Substance use is becoming more and more normalised, where society’s approach towards drug use is changing quite fast. This abruptness by which societal change takes place does not always ripple down into properly informed individuals. The use of medicinal cannabis has been a controversial topic which raises a lot of questions and concerns.
To help increase awareness and clarify some of the misconceptions on the 24th September an online lecture was held by the OASI Foundation, entitled ‘Medical Cannabis… Myth or
Miracle? Dr. Aloisia Camillleri, an addiction consultant psychiatrist was the main speaker and this lecture was held in collaboration with the Malta Association for Social Workers and the Malta Chamber of Psychologists. The lecture was well attended, with a total of forty-nine participants, all hailing from different professions, mostly relating to social sciences.
Mr. Noel Xerri, OASI Chief Executive introduced the subject, followed by Ms Gail Debono, a warranted forensic psychologist, representing the Malta Chamber of Psychologists. Ms Debono
spoke about the lack of information regarding medical cannabis, and quoted research which expressed how a large number of professionals require more information in their curriculum as learning professionals. Ms. Kerry Hermitage, a current affairs & PR officer represented the Malta Association for Social Workers, followed Ms Debono’s message, remarking that the issue of medicinal cannabis needs to be evidence based and similar lectures of discussion are essential to help professionals expand their knowledge. She concluded that we need to view issues from a holistic perspective and that it is important that people across the board are all on the same page with regards to information on medicinal cannabis.
Dr Camilleri, the main speaker mentioned that the Maltese Association of Psychiatry are in favour of medical cannabis, only when these is scientific evidence that is beneficial for particular conditions. Conditions that have been backed by research, were medicinal cannabis proved indeed helpful are some types of epilepsy in children, some cancer patients, were medicinal cannabis helped with nausea and lack of appetite, and in some cases of chronic pain. Dr Camilleri remarked that other conditions are only backed with little or no research for one to be able to justify the benefits of medical cannabis. Currently, 1900 people are prescribed medicinal cannabis in Malta.
Dr Camilleri also insisted that medicinal cannabis can be detrimental in some mental health conditions like ADHD, bipolar disorder and depression.
The OASI Foundation would like to thank all speakers, entities and participants for their participation and contribution.
OASI is a non-governmental and not-for- profit organisation with its headquarters in Victoria Gozo. Its operations are deep rooted in the social needs and care of the people with a specific mission to see to the social caring of issues and cases of drug and alcohol abuse and other addictions. The services are open to all and are given free of charge.
Since its very foundation in June 1991, OASI Foundation has continuously created various awareness campaigns and to enhance a positive mentality amongst our community through its slogan Life is beautiful… worth living! Through Social Awareness department has always reached children and youths through innovative ways. Through informal learning, the Foundation can proudly state that it has helped various youths who either were on their first steps of developing an addiction or was an eye opener to seek help to overcome their addiction. More than that, OASI has offered treatment and rehabilitation to hundreds of youths in difficulty to find their way to recovery.
Over the years, the Youths 4 Youths project has always been a huge success with children who attended where they had a great time while learning invaluable lessons. HSBC Malta Foundation
has been supporting the Foundation since 2013, with the organisation of the Youths 4 Youths project. The aim behind this project is to target Gozitan children and help them socialize with others through edutainment activities, while also providing a safe and healthy learning environment. Despite, the recent uncertainties we have faced this past year due to the COVID-19 pandemic, this year remarked the 8th edition of this event. We also had 34 young participants whose ages ranged between 6 to 13 years of age. Thanks to Calypso Trains, youths were transported to the Government Experimental Farm in Xewkija, and toured around the premises which provided insight on indigenous fauna and agricultural methods.
Thereafter, the children were back to OASI where they had a quick break and the opportunity to get to know one another. Sports games were also organised by Ms Mary Angie by which we aim to promote a healthier lifestyle, both physically and mentally. At the end of the activity, a certificate of participation was awarded to the children for their attendance. This activity will ultimately help children to view the OASI Foundation not only as an institution, but as a safe place where people can seek help if they should ever be involved in any social problems.
The OASI Foundation would like to thank HSBC Malta Foundation for the sponsorship along the years, as without its help, such an activity would not be possible.
What happens during drug dependence and what are the leading factors? There are in fact several factors which contribute to substance dependence, including societal, biological, environmental factors, age of first use, and family history, just to name a few. In this article however, the main focus will be the biological factor, more specifically, what happens in the human brain when someone makes use of substances.
Neurotransmitters: what are they?
First things first, the route of communication in the brain is through chemical messages also known as neurotransmitters. Drugs, including alcohol interfere with these neurotransmitters, which of course, might have a detrimental effect on the brain. One of these effects affect what is known as the pleasure/pain centres in the brain. Our brains have been wired through a long process of evolution and a will to survive, to wherever possible, maximise pleasure and minimise pain. Ultimately, this is an adaptive behaviour which is necessary for us to survive. Therefore, it is necessary to feel good while we eat, otherwise we might not find it necessary to do so. On the other hand, it is essential that we feel pain when we touch fire or a hot item, otherwise we would not be aware of imminent danger which would possibly be life threatening.
How do drugs affect the brain?
Drugs affect the brain by signalling the brain to create a high of pleasure leaving the person feeling temporarily confident, creative and amused. Of course, this artificial high will interfere with the brain’s natural reward system, including natural survival processes. It is fair to mention that not everyone who tries out a drug will end up becoming an addict, however, it is impossible to predict who is at more risk. Studies show that the more one uses drugs the more neurobiological changes than place inside the brain. Therefore, the best solution for this would be not to attempt drug use in the first place. After some time interfering with this pleasure/pain centre, together with drug withdrawals and the general consequences of drug use, it becomes increasing difficult to produce the same effect. Hence, the user would now need to up the dose of that drug or shift to a more potent drug and all of this, is to feel normal or pain free. The person who once sought drugs infrequently for bouts of temporary pleasure, is now making frequent, if not daily use of drugs to get rid of pain.
Moreover, the longer the person stays in the dependence stage, the harder it is for them to stop albeit not impossible. If a person however, decides that they will stop using their drug of choice and make use of another drug, they might risk entering the world of cross addiction or else a relapse.
Would occasional use be a good idea?
Some people who have had a hard time with drugs might tend to think that they will somehow learn to control their use and that they will resort to a strict schedule, where they will only make use of their drug of choice on the weekends or once a month. This is indeed rarely possible, over a long period of time. The reason behind this is that as long as a person keeps playing with fire, they are bound to get burnt. What works best seems to be total abstinence from both alcohol and drugs. As mentioned before, one drug can lead to another. You may have never had a problem with marijuana or alcohol, but if you start using them, you might 1. Get addicted to them or 2. Lead you back to your drug of choice. Furthermore, treatment is about learning new coping skills and adopting a new way of living. If a person wants to keep making use of some substances but others, would they be learning new skills and learn to live independently?
Process of addiction
- Drugs can be introduced by friends, family or romantic relationships. The person might also experiment for various reasons.
- The first few attempts at drug use are usually negative experiences.
- The user starts to believe that they are in control of their use and that they can still manage school, work, family life etc.
- Some people stay in this stage for a lengthy period of time.
- The person actively searches for the drug and ensures that they have a steady supply for them use.
- Find it difficult to enjoy a social occasion or deal with life stressors without it.
- May start to drop out and isolate themselves.
- At this stage, substances have become a significant part of someone’s life.
- Activities which the person enjoyed before are no longer enjoyable.
- Financial and legal difficulties might come in which force the user to beg, steal or illegally make money to feed their addiction.
- Lie to family members and loved ones about their whereabouts and their activities.
- Users can also deny that there is a problem.
Of course, with drug and alcohol use there are several risks and consequences. We can agree that the worse scenario is indeed death, were the person is not granted a second chance to try again, attempt a rehabilitation program, focus on the positives and enjoy a healthy and sane life. Overdoses can be intended or unintended.
It is never too late to seek help. Recovery is a tough journey, it requires hard work, trust, communication and a strong support system but these are all worth it. Additionally, the first step is always the hardest, yet if the first step does not happen, there cannot be the second, the third and the fourth.
The OASI foundation can offer this help. If you or a loved one are going through this difficult journey, reach out to our foundation and we will together discuss what help we can offer to deal with the hardships and pain of an addiction.
Eating disorders are increasingly on the rise. This is worrying as studies show that young people between the ages of 15 and 24 who suffer from anorexia are 10 times at risk of dying compared to their same-aged peers. These disorders may unfortunately not be taken seriously which only brings despair, anger and frustration on the person going through them We will look into six specific diagnoses: (1) Pica, (2) Rumination Disorder (RD), (3) Avoidant/Restrictive Food Intake Disorder (ARFID), (4) Anorexia Nervosa (AN), (5) Bulimia Nervosa (BN), and (6) Binge Eating Disorder (BED).
Those who suffer from pica consume items that have non-nutritional value and this is the only Eating Disorder that can be diagnosed together with another eating disorder. A person with pica might eat paint chips, stones, paperclips, metal scraps and other objects which indeed can potentially lead to poisoning, brain damage, nutritional deficiencies, blockages in the digestive tracts, infections and tears in the lining of the oesophagus or intestines.
People with rumination disorder regurgitate food and then either chew it again, swallow it or spit it out. People with this disorder might manage to hide it and they may experience guilt and shame. Some symptoms include repeated regurgitation of food, weight loss, bad breath and tooth decay, indigestion and stomach aches.
Avoidant/Restrictive Food intake disorder entails a broad set of eating disorder behaviours. The person refuses to eat a food item, however, not because of physical limitations. Although similar to anorexia in terms of intense restrictions on the amount and type of food one eats, people with ARFID are not preoccupied with how they look, their shape or their size. Someone with ARFID consumes little calories for their bodies to work properly which leads to weight loss, dizziness, trouble concentrating, weakened immune system, feeling cold and low iron and thyroid levels. Other symptoms might involve shame or difficulty eating around others, fears of choking and dressing in several layers to hide weight loss or retain heat. Anxiety disorders, those on the spectrum of autism, and ADHD can also be linked to ARFID.
The most known eating disorder is anorexia nervosa which manifests itself by intense fear of gaining weight which most often leads to starvation. Although the person might lose a lot of weight and look thin and malnourished, there is still a perception that they are overweight. This disorder often develops during puberty and the majority of suffers are female. Psychological, environmental and social factors can contribute to the development of anorexia. The sufferer beliefs that life would be much better if they were thinner. Self-esteem is based on how your body looks, might lead to insomnia and a relentless obsession over weight gain. Other signs include excessive worrying about food, dieting and calories, excessive exercise, no interest in social activities, lie about how much food has been eaten and avoiding eating in public.
Bulimia nervosa involves a binge on food, followed by purging later on. Someone with bulimia might not lose a lot of weight. Eating is out of control and excessive, and the person purges with the intention of not gaining weight from the food that has been eaten. Binging can make the person feel ashamed however purging brings with it a temporary false sense of relief. Naturally, it is hard on the digestive system and dehydration, mineral imbalance can lead to heart or kidney problems. The stomach can be affected due to repeated vomiting together with hormonal problems, acid reflux and tooth and gum disease. The brain is also affected and is it often linked to depression and anxiety.
Binge eating disorder is when someone overeats compulsively as a way of coping with emotions or stress. It is an ongoing psychological problem and a vicious cycle were the person binges to relieve tension or numb negative feelings, only to feel the negative feeling again soon after. The person loses control and might hoard food and eat it secretly. This can be accompanied with unusual food rituals and abnormal eating patterns. Complications include obesity, sleep apnea, high blood pressure, shortness of breath, diabetes and heart disease.
Eating disorder treatment depends on your particular disorder and your symptoms. It typically includes a combination of psychological therapy, nutrition education, medical monitoring and sometimes even medications. Eating disorder treatment also involves addressing other health problems caused by an eating disorder such as anxiety, stress and regulation of emotions. Remember that help is out there and professionals will be ready to help you manage your problem and regain control over it.
The following are Step 6 to Step 12. At OASI, these steps are worked with a sponsor or their counselor once a person finishes the residential program. This does not mean that the following steps are of less importance than the first five, in fact, it is highly recommended that recovering addicts continue working on all the steps.
Step 6: Were entirely ready to have God remove all these defects of character.
- At this stage character defects, such as dishonesty, resentments, impulsivity, and pride are recognized.
- Once a person accepts these character defects, it does not mean that these defects will disappear as this is a process that requires time and effort.
Step 7: Humbly asked Him to remove our shortcomings.
- This is when one starts trying to change their character defects
- This requires a person to be open-minded, humble and faithful
- Communication with one’s Higher Power and Sponsor is also important
- This is also a process that takes time.
Step 8: Made a list of all persons we had harmed and became willing to make amends to them all.
- This is when a person starts to identify the pain, they had caused others during their active addiction
- Discussing these issues with a sponsor could be quite helpful and is recommended
- There could be an instance were trying to make amends would hurt the involved person even more and one realizes that it would be more considerate to not do so. For this reason, not all amends can be made.
Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others.
- This is the actualization of the previous step.
- If amends are made verbally, one needs to ensure that their actions reflect this and a change in behavior follows.
- Making amends must involve sincere efforts to apologize and adopting the right attitude before making an approach is essential.
- Talking through these amends with a sponsor could be helpful as they can discuss how it could be done.
Step 10: Continued to take personal inventory and when we were wrong promptly admitted it.
- This step continues to build on Steps 4 and 9.
- This step requires the person to keep a personal inventory of what they are going through.
- This is an important part of recovery as it allows the person to analyze the reasons behind decisions they make.
- This allows the person to strengthen and protect their recovery as well as keep a good relationship with themselves.
Step 11: Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- This is Step 2 and 3 being practiced on a daily basis.
- This is spiritual rather than religious and the purpose of this Step is to connect with your Higher Power.
- The way in which a person prays or meditates is not important. What’s important is the effect these practices leave in a person’s life.
Step 12: Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
- During this step, the focus shifts from ourselves to others.
- This involves sharing your experiences with others who might be going through similar situations.
- The last of the 12 Steps is to carry the message to others and to put the principles of the program into practice in every area of life.
- This has several benefits as it reminds recovering addicts of their early days in recovery and keeps them concerned about their own recovery.
While going through the 12 steps, it is important to remember that addiction recovery is a lifelong journey that requires work and dedication. One can never really say that they are finished with the program. Some might even decide to start the steps from the beginning again but this obviously depends on the person’s needs.
The 12-step recovery program was originally created in the 1930s and its main focus was alcoholism. Since then, the program has been adapted to several types of addictions, including drugs and gambling. AA’s 12-Step approach follows a set of guidelines designed as “steps” towards recovery. Many have found that these steps were not merely a way to stop drinking or using drugs, as they eventually became a guide towards a new way of life.
Step 1: We admitted we were powerless over alcohol and that our lives had become unmanageable.
- Understanding and accepting this step is very important
- The concept of powerlessness is crucial to the 12 Step program
- Although a simple step, admitting powerlessness and unnameability is not always easy
- Denial can be a strong impediment at this stage
Step 2: Came to believe that a Power greater than ourselves could restore us to sanity.
- This step is about finding something outside of ourselves that inspires and helps us remain clean and sober
- One does not need to be religious to work this step but Spirituality is important
- Members are not required to accept someone else's concept of God, only to trust that there is a power "greater than themselves" however they wish to describe it or understand it
Step 3: Made a decision to turn our will and our lives over to the care of God as we understood Him.
- This step requires action
- Letting go and acceptance are integral to this step
- Change will not occur overnight as this is a process
Step 4: Made a searching and fearless moral inventory of ourselves.
- This step consists of a detailed personal inventory of one’s good and bad qualities
- This step allows for a clearer understanding of one’s self as it allows for self-reflection
- This is not an easy step as it involves exploring past experiences and emotions
- Complete honesty is crucial when doing Step 4
Step 5: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- During this step, the contents of Step 4 are discussed
- At this stage, certain patterns and behaviors might become apparent and this helps the recovering addict start understanding themselves better
- A sense of relief is usually felt after this step and the person can continue to let go
At OASI, these first 5 Steps are done while the recovering addict is still doing the residential program. However, the remaining Steps are just as important and it is recommended that the recovering addict continues to work them with their counsellor or a sponsor once the residential part of the program is finished.
Nowadays whenever anyone wants to look up something, we have the Internet which easily accessed due to the advances technology has made. While this is a good thing, it can also lead to some misinformation to someone who does not look through the information properly and this is something which occurs a lot with addiction and drug use. This article will help us to debunk any myths regarding drug use and focus on the facts surrounding these myths.
Myth: “All drugs are addictive” – True
Fact: Yes, all drugs are addictive as they affect the brain’s reward centre where a flood of dopamine and the person using experiences a high so the brain will want to experience this again. There is no evidence that a person will get ‘hooked’ on the drug after one or two uses, however some drugs create dependence much quicker than others. It also depends on the person who is using the substance and their disposition to substance abuse. There are a lot of things which affect addiction and it is difficult to pinpoint the exact moment when a person becomes dependant on the substance they use.
Myth: “You have to use drugs for a long time before they can really cause damage” – False
Fact: Drugs can cause the brain to malfunction and send the wrong signals to the brain and body and in worst case scenarios, can potentially lead to difficulties breathing, heart attack, coma or death. Drugs also affect our behaviour significantly and this can lead to the person doing certain things which can lead to them engaging in risky behaviour. This can happen on the first time the person makes use of the substance.
Myth: “Drugs relive stress. They help deal with problems” – False
Fact: Drugs only make the person forget about their troubles and problems. Naturally, this does not mean that the initial problem has been solved. So once the drug wears off, the problem is still there for the person to deal with and sometimes more problems come up as a result of this. For others, having the initial problem together with an addiction, might lead to an increase in substance abuse, which worsens the issue even further.
Myth: “Addicts are bad people who do not try to stop” – False
Fact: Addicts are people who develop drug dependence due to multiple factors surrounding the individual. Something which is important for everyone to understand is that addiction is a chronic disease and it is not a choice. No one uses drugs to become an addict. Genetics play a big role, and a person will be physically more prone to become dependent on substances. The environment of the person also affects addiction as well as other factors which link together such as certain traumas that the person might have gone through. Addiction does not discriminate against anyone.
Myth: “As soon as a person feels normal, all the drug is out of the body” – False
Fact: While the amount of time for the person to feel normal again may not seem that long, traces of the substance can still be in the body for quite a long time. This depends on quite a number of things such as gender, weight, age and the substance used. For example, cocaine can be found in the body up to one week after use and marijuana can be found up to 3 months after use.
It is easy to read through myths surrounding drugs and believe what is written, however, it is important that one reads through information which is factual.
Being afraid it a natural instinct, we all experience fear. Most active addicts will contemplate recovery as this is something new to them, and with new things, comes along new challenges, new obstacles, new fears and what ifs’. Fear is a sign that you are ready to meet the unknown and face a new life free of substances.
By choosing recovery, you will experience fear, and it’s not just one fear, but you will find yourself facing quite a few fears as you take your first steps on the road of recovery. The beautiful aspect of recovery is the fellowship, and this will provide you with much needed support and comradery.
The initial steps of recovery encourage you to start to realize how powerless and unmanageable your life was when it came to your addiction. Fear of relapse is one of the common fears; is it worth it after all, if the chances are, I might relapse? Everything is worth it if it will benefit you. Frankly recovery will require a change in lifestyle however the rewards that you will reap make these changes worth it.
In a disjointed way, addiction is comfortable for the addict as they feel that drugs and alcohol help them deal with reality. This is what is known as the Big Lie. It is however this same addiction that convinces you this so as to keep you hooked in a vicious cycle. The change that was mentioned previously includes a change in lifestyle, attitudes, friends, places, and so on. The fear originates from the fact that the only reality they know is that of their addiction, and making this change is indeed scary. However, change is both good and healthy.
Withdrawals are an addict’s worst nightmare; the sweats, delirium, body aches, hallucinations, paranoia, nausea, vomiting, anxiety, and so on. Some addicts do not opt for recovery as they fear their withdrawals, however, with a good support system and medical supervision, it can help you overcome this fear. Keeping in mind that withdrawals are finite and that they will end after a few days, will help you feel better and keep you motivated to overcome it. Withdrawals are a consequence of your addiction, and a concept of insanity comes into play, as one would never choose to go through this nightmare again. Going through withdrawals can help you realize the battles you have fought to be in Recovery; and it is not worth it to risk something good for a negative outcome.
Going through active addiction, we have a lot of regrets towards what we have done to our loved ones. Being in recovery entails facing reality as it is and realizing that we cannot hide behind drugs and alcohol. Therefore, facing reality can manifest itself as another fear in recovery. Being so accustomed to twisting reality and emotions with drugs and alcohol, reality now can become overwhelming, and thus we need to accept reality as it is and find our own ways to deal with our own reality in a healthy way. Self-help groups such as Alcoholics Anonymous will help us understand our new reality and will provide us with the needed support to face our reality without fears.
But…will I get bored of being in Recovery? Will I find it boring without the thrill and excitement of substances? One cannot compare life in recovery with life in active addiction, as the two are opposites. You cannot compare the highs of drugs with the highs of recovery. With recovery you learn more about who you are without substances. Recovery is not easy, just like with anything else that’s worth it, it takes time and effort to maintain it.
It can be very overwhelming going into rehab for the first time; thoughts and feelings start to pound on you; What will I expect? What can I do and what is forbidden? It is completely normal, to feel anxious or nervous, excited and eager to start working towards your recovery, perhaps also angry, that you have reached this point of exaggeration in your life, together with a mixed array of confusing thoughts and emotions.
The alarm goes off at 6am, giving time for the fellows to wake up and get ready for the morning meditation at 6.30am. As soon as that is over, we put on our walking shoes and we are off for a morning walk at 7am just round the neighbourhood to get our hearts’ pumping early on in the day. Arriving back to the premises, breakfast is prepared and we all sit down for the most important meal of the day. Fostering a healthy lifestyle is key for recovery.
Then it’s 10am, we gather around for the first group of the day, The Feelings Group. Entering this group for the first time can be a bit intimidating as this is the time where the person is asked to remove their masks and render themselves vulnerable to their insecurities and paths that led them to the red chair they are sitting on. Do not fear this as this is the stepping stone you need to start uncovering what has led you to your present situation. You will relate to others, and others will relate and find comfort in you. After a few groups, you will start to wonder, ‘maybe I am not alone and people can indeed understand what I am going through.
Being in recovery is more than just not using; it’s an ongoing process of growing together with healing mentally, emotionally, physically, and spiritually. It is also a process of acquiring daily living skills such as cooking and doing chores. Keeping yourself and your surroundings clean helps you to have a clear mind and that is why at 11.15am, the fellows start to clean the residential home. Tasks are assigned and everyone gets to do their part for the benefit of the whole group.
During recovery, the body will go through many changes and thus, the benefits of eating healthily can give the body a better chance of recovery as it will increase your energy levels. Lunch is prepared and at 1pm, fellows and staff sit down for lunch together.
After lunch, the dining area is cleaned and you will have some time to relax and prepare yourself for the second group of the day. At 2:30pm, The Afternoon Groups are never the same. This is because they are centered around a specific purpose, such as Goal Setting Group, Honesty Group, Peer/Group Evaluation, and Week Evaluation. These types of groups will help you to focus one thing at a time and gives you a space to work on yourself with the help of the other fellows’ feedbacks.
The evenings vary according to what day it is, and you have the time to be more at ease and work on your therapeutic pamphlets and do some readings. You gather with your fellows again to have dinner together at 7.15pm, and then watch the news at 8pm. At the end of every day, you have the chance to keep a personal journal, also known as the significant events, to keep track of how your day has evolved. Finding time to relax and unwind is also imperative for one’s recovery. Fellows can enjoy a game of UNO together and have a good laugh before retiring to bed at 9.45pm.
That’s about it, a general day at OASI. However, we cannot leave out other activities that might be enjoyable by the fellows which vary throughout the week. Going to the beach during summer and watching movies during the weekend are two things that fellows look forward to.
But simplifying a day in a rehab does not give it justice, because every day is a different day with new challenges that we must learn to face. However, once in recovery, you are never alone and finding help and support from the fellowship is a benefit that you will have access to in times of need.