Are you Smoking… Or being Smoked?Posted on October 16, 2012
By Dr. Raju Hajela, Addictionist
People often consider smoking cigarettes to be their comfort, choice and the “lesser of evils” in recovery from addiction related to alcohol and other drugs. In reality, research has demonstrated, unequivocally, that the same brain circuits that are affected by alcohol and other drugs are involved with nicotine. It has also been noted that relapse rates are higher among smokers than amongst those who quit smoking as part of their recovery.
Tobacco, in the form of cigarettes, is often the first drug that children or youth try when they begin experimenting with substances and wanting to do what adults do to relax! The “relaxing effect” of smoking is driven more by relief than reward. This is true for all aspects of addiction – the reward that one may get initially increasingly turns into a chase to seek relief as addiction-related changes take place in the brain. Nicotine is the ingredient in tobacco that is highly addictive, as it acts directly on the acetylcholine receptors, which are vital for healthy functioning of the brain and body. Further, there is stimulation of the endo-opioids, such as endorphins, and endo-cannabinoids, such as anandamide, which activate the reward circuitry, making it quickly dependent on that outside stimulation rather than maintaining self-sufficiency through natural mechanisms, such as healthy eating, exercise, yoga and meditation. A disordered endo-opioid and endo-cannabinoid system has serious implications for mental health and pain problems, in addition to addiction-related problems, which result from problems in the brain reward, motivation, memory and related circuits.
From a treatment and recovery perspective, the psycho-social-spiritual components for tobacco (nicotine) addiction are the same, hence, attention is needed for clarifying feelings and challenging addictive thinking. The biological base of addiction requires consideration for nicotine replacement therapy (NRT), to deal with withdrawal symptoms, while changes are made behaviourally to develop a smoke-free lifestyle. Naltrexone, which is an opioid antagonist, can be useful to decrease cravings too, while the endo-opioid system recovers its more natural function. Bupropion and Varenicline are agonist medications that can be helpful as well. Ongoing research may lead to medications that are useful in covering off the cannabinoid circuitry in time to come.
On the other hand, those that smoke cannabis (marijuana) are in a double jeopardy situation, as the endo-cannabinoid system becomes directly impaired due to the marijuana being ingested, in addition to the addiction-related brain circuitry effects. It is helpful to use Steps 1, 2 and 3 from 12 Step Programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) as a starting point to address recovery from tobacco addiction.
From a practical standpoint, it is essential that someone who is a smoker makes smoking a solitary, outdoor activity, even before quitting, in order to break the associations (environmental cues) that drive addict thinking and addict behaviours. Best results with smoking cessation are achieved when all the bases – biological, psychological, social and spiritual – are covered.
For more information on Tobacco Cessation, please consult the National Institute on Drug Abuse (NIDA) website. In addition to articles about tobacco, this website is a wealth of information for other substances of choice and has a subsite specifically designed for Teens.
At HUM we approach addiction as addiction so if you are struggling wtih tobacco cessation or any other type of substance or process addiction, please contact us at 403-536-2480 to schedule an assessment or get more information.
We are Moving!Posted on October 10, 2012
HUM is very excited to announce that we are in the process of developing a space that we can call our own right here in the Mission neighbourhood. Our new address will be: Suite 305, 320-23rd Avenue SW (between 4th Street SW and the old Holy Cross Hospital site in the Alberta Professional Centre).
To facilitate the move to the new building our office will be CLOSED on December 3rd and 4th 2012. We are unsure how group therapy on these days will be impacted but will provide clarification of this closer to our moving date. We will not be open for individual therapy appointments either day.
Please stay tuned for more information about the move, including the date and time for our Open House celebration! In the meantime, here is a picture of our building:
HUM Team UpdatesPosted on October 2, 2012
Dr. Raju Hajela just returned from a week in Geneva, Switzerland where he attended the 14th Annual Meeting of the International Society of Addiction Medicine (ISAM). Attendance was up this year to around 500 people and the ASAM definition of addiction, that has been endorsed by ISAM, seemed to be front and centre on people’s minds with less focus on behavioural treatments alone. After being back in Calgary for a few weeks, Dr. Hajela will be out of the office again for a long anticipated journey home to India from November 10-27. Groups will be co-facilitated by Sue Newton, Paige Abbott, and our Associates in his absence and will continue as usual.
One of our Associates, Patricia Lavelle, has been co-facilitating our Tuesday Early Mixed Recovery Group since September 2012 and will be hosting our Building Blocks to Better Relationships workshop series in November 2012. Please check out our website for more information about this exciting workshop. We are pleased to have Patricia, who spends her other work time between EFAP and private practice work, in the HUM office more. Patricia will also help cofacilitate groups when other HUM staff are away
Social MediaPosted on August 30, 2012
Please like us on Facebook and follow us on Twitter! Social media from HUM is a great way to stay connected to new developments in addiction, mental health, and chronic pain, as well as updates about HUM’s programs and services.
Most recently there have been a lot of interesting articles about marijuana use and the impact on the brain. Look for these on our Facebook page and Twitter feed.
What people are saying
I just wanted to thank Dr. Hajela, Sue and everyone else at the clinic for teaching me so much on this very short elective. I can see the tremendous difference your clinic makes in the lives of its patients, and it’s very inspiring.
“I am forever grateful for the opportunity and the staff. Each played a crucial role on my journey in recovery. It’s a safe place to be knowing I will be met with understanding, honesty, and compassion.”
“Exactly what I needed-a holistic approach to recovery. Fantastic team approach by the HUM team. Would highly recommend HUM for a successful start to recovery.”
“It was nothing like what I had expected, it was even better and where I am in my journey was originally unimaginable. Thank you for helping me find hope and curiosity!”
“I see that IOP gives me a chance to hear, absorb, integrate, and practice new ways of thinking and acting. Each phase and the time in between also allowed for this knowledge to start to become practical.”
“I really appreciated the professionalism of all the staff. The environment and the people are very welcoming”
“I am convinced this is the single most important program I have and ever will attend. Phenomenal!”
“I’m so impressed with how [Paige] and Dr. Hajela SO understand addiction, and how to help me see the blind spots, release some shame (or at least see it!), gain insight and connect with actually FEELING what is going on with me and how the disease shows up for me ….so amazing… Thank-you very much.”
“[The IOP] was an amazing opportunity. I liked the topics that were covered and the group therapy.”
“[For the IOP] I liked the balance of education, self-care, and sharing. I really like the ongoing discussion in the education sessions and sharing during this time, as well as in group [therapy]”
“[The IOP] was great-not just for recovery, but for life”
Anonymous Evaluation Form
“[IOP] group was great for opening up and constructive feedback”
Anonymous Evaluation Form
“[The IOP was] informative, interactive and entertaining. Keep up the great work!”
“Thank you for the very excellent group [therapy session]. The small change in perspective of my communication is making waves.”
“The newsletter sent to me was a reminder to thank you for your weekly video messages. They are quick but helpful bits of info which give you food for thought! Keep them coming!”
“The Family weekend [of the IOP] was incredible for me personally. Thank you many times over for this wonderful opportunity.”
Rebecca Foster, Foreward Reviews
The mixture of practical information and reassurances make this essential reading for patients and their loved ones.
With their first book, Addiction Is Addiction, Raju Hajela, Sue Newton, and Paige Abbott aim to foster “more open and honest dialogues about the role of Addiction in society, without stigma or judgment.” This comprehensive, well-organized guide discusses the features of addictive thinking and feeling, suggests holistic recovery methods, and offers useful definitions, diagrams, and case studies.
The authors are affiliated with Health Upwardly Mobile Inc., a health and wellness company based in Calgary, Alberta. Tracing the history of addiction back to the eighteenth century, when it was first known as “alcoholic disease syndrome,” they present an expert view of the disease’s symptoms and outlook. By stressing that addiction is a “chronic brain disease” rather than a “moral failing or personal weakness,” they evince a compassionate perspective that will encourage patients and their family members to examine their emotions and take a proactive, spiritual approach to recovery.
Addiction is influenced by both genetics and environment, the former accounting for perhaps 50 to 60 percent of incidence. Trauma does not cause it, but can aggravate it. Although the book is full of such relevant background details, the facts never become overwhelming thanks to the variety of materials included. Intriguing case studies, most of them narrated in first person, are set in italics, and diagrams and tables illustrate patients’ likely feelings, relationship roles, and recovery stages. Reading this should be an interactive experience, what with self-assessment questions and affirmations, a journaling template, and a recovery activities checklist with a sample schedule. Extensive endnotes and bibliography plus a helpful glossary provide ample resources for further research, and chapter summaries will ensure that all the take-home messages sink in.
Sometimes the book goes into too much detail for laymen. However, this means that it can be used by professionals as well as patients. An appendix on chakras seems out of place, even with the book’s focus on spiritual means of recovery. The authors have also made the unusual decision to always capitalize Addiction, “to emphasize that it is a proper noun and the name of a serious disease.” That’s as may be, but in practice it can look like a repeated typing mistake. Information appears to be specific to North America, especially when it comes to funding limitations and patient advocacy, but the general principles of care should be applicable worldwide.
This book is strongly recommended to those who have participated in groups like Alcoholics Anonymous or Narcotics Anonymous. The mixture of practical information and reassurances will make it essential reading for patients and their loved ones.
Disclosure: This article is not an endorsement, but a review. The author of this book provided free copies of the book and paid a small fee to have his/her book reviewed by a professional reviewer. Foreword Reviews and Clarion Review make no guarantee that the author will receive a positive review. Foreword Magazine, Inc. is disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255.
Three health care professionals present an approach to treating addiction as a disease having both physical and psychological components.
In this debut health book, Hajela, Newton, and Abbott address the challenges of addiction from a holistic medical and social perspective. The book opens with an explanation of addiction—which the authors capitalize throughout, part of their effort to mitigate the stigma associated with the word—as a condition that impairs the functions of the brain. They address the physical and behavioral symptoms associated with it, using pathology as a framework for understanding and treating addiction. Without blaming the patient for developing the condition in the first place, the book attempts to acknowledge the role of personal responsibility in managing a condition often attributed to individual shortcomings. The authors address medical treatments that can be effective for some forms of addiction, like alcohol and opiates, as well as the role of psychotherapy in treating underlying psychological problems and combating the thought patterns that lead to addiction behaviors. While much of the book is aimed at people dealing with addiction, later chapters discuss the roles of friends and family and treatment providers, along with strategies each group can employ in supporting the patient. For the most part, the book advocates a balanced, reasonable approach to dealing with addiction in its many forms, drawing on research and standard practices developed by mainstream organizations. As a result, it is disconcerting when the text introduces energy healing as a component of treatment: “It is important to understand that when people are out of balance in any of the energy centres, or chakras, people run at either a higher or lower level of energy.” Although an appendix explains the concept of chakras in more detail, energy healing is not essential to the book’s mission, and skeptics will still find it a useful resource for developing an approach to treating both the mental and physical aspects of addiction and understanding it as a chronic disease.
Comprehensive approach to treating addiction as a condition affecting both mind and body.
I have found HUM very supportive and non-judgmental, yet I have been challenged every step of the way. The spiritual, emotional, social, and intellectual teaching has been clear and consistent but never forced.
My experience has been mainly positive for the most part. Anything negative or perceived as negative, I have been able to discuss with staff and it is professionally dealt with.
I value my weekly [group therapy] sessions at HUM greatly. My personal experience there means more to me than I can describe in one paragraph. It helps me really understand my recovery and my life when sometimes I feel that everything is lost or in a state of confusion.
I was very fortunate to hear about HUM and then become a patient. I may well have averted death if I did not receive the guidance and support of HUM. Having the backing of HUM as I returned to work and went off again was invaluable. Dr. Hajela listened to me and had the knowledge and understanding that gave me the confidence to be patient in my early recovery. I was never judged though I expected to be. I am grateful beyond words for the help I received in battling my addiction.
Very professional , discreet, and honestly committed to helping people in recovery.
Thought provoking sessions that focus particularly on my addiction. Understanding a problem and all of the subtleties that come with it are crucial to my recovery.
I felt very safe and comfortable and I felt truly cared for by the staff and never judged
[The HUM IOP] was great, I learnt so much
I am very satisfied with the services I receive at HUM. I feel that I am recognized and acknowledged by the staff…I feel very comfortable coming to HUM and appreciate the team approach. In closing, I must say that I feel very supported by the professionals at HUM.
The HUM group is a great asset for any person struggling with addiction as well as the complicated issues that surround them.
I really like how open the staff are. They are easy to connect with and talk to.
The IOP is awesome! This was life changing for me
I appreciate the attitude that recovery is approached with
The IOP provides fantastic support and the feeling that problems are manageable, there is hope in recovery, and it is never too late to seek help