Dr. Henry Paul, MD

Psychiatrist, Author and Educator

DRIVING HIGH KILLS JUST LIKE DRIVING DRUNK DOES!

August 28th, 2014

The New York City teenager who admitted smoking marijuana and speeding before crashing into a tree in 2012, killing four of his friends, has been sentenced to five to 15 years in prison. NBC New York

A Pine Plains teenager has been found guilty in connection with a high-speed crash that killed two other teens last summer; it’s been an emotional case that likely will bring little comfort to surviving family members but hopefully will send a powerful message about the dangers of drugged driving. Daily Freeman

Two teen drivers, one on Long Island and one in the Hudson Valley, are being sentenced for deadly crashes that killed their friends. This is tragic for all involved and it should be a wake-up call for parents to talk to their kids about the consequences of driving high.

Teenagers never set-out to hurt their friends when they drive high or drunk, no one does. But the tragic truth is that drugged driving does kill!

Substance abuse is on the rise in the United States, particularly, amongst teens and young adults in their 20’s. Governors, guidance counselors and medical professionals around the country are talking about the growing heroin epidemic and the abuse of prescription drugs. Just last week the Federal government tightened the restrictions on hydrocodone, a drug that is part of a growing epidemic of prescription drug abuse that, in many cases, leads to heroin addiction.

In a November 2013 Teen Vogue article, Riding High: Teens Talk Smoking Weed and Driving Stoned by Julia Rubin, a young woman admits that: Though she’s driven high, she’s never driven drunk, nor would she get in a car with a friend who’s been drinking. Why the distinction? Driving high is risky, but driving drunk is worse.

For years, there has been discussion about the effects of marijuana and other drugs on a person’s ability to drive. What we are discovering is that marijuana does impair driving ability. For many teens the results, as we see with these two young drivers, are tragic.

Talk to your kids about drugged driving and driving high. Smoking pot is not a “rite of passage” for teenagers. The stakes are much too high!

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.

NEW STUDY SAYS LET THEM SLEEP

August 26th, 2014

Your teenager wants to sleep later and now his doctor agrees. Middle and high school students shouldn’t have to start school until 8:30 in the morning or later, the American Academy of Pediatrics says. NBC News

With school starting next week, now is as good a time as ever to discuss how much sleep your teenager needs. A new study out yesterday from the American Academy of Pediatrics says that children, teens in particular, need more sleep and suggests that they would be more successful in school if the school day did not start before 8:30 am. Most school days now start for teens between 7:15 and 7:30 am.

In an interview with NBC News, Dr. Judith Owens, director of sleep medicine at Children’s National Medical Center in Washington, who led the team that wrote the group’s policy statement on the issue said, “The research is clear that adolescents who get enough sleep have a reduced risk of being overweight or suffering depression, are less likely to be involved in automobile accidents, and have better grades, higher standardized test scores and an overall better quality of life.”

In a statement, the American Academy of Pediatrics said insufficient sleep in adolescents is an important public health issue that significantly affects the health and safety, as well as the academic success, of our nation’s middle and high school students. It went on to say that a substantial body of research has now demonstrated that delaying school start times is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to students with regard to physical and mental health, safety, and academic achievement.

TIME reported in their article on the study that according to a 2006 National Sleep Foundation poll, 87% of high school students don’t get the recommended 9 to 10 hours of sleep they need to function at their best and promote healthy mental and physical development; most average around seven hours of sleep on weeknights.

Parents should talk with their teens about how important sleep is to their overall health and well-being. While we cannot change the school day this late in the game, we can make sure that teens understand the power behind getting enough sleep. Encourage them to turn off the I-Phone and music and put aside the TV remote to make sure to get those extra z’s. The best environment for sleep is in a room without a lot of electronics and which is cool, quiet and dark.

Parents should also know the common causes of insomnia. These include stress, anxiety, stimulus overload, caffeine, and side-effects to medications. Here are some links to my blogs explaining the various sleeping problems and suggested treatments.

NEW REGULATIONS ON DISPENSING HYDROCODONE. WILL IT MAKE A DIFFERENCE?

August 25th, 2014

In Move to Curb Drug Abuse, D.E.A. Tightens Rule on Widely Prescribed Painkiller — The stricter rule for hydrocodone, which is the most widely prescribed painkiller in the United States and which is an ingredient in drugs like Vicodin, is one of the most far-reaching efforts to stop the growing epidemic of prescription drug abuse. More than 20,000 Americans die every year because of prescription drug abuse, according to federal data. The New York Times

On Friday, the federal government tightened the regulations on the most prescribed painkiller in America, hydrocodone. The reason? Hydrocodone is an ingredient in drugs like Vicodin and a leader in the growing epidemic of prescription drug abuse here in the United States.

As a psychiatrist treating adults and teens for over 30 years, I know that painkillers like Vicodin are highly addictive and are adding to a growing heroin addiction in this country.

As far as hydrocodone, the changes that the government requires are sweeping, making it much more difficult to prescribe the drug. For this drug, doctors will no longer be able to call in prescriptions, and patients will no longer be able to get refills on the same prescription without returning to their doctor for a visit. The DEA (Drug Enforcement Administration) published a rule on Thursday, August 21, 2014, which also requires pharmacies to keep the drug in a vault.

The problem is that the abuse of painkillers claims more lives than any other drug including heroin and cocaine combined, and hydrocodone and other painkillers are the leading cause of heroin addiction. The heroin addiction is out of control, and I have written several blogs about it and the need for more education about the epidemic. See my blogs on heroin Governor Cuomo Recognizes Heroin Epidemic and The Growing Heroin Problem in America.

These new restrictions are not a solution to the problem, but they do acknowledge the need to do something. Oxycodone, the main ingredient in OxyContin, which I am sure many of you have heard about, is highly addictive and has been restricted for years.

The downside of restricting all of these drugs is that it will most likely lead to an increase in heroin abuse. Why? Because synthetic heroin is cheap. The reality is that it is good to be aware of the need for restricting medications like hydrocodone, but we need to also be vigilant about educating our teens and young adults, the most affected population, about the dangers of these drugs and heroin.

SCREENING PRESCHOOLERS FOR DEPRESSION IS A GOOD IDEA

August 22nd, 2014

Depression can strike at any age, even among preschoolers, researchers report. CBS News

A very interesting study came out this month that looked at depression in preschoolers. The study found that preschoolers who are depressed are two and a half times more likely to continue to experience symptoms in elementary and middle school.

The study, published recently in the American Journal of Psychiatry, was done at Washington University by a team headed by Dr. Joan Luby, who directs the university’s Early Emotional Development Program. It included 246 preschool children, ranging from three to five years of age. Luby’s team evaluated the children for depression and other psychiatric conditions over time.

At the onset of the study, 74 of the children were diagnosed with depression. Six years later, 79 of the children met the criteria for clinical depression, including about half of the 74 children diagnosed with depression when the study began. Of the 172 children who were not depressed as preschoolers just 24 percent of them went on to develop depression later.

The study identified a higher risk of depression for children whose mothers had suffered from depression, and those who were diagnosed with a conduct disorder while in preschool.

When I was in training, we were taught that young children could not suffer from depression because they were not old enough to have a superego — a mental structure described by Sigmund Freud that develops at about eight years old. This theory, which denied the obvious, which was that we often saw depressed young children, flew in the face of reality and caused depressed children to be left untreated up until the last few decades.

Today, we know that people of all ages can suffer from depression, especially young children who grow up in stressful circumstances. If untreated, this depression can lead to severe consequences including further depression, educational slowing, behavior disorders and other syndromes.

I agree with the researchers that children as early as three years old should be screened. Childhood depression can be treated, and there are a host of interventions that help including psychotherapy, family therapy, and medication.

SHOCK EM’ OUT OF AUTISM?

August 21st, 2014

Jennifer Msumba is on the autism spectrum. For seven years, she was treated at the Judge Rotenberg Center in Canton, Massachusetts, where she received painful electric shocks aimed at modifying her behavior. She describes being strapped, spread-eagle to a restraint board and shocked multiple times before she left the center in 2009. CBS Evening News.

Autism Spectrum Disorder (ASD), also known as Pervasive Development Disorder, is a diagnosis that is more prevalent than ever before and one that is concerning not only for the medical community, but for the parents and families of those diagnosed with it, too.

Back in March of this year, a CDC study reported that one in 68 children has Autism (ASD). This was a 30 percent increase since the agency estimated just two years before that one child in 88 suffered from the disorder. There is some controversy as to the validity of the reported increase in diagnosis but ASD remains a major issue in this country. It is one of a parent’s most feared diagnoses.

The CBS News story is the first to really “out” electric shock as a treatment for those with ASD. After watching the segment, you certainly can see there is controversy attached to its usage, as well.

ASD is a condition that has a number of variables, and those are specific to each person diagnosed with it. Some people cannot communicate at all while others are social. Some can be compulsive and inflexible, preoccupied with similar ritualized behaviors that can go on for hours. Others can be aggressive and prone to angry outbursts or temper tantrums. Some have mood swings, can be hyperactive, and the list goes on. The important thing to recognize is that all these symptoms do not show up in every person diagnosed with ASD.

Without knowing the full story and seeing the diagnoses of the patients included in the news story, I cannot render an appropriate opinion on specific treatment recommendations, but I can say that the use of shock therapy for these types of children seems far-fetched to me. Using shock conditioning seems primitive, if not downright out of the realm of accepted standards of care. When I treat young people with ASD I almost always recommend medication and behavioral therapy, as well as proper educational placement. I have never recommended electric shock and find it difficult to imagine ever prescribing.

LAUGHTER CAN OFTEN HIDE THE PAIN

August 15th, 2014

Williams, 63, who had been struggling with depression before his apparent suicide on Monday, told Terry Gross on the “Fresh Air” NPR radio show in 2006 that mania was something he imitated for characters he sometimes performed. But depression, he said, was more personal.

“Do I perform sometimes in a manic style? Yes,” Williams said. “Am I manic all the time? No. Do I get sad? Oh yeah. Does it hit me hard? Oh yeah.” Huffington Post

It is not a secret that Robin Williams has struggled with depression and substance abuse during his career. In recent years, he has talked openly about his struggles. With Robin Williams, I suspect that the humor hid a lot of the pain.

It is not certain why people get depressed, but there is some evidence that there may be a genetic tendency to inherit depression-especially bipolar depression from which he seems to have suffered. This may have been the case with Williams, but we will never know. It has been described that he suffers from bipolar disorder and when depression strikes bipolar patients it is often worse than others. Depression is also associated with Parkinson’s disease from which it has been said he suffered.

The symptoms of depression usually involve sad or irritable moods, diminished interest or pleasure in activities, sleeping too much or too little, weight loss or gain, slowness or agitation in movement, and fatigue or loss of energy, as well as feelings of worthlessness, inappropriate guilt, and a diminished ability to concentrate or make decisions. Depression can also lead to recurring thoughts of death and suicide. Anger, social withdrawal, and feelings of helplessness and hopelessness also commonly characterize depression. Depression does not discriminate – having fame and money is not an escape from this disease, and yes, depression is a disease.

In my opinion, depression is a symptom of unresolved inner conflicts, feelings of perplexity, and confusion about the environment and oneself and is also associated with a degree of genetic and biologic causation. Depression is a symptom that should lead loved ones and friends to try to understand what is truly troubling and driving the person they love to such despair. Patience and compassion are the keys!

Robin Williams was a wonderfully, funny actor who brought many a smile to millions of faces. For that, we will remember him!

Hashtags: #drpaul #drhenrypaul #henrypaulmd #whenkidsneedmeds #mentalhealthteens #robinwilliamsdeath

ARE YOU CONSIDERING MEDICATION FOR YOUR CHILD?

August 11th, 2014

As a child psychiatrist for over 30 years, I fully understand why parents are often anxious, hesitant, and concerned about giving medication to their child. All too often, such feelings arise from the biased, misleading, and even fabricated stories that are conveyed through the media. You wonder if you’re doing the right thing, what the long-term effects might be and should you try something more holistic. You read all kinds of posts and information on the Internet that, quite frankly, can be scary. The reality, though, is that your child needs this medication, and you need to be able to sleep at night and not worry that you are harming your child.

I have evaluated, treated, and prescribed medication for thousands of young people in settings that include hospitals, outpatient public clinics, residences, foster agencies, and in private practice, and I have followed the progress of many of them over the course of many years. I have plenty of experiences prescribing all of the current psychotropic drugs, and I have treated children and teenagers with all the various disorders including ADHD, bipolar disorder, Oppositional Defiant Disorder (ODD), Asperger’s, and more. I have seen the therapeutic effects of medication when administered properly, the harmful effects when they are abused or prescribed incorrectly, and I have observed the side effects that occur on a rare occasion.

In 2013, I wrote the book When Kids Need Meds: Everything a Parent Needs to Know about Psychiatric Medication and Youngsters. Look, I don’t believe every child with a mental disorder needs medication, but I strongly feels that some do. To withhold these important therapeutic agents can be harmful and, in some cases, tragic. In When Kids Need Meds, I discuss mental disorders, explain the process of psychiatric evaluation, answer many questions, and talk about stimulants, antidepressants, antipsychotics, mood stabilizers, sleep medications, anti-anxiety drugs and others. I also stress the importance of non-medication therapies and provide references for readers to obtain more information. My goal is to provide a guide that covers almost every aspect of an extremely important and very prevalent topic as it educates, comforts, and provides support. I hope you will find it a resource and that it helps you to make peace with having to give your child medications.

Click the picture to purchase a copy of the book!

Hashtags: #drpaul #drhenrypaul #henrypaulmd #whenkidsneedmeds #mentalhealthteens #Kidsmeds #childmeds #teenmeds