Category Archives: Alcohol Abuse

Lecture: Pain and Addiction: Challenges & Controversies

Past Lecture: Frontiers in Addiction Lectures Series

Presented by Thelma McMillen Center

Pain and Addiction: Challenges & Controversies

May 19, 2015

Hoffman Health Conference Center, 3315 Medical Center Drive, Torrance, CA

8:30 AM Breakfast

9:00 – 11:30 AM Lecture


Mel Pohl, M.D. Medical Director
Las Vegas Central Recovery
Las Vegas, Nevada

Attendees Will:

  • List examples of the complicated co-occurring diagnoses of chronic pain and addiction when they both occur in an individual
  • List implications for treatment interventions with chronic pain with specific discussion of central pain syndromes
  • Describe and show brain mechanisms for the experience of pain and suffering

FREE Continental Breakfast Provided

RSVP not required.
Call (310)-257-5758 for further information.

Torrance Memorial’s Health Conference Center
3315 Medical Center Dr. Torrance, Calif. 90505 (off Skypark Dr; between Hawthorne & Crenshaw)

(off Lomita on Hospital & Technology Dr.), near the Emergency area. SHUTTLE AVAILABLE.

Target Audience: MDs and Psychologists (*), RN (BRN Provider #300), LCSW & MFT (PCE #1881), CAADAC (2S-02-489-0716), CAADE (CP20955C0816) and allied health professionals.

Torrance Memorial Medical Center is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians.

Torrance Memorial Medical Center designates this live activity for a maximum of 2.5 AMA PRA Category I credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This credit may also be applied to the CMA Certification in Continuing Medical Education.

Click here for Torrance Memorial Medical Center events.

Parenting 101

February 2013

1.  My ex-husband is an alcoholic & drug addict and has almost no contact with our two children (12 & 15).  My oldest daughter is beginning to worry me with her recent behavior.  She blames me for her father’s problems, and often talks about how weak he is to have become addicted.  I know some of her friends have been caught drinking and I’m afraid that’s the path she’s headed down.  Is there anything I can do to make sure she’s drug-free?

If your daughter has not had any education on the disease concept of addiction it would be a good thing to make sure she gets.  Addiction is a diagnosable brain disease, not a weakness and whether he is active in her life or not, he is her father and it is important she have a framework for understanding what has happened to him. As far as making sure your daughter stays drug free, there are no guaranteed methods but there’s a lot you can do to increase the chances that she does not damage her life with substance use.  Along with some education on the disease concept to understand her father’s affliction, she needs to understand her own genetic predisposition and the risks associated with it. She needs a very clear message from you stating the family boundaries about substance use and that no amount (alcohol included) is acceptable while she is a minor in your house. You can assist her in building positive aspects to her life; positive passions, hobbies and accomplishments are wonderful protective assets. Keep the dialogue about substance use open, it is not a one conversation issue. One of the most important things is to make sure you are as aware as possible of what she is or is not doing substance-wise. One of the easiest methods is to make a hard rule family tradition that she must give you a hug or a kiss on the cheek anytime she comes home, even if that means waking you up.  A significant degree of intoxication can be hidden by keeping even a small physical distance. If she is close enough for physical contact with you,  it will be much easier to discern if she has been drinking or using.   Finally, both your children would greatly benefit from speaking with a professional drug counselor, especially one that is a recovered addict.  They would be very helpful in helping your children understand the ‘psychology’ of an addict,  and clear up the misunderstanding that you had much to do with her father’s ‘problem’, and how they are at risk if they have similar thoughts as addicts do.

2.  My 17yo son is a good student – popular & gets good grades.  Several of his friends come from very financially successful families and I’ve heard them talk about having parties without their parents – how do I make sure my son understands that just because these friends have money and (maybe too much) freedom, doesn’t make them invincible when it comes to drinking or drugs?

The key to successfully raising children in these very difficult times (difficult because there are so many choices that have lifetime impacts) is communication, communication and communication.  Have frequent talks where you make clear your expectations.  Especially let him know that because you observe him making good choices, even when some of his friends are making poor ones, that you will continue to allow him the freedoms he enjoys, i.e. going to his friends ‘gatherings’ as long as he continues making good decisions. All people, especially teens need constant positive reinforcement to stay on the right path. He may act like he is tired of hearing this over and over, but the truth is it really helps you stay in touch.  Alternatively, if you are truly against his attending his friends’ unsupervised parties, you should make clear your unwillingness to approve his participation in those activities.   Remember,  the feeling of “invincibility” is a normal part of adolescent development.  It is all too easy for them to believe it “cannot happen to me or my friends.”   This means that you must make sure that your son has the information on both the risks of alcohol and drug use, as well as the very real and certain negative impacts it has. There is a lot of solid research showing the negative impacts of alcohol and other substances on the developing brain and discussing that with him is worthwhile.  Unfortunately, it is just not, by itself, tremendously effective. To give your son the best chance at avoiding substance use-driven harms, he also needs an ongoing dialogue with you about substance use and very clear boundaries that no level of such is acceptable while he is a minor in your house.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention.  The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth.  For local resources or more information, please visit our website or if you have questions you’d like our experts to respond to, contact:

Parenting 101

December 2012

1.   My husband and I have one daughter – 8 years old.  She was born to us relatively late in life so we have spoiled her and lavished her with pretty much anything she’s wanted.  Unfortunately now she’s become seriously materialistic and doesn’t seem to appreciate the small things we do for her.  Also, when we expect her to clean her room or do any other chores she has a fit and refuses.  We know this is our fault, but don’t know where to start to fix it.  We need help.

Enabling children is an unhealthy approach for both the parent and child and is done all too often by both older and young parents.  Enabling is often confused with spoiling, which are two different issues.  While spoiling has to do with an individual receiving much more than they need, enabling has more to do with not holding someone accountable for both their behavior and decisions.

The only way to begin reversing the effects, which will be more difficult for you than for her, is to stop enabling.  Make her totally responsible for her actions by enforcing consequences, which imitates the real life of adults. This includes no lectures, criticisms, or judgments, except whether or not she follows through on what she was supposed to do.  Remember, you cannot control her or what decisions she makes, but you control ALL her privileges and freedoms! When she defiantly tells you she doesn’t care if you take her privileges away, and she will, just know that it does bother her or she would not have put any emotion into her response. Apply this to all her responsibilities – homework, cleaning room, taking out trash or feeding the pet, etc. – and tie it all into earning privileges. Give this change in direction some time to process and she will start to come around.  However, expect a great deal of tantrums and poor behavior – neither of which are of much consequence unless she destroys something in the process (i.e. breaks something or calls hurtful names).  So there should also be a consequence in place for being destructive.  She should be allowed to express anger or frustration as long as it is not destructive.

2.   I am the single mom of a 14year old girl who  believes she can make all decisions for herself (including whether she smokes, drinks, or “dates” older boys).  Any time I try to enforce any boundaries, rules, or discipline she takes off and doesn’t come home for hours – and I have no idea where she is.  I have to work and have tried to keep her involved in sports and other after school activities, but so far nothing has worked.  Her father is not involved and I’m dealing with this all alone.  What should I do next?

There are a significant number of very important factors that could be influencing both your daughter’s behavior and your own behavior in a case such as this. Due to those potential complexities we would highly recommended that you seek the professional services of a therapist who specializes in adolescents.  One thing for you to start considering is  how to attend to your daughter’s safety. If you have no idea where she is, who she is with or what she is doing,  and older boys, smoking and/or  drinking are already on the table the risks she may be taking could be substantial. Notification of the authorities if she runs away, and letting her know that they will be notified, needs to be considered. Involvement in the legal system is not something that parents would normally seek, but if you have no control over her comings and goings there is little other option. While the police don’t have the resources to go looking for her,  they will make out a report…and if she is spotted by a policeman they will pick her up and return her home.  If this happens, you will either need to be there, or have an adult there to receive her.  Many PDs will have you call them when she returns home and will come over and explain to her that a 14 year old is not allowed out of the house without permission, and how she may temporarily lose her freedom if  she continues to run away and is taken to a juvenile detention facility

Strengthening of boundaries and consequences will not solve the issue completely though. They are needed, however, and children who do not have them tend to act out (they need them to feel safe), but used alone they either accelerate the problem or simply tamp it down for a future explosion of greater magnitude. There are reasons that your daughter is seeking reward through inappropriate channels. It is crucial that you find out what these reasons are and get  her the appropriate help to address them. There are reasons that your daughter displays the lack of respect that she does towards you. You need to find out what they are and you and your daughter work to address them.  Pick a therapist carefully, ask questions about their assessment of your situation (after a few sessions) until you are satisfied they have communicated to you what they see as the problem and you understand what they are conveying, ask what the treatment plan is (do not settle for general or evasive answers, a real set of goals and objectives and a plan for attaining them is needed).

Remember, all children want to feel loved and accepted.  No criticism or judgment of her. She is always running to her friends because that is what she gets from them – acceptance and a place to belong.  Do your best to create a home that provides what she seeks.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention.  The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth.  For local resources or more information, please visit our website or if you have questions you’d like our experts to respond to, contact:

Parenting 101

November 2012

1.  I know most energy drinks contain lots of caffeine and I’m concerned because my 12yo son and his friends drink them all the time.  Is it possible for them to become addicted to these drinks?  Should they be consuming them at all?  Are there long-term effects?  Thank you for whatever information you can provide me.

Caffeine is a stimulant and all stimulants have some addiction risk. Remove someone who normally has a few cups of strong coffee every morning from those cups of Joe and most will get a low grade headache, which is actually a withdrawal symptom. The levels of caffeine in many “Energy” drinks dwarf the amount in coffee,  and other substances such as Taurine and Guarana are often also present.  Most energy drinks contain very high levels of sugar also. Increase one’s energy and desire for exertion, stimulate their cardiovascular and induce a level of sugar that contributes to dehydration and you can have a very dangerous combination (add alcohol and it becomes incredibly dangerous). Is there anything listed you do not want your child to have? Is there anything that you consider beneficial enough to counterbalance any negatives you found? Does a 12-year old need induced energy?

Like many of the new food fads, energy drinks are controversial. For any foods we eat or drinks we consume, we need to educate ourselves as to what’s in them and how they affect us. Read the ingredients of what is in your child’s energy drink yourself and then do some brief Internet research on what you find.  There you will find a plethora of information both positive and negative. We suggest you discuss this information, in an adult manner, with your children and have them weigh both sides of the information you collect.  It is also a good idea to have them collect their own information and compare it with what you found.  This approach is a great tool  to educate ourselves and our children whenever whenever there are tough decisions to be made that may have long term affects on our lives.

2.  Our daughter is a freshman in college in another part of the state.  We’ve been in consistent touch with her since she left for school, but we’re growing concerned because her calls are becoming less frequent, her grades have slipped a bit, she seems less than forthcoming when we ask her about friends, classes, etc. and now she’s talking about not coming home for the holidays.  What can we do from a distance to make sure she’s safe and stays on track?

When our children go away to college, and are over 18, we have surprisingly little control over their behaviors, activities and whereabouts.  They are, in the eyes of our society, our legal system, and the college, legal adults, even if we consider them inexperienced and not yet ready.  This is the reason that teaching our children how to handle freedom and responsibility must start long before they reach this age.  So depending on how much your daughter learned about these life skills before going away to college will determine how well she handles decisions when she is on her own.

Colleges do not send copies of grades to parents, they do not call or inform parents of progress or problems because they view the student as the person solely responsible for their enrollment decisions regardless of who pays for the tuition or boarding.

However, if you control the money, then you have some power of accountability.  Make sure your child knows that your continued financial support is dependent on having a copy of all grades at the end of each grading period, including passing classes and carrying a minimum number of units.

You should put together an agreement if you have a certain grade average expectation (you can even include when to call, if you feel it is necessary).  There should be a simple understanding that if your expectations and/or agreements are not kept, then they lose the opportunity to attend that school, leaving them with the choice to find their own funding, get a job, or come home and go to community college.  Remember, going to college is strictly a privilege and not a right.  It is not possible to control any of their day to day activities, but it is always possible to hold individuals accountable.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention. The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth. For local resources or more information, please visit our website or if you have questions you’d like our experts to respond to, contact:

Parenting 101

October 2012

My husband and I are currently separated and share joint custody of our 15yo daughter.  My issue is this – I do not want my daughter drinking at all but my husband believes that if he allows her small amounts of alcohol at home, she won’t feel the need to drink outside with friends.  I strongly disagree.  I don’t know how to get my husband to agree on this.

Research (including very recent research) shows that supervised drinking at home has opposite effects to those intended.  For instance a 2011 study, lead-authored by University of Minnesota professor Barbara McMorris, found that teens whose parents allow supervised drinking are more likely to have problems discontinuing alcohol use, have problems at school, problems at home, get into fights, suffer from injuries caused by alcohol, experience “blackouts” or unconsciousness due to extreme intoxication, and have sexual experiences they later regret. This and multiple other studies have shown that allowing in- the- house drinking for teens increases their risks. We would encourage a conversation with your husband based on science and data rather than opinion.  Look up and print out the research and ask him what information he had based his opinion on. Offer to take a parenting class together or see a family therapist together, if necessary, to get on the same page with this issue. Let him know that you know that this is an extremely serious issue for your daughter’s welfare.  It’s essential to remember that when parents, either living together or apart, do not provide a united front, they send contradictory messages to their children.  The result is a huge compromise to the parental front and leadership. Your ex-husband is most likely coming from a place of personal belief that hopefully can be modified by him reading up on the statistics of parents who believe in this model.  Most parents who believe the same as your ex-husband are attempting to win their child’s respect by being the ‘cool’ parent.  No matter what your husband continues to do, always keep in mind that even if your children don’t like that you are too strict, they will, in the end, have more respect for you because they will eventually understand how much you care for their safety.

Our 16yo son participates in several sports and is very popular with this teammates.  I have a growing concern about the number of his friends who’ve mentioned the “meds” they take for pain and injuries suffered during  their games.  He says they don’t share but I’m very suspicious that that is not true.  What is the best way to ensure that he doesn’t use his friends’ medications?  I’m not even sure how to tell if my son is using their meds.

There is no way to absolutely ensure that your son does not use his friends “meds.”  Some “meds” will show up on urine drug tests and some will not. There are some important pieces of information that would be needed to give you the best and most complete answer.  For example, are his friends talking about the “meds” in front of you and naming them? If so,  what “meds” are they taking? Are there reasons for your suspicions that he may have taken the “meds”?  A one-on-one conversation with a knowledgeable local drug and alcohol counselor, or therapist who works with youth, may well have a good return on investment  in helping you find clarity and the best approach to take.  Above all, it is critical that you do your best not to compromise your trust in your child by making unfounded accusations about possible drug use.  Until you have proof, assume the best.  But, do sit down and address your concerns being careful to use ‘I’ statements.  ‘You’ statements almost always come across as accusations.  Explain to him you need a way of finding reassurance that you do not need to worry about the drugs you have heard about.  Ask him for suggestions.  Suggest that maybe he would agree to enroll in the voluntary drug program at school (most high schools now have them).  However, most importantly, keep your communication open and truthful.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention.  The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth.  For local resources or more information, please visit our website or if you have questions you’d like our experts to respond to, contact:

Parenting 101

September 2012

1. My 15yo daughter has always hung out with older kids and it hasn’t been a problem until now.  She’s a freshman hanging out with juniors and seniors and I notice her attitude is getting worse by the day.  Many of them have their drivers licenses  and she wants to be gone all the time, plus I suspect there is some drinking going on as well.  Should I just cut her off from all of her friends?  My house is becoming a war zone.  Help!

As the parent of a 15 year old it is very important both that you know who she is with and where she is.  Additionally,  remember that it is very common for a 15 year old girl to want to hang out with older boys.  Because most girls mature emotionally before boys, many are turned off by the immaturity of the boys their own age.  This situation, created from nature, has made for an age-old dilemma because older peers are involved in riskier behaviors.  If you have suspicions there is most likely good reason. Make it a condition of going out that she greet you face to face with a hug when she returns. Close contact will allow you to get a good idea of whether she is under the influence of anything. It is surprising what level of intoxication can be hidden with even a little distance. Alcohol and automobiles are a deadly combination for teenagers and one you need to protect her from. You can also easily purchase Alcohol Saliva Test Strips, the large advantage of these over urine testing is that you only need observe her not ingesting fluids for five minutes and then have her spit in a cup, no worries about diluting the sample,  no discomfort about restroom observance, and no dealing with the “I can’t go right now” game. If you confirm drinking in any manner then the people she was with should be off limits .  Remember, you are in charge. It is an appropriate time in life for her to test boundaries and want to assert independence.   It is not practical to just cut her off from her friends.  Most often they will just go behind your back.  It is important that your relationship be one of trust and respect.  Therefore it is critical that your daughter’s choices be more closely monitored than those of someone two or three years older.  However, she must feel that the choices she makes are respected.  As long as her choices demonstrate responsibility she should be granted freedom.  It is perfectly reasonable (and responsible) to know where she is at all times, and who she is with – names, phone numbers and parent contacts. Be prepared for resistance and to be unpopular, but do not allow her to verbally, or otherwise, abuse you for exercising what is both your right, and more important, your responsibility as a parent.

2. My husband and I have a fundamental difference as to how to deal with our 16yo son and his growing interest in girls.  My husband kids and jokes and treats it all pretty casually, but I’m concerned because our son seems almost obsessed at times, he’s constantly texting and recently I discovered him in chat rooms with people he doesn’t even know.  I feel very alone with this issue and need some advice desperately.

It is more often the case that parents have some notable differences in the way they want to parent.  Simply put, very few parents were brought up in identical situations or with identical rules.  None of us had a ‘perfect’ childhood, or perfect parents which means we can’t claim exclusive knowledge of how to raise a child. That is why parenting, at best, can be described as a compromise between the way mom and dad desire to raise their children. Your child’s situation provides the perfect opportunity to find a reasonable compromise to deal with the problem.  Find a peaceful environment, somewhere away from your son, where the two of you can sit down and talk about your concerns without judging or criticizing each other’s feelings or point of view.  Knowing that all children need ‘guidance’ with growing up issues, create some ‘guidelines (or rules)’ that will address both of your points of view.  If you discover that you have exact opposing views, then target a view that meets each other half way.  Unless one parent  is advocating something that is illegal or has real potential for harm, all compromises must be  taken seriously. Once mutually constructed guidelines are created you must present  to your son as a united front!  The most important factor here is that your child sees you as both on the same page and in full support of each other regardless of your individual opinion, which you must not share with your child. Later if something does not work, or you anticipate problems, then it is time to meet alone again with your parenting partner to renegotiate.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention.  The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth.  For local resources or more information, please visit our website or if you have questions you’d like our experts to respond to, contact:

Parenting 101

August 2012

1.    I’m curious about these Hookah Bars I see around the area.  Do they have age restrictions?  Is it just “regular” tobacco smoked in them?  Do they serve alcohol, too?  I have two high schoolers and would not like it if they were able to go into those establishments. Thank you.

Hookah bars are subject to the same laws and regulations as apply to other methods of smoking tobacco  (cigarettes, cigars etc.), so these can change from city to city. It is illegal for those under 18 to be sold tobacco products in California and that includes Hookah bars. The tobacco products smoked at Hookah bars are often flavored. Hookah bars, may in some areas allow indoor smoking if their primary business is the sale of tobacco products, similar to a cigar shop/lounge. Any establishment that serves alcohol must follow all applicable state and local laws regarding patrons under age 21. Because Hookah bars do target a younger, generally college age crowd, they are not likely to serve alcohol, although some bars and clubs that serve alcohol have created outdoor hookah areas. Hookahs are just as dangerous and addictive as any other method of smoking tobacco and you are right in not wanting your children to be frequenting establishments that promote it. If there is a particular establishment that you are concerned about, you may want to check what licenses that establishment holds and what state and local laws apply. Selling of tobacco products to minors or allowing minors on the premises, if law forbids their presence, can lead to fines and loss of license for retailers.

2. We have a 4yo son who is very difficult to “control.”  If he doesn’t get what he wants he sometimes goes into a frenzy and throws huge fits (it doesn’t matter where we are).  It’s gotten so bad we hate to take him with us anywhere.  We’ve tried several different kinds of discipline but it seems nothing works.  Is he too young for counseling?  What about spanking?  Help, please.

All children learn different behavioral methods in order to attempt to get the things they want, or believe they want.  In truth, adults do this as well, only children have fewer resources or ‘power’ to be able to get what adults can.  As a result they resort to any behavior that provides them with results.  To a child, a good result is anything that gets others, especially parents, engaged.  A very simple rule of engagement is the more attention you can draw to yourself, the better the chance you will succeed in getting what you want.  This explains why your child goes into a “frenzy,” which is another term for a tantrum.

Your son may be only four years old, but he knows perfectly well that you not only dislike this behavior but it genuinely upsets you and puts him in a position of  ‘negotiating’ with you for things he wants.  It doesn’t matter whether he gets positive or negative attention, they both draw you into his personal drama to the point you will be very tempted to give him what he wants so he will stop.  Research shows that children first learn this type of manipulative behavior at 7 months of age, so at four years old, your son is an old pro.

It begins with small situations that ‘upset’ him, and over the years grows into what can seem like a frenzy.  Your only hope of stopping this behavior, and it can be stopped, is to learn to ‘disengage’ with your child.  When you first begin to ignore this behavior there is a natural reaction of him to increase his frenzied behavior in order to maintain the hook it has on you.  However, if you can hold out, the behavior will begin to fade.

At home, have a designated place where the child is in ‘time out’ until they settle down.  Do not engage in conversation, debate, or give any attention during this time.  If it happens at the market or in a restaurant, simply leave your cart, or excuse yourself from the table, and remove  both you and the child from the immediate environment.  Put him in a place you temporarily can use for time out that is just outside the store or restaurant and explain that he can return when his ‘tantrum’ is over.  You may have to leave early from the store or the restaurant, but these small sacrifices will pay big dividends in the end.

From what you describe of your child, he will be more likely to change when your parenting changes than by listening to words that a stranger (counselor) would tell him.  Children process actions much better than words.  Since you will be the one with him when inappropriate behavior surfaces, you are in a far better position to provide guidance.  While very moderate spanking, that never leaves red marks, may be legally accepted, it has not been shown to improve behavior. The main disadvantage of spanking is that it inadvertently justifies hitting others when we are upset, it sets a negative example for our children, and is totally unnecessary to help children learn appropriate behaviors.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention.  The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth.  For local resources or more information, please visit our website or if you have questions you’d like our experts to respond to, contact:

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