Background; Whether cannabis can cause psychotic or affective symptoms that persist beyond transient intoxication is unclear. We systematically reviewed the evidence pertaining to cannabis use and occurrence of psychotic or affective mental health outcomes.

Methods; We searched databases from their inception to September, 2006, searched reference lists of studies selected for inclusion, and contacted experts. Studies were included if longitudinal and population based. 35 studies from 4804 references were included. Data extraction and quality assessment were done independently and in duplicate.

"we conclude that there is now sufficient evidence to warn young people
that using cannabis could increase their risk of developing a psychotic illness later in life."

Findings; There was an increased risk of any psychotic outcome in individuals who had ever used cannabis (pooled adjusted odds ratio=1·41, 95% CI 1·20-1·65). Findings were consistent with a dose-response effect, with greater risk in people who used cannabis most frequently (2·09, 1·54-2·84). Results of analyses restricted to studies of more clinically relevant psychotic disorders were similar. Depression, suicidal thoughts, and anxiety outcomes were examined separately. Findings for these outcomes were less consistent, and fewer attempts were made to address non-causal explanations, than for psychosis. A substantial confounding effect was present for both psychotic and affective outcomes.

Interpretation; The evidence is consistent with the view that cannabis increases risk of psychotic outcomes independently of confounding and transient intoxication effects, although evidence for affective outcomes is less strong. The uncertainty about whether cannabis causes psychosis is unlikely to be resolved by further longitudinal studies such as those reviewed here. However, we conclude that there is now sufficient evidence to warn young people that using cannabis could increase their risk of developing a psychotic illness later in life.

Theresa HM Moore, Stanley Zammit, Anne Lingford-Hughes, Thomas RE Barnes, Peter B Jones, Margaret Burke and Glyn Lewis. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. The Lancet 2007; 370:319-328

Life With Hope: A Return to Living Through the Twelve Steps and Twelve Traditions of Marijuana Anonymous

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The subjective experience of well being was examined in abstinent Alcoholics Anonymous (AA) members. In addition, the social perceptions of an abstinent alcoholic’s well being were examined in three nonalcoholic French-Canadian samples:

• male police officers,
• Catholic nuns, and
• university women.

The lowest ratings of well being were reported by

• short-term abstinent AA members and
• university women,

The highest ratings were reported by Catholic nuns.

However, the level of well being among abstinent AA members was positively related to the length of abstention.

The three nonalcoholic groups evaluated an abstinent AA member more positively than a non-abstinent alcoholic.

These evaluations of an abstinent AA member converged with the AA members’ self-evaluations on the measure of well being.

Research; Kairouz, S.; Dibe, L. Abstinence and well-being among members of alcoholics anonymous: Personal experience and social perceptions. Journal of Social Psychology, 140(5):565-579, 2000

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Method: Forty-one chronic alcoholic men and forty control subjects of comparable age and forty control subjects of comparable age and education level were evaluated. The patients received the neuropsychological tests and social disability scale after a 3 week period of abstinence. Each subject was given an extensive battery of neuropsychological tests assessing language skills, attention, memory and cognitive functions related to frontal regions of brain. Two groups were compared regarding the results of Wisconsin Card Sorting Test (WCST), Line Orientation Test (LOT), Visual Auditory Digit Span Test (VADST), Stroop Test, Mini Mental State Examination, and Hamilton Depression Scale. Social disability level was determined by the administration of the Short Form General Health Survey of Medical Outcome Study (SF-MOS). The symptoms and the symptom severity of alcohol dependent patients were evaluated by using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), a semi-structured instrument for clinical interview and symptom rating.

Results: Alcoholic patients showed a significant impairment on auditory part of VADST. Similarly LOT results were significantly different between alcoholics and control group. The following WCST subscores were statistically different between the two groups: Total answer, total error, total perseverative responses, perseverative errors, percent of perseverative errors, nonperseverative errors, number of categories completed, and conceptual responses. Stroop Test results showed no statistical difference between the two groups. Social disability scores were significantly higher in alcoholic patients compared with the control group. 63.42% of the forty-one patients, had severe disability. Statistical analysis failed to show any significant correlation between the neuropsychological test results and disability scores.

Conclusion:

Alcohol dependent patients displayed significant neurocognitive impairment and high levels of social disability compared with healthy controls.

Social disability levels did not appear to be correlated with neurocognitive dysfunction.

Research report; Cognitive Functions and Social Disability in Alcohol Dependency. Dr. Sibel MERCAN, Dr. Berna ULU?, Dr. Ahmet GÖ?Ü?. Turkish J of Psychiatry, 1999; 10(1): 3-12

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Alcoholic Denial as a Psychological Defence

Denial takes two major forms.

Posted via web from Recovery Is Sexy’s posterous

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Reconstructing the alcoholic family.
World view change in co-dependents, Adult Children of Alcoholics/Al-Anon self-help groups
More @ www.recoveryissexy.com

Posted via web from Recovery Is Sexy’s posterous

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Feminist critics of AA have

* challenged the language of AA’s Twelve Steps,
* the spiritual nature of the steps, and
* the male-dominated culture of the Twelve-Step program.

Posted via web from Recovery Is Sexy’s posterous

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The clinical and scientific implications of the alcohol dependent patient-treatment matching study, Project MATCH, are discussed.

The following are the results of the study:

• a small number of matching effects;
• a suggestion that clinical efficacy may be improved in some cases if clinicians take into account certain client characteristics: trait anger, alcohol dependence, social support for drinking, and psychiatric severity;
• a suggestion that affiliation with Alcoholics Anonymous (AA) may be increased with Twelve Step Facilitation (TSF);
• a suggestion that increased involvement in AA may be associated with long-term sobriety;
• a suggestion that the Twelve Step approaches and AA may promote sobriety because they provide an alternative social network that does not support alcohol consumption.

Research report; Cooney, N.L.; Babor, T.F.; DiClemente, C.C.; Del Boca, F.K. Clinical and scientific implications of Project MATCH. In: T.F. Babor and F.K. Del Boca, Treatment Matching in Alcoholism, Cambridge, UK: Cambridge University Press, 2003. 275 p. (pp. 222-237) (168018)

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How does the Brief-TSF model work?

Defining the Brief-TSF processes

This model brings together three people to achieve sobriety in one of them. These are the;

• experiential contributor (AA Peer Sponsor) and
• professional care (Twelve Step Facilitator) to collaborate in facilitating self help recovery for the
• alcoholic (normally known as the patient or client).

Each of the three people brings to the intervention knowledge’s and functions known as ‘domains of praxes’. Within each domain are the constituents of experience, training, perceptions, goals and capabilities.

Functional Domain

The Brief Twelve Step Facilitator facilitates self-assessment by the patient, introduces them to a ‘Peer Sponsor’ and facilitates understanding of the ‘Program of Recovery’. In addition the healthcare worker assesses and addresses or refers the patient for any co-morbidities.

The Peer Sponsor shares their ‘experience, strength and hope’ with the patient, provides initial resources to attend meetings, introduces the ‘Newcomer’ to Alcoholics Anonymous members and explains the program of recovery from drinking.

The patient chooses what, when, and how they can use information, from each of the providers. This is true Self help within a paradigm of mutual help.

Additionally, the patient is supported in seeking professional treatment/therapy for other issues.

Recovery Domain

Each participant maintains their integrity and independence within their domain.

The primary goal of Brief-TSF is affiliation with Alcoholics Anonymous as described in the Stages of AA Affiliation.

Recovery includes attending AA meetings and other activities, stopping drinking, ‘working’ the program of recovery and consulting with a peer sponsor within an affiliation scheme.

The whole facilitated process producing a ‘Domain of Recovery’.

Disease Domain

Alcoholism is a primary, chronic, progressive three fold disease – mental, physical and spiritual. Alcohol dependence is fatal if not arrested by abstaining from alcohol.

Each participant has a hand in recovery

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The Buddha’s Secret

The Buddha spent years seeking the secret to understanding the human condition and the sufferings that go with it. His insight was simple, and it can free you of an illusion that promotes dependence. The secret is, “There is no secret.”
FRom; WWW.Recoveryissexy.com

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In the first major twin study to compare genetic and environmental factors that contribute to the risk of alcoholism in both sexes, researchers have found that genetics plays an important role in determining alcohol dependence in women as well as in men. The study contradicts the long-held assumption that a woman’s environment is more likely to influence whether she becomes dependent on alcohol.

The study was conducted by scientists at Washington University School of Medicine in St. Louis and Australian collaborators at the Queensland Institute of Medical Research. It was funded by the U.S. National Institute of Alcoholism and Alcohol Abuse, and the findings were published in a recent issue of the journal Psychological Medicine.

While there is ample evidence for an important genetic influence on alcoholism risk in men, the tie between genetics and alcoholism in women has been uncertain, said the paper’s lead author, Andrew Heath, Ph.D., a professor of psychiatry at Washington University.

The study sought to address this shortcoming. It involved 2,685 pairs of twins, all participants in an adult twin study started in Australia in 1978 and maintained by the Australian National Health and Medical Research Council. The two members of each pair were raised in the same home environment. The study included — for the first time — twins of opposite sex as well as twins that were either both male or both female.

Telephone interviews with the twins were conducted to assess whether the participants had lost control over their drinking, were unable to cut back on drinking or had similar problems with alcohol.

Twins who had an alcoholic identical twin were much more likely to be alcoholic themselves than were twins who had an alcoholic fraternal twin, and this was equally true in women and in men. More surprisingly, men who had an alcoholic twin sister had very high rates of alcoholism.

“If shared environmental factors are of predominant importance in women but genetic influences predominate in men — a commonly held belief — then we would have expected to see very low concordance for alcoholism of unlike-sex twin pairs,” Heath said. “That wasn’t the case.”

The study also found that women with an alcoholic identical (monozygotic) twin sister were six times more likely to be alcohol dependent than other women. Monozygotic twins share the same genetic makeup. Dizygotic, or nonidentical, twins, who are not more alike genetically than ordinary sisters, were only three times more likely to be alcohol dependent if their twin had a drinking problem.

The study also examined whether psychiatric disorders that commonly precede or coexist with alcoholism, such as childhood behavior problems like lying and stealing or depression, were as strongly associated with risk of alcoholism in women as in men.

“It used to be believed that depression predicted increased risk of alcohol problems in women, whereas a history of childhood behavior problems predicted alcoholism risk in men. We found that depression is a potent predictor for alcohol dependence in both men and women,” said Heath. “A history of behavior problems also is as strong a predictor in women than in men — slightly more powerful in women, in fact.”

Heath AC, Bucholz KK, Madden PAF, Dinwiddie SH, Slutske WS, Bierut LJ, Statham DJ, Dunne MP, Whitfield JB, Martin NG. “Genetic and Environmental Contributions to Alcohol Dependence Risk in a National Twin Sample — Consistency of Findings in Women and Men”. Psychological Medicine. 27(6):1381-1396, 1997 November.

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