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What Video Game Addiction and Opioids Have in Common

What Video Game Addiction and Opioids Have in Common

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Right away, there are going to be some people reading this who (like me) love to spend more than a few hours staring at a screen, smashing buttons on a controller. Before you assume we are saying video games and opioids are the same- we are not. But what we are doing is looking at what they do have in common.

Recently, the World Health Organization (WHO) announced it would be classifying gaming disorder as an official mental health diagnosis. For years, mental health professionals have recognized behaviors they thought proved video game addiction as a serious problem. With this new stance on video game addiction, there comes plenty of controversy and contention. Some people argue that this is an unfair characterization of avid gamers, while others are truly convinced there is enough evidence to support the need for gaming disorder intervention.

So, without taking a side, let us look at the new concept of video game addiction and gaming disorder while comparing it to another well-known addiction- opioids.

WHO Decides When Gaming Is Too Much?

As of 2016, WHO has 191 member states and other countries that have been granted observance status. Despite the various differences in language, culture and medical traditions they all seem to agree on common definitions of diseases. These outlines are included in the International Classification of Diseases (ICD). WHO is an agency of the United Nations, and specializes in international public health.

According to the most recent edition of the ICD, the criteria for people who may suffer from a video game addiction include those who allow gaming to negatively impact:

  • Occupation
  • Education
  • Family
  • Social lives

The WHO definition of gaming disorder is pretty broad. This kind of ambiguity could lead to anyone who just spends a little too much time playing Xbox on the weekend to being labeled with a video game addiction. Thankfully, the American Psychiatric Association has proposed a set of slightly more detailed diagnostic criteria. These criteria will probably be akin to those put forth in the Diagnostic and Statistical Manual (DSM) for Internet gambling disorder. For one to qualify for that diagnosis, their gambling/gaming would create “significant issues with functioning.” Also, it would call for five of the following signs:

  • Preoccupation or obsession with Internet games
  • Withdrawal symptoms when not playing games
  • Tolerance for gaming; need to spend more time playing to be satisfied
  • At least one failed attempt to stop or cut back on playing games
  • A loss of interest in other activities
  • Overuse of digital games despite realizing the impairment they have caused
  • Lying to others about game usage
  • Using gaming to escape or relieve anxiety or guilt
  • Impaired or lost relationships due to excessive gaming

According to the general consensus, video game addiction can develop at any age. However, many national studies primarily focus on kids under the age of 18.

Video Game Addiction VS Opioid Addiction

If we start by just looking at those signs of video game addiction, we can already see some parallels starting to shape up. For people who struggle with opioid abuse, signs of addiction can also include negative impacts on family, occupation, social life and education. Looking more at the break down of video game addiction symptoms, we can draw even more similarities.

Reward Response

One reason people use drugs is very closely connected to why they play video games- how the brain rewards them. For those with video game addiction, there are functional and structural alterations in the neural reward system. This is a group of structures in the brain commonly associated with feeling pleasure, learning, and motivation.

The same characterization can be made of opioid use. When someone addicted to opioids uses these drugs, they also experience activity in the brain’s reward system. While it may not stimulate learning and motivation in the same way, those pleasure sensors will light up with activity.

Image studies have shown that the urge to play video games activates the same brain regions that light up when illicit drug users even think about using.

Withdrawal Symptoms

Surely, we aren’t going to say that people who struggle with a gaming disorder experience the same intense and harmful withdrawal symptoms as those who abuse opioids, but we can see that withdrawal is still a common thread. According to Computer Gaming Addicts Anonymous, some of the common video game withdrawal symptoms that we often see with opioid addiction include:

  • Feeling of emptiness
  • Depression
  • Anxiety
  • Irritability or restlessness
  • Sleep problems
  • Headaches
  • Nausea
  • Obsessive thoughts

Of course, those who struggle with opioid abuse deal with a very different level of severity when it comes to withdrawal. The symptoms associated with opioid addiction are more likely to create a serious health risk than those currently attributed to video games.

Co-occurring Issues

For a lot of people who struggle with an addiction of any kind, there are often co-occurring issues or disorders. When you look at some of the research we find video game addiction is no different. Professor Douglas Gentile from Iowa State University has researched game addiction for several years. In one three year study of over 3,000 kids, he found that people who do develop compulsive gaming habits see an increase in:

  • Depression
  • Anxiety
  • Social phobia symptoms

Also, rates of ADHD are very high among the population of people who struggle with what might qualify as a gaming disorder. When it comes to opioids, co-occurring issues are also very common, including depression and anxiety disorders.

Tolerance and Obsession

It is true that just like with drug use, you can develop a tolerance to video games. When once you would be content with an hour or two of playing a game to take you out of yourself for a while, over time you will be drawn more and more into spending time playing the game.

Have you ever decided to go on an all-nighter with a RPG or FPS? Some people are looking at those letters and wondering what language of nerd I’m speaking. That is ok. But for my fellow gamers, many of you probably know the feeling that there is never enough time to rack up those upgrades or find the perfect save point. Every time you say “I’ll stop after this boss fight,” only to find yourself an hour later customizing your avatar- that is the obsession.

Now while we can’t say that this obsession is always the same for everyone, it is still something to consider. Surely we should not label everyone who dedicates time to beating their high score with video game addiction. Still, when someone needs to play more and more to feel satisfied, that is the tolerance building. With opioids, this is the body needing more of the drug to get the same euphoric effect over time; or just needing it to feel “normal”.

And when you spend all day at the office thinking about what you’re going to spend all that XP on when you finally get home, the obsession might be starting to impair the rest of your life. With opioids and other drugs, this looks like spending all day planning to use or thinking about how to get more.

Innovative Addiction Treatment

At this point, gaming disorder is still a new diagnosis, so most facilities are still working on effective treatment plans. As more research becomes available, there will probably be a variety of approaches to video game addiction treatment. Still, the need for innovative addiction treatment is pretty obvious when considering an addiction that is based on technology.

For most addiction recovery programs, the idea of abstinence is a common cornerstone. Not using drugs is kind of the whole point of getting clean and sober. However, when it comes to things like internet gaming disorder, it is hard to be completely abstinent from the internet in 2018. Taking into account that fact that most people use the internet for their work, or for staying connected socially, you find it is pretty much impossible to remain offline for long. Therefore, any new ideas around cognitive behavioral therapy and psychiatry can make a big difference.

While most people know that video game addiction is nowhere near as severe as opioid addiction, we still think making these kinds of connections may help people better understand the idea of gaming disorder. Many healthcare professionals believe that one problem facing effective video game addiction treatment is the idea that it is not harmful.

When it comes to opioids and other drugs, innovative addiction treatment can be the difference between life and death. Safe medical detox is a vital part of building a stable foundation for long-term sobriety. People who struggle with addiction also need more than just a reliance on abstinence. This is why holistic addiction treatment is so important with addressing the opioid crisis in America today.

Palm Partners Recovery Center believes that personalized and holistic addiction treatment is essential to helping people struggling with drugs or alcohol to not only overcome their addictions, but to transform their lives. No matter what your addiction, you should have access to compassionate care and options for effective care. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.

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Flesh Eating Krokodil Drug Resurfaces on American East Coast

Flesh Eating Krokodil Drug Resurfaces on American East Coast

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Justin Mckibben

Back in September of 2013 doctors in Arizona were understandably alarmed after two potentially related cases of a now infamous flesh eating Krokodil drug appeared in the state, one of the first ever reports of the drug in America. That year doctors in Illinois also reported treating individuals suffering serious damage due to use of the corrosive recreational narcotic. Since then the drug has seemingly been absent from the front lines of the opioid epidemic in America. However, after a few recent reports, some are worried it might make a surprising comeback. This time, it appears Krokodil has resurfaced on the East Coast.

What is Krokodil?

The main ingredient in Krokodil is the drug desomorphine. It is a derivative of morphine that is 8 to 10 times more potent. Desomorphine was first patented in the United States in 1932.

The drug got its now notorious nickname from the Russian word for crocodile; due to the fact users often develop scale-like, green skin. Other permanent effects of the drug include:

  • Speech impediments
  • Erratic movement

Krokodil can be manufactured illicitly from products such as:

  • Codeine
  • Hydrochloric acid
  • Turpentine
  • Red phosphorus
  • Gasoline

However, artificially producing desomorphine like this causes the drug to be dangerously impure. It contains toxic and corrosive byproducts from the home-made chemical combination. The rotting effect these chemicals have on the flesh is why many people call it the ‘zombie drug’.

Krokodil in Europe

As a recreational and injectable drug, ill-reputed and home-made Krokodil was first reported in the middle and eastern areas of Siberia way back in 2002. According to medical reports, it then quickly spread across Russia and other Soviet republics with a distressing impact on those it came into contact with. The drug became so popular because compared to the more mainstream opioids like heroin the high is much stronger and it was extremely cheap to produce. The drug is also highly addictive.

This drug has devastating effects on its users, who have an average life span of only 2 to 3 years after they start using. The chemicals within Krokodil literally rot and eat people away from the inside.

Krokodil Coming to America

In 2013 the leg of a young woman in Lockport Illinois named Amber Neitzel, 26 at the time, was photographed because of the intense damage Krokodil had done to her tissue. Most of the previous reports of Krokodil in the U.S. appeared mostly in the Southwest. Now one story has some worried it’s back and getting around.

An overdose patient found all but rotting alive in Manchester, New Hampshire last week told responders he believed he’d been injecting the drug Krokodil. In relation to the story, reporters spoke with Chris Hickey with American Medical Response, who said,

“It’s pretty much the dirty sister of morphine and heroin,’ Hickey said. ‘A lot of times, it’s cut with something like gasoline or the ground-up red phosphorus from the tips of matches or drain cleaner.”

With someone who is literally rotting away in front of you it turns the stomach of even the most seasoned provider.”

The opioid epidemic is already affecting the vast majority of Americans in one way or another, whether they are struggling or someone they know, and most experts predict we still haven’t reached the pinnacle of the problem.

Already there are awfully hazardous synthetic drugs like fentanyl and carfentanil being slipped into the illegal drug trade through heroin and home-pressed prescription pill form. These two substances alone have supplied most states with a surge of opioid overdoses and deaths.

If Krokodil is really making a comeback, how much worse could the opioid epidemic get and how quickly will law enforcement, public health officials and communities be ready to respond? Will this be the deciding factor in pushing the overdose death rates to new and demoralizing peaks?

Drugs like these are far too real and costing far too many people their lives. There is another way, but it begins with taking action. Seeking safe and effective treatment can be a crucial step to changing your life. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.

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Officials Push for Safe Injection Sites in Boston at City Council

Officials Push for Safe Injection Sites in Boston at City Council
Author: Justin Mckibben

For some time now government officials in different states across America have been pushing for the implementation of safe injection sites in their neighborhoods to combat the perpetual rise of opioid addiction and overdose death. This time last year there were proposals in New York, California and Washington D.C. to open such facilities. With the rising rates of overdose and death more officials have asked for the opportunity to at least examine the potential impact of safe injection sites. Now, officials are pushing for safe injection sites in Boston.

This request didn’t come lightly, either. The Massachusetts Medical Society is actually imploring state officials to open a safe injection site within the City of Boston, with desperate hope of curbing the numbers of casualties.

Safe Injection Presented to City Council

The Boston city council members heard arguments both for and against safe injection sites in Boston, and the debate is on as to what to do with the information.

Advocates for safe injection sites in Boston believe such facilities save lives by making emergency medical treatment immediately available. Dr. Henry Dorkin with the Massachusetts Medical Society supports the idea, stating:

“In fact, if you don’t have them in a facility with Narcan readily available, they’ll die very quickly,”

Just to clarify, safe injection sites are secure locations with medical staff available where addicts can use heroin under medical supervision. It provides what could be considered neutral ground where the drug user will not have to worry about being charged with criminal possession, while also having a first line of defense against overdose. Safe injection sites do not provide drugs, they simply provide the space and with some clean needles are also available.

Probably one of the most popular examples used by advocates of safe injection sites has been the famous facility in Vancouver, Canada that helped save dozens of lives. City Councilors Anissa Essaibi-George and Frank Baker, who requested the hearing, point out that the safe injection sites in Vancouver reduced fatal opioid overdoses by 35%.

This kind of decrease in overdose fatalities would make a huge difference in Massachusetts. The state Department of Public Health says the state’s top cause of accidental death so far this year is opioid overdose. The department says an average of 6 people a day in Massachusetts die from opioid overdoses in 2017, making. A 35% decrease would make a tremendous improvement on the community.

Anti-Injection Sites Argument

Opponents of safe injection sites in Boston say that these facilities do nothing to address the true problem, which is addiction. Sue Sullivan of the Newmarket Business Association states:

“It’s an existence. We need to figure out how we’re going to save these people and it’s not safe injection sites,”

Looking at the Vancouver statistics was apparently not enough to convince the entire city council. One feature of safe injection sites is that they often have a team of treatment professionals who encourage addicts who visit the facility to get treatment. They provide information about safe medical detox and other levels of care to those who are interested in getting help. However, one city council member, Frank Baker, states:

“263,000 visits a year by 6,500 individuals. And it has only 404 referrals to onsite detox,”

Some officials believe that this measure of harm reduction isn’t enough to really solve the issue without getting more people into drug addiction treatment and off the streets.

Possible Benefits of Safe Injection Sites in Boston

The primary function of safe injection sites is to preserve life. The idea is that while it may not be a lasting solution, it is a way to save lives. Safe injection sites allow people struggling to have the opportunity to survive their addiction long enough to get treatment. Beyond slowing down drug related deaths, safe injection sites in Boston could offer a number of other positive outcomes.

In May of last year we also covered a report titled Alternatives to Public Injection in which experts with experience operating supervised injection facilities (SIFs) shared data that shows:

  1. People who use SIFs take better care of themselves
  2. SIFs reduce or eliminate addicts needle sharing
  3. Ultimately, participants reduce their drug use all together
  4. SIF participants gain access to other medical and social services
  5. Participants have resources to seek addiction treatment
  6. SIFs do not increase drug use in the surrounding area
  7. Crime and public disturbances decrease in the areas around these programs
  8. There has not been a SINGLE overdose death in any of these programs over many years of operation

Rates of people visiting safe injection sites attending treatment may not be as good as they could be. However, the fact that they have no experienced a single overdose death at these facilities is an incredible improvement.

Are we going to see safe injection sites in Boston? Are more American cities going to consider this option? Is having a safe injection site a good idea?

While getting the right kind of safe and effective addiction treatment can create lasting change, preventing the ongoing deaths from drugs is also a worthy cause. Holistic healing programs are designed to address every aspect of addiction. If you or someone you love is struggling, please call toll-free now.

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Why are Insurance Companies Focusing on Maintenance Drugs?

Why are Insurance Companies Focusing on Maintenance Drugs?

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Justin Mckibben

Addiction is not an easy problem to address. It is a complex issue with many variables, so of course there is no simple answer to fix it. There is no one-size-fits-all solution; no monopoly on the right kind of treatment. It is understandable that there is a degree of effectiveness with utilizing any medical means available to try and address addiction, but are maintenance drugs really the answer?

Surely medication assisted treatment is useful, and it helps a lot of people. Most inpatient treatment programs utilize some form of medication to ease withdrawal symptoms and other side-effects of long-term drug use. The detox period of treatment usually focuses on medically assisting someone struggling with drugs in this transition.

However, is getting people off of one drug by making them dependent on another really the best case scenario? It seems now insurance companies are putting more effort into using maintenance drugs to treat addiction. Is this really a better strategy?

Maintenance Drugs

Firstly, let us make a clear definition of what maintenance drugs are. Typically, the definition of maintenance drugs is along the lines of prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines.

Examples of common maintenance drugs are medications such as:

  • Fluticasone and salmeterol (Advair Diskus) which is used to treat asthma
  • Insulin glargine (Lantus) used to treat diabetes

If you consider these examples the point is that people use these medications to “manage” their illness, not to overcome or remedy it. So looking at the issue of addiction, there are some well-known maintenance drugs, specifically concerning opioid addiction.

These medications can be effective, but they also present a level of danger themselves. Even though doctors prescribe them to combat withdrawals, they actually can create their own devastating withdrawals, especially with long term use.

Aetna Aims for Maintenance Drugs

Aetna is one of the nation’s largest insurance companies. In a recent Aetna report, the company is prepared to remove a major restriction for patients seeking maintenance drugs for opioid addiction. The change is set to begin this coming March. Aetna is the third major health insurer to announce such a shift in policy in recent months, now in league with Anthem and Cigna insurers.

To be more specific, this insurance company will stop requiring doctors to seek approval before they prescribe particular medications that are used to combat withdrawal symptoms. One of these medications is suboxone, a well-known medication that many people use to fight opiate addiction.

The common insurance practice is known as “prior authorization”. The reason they are seeking to eliminate this policy is because it sometimes results in delays of hours to days before a patient can get the medications.

This new approach to regulation of maintenance drugs impacts all its private insurance plans, an Aetna spokeswoman confirmed.

Advocates of Maintenance Drugs

Addiction treatment advocates to support having expanded access to maintenance drugs. Dr. Corey Waller, an emergency physician who chairs the American Society of Addiction Medicine’s legislative advocacy committee, states:

“It’s a first-line, Food and Drug Administration-approved therapy for a disease with a known mortality. [For] every other disease with a known mortality, the first-line drugs are available right away.”

Essentially, the idea that parity laws require insurers to cover addiction treatments at the same level as other kinds of healthcare means these kinds of medication should be available for immediate access. This should be the same for all forms of addiction treatment.

Opinion: Treatment over Maintenance

While many would argue that maintenance drugs are a form of treatment, it is still a relevant argument that maintenance drugs are also imperfect and could actually be harmful if they become the cookie-cutter answer implemented by most insurers.

While harm reduction is understandable, and maintenance drugs can help people struggling with heroin or other dangerous opioids avoid other serious risks, the fact is many maintenance drugs include their own side-effects. Some often become subject to abuse themselves.

For instance, suboxone can be useful as a harm reduction tactic, but it can also be abused. Many people who have used suboxone as a long-term solution have found themselves battling suboxone withdrawal symptoms. The dangers of suboxone are very relevant.

The same, if not worse, has often been said about methadone maintenance drugs. While they may keep someone alive to get treatment, there should still be a strong emphasis on treatment itself. Maintenance drugs are most effective when part of a program. They are not a substitute for a treatment program.

Treatment should focus on finding solutions, not prolonging the suffering. Drug and alcohol addiction treatment should come from a holistic approach that addresses more than just physical ailments. Holistic treatment focuses on providing extensive and personalized therapy, combined with physical and emotional heal. If insurance companies want to focus on combining rational medical resources with comprehensive treatment, then this could be a great thing. However, if the focus becomes a quick-fix drug option opposing a full recovery through treatment, it only adds to the danger.

Maintenance drugs have support from the recovery community, but typically they must be accompanied by therapy and other means of treatment. Maintenance drugs are just that- drugs. They are often powerful narcotics, and are true to their title- “maintenance,” not a permanent solution.

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Boynton Beach Sees 5 Overdoses in One Night

Boynton Beach Sees 5 Overdoses in One Night

Author: Justin Mckibben

Boynton Beach is beautiful area in South Florida, just north of Delray Beach and south of West Palm in Palm Beach County. The area has been described as “America’s gateway to the Gulf Stream.” Boynton Beach has also been hit by the affected opiate epidemic. Roughly 250 overdoses have occurred this year in Boynton, which is the third largest city in Palm Beach County. While some cities have seen similar spikes in overdoses and drug-related deaths for some time, Boynton Beach experienced a record breaking jump in overdoses overnight this past Tuesday.

The reports of drug overdoses started before sunset. By Wednesday morning police and paramedics had been called to the scene for five separate overdose incidents. For one night, this is the most the city of Boynton Beach has ever seen. As if that weren’t intense enough, all the overdoses occurred in a 12-hour span.

Out of the five, two died and three survived thanks to the life-saving efforts of first responders. This is just another example of how hard the opiate epidemic has hit some cities now more than ever. It is also an indication some of the efforts being made in Palm Beach County are for good reason.

Tracking the Problem

The only available details on the five victims so far include:

  1. 5:19 p.m. report of a man found in a parked car near Seacrest Boulevard
  2. 9:44 p.m. a man was found in a car at the 7-11 convenience store
  3. 10:31 p.m. a 40-year-old man was found dead in his bathroom at the Las Ventanas apartment complex on Federal Highway
  4. 30 minutes later, a man was found near the Rosemary Scrub Park
  5. 2 a.m. a man identified as Thomas Varner was found unresponsive at the Homing Inn on Federal Highway — a place police know well for its number of overdoses

Varner, who was the final overdose of the five, received CPR from police officers at the scene. After an attempt to revive Varner by paramedics using life-saving medication Narcan, used to reverse the effects of opiate overdose, he was rushed to Bethesda Hospital East. where doctors tried to save him. Unfortunately, Varner did not survive his overdose. Police Captain Mike Johnson, the shift’s commander during the evening in question, expressed his own concerns with the news, saying:

“We’re in the business of saving lives and when you can’t do that, especially when you have two last night that were fatal, that’s frustrating. But we also recognize that we’re just one prong of this public health crisis.”

Boynton Beach is Not Alone

Boynton Beach is definitely not the only city dealing with increasing drug overdoses. The outbreak of overdose rates and overdose deaths is nationwide. For Palm Beach County, the ‘recovery capitol’ also faces its obstacles with addiction.

  • In Lake Worth alone there were 220 overdoses from January to August of this year
  • Palm Beach County firefighters responded to 1,246 opioid-related overdoses in that same period
  • Delray Beach already had about 394 by late September

Thankfully, Narcan and Naloxone are readily available for first responders, and expansion programs continue to progress across the country. In this 12-hour period four of the victims were taken to Bethesda and were given Narcan.

The fifth man he had already died at the scene.

Not Just Heroin?

Another question is concerning recent reports from several spots in the country where other dangerous drugs are being mixed in with heroin. According to Police Captain Mike Johnson this is- “more likely than not a new batch of heroin hit the city in the last couple of days.” So the question becomes, is there a new batch mixed with something even more toxic set to hit Boynton Beach.

At Las Ventanas, where one victim was found dead, police believe they found the painkiller Fentanyl in the apartment. Fentanyl is an opiate said to be more than 50 times as powerful as heroin. This is not the first time Fentanyl has caused some problems for Palm Beach County. Medical examiner records indicate Fentanyl also played a role in more than 100 overdose deaths in Palm Beach County in 2015. Captain Johnson said,

“It’s an obvious public health crisis. Law enforcement is only one component of addressing that health crisis. The amount of heroin that’s being sold on the street and the amount that’s being cut with Carfentanil or Fentanyl is increasing.”

Due to the rising risks present in some communities Palm Beach County is already organizing events and seminars to properly educate and arm the public with resources for overdose prevention.

One of the most prominent aspects of attacking the addiction issue is the existence of effective, supportive and compassionate drug addiction treatment. One powerful way we can prevent overdose is to make sure those suffering get the quality of care they deserve. If you or someone you love is struggling with substance abuse or addiction, please call now.

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