NEW PERSPECTIVES SUMMER 2016 FB d

StartingYoung Insight into adolescent addiction comes as new guidelines urge early prevention

Treatment providers have known for years

“ The excitement of this study is that now perhaps we have a signalling pathway that could be targeted for the treatment of addiction. ”

that adolescents are more susceptible to drug use and consequently, addiction. But now they might know why. Researchers recently discovered a speci c pathway in the brain that makes adolescents more prone to problematic substance use, which could lead to stronger prevention e orts. By studying how cocaine a ected the behavior of young and adult mice di erently, researchers found that a mechanism in the brain which regulates speci c protein production also controls addictive behaviors. By manipulating that mechanism, researchers were able to mitigate cocaine’s addictive e ects. “Now we have a bidirectional switch that can turn on and o the cocaine-induced changes in the brain,” says lead researcher Dr. Mauro Costa-Mattioli of the Baylor College of Medicine.

Total improvement Experts say the benets of implementing early intervention e orts far outweigh the cost. Although limited data exists, studies show investing just one dollar can produce anywhere from a few dollars to $26 in cost savings down the road. “ us a well-designed, well- implemented early childhood intervention can dramatically benet the community and society as well as improve children’s and families’ quality of life,” Dr. Volkow says. But the benets of early intervention go beyond substance abuse. Experts say many of the risk factors for substance abuse are the same indicators for other social, behavioral and academic problems. ey say creating a prevention program to address and reduce the risk of substance abuse will pay big dividends across the board. “Interventions designed to reduce early risk factors show benets in a wide range of areas,” Dr. Volkow says. “Including improved personal and social functioning, better performance in school, and less involvement with the juvenile justice system or mental health services.”

“ Early childhood intervention can dramatically benefit the community and society as well as improve children ’ s and families ’ quality of life. ” - Dr. Nora Volkow, NIDA director

- Dr. Mauro Costa-Mattioli, Baylor College of Medicine

One size fits all What’s most exciting about the study is that the pathway does not appear to be speci c to cocaine. A second study examining nicotine returned similar results, leading researchers to believe any treatments targeting the pathway would be e ective for all substances. “In the case of nicotine, it’s exactly the same thing,” Dr. Costa-Mattioli says. “All the drugs of abuse, they reduce the activity, they hijack or change this mechanism.” Researchers say they’re still interested to see if the mechanism plays a role in the transition from social substance use to more problematic use. But they say simply identifying such a crucial link of the substance use chain could lead to signi cant prevention methods. “Of course, the excitement of this study is that now perhaps we have a signalling pathway that could be targeted for the treatment of addiction,” Dr. Costa-Mattioli says.

First eight years T o address adolescent drug use, experts say prevention e orts have to start earlier than most would expect. e National Institute on Drug Abuse (NIDA), the government’s top agency on substance use, recently released new guidelines suggesting prevention education should start in the rst eight years of a child’s life. O cials acknowledge that early childhood is not a time period normally associated with drug use. But they say factors with family, school and community environments can shape development of certain emotional and behavioral issues that can manifest in substance abuse problems even decades later. “Central to intervening early is the idea of shifting the balance of risk and protective factors in a way that builds a foundation for optimal social development and resilience,” says NIDA Director Dr. Nora Volkow.

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“It’s really just about being around like-minded people and developing that ‘we’ as a support system.”

– Dr. Gerard Love, Slippery Rock University

More college campuses are dedicating housing to students recovering from addiction

“Universities are supposed to be about dialogue, and having this is a great opportunity for dialogue,” Dr. Love says. “Bringing this whole notion of addiction out of the shadows and increasing understanding, I think will be a good byproduct of this.”

“It’s really just about being around like-minded people and developing that ‘we’ as a support system,” Dr. Love says. Dr. Love says simply having a recovery space on a college campus could help change perceptions about recovery and remove the stigma surrounding addiction.

House parties, keg stands and spring break. The stereotypical images of American college life may revolve around drinking and party culture, but that image may be changing as more universities look to make campus a welcoming space for recovering addicts to live and learn. In the fall of 2016, a growing number of colleges will debut new Living-Learning Communities (LLCs) speci cally for people in recovery. While LLCs typically occupy a oor of a dormitory and center on a

shared interest or academic eld, these new student housing sections will provide a safe and positive environment for recovering students.

they need to succeed academically and in their personal lives. “Historically, students who are in recovery really struggle to come back to campus without that [supportive housing] program,” says Kris Barry, the school’s health and wellness advocate. The LLC will house six to 10 students and feature evidence-based recovery programming. that, they say they hope to foster a culture of personal growth among all students, particularly those in recovery. “I see them as being leaders here on campus and then taking that and changing the dialogue about addiction,” Barry says. “We know that the traditional college experience can be hostile to the goals of anyone in recovery, and we want to support them as much as possible.”

“It’s something I’ve always wanted to see implemented at the university,” says Dr. Gerard Love, a drug and counseling professor at Slippery Rock University in Pennsylvania where a new eight-person LLC will open in the fall of 2016. Slippery Rock of cials hope to offer recovery-related programming at least once a week with topics such as nutrition, team building and spirituality. The hope is that the apartment-style living space will provide students a network to help them focus on both academics and recovery.

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Boyd Austin says student communities centered on recovery provide a welcome relief for students to explore their university in a supportive and positive way.

Experts say universities are increasingly adding recovery programs focused on creating a community among students, but ones incorporating housing are still few and far between. “This started about 30 years ago, but it has really taken off in the last 10 years,” says Amy Boyd Austin, president-elect of the Association of Recovery in Higher Education.

“I see them as being leaders here on campus.”

community of people who are engaging in college in the same way,” Boyd Austin says.

– Kris Barry, University of Minnesota - Rochester

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“Preventing or delaying the onset of marijuana use could prevent or delay the onset of alcohol use disorder.” -Dr. Renee Goodwin

Marijuana users are ve times more likely to develop an alcohol abuse disorder, according to a new study

When it rains it pours. e old idiom may be familiar to many drug users who often nd themselves battling more than one addiction. While previous research has shown multiple substance abuse disorders often go hand in hand, a new study suggests simply using marijuana can lead to a much higher risk of developing an alcohol use disorder.

Uses In Treatment For those already struggling with marijuana or alcohol use disorders, researchers said the knowledge that the two behaviors are linked could help people see the bigger picture of their addiction, and could prove useful in their journey toward recovery. “In some ways it may seem self- evident, but it may not be,” Dr. Goodwin says. “If you’re trying to quit drinking, it’s good to know that quitting marijuana could increase your chance of being successful.”

Finding the Link Researchers at Columbia University analyzed data from 27,461 people who had used marijuana at the time of rst testing, but had no history of alcohol related disorders. When researchers checked back three years later, they found marijuana users were ve times more likely to have developed an alcohol abuse disorder.

Researchers said they were surprised the link wasn’t between marijuana use disorder, but simply marijuana use itself. “I think it’s important for people to be aware that there are certain behaviors that come with specic risks,” says Dr. Renee Goodwin, one of the lead researchers. “It would be particularly useful for youth.” Because youth are at a higher risk of experimenting with both drugs and alcohol, researchers said educating them about the total scope of risk is not only important, but could help curb problematic behaviors. “Preventing or delaying the onset of marijuana use could prevent or delay the onset of alcohol use disorder,” Dr. Goodwin says. “Statistically it should.”

Zero relationship to mood and anxiety disorders As marijuana use has increased in the U.S., with some states even voting for legalization, some have wondered what the psychological cost will be to users. To investigate the question further, other researchers at Columbia University also conducted a recent study to determine if a link exists between increased marijuana use and psychiatric disorders. Although the results, published in the journal JAMA Psychiatry, mimicked previous research in showing a strong relationship between marijuana use and other substance abuse disorders, the ‡ndings in regards to psychiatric disorders were much diˆerent. ‰e study showed no relationship between marijuana use and increased instances of mood and anxiety disorders, only substance abuse disorders. But despite the lack of a connection, researchers still cautioned against public policy that could lead to increased marijuana use. “‰e lack of association between more frequent cannabis use with increased risk of most mood and anxiety disorders does not diminish the important public health signi‡cance of the association between cannabis use and increased prevalence and incidence of drug and alcohol use disorders,” the authors wrote.

“I think it’s important for people to be aware that there are certain behaviors that come with speci c risks.” -Dr. Renee Goodwin

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Responding to Crisis New Perspectives launches new opiate program

Each four-hour session consists of process groups or video presentations on opioids or other drugs, group therapy, psychoeducation to address psychological, social and physical consequences, and education on chemical health awareness. Individual and family counseling is scheduled as needed. Medication-assisted therapy is also an important part of the opiate addiction treatment program at New Perspectives. In recent years, one of the major advances in addiction treatment has been the development of medications such as suboxone that are designed to ease withdrawal from heroin and other addictive substances. New Perspectives refers opiate-addicted clients to local clinics and physicians who can administer suboxone or methadone to ease withdrawal symptoms. through the initial withdrawal stages, then we are able to work with them,” Evans says. “ ey can concentrate on the program and not on their aches and pains.” As a result, clients have a much better chance at recovering, he notes. “Once we get clients into medication- assisted treatment and they get

“If you want to be a winner, you’ve got to hang with winners.” – Ray Evans

As the recent overdose death of Minnesota pop-music superstar Prince highlighted, the United States, Minnesota and the Twin Cities area are in the midst of an epidemic of opiate misuse and addiction. e opiate addiction crisis has been documented by emergency rooms across the state, says Ray Evans, clinical supervisor at New Perspectives. “We’ve been seeing more and more people overdosing statewide and nationwide,” Evans says. In response to the need, New Perspectives Behavioral Health recently began o ering an intensive outpatient treatment program to serve those who are addicted to opiates. e program’s objective is to reduce relapse, accidental overdose and admission to emergency rooms, and to increase recovery rates for those struggling with addiction to heroin or any other type of opioid. New Perspectives o ers both outpatient day and evening programs and intensive outpatient care with a lodging option.

Director John Woods in front of the New Perspectives entrance

Inside New Perspectives

Vital education Program sessions take place four times per week for seven weeks (28 four-hour sessions). is is followed by continuing care, which meets for two four-hour sessions per week, then once weekly for four weeks. e average program totals 200 hours, but may be adjusted based on each client’s needs and progress in recovery. • e program provides information and education in six vital topic areas, including: • Acute intoxication and withdrawal potential • Biomedical conditions • Emotional/behavior/cognitive problem checklist • Readiness to change • Continued use and continued problem potential • A ercare to prevent relapse “You can have support 24/7 from people around you who have been there and done that.” – Ray Evans, clinical supervisor, New Perspectives

Long-term recovery e program also provides referrals to post-treatment, supportive housing in which recovering opiate users live together in small groups, attend Narcotics Anonymous meetings and provide mutual support. Living in supportive recovery housing has proven to be e ective in helping clients avoid relapse and establish a solid foundation for long-term recovery, Evans says. In supportive housing “you can have support 24/7 from people around you who have been there and done that.’’

e small-group setting gives clients an opportunity to observe what other people are doing to achieve long-term recovery, he says. “If you want to be a winner, you’ve got to hang with winners.”

Since New Perspectives launched the opiate addiction treatment program several months ago, the response from the local community has con rmed the need, Evans says. “It’s starting to take o ; it seems to be something that people are looking for.” 

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