60 Minutes on Grandparents Raising Grandchildren: Reading Between the Lines

On Sunday, 5/13/18, the news magazine show Sixty Minutes aired a new story about grandparents raising grandchildren which focused entirely on the epidemic of opioid addiction as the primary cause of the middle generation taking such poor care of their kids that the grandparents had to “take over.” 

The show reported that there are now over one million grandparents raising grandchildren because of their own kids’ failings

This hearkens back to my very first post on my Psychology Today blog, back on June 22, 2011, in which I discussed the already skyrocketing incidence of grandparents raising their grandchildren because of their dysfunctional children’s abdication of the parental role (rather than in those cases of temporary needs like a military deployment). Note that this post was written well before the current brouhaha about the opioid epidemic.

I discussed the idea that the children were, in a sense, being “gifted” to the grandparents, who seemed to the children to have a pathological need to raise children despite continually complaining about it.

I wrote that the major apparent (pardon the pun) reasons were because the children:

1. Carry the psychiatric diagnosis of borderline personality disorder (BPD) and neglect, abuse or otherwise endanger their children. 

2. Have antisocial traits and end up in jail (antisocial personality disorder is also a Cluster B personality disorder just like BPD). 

3. Are addicts or alcoholics. Many of those folks may also exhibit significant Cluster B personality traits at one time or another, although in addicts the traits may disappear if and when the addict cleans up.

As most of my readers will know, I believe that the parents’ intrapsychic conflicts over the role of raising children is by far the most important cause of cluster B symptoms and acting out by their children and adult children. 

Furthermore, the grandchildren in these cases are also being subjected to its manifestations and might later develop the same disorders themselves.

In a previous newsmagazine show from around the time of the earlier post, grandparents raising their grand kids were heard to say how much they loved taking care of the grand kids, but how chasing after them made them soooooo tired! And clearly if we heard that, so did the grand kids. So the grandparents end up doing to the grandchildren the same problematic things that they did to their own children.

Some of these grandparents were interviewed on the Sixty Minutes segment, and the reporter discussed how they were plowing through their retirement savings, having to downsize and not go on previously planned vacation trips, arguing more between themselves, and even worrying about how they would find the money to treat their own illnesses like, in one case, cancer.  Again, if we heard this, so do the grand kids. In fact, one child was asked what the grandparents were giving up in order to take care of them, and replied, “Grandma had to give up dating. She says it all the time.”

Two grandparents protested, “We can’t not do it [take care of the grand kids]; they’re our family!”

When it described what went on before the grand kids were “rescued” by their grandparents, the story did a good job of describing how older siblings would have to become so-called “parentified children” for their younger siblings, and how they felt they had to grow up too fast. I described what can happen in that situation in a previous post.

So was there any evidence that these grandparents may have engaged in problematic relationships with the absent parents that affected the middle generation’s irresponsible behavior with their own kids? Well, no direct evidence, but a couple of things were mentioned in passing that might suggest that this was the case.

In two of the described cases, the grandparents spoke of keeping track of what was going on with their kids and grand kids as the parents became homeless and crashed at various shady dives and crack houses along with their children. Rather than simply calling protective services to investigate, one set of parents bought their child a van and put a tracking device on it, while another set said they camped out across the street from one of said crash pads to make sure that their grandchildren were not being abused. Apparently all night long!

We don’t know for certain how long this sort of “tracking” was going on, but my guess is: a long, long time. As readers recall from my previous posts, the parents’ conflicts over their parental role in many (but not all) of these cases leads them to vacillate between severe over-involvement and severe under-involvement with their kids. One of these two poles often predominates much (but not all) of the time. This creates the double message to the children, “I need you-I hate you.” Constant tracking is one manifestation of the over-involved polarity.

So am I dismissing all of the so-called evidence that opioid addiction is a biogenetic disease over which these parents have no control, and that it has nothing at all to do with family dynamics? Well, yes. If you believe these people have absolutely no control over their drug use, you would also have to believe that:

1.     12 Step Programs like AA and NA could never work. Especially when the addict has "hit bottom" (that is, when the addiction is at its worst).   

2.  The way the drugs makes them feel is so all-encompassing that they lose all ability to reason and the ability to appreciate the harm they are doing to themselves and their own children, or lose the ability to care about that at all.     

3.  If you pointed a gun at them and told them that if they picked up the drug or drink in front of them you would shoot them the moment they did, assuming they believed you and were not overtly suicidal at the time, then they would have to go ahead and let themselves die.

Do you really believe those things?

Drug Abuse and Drug Companies

As most readers will know, opiate abuse and overdoses have increased dramatically in recent years, and it’s all over the news. Some of the public may even be aware of the role of drug companies and drug distributors in the process – the latter being recently profiled on an episode of Sixty Minutes. Let’s look at the role of the drug companies.

A Pharma executive, a billionaire, was arrested in October on charges of bribing doctors to prescribe opioid painkillers. (http://fortune.com/2017/10/26/john-kapoor-insys-therapeutics-arrested-net-worth/). The Department of Justice arrested Insys Therapeutics founder John Kapoor, 74, in Phoenix. Kapoor was charged with using bribes and fraud to prop up sales of a pain medication called Subsys, a fentanyl spray typically used to treat cancer patients suffering excruciating pain. Fentanyl is 50 to 100 stronger than morphine, and contributed to the overdose deaths of pop stars Prince and Tom Petty.

When it comes to drugs of abuse, the lunatics seem to have taken over the asylum in medicine these days. In their push towards huge profits, dangerous drugs are being hawked when cheaper, less toxic, and less addictive alternatives are available for treating some conditions. And as discussed in this blog, whole diseases such as “adult adhd” have been invented out of whole cloth.

For those readers who may not know, potentially addictive drugs are referred to by the Drug Enforcement Agency (DEA)  as “scheduled” drugs. Schedule I drugs are the illegal ones. Schedule II drugs are those with the highest abuse potential: narcotics and stimulants. Schedule  IV drugs are those considered to be of low potential for abuse. If you didn’t know how the drugs were scheduled, you certainly would never know it from listening to presentations by doctors working with Pharma.

Pharma hires doctors to do research on as well as give talks to other doctors about their products, totally with the goal of increasing sales – if patients do happen to benefit in some way, all the better – but that is hardly a requirement. The slides that are presented during the talks are furnished entirely by the drug company after being approved internally; the doctors giving the talks are not allowed in most instances to use their own slides.

Pharma is particularly known for employing what they call “Key Opinion Leaders” (KOLs) to give promotional talks to doctors around the country. The more academic credibility they seem to have the better – that is one source of determining who might be a KOL. But it is not the only one.

Pharma can actually get any given doctor’s prescribing records from the pharmacy industry (unless the doctor “opts out” of allowing his or her data to be mined in this way. Most docs are not even aware of this option—and having the information publically available is the default position). Pharma then uses this data to see if prescriptions for their products increase after one of their KOLs makes a presentation. 

Those doctors that make the best salesmen are hired again and again, while those who do not measure up are dropped.

A colleague of mine has taken a course required in Tennessee for licensure that discusses the “proper way” to  prescribe drugs of abuse. The course was sponsored by our malpractice carrier. According to him, one year the leader of the course scolded the doctors present for not prescribing enough opiates to people with chronic pain. 

The doctors were told how much suffering they were causing these patients by withholding these medications. Just one year later, after the “opioid crisis” hit the news, the same course was given. Only this time, the doctors were scolded because they were prescribing these “suddenly” dangerous and highly addictive substances to their patients with chronic pain!

I have discussed in previous posts how the risks of that class of medication (Schedule IV) have been wildly overblown in the medical literature and in public news stories. As well as being classified as “low abuse potential” by the DEA, they do not cause intoxication, and have next to no side effects compared to just about any other class of meds in most patients. I am not saying they are never abused, but usually only by people that mix them with opiates and alcohol. 

And of course any individual can have a bad reaction to any drug. It seems benzo’s are never discussed without the admonition that the “are addictive,” or have a few side effects in (some) patients – while drugs like amphetamines (Schedule II) that are abused far more often, and have more potential adverse or toxic side effects, are enthusiastically pushed.

And I do mean pushed, as in supplied by pushers masquerading as drug companies. I recall a “grand rounds” (a major lecture at an academic department in a medical school) from maybe 18-20 years ago in which the KOL was saying that about 18% of all adults should be on high doses of speed, that the reason that many of the parents of kids diagnosed with ADHD were substance abusers was because, "If you had a kid with ADHD, you'd drink too," and that kids who had ADHD could concentrate intensely on video games in an arcade despite multiple and pervasive loud distractions all about because that is "not concentrating." (I always wondered what the heck it supposedly was). I kid you not.

As another amazing example of drug pushing, one news service for psychiatry called MDLinx devotes a whole e-mail newsletter to articles extolling the use and virtues of drugs like Adderall and Concerta. Some recent examples:

MDLinx Psychiatry 3/13/18 - Ranked, sorted, and summarized by MDLinx editors from the latest literature.

IN THE NEWS SHP465 mixed amphetamine salts effective, safe for ADHD in adults Liz Meszaros, MDLinx, 03/08/2018

Researchers investigate the link between ADHD and risk of self-harm Paul Basilio, MDLinx, 02/23/2018

Study of 23,000 people links ADHD with genetic signature for delay discounting. Paul Basilio, MDLinx, 12/11/2017

They also have a section of their more general psychiatric newsletters also devoted to this goal that is called the ADHD Resource Center: A collection of articles and features related to ADHD with articles like:

AAP Experience - American Academy of Pediatrics              National Conference & Exhib Conference Of course, none of these Pharma sales mechanisms would matter that much if there were not already a ready market for abusable medications. That market is growing, and adverse childhood experiences and family dysfunction are a huge part of that problem. Still, as Steppenwolf used to sing, “G-d damn the pusher man.”

Dumb Hidden Assumptions in Drug Abuse Research - An Update

And do not forget the private prison system and racist people in positions of power who want to ruin the lives of as many African-American youths as possible.

In my post of November 21, 2014, I reported on a study that showed that regular adolescent marijuana use was associated with a reduced likelihood of finishing high school, among other things. The authors of the study attributed these results to marijuana essentially causing brain damage, rather than to the fact the kids who feel the need to get stoned all the time have other problems which could easily account for their poor performance. Almost none of these other problems were controlled for in the study.

I asked, "What on earth makes people who draw the conclusion that the drug was the primary cause of the lower achievement become so stupid that they don't see that frequent drug use is a sign that the teens already had emotional problems before they even started smoking - and that it was these problems that predate the drug use that were the real cause of both the drug use AND the poor performance?"

Well guess what? Two new studies show exactly what I was talking about.

First was a new, ongoing study funded by the U.K. Medical Research Council, the Welcome Trust, and the University of Bristol, whose authors had no financial conflicts of interest. It's key clinical point: Previous research findings showing poorer cognitive performance in cannabis users may have resulted from the lifestyle, behavior, and personal history typically associated with cannabis use rather than the cannabis use itself.

Occasional to moderate cannabis use at a young age was not found to be associated with detrimental effects on cognition or educational performance. It was true that adolescents with heavier use – defined in the study as self-reported lifetime use of cannabis 50 times or more by age 15 – had a modest 2.9% decrease in educational performance on a compulsory school exam given at age 15 or 16, compared with never-users. However, heavier use had no impact at all on IQ scores measured at age 15 after adjustment for potential confounding factors.

"Previous research findings showing poorer cognitive performance in cannabis users may have resulted from the lifestyle, behavior, and personal history typically associated with cannabis use rather than cannabis use itself,” said Claire Mokrysz, of University College London.

She reported on 2,612 children who had their IQ tested at ages 8 and 15. Adolescents with heavier cannabis use by age 15 had a nearly a 3-point lower IQ at that age than did never-users, after adjustment for IQ at age 8. However, upon further adjustment for maternal education, pregnancy, and early-life factors, and use of tobacco, alcohol, and other recreational drugs, the difference in IQ between heavier and never-users vanished.

Heavier users of cannabis scored an initially impressive 11% lower than never-users on the standardized educational performance exam in an unadjusted analysis. After adjustment for the potential confounders, however, the difference shrank to a modest 2.9%. 

Performance, by the way, is not the same thing as ability. Even in this study, no effort was made to control for the motivation of test subjects, or for whether they were being distracted by ongoing problems such as family chaos at home.

The authors added that the belief that cannabis is particularly harmful may detract focus from and awareness of other potentially harmful behaviors. Not to mention other more important psychological and family issues.

The second study was done by neuroscientists at the University of Colorado at Boulder and published January 28, 2015 in the Journal of Neuroscience. Its major finding: Daily marijuana use is not associated with brain shrinkage when using a like-for-like method to control for the effects of alcohol consumption on those who both drink and toke up.

Kent Hutchison, a clinical neuroscientist at the University of Colorado, Boulder, and the senior author of the study, said his team reviewed a number of scientific papers that showed marijuana causes different parts of the brain to shrink, and his team found the studies were not consistent.

"So far, there's not a lot of evidence to suggest that you have these gross volume changes" in the brain, Hutchison said. 

I wonder how often Nora Volkow and other leaders of the National Institute on Drug Abuse will discuss these two studies or even mention them in their public presentations opposing marijuana legalization. Probable answer: NEVER.

Dumb Hidden Assumptions in Drug Abuse Research

The mental health professions these days seem to want to blame their patients' repetitive problematic or self-destructive behavior on just about anything except what is, in the large majority of cases, the primary causes: family dysfunction and adverse childhood experiences (ACE’s). And I mean, they would rather it be almost anything else.

In my post of February 26, 2011, I discussed how a slight increase in aggressive thoughts following the playing of violent  video games by adolescents was translated by researchers into the games being a major risk factor for the development of youth violence. The fact that most compulsive video game players are inveterate couch potatoes who do not get out much never entered into discussions.

Not surprisingly, a recent longitudinal study (Fergus0n et. al., J. Psychiatr Res 2012; 46: 141-146), showed that, by taking other variables into account such as intra-family violence, the correlation between video games and even short-term aggression could no longer be established.  Another older paper from the same lead author (Ferguson and Rueda,  J Exp Criminol, 2009; 5:121-137) showed that aggressiveness in the laboratory, as expected, did not correlate with violent acts in real life.

Focusing on minor targets like video games risks leading social activists and public policy makers to ignore the far more important causes of youth violence like child abuse.

So of course, now that the tide is turning against the insane drug war against  marijuana, which has turned a significant percentage of the population into criminals (who tend to only be prosecuted if they happen to be African American), the folks who refuse to look at reality are now publishing "studies" that attribute a host of problematic behavior almost entirely to the devil weed – while all the while making the most ridiculous hidden assumptions imaginable. 

People who feel the need to be stoned all the time have enough problems; we do not need to make up a bunch of other ones.

In Carl Hart’s book High Price , he recounts his adventures as a reviewer of potential drug abuse studies for funding from the National Institutes of Health. He mentioned that the research agenda was being controlled by the National Institute on Drug Abuse (NIDA). He makes it clear that they were only interested in studies that showed the dangers of street drugs, not on studies which countered the many myths in the field that he had described in the rest of the book. (NIDA also ignores the dangers of the very same drugs they demonize when Pharma sells them for conditions such as "ADHD").

Now comes a study out of Australia and New Zealand: “Young adult sequelae of adolescent cannabis use: an integrative analysis” by Edmund Silins and others. (Lancet Psychiatry, 2014;

1: 286–93). Here is the abstract:

Methods: We integrated participant-level data from three large, long-running longitudinal studies from Australia and New Zealand: the Australian Temperament Project, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. We investigated the association between the maximum frequency of cannabis use before age 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The number of participants varied by outcome (N=2537 to N=3765).

Findings: We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high school completion (adjusted odds ratio 0·37, 95% CI 0·20–0·66) and degree attainment (0·38, 0·22–0·66), and substantially increased odds of later cannabis dependence (17·95, 9·44–34·12), use of other illicit drugs (7·80, 4·46–13·63), and suicide attempt (6·83, 2·04–22·90).

Interpretation: Adverse sequelae of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefi ts. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects.

Funding: Australian Government National Health

The authors claimed to control for confounding variables, but most of these "controlled" variables were unrelated to ACE’s or ongoing family chaos. They were such things as age, sex, ethnicity, socioeconomic status and mental illness. The authors did control for a few possibly relevant parental variables like alcohol use, tobacco use, divorces, and history of depression. But not for how the parents actually behaved around their children, how they treated their children, child abuse or neglect, how chaotic the home environment was, or how and how consistently the children were or were not disciplined.

What on earth makes people who draw the conclusion that the drug was the primary cause of the lower achievement become so stupid that they don't see that frequent drug use is a sign that the teens already had emotional problems before they even started smoking - and that it was these problems that predate the drug use that were the real cause of both the drug use AND the poor performance?

The authors used exactly one rather vague sentence in their discussion to refer to this possibility, which most readers will miss: “…cannabis use in adolescence could be a marker of developmental trajectories that place young people at increased risk of adverse psychosocial outcomes.” (p. 291). 

Ya think?

Schizophrenic Attitudes towards Legal versus Illegal Stimulants

The United States has always had a peculiar and highly inconsistent attitude towards amphetamines, and it seems to become more and more schizophrenic about them with each passing day. The government, the National Institute of Drug Abuse (NIDA), and the media systematically overstate the dangers of the illegal variety, while systematically understating the dangers of the legal varieties. 

In actuality, as neuroscientist Carl Hart points out in his book High Price, there is really no significant difference between these two. 

Why aren’t kids who are given daily doses of Adderall getting “meth mouth?” Again according to Dr. Hart, because meth mouth is not actually caused by methamphetamines per se. A media-generated old wive's tale.

In my past writing on this subject, I have brought up a couple of interesting stories about stimulants that bear repeating. (If you’ve seen them, skip this paragraph and the next). When I was a freshman in college from 1966-1967, I was going to school in Berkeley. I got to personally witness the hippie scene in the Haight Ashbury in San Francisco months before the media even knew it was there. As you may know, the hippies were all in favor of experimenting with getting high on a variety of drugs. But even they used to say, “speed kills.”

Then much later in my life there was a talk I attended given by a representative at NIDA, who went on and on about how illegal stimulants deplete the brain of dopamine and thereby destroy the ability of addicts to have pleasurable experiences with anything besides maybe the drug itself. This of course is another one of those grossly exaggerated scare stories. Taking it at face value, however, someone in the audience got up and asked, “So aren’t we doing that to our kids with ADHD?” The non-answer from the NIDA man, “But the drugs work so well!”

Interestingly, the Federal Government's drug regulatory agencies seem to think that stimulants are far more dangerous and prone to abuse than benzodiazepines. Benzo’s are demonized by almost everyone in both their legal and its non-prescription uses. Stimulants are classified as Schedule II, which means they have a high potential for abuse. Opiates like oxycontin are also Schedule II.

Benzo’s, on the other hand, are classified in schedule IV, which consists of drugs considered as low risk for abuse and dependence. That is correct. When was the last time you ever read in the newspaper or online about a big bust of an illegal valium dealer?

I came across a really interesting history of America's attitudes towards amphetamines on line at http://motherboard.vice.com/read/the-speed-of-hypocrisy-how-america-got-hooked-on-legal-meth?utm_source=digg&utm_medium=email.

A sample of the subtopics covered:

In the sixties, stimulants were hawked by the drug industry as diet pills, resulting in an epidemic of stimulant abuse among housewives. (This was dramatized in the movie The Divine Secrets of the Ya-Ya Sisterhood - DA). According to the above story:

"By 1970, nearly 10 percent of American women regularly used or were dependent on some form of amphetamine, most prescribed for weight loss. In his book Speed-Speed-Speedfreak, Mick Warren reminds us that hooked housewives and twenty-something women were established cultural tropes….” 

To make up for ground lost from this scandal, Pharma and its surrogates are now in the midst of making a huge and concerted effort to market to women both the drugs and the condition known as “Adult ADHD.” 

There’s a lot more interesting history in the web story. I would recommend the whole piece to anyone interested in this subject. The pictures of old advertisements are particularly awesome.

Book Review: "High Price" by Dr. Carl Hart: A Life and the Lies in Drug Abuse Research

For a long time I have been critical about conclusions drawn from animal experiments which purported to be models for addictive behavior with drugs in humans. In particular, I got annoyed hearing over and over about how rats and rhesus monkeys would press levers to get cocaine, heroin, or methamphetamine compulsively, even until they died, choosing drugs over even food and water. These experiments were touted  incessantly by so-called experts. As I mentioned in a previous post, the head of the National Institute for Drug Abuse, Dr. Nora Volkov, even had the nerve to say that rats and humans could have the same phenotype!

My usual response to this was that rats and monkeys do not know about the damage the drugs might do to them, but that humans do, and that makes the comparison ridiculous if not completely preposterous. Furthermore, if a monkey experienced the “crash” that followed stopping cocaine or meth, it would not know that the crash was due to the drug, only that the drug stopped the crash.  And scientists even STILL have had no luck in finding rats who hide bottles of alcohol.

As it turns out, these points, while probably valid, are only minor considerations in determining the lessons to be learned from these animal studies. A far bigger issue was that the experiments were not even accurately or honestly described by those touting them. In an outstanding new book called High Price by African-American neurospsychologist Carl Hart, a faculty member at Columbia University, the author points out that descriptions of the environments in which the animals were kept were completely missing from the descripions, but that environmental factors were key in determining animal drug use behavior.

Dr. Carl Hart

The animals in these experiments were essentially kept in solitary confinement, as they had throughout most of their lives, and had nothing else to do but push the lever!  If they were instead placed in an enriched environment with alternatie activities available and other animals with which to socialize, their “drug-seeking” behavior changed drastically.

A series of experiments that the drug warriors don't want you to know about were conducted in the 1970s, and known as Rat Park. Researchers allowed two groups of rats to self-administer morphine. They housed the first group in stark cages, one rat to a cage. They placed the second group in an “enriched environment,” which offered opportunities to burrow, play, and copulate. The isolated rats drank 20 times more morphine-laced sugar water than those enjoying the Rat Park. These results have been reproduced using both cocaine and amphetamine.

Dr. Hart points out that if you were held in solitary confinement with just one movie to watch, you might watch it over and over. That would not prove that the movie itself was addictive!  In people, when they have appealing alternatives, they often do not choose to take drugs in a self-destructive manner.

Add to the mix of misinformation about drug abuse is the unheralded but monumental effect of racism on both drug use and the prevailing ideas about it.  Legal bans on certain drugs (and not others) were legislated after widespread reporting of highly exaggerated horror stories about drug use by a despised minority:  crack cocaine by Blacks, marijuana by Blacks and Mexicans, methamphetamines by toothless "poor white trash" in Appalachia, and opium by Chinese railway workers. No one was immune from these cultural influences and myths, including the minorities themselves. The Black Caucus in the United States Congress was, originally, solidly behind the huge and unfair differences in the length of jail sentences for people convicted of using crack vs. powdered cocaine, the effects of which drugs are physiologically identical.

Some facts:  The problems in the black urban community attributed to crack were already prevalent well before crack was even introduced. The vast majority of illegal drug users do not become addicted or even psychologically dependent on the drug. Among addicts, half are employed full time. Violent convicts in jails are less likely to abuse drugs than other prisoners. The vast majority of homicides do not involved drug use, and alcohol is probably the worst offender among those that do. Dealing crack is only about as profitable as working at McDonalds for low level dealers. Few people who abuse drugs take only one drug, yet there are very few studies of the effects of combinations of drugs. Self reports from addicts who are asked about their cravings for the drugs do not predict whether or not an addict in recovery will relapse.

Adderall and Methamphetamine are nearly identical molecules with identical effects, yet drug manufacturers go out of their way to say that those children treated with stimulants for “ADHD” are no more likely to go on to abuse drugs than anyone else.  Of course, since their drugs are already being legally provided to them by physicians, they have no need to obtain them from illegal sources, which is one of the measures the experts use to measure drug abuse!

This kind of circular reasoning in the literature abounds. In a series of experiments with rhesus monkeys, Dr. Hart reports, “…researchers found that the animals’ choice to use cocaine is reduced to the size of the food reward they are offered as an alternative.” People are now using this data to claim that junk food is as addictive as cocaine, when initially cocaine was claimed to be “…especially addictive because animals preferred  it to food when hungry.” (p.93).

The book by Dr. Hart is especially eye opening because it combines discussions of this sort of pseudoscience with the author’s explorations about his own personal story. As an African-American having grown up in an inner city in which many of his friends and relatives did poorly and got into drugs and crime, he asks himself why he not only escaped this but became an Ivy League professor and an expert. The experiences of this black man in America shines a bright light on the real causes of self destructive behavior. It is not drugs.

The following graphic is not discussed in the book, but, with what we know about the havoc that a felony conviction and hanging out with convicts for months or years can create in the lives of young men, it is clear that far more harm is inflicted on drug users by the laws against drug use than by the drugs themselves.

By the way, do you know how to abuse drugs? You hold them in your hand and scream at them, “You worthless pile of sh*t!  You call that a buzz?? You suck!” You then throw them to the ground and stomp on them. 

Yeah, it’s the self that’s being abused by addicts, not the drugs. 

You owe it yourself to read this highly engrossing and informative book.

Are the National Institute on Drug Abuse and Big Pharma in Bed?

Nora Volkow, M.D.

At the annual meeting of the American Psychiatric Association (APA) in San Francisco in May, Nora Volkow, the director of the National Institute on Drug Abuse (NIDA) was just brimming with a lot 'o news about the square of the hypotenuse. No, I'm sorry, I mean about how much more we know about drug abuse because of brain imagining techniques. This new knowledge she spoke of was summarized in the Psychiatric News, the newspaper of the APA, in the June 21 issue.

The gist of the story was that the drugs themselves impair certain brain circuits, which must then be somehow strengthened through treatment.

One of the points she raised is that drugs like methamphetamine cause dopamine receptor signaling to be decreased in the pre-frontal cortex - the part of the brain known to be crucial in executive control (decision making). Thus, the normal brakes on someone indulging in something are supposedly damaged.

If this be true, one might think that she would be up in arms about the widespread, indiscriminate use of amphethamines like Adderall in children. At the very least, a high percentage of ADHD diagnoses are given to kids suffering from the effects of living in a chaotic environments of one sort or another, and for whom family therapy would be the most important treatment. Perhaps there are some cases of ADHD that are due to neurotoxin exposure or something like that in which the benefits of the use of stimulants outweigh the risks - a questionable assertion itself since the average academic gain for ADHD-diagnosed kids on stimulants is all of about three whole months.

For some reason, however, while she acknowledges in other venues that prescription drug abuse, including that of stimulants, is a major problem, she continues to maintain that stimulants are safe and effective when used for ADHD.

She does admit in one article that ritalin basically works the same way in the brain as cocaine! So is she saying that there is some point at which the alleged adverse affects on executive functioning she was going on and on about at the APA magically become inconsequential?

And yet, she also spends some of her time exaggerating the adverse effects of the devil weed , marijuana, in a campaign to keep it illegal.  It seems there is a double standard she has towards the risks of the drugs sold by Pharma compared to those that are not.

How much worse than the physiological effects of pot, one might ask, are the adverse effects on potheads of jailing them and turning them into felons for the rest of their lives. Or the risks to black kids? They are no more likely than white kids to smoke pot, but are four times more likely to be arrested for it. These are not adverse effects?

"Think about it: Do you want a nation where your young people are stoned?" she was quoted as asking.  I hate to break this to her, but any kid who wants to get marijuana already can. It's like one of the biggest cash crops in several states.

I don't think she has come out in favor of prohibition against alcohol or tobacco, two substances with far more potential adverse physiological effects than pot ever thought about having, so that she might at least be consistent. Does she think that young people aren't already getting "stoned" on booze? As mentioned, she does not seem to be all that concerned about the adverse effects of the stimulants - that she herself describes - when used for legal and "proper" uses. More on that in a sec. Nor does she mention that prescribed stimulants are diverted to "non-medical" uses far more often than even opiates!

It seems almost like she thinks the risks of drugs are entirely dependent on whether or not drug companies make money from them.

I am not surprised by any of this. Many years ago I listened to a talk from someone from NIDA about the horrible effects of dopamine depletion in the brains of regular amphetamine users.  I thought about getting up and asking a question, but someone beat me to it. "Doesn't this happen in kids taking stimulants for ADHD?" the fellow asked. 

The answer? "But the drugs work so well!" As if that were an answer. Now I don't know if NIDA and Big Pharma are in bed together, but that answer sure made me wonder about it.

Another truely breathtakingly bizarre point Volkow made at the APA, as reported in the newspaper (unless the journalist got it wrong):

"Among both lab animals and humans, voluntary initiation of drug use leads to subsequent loss of control and development of addiction among 10% of subjects. The lab rats and mice are uesful for refuting old stereotypes.

Some people still consider addiction moral turpitude, she said. 'But how can you develop the same phenotype in a rat, who have no moral precepts?'"

This argument is a bit of a straw man, since thoughtful mental health professionals these days are not so much concerned with the issue of sin, but more with the question of whether or not drug abuse is due to deliberate and purposeful self-destructiveness. The fact that the 10% figure applies to both rats and people seems to argue for some sort of genetic cause, does it not?

But rats having the same phenotype as human beings? Really?!? I personally have never met any rat that understands the negative effects that a drug might be having on it, or that is able to anticipate the future consequences of continuing to imbibe. People do have these abilities. Furthermore, as I have already pointed out in various venues, scientists still have yet to locate any rats that hide bottles of alcohol.

And now back to that whole executive functioning thing. Methinks she is grossly exaggerating certain of the risks from drugs used entirely to get high. (Anyone remember the scourge of "crack babies?"  Turns out that was all one big - and racist - lie).

Seems to me the supposed "impairments" in executive functioning in addicts that she talks about are awfully specific and limited. In the past, a lot of cocaine addicts, for example, used to burglarize houses and fence the goods to support their habits without even getting caught. It would seem to me that quite a bit of executive functioning is being exhibited in that endeavor. Imagine what master criminals they might be if they had unimpaired executive functioning. It boggles the mind!

And if addicts do have a sort of brain damage, how can some of them suddenly just stop using after attending just one meeting of a 12 step program, and then stay sober by continuing to be in the program? Not as many as we'd like, but still many do. The 12 steps were based originally on techniques used by Protestants to get others to adopt their religious beliefs, not treat brain dysfunction. So how is it that what is essentially a change in cognitive beliefs can fix a brain overnight?

I have argued that many of the brain changes observed in MRI studies are actually conditioned responses due to neural plastic changes in brain structure and function in response to the social environment (No, not all of the observed changes. Some can indeed be due to drug effects, trauma, or disease. Duh). The conditioned changes can indeed happen in relatively short time frames. But literally overnight? Please.