WHEN IS A DRUG NOT A DRUG?

WHEN IS A DRUG NOT A DRUG?

BY CARL E. KING

WE CAN'T TURN ON A Television or pick up a newspaper these days without hearing or reading about drug testing. Most large companies are either testing applicants and employees for drugs or are considering doing so. Drug testing through urinalysis is one of this country's fastest-growing businesses. The US government has not only endorsed testing in general but in fact ordered it for private companies regulated by the Department of Transportation.

The current interest in drug screening is commendable. Since widespread testing has begun, the national use of every illicit substance except crack has declined. Clearly, workplace testing is one of the only strategies in the 20-year war on illegal drugs that seems to be working.

But our battle plan has a flaw. While we've been testing diligently for drugs, a single substance has escaped notice, a substance that causes twice the problems of all illegal drugs combined: alcohol.

Alcohol is the most abused substance in the United States today and affects seemingly normal men and women from every walk of life. Its cost to society is staggering. The Research Triangle Institute of North Carolina reports alcohol abuse was responsible for $50.6 billion in reduced productivity in 1988, compared with $25.7 billion in losses from drug abuse. Our nation spent $9.5 billion in health care costs for alcohol-related problems, compared with $1.2 billion for drug-related problems.

The Employee Assistance Society of North America states absenteeism among alcoholics and problem drinkers is as much as 8.3 times higher than for other employees. Alcohol abusers also have a two to three times greater risk of being involved in industrial accidents. The society's studies show that up to 40 percent of industrial fatalities and 47 percent of industrial injuries are due to alcohol abuse. Even nonalcoholic members of an alcoholic's family use 10 times more sick leave than other employees.

Alcohol problems are not limited to the workplace. The US Department of Health and Human Services reports that alcohol was involved in half of all highway deaths last year, resulting in 25,000 fatalities. It is also a factor in 50 to 70 percent of all murders, fatal accidents, and fire deaths and in over half of all arrests. Considering alcohol's dramatic impact on our nation and businesses, any responsible substance abuse program should screen for it.

Why alcohol is not routinely tested for is unclear. However, there are probable causes for its omission. Urinalysis is legally acceptable for drug testing but is not a good test for alcohol. Alcohol evaporates from urine during shipment, causing the final reported content to be less than it was at collection. Also, because alcohol eventually moves to the kidneys and is held there until expelled, a urine test can report an alcohol level consistent with being legally intoxicated even though the person providing the sample is no longer affected by the intoxicant.

Intoximeters, or breath-testing machines, are an excellent means of alcohol detection and constitute legally acceptable evidence. However, they are costly, require certified operators, and must be calibrated continually. These drawbacks make them difficult for the average company to use in substance screening programs.

Saliva tests are inexpensive. They are, also generally acceptable for establishing probable cause to move forward to a confirmatory urine or blood test. Unfortunately, the test materials have a limited shelf life and must be kept cool.

Blood testing is the only accurate method of proving alcohol intoxication, but it is intrusive and costly. Blood tests are practical only when there is a reasonable suspicion that the person being tested has alcohol in his or her system.

Considering that most available alcohol testing methods have some drawbacks, it is understandable why some executives choose not to screen for alcohol. However, new technologies provide us with accurate, easily-administered, cost-effective screening methods that should now be considered.

For example, new disposable breath testers are an effective way to check for alcohol in a subject's system while testing for other drugs. If a breath test is positive, the subject is then required to provide a blood sample for shipment along with the urine sample. A laboratory tests the blood to confirm the presence of alcohol while the urine is tested for other drugs.

Adding alcohol to corporate substance abuse testing programs makes sense.

Since disposable breath testers cost $3 or less, they are a cost-effective screening method. They allow employers to eliminate from suspicion employees who have no alcohol in their systems and concentrate on those who test positive. Since a breath test can be confirmed by a blood test, they make good sense in a screen-and-confirm program.

When choosing a disposable breath tester, managers should select one that has been properly verified and validated. It's a good idea to review those that have received favorable scrutiny from the Department of Transportation and that match a police intoximeter for accuracy. Blood and urine tests should be conducted by a forensic laboratory, preferably one certified by the National Institute on Drug Abuse (NIDA). NIDA-certified labs have excellent quality control and chain-of-custody procedures and are likely to survive court challenges.

Since accurate and cost-effective methods of alcohol screening are available, and since alcohol abuse is far more costly and damaging to American business than drug abuse, adding alcohol screening to corporate substance abuse testing programs makes sense. Any company that tests for drugs and not for alcohol is open to the criticism that its testing is incomplete.

About the Author . . . Carl E. King is CEO of Team Building Systems Inc., which specializes in employee and applicant screening, in Houston. He is a member of ASIS.

26 Reasons Why You Should Avoid Drugs

26 Reasons Why You Should Avoid Drugs By Gregory Hammonds

Drug Addiction starts out as a casual, sometimes social, activity and escalates. A look at the risk before one gets too far, from one who has lived through it.

1. Drugs are stimulants and gives its user a false sense of limitless power and energy

2. When drugs wear off, or you come down, you become depressed, edgy and craving for more

3. Feelings of restlessness, irritability, mood swings, sleeplessness and weight loss

4. Emotional problems

5. Isolation from family and friends

6. Psychosis, paranoia, anxiety, disorders and delusions

7. Cocaine damages the inside of the nose

8. Inflamed nasal passage

9. Increase risk of hepatitis and HIV

10. Severe respiratory infections

11. Heart attack, chest pain, respiratory failure

12. Strokes, abdominal pain and nausea

13. A change in behavior

14. Keeps you broke

15. Lose interest in school, family and any activities outside of getting high

16. Affects your eating habits; depending on the drug: can cause weight loss or gain

17. Become withdrawn, tired and careless about personal appearance

18. Lose interest in holding a job

19. Tempts you to steal

20. May even tempt you to kill someone

21. The substance controls you, you do not control it

22. It is a device used to shorten your life span

23. It is poisonous and slowly kills you

24. Eats up the brain cells

25. It makes you do things that you thought you would never do

26. It steals your identity.

Common Antidepressants May Affect Imune System

By Dr. Ben Kim
DrBenKim.com

According to scientists at Georgetown University Medical Center and at Robarts Research Institute in Canada, selective serotonin reuptake inhibitor (SSRI) antidepressants such as Prozac, Paxil, and Zoloft may have a significant effect on the immune system.

This contention is based on the recent discovery that serotonin is exchanged between important cells in the immune system, and is specifically used to trigger an immune reaction in response to various stimuli.

Serotonin is a chemical that is transmitted between cells in the brain. It is associated with feelings of pleasure, mood, and appetite.

SSRI drugs like Paxil and Prozac are antidepressants that are designed to keep serotonin within the stimulating regions between cells in the brain, which is intended to enhance serotonin's positive effects.

Since SSRI antidepressants have a direct impact on serotonin, it stands to reason that these drugs have some effect on the immune system.

As more is discovered about what serotonin does in the immune system, the specific impact that SSRI drugs have on immune function should become more clear.

Cells in the brain communicate mainly through chemicals, also known as neurotransmitters.

The immune system is different from the nervous system in that it communicates mainly through physical contact. Various cells in the immune system grab a hold of foreign invaders and present these invaders to white blood cells called T-cells. This enables T-cells to reproduce in large numbers and trigger an immune response that is aimed at ridding the body of the foreign invader(s) in question.

What scientists at Georgetown University Medical Center and Robarts Research Institute found is that the most prominent type of cell - called the dendritic cell - that presents invaders to T-cells can quickly release serotonin, which is thought to facilitate the T-cell response to foreign invaders.

In the words of one of the scientists involved with this contention,

"Drugs that block serotonin reuptake likely change some of the parameters of T-cell activation, but we don't know yet if it enhances or inhibits the total immune response. But it is something that should be explored because we really have no idea what SSRIs are doing to people's immune systems."

In other words, SSRI drugs, like all other drugs, are not smart enough to effect just one part of human physiology.

Some people would rephrase this to say that all drugs have side effects.

I would say that all drugs have multiple effects.

The term side effects is a crafty phrase that has entered our vernacular as a way of camouflaging the truth that all drugs have multiple effects on the body at all times.

It this light, it is inaccurate to say that Paxil's main effect is to decrease a tendency to feel depressed, while a possible side effect is immune dysfunction.

It is most accurate to say that Paxil and other SSRI drugs have multiple effects on human physiology, one being mood regulation, and another being altered immune function.

For me, the take home message from the study referenced above is that people should be acutely aware of all of the potential effects of antidepressants before using them for the short or long term.

Although my approach to addressing depression through natural means is beyond the scope of this article, here are a few of the essential recommendations that I share with people who ask me for help with depression:

• Ensure daily intake of a reliable source of EPA and DHA (I use and recommend cod liver oil)
• Whenever possible, get some exposure to sunlight without getting burned
• Engage in some form of exercise each day
• Discover a purpose for your life that goes beyond your own immediate wants and needs
• Learn how to be a good friend, how to recognize a good friend, and how to keep a good friend (if you want guidance on how to do these three things, I know of no better resource than The 7 Habits of Highly Effective People, by Stephen Covey)

NEW YORK TIMES

Parents who talk to children about the risks of illicit drugs sometimes despair that their warning goes in one ear and out the other. But the message just might stick in a young brain if it is repeated enough, according to a study of parental and adolescent attitudes released today.

The study by the Partnership for a Drug-Free America, a nonprofit coalition, also reported a dramatic disconnection between parents and children in getting the message through. The study is being released at www.drugfreeamerica.org.

An overwhelming 98 percent of the parents in the study said they had talked with their children about drugs, but only 65 percent of teenagers recalled having had such a conversation. And 27 percent of teenagers said they learned a lot from their family about the hazards of drugs.

Not surprisingly, the study reported that the more adolescents heard from parents about he risks, the less likely they were to use drugs, even though some failed to heed the advice. Of the teenagers in the study who said they had heard nothing at home about the risks of drugs, 45 percent said they had smoked marijuana within the last year. One-third of those who said they had learned a little at home used marijuana in the same period. But among teenagers who said they had learned a lot, only 26 percent said they smoked marijuana, the drug of choice after alcohol and tobacco.

Comparable reductions were reported in the use of inhalants, hallucinogens like LSD and crack cocaine.

When parents hesitate to tell their children about drugs, said Stephen Dnistrian, executive vice president of the partnership, "We can make a pretty safe assumption that there is probably not a lot of communication between parent and child about a lot of things."

The latest Partnership Attitude Tracking Study, the 12th such study since 1987, was conducted last year by Audits and Surveys Worldwide, a a market research firm based in New York. It sampled 6,852 teen-agers, ages 13 to 18; 2,358 children, 9 to 12, and 809 parents across the United States. The margin of error in the responses was 1.8 percentage points for teen-agers, 2.8 for re-teen-agers and 3.9 for parents.

Though virtually all the parents said they raised the issue of drugs with their teen-agers, fewer than half, or 48 percent, said they had done so four or more times in the previous year.

Black parents were more likely than Hispanic or white parents to say they discussed the risks of drugs regularly with their children. Fifty-seven percent of black parents in the study said they did so, compared with 45 percent of Hispanic parents and 44 percent of white parents. And 31 percent of the black children in the study recalled having such conversations, compared with 29 percent of Hispanic children but only 19 percent of white children.

Many parents cannot seem to bring themselves to believe that their children might experiment with drugs. According to the study, 42 percent of the teen-agers said they had tried smoking marijuana, but only 14 percent of the parents thought this was possible. And 53 percent of teen-agers said they had been offered marijuana; 37 percent of parents considered it likely.

The White House's director of national drug control policy, Gen. Barry R. McCaffrey, said the study made an important point about the disparity between perception and reality in parents' conversations with their children about the dangers of drugs. "Like a good teacher, they must check the feedback," he said.

General McCaffrey's Office of National Drug Control Policy defined as its first goal educating and enabling young people to reject illegal drugs, as well as alcohol and tobacco. Congress appropriated $195 million for a national campaign to sway an audience of 9- to 18-year-olds with prime-time commercials and print advertisements. The campaign, which began in July, also tries to persuade parents to confront the problem.

By Christopher S. Wren

Helping a Child Who Is Using Drugs

If warning signs point to a child on drugs, it's time to take action. If you deal with possible drug use head-on, there's a very good chance your child can be helped. Don't spend time hiding from the problem. Spend your time helping your child. The faster you act, the faster your child can start to become well again.

Sit down with your child for an open discussion about Alcohol and drug use. Openly voice your suspicions to your child but avoid direct accusations. Do not have this conversation when your child is under the influence of alcohol or other drugs, and make sure you sound calm and rational. This may mean waiting a day if he comes home drunk from a party, or if her room smells like Marijuana . Ask your child what's been going on in her life. Discuss ways to avoid using alcohol and other drugs in the future. If you need help during this conversation, get another family member, your child's guidance counselor, or physician involved.

Remember to reinforce your no-drug policy during the conversation. Be firm and enforce whatever discipline you've laid out in the past for violation of house rules. You should discuss ways your child can regain your lost trust: calling in, spending evenings at home, or improving grades.

Just like many adults, many young people deny their alcohol and other drug use. If you have strong evidence that your child is lying, you may want to have her evaluated by a health professional experienced in diagnosing adolescents with alcohol- and drug-related problems. If you decide to go this route, remember that you're trying to help your child. Don't make the doctor's appointment seem like a threat or a punishment.

If your child has developed a pattern of drug use or an addiction, you will probably need to seek professional help. If you do not know about drug treatment programs in your area, call your doctor, local hospital, state or local substance abuse agencies, or county mental health society for a referral. Your school district should have a substance abuse coordinator or a counselor who can refer you to treatment programs, too. Parents whose children have been through treatment programs can also provide information.

Drug addiction is now understood to be a chronic, relapsing disease. It may require a number of attempts before your child can remain drug-free. Don't despair if your child's first try doesn't produce long-lasting results. Even if it's not apparent at the time, each step brings your child closer to a healthy life.

Why Teenager Use and Abuse Alcohol and Other Drugs ??

To curb your children's substance use, you must understand it. Every one of today's adolescents has sat through countless lectures about the dangers of substance use from you, or in school classes and assemblies, the media, or DARE (Drug Abuse Resistance Education, a group with a strong elementary and middle- school presence). And every year thousands of older teens sign "prom promises" and other agreements vowing not to abuse substances. So with all this education and all these warnings, why are these dangerous substances still so appealing for teens?

There are several reasons youth gravitate toward substance use, usually beginning with alcohol, tobacco, and marijuana, and in some cases moving on to more dangerous drugs such as LSD, cocaine, Ecstasy, heroin, and other potentially lethal mixtures.

Everybody's Doing It

Teenagers are astute observers, and they see lots of people using various substances. They see their parents and other adults drinking alcohol, smoking, and unfortunately, sometimes abusing other substances too. They look at TV and magazine and see hundreds of cool ads for alcohol and tobacco products. Movies, music, internet and TV often glorify the substance-soaked nightlife of bars and clubs and make drug use look much more prevalent than it is. In a 1999 “Substance Use in Popular Movies and Music” report, 98% of movies studied depicted substance use, and 75% of rap songs mentioned substance use. In 2003, forty two percent of teens agreed that movies and TV shows make drugs seem like an ok thing to do. And most important, they usually see some other teenagers who enjoy alcohol, cigarettes, and other substances. How can it be wrong?

The teen social scene often revolves around drinking and smoking pot. That's what the word "party" means to most teenagers. Some parties, like family-sponsored birthday bashes and sweet sixteens, as well as cast parties and sport team parties, don't involve alcohol, but many “real" parties do. Sometimes friends urge one another to try a drink or smoke something, but it's just as common for teens to start using a substance because it's readily available and they observe all their friends enjoying it. Not only that, but it's a way to be social. Teens wildly overstate the number of their peers who use drugs. Peer pressure is often more of an internal thing, where teens think “my friends are doing it and I don’t want to be the only one not doing it.” One young man told me, "If I didn't drink, I wouldn't have anyone to hang out with." Teens see their friends enjoying themselves with various substances, and so they view it as acceptable. The flip side is that when their friends think that drinking is stupid or smoking pot is scary, they're much less likely to try it.

Escape and Self-Medication

Life is often difficult for teenagers. When they're unhappy and uncomfortable with themselves and have neither a healthy outlet for their frustration nor a trusted confidant, they may turn to chemicals for solace. Depending on what substance they're using, they may feel blissfully oblivious, wonderfully happy, or energized and confident. When they're given a chance to take something to make them feel better, many can't resist. "When I smoke up," one of my clients put it, “I can just forget about everything that's pressuring me."

After their initial exposure to a substance, teenagers start to believe it can ward off their painful feelings. It's a dangerous shortcut to solving problems, but what do they care? If their lives aren't going well, they figure they have nothing to lose. Of course, their problems don't vanish, and once the effects of the substance have worn off, they're left with the same problems as before, plus the low, depressed feelings that some substances leave you with. So these teens come back for even more of that substance. Before long, the substance takes on the role of a mood enhancer, an antidote to any unpleasant situation, and in many cases a crutch to deal with everyday life. As you'll see, any immediate benefits are short-lived.

Boredom and Instant Friends

Teens who can't tolerate being alone, have trouble keeping themselves occupied, and crave excitement are prime candidates for substance abuse. Not only do alcohol and marijuana give them something to do, but those substances help fill the internal void they feel. One boy's statement captures this sentiment. "When I'm stuck in my house with nothing to do," he said, "all I can think about is going out to party." Alcohol and drugs become false friends whose glittery promise of a good time is alluring to a bored adolescent. These false friends also help restless, bored, risk-taking teens to forget about troubles that they often face, like family conflicts, school failure, and peer rejection. Further, they provide a common ground for interacting with like-minded teens, a way to instantly bond with a group of kids. Soon the illicit substances define their existence and they spend increasing amounts of time seeking ways to get high.

Rebellion

What better way to express anger at your parents than doing something they tell you not to? Different rebellious teens choose different substances to use based on their personalities. I’m often struck by teenagers’ lethal combination of despair and anger. Alcohol is the drug of choice for the angry teenager because it frees him to behave aggressively. One young man told me, “When we’re drinking, the rest of the world can go to hell.” Methamphetamine, or meth, also encourage aggressive, violent behavior, only can be far more dangerous and potent than alcohol. Marijuana, on the other hand, often seems to reduce aggression and is more of an avoidance drug. LSD and hallucinogens are also escape drugs, often used by young people who feel misunderstood and may long to escape to a more idealistic, kind world. Smoking cigarettes can be a form of rebellion to flaunt their independence and make their parents angry.

Instant Gratification

Drugs and alcohol work quickly. The initial effects feel really good (of course -- why else would people use substances?). It's easy to get a nicotine buzz from a cigarette, or the warm, happy feelings that come with a few drinks. Who doesn't want an easy way to be happy? Young people do -- especially unhappy young people who want to get rid of their bad feelings fast. Another teen told me, "When I get into a fight with my parents, I'm out the door. I just can't get stoned fast enough." It's a short-term shortcut to happiness. The problem is, again, that not only do any problems they were trying to avoid still exist once the happy feelings wear off, but most substances that lift you up high end up dropping you way low, so you're sadder than you were before you started. At the very least, you're back where you started emotionally, and that's not good enough for some teens.

Lack of Confidence

Many shy teenagers who lack confidence report that they'll do things under the influence of alcohol or drugs that they might not otherwise. One girl readily acknowledged this, saying, "I have to get drunk before going to a party. Otherwise, I wouldn't be able to talk to anyone.” Of course, this is part of the appeal of drugs and alcohol even for relatively self-confident teens; you have the courage to dance if you're a bad dancer, or sing at the top of your lungs even if you have a terrible voice, or kiss the girl you're attracted to. And alcohol and other drugs tend not only to loosen your inhibitions but to alleviate social anxiety. Not only do you have something in common with the other people around you, but there's the mentality that "if I do anything or say anything stupid, everyone will just think I had too many drinks or smoked too much weed." For too many teens, substances become a crutch they rely on, and they don't feel comfortable in a social setting without them. This is the kind of confidence booster they can do without. Young people who feel bad about themselves are more susceptible to substance abuse, but the false sense of security alcohol and drugs give them is short-lived. And to make matters worse, substance abuse leads its users to make poor decisions that further undermine their self-confidence in the long run.

Misinformation

Perhaps the most avoidable cause of substance abuse is inaccurate information about drugs and alcohol. After all, there are so many statistics and facts readily available to teens! But nearly every teenager has friends who claim to be experts on various recreational substances, and they're happy to assure her that the risks are minimal. Several years ago, a young man told me his definition of a drinking problem was an alcoholic on skid row. Anything short of that, even vomiting, blackouts, and passing out, was no big deal. The same is true of Ecstasy, "a totally harmless drug," marijuana -- "It's not addictive and doesn't have any kind of negative side to it" -- and any other substance. It's important for you to provide accurate information and correct misconceptions, not just about the most lethal drugs like meth and heroin but about drugs like alcohol, tobacco, and marijuana, which many teens don't take seriously enough.

Parents' Cues

Sometimes parents inadvertently encourage their children to use alcohol or other substances, when we don’t recognize what powerful role models we are for our kids. Your condoning of occasional drinking, getting drunk yourselves, using illegal drugs, telling funny or entertaining personal stories that involve heavy drinking or drug use, or making light of the risks involved is called enabling in my line of work. This term refers to behavior that ignores or promotes an emerging problem with illicit substances. When you deny or minimize the seriousness of your teenager's actions, you're giving him subtle permission to continue.

The emotional climate in your home can also precipitate substance abuse. Inadequate parental involvement and lack of supervision put teenagers at risk. Poor family communication only worsens the problem. Teenagers who can't talk to their parents are more likely to feel isolated and unhappy, and these feelings lead them to seek chemical solutions to their problems. Finally, parents' relationships and behavior send powerful messages to their children about how to cope with problems. If they see you continually avoiding difficult issues, they'll probably do the same.

© 2001 by Neil I. Bernstein. From “How to Keep Your Teenager Out of Trouble and What to Do if You Can’t” by Dr. Neil I. Bernstein (2001, Workman Publishing, New York). Used with permission.