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Fear of sadness can motivate drug use

What drives addicts to use more drugs?

The common perception is that addicts are driven to use more drugs or alcohol to get high or drunk but anecdotal accounts – and recent research – may indicate another reason.

Many drug abusers say they continue to use because they are afraid of getting physically or emotionally sick. Opiate addicts say they continue to take prescription drugs or use heroin because they don’t want to experience withdrawals. They continue to use to “feel normal” and avoid getting sick while many alcoholics say they continue to drink to avoid the shakes or delirium tremors (DTs).

Recent research by Rutgers University Department of Psychology indicates that similar reasons drive cocaine users to keep using – they fear the emotional lows that came with withdrawing from cocaine and continue to use to feel normal. Rutgers Professor Mark West, and doctoral student David Barker discovered through animal studies that the “high” of drug use from cocaine is short lived and is “quickly replaced by negative emotional responses whenever drug levels begin to fall,” propelling them to use more.

To inform their study they used rats that required more cocaine when they started to feel negative emotions (evident through their high pitched cries). They say that animals are important for drug testing studies because humans may not give reliable or truthful answers to questions about drug abuse. West and Baker concluded that negative emotions largely motivate cocaine abuse and can therefore play an important role in regulating cocaine abuse and the abuse of other substances.

In our Colorado addiction treatment programs here at Harmony we have seen that addiction usually starts by wanting to chase a high and ends with the need to continue drug use to avoid dealing with withdrawal, sickness, negative emotions or any emotions at all. That is why we have a comprehensive detoxification program followed by group and individual therapy that help clients cope with all emotions – negative or otherwise – and help them “feel normal” without drugs or alcohol.

Last week was a big news week for the FDA who has gained both scrutiny and praise for its decisions regarding prescription painkillers.

The FDA finally recommended that hydrocodone containing drugs are reclassified from a Schedule III drug to a Schedule II drug, which imposes greater restrictions on prescribing and access to this class of drugs. By changing the classification they will be restricted in the same way oxycodone and morphine are.

Given that hydrocodone drugs are the most widely prescribed in the US and the highly addictive, this has been long awaited. In 2011 alone, there were 131 million prescriptions written for hydrocodone and according to the DEA it ranks as the first or second most-abused medicine in the U.S. alongside oxycodone. The abuse of these drugs has resulted in an estimated 100,000 accidental overdoses in the US over the last decade. A huge proponent of this measure, Democratic Sen. Joe Manchin stated this was a “tremendous step forward in fighting the prescription drug abuse epidemic that has ravaged West Virginia and our country,” and “Rescheduling hydrocodone from a Schedule III to a Schedule II drug will help prevent these highly addictive drugs from getting into the wrong hands and devastating families and communities.”

Just as the praise was soaring for the FDA, they announced their approval of a new painkiller that is a stronger version of hydrocodone called Zohydro ER. The drug is stronger for those that require around the clock pain management that requires pure hydrocodone rather than the current versions that combine hydrocodone with non-narcotics like acetaminophen. The approval reportedly came as surprise since a panel of pain specialists gave it a negative review last year – saying the US didn’t need another form of widely abused prescription drugs.

Patient safety advocates like Avi Israel, who lost her son who committed suicide while struggling with painkiller addiction, asserted, “We’re just going to kill more kids and then the FDA is going to come back and say, ‘oh, we made a mistake.’” Lawmakers in Washington who have been working hard to deter prescription abuse in their states were especially critical of the fact that the pills have no abuse deterrents (so they can’t be crushed or snorted) like the new forms of OxyContin do; “FDA not only approves this dangerous drug, but does so without requiring any abuse-deterrent features. This is outrageous,” said Rep. Bill Keating, D-Mass.

Here at Harmony Foundation we continue to see the trend of opioid painkiller abuse in our prescription drug treatment program in Colorado – among young adults and adults alike. While the new reclassification measure is notable, we share the sentiment of Keating and Israel that there does not need to be yet another prescription drug with potential for abuse on the market.

Vice President Joe Biden will be in Boston today speaking at the John F Kennedy Presidential Library hosting The Kennedy Forum on community mental health. The Forum is a two-day event falling around the 50th anniversary of the signing of the Community Mental Health Act by President John F. Kennedy.

This was the last legislation signed by JFK before his assassination and provided funding for community mental health treatment centers with the goal of deinstitutionalizing those with mental illness. Instead of being held in state facilities with reputations for neglect and poor treatment, the mentally ill were encouraged to seek treatment at local community facilities. The intent was that people could get treatment while living and working at home.

In 1963 the typical stay at a mental institution was 11 years for someone with schizophrenia. The legislation to build 1500 centers intended to reduce the 500,000 people living in mental institutions by 50%. However, only half of the centers were ever built or funded while 90% of the beds in mental institutions were cut. This translated into many without a place to go – often ending up homeless or in prison.

JFK’s nephew, former U.S. Rep. Patrick Kennedy, who leads the Kennedy Forum on community mental health explains, “The goals of deinstitutionalization were perverted. People who did need institutional care got thrown out, and there weren’t the programs in place to keep them supported.” To improve this, Patrick Kennedy has gathered advocates like Joe Biden, Chelsea Clinton, MSNBC’s Chris Matthews and Chicago Bears wide receiver Brandon Marshall for the Forum to come up with an agenda for improving mental health care.