In Siskiyou County, the rate of
substance abuse is higher than in Los Angeles. Our residents are more likely than adults
statewide or nationwide to be chronic drinkers and deaths from cirrhosis/liver disease are
higher than average. Ninety percent of Child Protective Services cases involve substance
abuse. It is estimated that around 75 percent of the Public Defender’s cases involve
methamphetamine. A major portion of the County’s budget goes toward dealing with
behaviors associated with substance abuse: Sheriff, Juvenile Hall, jail, Probation,
District Attorney, Public Defender, Child Protective Services, Human Services, Public
Health, Behavioral Health, County Counsel -
not to mention court system costs. Our larger local businesses that drug test report
difficulty in finding employees who can test clean.
Some people use drugs and alcohol without becoming addicts. About 20
percent become addicted. At a conference held at the Miner’s Inn, Dr. Alex Stallcup
explained what happens in an addict’s brain that is different from normal. All
animals instinctively need food and water to survive. As humans, we have been designed
with a craving or drive system to fulfill basic needs. When these needs are satisfied, we
are rewarded with a feeling of pleasure. This is how nature helps us to survive and to
multiply. When our drives create an impulse to act to satisfy an unmet need, the adult
brain automatically weighs that impulse against a sense of right and wrong and judges it
as to whether the action is worth any risk or effort. This is how the adult brain
regulates behavior to that which is appropriate and productive. One of the effects of drugs is to suppress the parts
of the brain that regulate impulses. The addict loses his ability to gage right or wrong
or the value or risk of an impulse. Making “dumb decisions” is part of the
disease process. The addict over-values the impulse and fails to see the downsides of
acting.
Various drugs chemically tap into this reward process of the brain by
stimulating the pleasure center. In the addict, chronic abuse of drugs has crossed the
line of stimulation to the point of damaging the pleasure or reward center. Biologically,
the brain protects itself from over-stimulation by ramping down its sensitivity. The
person becomes “tolerant” of the drug. It takes more of the drug to produce the
same pleasurable effect.
Dr. Stallcup compared what happens to an addict to someone who plays
in a rock and roll band. At first, the loud music temporarily numbs the hearing. After you
leave the event, your ears still ring and it takes a while to recover normal hearing. As
exposure continues, the hearing protects itself with temporary ramping down of sensitivity
to noise. The person becomes hard of hearing. Eventually, they become over-exposed and the
hearing responds protectively with fixed and permanent deafness.
The addict who sobers up, finds that they have damaged their reward
center and are no longer as sensitive to feelings of pleasure. For instance, a meth addict
coming off the drug may only have three out of 50 pleasure receptors still functioning.
Their brain has become so desensitized that they crave drugs to feel the same amount of
pleasure that a non-addict would get from an activity. Once an addict is tolerant to a
drug and stop taking the drug, they find themselves as low as they were high. The sober
addict’s brain suffers from a biological state of
“dysphoria” – a negative, angry state where they cannot feel
good for a long time.
The good news is that, according to Alex Stallcup, meth addiction is
now a highly treatable disorder with success rates of 50-60 percent. He uses a Craving
Identification and Management Model (CIM) to overcome resistance to treatment by
addressing: (1) discomfort and other symptoms during withdrawal; (2) people, places and
things that are habitual cues for using drugs; (3) any mental health problems; and (4)
stressors. All of these factors can motivate a
relapse. Treatment and recovery includes court and other incentives to help motivate the
patient and an individualized plan of wrap around services designed to reduce relapse cues
and provide a network of support for dealing with stressors such as keeping appointments,
dealing with relationships or finding a place to live and a living. Stallcup strongly
opposes Proposition 5 – NORA the Non-violent Offender Rehabilitation Act which is on
this November’s ballot. It removes many of the tools that can be used under the CIM
approach for treating addicted people.
The Siskiyou Community Services Council Substance Abuse Continuum of
Care (SACC) Project is a large group of individuals working on a countywide plan for
community-based approaches to effectively prevent, treat and support the recovery of
addicted people, their families and communities. Call (530) 926-5127 for additional
information. |
