Enchanted with Chemicals Larry K. Brendtro · Stanley Coopersmith (1967) Significance Competence Power Virtue UNIVERSAL HUMAN NEEDS Attachment Achievement Autonomy Altruism. Emmy

Enchanted with Chemicals

J. C. ChambersLarry K. Brendtro

in memory of

J. C. Chambers

Stronghold Counseling

Academy for Seniors

September 19, 2018

Enchanted with Chemicals

J. C. Chambers

This presentation available at reclaimingyouth.org/handouts

Enchanted with Chemicals

J. C. Chambers

Marketing of Drugs

Weller than Well

Adversity and Drugs

The Vital Balance

The Brain and Drugs

What is most important for a happy life?

Children and elders are held in great respect..

The village is responsible for rearing children.

Leaders use power to serve the people.

Resources are shared to meet needs of all.

Indigenous Wisdom

Blackfoot Child Rearing

Abraham Maslow

1938

Sioux Child Rearing

Erik Erikson

1938

Indigenous Cultures Treat Children as Sacred Beings

The old are dedicated to the

service of the young as their

teachers and advisors, and

the young in turn regard them

with love and reverence.

Ohiyesa

[Charles Eastman]

The Soul of the Indian, 1911

Circle of Courage Values

Medicine Wheel is by Lakota Artist George Bluebird

Belonging

Mastery

Independence

Generosity

1

What is the active ingredient for healthy children, families and communities? Junlei Li

1. Strong emotional bonds

2. Increasingly complex tasks

3. Shifting power to learner

4. Relationships of reciprocity

Attachment

Achievement

Autonomy

Altruism

Developmental Relationships

Urie Bronfenbrenner

Hierarchy of NeedsAbraham Maslow (1943)

Belongingness Esteem Self- Actualization Self-Transcendence

Resilient BrainsAnn Masten (2014) Attachment Mastery Motivation Self-Efficacy Spirituality/ Purpose

Resilience Research Bonnie Benard (2004) Social Competence Problem Solving Autonomy Purpose

Native ValuesMartin Brokenleg (1990) Belonging Mastery Independence Generosity

Roots of Self Esteem Stanley Coopersmith (1967) Significance Competence Power Virtue

UNIVERSAL HUMAN NEEDSAttachment Achievement Autonomy Altruism

Emmy

Werner

Quechua Children

From the moment I entered their village, I was captivated by their respectful behavior, self-confident demeanor, and astonishing creativity.

Inge Bolin

Vancouver Island University

BelongingLoneliness is seen as the saddest experience so all are included in circles of respect.

Mastery Children are eager to learn and achieve but never flaunt their superiority.

IndependenceYouth are given important responsibilities and are never harshly punished.

GenerosityYouth care for younger children and contribute to the community.

Humans lived in egalitarian cultures as hunter gatherers for 99% of history.

Christopher Boehm

The Survival of the Fittest Most Generous

The Social Brain and the Spirit of Ubuntu

Humans can only live in harmony in cultures of respect.

Enchanted with Chemicals

J. C. Chambers

Marketing of Drugs

Weller than Well

Adversity and Drugs

The Vital Balance

The Brain and Drugs

Basic needs are common to all mankind and are therefore shared values.

Most “symptoms” of emotional problems are the result of unmet needs.

Abraham Maslow

Addiction: A Medical View from the American Society of Addiction Medicine

Addiction is a chronic lifelong disease that cannot be cured but must be managed like

diabetes, typically with drugs.

That view is challenged by a new science of epigenetics and resilience.

Epi is Greek for on top of.

Throughout life, the brain has remarkable powers to change its structure to cope with challenges.

Both positive and negative experiences redesign the brain, for better or worse.

Kenneth Doidge

Neuroplasticity

Neuroplasticity includes addiction.

Genes and extreme stress make some vulnerable to drug abuse.

And abuse of drugs can lead to changes in many brain areas.

Addiction

Drugs Disrupt Genes

These drugs do not just have the action we are told about but often have much greater effects throughout the body than the one the company markets.

David Healy

University of Cardiff, Wales

ENDORPHINS(Endogenous Morphine)

Dopamine: triggers the brain’s reward and pleasure center

Serotonin: feelings of hope and well-being

Oxytocin: social bonding and stress reduction

Healthy Brain = Happy ChemicalsDopamine Serotonin Oxytocin ENDORPHINS

Natural Endorphins

Relationships

Exercise

Hugging

Laughter

Music

Chocolate

Favorite food

Being in nature

Meditation

Helpers High

Narcotics Trump Endorphins

OxyContin

Vicodin

Fentanyl

Heroin

Enchanted with Chemicals

Substances can become substitutes for fulfilled relationships.

JC Chambers

From Relationships to Drugships

Oxytocin Trust and Bonding

EROS AGAPEPHILIA

Most psychiatric drugs repress oxytocin, the trust hormone that fosters bonding, empathy, and caregiving.

Addictive Drugs Hijack the Brain’s Pleasure System

Ventral Tegmentum400,000 Neurons produce dopamine

Extreme levels of this pleasure chemical flood the habit-forming area.

Tolerance

More drugs are needed to get high—or eventually even to feel normal.

Most Doctors Are Ill-Equipped to Deal With the Opioid Epidemic.Few Medical Schools Teach Addiction.

Problems in Living Become DisordersTreated with Drugs

From 24 disorders in 1978, DSM-5 now has 265 plus modifiers.

DSM mixes biological disorders like autism with diagnostic labels for problems in living.

Surge of “Disorders”

Maybe it’s an Arrow Intrusion Disorder.

Most childhood difficulties are developmental or adjustment problems..

Emotional and behavior problems are viewed as diseases but seldom are caused by brain deficits.

Jon McClellan, MD

University of WashingtonJohn Werry, MD

University of Auckland

Limits of the Medical Model

Drugs for Symptoms

All too often, drugs are prescribed instead of teaching people skills to deal with distress.

Medications only blunt sensations but do nothing to resolve them.

Bessel van der Kolk

Disruptive Mood Dysregulation Disorder

More likely to be medicated

Different Diagnosis but the Same Trauma

Robert Foltz

Post Traumatic Stress Disorder

More likely to get therapy

The conflict of interest between psychiatry and the drug companies is absolutely vicious and obscene.

Ralph Rabinovitch, MD

Pills for Every Problem

70% with a DSM label have at least one other diagnosis—with drugs available for each.

Polypharmacy is unsupported by research, unmonitored, harmful, and even dangerous.

Allen Frances

After alcohol, marijuana, and tobacco, prescription drugs have become the most common substances of abuse.

Opioids prevent pain but now produce more deaths than traffic accidents.

Antipsychotics and anticonvulsants (marketed as “mood stabilizers”) are now prescribed for many conditions.

This “atypical antipsychotic” was a top-selling drug in 2014, producing 7.5 billion dollars revenue from 9 million users.

A fine of 19.5 million for marketing this drug for use with children and elderly is a tiny cost of doing business, less than 3/100 of one percent of sales.

Abilify (aripiprazole)

Clozaril (clozapine)

Etrafon (perphenazine, amitriptyline)

Geodon (ziprasidone)

Haldol (haloperidol)

Loxitane (loxapine)

Mellaril (thioridazine)

Moban (molindone)

Navane (thiothixene)

Orap (pimozide)

Permitil and Prolixin (fluphenazine)

Phenergan, Phenadoz, Promethegan (promethazine)

Reglan (metoclopramide)

Risperdal (risperidone)

Serentil (mesoridazine)

Seroquel (quetiapine)

Stelazine (trifluoperazine)

Thorazine (chlorpromazine)

Triavil and Trilafon (perphenazine, amitriptyline)

Zyprexa (olanzapine)

We have no evidence about the safety of these agents or their effectiveness in controlling aggression. Why are we doing this?

John March,

Duke University School of Medicine

Epigenetics as Side Effects: Drugs & Tardive Dyskinesia

Epigenetic side-effects caused by a drug may persist after the drug is discontinued. Some iatrogenic diseases such as tardive dyskinesia are epigenetic in nature. The

consequences for modern medicine are profound . Csoka & Szyf, 2009, abstract

Abilify Side Effects: Physician’s Desk Reference thoughts about suicide or dying, attempts to commit suicide, new or worse depression, new or worse anxiety, feeling very agitated or restless, panic attacks, trouble sleeping (insomnia), new or worse irritability, acting aggressive, being angry or violent, acting on dangerous impulses, an extreme increase in activity and talking (mania), or other unusual changes in behavior or mood. Abilifymay cause neuroleptic malignant syndrome, a serious and potentially fatal reaction to the drug. Call your doctor immediately if you develop muscle stiffness, confusion, irregular or rapid heartbeat, increased blood pressure, excessive sweating, shaking, and high fever. Abilify may cause tardive dyskinesia, a potentially irreversible condition characterized by uncontrollable muscle spasms and twitches in the face and body.

Off-Label UseOnce on the market, a drug can be prescribed for

conditions or populations that it is not approved to treat. Teresa Carr, Consumer Reports

70% of persons on the DSM-5 Task Force have connections to the drug industry.

Safra Center for Ethics, Harvard University

DSM is not valid and will no longer be used in funded research.

National Institute of Mental Health

Enchanted with Chemicals

J. C. Chambers

Marketing of Drugs

Weller than Well

Adversity and Drugs

The Vital Balance

The Brain and Drugs

Opioid Deaths Now Exceed Traffic Fatalities

OPIOIDSBirth of a Big Lie

“Addiction rare in patients treated with narcotics.”

Hershel Jick

1980

Cited in over 600 Big Pharma-Fueled Reports to Promote Drugs “Medical evidence overwhelmingly indicates that properly administered opioid therapy rarely if ever results in ‘accidental addiction’ or ‘opioid abuse.’”

FDA has limited oversight on the promotion of controlled drugs.

Purdue PharmaAddicts a Nation

Expense-paid “Pain Management” Conferences to recruit professionals for a speaker’s bureau.

Target doctors who prescribe the most opioids.

Purdue agents contact 94,000 physicians and earn an average $77,000 bonuses for their sales.

Patients are given starter coupons for a free 30-day supply of OxyContin.

Promote use for many conditions like back pain.

Hide risks in hired articles and publications.

Directly market drugs to consumers.

The average American TV viewer watches as many as nine drug ads a day, totaling two working days per year.

Side effects include . . .

Big Pharma is More Powerful than the Federal Government

The Sacklers were first investigated by Senator Estes Kefauver in 1962 who found Purdue Pharma had a total system to produce, test, and market drugs while outmaneuvering government regulators.

Purdue Pharma Billionaire Patents New Drug for Opioid Treatment

Richard Sackler whose family owns Purdue Pharma which created the opioidcrisis has now received a patent for a drug to treat opioid addiction.

Financial Times, Sept. 7, 2018

Big Pharma Pays Researchers to Push $1,000-Per-Day Drugs

$240 MILLIONeach year is spent lobbying Congress.

Big Pharma makes

$10 BILLION in annual profits from opioid sales.

Obama’s FDA is a Revolving Door for Big Pharma

Purdue Pharma Lawyer Rudolph Giuliani Gets $1 Million DOJ Grant

Treatment creep.Add new medications without stopping the old.

Diagnostic creep.Prescribe medications for each diagnostic label.

Doctor creep. Patients secure drugs from multiple providers.

Pharma creep.Marketing pills for every human unhappiness.

The Polypharmacy CrisisAllen Frances

Polypharmacy:

“unsupported by research,

unmonitored, harmful, and

even dangerous.”

For example, medicating

youth for bipolar disorder

may shorten their life span

12 to 20 years.

Allen Frances, 2013, p. 107

“Five Poison Pills You Can Replace with Marijuana”

Marijuana World News

Is Marijuana the Next Big Pharma?

Pain Pills

ADHD Pills

Sleeping Pills

Anti-anxiety Pills

Anti-Depressant Pills

Marijuana use dampens the brain’s response to reward over time.

Enchanted with Chemicals

J. C. Chambers

Marketing of Drugs

Weller than Well

Adversity and Drugs

The Vital Balance

The Brain and Drugs

Adverse Childhood Experiences

Household Stress1. Divorce or separation

2. Substance abuse

3. Domestic violence

4. Criminal behavior

5. Mental illness

Abuse and Neglect6. Psychological abuse

7. Physical Abuse

8. Sexual Abuse

9. Physical Neglect

10.Emotional Neglect

Kaiser Permanente andCenter for Disease Control

1. Parent divorce/separation

2. Substance abuse

3. Domestic violence

4. Mental illness

5. Criminal Behavior

6. Psychological abuse

7. Physical Abuse

8. Sexual Abuse

9. Physical Neglect

10. Emotional Neglect

The Impact of Adversity

Adverse experiences are toxic when they interfere with developmental needs. AttachmentAchievement

Autonomy Altruism

Toxic Stress

A child’s brain has no program to cope with maltreatment by caregivers.

Dante Cicchetti

Birth

Death

Chemicals and Autism

John has little speech and flaps his hands while Sam uses his iPad. Drugs used during surgery at 3 months made the difference.

Antipsychotic medications designed to sedate adult psychosis are now widely used with ADHD and aggressive children.

Is Addiction a Learning Disorder?

● Teen brains are primed for pleasureand pleasing friends, hyping risk.

● Kids learn habits for quick pleasure.

● Most end addiction by their 30s.

Maia Szalavitz

At Risk for Addiction

Bold, impulsive youth—often boys—like to try new things.

Sad and anxious persons may self-medicate—typically girls.

Trauma, ADHD, depression, and delinquency also put youth at greater risk.

Mental Disease

The History of Psychiatry: Past, Present, and Future

Karl Menninger

The Vital Balance

Mental Health Weller than Well

Enchanted with Chemicals

J. C. Chambers

Marketing of Drugs

Weller than Well

Adversity and Drugs

The Vital Balance

The Brain and Drugs

J. C. Chambers

1959-2018 J. C. Chambers & Mark Freado

Glance at Problems,

Gaze at Strengths

JC Chambers

There are two kinds of medication: cosmetic drugs and curative drugs….

Every single drug on the shelf of the psychopharmacopoeia is cosmetic.

Martin Seligman

The Circle of Courage: Resilience and Thriving

Should the Goal be Abstinence or Harm Reduction?

Is Drug use a Disorder or a Risky Coping Strategy?

Belonging. Acceptance without judgement.Mastery. Opportunity to listen and to learn. Responsibility. Building strength and hope. Generosity. Helping and encouraging others.

AA Support Groups Meet Basic Human Needs

Positive

27%

Negative

47%

Neutral

26%

Medications

Positive

62%Negative

10%

Neutral

28%

Psychotherapy

ASETS Study: How youth feel about…

Why do teens engage in high risk behavior?

Their emotional brains are surging in the need for excitement.

Their executive control areas are still under construction.

We treat each other with respect.

We help others if they have problems.

We reject all physical or psychological violence.

Circle of Courage in Adelsheim, Germany

George Bluebird

Lakota Artist

The Circle of Courage

Violence includes humiliation and depreciation of the other person.

When we engage in violence, we want to make the other “small” and ourselves superior.

That stands in bold contrast to showing respect to one another.

Project Fördernde, 2017

We used to have fights every day, but now we never fight—we have learned to treat one another as human beings.

Youth in Peer Helping Groups

Many staff used to call in sick because of all the stress of this job—but now we enjoy coming to work.

Corrections Officer

Positive Stress

Tolerable Stress

Trauma

Toxic Stress

The Path to Trauma

Stress

Supports

Strengths

Resilience

The Path to Resilience

Independence

Mastery

Belonging

Generosity

Independence

Mastery

Belonging

Generosity

Independence

Mastery

Belonging

Generosity

Independence

Mastery

Belonging

Generosity

Transformation: The Power of Compassion

Reclaiming Youth SeminarsSioux Falls, South Dakota, July 2019

Enchanted with Chemicals

J. C. ChambersLarry K. Brendtro

in memory of

J. C. Chambers

Stronghold Counseling

Academy for Seniors

September 19, 2018