substance abuse

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There is something very funny going on with substance abuse.  There is less of it among teens. Less since — it has been suggested — teenagers are increasingly occupied by the amusing complexities of cell phones. Read more on Teens Favor Phones Over Drugs?​…

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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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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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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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I have seen more than I can count of them, veterans with chronic pain symptoms.  Nobody who serves our nation should be left to suffer.

In my world – nobody at all should be left to suffer.

I’ve worked in the Veterans Affairs system in many cities in several states and in various positions.  I’ve been the doctor who sits in the office and sees them one by one, diagnosing them and prescribing treatment.  I’ve been the evaluator who examines them and decides what kind of pension or how much disability they get.  I’ve been the director of day treatment centers where we try to give these noble servants of the people everything from activities to fill up their days, to continuing therapy for problems such as PTSD, and even food and shelter. Read more on How To Help A Veteran In Pain…

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Amazingly enough, I have avoided writing about Charlie Sheen so far.
I do not believe his story to be that unusual — just different from others in a matter of degrees.

Charlie SheenNo, he is not my patient and I have not officially examined him.  I have figured out that the writers of his show seem to have done a lot of basing the character he plays on — well, him.

His creative and limit-pushing exploits seem to be a little more over the edge than most.  My guess — and it is a guess at this point — is that he, like other actors (seems to me David Arquette has complained of “racing thoughts” in the not too distant past), is probably what we call a “dual diagnosis;” that is, underlying bipolar illness with some substance abuse associated.

Read more on Oh No! Not Charlie Sheen Again!…

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I have not been a chronic television watcher since early childhood, mainly because the projections on a two dimensional screen seem to be to be — at best — a weak distillation of the human drama that happens in my office.

Hamburber Helper puppet needs a helping hand -- in Rehab

Hamburger Helper puppet needs a helping hand -- in Rehab

But for my patients, I know well that the line between what they see on television and what they see in their living room is blurred at best.

I have, however, been compared to various TV shrinks — which I have been told is a compliment.  The first person who told me I was like one, I asked why.  When she said “because you always say the right thing.”

I was obviously flattered since you better believe I am NOT scripted.

Read more on Has A Celebrity Got A Chance At Rehab?…

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