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…
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…
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.
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.
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.
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.”