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RTOR.org writes

I remember my struggles with quitting drugs and alcohol quite vividly. I was at a point in my life when chasing intoxicated states was all that I could think about. It was a way for me to escape the negative feelings and the harsh realities of where I was in my life. My thought process at the time was something along the lines of:

Sad? Crack open a beer and light up a joint.

Lonely? Head out to the bar for some social intoxication.

Unhappy? Chase the dragon towards another high to forget about it all.

I knew this destructive behavior would catch up to me at some point, and it finally did. I ended up in jail for two years on drug-related charges. It was there that I decided to finally get sober and quit the habits that had destroyed my life and damaged my relationships.

Quitting drug and alcohol consumption is very much a mental health issue that requires strong emotional fortitude and resolve. I am very proud to say that after 9 years, I am still sober. I have transformed myself into a successful entrepreneur, fitness guru, and a positive force in the lives of my friends and family. I love sharing my story with others and discussing all of the benefits I have experienced from getting sober.

Below, I have prepared a list of the top 5 mental health benefits of quitting drugs and alcohol in hopes that it inspires those who are currently struggling with addiction to take the necessary steps towards sobriety.

1. Enhanced Mental Clarity

During the height of my drug and alcohol addiction, I felt as though everywhere I went I had a grey cloud floating above my head. I was foggy, unmotivated, and unfocused. After I got sober, I immediately noticed that the cloud had lifted. I started thinking clearly about my goals and what I wanted in life. I began seeking out new knowledge and interests, which led to me starting my own digital marketing company. Honestly, it felt amazing.

To this day, I love the fact that when I wake up in the morning, I have a clear intention and focus. Enhanced mental clarity is a great benefit you will receive after quitting drugs and alcohol.

2. Reduced Risk of Mental Health Issues

Did you know that drug and alcohol consumption increases the risk of developing serious mental health disorders such as anxiety, depression, and schizophrenia? Substance use can exacerbate underlying mental health problems. If mental health conditions are something that runs in your family, it’s a good idea to kick any substance abuse habits and quit them quickly.

A lot of people will abuse prescription drugs or alcohol to help cope with their mental health issues, but the reality is, those substances only make things worse. Reducing the risk of mental health complications is another strong benefit you will experience after you quit abusing drugs and alcohol.

3. Better Relationships with Family and Friends

At one point during my struggles with addiction, I realized that my relationships with my family and my friends were suffering immensely due to my dependence on altered states. These are the people that are most important to me, and I realized that I was simply tired of neglecting them in return for short bursts of feeling high or drunk.

After I got sober, I connected with my friends and family in a much more meaningful manner. They have helped me in countless ways during my time being sober, and have inspired me to become the man I am today. Stronger relationships with my family and friends have led to increased happiness and greater purpose in my life. This benefit of quitting alcohol and drugs cannot be emphasized enough!

4. Increased Self-Esteem

It’s funny that after I stopped using alcohol and drugs as a coping mechanism, I felt I had discovered who I truly was as a person. My self-esteem skyrocketed, I gained confidence in every aspect of my life, and I haven’t looked back since. Drugs and alcohol were holding me back from reaching my full potential. Unfortunately, it wasn’t until I got sober that I realized this.

I also got healthier and became passionate about exercise and proper nutrition. These interests helped me advance my self-esteem and emotional strength even further. A huge benefit of quitting drug and alcohol use is an immediate increase in self-esteem. You will feel better about yourself after you quit those destructive habits.

5. Improved Memory

It’s no secret that alcohol and drug use affects cognitive abilities. Talk to anyone after a night of binge drinking and their memory of the night will be an incomplete haze. This also holds true for drugs like marijuana and cocaine. These substances have a profoundly negative impact on your memory.

Instead of hurting your brain with damaging substances in order to experience nights you won’t even remember, wouldn’t you rather create profoundly positive moments that will remain in your mind for a lifetime?

Quitting drugs and alcohol was the best decision I ever made. I have certainly experienced the five benefits mentioned above and cannot emphasize the importance that staying sober has had on my life. If you are struggling with addiction or substance abuse issues, remember all of the great benefits you will receive by cutting these damaging substances out of your life for good.

Have you experienced any of the benefits mentioned above after quitting drugs or alcohol? Which of the above benefits is most important to you personally? Please leave a comment below and share your thoughts!

If you or someone you…

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Project Know writes

Drug or alcohol addiction, or even addiction to both drugs and alcohol, can be treated. Medical and psychological research has determined new ways to help addicts who have the will to recover, get clean and sober, and stay that way.

Getting addiction help usually begins when an addict faces up to his or her addiction problem and realizes that assistance is necessary to fight it. However, even addicts who are forced into getting sober, such as teenagers compelled to enter rehabilitation by their parents or educators, or drug abusers with sentences for drug-related crimes that include addiction treatment, find that they are able to get clean and sober.

Rehabilitation treatment, which can include medical support for overcoming physical addiction and other physical effects of drug and alcohol abuse, as well as counseling to overcome the root cause of an addiction disorder, is the key to getting sober and rebuilding a healthy, drug-free life. Realizing that you or someone you care about needs addiction help is not a sign of weakness. It is a sign of strength, and we are here to help you find the help you need to get clean and sober.

WHY IS ADDICTION HELP NECESSARY?

Substance addiction is a recognized brain disorder that responds quite well to treatment. It is no more a reason for shame or embarrassment than diseases such as diabetes or heart disease, which are both organic and possibly linked to lifestyle factors. A recreational user of…

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Dual Diagnosis writes

The National Bureau of Economic Research (NBER) reports that there is a “definite connection between mental illness and the use of addictive substances” and that mental health disorder patients are responsible for the consumption of:

  • 38 percent of alcohol
  • 44 percent of cocaine
  • 40 percent of cigarettes

NBER also reports that people who have been diagnosed with a mental health disorder at some point in their lives are responsible for the consumption of:

  • 69 percent of alcohol
  • 84 percent of cocaine
  • 68 percent of cigarettes

There’s clearly a connection between substance abuse and mental health disorders, and any number of combinations can develop, each with its own set of unique causes and symptoms, as well as its own appropriate intervention and Dual Diagnosis treatment methods. Which Dual Diagnosis treatment program is the best fit for your loved one?

Self-Medication

By far the most common issue connecting mental illness and substance abuse is the intention of patients to medicate the mental health symptoms that they find disruptive or uncomfortable by using alcohol and drugs.

Some examples include:
  • The depressed patient who uses marijuana to numb the pain
  • The patient suffering from social anxiety who drinks to feel more comfortable in social situations
  • The patient who struggles with panic attacks and takes benzodiazepines like Xanax or Valium in order to calm the symptoms or stop the attacks before they start
  • The patient with low energy and lack of motivation who takes Adderall, cocaine or crystal meth to increase their drive to get things done

Unfortunately, drugs and alcohol often do little to address the underlying mental health symptoms and ultimately create a whole new batch of problems for the patient while also…

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Whitehouse writes

ADDRESSING THE DRIVING FORCES OF THE OPIOID CRISIS: President Donald J. Trump’s Initiative to Stop Opioids Abuse and Reduce Drug Supply and Demand will confront the driving forces behind the opioid crisis.

  • President Trump’s Initiative to Stop Opioid Abuse will address factors fueling the opioid crisis, including over-prescription, illicit drug supplies, and insufficient access to evidence-based treatment, primary prevention, and recovery support services.
  • The President’s Opioid Initiative will:
    • Reduce drug demand through education, awareness, and preventing over-prescription.
    • Cut off the flow of illicit drugs across our borders and within communities.
    • Save lives now by expanding opportunities for proven treatments for opioid and other drug addictions.

REDUCE DEMAND AND OVER-PRESCRIPTION: President Trump’s Opioid Initiative will educate Americans about the dangers of opioid and other drug use and seek to curb over-prescription.

  • Launch a nationwide evidence-based campaign to raise public awareness about the dangers of prescription and illicit opioid use, as well as other drug use.
  • Support research and development efforts for innovative technologies and additional therapies designed to prevent addiction and decrease the use of opioids in pain management.
    • This will include supporting research and development for a vaccine to prevent opioid addiction and non-addictive pain management options.
  • Reduce the over-prescription of opioids which has the potential to lead Americans down a path to addiction or facilitate diversion to illicit use.
  • Implement a Safer Prescribing Plan to achieve the following objectives:
    • Cut nationwide opioid prescription fills by one-third within three years.
    • Ensure that 75 percent of opioid prescriptions reimbursed by Federal healthcare programs are issued using best practices within three years, and 95 percent within five years.
    • Ensure that at least half of all Federally-employed healthcare providers adopt best practices for opioid prescribing within two years, with all of them doing so within five years.
    • Leverage Federal funding opportunities related to opioids to ensure that States transition to a nationally interoperable Prescription Drug Monitoring Program network.

CUT OFF THE SUPPLY OF ILLICIT DRUGS: President Trump’s Opioid Initiative will crack down on international and domestic illicit drug supply chains devastating American communities: 

  • Keep dangerous drugs out of the United States.
    • Secure land borders, ports of entry, and water ways against illegal smuggling.
    • Require advance electronic data for 90 percent of all international mail shipments (with goods) and consignment shipments within three years, in order for the Department of Homeland Security to flag high-risk shipments.
    • Identify and inspect high-risk shipments leveraging advanced screening technologies and by using drug-detecting canines.
    • Test and identify suspicious substances in high-risk international packages to quickly detect and remove known and emerging illicit drugs before they can cause harm.
    • Engage with China and expand…

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Additionally here is what other leaders are saying about his plan!

Members of Congress

Speaker of the House Paul Ryan (R-WI): “The opioid epidemic continues to ravage our communities, and President Trump is right to continue the fight against it. This announcement comes as Congress readies a critical funding bill that will direct more resources to fight this epidemic. By expanding access to treatment and recovery efforts that have proven successful, we can empower individuals to retake control of their lives. And by investing in increased law enforcement efforts, we can empower local communities to address the problem at its root and stop the spread of these deadly drugs.”

House Majority Leader Kevin McCarthy (R-CA): “.@POTUS’ proposals to combat opioid addiction demonstrate that there is ample opportunity to reach a bipartisan consensus. We must stop the tide of this epidemic so the American people can live freer and happier lives.”

Sen. Tom Cotton (R-AR): “It’s good to see the President give the opioid crisis his personal attention, and I will be introducing legislation soon to make sure the people who profit off the spread of addiction receive the punishment they deserve.”

Sen. Shelley Moore Capito (R-WV): “The plan the president announced today is a significant step forward in combatting this epidemic, and it proves that the administration truly understands it is going to take a comprehensive, all-hands-on-deck approach to make real progress in this fight.”

House Energy and Commerce Committee Chairman Rep. Greg Walden (R-OR), Health Subcommittee Chairman Rep. Michael C. Burgess, M.D. (R-TX), and Oversight and Investigations Subcommittee Chairman Rep. Gregg Harper (R-MS): “We welcome the Trump Administration’s proposals and look forward to continuing to work closely with them to combat the deadly scourge. From helping those struggling with addiction on the road to recovery to providing resources to those on the front lines combating the crisis, we see great potential in these ideas, many of which track with our ongoing efforts.”

Rep. Richard Hudson (R-NC): “I appreciate President Donald Trump’s leadership and passion on this issue, and I welcome the president’s proposal. This issue is important to me, and I remain committed to working with the administration, my colleagues, and state and local officials to raise awareness and find ways to defeat this opioid epidemic.”

Rep. Elise Stefanik (R-NY): “The President’s plan today will address many of the factors contributing to this crisis as well as provide support for those who are suffering from addiction and their families. I commend President Trump for making this a top priority for his Administration.”

Rep. Bill Johnson (R-OH): “The President’s bold vision very clearly lays out a plan to reduce drug demand, and prevent over-prescription while scaling up research and development to find alternative non-opioid treatments. It also cuts off the flow of illegal drugs across our borders and within communities, toughens criminal penalties for major drug traffickers, and expands opportunities for proven treatments.”

Rep. Evan Jenkins (R-WV): “I welcome the president’s announcement of new actions and priorities to address the opioid crisis, which has devastated communities and families in West Virginia. The president has proposed a bold stance against the worst drug traffickers in our communities, sending a clear message to dealers who knowingly traffic large quantities of deadly drugs.”

Rep. David McKinley (R-WV): “Good to see @POTUS announcing that his administration will be taking this step. Educating children, and the public at large, on the dangers these drugs pose is a critical step.”

State Officials

Gov. Asa Hutchinson (R-AR): “I appreciate @POTUS’s initiative to address the opioid crisis while strengthening proven treatments for opioid & other drug addictions. We must cut off the flow of illicit drugs within our communities & help save lives through enforcement, prevention & recovery support services.”

Gov. Jeff Colyer (R-KS): “I’d like to thank @POTUS for…

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The WashingtonPost writes

 January 7

Beth Schmidt always begins her opioid-awareness sessions by introducing her boy. At one such event, she motions toward his photos — the solemn baseball-team picture, his sweet, clean-cut middle school portrait, the cheek-to-cheek selfie of mother and son — as she tells a hushed audience of about a dozen how Sean fought and lost his battle with opioid addiction.

“He actually overdosed right here in Mount Airy at the Twin Arch Shopping Center,” she says, “in a parked car.” It was December 2013, two days after his 23rd birthday.

His death catapulted Schmidt, now 50, into a life she couldn’t have envisioned during her years as a “baseball mom, room mother and field-trip mom” to her three sons. A co-founder of Maryland Heroin Awareness Advocates, Schmidt travels the state advocating for opioid addiction prevention and treatment, and explaining how to use the overdose-reversal drug naloxone. Too late for her own son — but not for the loved ones of others.

“Never in a million years did I think I’d end up helping people save their own children from dying by overdose,” she says. “But as a grieving mom, I don’t want anyone else to have to walk in my shoes.”

The opioid epidemic continues its deadly march, devastating families and decimating communities at an astounding rate. According to the Maryland health department, there were 1,029 opioid-related deaths from January through June 2017, compared with 873 for the same period in 2016.

Naloxone is increasingly seen as the first line of defense in an opioid overdose. When administered within the first minutes — even up to an hour or more — of a potentially deadly overdose, it can resuscitate a victim before their fate is sealed.

Naloxone — also known by its most common brand-name version, Narcan — was once only in the purview of first responders. But enhancements in law and policy are increasing access to the drug, placing it more easily into the hands of anyone who wants it in a “remarkably rapid progression,” according to Corey Davis, deputy director of the Network for Public Health Law.

Maryland and Virginia allow pharmacies to dispense the drug to anyone who asks, no prescription or training necessary. In those states and most others, walk into a CVS, Rite Aid or other pharmacy, ask and receive.

To addiction-awareness advocates, such easy access signifies lives reclaimed. It’s “not just people in active addiction who should have Narcan,” said Joe Adams, the medical director of an opioid-treatment program in Baltimore, “It’s anybody with teenagers or young adults in their household — anybody who’s prescribed or knows someone who’s taking prescription opiates. I’ve heard from plenty of people who were glad to have had it because they were able to save someone’s life. And I’ve heard from plenty of people who wish they’d had it.”

What an overdose does

imply put, death by opioid overdose — whether prescription painkiller or…

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If shorter days and shifts in weather zap your energy and make you feel blue, you’ve got classic symptoms of a seasonal mood disorder. Seasonal affective disorder (SAD) is a form of seasonal depression triggered by the change in seasons that occurs primarily in winter. Why do some people get SAD? Experts aren’t certain, but some think that seasonal changes disrupt the circadian rhythm: the 24-hour clock that regulates how we function during sleeping and waking hours, causing us to feel energized and alert sometimes and drowsy at other times.

EVERYDAY HEALTH WRITES

Another theory is that the changing seasons disrupt hormones such as serotonin and melatonin, which regulate sleep, mood, and feelings of well-being. About 4 to 6 percent of U.S. residents suffer from SAD, according to the American Academy of Family Physicians, and as many as 20 percent may have a mild form of it that starts when days get shorter and colder. Women and young people are more likely to experience SAD, as are those who live farther away from the equator. People with a family history or diagnosis of depression or bipolar disorder may be particularly susceptible.

“It is important to treat SAD, because all forms of depression limit people’s ability to live their lives to the fullest, to enjoy their families, and to function well at work,” says Deborah Pierce, MD, MPH, clinical associate professor of family medicine at the University of Rochester School of Medicine and Dentistry in Rochester, New York. Here are a few SAD treatment options you might want to consider.

Try Light From a Box

Light therapy boxes give off light that mimics sunshine and can help in the recovery from seasonal affective disorder. The light from the therapy boxes is significantly brighter than that of regular light bulbs, and it’s provided in different wavelengths.

Typically, if you have SAD, you sit in front of a light box for about 30 minutes a day. This will stimulate your body’s circadian rhythms and suppress its natural release of melatonin. Most people find light therapy to be most effective if used when they first get up in the morning, according to researchers at the University of Michigan Depression Center in Ann Arbor.

A study published in 2014 in the Journal of Affective Disorders found that one week of light therapy may be as effective as two, though most people continue light therapy throughout the entire season that they’re affected.

Use Dawn Simulators

Dawn simulators can help some people with seasonal affective disorder. These devices are alarm clocks, but rather than waking you abruptly with loud music or beeping, they produce light that gradually increases in intensity, just like the sun.Different models of dawn simulators are available, but the best ones use full-spectrum light, which is closest to natural sunlight. Russian researchers found that dawn simulators were as effective as light therapy for people with mild SAD, according to a study published in 2015 in the Journal of Affective Disorders.

 

Talk With Your Doctor

Talk With Your Doctor

Because SAD is a form of depression, it’s best diagnosed by talking with a mental health professional. “There are a number of screening questions that can help determine if someone is depressed,” Dr. Pierce says. “Your doctor will be able to sort out whether you have SAD as opposed to some other form of depression.”

If you have SAD, therapy can help you work through it. About 12 years ago, Arlene Malinowski, PhD, 58, recognized she had SAD when she read about the symptoms in a magazine article.

“I would notice a drop in how I felt and perceived the world in the winter,” the Chicago resident recalls. The psychiatrist she had been seeing for depression confirmed it.

 

Consider Antidepressants

If light therapy or psychotherapy does not sufficiently boost your mood, prescription antidepressants may help you overcome seasonal depression. But avoid medications that might make you sleepy, advises the Royal College of Psychiatrists. Some people think it’s only necessary to take antidepressants during the winters when they’re feeling the blues, but they must do so every winter, the organization says.

It’s important to recognize when the symptoms of SAD start, and to see your doctor for a prescription before they escalate, says Ani Kalayjian, doctor of education and adjunct professor of psychology at Columbia University in New York City, who specializes in traumatic stress.

 

Add Aromatherapy

Add Aromatherapy

Aromatherapy may also help those with seasonal disorder. The essential oils can influence the area of the brain that’s responsible for controlling moods and the body’s internal clock that influences sleep and appetite, Dr. Kalayjian says.

You can add a few drops of essential oils to your bath at night to help you relax. Essential oils from the poplar tree in particular were found to help depressive disorders in a study published in 2015 in the Journal of Natural Medicines.

 

Get Moving

Get Moving

As it does with other forms of depression, exercise can help alleviate seasonal affective disorder, too. Outdoor exercise would be most helpful. But if you can’t exercise outside because it’s cold or snowy, choose a treadmill, stationary bike, or elliptical machine close to a window at the gym.

Exercise can also help offset the weight gain that is common with seasonal affective disorder, Kalayjian says. Malinowski says she’s more vigilant about sticking with her exercise and yoga routine in the dead of winter.

 

Seasonal affective disorder (SAD) is a type of depression that’s related to changes in seasons — SAD begins and ends at about the same times every year. If you’re like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. Less often, SAD causes depression in the spring or early summer.

Treatment for SAD may include light therapy (phototherapy), medications and psychotherapy.

Don’t brush off that yearly feeling as simply a case of the “winter blues” or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year.

Symptoms

In most cases, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. Less commonly, people with the opposite pattern have symptoms that begin in spring or summer. In either case, symptoms may start out mild and become more severe as the season progresses.

Signs and symptoms of SAD may include:

  • Feeling depressed most of the day, nearly every day
  • Losing interest in activities you once enjoyed
  • Having low energy
  • Having problems with sleeping
  • Experiencing changes in your appetite or weight
  • Feeling sluggish or agitated
  • Having difficulty concentrating
  • Feeling hopeless, worthless or guilty
  • Having frequent thoughts of death or suicide

Fall and winter SAD

Symptoms specific to winter-onset SAD, sometimes called winter depression, may include:

  • Oversleeping
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain
  • Tiredness or low energy

Causes

The specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include:

  • Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. This decrease in sunlight may disrupt your body’s internal clock and lead to feelings of depression.
  • Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.
  • Melatonin levels. The change in season can disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood.

Take signs and symptoms of seasonal affective disorder seriously. As with other types of depression, SAD can get worse and lead to problems if it’s not treated. These can include:

  • Social withdrawal
  • School or work problems
  • Substance abuse
  • Other mental health disorders such as anxiety or eating disorders
  • Suicidal thoughts or behavior

Treatment can help prevent complications, especially if SAD is diagnosed and treated before symptoms get bad.

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SALT LAKE CITY — The Drug Enforcement Administration, local law enforcement officials and others involved in fighting the illicit use and distribution of opioids are bringing the DEA’s “360 Strategy” to Utah.

“This strategy has been developed to specifically address this vicious, this deadly heroin and opioid epidemic that is burgeoning across the great state of Utah and many other parts of the country,” said Brian Besser, DEA District Agent in Charge for Utah.

The DEA’s 360 Strategy has been deployed in several pilot cities throughout the country, but the program’s implementation in Utah marks the first time the strategy is applied to an entire state. Roughly 30 Utahns die each month due to heroin or prescription painkiller overdoses.

According to the DEA, the strategy is an “innovative, three-pronged approach to combating heroin/opiod use.” It includes coordinated law enforcement actions against drug trafficking, enforcement actions against pharmaceutical drug manufacturers, wholesalers, pharmacies and practitioners operating outside of the law and community outreach efforts.

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Mercury News

Everyone knows cigarettes can kill. Yet 36.5 million adults in the U.S. still smoke.

So after the labels and warnings, the restaurant bans and the grisly ad campaigns, the Food and Drug Administration is exploring a radical approach to helping people quit: regulating nicotine in cigarettes. If the FDA follows through — something far from certain — the shift could prompt some to quit or, at least, switch to relatively safer products like electronic cigarettes or vaping.

Peruz Nazli, who sat on a bench near New York’s Central Park with cigarette butts around her feet, said she was delighted when she heard about the agency’s plans.

“It’ll be easier to quit,” said the 59-year-old retail worker, who started when she was 14. “People look at us different.”

The FDA’s initiative may upend the $130 billion American tobacco industry. It’s also likely to set off a ferocious lobbying and legal war in Washington, and push the cigarette industry to develop products that rely less on burning carcinogenic tobacco and more on delivering doses of nicotine through cleaner vapor. Smoking-related illnesses cost $300 billion a year, according to the Centers for Disease Control and Prevention.

Interviews with New York smokers suggested that few had taken notice of the proposal announced last week, but many said they would be more likely to switch to new delivery devices than to smoke diluted cigarette after diluted cigarette. Some have already made the change.

Kevin Cleare, 36, who picked up his first cigarette from a junior-high buddy when he was 13, turned to vaping three years ago on his doctor’s advice.

He quit smoking cigarettes for the first time three years ago but resumed for a few months amid a stressful breakup before turning to vaping. Now he’s “never going back,” and vaping looks like a long-term option.

“I’m so disgusted with cigarettes — the smell, the taste,” he said. “This is a fair, reasonable compromise.”

Over the past decades, U.S. regulators have banned smoking in many public places, sending smokers outside or into isolated corners. The rate of adult cigarette use has declined by a quarter since 1965 to only 15 percent, according to the CDC. Teens foresee life as a pariah and turn elsewhere, with daily smoking among high school seniors down to 5.5 percent in 2015.

Kids look at smokers and say, “You’re crazy. What are you doing?” said Cleare, who works with teenagers at the New York City health department.

Encouraging the remaining wannabes to suck on vape gizmos that resemble digital tape recorders is a planned inconvenience.

“This is just another way in making it less satisfying,” said Douglas Kamerow, a senior scholar at the Robert Graham Center for Primary Care Policy Studies in Washington.

Those who stick with cigs are an increasingly gray crowd.

After emerging from a Mercedes-Benz onto a Brooklyn curb, Trevor Carter reached for a cigarette. The car belongs to his daughter. In the back seat is his grandson.

Carter, 68, has smoked for 50 years, a habit he says is harder to break than cocaine or booze, both of which he kicked. If the retired businessman doesn’t give up smoking by year-end, he said, his girlfriend will dump him.

“I’m ready, but I can’t break the habit,” said Carter. But he said he won’t try vaping or e-cigarettes, which mimic the traditional item. Instead, he’s “trying to quit the natural way.”

E-cigarettes are about 95 percent safer than smoked tobacco, according to the U.K. Centre for Tobacco and Alcohol Studies. Vaping atomizers and e-cigarettes heat liquid nicotine, which then becomes vapor. They don’t contain carbon monoxide and tar, chemicals in cigarettes that hurt smokers’ health. The FDA plan would encourage the use of the stand-ins by delaying further regulation until August 2022, giving tobacco companies a chance to build up a range of alternatives.

After the FDA’s announcement last month, shares of the two largest cigarette sellers in the U.S., Altria Group Inc. And British American Tobacco Plc, suffered their biggest single-day drop since the recession, reflecting investors’ belief that companies aren’t prepared for the new era.

Vivien Azer, a research analyst with Cowen & Co. who follows the industry, said that despite the sell-off, companies are trying to adapt with new products that take them beyond the simple equation of flame plus leaf.

“Everyone seems to be leaning in heavily into ‘heat not burn,’ ” she said.

In one study published in 2015, cigarettes with lower levels of nicotine reduced not only nicotine exposure and dependence, but the number of cigarettes smoked. The research, conducted over six weeks and published in the New England Journal of Medicine, studied 780 people who regularly smoked with no interest in quitting.

For now, younger smokers are caught between eras.

John Mastbrook, 33, a bearded Brooklyn bike messenger, started smoking at 12 in his native Fairfax, Virginia. He vapes from time to time to wean himself from the cigarettes he rolls himself. “It’s just a good alternative,” he said.

Smoking refugees like Cleare who’ve switched to vaping recognize, though, that they may still spend their lives tethered to a habit they don’t want. He says he’s just “trading one vice for another.”

“I’m still obviously addicted to nicotine,” Cleare said, pausing to cough into his arm.

KUNC reports

This spring, 16 state patrol officers from Colorado and Wyoming took a couple days off their usual work schedule to do something special. They assembled in a hotel conference room in Denver. As instructed, they wore street clothes for their first assignment: going shopping at nearby marijuana dispensaries.

“It’s a brave new world,” said instructor Chris Halsor, referring to the years since Colorado legalized recreational marijuana.

There are now more marijuana dispensaries in Colorado than there are Starbucks shops, said Halsor, a Denver lawyer and former prosecutor. And though consuming cannabis is legal across the state, driving under its influence is not.

The cops in that conference room, with their buzz cuts and Mountain Dew, are all part of the force charged with keeping the roads safe. But first, they needed a formal pot education — to learn how to identify various marijuana products and paraphernalia when they pull over a driver they suspect is under the influence.

Here’s the rub: Despite the increasingly legal use of cannabis in many states, cops still don’t have the equivalent of a reliable alcohol breathalyzer or blood test — a chemically based way of estimating what the drug is doing in the brain. Though a blood test exists that can detect some of marijuana’s components, there is no widely accepted, standardized amount in the breath or blood that gives police or courts or anyone else a good sense of who is impaired.

A number of scientists nationally are working hard to create just such a chemical test and standard — something to replace the behavioral indicators that cops have to base their judgments on now.

“We like to know the human error and the limitations of the human opinion,” said Tara Lovestead, a chemical engineer at the National Institute of Standards and Technology in Boulder, Colo., who is working on setting standards for what a marijuana detection test might require.

It’s actually really hard for Lovestead to do this kind of research because she works in a federal lab; federally, cannabis is considered a Schedule 1 substance, “a drug with no currently accepted medical use and a high potential for abuse.” So even though Lovestead is in Colorado, getting hold of a sample for research purposes is just as hard as getting hold of heroin.

“We cannot use the stuff down the street,” she said.

Aside from being a bureaucratic mess, coming up with a standardized blood or breath test is also a really tricky chemistry problem because of the properties of the main psychoactive chemical in cannabis: delta9-tetrahydrocannabinol, or THC.

In states like Colorado, there is a THC blood test that law enforcement can use to show “presumed” impairment. If a person has more than 5 nanograms of delta-9-THC per milliliter of blood, a court or jury can infer that they are impaired, according to Colorado law (this is called “permissible inference” in legalese).

But Lovestead and others maintain that, scientifically speaking, that cutoff doesn’t actually mean anything.

“We just don’t know whether or not that means they’re still intoxicated, or impaired or not,” she said. “There’s no quantitative measure that could stand up in a court of law.”

Turns out it can be a lot harder to chemically determine from a blood or breath test that someone is high than to determine from such a test that they’re drunk.

Ethanol, the chemical in alcoholic drinks that dulls thinking and reflexes is small and dissolves in water. Because humans are mostly water, it gets distributed fairly quickly and easily throughout the body and is usually cleared within a matter of hours. But THC, the main chemical in cannabis that produces some of the same symptoms, dissolves in fat. That means the length of time it lingers in the body can differ from person to person even more than alcohol — influenced by things like gender, amount of body fat, frequency of use, and the method and type of cannabis product consumed.

In one study, researchers had 30 frequent marijuana users stay at a research facility for a month without any access to drugs of any sort and repeatedly tested their blood for evidence of cannabis.

“And it shocked everyone, including ourselves, that we could measure, in some of these individuals, THC in the blood for 30 days,” says Marilyn Huestis, a toxicologist with the University of Maryland School of Medicine who recently retired from leading a lab at the National Institute on Drug Abuse.

The participants’ bodies had built up stores of THC that were continuing to slowly leech out, even though they had abstained from using marijuana for a full month. In some of those who regularly smoked large amounts of pot, researchers could measure blood THC above the 5-nanogram level for several days after they had stopped smoking.

Conversely, another study showed that people who weren’t regular consumers could smoke a joint right in front of researchers and yet show no evidence of cannabis in their blood.

So, in addition to being invasive and cumbersome, the blood test can be misleading and a poor indicator of whatever is happening in the brain.

Recently, some scientists have turned their attention to breath, in hopes of creating something useful.

A number of companies, like Cannabix Technologies and Hound Labs, are in the process of developing breath detection devices. Tara Lovestead is providing the data that will help relate the concentration of THC detected in the breath to what’s in the blood. Even though blood provides an incomplete and indirect inkling of what’s happening in the brain, it’s the measure law enforcement turns to as a benchmark.

That, too, is a chemist’s nightmare. THC and other cannabinoids — the chemicals that cause a high — are really squirrelly. They degrade quickly and appear only in very tiny amounts in the breath.

Luckily, Lovestead’s specialty is detecting tiny amounts of chemicals in the air. She and her colleagues have worked on methods to use tiny air samples to detect evidence of arsonburied bodies and hidden explosives. Marijuana is the next challenge.

In the future, she said, an accurate breath test would likely involve looking at a lot more than just THC — probably a whole combination of chemicals.

“One thing to look for would be metabolites — something that comes out of the breath that shows it actually went through your system,” she said. Such a test would greatly reduce the possibility that someone might test positive from inhaling secondhand smoke, she said.

In the meantime, it’s up to law enforcement officers like the ones in Chris Halsor’s class to make the call, based on circumstantial evidence and their best guess.

“The whole point of this class is to get the officers to make correct decisions,” said Halsor.

Many officers in his courses have never used marijuana — or haven’t since some exploratory puffs in high school. These officers need training, he said, to boost their confidence — “confidence that they’re making the right arrest decision and confidence that they’re letting people go who really aren’t impaired.”

The cops attending his seminar in the spring paged through Dope Magazine, chuckled at a photo of an edible called “reef jerky” and watched a video together on how to dab — heating concentrated marijuana and inhaling the vapors. In their visit to a local marijuana dispensary, they examined gold-plated blunts — hollowed-out cigars filled with marijuana.

But the real test of these officers’ ability to identify the signs of cannabis impairment faced them outside the hotel, in a parked RV that was plastered with bumper stickers.

Four volunteers for the project were inside the RV, legally getting as high as they wanted to, from a big plastic tub full of pot products.

“Good music, good company, good weed. It all goes together,” said Eugene Butler, one of the four volunteers.

Butler and the three others had never met before. They had volunteered to get high and then interact with cops to help the officers learn the signs of cannabis impairment.

“We’re going to willfully smell like pot around a bunch of cops,” said Sharica Clark, laughing.

Inside the hotel, the officers practiced roadside sobriety tests on the four volunteers — determining each time if, in real life, they would have arrested these people for a DUI.

All the volunteers had smoked a lot of pot inside the RV. But in the sobriety tests, they performed differently.

A volunteer named Christine, for example, did well on math, quickly calculating how many quarters are in $1.75. But she didn’t do well on other things, like balancing, remembering instructions and estimating time. (She was concerned about recrimination at work, and NPR agreed to use only her first name).

Christine, the officers all decided, would be a danger behind the wheel. In real life, they would have arrested her.

“Yeah, she’d be going to jail,” said Rich Armstrong, an officer with Colorado State Patrol.

But things weren’t so clear with the other volunteers. A lot of the officers had decided they wouldn’t arrest Eugene Butler or a volunteer named John (who also asked that we not use his last name); both men aced the same roadside tests Christine flunked, even though they, too, had just smoked a lot in the RV.

And when it came to Sharica Clark, the officers decided it was essentially a toss-up as to whether they would have arrested her, based on her performance on the roadside tests. Yes, her pupils were huge, and she had a tough time touching her finger to the tip of her nose while her eyes were closed. But her balance, counting and recitation of the alphabet were, as Colorado State Patrol Officer Philip Gurley put it, “spot on.”

“It was a tough one,” said Tom Davis, another officer with Colorado State Patrol.

Right now, these officer’s opinions loom large. If they decide you’re driving high, you’re going to jail. But at the end of the day, they’re just making educated guesses. Two different officers could watch the same person doing the same sobriety test and make different decisions on whether to arrest. In previous courses, officers had decided that a volunteer was impaired when in fact the volunteer hadn’t smoked at all.

So, just like the THC blood test, the judgments officers make can also yield false positives and negatives.

“This is one of those subjective areas,” said Armstrong.

“It’s too subjective,” said Lovestead.

She recently published a paper in the journal Forensic Chemistry where she found the vapor pressure of THC — one of its fundamental physical properties. Lovestead believes finding and standardizing that measurement is a small but significant steptoward a more objective route for evaluating intoxicated drivers.

In the meantime, courses like Halsor’s are the best resource for officers. And at least now the class participants know what pot strains like Skunk Dawg, Hippie Chicken and Chunky Diesel actually smell like.

“Yeah,” said Gurley. “It smells like the bottom side of a rock.”