Category Archives: Prescription Painkillers

Major League Sports Needs To Get With The Program…

Addiction in the News Addictive Behaviors Alcoholism blog Drug Addiction Heroin Addiction Marijuana Legalization Prescription Painkillers

images-5No other system is entrenched in the idea of drug addiction being characterlogical then sports. Any issue with drugs is pegged with the cliches of addicts “waste of talent” “cheater” “undeserving of their talent” “a disgrace to kids”. What is never heard in the alcohol financed sports world is “disease” “Mental health issue” or “Pathology”. There was a time when Ryan Leaf was thought to be a once in a decade type quarterback, one of the greats. What could have happened if the NCAA and NFL had a comprehensive policy and program to deal with issues before they reach a crisis level. As it is, Ryan Leaf is another cautionary tale of lost potential working at a car dealership of maybe a high school coach if he can stabilize. The drug policy in professional sports is arcane and rooted in punishment. That is bad policy rooted in shame and the result is stories like Ryan Leaf’s.

www.espn.go.com/dallas/nfl/story/_/id/11495757/ryan-leaf-sentenced-5-years-prison-violating-probation

Joe Schrank

Robin Williams: Depression, Addiction, Open-Heart Surgery, Parkinsons…

Addiction in the News Addictive Behaviors Alcoholism blog Drug Addiction Heroin Addiction Marijuana Legalization Prescription Painkillers

Robin Williams is dead. Is this a shock? No. Is it a tragedy? Absolutely. Without knowing any of the details about his psychiatric treatment, from a purely statistical standpoint Mr. Williams had a number of risk factors that are often identified ‘after the fact’ in suicidal patients – he suffered from a serious mood disorder, addiction to drugs and alcohol and he had open-heart surgery which is well-known to be associated with severe depression even years later. Now we are finding out that he suffered from early stage Parkinson’s Disease.  images-3To the general public his comedic veneer and successful acting career probably made it seem like he was impervious to the ravages of depression and addiction – clearly a falsehood.
It’s fascinating that in the wake of his death, one of the immediate reactions among pundits and medical professionals is that “we hope that Mr. Williams’ death brings to light issues about depression and addiction and helps end stigma so that people come forth and get help.” The implication is that those who are too ashamed to ask for help for depression and/or addiction suffer the consequences. While we are all in support of ending the stigma associated with mental illness and addiction, the fact is that Robin Williams was totally open about both of his struggles not only with depression but also addiction. Without knowing any of the details about his illness or his treatment, it is difficult, if not impossible to speculate about exactly what happened to him. Yet it is possible that he survived as long as he did because he was open about his problems and received a good deal of help for them. The sad fact is, that people who have multiple risk factors for early death often die young. This is true for those suffering from illnesses like diabetes, cancer and heart disease, and it is also true for those who suffer from certain mental illnesses – primarily mood disorders and psychotic disorders – and certainly addiction.
While the field of psychiatry has its limits, one thing we know well is that the risks and consequences of major mental illness are real and severe, and are clearly exacerbated by the use of drugs and alcohol. We know that Robin Williams suffered from a mood disorder, either Bipolar Disorder or Unipolar Depression complicated by addiction – a combination that is possibly the most catastrophic of all the major mental illnesses. Whether or not he actually suffered from Bipolar Disorder or just “Unipolar” Depression is irrelevant – we will probably never know the exact details of his psychiatric treatment.
Bipolar disorder, otherwise known as Manic Depression is a disease of the brain characterized by major shifts in mood that vacillate between high energy manic states, periods of relative calm, and very low mood depressive and often suicidal feelings – it is a major mental illness that is almost entirely treated with medication. People who suffer from Unipolar Depression experience periods of severe depression, sometimes resulting in suicidal thinking that lasts for days to weeks or even months, followed by periods of relatively normal mood. The good news is this: with medication, therapy and avoidance of drugs and alcohol, many patients who suffer from both Bipolar Disorder and Unipolar Depression can keep the symptoms check and live a relatively stable life. The bad news: Many patients who suffer from these mood disorders are at a heightened risk of a number of tragic problems including suicidal behavior, substance abuse, violence, job loss, relationship problems and serious health issues.
The statistics are impressive: About 2 million Americans suffer from bipolar disorder with an equal distribution between men and women. Depression probably affects upwards of 20% of Americans at some point in their lives. In 2012, 16 million adults over 18 (6.9% of the population) suffered at least one Major Depressive Episode in the prior year. Up to 50% of patients who suffer from Bipolar Disorder make a suicide attempt at some point in their lives and about 10-15% succeed in killing themselves. Life stress, addiction, broken relationships, social isolation, physical health problems and medication non-compliance all increase the risk of suicide.
One of the major challenges patients suffering with Bipolar Disorder face is the need to continually take “mood stabilizing” medications despite that fact that they can cause feelings of “dullness”, and emotional blunting. They even need to take the medication during times of “euthymia” (normal mood). Many patients complain that “normal” living feels like depression to them – they enjoy and often thrive on the highs associated with manic behavior – which is often a source of creative and/or athletic genius. Many Bipolar patients stop medication despite their doctors telling them that they need to continue taking them, even when they are stable and doing well. They like being manic. Further complicating the picture is the fact that for many people, manic episodes, while ominous, can be a source of major creative and intellectual inspiration.
The fact is, Mood Disorders are chronic, relapsing, remitting diseases of the brain that require on-going treatment and monitoring by mental health professionals. Studies clearly show that every time a person suffers from an episode of mania or depression, the brain becomes somewhat de-stabilized which results in a more insidious course of the illness. That is, future episodes last longer, are more severe and come more frequently – thus the recommendation to treat these illnesses early and aggressively with medication, psychotherapy and cognitive behavioral therapy.
A final point about suicide: despite decades of serious research and study, predicting suicide, and other violent behaviors remains a difficult task since it is a relatively rare, though tragic problem. The problem is that while people who commit suicide almost always demonstrate a number of risk factors, the overwhelming majority of people with the same risk factors as Robin Williams, will never attempt or commit suicide or other violent behaviors.
We need to take depression, addiction and all mental illness seriously as diseases that require treatment. The behaviors associated with these illnesses are not simply “bad choices”, but manifestations of chronic brain problems that we are still trying to understand.

 

— Scott Bienenfeld, M.D.

What Is Naloxone and Why Do We Carry It?

Prescription Painkillers

It’s hard to listen to the news these days and not hear something horrible with regards to the nationwide problem of drug overdose deaths, many of which involve prescription painkillers and/or heroin. The statistics are stark: Deaths from drug overdoses have more than tripled since 1990 and the problem is only getting worse. In fact, around 2011, the number of drug-overdose deaths in the United States surpassed deaths from motor vehicle accidents. That’s right – you have a higher chance of dying from a drug overdose than from a car accident. In 2008, more than 36,000 people died from drug overdoses, and about 15,000 died from painkillers!

Certainly, the meteoric rise in narcotic painkiller prescriptions has fueled this epidemic. One study indicates that enough painkiller prescriptions were written in 2010 to medicate every American daily for an entire month. Further complicating matters is the fact that the nation’s heroin epidemic has also skyrocketed, contributing to the death toll. Many people who start out addicted to painkillers switch to heroin because it is often a lot cheaper to obtain, and usually easier to acquire.

At Rebound Brooklyn, we recognize that addiction to opiates, either prescription drugs or heroin, is a dangerous and often fatal problem, the result of acute overdose, which causes respiratory collapse and ultimately, death. Until recently, there was little to do for an opiate overdose victim other than call 911 and perform CPR if necessary while awaiting the ambulance. Huge numbers of overdose victims die on the way to the hospital, or waiting for help to arrive.

A long-known treatment for acute opiate overdose is administration of a medication called Naloxone or “Narcan” which immediately reverses opiate overdose and “wakes” the person up, preventing death. Formerly, only available in hospital settings, Naloxone is now available in easy to administer kits that laypeople can use to save lives. Kits are being provided to police officers, fire fighters and others who are often “first responders” to suspected opiate overdose scenes. Minimal training is involved, and the ability to administer Naloxone immediately “in the field” can be a lifesaver for thousands. At Rebound Brooklyn, we carry and are trained to administer Naloxone in the event of a suspected opiate overdose, and while our hope is that we never have to administer it, the fact that we have Naloxone, and are prepared in the event of an emergency is a very comforting thing.

From Nora Volkow, M.D. :
http://www.drugabuse.gov/about-nida/noras-blog/2014/02/naloxone-potential-lifesaver

American Journal of Public Health Article:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661437/