Addiction Mind

Almost every addicted individual believes at the outset stopping using drugs without help is easy and most people try to quit without seeking treatment. Although some people are successful, many attempts result in failure to achieve permanent abstinence. Research suggests that long term drug abuse results in changes in the brain that last long after a person stops using drugs. These changes in brain function from drugs can have many behavioral consequences, including an inability to exert control over the impulse to use drugs, despite adverse consequences the defining characteristic of addiction. Understanding that addiction has a fundamental biological component may help explain the difficulty of achieving and maintaining abstinence without treatment.

Motivational Enhancement Therapy

Motivational Enhancement Therapy is a counseling approach that centers on the individual and aims to initiate behavioral changes by helping people resolve ambivalence about engaging in treatment and by stopping drug use of alcohol, marijuana and nicotine. This approach employs strategies to evoke rapid and internally motivated change, rather than by steps, through the recovery process. This therapy consists of an initial assessment session, followed by two to four individual treatment sessions with a therapist. In the first treatment session, the therapist provides feedback to the initial assessment, stimulating discussion about personal substance use and eliciting self motivational statements. Motivational interviewing principles strengthen motivation and build a plan for change. Therapists suggest coping strategies for risky situations. In subsequent sessions, the therapist monitors change, reviews cessation strategies in place and continues to encourage commitment to change or sustained abstinence. Patients sometimes bring a significant other to sessions. Research suggests that the effects of motivational enhancement therapy depend on the type of drug participants used and the goal of the intervention. Doctors use the motivational enhancement therapy successfully with alcoholics to improve both treatment engagement and treatment outcomes such as reductions in problem drinking. Adults who are dependent on marijuana make strides in recovery when using motivational enhancement therapies in combination with cognitive behavioral therapy. Participants abusing other drugs like heroin, cocaine, nicotine and for adolescents who tend to use multiple drugs show mixed results when undergoing motivational enhancement therapies. In general, studies show that motivational enhancement therapies are more effective by engaging drug abusers in treatment than for producing changes in drug use.

Nicotine Addiction

The nicotine high can sometimes be imperceptible, as it eliminates withdrawal symptoms and fills nicotine users with a sense of calm. Some users experience a ???已늨tine buzz,??most common in first-time nicotine users or after a period of abstinence. The main nicotine high starts almost immediately upon ingesting nicotine????pecially for tobacco smokers????퓪d lasts for a very short duration. Smokers feel it almost immediately after taking the first puff of a cigarette, while those who chew tobacco tend to feel the nicotine high within a minute of starting to chew. A wave of calmness passes over the user???body, replacing the agitation of withdrawal, as soon as the nicotine is transferred to the brain. As the nicotine levels increase, nicotine users may feel feelings of calmness and relaxation replaced by a tingling sensation and sense of heaviness.

According to a National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration, 23.2 million people, or 9.4 percent of the United States population, aged 12 or older needed treatment for an illicit drug or alcohol use problem in 2007. Of these individuals, 2.4 million people totaling 10.4 percent of those who needed treatment, received treatment at a specialty facility such as a hospital, drug or alcohol rehabilitation or mental health center. Thus, 20.8 million people, or 8.4 percent of the population aged 12 or older, needed treatment for an illicit drug or alcohol use problem but did not receive it. These estimates are similar to those in previous years.

Addictive Potential of Steroids

Animal studies have shown that steroids are reinforcing. Animals will administer steroids to themselves when researchers gave them the opportunity. Animals do this with other addictive drugs, too. The addictive property is more difficult to demonstrate in humans, but the potential for steroid abusers to become addicted is consistent with continued abuse, despite physical problems and negative effects on social relations. In addition, steroid abusers typically spend large amounts of time and money obtaining the drug, which is another indication of addiction. Individuals who abuse steroids can experience withdrawal symptoms when they stop taking steroids. Symptoms include: mood swings, fatigue and restlessness, loss of appetite, insomnia, reduced sex drive and steroid cravings. Withdrawal symptoms may contribute to continued steroid abuse. One of the most dangerous withdrawal symptoms of steroid use is depression. When persistent, depression can sometimes lead to suicide attempts. Research indicates that some steroid users might turn to other drugs to alleviate some of the negative effects of steroids. For example, a study of 227 men admitted to a private treatment center for dependence on heroin or other opioids in 1999 found that 9.3 percent had abused steroids before trying any other illicit drug. Of these, 86 percent first used opioids to counteract insomnia and irritability resulting from the steroids.

Consumer Driven Health Care

Defined narrowly, consumer driven health care refers to health insurance plans that allow members to use personal Health Savings Accounts, Health Reimbursement Arrangements, or similar medical payment products to pay routine health care expenses directly, while a high-deductible health insurance policy protects them from catastrophic medical expenses. High-deductible policies cost less, but the user pays routine medical claims using a pre-funded spending account, often with a special debit card provided by a bank or insurance plan. If the balance on this account runs out, the user then pays claims just like under a regular deductible. Users keep any unused balance or "rollover" at the end of the year to increase future balances, or to invest for future expenses.

This system of health care is consumer driven health care because of routine claims using a consumer-controlled account versus a fixed health insurance benefit. That gives patients greater control over their own health budgets. In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care they receive. Consumer driven health care received a boost in the U.S. in 2003, with passage of federal legislation providing tax incentives to those who choose such plans. Proponents argue that most Americans will pay less for health care in the long haul under consumer drive not only because their monthly premiums will be lower, but also because it increases free-market variables in the health care system, fostering competition, which in turn lowers prices and stimulates improvements in service.The Medicare Prescription Drug Improvement and Modernization Act includes provisions to stimulate the popularity of these plans. The law expanded medical savings accounts, renaming them Health Savings Accounts and created tax incentives to encourage adoption of high-deductible health plans. Banks were empowered to create accounts, which deliver tax-free interest to the holders, who can then withdraw money tax free to pay for qualified health care expenditures. To qualify for an HSA, the purchaser must also have a qualifying high-deductible health insurance plan. Participants contribute more to the savings account than would be required to fulfill their annual deductible, and any unused portions of the account accrue without tax penalty so long as the funds are only for qualified medical expenses.

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