Alcoholics Risk Osteoporosis

What Is Osteoporosis?
Osteoporosis is a disease characterized by a reduction in bone density. Bones get smaller and weaken, putting people with the condition at a greatly elevated risk of breaks and fractures. Osteoporosis in older people is a serious health risk, often causing reductions in mobility and pain and broken bones after falls.

• 44 million Americans suffer from osteoporosis.
• Chronic alcohol consumption increases the risks of osteoporosis.
• Studies show that 25 percent of alcoholic men in their 30s, 40s and 50s show low bone density (Alcoholism Clinical and Experimental Research).

Alcohol causes a reduction in bone health and increases the risks of broken bones by decreasing coordination (alcoholics tend to fall down with greater than normal frequency).
How Does Alcohol Cause Osteoporosis?
Long-term heavy drinking damages bone health in many ways:

• Heavy drinking reduces the body’s production of vitamin D, which is needed for calcium uptake.
• Heavy drinking can alter hormone levels, decreasing testosterone in men and estrogen in women. A reduction in either of these hormones is associated with an increased risk of osteoporosis.
• Alcoholics often have high levels of the stress hormone cortisol, which is harmful to bone health.
• Alcohol increases the body’s production of parathyroid hormone, which decreases calcium levels.

What’s the Solution?
The solution to alcohol-related bone density losses is to stop consuming the substance that is causing the problem. Alcoholics who quit drinking tend to experience increased bone health, and in some cases, lost bone is even re-grown. 
Other measures that can help include:

• Weight-bearing exercise
• Quitting smoking (smoking is also harmful to bone health)
• Eating well (concentrating on getting sufficient vitamin D and calcium each day. Calcium is found in dairy products and green leafy vegetables.)

Are You Ready to Change Your Life? Understanding the Stages of Change Model?

Radical life changes don’t often come out of thin air. Change begins as an idea and then a motivation and then finally, becomes an action; and this process towards change takes time.
The stages of change theory is a psychological model developed in the 1970s that is used to help patients understand how change occurs and to help treatment providers design interventions matched to each client’s needs at distinct stages.
The Stages of Change

1. Pre-contemplation - In this first stage, you don’t feel that you have a problem that needs changing and so aren’t thinking seriously about taking any action.

2. Contemplation - During this second stage, you have come to realize that you do have a problem, but you’re not quite sure yet what, if anything, you want to do about it. You may still very much enjoy your drinking or using (although it does cause some problems) and you’re not sure if you even want to stop…Something to think about.

3. Preparation – You have decided that change is needed and that change will come. You start thinking about how to accomplish your goal of change.

4. Action - You take action to make your life change. This could be by going to AA meetings or getting into treatment, for example.

5. Maintenance – You have achieved your goal of change and now you are trying to maintain it. This stage lasts from 6 months to 5 years in duration.

6. Termination or Relapse – Eventually (after 5 years) when you no longer have any desire to use and no longer require any external support to stay abstinent; you may consider your change terminated. An alternate to termination in the stages of change model is relapse. Relapse brings a person back full circle to step one again.

A person visiting a website on addiction treatment and reading an article on life change would likely be in the contemplation or preparation stage of change.

If you know you are ready for change and would like to see what treatment options are available in your area, please call the addiction treatment specialists at the National Resource Center at (866) 762-3712.

For Men; Chronic Heavy Drinking Lowers Testosterone Levels. What Does This Mean for You?

Chronic heavy drinking is bad for you, we all know this, but if you’re a man, have you heard that heavy regular drinking might also make you less manly!?!
Alcohol does funny things to testosterone levels; none of them good. Studies have shown that when consumed in binge amounts, some men may react by showing a temporary surge in testosterone levels; a hormonal jump that may well in part explain drunken aggression. Other studies have shown, contrarily, that binge drinking causes an acute reduction in testosterone levels, for about a day or so.
In general though, heavy, lengthy and regular use of alcohol has a diminishing effect on testosterone levels. Heavy regular alcohol use robs men of normal testosterone levels, which causes a number of negative health effects.
Chronic use of opiate pain medications, such as vicodin, oxycontin or others, is also known to diminish testosterone levels.
The Consequences of Lowered Testosterone Levels Include:

• Fatigue
• A decrease in sex drive
• Erectile dysfunction
• Weight gain (fat gain, especially around the mid section)
• A loss of lean muscle
• Irritability
• Body hair loss
• A decrease in bone mass and a resultant increase in the risks of breaks and fractures
• Depression
• Male breasts
• Shrinking testes
• An increase in certain cardiovascular disease risks (men with very low testosterone levels are at a very high risk of heart attack)

Countering Alcohol Induced Testosterone Deficiencies
Lower than healthy testosterone levels can cause symptoms that are unpleasant, unattractive and downright dangerous. If alcohol causes you to lose testosterone, an obvious first step to restoring a better hormonal balance is a dramatic reduction or cessation of alcohol use.
Other methods that can increase testosterone include:

• Medications
• Exercise – weight lifting type exercises increase testosterone levels more than cardio exercises
• Weight loss – carrying extra fat, especially a body weight that is 30% or more above ideal, can lead to hormonal imbalances
• Getting a full night’s sleep
• Diminishing chronic stress in your life (stress is a testosterone killer)
• Good nutrition. Although weight loss is a great way to boost testosterone levels, crash diets can have the opposite effects. Stick to sensible healthy eating and exercise for weight loss.

Talk to your doctor if you worry that your testosterone levels may be low. An accurate diagnosis of the problem is always a solid first step to a good solution.
If, after a diagnosis of low testosterone levels, you find yourself still drinking alcohol at anything above a very minimal amount and infrequently, you may need to reevaluate your relationship with alcohol – after all, continuing to drink even knowing the harms that alcohol does to your body, is a hallmark sign of an alcohol problem.

5 Techniques for Dealing with Cravings

You can do your best to minimize your exposure to those things, places and people that trigger drug cravings, but you will never eliminate cravings entirely. Learning to manage and overcome drug or alcohol craving is therefore an essential skill in any journey of recovery.
Addiction treatment programs teach those in recovery skills that when practiced and used in real world situations of temptation, can prolong recovery for yet another day; day by day.
Here is a brief overview of some of the methods taught to help manage drug or alcohol cravings, as recommended by the National Institute on Drug Abuse (NIDA).
Distraction
Getting out of a situation of craving and distracting yourself with another activity is an excellent way to avoid succumbing to temptation.
Experts recommend that you make a list of activities that can distract you from a craving should the need arise (going bowling, taking the dog for a walk, doing the groceries etc.).
Many people attempt to manage cravings for a certain drug by using another drug, for example, a cocaine addict may use marijuana to help manage cocaine cravings. This is a very poor technique and too often leads to full relapse; and so having a list of better alternatives at the ready can help to minimize drug substitution behaviors.
Remembering Why You Don’t Use
During an intense craving, people fixate on a remembrance of the pleasures of drug use, forgetting temporarily the reasons why they stopped using in the first place. Reminding yourself why you chose to stop using during a period of craving can strengthen your resolve to wait it out.
Some therapists recommend that you in fact write down a list of good reasons for staying sober on an index card and keep that card on your person at all times. Then, during a tough moment of temptation, you can review your list and remember at that moment exactly why you need to stay strong.
For example

• Worsening liver disease
• Lose custody of my children if I use
• My wife may leave me
• I will lose my job if I test positive one more time

Talking Through the Craving
Talking through an episode of craving as it happens can help you to manage the severity of it. Telling someone you trust about what you are going through at the moment of a craving can empower you and reduce some of the anxiety associated with struggling against temptation alone. Talking through the craving as it happens can also help you to better understand what specifically led to the feelings of temptation.
Letting Go – Feeling the Craving
Letting yourself experience a drug or alcohol craving in a very abstract and detached kind of way can greatly diminish the experienced intensity of the event.
Therapists counsel you to envision the craving as a wave that is going to wash over you, starting low, gaining in intensity, peaking and then subsiding. Instead of fighting the craving, as you normally would, when letting go you try to experience the craving as fully as possible.
Get into a comfortable and secure place, sit back and let yourself feel the craving.
Notice:

• What does it feel like?
• What do my feet feel like? My knees, my stomach,  my neck, etc…
• How strong is the craving right now? Is it getting stronger or is it subsiding?
• Can you describe the feeling of the craving in words?

In a paradoxical way, in concentrating on experiencing the craving fully you detach yourself from its influence. Many people find that this detached experiential method greatly reduces the intensity and even frequency of experienced cravings.
Reducing the Power of the Internal Voice
In most of us, feelings of craving unleash an internal voice that convinces us of the inevitability of use.
A craving might cause internal voice statements such as:

• I need a drink
• I can’t fight this any longer

However, once we take an objective look at craving induced inner voice statements, we can see that they are not inherently true at all; and so we can learn to counter these statements with more accurate reflections of reality.

• “I need a drink” becomes, “I may want a drink, but I don’t need a drink, and all feelings of craving will pass.”

• “I can’t fight this any longer” becomes, “Cravings can be unpleasant and difficult, but they are only temporary, I will feel better in a minute, as long as I don’t drink or use.”

A Cognitive Behavioral Therapy (CBT) Approach
These and other techniques for managing and overcoming cravings to use drugs or alcohol are taught as an aspect of CBT as offered for addiction recovery. Myriad clinical studies prove the efficacy of CBT as a treatment for addiction.

Addiction Recovery: How Long Does it Take?

Addiction rarely occurs overnight, and like the descent into the disease, the journey out of it can take some time.
People naturally want to know how long treatment and recovery will take. They want to know when they can expect to feel better and when they’ll stop craving that drink or that hit so badly.
Frustratingly, concrete answers to questions like these are hard to come by. Every person recovers in their own time, and every person requires something different on what is always a very individual journey.
The only part of recovery that transcends this individual experience is the reality of a lifetime of recovery. No matter who you are, once addicted, addiction recovery is for life.
The Facts of Recovery

• Addiction remains an incurable disease. Although treatment can induce remission, recovery lasts a lifetime.

• The National Institute on Drug Addiction (NIDA) does not recommend residential or outpatient programs that last fewer than 90 days, calling programs shorter than this “of limited effectiveness.”

• NIDA recommends staying involved in addiction treatment for “significantly longer” than 90 days as the best way to encourage lasting success.

• NIDA recommends that people taking methadone to help break their addiction stay on the medication for a minimum of 1 year before attempting to taper off.

Longer Is Generally Better
There are no quick fixes to overcoming an addiction, and you should be wary of those treatment methods that promise the impossible. When deciding to get treatment for your addiction, realize that recovery is a lengthy journey. For the best chance of continuing recovery, you will need to invest significant time and effort into your treatment experience.
People who enter a short- or long-term residential addiction treatment program will need to continue their involvement in aftercare outpatient programs to maximize their chances of success. That will provide them continued support and encouragement on their path of recovery.
To learn more about addiction treatment programs in your area, call the National Resource Center at (866) 762-3712. Treatment experts are available around the clock to answer your questions, without obligation, and recommend quality addiction treatment near you.

The 4 Medications Used to Treat Alcoholism

Can medication keep you sober? Probably not, but medication may help you stay sober, especially when medications approved for the treatment of alcoholism are combined with therapy.
While researchers have yet to find a real medication-based cure for alcoholism (and research continues in earnest), the U.S. Food and Drug Administration (FDA) has approved four medications for use in treating the disorder. These medications are all used to help people avoid relapse or decrease drinking.
The four medications approved by the FDA to treat alcoholism are:

• Acamprosate
• Oral naltrexone
• Injectable naltrexone
• Disulfiram

Why Use Medication?
Research shows that adding an approved medication for alcoholism to counseling or other forms of addiction treatment improves treatment outcomes. Alcoholism medications have been found to:

• Reduce enduring symptoms of withdrawal that can prompt relapse (acamprosate)
• Help minimize alcohol cravings
• Help recovering alcoholics who temporarily slip back into drinking to avoid complete relapse
• Prolong intervals between slips or relapses
• Increase the benefits of counseling or other alcohol treatments

Medication can help an alcoholic in early recovery stay sober long enough to develop sober living and social skills that provide a continuing base for further sobriety. These medications also reduce the severity of cravings and withdrawal symptoms.
Acamprosate (Campral)
Acamprosate helps restore brain function damaged by alcoholism, and in doing so helps alcoholics maintain abstinence.
Alcohol causes intense but relatively brief withdrawal symptoms, and much longer lasting but milder symptoms of withdrawal. Although milder, these enduring withdrawal symptoms (such as difficulty sleeping, irritability and anxiety) can lead to alcohol relapse.
Acamprosate helps motivated recovering alcoholics maintain abstinence by reducing the severity of these longer lasting withdrawal symptoms. Acamprosate is thought to reduce glutamate activity, but its exact means of action remains poorly understood.
How Well Does Acamprosate Work?
Some studies show that acamprosate can double durations of abstinence. Other studies have shown less impressive outcomes. Acamprosate seems to work best for people who are motivated to stay abstinent. It must be taken three times daily, so patient compliance is very relevant.
Advantages of Acamprosate

• Acamprosate is not metabolized in the liver, and so can be used by patients with liver damage or cirrhosis.
• It can be used by patients taking methadone or Suboxone, and by those who require opiates for pain control (unlike naltrexone).
• It causes no withdrawal symptoms and can be stopped suddenly if needed. It can also be taken safely with benzodiazepines.
• It cannot be abused and it is not dangerous, even at overdose quantities.
• Side effects are generally minimal, and those that occur are well tolerated.

Acamprosate becomes fully effective between five and eight days after treatment initiation.
Oral Naltrexone (ReVia)
Patients taking oral naltrexone experience reduced cravings for alcohol and, while taking the medication, drinking alcohol won’t produce as much pleasure. Since drinking doesn’t make people on naltrexone feel as good, people that slip while taking the medication tend to drink lesser amounts.
Oral naltrexone works by blocking receptor neurons in the brain’s natural opioid system. With these receptors blocked, consuming alcohol is not as pleasurable. Additionally, neurons in the mesolimbic system (the opioid system) are thought to be responsible, at least in part, for alcohol cravings. Blocking these receptors with naltrexone reduces craving intensity.
How Well Does Oral Naltrexone Work?
Oral naltrexone is effective at helping people maintain abstinence or drink less. Studies of oral naltrexone have shown that, compared to people taking a placebo, people taking the medication:

• Have lower rates of relapse
• If they do drink, drink less often and drink less in a sitting

Advantages of Oral Naltrexone

• It works well, particularly for people who experience heavy alcohol cravings and who are motivated to maintain abstinence.
• It is well tolerated, causing few side effects (the most common side effect is nausea).
• It has no abuse potential and causes no withdrawal symptoms.

Disadvantages of Oral Naltrexone

• It cannot be used by some people with liver problems.
• It cannot be used by anyone using methadone, Suboxone or requiring opiate pain medications.
• It may increase a person’s vulnerability to opiate overdose by decreasing opiate tolerance.

Most people begin oral naltrexone therapy within three to seven days after achieving alcohol abstinence. Naltrexone is FDA-approved for up to three consecutive months of treatment.
Injectable Naltrexone (Vivitrol)
Injectable naltrexone works in the same way as oral naltrexone to reduce alcohol cravings and decrease the pleasures of alcohol consumption. While oral naltrexone needs to be taken daily, intramuscularly injected naltrexone works for a continuous month. With a monthly injectable dose, everyday compliance is not an issue.
Studies that have examined the efficacy of naltrexone as a treatment for alcoholism have consistently encountered patient non-compliance as a barrier to successful treatment.
The advantages and disadvantages of injectable naltrexone treatment closely mimic those of oral naltrexone treatment. The main benefit of injectable naltrexone is increased patient compliance. Some points of concern include:

• The possibility of an injection site reaction.
• The duration of effectiveness means that any adverse reactions experienced will be experienced for 30 days.

Disulfiram (Antabuse)
Patients talking disulfiram cannot consume alcohol without becoming very ill. Patients taking this medication know this, and so avoid drinking alcohol while taking the medication. This helps people in recovery prolong abstinence and avoid relapse.
How Does Disulfiram Work?
Normally, alcohol is metabolized by the body into acetaldehyde and then into acetic acid. Disulfiram disrupts the final stage of this process (the metabolization of acetaldehyde into acetic acid), causing a much higher level of acetaldehyde in the body after any alcohol consumption.
High levels of acetaldehyde in the bloodstream lead to very uncomfortable reactions, such as the following:

• Hyperventilation
• Thirst
• Nausea and vomiting
• Chest pains
• Dizziness
• Confusion
• Muscle weakness

At higher doses, the combination of disulfiram and alcohol can lead to serious reactions that can include symptoms such as:

• Seizures
• Heart failure
• Respiratory depression
• Death

Disulfiram is no longer given in doses high enough to likely cause a very severe or dangerous reaction. In the past, disulfiram was given in high dosages to patients in combination with alcohol, but that is no longer accepted medical practice.
Does Disulfiram Work?
Studies have shown that disulfiram helps to reduce drinking days amongst the actively drinking, but does not seem to work better than placebo in supporting abstinence. Patients who are supervised while taking their medication (to ensure compliance) seem to do better than those who are left unsupervised.
Disulfiram is not an appropriate medication for people with any of the following:

• Mental illness
• Poor impulse control
• Cognitive impairments

No one should take disulfiram without a full understanding of the effects and potential consequences of the medication.
Medications Can Help Support Recovery
Medications can play a very supportive role as one of several pillars in a foundation of recovery. No medication yet available for the treatment of alcoholism works very well when offered as a standalone therapy — all must be combined with other therapies.
If you are interested in quitting drinking or reducing your consumption of alcohol, talk to your doctor about your suitability for any of the above medications. To find a doctor versed in alcoholism recovery, contact the National Resource Center at (866) 762-3712. The center is a free service providing treatment specialists 24 hours a day to answer your questions and put you in contact with appropriate healthcare professionals in your area.

Treatment for Dual Diagnosis: Substance Abuse and Mental Illness

People who have both a mental or emotional disorder and a drug or alcohol addiction are said to have a dual diagnosis disorder. A dual diagnosis disorder is very common and it’s also very treatable. For the best chance of recovery, people with a dual diagnosis need integrated treatment for both substance abuse and their mental or emotional disorder at the same time.
How Common Is a Dual Diagnosis?

• More than half of all people with a serious mental illness also have an alcohol or drug abuse or addiction problem, according to the Substance Abuse and Mental Health Services Administration.

• More than fifty percent of drug abusers and 37 percent of alcohol abusers have a mental illness, according to the Journal of the American Medical Association.

Why Is Integrated Treatment so Important?
Each condition worsens and can prompt the other:

1. Alcohol and drugs can worsen psychiatric symptoms, reduce the effectiveness of psychiatric medications and reduce the likelihood of treatment compliance.

2. Symptomatic mental illness can prompt the use of alcohol or drugs as self medication, and can reduce the resolve or ability to stay abstinent.

For a better chance at lasting recovery, treatment must address both problems at the same time — and, ideally, should be from the same team of doctors, therapists and healthcare professionals.
Effective Dual Diagnosis Treatment
The first step in dual diagnosis treatment, if needed, is medical detoxification, which focuses primarily on the addiction. After successfully withdrawing from drugs or alcohol, the client can then participate in more integrated treatment for both addiction and mental illness.
Some components of effective dual diagnosis treatment programs include the following:

• Programs that are developed exclusively for the treatment of dual diagnosis patients and that offer group therapy sessions comprised of patients undergoing similar challenges.

• Programs that offer case management services, ensuring that the therapeutic services of a team of clinicians are delivered in an integrated manner and with full cooperation and communication between all involved.

• Programs that bring in family members for support, education and involvement in the recovery process.

• Programs that offer life-skills training, education or employment assistance programs.

• Programs staffed by doctors able and willing to prescribe medications as appropriate.

Recovery From a Dual Diagnosis is Very Possible
A dual diagnosis can complicate the situation, treatment can take longer and dual diagnosis patients should seek out care specific to their needs — but dual diagnosis treatment can and does work.
Call the National Resource Center at (866) 762-3712 to learn more about treatment programs in your area that meet the needs of those with both mental illness and addiction.