Dr. Henry Paul, MD

Psychiatrist, Author and Educator

BLACK BOX WARNING ON PAINKILLERS

March 25th, 2016

“They’re the most powerful painkillers ever invented, and their creating the worst addiction crisis America has ever seen.” TIME Magazine Cover June 2015

The US Food and Drug Administration this week announced that painkillers, such as OxyContin and Fentanyl, will now have to carry a “black box” warning stating the dangers of abuse, addiction, overdose and death.

It is called a black box warning because that is how it appears – in a black box. According to the FDA website, “it appears on a prescription drug’s label and is designed to call attention to serious or life-threatening risks.”

The FDA hopes that this warning will help to slow a growing epidemic in this country of opioid addiction that is leading to heroin addiction, overdose and death. In 2015, TIME magazine reported in their cover story that “9.4 million Americans take opioids for long-term pain and 2.1 million are estimated by the NIH (National Institutes of Health) to be hooked.”

The article went on to say that the crisis is a “tragic combination of good intentions, criminal deception and feckless oversight to turn America’s desire to relieve its pain into such widespread suffering.”

Here’s what the FDA told CNN about how this warning will work. “When a patient gets his or her prescription filled, the bottle should have a notification indicating there is a black-box warning for the drug. The consumer would need to go to the manufacturer’s website for details. In addition, pharmacists are encouraged to provide patients with a medication guide — consumer-friendly language explaining the risks of the drug. Under this new effort from the FDA, all instant-release drugs will need to have such a guide. It is up to the pharmacist to dispense this information, something the FDA encourages.”

The FDA ruling is a long-overdue step toward fighting America’s drug epidemic. I’m not sure it is realistic to assume that consumers will go to the manufacturers website for details, but I do think that pharmacists taking the time to go over the risks of painkillers will help. I have to agree with Senator Markey in what he told CNN, “It’s too little, too late.” We have a long way to go to turn this epidemic around and educating the public and doctors is key.

LINKS
Time Magazine Releases Cover Story on Pain Killers
Physicians for Responsible Opioid Prescribing
FDA now requires ‘black box’ warning on painkillers

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription.

YOU WANT TO BULLY ME?

March 18th, 2016

Bullying is a topic that I have talked about frequently in my blog and with patients and educators. Sadly, bullying is much worse for children today. Why? Because social media created cyberbullying making it easy for bullies to taunt, tease and threaten their victims around-the-clock.

I recently came across a story online at Choices magazine by a young woman who was bullied and decided to fight back. The article tells the story of Nicole, who had hundreds of friends and never thought she’d ever be the target of bullying. Until one day she was accused of doing something that angered many in her class, and so she was now being trashed on Facebook, tormented by a barrage of nasty, hurtful texts and on the verge of falling apart. Until one day she decided to fight back. Choices chronicles her story in “The Girl Who Got Even: A True Cyberbullying Story.”

Nicole’s mom became concerned about the bullying and did some research and found Shawn Edgington, one of America’s leading experts on cyberbullying prevention. Edgington had been speaking at schools and had come to the realization that teens would respond better if he had a young person they could relate to, so he asked Nicole if she would tell her story. She told Choices, “She jumped at the opportunity. For her, there was no better way to get even with her tormenters than by telling the world what she had endured and what she had learned.”

With Nicole as his campaign spokesperson, Edgington formed the Great American NO BULL Challenge. Their website says their mission is to provide a global social media platform to promote youth leadership, cyber citizenship, and social change through peer-to-peer engagement and action. NO BULL is powered by the voices of youth (ages 13-23) through short video documentaries, PSAs, and Vines that they write and produce.

Nicole told Choices that working with Edgington on his campaign has been healing for her. She even said that one of the students who tormented her reached out to apologize for believing in the false accusations and partaking in the bullying.

It was great that Nicole confided in her mother and that her mother was proactive in helping her daughter. Parents need to educate themselves about bullying. There are effective intervention programs across the country that parents should get involved with in their children’s schools. Schools should be encouraged to create and enforce anti-bullying policies and to have class discussions about bullies.

I have counseled plenty of children over the years who have been the victims of childhood bullying. Bullying comes in many forms, but intimidation, teasing and the threat of violence are often involved. The sooner a child begins to deal with their bullying the better the outcome. For Nicole, she not only beat back the bullies she found that she “felt relief” and that her world seemed “in balance” again.

LINKS

The Girl Who Got Even: A True Cyberbullying Story – Choices
Shawn Edgington – Cyberbully Prevention Expert
Great American NO BULL Challenge
What to Do If You Think Your Child is Being Bullied – Dr. Henry Paul Blog

YES, IT CAN HAPPEN IN YOUR FAMILY!

March 9th, 2016

The hardest part about the heroin epidemic in this country is getting those who think “not in my family” to understand that it happens to ANY family. It happens to high school and college athletes – the “good kids” — and it occurs in higher numbers in our adult population over age 50. Why? Because painkillers are prescribed to injured athletes and adults with injuries and chronic pain, and painkillers are a gateway drug to heroin.

Let’s focus today on adolescent athletes and how an injury can lead to addiction. A 2013 study published in the American Journal of Public Health found that young athletes are 50 percent more likely to abuse painkillers. Just yesterday CBS News ran a story about college high school wrestler Robert King who was prescribed the painkiller Percocet for his broken foot and who just a few years later found himself addicted to heroin.

According to CBS, “King’s story is not an uncommon one. As the heroin epidemic continues to rage throughout the country, high school athletes are falling victim to addiction in alarming numbers.”

I have written blogs about painkiller and heroin addiction for the past year and the need in this country for more awareness, and I applaud families who are opening up about their loved one’s addiction. Now, even in obituaries families are candidly disclosing the cause of death as a drug addiction. Families are not trying to scare anyone. On the contrary, they are helping to promote awareness that just may save a life.

In the CBS story, Jack Riley, Deputy Administrator of the Drug Enforcement Administration (DEA), emphasized that addiction cuts across every demographic group. He told CBS, “Heroin never discriminates, and athletes are no different. This dangerous drug has become a powerful weapon of mass destruction for drug addicts, some of whom are athletes who first became addicted to painkillers while rehabilitating from sports injury.”

So what should parents do? Most important is to educate yourself about the growing painkiller and heroin epidemic. If your school or community is offering drug awareness education forums — go! Encourage your friends to go with you too. Learn about Narcan™ (naloxone) an opiate antidote. Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin. Many local communities are training first responders and school staff in the use of Narcan.

Trust your instincts. If you think something is off with your teen, you’re probably right. Ask questions and get answers. If you have a child on pain medication, ask the doctor about it. In the end, remember this is an epidemic in this country so do what you can do to prevent it from spreading to your family. Knowledge is power – always a good place to start!

LINKS

The surprising path from student athlete to heroin addict CBS

You can make a difference in the growing heroin epidemic. Blog by Dr. Henry Paul

He died of a Heroin overdose! Blog by Dr. Henry Paul

LET ‘EM SLEEP

March 9th, 2016

The debate rages on about whether-or-not schools are starting too early in the morning for teenagers. Currently, in the U.S. more than 4 in 5 middle and high schools start classes at or before 8:30 am.

TIME magazine recently ran a story “Why schools are struggling to let students sleep in.” In the article California school assistant superintendent, Jody McClay remembers first hearing complaints several years ago from parents and students who said that school was starting too early. She said it puzzled her at first and that she thought at the time the simple solution was just for kids to go to bed earlier. Then she learned about sleep phase delay. This disorder is a medical term for how puberty affects bedtime. The hormone changes cause a shift in the circadian rhythms that makes it difficult, if not impossible, for some teens to go to bed before 11 pm and wake up before 8 am. This lead McClay to ask the question; should school start later?

In 2014, the American Academy of Pediatrics made a formal recommendation to delay school start times. Studies have shown that students who do get more sleep, preferably nine hours, perform overall better in school, particularly on tests.

It seems like starting school an hour later shouldn’t be such a big deal, but it is. It’s also costly. The snags many districts face in starting school later include costly changes in busing, complications for athletic programs that most likely will see students leaving early for games, a need to adjust the starting time in primary schools to accommodate busing schedules, and a later start time for students who want to work after school.

For parents starting school later makes it more difficult. Starting school an hour later can create a host of problems for parents trying to get to work on time.
Some schools are making the change and have done so with precision, patience, compromise and lots of trial and error and studying what works and what doesn’t. Karen Garza, the superintendent of Fairfax County Public Schools in Virginia, said that her school has made the change and that, for the most part, it’s been a success. Garza thinks that other schools will take the plunge – they have to. I agree.

LINKS

Why Schools Are Struggling to Let Students Sleep In TIME (available to subscribers online)

Why More Schools Are Letting Their Students Sleep In Huffington Post

New Study Says Let Them Sleep In Dr. Paul Blog

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription.