Alcohol and / or drug (AOD) abuse, and AOD abuse related issues are among society’s most pervasive medical and social problems.  Assisted Recovery Centers of Arizonarecognizes that appropriate treatment can be effective for motivated individuals seeking recovery.  This Agency’s treatment protocols are based on the research and work of the University of Pennsylvania School of Medicine, TreatmentResearchCenter, in Philadelphia.  The protocols fully integrate pharmacological options and psychosocial support in the recovery process.  This type of integrated program is an example of the Pennsylvania Model of Recovery, which distinguishes this approach from other protocols, which reject the use of pharmacological agents as an adjutant to aid in the recovery process.

The Pennsylvania Model is based on a medical model in which a full range of empirically tested treatment options is offered to individuals who are dependent upon AOD.  TheUniversityofPennsylvaniahas a 20-year history of clinical studies, which has led to the development of the Pennsylvania Model protocols.  The medical and scientific community recognizes the research of theUniversityofPennsylvaniaas representing important advances in the treatment of addictions.  For example, the University pioneered the use of the pharmacological agent Naltrexone HCI, which suppresses the craving to consume alcohol or opiates, and dramatically reduces relapse. (Archives of General Psychiatry, 49:876-880, 1992 Volpicelli etc.)

Assisted Recovery recognizes the value of clinical research, and was among the first in the nation to implement a program based on research.  Our program uniquely combines not only quality compassion and concern, but also the best of empirically discovered strategies to assist AOD dependent individuals to become sober and happy, and most importantly, remain so.

Assisted Recovery and the Pennsylvania Model embrace the concept that AOD dependence is a Bio-Psycho-Social condition, which is clearly influenced by genetic factors.  We accept that there are many paths to recovery.  For example, countless individuals have recovered from AOD via the traditional Minnesota Model or Twelve-Step format. Appropriate individuals, who would benefit from such a program, would find this Agency fully supportive of their efforts.  For those individuals who are not comfortable, or have repeatedly failed to achieve sobriety via the Minnesota Model, Assisted Recovery offers the Pennsylvania Model of Recovery.

Proponents of legalizing marijuana have long argued that criminalization of the drug causes more problems than it solves. For instance, taxpayers spend between $7.5 billion and $10 billion a year on arresting and prosecuting Americans for marijuana-related crimes. Supporters of legalized marijuana maintain that this money would be better spent cracking down on violent criminals.

Now, pro-legalization backers have yet another point in their favor: According to a new study from the University of Colorado-Denver, the 16 states that have legalized medical marijuana have seen an average 9 percent drop in traffic deaths since their medical marijuana laws took effect. The study analyzed data from 1990 through 2009.

“We went into our research expecting the opposite effect,” says study co-author Daniel Rees, a professor of economics at the University of Colorado-Denver. “We thought medical marijuana legalization would increase traffic fatalities. We were stunned by the results.”

When it comes to traffic safety, can marijuana really save lives?

Is marijuana an alcohol substitute?

Is this a sign of the times? A new study ties legalization of medical marijuana to a decrease in fatal car crashes in 16 states. One possible reason: Motorists who are high tend to drive slowly.

It’s long been known that alcohol is a primary contributor to deadly car crashes. According to estimates from the Insurance Institute for Highway Safety, drivers with a blood-alcohol level above 0.15 percent are 385 times as likely to be involved in a fatal crash as sober drivers are. In every state, the legal limit for driving while intoxicated is 0.08 percent.

The University of Colorado-Denver study found that the increase in legal use of medical marijuana often leads to a reduction in alcohol consumption. The study cites data from the Beer Institute, an industry trade group, indicating that beer purchases go down by an average of 5 percent after medical marijuana laws are passed. In these states, the researchers theorize, some people are smoking marijuana rather than downing booze.

A 2009 study from the University of California, Berkeley, backs up that finding. Four of every 10 patients at the university’s medical marijuana dispensary said they used marijuana to curb alcohol cravings.

Are high drivers better than drunken drivers?

The differences between drivers under the influence of alcohol and those who’ve smoked weed are stark, says Mason Tvert, executive director of the marijuana legalization advocacy group SAFER (Safer Alternative for Enjoyable Recreation).

“People who abuse alcohol take more risks, drive faster and are less likely to recognize that they’re impaired,” Tvert says. “They feel like Superman when they’re drunk.”

By contrast, motorists who’ve puffed pot “drive slower, are less likely to take risks, and are more likely to recognize when they’re impaired and decide not to drive,” he says.

Studies support Tvert’s view: A clinical trial conducted in Israel compared the simulated driving skills of people who’d consumed alcohol and those who’d smoked marijuana. The researchers found that alcohol caused these people to speed up their driving, while smoking marijuana prompted the drivers to slow down. An analysis by the U.S. Department of Transportation found marijuana rarely is the only drug found in the bodies of drivers who’ve died in car crashes.

Is driving under the influence of marijuana safe?

Mothers Against Drunk Driving (MADD) advocates against impaired driving of any form, and that includes smoking marijuana and getting behind the wheel. Emily Tompkins, MADD’s executive director for Colorado, says the group is keeping tabs on marijuana legalization and how it affects traffic safety.

MADD isn’t interested in determining how much marijuana someone can consume to remain within a legal limit, but Tompkins urges people who smoke marijuana (medical or otherwise) to be aware of when their driving is impaired. Tompkins claims marijuana-impaired drivers often show their medical marijuana cards to police officers who pull them over, as though the card legally entitles them to drive under the influence of drugs — which it does not.

The U.S. Department of Transportation found that although the harm of marijuana for drivers is minimal compared with that of alcohol and other drugs, it may be dangerous in certain situations, such as when quick thinking is required or when a driver has combined marijuana with alcohol or other drugs.

No one is advocating that driving while stoned is better than being alcohol- or drug-free, but experts agree that marijuana use while driving presents far less danger than many other drugs as well as alcohol.

Meanwhile, more Americans appear to be embracing marijuana. A Gallup poll released in October 2011 found that a record-high 50 percent of Americans favor legalizing marijuana. In 2009, the National Survey on Drug Use and Health showed 16.7 million Americans age 12 and older had smoked pot at least once in the month before being surveyed.

Could widespread legalization boost road safety?

Dan Rees, an economics professor at the University of Colorado-Denver, says he was “stunned” by the findings of the medical marijuana study.

While the University of Colorado-Denver study presents striking evidence of marijuana’s effect on road safety, the research was limited to motorists who have access to medical marijuana. In some states, that’s a relatively significant portion of the population. In Montana, 3 percent of the state’s population has access to medical marijuana; in Colorado, it’s 2.5 percent. Actual percentages for marijuana use may be considerably higher than that, however.

“Under medical marijuana laws, caregivers and patients can grow marijuana, and there’s very little policing of this,” Rees says.

Rees believes that authorized marijuana users often sell or give pot to others for recreational use. He says many of those recreational users probably are young adults — a group who’s responsible for a disproportionately high number of alcohol-related car crashes. Marijuana advocacy group NORML says pot is the third most popular recreational “drug” in the United States, behind alcohol and tobacco.

Rees teamed up with D. Mark Anderson, assistant professor of economics at Montana State University, on the marijuana study.

For now, medical marijuana is legal in Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington, as well as the District of Columbia. In those places, doctors prescribe marijuana to ease pain and suffering for patients with conditions like cancer.

Federal law prohibits the growth and sale of marijuana for any purpose. Opponents of legalizing the drug maintain that marijuana is a “gateway” to harder drugs like cocaine and heroin, and argue that the dangers posed by stoned drivers would rise.

While widespread legalization of marijuana isn’t likely in the near future, such a move might have a dramatic effect on road safety if drivers — particularly young adults — flock to marijuana instead of alcohol to get buzzed.

“When you see fewer traffic accidents in every state that legalizes medical marijuana, that’s strong proof,” Rees says.

According to the 2010 National Survey on Drug Use and Health(NSDUH), about 2.4 million Americans use prescription drugsfor non-medical purposes (in other words, without a prescription or to get high). In November 2011, the U.S. Centers for Disease Control reported that the death toll from narcotic pain reliever overdose — about 15,000 a year, or 40 deaths a day — is now greater than that of heroin and cocaine combined.

It’s understandable, then, that critics of these new superdrugs cite the potential for addiction and abuse as a reason for caution.

Dr. Gharibo acknowledges that abuse is a concern with opioid narcotics: “The majority of the misuse out there starts out very casually. Patients may double up on their medications and then build up a certain degree of tolerance.” He also notes: “There’s a lot of misprescribing out there that pretty much started in the late ’90s, where we started overprescribing opioids. Now we’re sort of treading back from what we did. There’s a pendulum that goes back and forth.”

Critics have also noted that Zohydro can be easily crushed, a feature popular with addicts who can snort the powder for an immediate high. OxyContin, which was initially also crushable, now comes in a more tamper-resistant form. Gharibo says, “For those products that are lacking the tamper resistance, it’s sort of like lacking the seat belt on a car. It’s just too easy to abuse.” He notes that more tamper-resistant opioid formulations are expected to become available over the next decade.

According to the AP article, patients taking the new superdrugs will be more closely supervised, since under government regulations a refill of pure hydrocodone requires a new prescription. By comparison, Vicodin may be refilled up to five times within six months of the time the initial prescription was written.

Acetaminophen: Safety Concerns

There’s another advantage to the new drugs: The makers of Zohydro also claim that it will actually be safer than Vicodin, since unlike that medication it won’t contain acetaminophen. Acetaminophen is the main ingredient in the nonprescription painkiller Tylenol, and it’s also found in many over-the-counter cold drugs. But too much acetaminophen can be harmful to the liver, and because it’s in so many products, overdose is a real danger.

“Oral acetaminophen toxicity is the leading cause of liver transplantations in the country,” says Dr. Gharibo, adding that often patients are unaware of their total acetaminophen intake.

Bottom line: These new pain medications ”could be a valuable addition,” says Gharibo. “It could be useful to have a broader palette to utilize, so that we don’t have to keep going up and up on the dosing for the drugs that are available now. I wouldn’t keep this particular compound from being approved.”

But, he says, Zohydro and the other super painkillers should only be used for a limited time and only for those patients who can follow their doctors’ directions and who are psychologically stable, ie, not prone to addiction. “They have to be used for the right clinical indication, in the right patient, and in the right setting.”

1. It is important that you make the decision to stop drinking.  You have to want to quit drinking, and be ready to do it. If you are thinking of quitting because your spouse, your mother, your probation officer, or some other person wants you to do so, your chances of success are diminished. The more support that you have from your family and friends will definitely be very helpful, but you must be the one that is making the decision.  You must do it for yourself and not for others.  The bottom line is that when you improve your life, the lives of everyone around you will also improve.

2. Set your quit date, and stick with it.  It could be today, tomorrow, or the day after the Special Event that you’re already committed to attend next week. It might be a good idea to set a special date that is easy to remember, like your birthday. Any day is a good day to make a new beginning. Do not pick a date too far in the future. It would be a tragedy to have made the commitment to quit, only to kill someone (or yourself) by driving drunk before that date arrives. Contact Assisted Recovery for information on enrolling in one of our Pennsylvania Model programs. Set up an appointment to come in so that we can discuss with you the evidence based treatment options offered by Assisted Recovery.

3. When the “quit” date arrives, come to Assisted Recovery for a free consultation.  When you decide to enter the Assisted Recovery Pennsylvania Model program, you will be immediately seen (in most cases) by a program physician.  The program physician will evaluate your case and prescribe safe, effective, approved anti-alcohol medications, for example naltrexone and ondansetron.  The physician may also provide a prescription to assist in the detoxification from alcohol.

4. Recovery is a process, not an event.  You will need to put effort into this process.  Plan to attend one or more meetings weekly for at least one full year. Assisted Recovery meetings are positive, informative, and fun. We stress the biological, psychological, and social components of recovery from alcohol dependence, and provide a variety of tools to help you deal with each.

5. The individual therapy sessions provided by Assisted Recovery will help you to make the adjustment in your thinking, away from irrational bad decisions. Define the goals of your personal recovery, and begin working towards them. Abstinence from alcohol is not enough; it’s only the beginning of the process of recovery. In order to achieve a happy, healthy sobriety, you’ll have to do some work. Setting and achieving your goals in life will provide you with long-term happiness and satisfaction, which the quick-fix of alcohol promises, but never delivers.

6. Get on with the rest of your life. Our goal is to help you get to the point where you don’t need us anymore. But that doesn’t mean that you’re cured forever, and all your work is done. You will have arrested your current bout with alcohol dependence, but if you start drinking again you will probably become re-addicted. Maintaining your commitment to remain abstinent requires some effort. Recovery is like climbing up the down escalator: if you’re not working to move forward, you’re automatically sliding backwards. We will assist you in developing a long-term strategy for preventing a relapse, and our meetings are always open to those who wish to return. Helping others is an excellent way to help maintain your commitment.

If you are ready to quit drinking for good, Naltrexone and
Assisted Recovery will help you to do it.