People with substance abuse issues often find that the Holiday Season can bring up old wounds – we look at some of the issues around guilt for the addicted person. Also news about treatment for gambling addiction, and a chat about the addictive qualities of caffeine.
Transcript (edited):
Welcome to the CNS podcast featuring Dr Darryl Inaba research director for CNS Productions.
CNS: Hi and welcome once again to the addiction podcast from CNS Productions, Im Howard LaMere here with Dr. Darryl Inaba. Darryl, in continuing with the holiday motif, were talking about guilt as one of the reasons for an increase in addiction during the holidays.
Darryl: I think its absolutely accurate. Lynn OConnor of Wright Institute did a study of women who seem to have more guilt and shame than men. The study looked at addicts and alcoholics entering treatment and measured guilt, shame and alpha-beta pride and found that those coming into treatment suffer tremendous amount of guilt, tremendous amount of shame about theyve done. They have a low self esteem, low pride in themselves and are on the receiving end of a lot of anger from their families who have seen them make promise after promise only to break them all. Recently Ive been working with gamblers and I am finding this anger more prevalent in gambler families. During the holidays there is a lot of societal pressure to interact with friends and family – those we might have injured and hurt, so there is going to be a lot more guilt, shame, and feelings of low self esteem, which contribute to the desire to alter your state of conscientiousness. The easiest way for people with compulsive disorders to alter their states of consciousness is to partake in those activities that screen or suppress their feelings of guilt and shame for a while. This desire to feel better leads to more slips and therefore more relapses during the holiday season.
CNS: More so than the rest of the year, just because of the pressure. Weve talked about drug relapses, weve talked about food. Now theres another topic in the news caffeine addiction. A report from the surgeon general stated that caffeine was habituating, rather than addicting. I dont think anyone who drinks coffee would dispute the fact that its addicting. I mean I have to have that first cup of coffee in the morning, I try, I try having tea, green tea, which has caffeine anyway and its still not the same. I mean, theres something very addictive about caffeine and so how can anyone say its not addictive?
Darryl: Well, it goes beyond denial, theres certainly going to be denial in terms of any kind of addiction. When it comes to caffeine its almost a cultural reticence or a fear that this – the last thing left to alter our states of conciseness – is going to be taken away, or looked on negatively, and so caffeine
CNS: More guilt
Darryl: A lot more guilt. Caffeine has remained under the radar for lots of reasons. Its escaped any crucial examination. Weve looking at nicotine and other substances like alcohol, but caffeine is probably the last thing well look at with that much scrutiny. Caffeine is defiantly an addictive substance. Its a xanthine alkaloid, its a stimulant, it creates similar, although at much lower levels and intensity, changes in the body as does cocaine, and nicotine and methamphetamine. It affects the same processes in the brain. Scientists have looked at caffeine for a long time and believe that anytime you drink over five hundred milligrams a day of caffeine, your brain and your brain chemistry is altered. Researches see the beginnings of compulsive or addictive tendencies. Above eight hundred to one thousand two hundred milligrams of caffeine a day a person begins to have negative body toxic effects. Ive always felt that caffeine maybe responsible for a lot more deaths than cocaine and heroin just from the toxic effects it can render to your heart and blood vessels. Caffeine causes distress in those areas of your physiology. As you mentioned, everybody who consumes caffeine, knows about withdrawal when they try to stop. The headache, that pressure headache in the front of your brain can last several months to a year before it finally begins to dwindle and go away. So caffeine is physically addicting, its certainly emotionally addicting. I dont know anybody who realizes that they use caffeine to get stimulated in the morning to wake up, to do their work and to get off on their day. When they take a vacation, take several weeks where they dont have to get up and do anything – just eat and have fun, they still reach for that cup of coffee automatically, instinctively without even thinking. This is a true, true dependency and a true habituation. So caffeine is defiantly an addictive substance, defiantly something that that were going to have to look at in terms of how its affecting our health.
CNS: Like the hybridization of marijuana, the proliferation over the last 5 or 10 years of coffee shops that sell really strong coffee, from Seattle to Silicon Valley, we must wonder if its related to computers and dotcom and the generation x factor, I dont know that thats true but were definitely seeing stronger caffeine products.
Darryl: I actually had to detoxify and go into recovery for caffeine addiction some twenty-five, thirty years ago. I found myself unable to go through the day without a cup of coffee in my hand. I had tremendous headaches each morning and they went away with that first cup of coffee. It was better than aspirin or anything else. When I realized my blood pressure was up and my heart had some unusual beats I recognized it was caused by my caffeine dependency and I stopped. Since then, Ive been in rigid caffeine recovery – no coffee. Unfortunately, no one can totally avoid caffeine. Its in cold products, aspirin, sodas, chocolates, candy- its everywhere. I deal with it in an unusual way. I make coffee for my wife. Ever since I stopped drinking coffee twenty five years ago, I get up the morning before her and make her coffee. Her tolerance increased over the years and now I have an espresso machine. She graduated from Starbucks and is into much stronger Petes coffee from San Francisco. Theres no end to where its going but you can definitely see that pattern. Im just lucky that I dont have a strong desire when I smell it; I have a strong desire in the morning
CNS: are you getting something from your nose?
Darryl: Yes, but I have to remind myself that I cant – otherwise I wont stop. Ill have that cup in my hand all day long and end up like I did before.
CNS: Another topic in the news this week is treatment for gambling. Perhaps gambling is not as much of an issue during the holidays as some of these other things weve talked about but for people that have an addiction of any sort it doesnt stop for a holiday. So whats in the news on gambling?
Darryl: Well, its very exciting news. Ive always believed that its not the particular activity or the drug that causes a compulsivity to continue something even though its creating a tremendous negative impact on your life. Its actually the ways the brain differs in certain individuals that conspires to rob them of their control and then conspires to keep them engaged in that activity even though they desperately what to stop. I dont know if theres a stronger addiction than gambling. Ive worked with cocaine addicts and alcoholics and heroin addicts but working with gambling addiction Ive concluded that it is one of the strongest addictions. Perhaps it is because our society doesnt place a stigma on gambling. Society labels addicts problem gamblers and/or pathological gamblers. Pathological gamblers cant stay away from the action and they bet everything. They loose their home, they loose their vehicle. More people are walking the streets to work and walking around town not because they are alcoholics who lost their license, but because they gambled away their vehicle and any money buy another one. They max out credit, get themselves in terrible debt, and start participating in illegal activities.
With the advent of brain imagining in the 1980s, researchers found the same type of changes and the same activity in the gamblers brain as they made a bet as they saw in the cocaine addicts brain or a meth addicts brain taking a hit. The brain process and the pathways are the same. What I find exciting is that now medicine has recognized that similarity. Medication that was originally developed for heroin addiction and then was found to be effective in blocking craving in alcoholism is also actively helping gamblers. By giving them naltrexone, an opiate antagonist that blocks the opiate receptors from opiates, which blocks a gamblers craving. They are able to remain in recovery and are better able to avoid taking that first bet. This has created a better understanding of what addiction is and opened an avenue for more appropriate and better treatments to help people with this condition.
CNS: Its exciting that we are finding ways to address these issues but Im again reminded of 1984, theres a danger of taking drugs to deal with drugs.
Darryl: Maybe so but in another reality, as I work with addicts, I think its a wonderful thing thats happening. The important thing to focus on is that addicts, especially gamblers beat themselves up wondering why theyre doing what they are doing. Now they are finally beginning to accept, through this whole medical process, that they really have an illness, that theyre not weak willed individuals, theyre not bad, stupid, crazy, or amoral. They have a biological difference that makes them unable to control these behaviors. This helps them to accept that they need treatment and they need to practice recovery better and with vigor.
CNS: Other options are the organic things that we can do. Weve talked about singing and dancing and other organic things that make us feel good.
To those folks listening, your comments and questions are more than welcome. Stop by the web site www. cnsproductions.com, drop us an email and well address your questions. Darryl, happy holidays once again.
Darryl: Stay warm, Howard, its getting cold.
CNS: Yes it is definitely winter, ok, bye-bye, that wraps our pod for today. Thanks for visiting the CNS pod cast. Please check back soon for the next in the series and visit our website www.cnsproductions.com.