Risk, resilience, and natural recovery: a model of recovery from alcohol abuse for Alaska Natives

Aim; The People Awakening (PA) study explored an Alaska Native (AN) understanding of the recovery process from alcohol abuse and consequent sobriety.

Design; PA utilized a cross-sectional, qualitative research design and community-based participatory research methods.

Setting and participants; The study included a state-wide convenience sample of 57 participants representing all five major AN groups: Aleut/Alutiiq, Athabascan, Inupiaq, Yup’ik/Cup’ik and Tlingit/Haida/Tsimshian. Participants were nominated and self-identified as being alcohol-abstinent at least five years following a period of problem drinking.

Measurements; Open-ended and semistructured interviews gathered extensive personal life histories. A team of university and community co-researchers analyzed narratives using grounded theory and consensual data analysis techniques.

Findings; A heuristic model of AN recovery derived from our participants’ experiences describes recovery as a development process understood through five interrelated sequences:

1. the person entered into a reflective process of continually thinking over the consequences of his/her alcohol abuse;
2. that led to periods of experimenting with sobriety, typically, but not always, followed by repeated cycling through return to drinking, thinking it over, and experimenting with sobriety; culminating in
3. a turning point, marked by the final decision to become sober. Subsequently, participants engaged in
4. Stage 1 sobriety, active coping with craving and urges to drink followed for some participants, but not all, by
5. Stage 2 sobriety, moving beyond coping to what one participant characterized as ‘living life as it was meant to be lived.

Conclusions; The PA heuristic model points to important cultural elements in AN conceptualizations of recovery.

Research; Mohatt GV, Rasmus SM, Thomas L, Allen J, Hazel K, Marlatt GA. Risk, resilience, and natural recovery: a model of recovery from alcohol abuse for Alaska Natives. Addiction. 2007 Nov 27

Brief-TSF is designed to address these issues.

My Name is Funky… and I’m An Alcoholic: A Story About Alcoholism and Recovery by Tom Batiuk Read more about this title…

Impulsivity May Trigger Addiction, Researchers Say

British researchers say that impulsivity seems to trigger addiction and not the other way around, Science magazine reported June 6.

People with addictions are known to be more impulsive and engage in more thrill-seeking behaviors than non-addicts, but it has been unclear whether those behaviors predated drug use or were the result of addiction.

Researchers David Belin and Barry Everitt of the University of Cambridge attempted to answer the question by studying rats known to have thrill-seeking or impulsive personalities. The researchers connected the rats to a device that delivered cocaine directly to their brains and then gave the rats control over their drug use. They found that the thrill-seeking rats tried the drug immediately and in high doses, while the impulsive rats used the drug less quickly and in greater moderation.

However, the authors found that after 40 days of access to the drug the impulsive rats had become addicted and could not stop using cocaine even when punished with an electric shock, while the thrill-seeking rats had grown tired of the drug and stopped using.

The research study is published in the June 6, 2008 edition of Science magazine.

See also;

• 12-Step Treatment More Effective than Alternative
• AA and Treatment Work Better Together
• Abstinence from Heroin Addiction Works
• Subscribe to BriefTSF by e-Mail

Theory and Practice of Group Counseling by Gerald Corey Read more about this title…

The Co-Occurring Center for Excellence. Addressing mental disorders and alcoholism, addiction co-occurring.

The Co-Occurring Center for Excellence (COCE) was created by SAMHSA in 2003 to provide information and a range of services to mental health and substance abuse administrators and policymakers at state and local levels, their counterparts in tribal and Native populations, clinical providers, other providers, and all other agencies and systems through which clients may enter the treatment system.

COCE provides state-of-the-art and sustainable technical assistance, training, information and resources, and links to other resources that serve persons with co-occurring disorders.

http://www.coce.samhsa.gov/

See also;

• Double Trouble in Recovery
• Dual Diagnosis Anonymous
• Double Trouble in Recovery for Alcoholics
• 12-Step Treatment More Effective than Alternative

The Dual Diagnosis Recovery Sourcebook : A Physical, Mental, and Spiritual Approach to Addiction with an Emotional Disorder by Dennis Ortman Read more about this title…

Antidepressant Induced Mania (ADM) Among People with Co-Occurring Disorders (COD). Sometimes, informally called Bipolar III disorder.

A recent study of medical charts at a bipolar specialty clinic gives new support to the idea that antidepressants can induce mania in some bipolar patients.

For some time, clinicians have been concerned about the problem of antidepressant-induced mania (ADM), but most research has not supported the connection between antidepressants and manic or hypomanic episodes.

This study looked at ADM and examined differences between patients with bipolar disorder and a substance use disorder (SUD) and patients without SUD.

The article presents solid evidence for a significantly increased risk of ADM in patients with co-occurring bipolar disorder and SUD. The article also comments about why the increased risk to these clients may not have been identified in prior research.

Manwani and colleagues investigated medical charts from 98 patients who were treated at a bipolar clinic between 2000 and 2004. These patients accounted for 335 antidepressant trials during that period. Of the sample, 55 patients (accounting for 184 of the trials) had a lifetime history of a SUD.

For this study, an episode of ADM was defined as hypomanic or manic symptoms within 12 weeks of beginning a new antidepressant medication.

There were some substantial differences between patients who did and did not have a SUD history—e.g., clients with SUD were almost twice as likely as those without SUD to be prescribed lithium (48.3% vs. 28.5%), and clients without SUD were twice as likely to receive divalproex as those with SUD (43% vs. 20.1%) and almost three times as likely to be prescribed an antipsychotic (31.8% vs. 11.4%).

The univariate analysis of differences in the number of antidepressant trials leading to ADM between patients with and without a SUD history showed little difference in the percentage of ADM episodes they experienced (20.7% of trials for those with SUD and 21.4% of trials for those without).

However, using a multivariate regression model of analysis, the authors found that:

• Patients with a lifetime SUD were five times as likely to experience ADM,
• The incidence of an antidepressant trial leading to an ADM was greater for clients with Type II or with bipolar disorder not otherwise specified than for Type I,
• Females were more likely than males to have an episode of ADM in response to an antidepressant trial, and
• Bupropion was the antidepressant least likely to cause an ADM.

The authors surmise that older research studies excluding people with a SUD might have led to subject pools that underrepresented individuals considerably more likely to experience an ADM than the subjects studied. Additionally, they describe how other confounding factors might have served to hide the effects of having a history of SUD on the likelihood of suffering an ADM.

A discussion of the limitations of their study (e.g., it was non-randomized, non-blind; concomitant therapy may have obscured treatment effect; no measures of adherence to medication regimens) is also given.

Research; Manwani, S. G., Pardo, T. B., Albanese, M. J., Zablotsky, B., Goodwin, F. K., & Ghaemi, S. N. (2006). Substance use disorder and other predictors of antidepressant-induced mania: a retrospective chart review. Journal of Clinical Psychiatry, 67(9), 1341–1345.

Co-Occurring Disorders Research and Resources Monthly Review. The Co-Occurring Center for Excellence (COCE), of the Substance Abuse and Mental Health Services Administration (SAMHSA), Vol. 1, No. 5, December 2006. Readers interested in finding out more about COCE should visit the Web site: http://coce.samhsa.gov/

See also;

• Double Trouble in Recovery
• Double Trouble in Recovery for Alcoholics
• Dual Recovery Anonymous
• Dual Diagnosis Anonymous
• Subscribe to BriefTSF by e-Mail

Dual Diagnosis, Counseling the Mentally Ill Substance Abuser by Katie Evans, J. Michael Sullivan Read more about this title…

• Alcohol Related Brain Injury
• Adolescent Children of Alcoholics
• Alcoholic jealousy
• Alcoholics Anonymous with Narcotics Anonymous
• ALCOHOLISM MYTHS
• Anti-craving Naltrexone Injection Reduces Drinking
• Brief-TSF Description
• Brief-TSF is Holistic Treatment
• Client Impressions About Alcoholics Anonymous
• Comparison of Addiction Treatment
• Counselor Characteristics
• Dentists and Alcohol and Drug Use
• Free Inhalant Abuse Education
• Inappropriate Treatment for Alcohol Withdrawal is Common
• Predictors of Relapse in Alcoholism
• Prescription Drug Overdose Becomes Big Killer
• Sleep, PTSD and Alcoholism
• Spiritual Assessment
• Sweet Tooth and Alcoholism
• Teen Drinking Leads to Risk of Alcoholism
• The Dry Drunk
• Thyroid Function in Depression and Alcohol Abuse
• Training; Domestic Violence and Substance Abuse
• TSF Description
• Twelve Steps to Recovery from Burnout
• Subscribe to BriefTSF by e-Mail

Predictors of relapse in 300 Brazilian alcoholic patients: a 6-month follow-up study.

Three hundred alcoholic patients were interviewed at hospitalisation and again 3 and 6 months thereafter in Porto Alegre, Brazil, from March 2002 to January 2004.

Assessment included the SCID-I to check for the presence of Axis I mental disorders, a questionnaire focusing on patient relationship with AA groups, and specific questions about participation in psychotherapy. A logistic regression analysis was performed to determine predictive variables for relapse or abstinence 6 months after discharge.

Previous treatment for alcohol dependence and being single proved to be associated with relapse,

Findings; adherence to AA, the presence of a comorbid depressive disorder, and probably adherence to psychotherapy could be associated with abstinence.

adherence to AA could be associated with abstinence

These findings reinforce the importance of psychotherapy and AA groups for alcoholics to remain abstinent for longer.

The greater adherence to treatment observed among depressive alcohol dependents can be explained by the fact that this is a comorbid condition that acts as a protective factor against relapse.

Predictors of relapse in 300 Brazilian alcoholic patients: a 6-month follow-up study. Subst Use Misuse. 2008;43(3):403-11. Terra MB, Barros HM, Stein AT, Figueira I, Athayde LD, Ott DR, De Azambuja Rde C, Da Silveira DX.

See also;

• Brief-TSF is designed to address these issues.
• 12-Step Treatment More Effective than Alternative
• Subscribe to BriefTSF by e-Mail

• 12-Step Recovery Theory And Application
• AA And Al-Anon
• AA And The Disease Concept Of Alcoholism
• Adolescent Children Of Alcoholics
• Al-Anon Offers New Life
• Alcohol Consumption In Patients Pancreatitis
• Alcohol Metabolization
• Alcohol Related Brain Injury
• Alcoholic Brain Damage And Thiamine
• Alcoholic Jealousy
• Alcoholics Anonymous
• Alcoholics Can Benefit From Al-Anon
• Alcoholism And Personality Disorders
• Alcoholism Is Also Genetic
• Alcoholism Myths
• Anti-Craving Naltrexone Injection Reduce
• Benefits Of Alcoholics Anonymous
• Beyond Codependency
• Brief-TSF Description
• Children With Alcohol Dependent Fathers
• Counselor Characteristics
• Craving Reduction
• Effective Professional Interventions
• Effects Of Gambling Addiction
• Free Inhalant Abuse Education
• Just For Today Card
• Mindfulness Can Help Recovery
• Prescription Drug Overdose Becomes Big Killer
• Process Of Recovery For Alcoholic Women
• Research Evidence For TSF  .
• Return To Drinking After Liver Transplantation For Alcoholic Liver Disease
• Role Of Significant Others
• Screening Can Decrease Teen Risk Behaviour
• Sleep Problems Affect Alcoholism Recover
• Spirituality And Helping In Alcoholics Anonymous
• Strategies For Dealing With Common Problems
• Strategies For Dealing With Denial
• Sweet Tooth And Alcoholism
• Symptoms Of Alcoholism
• Teen Drinking Leads To Risk Of Alcoholism And Social Exclusion
• The Aging Alcoholic
• The Classification Of Alcoholics
• The Dry Drunk
• Thyroid Function In Depression And Alcohol Abuse
• TSF Description
• Twelve Step Recovery Is Spiritual
• Twelve Steps To Recovery From Burnout
• What About Partners Of Alcoholics?

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An empowerment process: successful recovery from alcohol dependence.

Aims. The purpose of this study was to explore the concepts and processes for successful abstinence from alcohol for Taiwanese Alcoholics Anonymous members.

Background. Attempting to identify the psychological and social influences upon alcohol consumption remission outside of alcoholism treatment could help professionals to engage in a broad array of community interventions in an informed fashion. Methods. Grounded theory method was utilized in this study. The study chose nine participants who had succeeded in abstinence, using theoretical sampling and conducted in-depth interviews by an open-ended questionnaire.

Results. The results of this study indicated that the core of the process during which alcoholic individuals succeeded in abstaining from further alcohol consumption was an empowerment process for the involved individual.

Alcoholics felt that their

• family,
• interpersonal relationships,
• jobs and
• personal finances all had been at ‘rock-bottom’ level following a long period of alcohol dependence.

This feeling caused the individual to experience an emotion of a loss of control and provoked the arousal of an alcoholic’s inner consciousness levels, this then resulting in the generation of a driving force for abstinence from alcohol for these individuals.

Conclusions. The expansion of an individual’s internal awakening power helps the individual to obtain assistance and to resist the temptation of further alcohol consumption.

Therefore, the power derived by individuals form the

• stages of repositioning,
• releasing,
• active sharing,
• resistance and
• assistance are the maintenance factors for an individual’s empowerment process that help maintain the successful recovery from alcohol for the involved individual.

Relevance to clinical practice. A good comprehension of the recovery processes for alcoholics, we believe, will trigger clinical professionals to pay appropriate attention to the specific problems and needs of alcoholic individuals, to build an effective resource network for treatment and to help solve alcoholics’ physical and psychosocial problems.

Yeh MY, Che HL, Lee LW, Horng FF. An empowerment process: successful recovery from alcohol dependence. J Clin Nurs. 2008 Apr;17(7):921-9.

See also;

• Twelve-Step Programs as an Adjunct to Psychotherapy and Psychopharmacology
• Brief-TSF ASSESSMENT

1. 12-Step Recovery Theory and Application
2. AA and the disease concept of alcoholism
3. AA attendance was best predictor of abstinence
4. AA Membership
5. AA Recommendations
6. Abstinent alcoholics can have reduced brain activation
7. Al-Anon offers new life
8. Alcohol Abuse in Older People
9. Alcohol consumption in patients pancreatitis
10. Alcohol Metabolization
11. Alcoholic jealousy
12. Alcoholics & Addicts Can’t ‘Just Say No’
13. Alcoholics Anonymous and church involvement
14. Alcoholics can benefit from Al-Anon
15. Alcoholics don’t see dangerous situation
16. Alcoholism and Personality Disorders
17. Alcoholism is also Genetic
18. ALCOHOLISM MYTHS
19. Anti-craving Naltrexone Injection Reduces Drinking
20. Beyond Codependency
21. Brief-TSF Description
22. Brief-TSF holistic treatment
23. COUNSELOR CHARACTERISTICS
24. Craving Reduction
25. Effects of gambling addiction
26. Elderly substance abuse
27. Free Inhalant Abuse Education
28. Management of substance-abuse disorders
29. Mindfulness Can Help Recovery
30. Neurotransmitter and neuromodulatory mechanisms involved in alcohol abuse and alcoholism
31. Physician Screening for Alcohol Cost Effective but Underutilized
32. Relapse Prevention in Primary Care
33. Return to Drinking After Liver Transplantation for Alcoholic Liver Disease
34. Screening Can Decrease Teen Risk Behaviors
35. Spiritual Awakening for Recovery
36. Spirituality and Helping in Alcoholics Anonymous
37. Strategies for Dealing With Denial
38. Symptoms of alcoholism
39. The Aging Alcoholic
40. THE DRY DRUNK
41. Therapeutic Alliance
42. Treatment and twelve-step strategies
43. TSF Description
44. Twelve Step recovery is spiritual
45. TWELVE STEPS TO RECOVERY FROM BURNOUT
46. UK Alcohol and Drug Professional Training
47. What about partners of alcoholics?
48. What About This Spiritual Awakening Thing
49. What is Brief-TSF?

• 12-Step Recovery Theory and Application
• AA attendance was best predictor of abstinence
• AA Fact File
• AA Membership
• Al-Anon offers new life
• Alcohol Abuse in Older People
• Alcohol Metabolization
• Alcoholics Anonymous
• Alcoholics can benefit from Al-Anon
• Alcoholism and Personality Disorders
• Alcoholism is also Genetic
• ALCOHOLISM MYTHS
• Anti-craving Naltrexone Injection Reduce
• Asking about drinking
• Beyond Codependency
• Brief-TSF Description
• Combined AA & Treatment for Addicted Physicians
• COUNSELOR CHARACTERISTICS
• Craving Reduction
• Dual dependence
• EFFECTIVE PROFESSIONAL INTERVENTIONS
• Effects of gambling addiction
• Free Inhalant Abuse Education
• Lesbian Alcoholics were Unloved
• Lesbians, Alcoholism & Depression
• Management of substance-abuse disorders
• Process of Recovery from Alcoholism
• Return to Drinking After Liver Transplantation
• ROLE OF SIGNIFICANT OTHERS
• Strategies for Dealing with Common Problems
• Strategies for Dealing With Denial
• Symptoms of alcoholism
• The Aging Alcoholic
• THE DRY DRUNK
• Treatment and twelve-step strategies
• TSF Description
• Twelve Step recovery is spiritual
• TWELVE STEPS TO RECOVERY FROM BURNOUT