Addiction is a potent topic for debate in our debate-happy society, but, as with so many of those topics, the debates usually generate more heat than light. That’s why we are glad that the American Medical Association and the American Psychiatric Association have put out this handy, easy to read guide about addiction, separating fact from myth. Addiction is an …
Marijuana and Bipolar
Marijuana and Bipolar-Yes or No? The use of marijuana in treating many and various illnesses is a hot topic among many of our San Francisco-area patients. Since legalization for medical uses, and even for recreation, seems to be spreading throughout the country, more and more people are looking into helpful uses for this ancient but little-understood plant. However, medical advice …
Deaths of Despair
Deaths of despair increasing, but only in the USA Mortality rates are rising in the United States, especially among poor, rural populations, and specifically among whites. Life expectancy in other groups continues its historic rise, and this rising pattern is also found in 16 other countries with comparable economic levels. This phenomenon has been dubbed “deaths of despair” because the …
Herbal Medicine
A recent study on the use of cannabis extracts to treat mental illness got us started thinking again about the whole field of herbal and “natural” medicine. Cannabis is currently experiencing an explosion of interest and some robust research is being done. However the interest is running far ahead of the available data about real uses and effects of various …
Increased Alcohol Use in the US
A detailed and impressive study finds dramatically increased alcohol use disorders in the US in the past decade. Between 2001-2002 and 2012-2013, regular high-risk drinking increased by almost 30%, and the number of people meeting criteria for alcohol use disorder grew by 49.4%. What else do we know about the health of Americans in the past few years? We know …
12 Steps
There are a few people in my experience who are as impressive in maturity and integrity as those people we have worked with who have been the most involved in 12 Step Programs. I didn’t come to this observation from any pre-conceived bias in favor of 12 Step Program. If anything, my involvement with 12 Step early on was pretty negative. It …
Harm Reduction
Reducing the Harm of Substances in Your Life: A Harm Reduction Approach Have you noticed that your substance use is impacting your mood, relationships, or work? Are you looking to reduce the negative impact substances are playing in your life? Harm Reduction methods can be useful in exploring ways to prevent harm and reduce risks in your life caused by …
4 Ways You Can Help a Loved One Cope with Addiction and Mental Illness
Mental illness and addiction co-occur more than some people may think. People with a mental illness are more likely to abuse substances while those with addictions are likely to either develop the symptoms of a mental illness or a full-blown mental illness. If there is someone in your life struggling with these two problems here are a few ways you …
Cannabis and Bipolar
More than half of people with bipolar will qualify for a substance use disorder diagnosis at some point. In many places, the most popular drug (other than alcohol) in people with bipolar is cannabis. People with bipolar are almost 7 times as likely to use cannabis than the general population. In the United States, many states have legalized cannabis for medical indications, and two states have legalized its recreational use. …
Self Injury is the 8th Leading Cause of Death
An article just published online in the prestigious journal JAMA Psychiatry makes us drawn case that our fascination with trying to come up with clear answers to questions that may ultimately be impossible to answer (what a person’s intent was when they injured themselves) is obscuring the fact that self-injury is now the eighth leading cause of death in this …
Medical Marijuana
20 states have laws authorizing the use of medical marijuana, but what is the evidence for the medical effectiveness of marijuana? An exhaustive review of the topic just published in the Journal of the American Medical Association finds that, overall, the evidence for marijuana’s effectiveness is quite poor. And while many of my younger patients tell me that the problem …
Alcoholics Anonymous
Alcoholics Anonymous is many things, and its role changes over time for those who remain involved in it long term. Most importantly, AA can be a life line for those who are suffering from the potentially fatal illness of substance abuse. It is a way of achieving freedom from alcohol and drug addiction with the help of supportive peers who …
The Problem of Denial: How to Help Loved Ones with Substance Use and Other Destructive Habits
“What can we do to help our daughter, who is a young adult, living at home, and who is not compliant with treatment recommendations from mental health professionals and appears to be using substances and behaving in other self destructive ways?” We are often asked what can parents and family of young adults or seriously affected adults with mental illness …
Mindfulness Based Substance Abuse Treatment Works
Relapse is common after substance abuse treatment, indicating that there is a clear need for effective followup options. A new study has found that cognitive-behavioral relapse prevention (RP) and mindfulness-based relapse prevention (MBRP) are both effective aftercare interventions for substance abuse treatment, but that the latter may have an especially enduring effect as far as reducing drug-use days and heavy …
“Hitting Bottom” and Substance Abuse Recovery
I’ve always been a bit ambivalent about the idea that sometimes, an alcohol or substance abuser needs to “hit bottom” before they can get well. For one thing, there aren’t that many people in our practice who have decided to stop drinking or using drugs as a result of a classic “hitting bottom” experience. For another thing, the whole idea …
Quitting Smoking Improves Mood
A study published in the British Medical Journal reports that quitting smoking had a simillar positive effect on mood as an antidepressant. The researchers did an analysis of 26 studies using a technique called a “meta-analysis” and looked at changes in mental health (anxiety, depression, mixed anxiety and depression, quality of life, positive affect, and stress) at ≥6 weeks’ post–smoking cessation …
What about Marijuana for Depression or Bipolar Moods?
Since we practice in San Francisco, which was at the forefront of the move to decriminalize marijuana, we find that many of the people with depression or bipolar have smoked, or are smoking, marijuana as a way of treating their depression. Over the years we have developed a general impression of marijuana as a psychotropic (mood affecting) agent.It has been …
Was James Bond a Lush?
Always in search of the latest cutting edge medical knowledge, we happened across a fascinating research article in the December 2013 British Medical Journal that asks the question – “Were James Bond’s drinks shaken because of alcohol induced tremor?” Before going any further and looking at the research methods and conclusions, we have to warn readers that this may be …
Herbal Supplements Often Not What They Claim
A recent study concluded that herbal supplements are often not what they claim to be. The study was published in the journal BMC Medicine and it got front-page coverage on the New York Times website. Using DNA analysis, researchers tested 44 products from a dozen companies. The DNA signatures were compared with samples obtained from horticultural greenhouses. The study was summarized in the New …
Coffee for Depression?
Feeling down? An article in Psychiatric Times suggests that drinking a couple of cups of coffee in the morning might help your mood. The study they cite found that those people who drank two or three servings of coffee per day (8 ounce cups of drip coffee – or shots of espresso) had a 50% lower rate of suicide compared …
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