Drug and Alcohol Addiction

Understanding Marijuana's Effect on Brain FunctionAlthough much is still unknown about the effects of marijuana use, there is ample evidence to suggest that marijuana has both short term and long term effects on brain function. Short term effects are experienced immediately, while long term effects are the result of a prolonged substance use disorder.

Marijuana’s Short Term Effects on Brain Function

When someone smokes marijuana, tetrahydrocannabinol (THC) quickly enters the bloodstream from the lungs. As the chemical is carried to the brain, it affects the cannabinoid receptors that generate a series of cellular reactions to create the high associated with the drug.

Different areas of the brain have different concentrations of cannabinoid receptors, but the highest density is found in the parts of the brain that control memory, concentration, coordination, and sensory perception. The most compelling evidence of marijuana’s short term effect on brain function is the fact that marijuana is the illicit drug most often found in the blood of drivers involved in vehicle crashes.

The most noticeable short term effects on judgement, problem solving, and coordination fade within 24 hours, but effects can still be felt as long as THC is in your system. Regular smokers can have positive urine test results 45 days after their last use, with heavy smokers having positive tests up to 90 days after quitting. During this time frame, it’s common for marijuana users to experience sleep problems and difficulty learning new facts or skills.

Marijuana’s Long Term Effects on Brain Function

It may seem reasonable to assume that marijuana only affects the brain as long as THC remains in the body. However, this is not true. A number of studies have shown cognitive impairment in the brains of those who use marijuana regularly but were not under the influence at the time of evaluation.  

Studies asking for self-reported data have found that heavy marijuana use during the teen or early adult years is linked with poor academic performance, greater unemployment, increased welfare dependence, and lower life satisfaction.

MRI brain scans of marijuana users who began smoking in their teens found impairment in the neural connections between the brain’s left and right hemispheres as compared to their peers who had never used marijuana. This suggests that using marijuana during adolescence can result in poorer internal brain communication. Although the brain can change and develop throughout one’s entire lifespan, the most significant periods of growth occur before age 21.

A New Zealand study found that people who begin using marijuana in their teens had lower IQs in their 30s compared to their childhood test results. The decline in IQ was most significant in the youngest and heaviest marijuana users.

A survey of people who lived with frequent marijuana smokers asked about whether the smokers frequently experienced difficulty with memory or cognitive tasks. The survey found marijuana use that began in the teen years was associated with an increased difficulty in remembering facts and figures later in life.

Marijuana’s Link to Psychiatric Disorders

There have been studies linking marijuana use to an increased risk of psychiatric disorders such as depression and anxiety. However, it is unknown to what extent marijuana actually causes psychiatric conditions.

The same genetic and environmental risk factors that play a role in substance abuse are also linked to a higher risk of mental health disorders. It is also commonly accepted that a portion of people with mental health conditions will turn to marijuana as a way to self-medicate the most bothersome symptoms of their condition. If their mental health issues are properly addressed, they no longer feel the need to engage in substance abuse.

Effect of Prenatal Marijuana Exposure

It is very difficult for researchers to ethically study the effect of prenatal marijuana exposure, but studies following the children of women who self-reported marijuana use during pregnancy have found an increased risk of hyperactivity and developmental disorders. Evidence is mixed as to whether marijuana use is linked to premature birth, but research indicates pregnant women who use marijuana are 2.3 times more likely to experience a stillbirth.

Impact of Rising Potency on Brain Function

Test of confiscated marijuana have shown that THC levels are rising rapidly. In the 1990s, the average THC content was about 3.7%. By 2014, THC content had jumped to 6.1%. The newer practice of dabbing, smoking or eating THC-rich hash oil from a marijuana plant, can deliver more than 50% THC.

Rising THC levels are concerning to healthcare professionals because they are thought to increase the negative effects of marijuana on both short term and long term brain function.

By Dana Hinders







What is a functioning alcoholic?Alcoholism can take many forms. While some people end up on the streets or incarcerated as a consequence of their addiction, many others continue to lead outwardly successful lives while struggling with their inner demons.

About High Functioning Alcoholism

Someone with high functioning alcoholism is able to hold down a job, socialize with friends, and maintain intimate personal relationships while demonstrating a pattern of dysfunctional drinking behavior. High functioning alcoholics still suffer from an addiction, but it’s harder to see evidence of the problem unless you’re looking very closely.

A functioning alcoholic may be able to hide the signs of a drinking problem by restricting drinking only to certain times or in certain situations. However, many functioning alcoholics are successful in hiding the signs of their addiction because they have someone in their life who is unconsciously encouraging or enabling the addiction by allowing them to avoid the consequences of their behavior. For example, this person may loan them money when they’ve overspent on alcohol or make excuses on their behalf when they’re too hungover to go to work or attend a social engagement.

High functioning alcoholics are more common than you might expect. Studies estimate that nearly 20 percent  of alcoholics meet these criteria. Of these functioning alcoholics, about 1 in 3 have a multigenerational family history of substance abuse.

High functioning alcoholics are often intelligent, hardworking, and educated people who are actively involved in the community. They may be your coworker, your next-door neighbor, or your best friend.

Problems Associated with High Functioning Alcoholism

Alcoholism is a progressive disease. Over time, tolerance to alcohol increases. This leads to increased consumption, eventually to the point where a high functioning alcoholic starts to experience the adverse lifestyle consequences we all traditionally associate with alcoholism.

In cases where a high functioning alcoholic works in a professional role responsible for the safety and welfare of others, the consequences of substance abuse could be disastrous. For example:

  • A doctor could make a mistake that harms a patient.
  • A lawyer’s mistake could land his client in jail.
  • A CEO’s poor business decisions could put the entire company in jeopardy.

It’s also worth pointing out that even someone who drinks excessively while maintaining the outward trappings of a successful life is still causing a great deal of physical damage. Some of the many health problems associated with alcoholism include:

  • High blood pressure
  • Stroke
  • Obesity
  • Liver disease
  • Pancreatitis
  • Mouth, throat, liver, breast, and/or colorectal cancer
  • Cognitive impairment
  • Gout
  • Seizures
  • Anemia
  • Depression
  • Nerve damage

Signs of a High Functioning Alcoholic

Traditionally, substance abuse disorders are defined by having alcohol-related problems with your personal relationships, career, finances, and/or the law. However, identifying a high functioning alcoholic requires taking a closer look at drinking-related behaviors.

Signs a person may need substance abuse treatment include:

  • Engaging in binge drinking, defined as four or more drinks in a two-hour period for women or five or more drinks in a two-hour period for men
  • Relying on alcohol to feel powerful, confident, and in control
  • Drinking to handle mental health issues such as anxiety and depression
  • Drinking alone
  • Drinking in the mornings
  • Frequently finding yourself drinking more than you intended to
  • Experiencing cravings for alcohol
  • Saying things you didn’t mean while you were drinking
  • Having trouble remembering the details of what happens when you were drinking
  • Being secretive or defensive about alcohol use

Dealing with Denial

Denial is the most common challenge associated with getting a high functioning alcoholic to seek treatment. These individuals honestly believe their alcohol use is under control. Since they’re not unemployed or in trouble with the law, they don’t feel they meet the same standard as the alcoholics portrayed in popular culture. In many cases, they think only someone who has hit “rock bottom” meets the criteria for alcoholism.

Staging an intervention is one tactic that may be effective in getting a high functioning alcoholic to seek treatment. An intervention is a structured meeting where friends and family present their concerns to the person who is abusing alcohol or drugs, offer treatment options, and state the consequences for refusing treatment. For example, a wife may share that she is worried about her husband’s alcohol-related health problems and concerned that the children have noticed their father is absent from social events when he’s been drinking. As a consequence, she might state that she wants a separation if her husband doesn’t seek treatment.

Interventions are not 100 percent effective, but a well-planned intervention using the services of a licensed counselor, social worker, psychiatrist, or psychologist could be just the push your loved one needs to get help.

By Dana Hinders

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Medication assisted treatment MATMedication assisted treatment (MAT) for opioid addiction has been endorsed by the American Medical Association, the American Academy of Addiction Psychiatry, and the American Society of Addiction Medicine. However, MAT is often misunderstood by those in search of effective recovery options.

What Medications Are Used to Treat Opioid Addiction?

The most common medications used to treat opioid addiction are:

  • Methadone
  • Buprenorphine (sold under the brand names Suboxone and Subutex)
  • Extended release naltrexone (sold under the brand name Vivitrol)

Both buprenorphine and methadone are classified as essential medicines by the World Health Organization. Methadone is given as an oral tablet, liquid, or wafer from licensed opioid treatment clinics only. Patients must visit the facility daily to receive treatment. Buprenorphine can be given as a tablet, a film placed under the tongue or against the inside cheek, or an implant inserted in the arm. Only specially credentialed doctors can prescribe buprenorphine.

Are There Any Side Effects?

Constipation and sweating are the most frequently reported side effects of treatment, followed by nausea, back pain, chills, weight gain, insomnia, and decreased libido. Side effects may decrease in severity as your body adjusts to the medication, but you should discuss any concerns about side effects with your healthcare provider.

The medications used to treat opioid addiction could interact with some prescription medications, such as SSRI antidepressants and those used to treat HIV. You will need to tell your healthcare provider about all of the medications you are currently taking to determine if medication assisted treatment is right for you.

Patients who suffer from liver disease require close monitoring white undergoing MAT.

Is MAT Safe for Pregnant Women?

MAT is considered safe for pregnant women, with much less risk to the unborn baby than continuing to abuse heroin or other opioids during pregnancy. Both methadone and buprenorphine will show up in a drug screen after a woman gives birth, but no action will be taken if your healthcare provider verifies that the medications are being used as part of your substance abuse treatment plan.

Since buprenorphine is a newer medication and has been the subject of less research, methadone is considered the standard choice for pregnant women. Buprenorphine is considered a Pregnancy Category C medication, which means the risk of adverse effects has not been ruled out.

After giving birth, women on low doses of methadone may be able to breastfeed. If you wish to breastfeed, this should be discussed with your healthcare provider.

How Long Does Medication Assisted Treatment Last?

The duration of MAT for opioid addiction is decided on a case-by-case basis. In most cases, the goal is to taper off the dosage slowly as you become more comfortable and confident in your sobriety. However, patients with a history of relapse can safely take their medication on a long-term basis if they are properly monitored.

There are three phases of MAT:

  • Induction: A medically monitored beginning of MAT, which occurs when the patient is in the early stages of withdrawal.
  • Stabilization: An adjustment of the dosage until the patient is reporting no cravings and experiencing few, if any, side effects.
  • Maintenance: When the patient is doing well with a steady dose of medication, options for ongoing recovery are discussed. This can include either tapering off the medication altogether or continuing indefinitely to prevent relapse.

Isn’t MAT Simply Substituting One Addiction for Another?

People who’ve struggled with opioid addiction are often leery of medication assisted treatment because they believe that it’s best to get sober without any pills in their system. However, the medications used for treating opioid addiction do not result in getting high. The dosage is intended only to reduce cravings and withdrawal symptoms by balancing the brain circuits affected by addiction. This gives your brain time to heal as you work towards recovery.

Medication assisted treatment does not interfere with cognitive functioning. This means you can work, attend school, care for your children, and enjoy relationships with friends and family while receiving treatment.

Can Medications Cure Opioid Addiction?

Treatment for opioid addiction should combine medications with counseling to address the underlying issues contributing to substance abuse. Medications on their own are not a sufficient treatment for addiction, but using medication assisted treatment has been proven to improve retention rates in counseling programs.

Addiction is a chronic illness, so someone who suffers from opioid addiction will never be fully cured in the traditional sense. However, treatment can help an addict learn to manage cravings to live a full and productive life.

By Dana Hinders

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