WHO YA CALLIN' AN ADDICRT?

The First In A Three-Part Series

There are certain needs that everyone has that must be satisfied to
survive, such as food, sleep or sex.

The addict, says Billy Heckle of Orangeburg, has acquired another drive
state. A registered pharmacist and certified addictions counselor at the
William J. McCord Adolescent Treatment Facility in Orangeburg, Heckle says
an addiction tells its victim to seek out that chemical - alcohol,
marijuana, cocaine - there's not that much difference.

When his or her brain is trained to respond to a chemical, he or she will
use almost any kind of chemical to satisfy that need. If the alcoholic
can't get a drink, he'll take a pill. If they don't have any pot to smoke,
they might use cocaine.

One observation made by both Heckle and Dr. Timothy Fischer, medical
director of the Tri-County Commission on Alcohol & Drug Abuse, was that
very rarely does the addict abuse just one drug; it's usually a
combination: alcohol, marijuana, cocaine and increasingly - prescription drugs.

Do you need help?

What is an alcoholic? "The term 'alcoholic' is a non-medical term used to
describe those who are dependent on alcohol," Dr. Fischer said.

"People should seek help LONG before they do," he added, "but denial is one
of the most common characteristics. If they think 'Maybe I should do
something,' or a friend or family member tells them they should, then they
probably need to listen. If they go to a bar, and they can't just drink one
or two, they should probably seek help."

"There are many signs of addiction," Heckle says.

"Are you developing health problems? Is your hypertension getting worse? Is
it complicating that illness?

"Are things with your family getting testy?

"Are you spending too much time and money on your habit?

"Is your job performance not what it used to be?

"Do you find yourself explaining your use to others? If you have to explain
what you did while under the influence and justify it, that's a red flag.

"Do you have blackouts or pass out? That's a very big red flag."

Test yourself:

So how do you know if you are heading toward an addiction to alcohol or
other drugs?

Dependence

1. Have you developed tolerance? (an increased ability to resist the drug's
effects)

2. Do you have withdrawal if you try to avoid it? (shaking, nausea,
sweating, sleep problems, vomiting, seizures)

3. Are you using it longer or more than you intend?

4. Have efforts to control it or cut down on its use been unsuccessful?

5. Is your involvement with alcohol or drugs taking up an excess amount of
your time?

6. Have you given up or reduced time that would have been spent socializing
with friends or working at your job or having fun as a result of using the
substance?

7. Have you continued using the substance despite medical or mental
problems caused or worsened by its use?

If you answer yes to three of the above seven questions, you may be
suffering from "dependence" on the substance and may need to seek treatment.

Abuse

1. Have you failed to fulfill your major role obligations at work, school
or home?

2. Have you, more than once, used the substance in a physically hazardous
situation (such as driving)?

3. Have you, more than once, had legal problems related to using the substance?

4. Do you continue to use the substance despite recurring social or
interpersonal problems?

If you answered yes to one of the above four questions, you are likely
abusing your substance of choice and may need to seek treatment.

Adolescent use

Dr. Fischer treats the medical problems of in-patient adolescents addicts
at the McCord Center. He had just seen a young man who said that on most
days he drank 12 beers and chased them with a pint of liquor.

Adolescents know the names of prescription drugs as well as pharmacist
Heckle does. Their family members are taking them, and they sneak pills
from them. Or they steal them from others whose family members have them.
Or they trade pot for them. People with chronic pain may be willing to sell
their pain pills, Heckle said.

"And, over the Internet, if you want a drug today, you can get it
tomorrow," Heckle said. "You have to have a credit card, so generally kids
get adults to get them, or they forge their parent's signature on
prescriptions."

The children at the McCord Center belong to lawyers, judges, ministers,
doctors as well as drug addicts, Dr. Fischer said, and when you hear their
stories, you wonder how they've survived this far.

A mother brought her young girl in as an in-patient recently, and a few
days later wrote her daughter to say she was moving out-of-state with her
boyfriend. "Don't follow us," she wrote.

A significant number of alcoholics started abusing by binge drinking as
college students, Dr. Fischer said.

"One of the things that our society does is we act like drinking is a good
thing," Heckle said. Alcohol is just part of going to football games and
other sports events now.

Kids think they are superhuman anyway, he said, and they want to do what
they see adults doing.

The diabetes

comparison

Dr. Fischer compares addiction to diabetes.

"A certain number of people are born with diabetes," he says. "A certain
number have a proclivity to develop it. But a certain number aren't born
with it and don't have a proclivity for it, but overeat and indulge so much
that they can develop diabetes."

Alcoholics are much the same way, he says. "Forty percent are genetically
inclined to be alcoholics. One guy told me that to him alcohol was better
than sex. One told me that he stayed sober for 19 years and then took
communion and got back on the bottle again."

Others have a proclivity to start drinking, he said, and if they do it
enough, this predilection will lead them to an addiction. They may think
they have it fully under control, but it can sneak up on them.

Still others start out without the tendency toward alcoholism but abuse it
enough that they cause an actual change in their brain and thus create an
addiction where there was none.

Dr. Donal F. Sweeney, author of "The Alcohol Blackout," compares the true
alcoholic to someone who is lactose-intolerant. "That person can't drink
milk sugar without the effects, and he's going to be that way all his
life," he said. "The only sensible thing is for him not to drink it. It's
the same way with the alcoholic. He's going to be that way all his life.
The normal drinker doesn't have to think about it."

Brain damage

Permanent brain damage can result from alcohol or drug abuse, Dr. Fischer said.

"Brains of alcoholics have become smaller, shrunken," he said. "Chronic
alcohol use dehydrates the body as well as the brain. It will kill brain
cells. They can grow back but not very quickly. You'll see memory problems,
forgetfulness, concentration problems. The person becomes more easily
frustrated."

Once a person is an addict, any type of psycho-active substance will
activate the addiction again, Heckle said. "For an addict, certainly the
recommendation is that they not try anything again."

Research

your medicines

Alcohol also affects whatever drug we take, Heckle said, explaining that
alcohol reacts adversely most commonly with benzodiazepine drugs, those
used as anti-anxiety agents, muscle relaxants, sedatives, hypnotics, and
sometimes as anti-convulsants. Valium, Xanax, Atavan and Chlonopin are four
of the most common of these "nerve pills" that shouldn't be taken with alcohol.

Opiates and amphetamines also depress the central nervous system and should
not be combined with alcohol. Amitriptylines, one of which is Elavil, may
also enhance the effects of alcohol. No more than 4,000 milligrams of
Tylenol should be taken in one day due to potential liver damage, and when
alcohol is being used, that number is cut in half, Heckle said.

Drugs for attention-deficit affect some people as stimulants, and when they
drink alcohol along with the drug, they keep the "high" longer. Many users
think of alcohol as a stimulant because it causes that euphoria initially,
but alcohol is actually a depressant, like other central nervous system
drugs, and causes a roller coaster ride that ends on a steep downhill slope.

Doctors and pharmacists often caution patients about drug interactions but
patients may not be listening. And a lot of people don't read the labels.
As a pharmacist and a counselor, Heckle recommends that patients research
their own medicines.

Because the benzodiazepines hit similar receptors in the brain, Dr. Fischer
says these drugs may actually be used to help the addicts who are coming
out of addiction.

Hope for recovery

Alcoholism is a disease, but with hope and determination, this disease can
be beaten.

"People ask me why I work with addiction medicine when my training is in
family practice," Dr. Fischer says. "'Isn't it depressing?' they ask."

But when Fischer was in family practice, he noticed that patients with many
problems were not recovering because they weren't able to or they weren't
trying. But when he worked with addiction, he saw patients suffering with
it come to him on the verge of losing their job, their family and their
home, and leave with their health restored.

"I would see them later, and they would look better and be so much
happier," he said. "They do get better."

You never know when they will, he said. He's known addicts who have slipped
back into addiction 40 times, only to beat it the 41st and live on for
years in recovery.

"With addiction, there's always hope," he said.