Drug court – the saner alternative

The saner alternative to locking up mild drug offenders, that is. And, drug courts work in at least some instances.

The biggest issue, it seems, is how knowledgeable a drug court judge is about addiction in general, and about the different behavioral specifics of alcoholics vs. crack cocaine users vs. powder snorters vs. meth users, etc.

Sex addiction about addiction, not beauty or sex

Married to the beautiful Tea Leoni, who seems personally, not just physically, beautiful? Check.

Married for 10 years, with two children? Check.

Self-proclaimed sex addict needing help? Check.

Actress David Duchovny announce he is a sex addict and is entering a treatment program.

Good luck, David.

Mother’s day, no mom

Two open eyesores
Pouring buckets of water
Which she called weeping.

Emotions flowing
Without consciousness behind.
A mom self-detached.

No apologies,
Whether her fault or more mine.
This IS what I felt.

Child abuse changes the brain

Specifically, it changes RNA in an epigenetic process known as methylation.

Ketamine good for depression?

Scientists aren’t horsing around when they claim the notorious horse drug and human drug of abuse ketamine can help depression.

It doesn’t work on levels of neutransmitters like norepinephrine, serotonin or dopamine, either. Instead, in some other way, it’s supposed to “reshape” the orbifrontal cortex of the brain, an area where dread and shame can arise.

AND, it starts to work in just 24 hours, far earlier than the month or so Prozac and other SSRIs can take.

Plus, in what is surely a disappointment for Big Pharma, ketamine is already generic. No high-priced gouging by the Eli Lillys of the world.

Prozac: No better than placebo?

A major new meta-analysis, as reported in The Guardian, makes exactly that claim. The full study, published in the Public Library of Science, is here. And, it’s not just Prozac; another major selective serotonin reuptake inhibitor antidepressant, Paxil, get the same critical nyet, as do two serotonin-norepinephrine reuptake inhibitor antidepressant:

The review breaks new ground because Kirsch and his colleagues have obtained for the first time what they believe is a full set of trial data for four antidepressants.

They requested the full data under freedom of information rules from the Food and Drug Administration, which licenses medicines in the US and requires all data when it makes a decision.

The pattern they saw from the trial results of fluoxetine (Prozac), paroxetine (Seroxat) [Paxil in the U.S.], venlafaxine (Effexor) and nefazodone (Serzone) was consistent.

“Using complete data sets (including unpublished data) and a substantially larger data set of this type than has been previously reported, we find the overall effect of new-generation antidepressant medication is below recommended criteria for clinical significance,” they write.

I think the conclusion is somewhat overstated, and meta-analysis research in general is sometimes overhyped; nonetheless, is this anywhere near bogus? I think the research probably is pretty solid.

In any case, Big Pharma is HUGELY worried and wasted no time to attack.

In adults, however, the depression-beating benefits were thought to outweigh the risks. Since its launch in the US in 1988, some 40 million people have taken Prozac, earning tens of billions of dollars for the manufacturer, Eli Lilly. Although the patent lapsed in 2001, fluoxetine continues to make the company money — it is now the active ingredient in Sarafem, a pill sold by Lilly for premenstrual syndrome.

Eli Lilly was defiant last night. “Extensive scientific and medical experience has demonstrated that fluoxetine is an effective antidepressant,” it said in a statement. “Since its discovery in 1972, fluoxetine has become one of the world's most-studied medicines. Lilly is proud of the difference fluoxetine has made to millions of people living with depression.”

A spokesman for GlaxoSmithKline, which makes Seroxat, said the authors had failed to acknowledge the “very positive” benefits of the treatment and their conclusions were “at odds with what has been seen in actual clinical practice.”

Hey, if you can remarket an antidepressant as another drug, as Lilly did by rebranding Prozac as a pre-menstrual issues drug after its patent expired, you’re going to be dollar-sensitive.

That said, as someone currently on citalopram (generic Celexa), and having run through comments on a post on this on Political Animal, I have a few thoughts.

First, if antidepressants did work BECAUSE they were placebos, why wouldn’t the placebo effect work with the first antidepressant? Why do so many people, unfortunately, try three or four before finding the right one for them?

Second, claiming a “spontaneous remission” for depression, saying that means we can and should go back to pre-drug days, is not just naïve but dangerous. Like a physical illness such as MS that goes into “remission” but then flares up again, depression can do the same.

Finally, we know too little, still, about brain chemistry to know exactly how antidepressants work. Therefore, claiming we know they don’t work is premature, even if that does prove to be the case 20-30 years from now.

Death, death of relationship hopes mean lots of acting out the past week

My mom died two weeks ago yesterday. Emotions over her seem to have punctured me deeply enough to force a more emotional, conscious awareness that a female friend of mine is, not now nor in the foreseeable future, going to be anything more than “just friends.” I like her enough, and she’s attractive enough, that I really want her, and I’m definitely kind of depressed it isn’t going to happen.

So, between the two, I’ve got a shitload of emotions I’ve been trying to stuff… and online porn surfing has been the method of stuffing.

Is lust an emotion?

Would you call lust an “emotion” or a “drive”? In either case, would “revulsion” be its best opposite?

Gurus, authoritarianism and recovery groups — not just an AA phenomenon

For years, beyond its religious emphasis, a major complaint many people have had about Alcoholics Anonymous (and NA), is the idea of “sponsorship.” While the idea of a mentor to help in one’s sobriety, especially if truly voluntarily chosen, may be an idea of worth, in reality, especially with it being a quasi-requirement of AA/NA, it is easily abused.

Predatory-minded sponsors can easily become controlling and manipulative to minds in the midst of trying to clear themselves of the fog of alcohol and/or drugs. Or, people who aren’t official sponsors can do some of this. The predatory nature can come in with sexual manipulation, establishing a power base in a local support group for the sponsor, and more.

Even outside the official sponsorship idea, gurus can set themselves up with new insights on the best way to get clean/sober, etc. And not just inside individual groups.

The name “Clancy” is well known for propagating an entire subset of groups within AA.

Many critics of AA have observed that, sociologically, it’s a place of redemption for people who washed out of their local Lions Club, or something similar.

But, it would seem the problem is related to recovery groups and personalities susceptible to addictions, and not 12-Step models of recovery.

Several examples from the world of “secular recovery” will suffice.

One is Jack Trimpey, founder of Rational Recovery. Trimpey, as though he were the Chief Justice of the Supreme Court of Recovery, has, in essence, declared recovery groups null and void. He has said alcoholics/addicts who continue to go to such groups are, in essence, still weak.

Then, you have Marty Nicolaus, founder of Lifering Secular Recovery, an offshoot of Secular Organizations for Sobriety. LSR ostensibly was founded as a separate recovery organization after a Nicolaus-led lawsuit against SOS over some serious recovery issues, such as “single-substance sobriety,” failed in court.

I’ve talked to enough people in LSR besides Nicolaus to not doubt that SOS needed a fire under it (to which its founder, Jim Christopher didn’t repond), and there were grounds for the lawsuit. However, I’ve also talked enough to people in SOS, and done enough analysis on my own, to know that personality issues, including Nicolaus’ personality, were involved.

And, at the individual meeting level, “control freaks” and other types have popped up in my LSR experience too. This is true for online meetings as well as face-to-face ones.

That said, I reject the idea of “the addictive personality” as many people (often not really addicts) use it. But, to the degree addiction exacerbates personality traits, and less desirable ones in some people, and recovery groups give them a platform to spew this out, this is a worrisome phenomenon.