November 30, 2017Whether it’s drugs, alcohol, smoking, food, gambling, working or shopping, addiction is costly to individuals and society, said Dr. H.E. Logue, a psychiatrist, who presented the CCHS Alice McLean Stewart Endowed Lecture on Addiction Nov. 10. In Alabama last year, addiction cost the criminal justice system $436 million and the healthcare system $300 million, he said. Addiction can also contribute to such co-morbid illnesses as borderline personality disorder, bipolar disorder, schizophrenia and general anxiety disorder, said Logue, founder and president of Affiliated Mental Health Services Inc. in Birmingham. His presentation was titled Understanding Addiction: Yours, Mine, Ours. Logue said the “big three” of addiction are smoking, alcohol and opiates. In 2016, there were 51,000 opioid deaths in the US and that number is expected to be repeated this year. “That’s 102,000 deaths in the last two years, Logue said. He said there are three stages of addiction: exhilaration, withdrawal and anticipation for more. “It’s an ongoing problem that never really goes away. The body never forgets’ it’s always there.” Logue noted the difference between addiction and dependence. He said addiction is an insatiable desire for a substance that overpowers and neutralizes judgement and behavior in a way that is detrimental. Dependence is use of a substance or behavior to alleviate pain. There are treatment options for addiction, he said, including Alcoholics Anonymous, 12-step programs, outpatient and inpatient programs and pharmacological treatments. The Alice McLean Stewart Endowed Fund for Addiction Education was established in 1994 by Alice McLean Stewart to promote addiction education at CCHS through the creation of a lecture series. Stewart received a bachelor’s degree in home economics from The University of Alabama in 1941 and a master’s degree from the University of Chicago in 1942. She taught in the Tuscaloosa City School System and Partlow State School from 1960 to 1988. The Ernest Cole Brock III Endowment for Continuing Medical Education Performance-enhancing substances can improve athletic strength and speed, but they carry significant risk to health and sports, said Dr. John Lombardo, the NFL’s drug advisory for anabolic steroids and other performance enhancing drugs. “That’s why they’re banned – because of the adverse health effects, and to create a level playing field and protect the integrity of the game,” Lombardo said. Lombardo provided the CCHS Ernest Cole Brock III Endowment for Continuing Medical Education lecture on Nov. 17. His talk was titled Performance Enhancing Substances. Lombardo listed some of the more common performance-enhancing substances. There are anabolic steroids, which are synthetic substances related to testosterone that promote the growth of skeletal muscle. Stimulants are another, and can include amphetamine, ephedrine and pseudoephedrine. Lombardo described stimulants as “effective and dangerous,” explaining that they work to stimulate the central nervous system, giving athletes enhanced reaction time and the ability to fight fatigue. But they can also cause seizures, cardiac arrest, gastrointestinal problems and dependency. Supplements, often consisting of herbs and plant derivatives and extracts, are another performance-enhancing substance used in sports. The US Food and Drug Administration does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed. “No independent agency is verifying the ingredients so you’re taking something no one has tested,” Lombardo said. He said up to 20 percent of supplements contain non-labeled substances that could cause a positive drug test. “We tell athletes to beware of supplements and don’t take them, but they will take these, they always do. There’s a fear factor. They’re so intent on getting better they’ll try anything.” Lombardo said there are times when substances that enhance performance are used for therapeutic reasons and exemptions are granted “recognizing that there are medical conditions for which they might be needed,” treating injuries and ADHD being a few. Most exemption are granted prior to use, not retroactively, “like after a positive test,” he said. The Ernest Cole Brock III Endowment for Continuing Medical Education lecture series was established by Ernest Cole Brock Jr., MD, and his wife, Hannah Brock, with the goal of educating health professionals about the treatment of concussions and other sports injuries. They created the fund to honor the memory of their son, Ernest Cole Brock III, who died in 1999 at the age of 36. The late Dr. Ernest Cole Brock Jr. was an orthopedic surgeon who practiced for many years in Tuscaloosa and a longtime physician for the Alabama Crimson Tide.