I guess the death of Anna Nicole Smith has become old news. All I found in the daily newspaper was a short item saying that the trial was going on in Los Angeles.
After more than one internet search, the only mention I found of what is going on online is this one, in what seems to be a Seattle tabloid.
I strongly suspect that this is a road that has been travelled more than I know. After all, I am not exactly a celebrity watcher. Nevertheless, from what we already know about folks like Michael Jackson, and from what Dr. Nathalie Maullin seems to have said under oath, I think we have a pretty good idea of what it is like to be a drug-seeking celebrity.
First, I think it worth noting that Dr. Maullin was on staff at Cedars-Sinai at the time. Now putting aside the PR of the latter (it is allegedly the best in L.A.; they have ads and some top notch publicity firm–) Cedars Sinai is a hospital. I can testify that to be on staff at any clinic or hospital, they do a background check. Read more on Anna Nicole’s Doctors Couldn’t Have Made Worse Decisions If They Tried…
Filed under Addictions, medicine, prescription drugs by on Aug 19th, 2010. Comment. 
I have a fable that is obviously too late for Aesop’s collection of same. It is unlikely to make its way into any later anthology. I might as well tell you about a tiny town whose sole virtue that it was on an interstate road that took a lot of people from various parts of California into Las Vegas, that famous refuge for people who are too sober and trying to get rid of excess money, sometimes while getting either married or divorced. Actually Littletown (we will call it that to avoid embarrassment to all two or three law abiding citizens). Had just one more virtue. Their county hired me as a consultant. I did last in that job for a while, even though it covered three different small clinics, each of which needed me just a day or two a week. Since every morning when I woke up, I had to have my husband remind me not only what day of the week it was, but what city and clinic I was supposed to be at. The clinic buildings looked different from one another on the outside, a fact which didn’t help me very much because I ended up working on the inside and usually ate lunch at my desk. The patients in all three clinics were different from those that I had seen prior to that time in my career, for I had not done more than sporadic work with addicts, and there were a fair amount of people on crystal meth. I practiced “from the book” and did the best I could (I always do) and helped some people somewhat, to get treatment and put their lives together. But it was in Littletown, where the stores on Main Street were empty and the only local culture was the yogurt shelf at the (chain) supermarket, that I really learned about crystal meth for the first time. Read more on Once Upon A Time There Was An Explosion…
Filed under Addictions, Substance Abuse by on Jul 20th, 2010. 2 Comments.
It has been over ten years since my husband and I visited this often-quiet community in Nevada. Gambling, resorts, a legal whorehouse not far out of town, pawn shops, bars; standard Nevada. Only the faintest echoes of the silver boom, people grasping for the romance, the all-night party feeling. We are not big gamblers, but we did some shows, and the party feeling was good for a weekend.
That was ten years ago. Now, there are a bunch of people looking for free beer, not caring about its quality. People talking about getting “wasted” and nobody, but nobody, talking about having “fun” doing it. There is a pall over the gambling halls. People are counting their pennies on 99cent specials. There are certainly no echoes whatsoever of the silver boom, and no evidence of romance, and only two or three people sitting in a room full of slot machines.
Some of what I do is very analytical. I actually figure out how many mg. of medication or supplement someone needs as a function of their weight. I think of the chemical reactions in their body that are either not working at all, or are working overtime. Some of what I do–sometimes I am surprised to know just how much and how effective it is–is feeling; is intuitive. Whether we are where the rich people go or where the poor people go, I feel fear. I am sure that this fear comes from feeling that the economy is “bad.” Read more on Don’t Get Wasted — Get Busy!…
Filed under Substance Abuse by on Jul 13th, 2010. Comment.
She was a 33 year old raven-haired exhausted woman who had probably been a beauty before she bore children, now aged 9, 6, and 4. She wanted a renewal on her sleeping pills. She did not want the antidepressant or anything else, just sleeping pills. She said that since the children all slept through the night, now she could, too. She had not only a tubal ligation at her final pregnancy, but an ex-boyfriend who was no more than a distant memory.
Her last doctor, apparently a rarity, had actually started by prescribing the sleeping pills every third night. That had not lasted more than four weeks or so. She wanted, and felt she “deserved,” sleep every night. She was convinced that was what the insurance doctors gave the rich people, so she was not going to let anybody skimp on her. Sleeping pills every night. She would not have to think about anything other than keeping a bottle by her bed and getting it into her mouth. Sleep would be automatic and life would be sweet.
The last doctor had been, to his credit, assertive enough to tell her that if this was what she wanted, she would be coming in every three months for the rest of her natural life on planet earth, to get sleeping pills. She thought that was just fine; that it was what everyone did and should do, since we had something as wonderful as sleeping pills in the world. Read more on Pharmaceutical Companies Are Stealing Our Dreams…
Filed under prescription drugs, Sleep, Substance Abuse by on Jul 1st, 2010. Comment.
She was nearly thirty, dark haired and round-faced and ambitious, and wanted to be a drug and alcohol counselor, maybe. Maybe not. She had only three months of sobriety from alcohol; probably wanted to be one of those people in power. So many programs dry people out and let them “stay on” a bit. So many people use their own exaggerated stories to “help” other people stay sober. A closet industry of subjective touchy feely, trampling, as many do on my long years of difficult, mind boggling training with cheap feel-good.
Her drug and alcohol counselor had told her that she would feel rotten for a while, so she had accepted that. But she felt obligated to tell me that she had felt rotten, so I let her talk and tried to listen.
People coming off alcohol may take as much as a year to get their sleep cycle back (alcohol represses Rapid Eye Movement sleep) and to stop feeling a little bit nervous. But this was not that. Read more on Serotonin Syndrome: Less Is More…
Filed under prescription drugs, Substance Abuse by on Jun 24th, 2010. Comment.
People who have panic disorder go to doctors to take care of it. I have had maybe hundreds of patients, more than I can count over my years of practice, who have come to me with this. Most of them do well. Usually the panic disorder runs its course.
That is not to say that panic disorder is not terrifying. Often people believe that their first panic attack is a heart attack. Often they have come to me already addicted to benzodiazepines by emergency room physicians who (understandably) worry a lot more about the immediate comfort of the patient than about the long term situation. Here is the official government take on panic disorder. Yes, find a psychiatrist you can trust. Yes, they recommend family and support groups. Good stuff, but free and easy to recommend. Yes, there is some exciting new research but as long as insurance companies and HMOs determine how people get treated, it is unlikely that research will be quickly translated into treatment.
Most people who go with the mainstream treatment do pretty well. Here is another description of mainstream treatment, a little more complete. Read more on A Real Doctor — Like House MD…
Filed under medicine, prescription drugs, Stimulants, Substance Abuse by on Jun 17th, 2010. Comment.
She was exactly my age, with a birthday only two days before mine. Same year. I know that there are more people born under the sign of Aquarius than any other astrological sign, so I am no longer surprised at the number of people who have birthdays in February. (Especially since, if you count back nine months, you end up with June, which is when everyone’s thoughts turn to love and their thyroids and probably other glands are hyper-secreting.) But this was one of those people who makes me think I look awfully good my age. Probably a function of middle class privilege and doing more intellectual than physical work.
This woman had a son who cared about her. The fact that she came to the clinic with him made her fairly special among those I was serving at the time. He had been worried when she seemed too sleepy and too angry and not herself.
Like most patients, she really did not want to tell me much about the other doctors she saw or what medications they gave her. I told her that I could check for interactions, and that her failure to tell me would increase her risk of having problems. I know that a lot of people get “pain killers” and don’t think that they count for “real medicine.” Read more on The Shrink As Sherlock — Detecting Opioid Addiction…
Filed under Addictions by on May 20th, 2010. Comment.
People told me I would have troubles in France because it was a “Catholic” country. I do not think any trouble I can remember came from the few people who actually attended church regularly. But back to politics. The parties were grouped into “left,” “right,” and “center.” The left included the commies, whom I had to reassure that even though I was an American I did not hate them. I found “rightists” fearing change as obsessively as any conservative (read “ultra-republican” American ever could. Read more on Psychology of Politics (and Politicians)…
Filed under Addictions, politics by on May 19th, 2010. Comment.
Thanks to modern technology and “time-shifting” I was able to watch the brief apology speech Tiger Woods gave to his wife and children, his fans, the employees of his charitable foundation and – probably most importantly – his sponsors.
Some critics question the sincerity of the greatest golfer ever – noticing his lack of emotion or even passion when apologizing, his unfamiliarity with the text he was reading from and his lengthy wait to even appear and give such an apology.
My concern was the total lack of mentioning a very serious aspect of the whole Tiger Woods fiasco – driving while intoxicated. The whole incident erupted on the world news scene when Tiger smashed his luxury SUV into a fire hydrant and a neighbor’s tree and was dragged unconscious from the vehicle by his wife.
His lack of consciousness was suspected to have been caused by drugs and/or alcohol by the law enforcement personnel at the scene. In fact, one person at the scene, a neighbor, stated he had seen Tiger consuming alcohol earlier in the day. But an attempt to collect medical evidence was denied by the Orange-Osceola State Attorney’s Office.
So perhaps the rich and powerful do get a few breaks the rank-and-file don’t get – such as avoiding criminal charges.
However, while dishing out apologies, Tiger Woods should have shown some remorse and/or regret for impaired driving. After all, most of the hubbub about the situation revolves around the universal acknowledgment of Tiger as the model for today’s youth. Read more on Truth and the Law — and Miranda…
Filed under Substance Abuse by on Feb 23rd, 2010. Comment.
There are actually people in southern California who complain about the winter. You have to get your jacket out of storage. It gets dark too early, but luckily some people start their night lives earlier.
There are flus and there are coughs.
There is cough syrup.
When I was in grade school, the only cough syrup our kindly family practitioner could give was something with codeine. I was a sick little girl who seemed to be allergic to everything she touched, so I got a little of some kind of precious substance when the winter snows hit New England, and my respiratory system remained intact with that little bit of codeine.
Read more on Over The Counter Doesn’t Mean “Safe”…
Filed under Substance Abuse by on Dec 21st, 2009. Comment.