Dr. Henry Paul, MD

Psychiatrist, Author and Educator

Monthly Archives: April 2016

ALARMING JUMP IN SUICIDE RATES

April 26th, 2016

I was surprised by the latest CDC report out this week that showed suicide rates in the United States were at their highest level in three decades. The report released on Friday said that suicides have increased in the US to a rate of 13 per 100,000 people, the highest since 1986. The increase is particularly pronounced among middle-age white people who now account for a third of all US suicides.

45274094_sAccording to the CDC study, more than 14,000 middle-aged white people killed themselves in 2014, and the overall suicide rate rose by 24% from 1999 to 2014. Among white men ages 45 to 64, the rate increased 43% and increased 63% for women in the same age-range. The study did not venture to say what the causes might be for the increase, but I think we can surmise that mental health, substance abuse and difficult economic times have contributed.

The study also showed a jump in the suicides amongst girls between the ages of 10 to 14. From 1999 to 2015 the number tripled from 50 to 150. This number is still very low but the fact that it tripled is a concern.

The study did show a decline for two groups; black men and seniors over age 75.

Robert D Putnam, a professor of public policy at Harvard, told the New York Times, “This is part of the larger emerging pattern of evidence of the links between poverty, hopelessness and health.”

The New York Times also reported that since they ran their story last week, they had gotten an overwhelming response. If you need to speak with someone for yourself or a friend or loved one you can call:

National Suicide Prevention Hotline: No matter what problems you are dealing with they want to help you find a reason to keep living. By calling 1-800-273-TALK (8255) you’ll be connected to a skilled, trained counselor at a crisis center in your area, anytime 24/7. This is a confidential, free call.

Crisis Text Line: They serve anyone, in any type of crisis, providing access to free, 24/7 support and information via the medium people already use and trust: text. According to their website this is how it works:

  1. Text 741-741 from anywhere in the USA, anytime, about any type of crisis.
  2. A live, trained Crisis Counselor receives the text and responds quickly.
    The volunteer Crisis Counselor will help you move from a hot moment to a cool moment
  3. As always, if this is an emergency and someone is in crisis you should call 911.

LINKS
U.S. Suicide Rate Jumps to 30 Year High NY Times, April 2016
Crisistextline.org
National Suicide Prevention Hotline
Suicide is a Growing Epidemic in America Dr. Henry Paul Blog, November 2015

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.

WHY SHOULD I CARE ABOUT A DRUG ADDICT?

April 15th, 2016

Addiction is similar to other diseases, such as heart disease. Both disrupt the normal, healthy functioning of the underlying organ, have serious harmful consequences, are preventable, treatable, and if left untreated, can last a lifetime. Source: From the laboratories of Drs. N. Volkow and H. Schelbert.

Last week I posted a blog about Narcan™ (naloxone), an opiate antidote that saves lives! It was brought to my attention this week that a local community coalition spreading the word about opiate and heroin addiction was offering a free Narcan training, and I was surprised by some of the online conversation about it.

33645761_sSome of the comments were about “letting the addicts die” because they (the addict) had made a choice to use drugs. Others were debating whether-or-not addiction is a disease. What these comments tell me is that there is a lot of confusion out there amongst adults about opiate addiction (including heroin, which is an opiate). So, I thought I would dry to address some of the confusion here.

First, drug addiction is a disease that develops over time as a result of the initially voluntary behavior of using drugs. While the full causes are not known drug addiction does take on a life of its own. Addiction ends up affecting a host of functions of a person’s body and mind.

In June of 2015, TIME magazine had a cover story, “Why America Can’t Kick Its Painkiller Problem.” The story makes the case that these addictions no longer start in the dark alleys with drug dealers, but rather start in doctors’ offices with everyday people seeking relief for their pain. These painkillers, known as opioids, are used to treat everything from migraine headaches to back pain, to sports injuries, to severe pelvic pain to chronic Lyme disease.

Here’s a little excerpt from the article that gives a pretty clear picture. “The longer patients stay on the drugs, which are chemically related to heroin and trigger a similar biological response, including euphoria, the higher the chances users will become addicted. When doctors, regulators and law-enforcement officials try to curb access, addicted patients buy the pills on the black market, where they are plentiful. And when those supplies run short, people who would never have dreamed of shooting up, like suburban moms and middle-class professionals, seek respite from the pain of withdrawal with the more potent method of dissolving and injecting the pills’ contents, or going straight to heroin.” (Massimo Calabresi, TIME)

This opiate epidemic is leading elected officials and the medical community to a point where we have to rethink pain management in this country. Law enforcement is on the treatment side. Yes, believe-it-or-not getting arrested leads to the beginning of treatment for many. What we need to do, and what was evident to me by reading some of the comments online, is that we have to put much more effort into awareness and prevention.

LINKS
Drugs, Brains, and Behavior: The Science of Addiction – this booklet explains scientific information about addiction that is easily understandable. Here is a link to a PDF you can download.

Why America Can’t Kick Its Painkiller Problem – You do need a TIME subscription to read this article.

How Science Has Revolutionized the Understanding of Drug Addiction

Easy to Read Drug Facts from the NIDA

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.

WHY SHOULD I GET NARCAN™ TRAINING?

April 4th, 2016

Narcan™ (naloxone) is an opiate antidote that saves lives! And, you should know how to use it because someday someone in your family just may need it.
Overdoses from painkillers and heroin, both opioids, are alarmingly on the rise in the United States. Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin. When a person is overdosing on an opioid, breathing can slow down or stop, and it can be very hard to wake them from this state.

20160404_142120Who is at risk for overdose? Your grandmother who just had a knee replacement, your aunt who is dealing with chronic back pain, your teenage son or daughter who first takes painkillers while recovering from a sports injury. The list can go on and on. Sadly, painkillers are prescribed at alarming rates, and long-term use leads to addiction. These painkillers are often the gateway drug for heroin.

On Tuesday, President Obama announced a series of initiatives aimed at curbing America’s opioid addiction epidemic. The steps he outlined would make it easier to obtain medication-based treatment, expand Medicaid coverage and increase the availability of a drug that saves people from overdoses.

Narcan is a drug that can save people from overdosing. It can be delivered in the nostrils with the use of a mucosal atomization device (MAD) or intramuscularly with a syringe. Narcan is a non-patient specific prescription that is distributed through an authorized agency, such as a local health department, and given to individuals who have been trained in opioid overdose recognition and response consistent with that agencies registration with their state.

What does Narcan do? Simply, Narcan knocks the opioids out of the opiate receptors in the brain. Tom Ferraro, professor of biomedical sciences at Cooper Medical School of Rowan University in Camden, N.J. told Newsworks in an online article published in 2014 that it essentially “blocks the ability of opioids to do what they do at the molecular level.”
Ferrero went on in the article to explain, “The proteins in your brain have special receptors that, when unlocked, release certain biochemical reactions. Think of opioids, like heroin, as being special keys, says Ferraro. When they get in your brain, they seek out those receptors, ‘latch on’ and unlock the lock. When the drug opens and closes that lock repeatedly, it ‘triggers a cascade of biochemistry inside that particular cell.’” He says, “this is the basic mechanism of being high. The heroin repeatedly unlocks the lock, releasing euphoria, pain relief and addiction from that cell.”

Narcan, on the other hand, cannot be used to get a person high, and if given to an individual who has not taken opioids, it will not have any effect on them. For more information on Narcan visit FDA.gov

LINKS
Obama Pushes For More Treatment for Opioid Addiction
CVS to Sell Heroin OD Reversal Drug Narcan in More Pharmacies
The overdose ‘antidote’: how Narcan works

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.