opinions if not follow our lead. This has never been easier to do than today with text messaging, blogs, YouTube videos, not to mention old favorites like letters to the editor, radio talk shows, and "coffee at the corner diner." But preparing a formal written argument or position paper, however, is something a bit more demanding.

Included below are links to 3 web sites that attempt to do just this. The first 2 are focused more on business and preparing White Papers related to products or services one wishes to provide. Although the examples used are not particularly useful given your objective, the methods outlines for accomplishing the goal are. The last link is to a rather good outline—and from a web site I refer to regularly with regards to anything related to writing, The Owl at Purdue university.

My formula has always been to prepare such a (see http://www.robertchapman.net/essays/parent.htm for an example ) paper from a perspective similar to on used when working with resistant, unmotivated, or disinterested clients in counseling. Counselors can never tell such clients what they need to know as this will invariably result in their dismissing you as either insufficiently knowledgeable to proffer anything worth considering or they will see you as a zealot with a personal agenda. In either case you lose the audience almost as soon as you start from such a position. Like the old adage suggests, “You can lead a horse to water, but cannot make it drink.” An interesting counter perspective is, however, “but you can salt the oats.” When you do this the horse becomes thirsty and its thirst motivates it to do what you had intended from the start. In short, the trick is to prepare a document that “makes the horse thirsty” so it decides to do what you had originally intended. In your case, to see the role that addressing collegiate drinking can play in resolving a financial dilemma that is a more prominent blip on senior administration’s radar screen. So you spend less time talking about the public health reasons for addressing collegiate drinking and more time addressing the quality of life consequences of it that cause students to transfer or not come to the school in the first place because of the reputation that results from the misperception of the social norms.

Reread Richard Bach's Jonathan Livingston Seagull; pay particular to Fletcher Gull at the end of the story, after Jonathan transcends to the next level of spiritual being. Fletcher tries to tell all the young, ignorant, egocentric gulls what they need to know to transcend their current 2-dimensional, limited, restricted lives as he takes over Jonathan’s role as teacher. The “know-it-all,” spiritually blind, adolescent gulls start to rebel and dismiss Fletcher as some old fart who has nothing to teach because he is not with the times and therefore burned out. Fletcher then remembers Jonathan’s most important lesson about the path to spiritual enlightenment…start with level flight, or as AA suggest, Keep it simple.

My grandfather used to say, “Sometimes you have to give folks what they want in order to get the chance to given them what they need…he was among the wisest people I have ever met, and he never got beyond the 8th grade.

The key points to remember when preparing something like a White Paper is not unlike what an effective counselor considers when interacting with a client who may be at an earlier stage of readiness to change—collaborate with the client (your audience) and persuasively invite him/her/it to look at the facts from a different perspective in order to come to new conclusions regarding them. If successful, these new conclusions will require a new or different course of action. Think of Professor Harold Hill in The Music Man and how he sold River City on its need for a boys band. I do not propose manipulation and deceit as as hill's style as a flimflam man, but I do suggest presenting the facts as they exist in such a way as to suggest the point your paper tries to make regarding a possible solution to an existing problem is viewed in a positive light.

A mentor once suggested to me, never approach a anyone regarding a problem by just sounding an alarm or asking what will be done; approach with a solution to the problem and an argument for why your solution should receive serious consideration.

Here are the links:

1. http://www.stelzner.com/copy-HowTo-whitepapers.php
2. http://www.mwknowles.com/free_articles/white_paper/white_paper.html
3. http://owl.english.purdue.edu/owl/resource/546/1/

What do you think?
Robert