Alcoholism: There’s no cure, but there is a test

Addiction and Recovery

By Bob Gaydos

Living in a world in which seemingly anything one might want is just a click away, it’s easy, maybe even natural, to assume there are quick fixes for everything. A robot for every chore. A cloud for every data storage problem. A pill for every illness.

Not yet. Sorry, alcoholics, there is still no pill that cures alcoholism.

It’s not for a lack of trying, to be sure. While research continues to find the magic pill, thus far the U.S. Food and Drug Administration has approved three medications to treat what is referred to clinically as alcohol use disorder or alcohol dependence. The FDA says the medications are non-addictive. According to the National Institute on Alcohol Abuse and Alcoholism, they are:

• Naltrexone, which is used to treat opioid addiction, but some researchers say can also help people reduce heavy drinking. It is available in pill and long-acting injectable form. Researchers say it acts in the brain to reduce the craving for alcohol in those who have already stopped drinking. However, treatment with naltrexone is not enough on its own. NIAAA says the medication was reported to be effective when combined with counseling, psychotherapy, and alcoholism support groups.
• Acamprosate, which the Substance Abuse and Mental Health Services Administration (SAMSHA) says makes it easier for some who have already stopped drinking to stay stopped by reducing withdrawal symptoms such as anxiety, insomnia and restlessness, that may follow lengthy abstinence. Of course, counseling, psychotherapy, and alcoholism support groups might help in these cases also.
• Disulfiram (Antabuse), which blocks the metabolism of alcohol by the body, causing unpleasant symptoms such as nausea, headache, sweating and flushing of the skin. The idea is you will get so sick if you drink alcohol while taking Antabuse you won’t want to drink alcohol. Or, as some alcoholics decide, you won’t want to take Antabuse. It’s the nature of the disease.

There are complications, starting with the fact that each individual is different, meaning some medications might work for some and not others. For example, according to SAMSHA: “Patients with liver damage usually cannot use either naltrexone or disulfiram. However, because acamprosate is not metabolized in the liver, patients with liver damage can safely take the medication.” All the medications have a variety of possible side effects.

Also -- and here’s the major stumbling block for many with a serious alcohol problem -- for each of the treatments the optimal recommended situation is that the person is abstinent at the beginning and is committed to recovery. That may mean detox and, for many, in-patient or out-patient treatment. It also means being honest with your doctor and rehab counselors about your goals, actually being willing to stop drinking and not looking for a quick fix for your problems.

Having a primary care doctor who has more than a cursory understanding of alcohol and drug abuse is an excellent starting point, especially if medication-assisted treatment is to be involved. This doctor must screen patients to determine the level of alcohol use, assess the need for or appropriateness of medication-assisted treatment, develop a treatment plan, choose an appropriate medication and monitor patient progress. If your doctor is unable or unwilling to do all this and you want to try medication-assisted treatment, he or she should refer you to one who is.

But remember, none of these drugs cures alcoholism. They are designed to help manage a chronic disease by discouraging or reducing alcohol intake. That’s obviously crucial, but on its own is not necessarily recovery, which is generally defined as avoiding the trouble associated with drinking as well as avoiding the alcohol itself.

This being a disease of the brain, it is recommended that some kind of counseling or support group accompany the use of these medicines.

It’s also important to know that, while there may not be a magic pill to cure alcoholism, there is a way to help determine a diagnosis of alcohol use disorder. The NIAAA offers a test that you can take:

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In the past year, have you:

• Had times when you ended up drinking more, or longer than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
• Spent a lot of time drinking? Or being sick or getting over the aftereffects?
• Experienced craving — a strong need, or urge, to drink?
• Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
• Continued to drink even though it was causing trouble with your family or friends?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

Your score: Mild: The presence of two to three symptoms. Moderate: The presence of four to five symptoms. Severe: The presence of six or more symptoms.

Be honest with yourself and -- as the test suggests -- acknowledge your drinking’s effect on others. That’s key, whether you call it alcoholism or alcohol use disorder and whether you use some pill to treat it or not.

bobgaydos.blogspot.com

Facebook has an algorithm problem

By Bob Gaydos

Algorithms are cool. I get it. I mean, I get that they’re cool, not how they work. I like to think that, if I had to, I could probably work really hard to understand them, but I dropped out of engineering school to do this. No regrets.

In fact, writing about life in all its complexities has given me an appreciation for what people -- real people, not some numbers-crunched algorithm people -- have to deal with on a daily basis. It has exposed me to the value of compassion, compromise and common sense.

Our universal dictionary, Wikipedia, defines an algorithm as “an unambiguous specification of how to solve a class of problems. Algorithms can perform calculation, data processing and automated reasoning tasks.”

But they can’t, obviously, do ambiguous.

I’m thinking about algorithms because Facebook, an Internet empire built on them, recently said it was going to hire 1,000 people to review ads in response to the embarrassing revelation that users’ news feeds during the 2016 U.S. presidential election were awash in political ads run by Russians, undoubtedly using their own algorithms to target various groups in an effort to influence the outcome. Facebook said Russians bought about $100,000 in ads -- with rubles -- but apparently the social media giant’s algorithms detected no ambiguity afoot with Russians arguing to protect Americans’ Second Amendment rights or stirring up anti-gay feelings, not in Moscow, but in the American heartland.

Congress is investigating. That’s good. It should do something this year. But Facebook has more than a Russia problem. It has become the major source of news for millions of Americans, yet its news feeds have been shown to be awash in fake news. Lots of really fake news, not Trump “fake news,” which is real news.

Facebook -- actually Mark Zuckerberg -- is talking about becoming a more responsible source of reliable news information and hiring “content moderators” to review, well, content, and a lot of additional people to look out for violent content on the site. Swell. 

If you will permit me a self-serving observation, he’s talking about hiring people to exercise judgment over what appears publicly on Facebook because: (1) algorithms can’t think or feel like people and (2) this is how responsible newspapers have operated forever. Just saying.

In the interests of full disclosure, I also will say I have had my own personal experiences with Facebook algorithms. Recently, I received an e-mail telling me that an ad I wanted to run boosting a column on a Facebook page I administer was rejected because it had too much copy. It didn’t say the copy was boring or poorly written or even offensive. Just too much of it.

OK, I’ve had editors tell me the same thing, but I was also never prepared to give an editor ten bucks just to run the column. Oh yeah, the ad in question was proposed in July. I got the rejection e-mail on Halloween.

Then there’s the friendly way Facebook greets me every day with news of the weather in Phillipsport. “Rain is in the forecast today, Robert.” Thank you. If I Iived in Phillipsport it would matter a lot more, but it’s a half hour drive and there’s a big mountain range between us and my page unambiguously says where I live. Can’t the algorithm read?

But the incident that really convinced me that Facebook had an algorithm problem was its response to a complaint I filed regarding a post that was being sarcastic about the dotard-in-chief. I am guilty as charged of leveling (much-deserved) sarcasm at the Trump, but this cartoon had him in a coffin with a bystander saying to Melania, “‘Sorry about the assassination, Mrs.Trump, but he knew what he signed up for.”

As a “content moderator” for newspapers for several decades, I would never let such a tasteless, provocative, potentially dangerous item to be published. I told Facebook the same thing. I said they should delete it. It encouraged violence at a violent time in our history.

The algorithm replied that the post did not violate Facebook’s standard of, I don’t know: Acceptability? Appropriateness? Decency? Who sets this pathetic standard?

I use Facebook a lot. It has many wonderful benefits. But “automated reasoning” is not a substitute for good old, gut-instinct common sense. It’s the best way to connect people with people. Maybe people cost a little more than algorithms, but I think Zuck can afford it and there are a lot of laid off editors looking for work. If it’s not fake news that he’s serious about running for president some day, he’ll be glad he did it.

I’m also curious to know what Facebook says if I decide I want to pay to boost this post. I wonder if they’ll let me run a picture of Zuck. Can I even call him Zuck?

Stay tuned.

bobgaydos.blogspot.com

Fly me to the moon ... please!

By Bob Gaydos

"Planet X"

Trump thinks he’s an emperor.

Secretary of State Rex Tillerson and about 70 percent of the country think the president is a moron.

Of that remaining 30 percent, a sizable portion believe Hurricanes Harvey, Irma, Maria and the earthquakes that rocked Mexico were god’s vengeance on humankind for (a) the mere existence of gays, lesbians, bisexuals and transgender persons and (b) the idea that such persons should be allowed the same rights as “normal” people. Others in this group take it as fact that there were a pair of dinosaurs on Noah’s Ark.

This is by way of reporting, in case you missed it, that Nibiru once again failed to live up to its hype. This is not disappointing, but it is getting old.

If you somehow missed it, Nibiru is a “giant planet,” supposedly discovered by the Sumerians, which, according to one translation of ancient Babylonian texts, passes by Earth every 3,600 years to allows its inhabitants to interact with earthlings. NASA says it's a hoax, but the prediction has evolved (or mutated) into Nibiru (also called Planet X), flying into or close by Earth, causing cataclysmic problems. That was supposed to happen in May 2003 and again in December of 2012. 

Also, Sept. 23 just passed. Missed again, although the “end of times” had been predicted by David Meade, a conspiracy theorist and self-proclaimed "Christian numerologist" who must have miscalculated, as did all those web sites dedicated to Nibiru.

It’s the interactive fly-by of Nibiru that caught my attention, though, not the hellfire and brimstone and rising tides theory. One would have to think that any celestial visitors these days would only have to slow down enough to take a peek at the headlines and decide to come back in another 3600 years when maybe we had our stuff a little better together.

Some people, however, are not willing to wait that long for contact with beings from elsewhere in the universe. Doug Vakoch is one of those. The president of METI (Messaging Extraterrestrial Intelligence) is moving along with announced plans to send messages to stars with planets thought to be capable of sustaining life. First transmissions are scheduled for next year, despite warnings from some noted scientists that in sending messages rather than just listening for them he may be inviting trouble in the form of nasty aliens, as portrayed in many science-fiction movies.

Vakoch and his crew of serious scientists dismiss those portrayals as the result of active imaginations and a situation for which we have no actual data. “One of the reasons people are so afraid of METI is that it seems riskier to do something than to do nothing,” he says.

Ironically, one of those who have voiced warnings about METI is Elon Musk, CEO of SpaceX. Musk is not the sit-around-and-wait -for-things-to-happen type.

Last month, as earthlings were breathing a sigh of relief at having been spared the wrath of Nibiru once more, Musk was in Australia at the annual meeting of the International Astronautical Congress moving up the deadline on his intent (some say pipe dream) to launch a manned mission to Mars. He’s talking 2024. Yes, seven years. Employing a really big rocket with lots of powerful engines, his plan is to launch two cargo missions to Mars in 2022 and four missions in 2024, two cargo and two with crews. Eventually, the goal is to create a colony, with the rockets transporting 100 people per trip.

Paying for his grand plans is always a question with Musk. He says he figures on building lots of rockets (smaller than his original plan) which can also be used to fly people to Paris or London or Tokyo instead of just Mars. He says his system could move people between any two cities on this planet in less than an hour, for an appropriate fee of course. People would be the payload on the Mars rockets, also. Investors welcome.

Closer to home, Musk says the really big rocket could be used to take people to the Moon. “It's 2017, we should have a lunar base by now,” he said in Australia. “What the hell is going on?”

Well, sir, as stated above, the president (whose business advisory councils you quit and who named a climate-denier to head NASA) thinks he’s an emperor, the secretary of state thinks he’s a moron and 30 percent of Americans -- some of whom think dinosaurs were on Noah’s Ark -- are apparently still OK with all that.

So, Messrs. Musk and Vakoch, if you don't mind, let’s get those rockets and inter-planetary messages going quickly, before the emperor declares war on Nibiru.

bobgaydos.blogspot.com