The Case for Recognizing Post Traumatic Stress Disorder as a Purple Heart Injury

The Case for Recognizing Post Traumatic Stress Disorder as a Purple Heart Injury

Receiving a Purple Heart in recognition of a veteran’s bravery and sacrifice is a cherished honor among military families. Traditionally given out by the Pentagon in the name of the sitting president, Purple Hearts formally recognize the physical injuries and sacrifices an individual endures in combat, including death.

But not all of the most disfiguring injuries our veterans experience during their service are physical, and the lasting effects of mental health disorders originating in combat are sorely underestimated and often ignored. If severe cases of post-traumatic stress disorder (PTSD) are capable of destroying someone’s ability to live a normal, healthy civilian life, why aren’t veterans with this condition considered for Purple Heart awards?

One reason may be a poor understanding of what trauma and post-traumatic stress disorder are and how they function. Trauma refers to an event that an individual perceives to be a serious threat to his/her life coupled with an intense feeling of being helpless to protect him/herself or prevent the threat from occurring. Post-traumatic stress disorder sets in as the brain develops new, often unhealthy responses to stimuli in an effort to prevent the trauma from recurring.

In the context of active duty personnel, trauma is the experience of being shot at, seeing a friend killed in combat, or running over an IED (improvised explosive device) and witnessing others be maimed or killed while one survives. Post-traumatic stress disorder following one of these events could look be intense feeling of anxiety anytime one hears sounds resembling gun shots, or sudden and vivid flashbacks to the traumatic event. If left untreated, post-traumatic stress disorder can drive a veteran to drug addiction, social isolation and/or suicide.

Some military officials worry, though, that if PTSD becomes an injury that makes soldiers eligible for a Purple Heart, individuals may be incentivized to fake these symptoms in order to receive the award. Others maintain that Purple Hearts are intended to memorialize the specific experience and ramifications of physical injuries received in combat, and that recognizing psychological injuries should necessitate an entirely separate award. Some health professionals advocate for the recognition of PTSD caused by combat trauma by linking it to head injuries received while on active duty.

At the heart of all these officials’ concern over expanding the group of injuries that make one eligible for a Purple Heart is a deep desire to respect and remember the extreme sacrifices of those willing to fight and die for our country.

Recognizing the psychological extent to which veterans are wounded by their military service would not dilute the meaning of the Purple Heart; on the contrary, it would deepen our understanding of how high a price so many have paid to protect our nation. As an award that recognizes severe injuries incurred on the battlefield, the military would be right to consider awarding veterans with combat-related post traumatic stress disorder a Purple Heart in honor of their sacrifice and bravery.

Between a Rock and a Hard Place: 3 Reasons You Can’t Ignore Trauma

Between a Rock and a Hard Place: 3 Reasons You Can’t Ignore Trauma

 

When you face difficult times, you have two options: work through the difficulty you’ve encountered or try to avoid it. For many who have lived through a traumatic experience, going around or burying traumatic memories can feel like the only feasible way to move forward. But whether we acknowledge or try to ignore them, our experiences continue to affect us long after they’re over; trauma is no different. Here are three reasons why you can’t ignore traumatic experiences and why you shouldn’t try.

 

  1. Trauma eviscerates your relationships with others. It is healthy and functionally necessary to trust others. This is obvious in everyday situations, like trusting the driver of a car stopped at a stop sign not to run you over as you cross in a crosswalk, but it’s especially important when it comes to close interpersonal relationships. Because a key component of many traumatic experiences involves the violation of trust by a loved one or a loved one’s inability to follow through on a promise, ignoring a traumatic experience you’ve had will make it difficult to form close bonds. For example, if a parent or loved one abused you, you may no longer trust that another person whom you care for deeply and depend on will not treat you the same way. Yet, avoiding feelings will leave you even more isolated from the people best positioned to lift you up and affirm your innate dignity as a human being.

 

  1. Trauma can be passed on. Our minds and bodies deal with traumatic experiences by creating new coping skills, some of which go on to harm us once we’ve returned to more normal conditions. A recent study published by researchers from the James J. Peters Veterans Affairs Medical Center has shown that the children of holocaust survivors, particularly those survivors who entered concentration camps and endured prolonged periods of starvation when young, have inherited biological markers of trauma survival. Specifically the holocaust survivors were seen to have a deficient amount of cortisol, an enzyme usually released by the body when stressed, and this deficiency was passed on to their children who in turn developed a surplus of other enzymes to compensate, and ultimately affected their health for the worse. Confronting your traumatic experience may be the most difficult thing you’ve ever done, but if you want to ensure your future children do not suffer for the wrongs others have done to you, it is imperative that you try.

 

  1. Only you should control you. No one asks for something bad to happen to them; sometimes things just happen to us and we are left to pick up the pieces. It is natural for a big event in our lives to inform our future decisions, but a traumatic experience can sometimes begin to interfere with activities we once loved. If you avoid the trauma you’ve experienced, you are empowering it to inform your decisions to an extent you are unaware of. Your life should be about what you want, not what you want to avoid.

 

You can work through difficult, traumatic life events. Processing your experiences with a therapist, close friend, or in another way that feels right for you, will lead to a fuller life for you and your children, and will decrease your use of unhealthy coping mechanisms, including substance abuse. By acknowledging your own traumatic experience, you’ll take back the narrative of your life and ensure that only you get a say in who you become.

 

 

Therapy and Horseplay: Four Things You Need to Know about Equine Therapy

Therapy and Horseplay: Four Things You Need to Know about Equine Therapy

When it comes to equine therapy, I’ll be the first one to advocate for its use. I’ve been an avid rider all my life, and there were many times I walked away from the barn feeling more relaxed and rejuvenated, and emotionally healthier and stronger, than when I left my therapist’s office. Horses are simply good for the soul. But put the two practices together, therapy with horses, and it can be an almost magical combination for those who have issues with addiction or trauma. The Guardian recently released an article exploring the benefits some recovering addicts and trauma survivors can reap when engaging in certified equine therapy. Please note that equine therapy is not just playing with or riding horses, but a specific kind of psychotherapeutic practice that involves the use of horses, mostly from the ground. If you’ve never heard of equine therapy or you’re not sure if it’s right for you, read on for four reasons you should consider trying it as a supplemental form of short-term psychotherapy.

  1. Horses are hard-wired to tune into you. Horses are herd animals by nature, which means they’ve learned to survive by being hyper-aware of and caring for the other animals around them. The Guardian reports that they can sense a human heart beat from up to four feet away and are capable of mirroring their body language and even their heart beat to match yours. Just like in human-to-human interactions, when an animal you’re interacting with copies your actions it creates feelings of being heard and supported. Car salesmen sometimes use this technique to close sales, but when you encounter the same technique in a therapy horse it has the effect of making you feel validated and safe.

 

  1. Interacting with horses can boost your self-esteem. As animals that sometimes weigh in excess of 1,000 pounds, horses and their innate physical power can be intimidating. Interacting with a therapy horse under the guidance of a licensed equine psychotherapist can help you to build rapport with your horse and overcome the fear that they will harm you just because they can. Working with a horse means learning to trust. Building confidence in the therapy horse spills over into a greater confidence in yourself and your ability to manage risks while staying safe.
  1. Horses don’t judge. It can be difficult to communicate a dark element of our past like a trauma we’ve experienced or an addiction we feel shameful of to even the most open and accepting of listeners. One of the many benefits of building a relationship with a therapy horse is that they do not ask questions or judge you for what you have done or experienced. Highly attuned herd animals, horses meet you where you are in the moment, whether you’re feeling confidant and peaceful or weepy and bleak.
  1. There is no right way to heal. Whatever your reasons for seeking out therapy of any kind, methods that resonate deeply with you are more likely to be beneficial than methods you think you “should” respond to, like traditional talk therapy. If horses are not your thing to begin with, equine therapy may not be the right fit for you. But don’t limit yourself to only certain methods of healing; everyone is different and everyone should find the activities and techniques that help them the most. Equine therapy, usually used short term, can have dramatic positive results.

Whether you grew up going out to feed the horses every day like I did or you’ve never touched a horse before in your life, equine therapy is an excellent therapeutic option for anyone struggling to build or rebuild their coping and communication skills and self confidence in the wake of trauma. Even those who think they have it all would benefit from having a loving friend who will “listen” to their troubles without question or judgment. What better way to prepare yourself for life’s ups and downs than building a relationship with a living being that will be there for you through hay or high water?

The Risks of College Age Drinking

Intervention for binge drinking in college has shown to be successful, but only for a limited time according to research published in the APA Journal of Consulting and Clinical Psychology. A total 1,040 college students participated in a twelve-month study by James Henson, PhD, a psychology professor at Old Dominion University. He concluded that “brief prevention efforts can be effective but may require colleges to implement intervention boosters to maintain these effects.”

The study found:

“At the one month follow-up, most students (82 percent) reported drinking less than before the intervention. However, most of these participants (84 percent) also ended up increasing their drinking over the following 12 months until they were back to baseline levels.”

This illustrates the importance of continuing education warning about alcohol related consequences. Early and regular prevention is a viable and practical method for teaching young people about the dangers of excessive drinking, especially in this high-risk age group.

Consider the following information reported by the National Institute on Alcohol Abuse and Alcoholism.

  1. Death: 1,825 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries.
  2. Assault: More than 690,000 students between the ages of 18 and 24 get assaulted each year by another student, who has been drinking.
  3. Sexual Abuse: More than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape.
  4. Injury: 599,000 students between the ages of 18 and 24 receive unintentional injuries while under the influence of alcohol.
  5. Academic Problems: About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall.
  6. Health Problems/Suicide Attempts: More than 150,000 students develop an alcohol-related health problem and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use.

It is evident that alcohol related problems involve not only those who do the drinking, but their actions can negatively affect other people in life-changing ways.

A popular new program at some colleges is promoting students not to experiment with drinking at all.

Students must already be sober and sign a “commitment contract” that they will stay clean throughout college through a well-outlined plan of structure,” according to a recent story in the New York Times.

There are now 135 Collegiate Recovery communities on campuses all over the country. They are geared to support students in recovery from addiction who are seeking a degree in higher education, by sharing the goals of providing personal support, preventing occurrences of relapse, and promoting academic performance. While “sober” colleges are promising ideas, for now this is not the reality on campuses today.

The Neurological Differences in Men and Women Smokers

Yale researchers have pinpointed a different brain response between male and female smokers by analyzing dynamic brain scans. This study marks the first time that PET (positron emission tomography) scans were used to create “movies” of how smoking affects dopamine, the neurotransmitter that triggers feelings of pleasure in the brain. This could lead to developments in gender-specific treatments to help smokers quit.

A new image analysis technique produced a novel multidimensional endpoint: voxel-level temporal patterns of neurotransmitter release in individual subjects. Scientists then combined this analysis technique with high-resolution brain scanning and high frequency motion correction to create the optimal experiment for capturing and characterizing the effects of smoking on the mesolimbic dopamine system in humans.

By examining these endpoints quantitatively, researchers demonstrated that the timing of dopaminergic responses to cigarette smoking differs between men and women. Men respond consistently and rapidly in the ventral striatum whereas women respond faster in a discrete sub region of the dorsal putamen.

The studies main finding is that male smokers activate dopamine in the right ventral striatum during smoking but female smokers do not. This finding, men activating more ventrally than women, is consistent with the established notion that men smoke for the reinforcing drug effect of cigarettes whereas women smoke for emotional reasons, such as mood regulation and cue reactivity.

According to Kelly Cosgrove, lead author of the study and an associate professor of psychiatry, diagnostic radiology and neurobiology at the Yale School of Medicine:

The study gives those developing smoking-cessation tools new insights into how to target men and women differently.”

Before this study, the neurological basis for the differences between the genders and smoking behavior had eluded researchers. These differences explain why men respond to nicotine replacement therapies such as the patch better than women do, and why women can have a harder time quitting smoking than men.

The effect could be far-reaching. Although strides have been made in helping people quit, smoking continues to be a major health issue. Cigarette smoking is responsible for more than 480,000 deaths nationwide each year, according to the Centers for Disease Control and Prevention. Men who smoke are 25 times more likely than nonsmokers to get lung cancer, while female smokers are 26 times more likely.

Although the Yale study was small, the findings were significant. This will encourage more research into gender specific programs and more treatment options.

Talk to your physician for information on alternative smoking cessation programs. Individual plans can offer long-term success and a healthier lifestyle. It is never too late to benefit from quitting the habit of smoking and reduce the associated health risks.

Can You Thrive After Childhood Trauma?

Recovery from traumatic events is never easy. However, humans are amazingly adaptable. Unfortunately, survival does not mean thriving. A person can survive traumatic events and be scarred for the rest of their life. Trauma affects children particularly profoundly. Children do not just get over trauma; they live with the consequences for a lifetime.

Children adapt so they can cope, but if they are emotionally overwhelmed, their brain goes into survival mode, which changes the way it grows and develops. An early traumatic experience has a profound effect on the way in which a child’s brain forms and functions. A brain that grows in response to a perceived threat is in overdrive and senses threat everywhere. Stress causes the brain to work too hard, too often, for too long. This creates a foundation for psychological distress and mental illness later in life.

Studies over the past 40 years found children who have been through abuse or extreme stress have higher rates of depression, anxiety and other mental and physical problems than other children do. Nevertheless, few scientists have attempted to understand the biology of what was occurring in the brains of these traumatized children. A growing, international field of study revolves around the ways early experience becomes embedded in the body and brain, and how those embedded traits change the brain’s function.

Charles Nelson is a researcher at Harvard’s Center for the Developing Child, who believes the notion of early brain plasticity is particularly compelling. He claims:

“By plasticity, we simply mean the brain’s ability to be molded by experience. And we have an expression that plasticity cuts both ways, meaning that if it is a good experience, it is probably good for the brain. But if it’s a bad experience, it may be bad for the brain.”

Nelson found that children who grew up neglected had less electrical activity in the brain and smaller brains overall than their peers; they had lost brain cells as well as the connections between those cells. This damage was present for a lifetime.

If certain healthful experiences do not happen, like appropriate nurturing or boundary setting, the brain does not know how to wire itself. There are many theories on how positive and negative experiences rewire the brain.  It is a mystery how some people withstand profound early adversity and seem to come out just fine, while others continue to suffer. Is there something neurological that allows for this difference or is the difference environmental? We know that with the right long term therapy, kindness and support, children can often change their brain function and life-outcomes.

There is growing empirical support for the efficacy of trauma focused cognitive behavior training (CBT) in decreasing psychological symptomology in abused or neglected children. Major components of trauma-focused cognitive behavioral therapy (CBT) for children and adolescents are exposure, cognitive processing and reframing, stress management, and parental treatment. Evidence now supports the success of many alternative and holistic treatment methods also.

Treating childhood and adolescent trauma can prevent or decrease the likelihood of developing future mental health conditions. Left untreated, brain dysfunction can eventually lead many to self-medicate with drugs and alcohol, risking addiction, depression and possibly suicide. Seek professional advice if you or a close family member have experienced a difficult situation or event. Recovery is possible with some effort and the correct help.

We Can Only Do So Much

Today, I am in Rio de Janeiro, Brazil. I am here to attend the Global Addiction conference, to present on some of the reasons why addicts around the world are denied access to care and to give a call to action that researchers do what we can to change that. It has been an exciting conference with the sharing of good ideas and a heated, yet respectful exchange of opinions. Still, I was given a stark reminder that we can only do so much to help those in need.

 

Yesterday, I went to Ipanema to visit the “Hippie Market.” It’s a beautiful market in a square just off the beach in Ipanema, where artisans and artists sell their wares. I love folk art, so I was very much at home. In the center of the square are the painters, probably fifty or sixty, selling their work. The center around the fountain is an explosion of color, with scenes of the crowded city, Christ the Redeemer, dancers, and others gracing the walkways. The colors were made more intense yesterday by the overcast sky and coming darkness.

 

In this vibrant scene, I found pain. Along one path was an older man selling colorful scenes of guitar players and children on the soccer field. His work was lively and inviting. He motioned me over, which I obliged. Though I had just gotten off the plane and wanted a nap, I had gone to the market because it is only open on Sunday and this was my only Sunday in town. In other words, I wasn’t in the market for a painting, I had just gotten to town, but I was certainly willing to chat.

 

Upon getting closer, I realized that the man was almost completely deaf. I couldn’t tell if he was deaf from birth. On the one hand, he barely spoke above a whisper and I could not make out one word of what he mumbled. On the other hand, he did not try to sign to me, as two other deaf merchants later did. In any case, I spent some time with him, letting him show me his paintings and indicating to him that I appreciated his work.

 

But he did not need my appreciation. He needed my money. It was clear as he pitched his paintings, pitched them harder than any other merchant I would meet that day, he needed a sale. The trouble was that these are paintings – and paintings of this size and type in the market go from $100 – $250 or so. I had only brought about a hundred bucks, to buy beads or baubles as children’s gifts. I probably could have talked him down, but a) I didn’t need a painting and b) I don’t like to haggle like that with artists. I don’t haggle on the price of my books and so I don’t expect others to haggle on the price of their work.

 

After a short time, I walked away to enjoy the rest of the market. Later though, just before I left, I caught a glimpse of the man, sitting forlorn behind his stall his head in his hands. He needed a sale and he likely wasn’t going to get one.

 

I have felt uneasy about this all night and into this morning. I honored the man too much to give him money without making a purchase. He wasn’t begging and I wasn’t going to insult him. At the same time, I’m here on a budget and I can’t throw down money every time I see someone in need. My uncle reminded me that there is only so much we can do and sometimes we cannot do anything at all. I don’t like any of these realities. The image of this forlorn artist will stay with me for a long time. But there are no do-overs. When the Hippie Market opens again for business, I will be home and he will once again try to sell his paintings.

America is Voting on Marijuana

A recent poll from The Huffington Post and YouGov claimed that more respondents were in favor of legalizing marijuana than were opposed to it. Results showed a favorable public bias, with 70% of respondents supporting the legalization of medical marijuana compared to 17% that opposed it. Legalizing marijuana as a whole saw a slightly tighter vote, though 51% of respondents were still in favor of making it legal, compared to just 34% who said it should not be legal.

Just because the public’s perception of marijuana is rapidly evolving does not mean we necessarily have all of the pertinent facts about the drug. It is not hard to find conflicting reports on whether marijuana is a drug that helps or hinders users. There is a dangerous misconception that researchers have a handle on marijuana’s risks versus benefits profile.

Although anecdotal reports abound, few randomized controlled studies support the use of medical marijuana for psychiatric conditions. The meager evidence for benefits must be carefully weighed against the documented risks, particularly for young people who use marijuana.

A Harvard Mental Health Letter points out a number of psychiatric risks associated with marijuana use, including addiction, anxiety, mood disorders, and other forms of psychosis. The letter also alludes to studies that have suggested long-term marijuana use can lead to “persistent cognitive problems.”

However, some studies have suggested that medical marijuana could be a critical component to affordable healthcare. A consensus exists that marijuana may be helpful in treating certain carefully defined medical conditions. An abstract published by JAMA Internal Medicine in August found that in the states where medical marijuana was considered legal through 2010 exhibited a nearly 25% reduction in opioid-induced overdose deaths. This is a significant number of saved lives.

The truth is we really just do not know a lot about marijuana’s benefit versus risk profile because, as a schedule 1 drug, there simply has not been any reason for the U.S government to support ongoing research into its effects, be they good or bad. This will change in the future.

In Oregon, Alaska, and Washington, D.C., voters will decide whether to approve marijuana for recreational use, while Floridians will weigh in on whether it will become the 24th state to approve marijuana for medical purposes. Clearly, marijuana use is here to stay and science needs to be allowed to catch up with research for the benefit of all.

Stemming the Rising Tide of Heroin Abuse

Why has heroin abuse skyrocketed, who is using it, and what can be done about the problem? Prescription opioids abuse data suggests the reason for a resurgence of heroin use in America.  According to the Journal of the American Medical Association (JAMA):

“Today’s typical heroin addict starts using at 23, is more likely to live in the affluent suburbs. They are often unwittingly led to heroin through painkillers prescribed by his or her doctor.”

Accidental prescription drug overdose is now the leading cause of acute preventable death for Americans, even more so than deaths from car accidents. Many addiction professionals have suggested for years that individuals who become addicted to prescription painkillers commonly move on to illicit heroin use. This is due to the expense and difficulty of continuously obtaining prescription medications. When individuals can no longer obtain their prescription opioids, they often switch to heroin. A large percentage of those users are appalled to find that the heroin they use is not as strong as their prescription drugs. This too can lead to overdoses. All around, the situation is tragic.

In August 2010, an abuse deterrent version of OxyContin became available. Within two years, the choice of OxyContin as a drug of abuse went from 35.6% to 12.8%. That was the good news; the bad news is that the same study showed heroin use nearly doubled in the same period. Addicts started turning to heroin as the easily-abusable form of OxyContin became unavailable.

The abuse of opioid pills and heroin are both taking a tremendous toll on our communities. A representative with the National Institute on Drug Abuse (NIDA) recently claimed that nearly half of young people who inject heroin say they abused prescription opioids before turning to the illegal drug. Heroin, a street drug, is unregulated, usually impure and often injected. As a result, IV heroin users suffer from collapsed veins, abscesses, infections of the heart lining and valves, and rheumatologic diseases. From sharing needles, IV heroin users are more likely to suffer from HIV, Hepatitis and other diseases.

Regardless of whether opioid drugs are prescribed pills or heroin, the amount of drugs available is shocking. Tom Frieden, the director of the CDC remarked recently about prescription pain medication:

“We found that health care providers in 2012 wrote 259 million prescriptions for opioids. That is enough for every American adult to have their own bottle of pills.” 

Policies to restrict opioid medications, alter them and better monitor accessibility, are increasingly being implemented. While the crackdown on and regulation of these drugs is a good thing, abusers have become more creative, turning to heroin to feed their addiction when prescription pills are unavailable. We need to treat the core cause of drug addiction and make treatment services widely available, not stigmatize those who are suffering.

Grandparents in Need of Help: Addiction and the Elderly

We often ignore troubling behavior in older people, letting these behaviors slide as signs of aging. Forgetfulness, falls or an inability to live alone may come with age, but they don’t have to. They can also be symptoms of substance abuse. Many, many of our aging and elderly family members and friends need help with substance abuse and misuse. The problem of substance abuse among the elderly is only expected to grow in the coming years.

Consider some disturbing conclusions from one study:

Due to the large population size and high substance use rate of the baby-boom cohort, the number of adults aged 50 or older with substance use disorder is projected to double from 2.8 million (annual average) in 2002–06 to 5.7 million in 2020. Increases are projected for all examined gender, race/ethnicity and age groups.

Why does substance abuse become a problem as people get older? As people age, our bodies metabolize substances differently. An individual that has had a nightly glass of wine for years will eventually not be able to tolerate the same amount of wine because our aging organs have increasing difficulty metabolizing the alcohol. This can be dangerous because the process is slow and we may not recognize that a change is occurring.  Yet with time, we will realize that a change has happened. For example, one glass of wine that was previously enjoyed with impunity could after time have the same effect as three or more glasses of wine, with falls resulting. The problem is, instead of recognizing a changing metabolism and an issue with drinking, the falls will likely be blamed on old age and no help will be given to the elderly person.

Is it retirement and perhaps boredom that causes higher rates of substance abuse among the aging? The issue is more complicated than being able to identify a single source of the problem. Peter A. Bamberger and Samuel B. Bacharach, coauthors of “Retirement and the Hidden Epidemic,” conducted a ten year study funded by the National Institutes of Health on substance abuse in older adults. Mr. Bamberger stated:

The impact of retirement on substance abuse was anything but clear cut, with the conditions leading to retirement, and the economic and social nature of the retirement itself, having a far greater impact on substance use than simple retirement itself.”

A number of circumstances can encourage substance abuse in later life. The home may feel too large and quiet after retirement. Loneliness and depression can occur due to loss of a spouse or friends, the end of a career, fewer social interactions, limited mobility, and children living at a distance. Boredom and loss of purpose in life are also triggers for substance abuse.

What are some of the signs we might be missing? Disorientation and memory loss are usually associated with growing older. Very often chemical dependency has similar side effects to dementia. Some medications for diabetes, blood pressure, sleep, pain and anxiety can all affect aging patients more than younger patients. As we grow older and need to take medications for various conditions, these medications in combination with one another, over the counter drugs, nutritional supplements, and/or alcohol, can cause interactions that put a person’s health at risk. All substance use needs to be closely monitored as we age. This means that medical professionals need to ask probing questions about all substance use, particularly with older patients.

For more information on the aging population and substance abuse, watch a lecture I gave at the Jewish Theological Seminary in New York this past June to learn the latest information on addiction in the elderly.