Substance Abuse

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I never smoked.  In my family, it was simply not an option.  My grandmother of blessed memory used to stand at the front door and kick out anybody who opened a box of cigarettes on the concrete stairs coming up to the front door, let alone anyone who actually looked as if they were or would smoke.

My father of blessed memory swore once that when he tried to bring home a buddy from Harvard who was smoking and appeared poorly dressed; my grandmother kicked him out at the door. Read more on Everybody Knows Smoking Is Bad — So Why Do Some Still Do It?…

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I have had a lot of trouble with the idea of criminalization of drug addiction for a very long time.

I am only one of a lot of folks who say “addiction is a real disease.”  People feel every bit as sick as people with other diseases, sometimes more.

The patients are certainly able to die every bit as dead. Read more on Babies Born Addicted…

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This story found me in the headlines: Colts’ Jim Irsay discusses addiction.” I had never heard of and would not have been able to cite the name of the owner of the Baltimore Colts. I certainly am no fan of professional football.  I have reviewed recent problems in other posts. It seems to me that football — seemingly more than other sports — breaks brains, heads, bones and lives and may foster drug addiction to boot. Read more on Baltimore Colts Owner Jim Irsay – Too Rich To Need Help?…

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In my previous entry to this blog, I talked about heroin overdoses and how people might be rescued – even if no doctors or EMTs are around.

Due to the timeliness, I mentioned the latest celebrity fatality, Philip Seymour Hoffman.  I am usually asked for my take on these things when a high-profile person dies because of drugs – whether legal prescription or illegal street drugs.

I hate doing this – mainly because it is a sad and depressing topic.  And yet, I do this not to capitalize on the notoriety of the victim, but with the intent of teaching the public about the dangers, possible solutions and new developments in treatment and education. Read more on Death From Drugs, Philip Seymour Hoffman and Staying Alive…

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You know me – Little Miss Skeptical.

I would never give a baby a loaded gun to play with, and I would never give non-medically trained civilians syringes full of drugs with the intent of having them stab somebody directly in the heart and push the plunger.

You probably know what I’m talking about if you saw the movie “Pulp Fiction” – apparently about four people in the world have not. Read more on Too Many Die From Heroin…

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Huffing

Whatever job I take, my husband says I basically function as a teacher.  There probably is some truth in this, and I seem to be forever reminding people that the verb “doceo,” the Latin verb “to teach,” is the word that the English language word “doctor” comes from.

Most of us doctors have little time for the teaching function.  This is not exactly what insurance pays for.  The internet is an explosion of information that absolutely dwarfs the ancient library at Alexandria.  Although I wish more people would be more aggressive about finding and using that information, I understand there is so much information that people don’t know who to believe.

That is the place where people should bombard their doctors with information they want clarified. Read more on Huffing…

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I found myself facing a person who had lost themselves in drug abuse.

Not so unusual — when dealing with public health clinics.  The prognosis is usually poor.  An addict won’t cooperate with treatment unless forced by the courts in most cases.

Here is what I said to one mental health center patient to convince him to go into rehab. Read more on The Speech That Made An Unwilling Addict Go To Rehab…

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In this life, everything should be as simple as it is, but not simpler.  That includes this questionnaire study about marijuana as an exit” drug for substance abuse.    This article hit a nerve because there are issues here I have come up against before.  And I mean “against.”  I don’t mean to say it isn’t “good science;” it is. I’m talking about the emotional resistance to the idea that detoxifying from a medication can be comfortable, painless, and effective.  I see this coming like I see the sun rising in the morning, because I have been to this place. A few years ago, I found myself in an informal banquet room across the parking lot from a hotel type establishment in a touristy part of San Diego.  There was a woman rep from the drug company, Hythiam.  She wasn’t an ex beauty queen like most reps, but a fairly credentialed therapist who actually knew what she was talking about.  My husband was there with me; a younger, chubbier, and more naïve me – therefore, less authoritative.

These Hythiem/Prometa folks had a great schedule of IVs that removed physiological cravings for various substances of abuse, including methamphetamine.  Basically, they use safe and older type drugs intravenously for a lovely pharmacological intervention.  The cravings stop, and the person does not “need” to use the drug. Neither they nor I was stupid and naive enough to think that was all you had to do.  Aftercare was important and I was ready to jump in.  They recommended vitamins — I recommended lots of vitamins, high dose, and chelated to cross the blood-brain barrier. But these addicted folks needed “prosthetic lives.”  When all you can muster goes to satisfying a craving or a need, there are not many hours left in the day for work or relationships.  I helped with this, too. Some people had problems, but they were mostly because of the psychosocial void left when they did not go for drugs, and their inability to fill it.  I worked my damnedest with these folks; and like the company, was eager to be accepted into the addiction community. There was this reception, and they had invited people from every substance abuse program in town.  I was there and ready to go to bat as the only physician who had experience with these folks locally. Two people showed up.  One was an older, fatherly type. The other was a young sidekick who was presumably learning from him.  This older guy said something that rings in my ears now. “You got to earn your sobriety.” Read more on Time to Stop Judging and Start Healing…

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The first time I heard about using empty whipped cream dispensers to get “high” was a long time ago.  I was living at my parents’ house after I had finished medical school in France.  I had done my thesis as quickly as possible, in the fall.  My residency was projected to start July first.  I promised my parents I would do what I could to earn my keep.  I sold kitchen cabinet fronts over the telephone, got involved in a chorus production of “Pirates of Penzance,” and substitute taught for awhile.

As a substitute teacher in suburban Boston I was taught everything from senior hygiene to 9th grade algebra.  A principal saw me teach 9th grade algebra and told me the heck with the credentials — the way I put across factoring quadratics was good enough for him to take me on permanently.  I was leading the class in yelling, singing, and dancing “everybody factor.”  And they were.

I told him I was going Cincinnati to start a surgical residency.  He stared at me in disbelief.  I told him I had more important news for him. Read more on Teens and Inhalant Addiction and — K2 Spice?…

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Whitney Houston’s death might be “old news” already, but I still think her death may not have been in vain.

Because Whitney was a star, we were treated to hearsay before facts.  She drank in the morning, in a public place, and according to some observers may have been behaving a bit strangely.

There is an old screener for alcoholism called the “CAGE” questionnaire.  It’s named after the four questions that presumably even a primary care physician — who has little room left in an overtaxed memory — could remember. Read more on Whitney Houston’s Death May Not Have Been in Vain…