Dr. Henry Paul, MD

Psychiatrist, Author and Educator

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.

LOOK THROUGH MY LENS

February 1st, 2016

43151727_sI made a great video discovery on YouTube this week. I found this 14-minute video that explained autism. Most impressive was that this video was done, start to finish, by a 16-year-old high school student who wanted to let her peers know what it was like to have autism. No she doesn’t have autism, nor does anyone in her family. But, after she met her friend Jaime with cerebral palsy, she realized that we all need a better understanding of what it is like to live with a physical disability or learning difficulties. With her single YouTube video, she has helped thousands of teens understand a complex disorder.

Alex Jackman told Choices Magazine that it all began when out of curiosity she joined a girl for lunch at summer camp. Jaime was in a wheelchair and often ate by herself. Alex and Jaime became good friends. Alex tells Choices how that might not have happened had she not approached Jaime and sat down with her for lunch.

Jackman says that through her volunteer work at a local autism organization she was inspired to create the video, specifically targeted at teens, to help them better understand the developmental disorder. She told Choices, “I wanted to make something simple that put you in someone with autism’s shoes.”

After a year of interviewing kids she had met through her volunteering, interviewing experts on Autism, and writing, filming and editing – Jackman posted “A Teens Guide to Autism.”  And, guess what? It took off. The video has been seen around the world and has won several awards! Kudos to Jackman for making a difference!

LINKS
The Autism Activist

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. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

THE FINAL SHOT – MENTAL ILLNESS

December 11th, 2015

A USA TODAY story out yesterday said, “At a time of heightened concern over police shootings, a new report estimates that people with mental illness are 16 times more likely than others to be killed by police.”

10411781_sWhy is this? The problem is a lack of treatment for those with mental illness, and I also think a lack of training of law enforcement to recognize it. Mental illness is still something that carries a stigma. People, in general, don’t want to talk about it. For years now, the main thing driving the conversation about mental health has been the mass shootings. People are arguing that mental illness is the reason behind the mass shootings.

Now, a new study out from the Virginia-based Treatment Advocacy Center is saying that about one-in-four fatal police encounters involve someone with mental illness. This study is moving beyond saying that not just those who decide to shoot others in a mass shooting have some mental illness, but that many victims of shooting by law enforcement may also have mental health issues that made them do something illegal that got them killed.

I agree, and this is why we need more dialogue and more solutions on how to help those with mental illness. There are over 8 million people in the United States who have a mental disorder that can alter their thinking and perception of the world around them. From paranoid syndromes to fear, loneliness and anger there are plenty of emotions, disturbances of judgement and other issues that are associated with mental illness that can cause a person to act out or sometimes simply not understand laws or social constructs. And, the disorders themselves ranging from bipolar disorder to schizophrenia to various personality and substance abuse disorders that increase vulnerability often go undiagnosed. For many, even if they are diagnosed, some just stop taking their medications and other forms of treatment.

So what’s the answer? Well, I think that Mayor de Blasio and #ThriveNYC is a start. I believe that having a dialogue and trying to develop programs that can help those suffering from mental illness is a good place to start. Look, people with mental illness are no more violent than others. A better understanding by all will help many to seek and get the help they need. America has to embrace this conversation before change can ever really take hold.

Join me on Facebook and let’s have a conversation about this. Ideas and change come from collaborative thinking and open discussion.

LINKS
“I Called the Police for Help, Not to Kill My Son”
Groups call on Congress to reform mental health system

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. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

POLICE AND SCHOOLS PARTNERING TO BETTER UNDERSTAND MENTAL HEALTH ISSUES

February 9th, 2015

Police and school officials in Fort Wayne, Indiana, are teaming-up to understand the basics of mental illness in young people in an effort to cut back on arrests of children in a mental health crisis. This partnership is inspiring to see because it is through collaborative efforts like this that young people who are at risk will get the best help.

16579192_sThe greatest way to help young people who have mental illness is to get them treatment and not to incarcerate them. The problem is that the symptoms of a mental health crisis are mistaken for delinquent behavior, and that can lead to arrest and possibly jail time.

There has been an ongoing debate in the medical community for years about the link between mental illness and criminal behavior. So why do so many Americans associate mental illness with criminal behavior? Because that is what is in the media and that’s what people remember. Think Sandy Hook. I’m sure what comes to mind for many is that the shooter was on the autism spectrum.

Behavior disorders in young people are often disrupting and bothersome to parents and teachers. It is normal for parents of teens to worry about their behavior, concerned that episodes of “acting up” may be harbingers of future antisocial, sociopathic development, or that their teens are on the road to violent criminality, substance abuse, living on the “edge,” and ending up in jail or prison.

The reality is that most normal teenagers do act up from time-to-time, sometimes in very disturbing and destructive ways. Adolescence is a time of testing limits. In young people who are still developing it remains self-evident that abnormal behaviors are often part of normal developmental progression, and they are temporary. In other instances it can be part of a disruptive behavior disorder, and if that’s the case the most important thing to do is to get the teen the proper treatment.

Young people with disruptive behavior disorders such as ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD), do occasionally break laws, especially those young people with Conduct Disorder. If your teen’s behavioral problems have proven to be intransigent, they may suffer from a behavioral disorder that requires greater attention and more specific help. The upside is that these disorders in young people can more easily be treated than the adult syndrome of “Antisocial Personality” (the Psychopath), which is notoriously resistant to psychiatric intervention. Youth carries with it more hope of intervention and possible change. Thus schools, police and mental health professionals working together offer the most fruitful hope.

Click here to read about the partnership between police and school administrators in Fort Wayne.

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. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

MY CHILD IS GAY! WHAT SHOULD I DO?

January 15th, 2015

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Most parents love their children! That love is what will help parents to survive the initial shock of hearing that their son or daughter is gay. After a period of disbelief or denial, most parents can be counted on to be supportive. Here are some guidelines for parents to deal with their child’s homosexuality.

  • If your teen is gay or lesbian you should provide emotional support, despite the fact that you may have trouble accepting it.
  • Counseling and/or psychotherapy are suggested for teenagers who are uncomfortable with or uncertain about their sexual orientation. Therapy can help with adjusting to society in general. Make no mistake, sending a child for conversion therapy to change their sexual orientation has not been shown to work.
  • There are many local and national gay support groups (see list below) that can help a homosexual teenager to overcome some of the stigmatization and negative feedback that he or she gets.
  • It is extremely important that ALL teenagers understand the information about the risk for sexually transmitted diseases. Homosexual transmission of HIV is common and knowing the importance of condoms and other protection against such transmissions is essential.
  • A very large percentage, up to 95 percent, of LGBT teenagers report that they are often called names or threatened. As a result, they often skip school because they feel unsafe. LGBT teenagers are three-times more likely to be assaulted than their heterosexual peers. In addition, they are threatened and injured more by weapons. Additionally, lesbian and bisexual teenagers are more likely than heterosexual girls to be victims of rape or attempted rape.
  • Take care of yourself, too. Parents should make sure that they seek support, as well. Groups like PFLAG are available to answer questions and offer help. The most important thing for parents is to gain knowledge, be understanding, and most importantly be supportive.

In my next blog, I will discuss the STDs and Safe Sex for teenagers.

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. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

HOMOSEXUAL TEENS “COMING OUT”

January 14th, 2015

15043553_sIn our culture, homosexual youths have to deal with a number of mental health issues. Ongoing discrimination fuels anxiety, depression and other stress-related mental health problems among LGBT people. In our culture homosexual youths have a higher suicide/mortality rate than heterosexuals.  It is estimated that 30 percent of all youth suicides are gay youths.

Many gay youths feel guilty about their sexuality and painfully different from their peers; they worry about the response from their families, are often teased and bullied, worry about HIV infection and other STDs, feel discrimination when joining various clubs and other activities, and often are rejected and harassed by other teenagers.  This leads to isolation and withdrawal, low self-esteem, depression, and sometimes trouble concentrating.  An added distress for gay youths is telling their parents and the fear of rejection.  (See my next blog about support for parents).

Often when teenagers become aware of homosexual stirrings they feel great confusion and attempt to deny and repress them.  This leads to anxiety, sometimes causing a teen to “run” for treatment to get the problem fixed.  They sometimes even make religious commitments to overcome the homosexual feelings thought to be bad or sinful.

“Coming out” is a popular term used when someone chooses to make their sexual preference known.  In most cases, teenagers will “come out” when asked about their sexual preference.  Over time, increased socialization with other gays tends to solidify the sexual identity of a homosexual teenager.  This decreases the sense of loneliness and isolation.  Some pride in being gay begins to develop.  Eventually, positive relationships with other gays and lesbians result in positive self-identification and ultimate integration and acceptance. This encourages teens to be open about their sexual orientations without defensiveness.  Increased awareness of homosexuality, and gay teens’ own growing self-acceptance and self-expression, hopefully will continue to reduce social prejudice against being gay.

Talking about your sexual preference or “coming out” is an uncomfortable issue for anyone.  For homosexuals it is also controversial. Just look at the gay athletes who in the past couple of years have come out in the NFL and NBA. How has it changed their lives; particularly their careers?  Homosexual teenagers see this and try to relate it to their own lives.  Who should they tell – friends, parents, siblings their doctor or coach?  The bottom line is that homosexual teenagers have to decide when and whom they are going to tell and how they are going to tell them based on their particular and unique families, friendships, and social adaptation.

It is not easy for teenagers to express their feelings, but in 2011, 183 teenagers provided their feelings to The New York Times “Coming Out” project.   Click on the link to read their stories.  You will come away with a much better understanding of what teenagers face and how they feel about “coming out” as homosexual   Here is also a link to the May 2011 NY Times article that outlines the project; “‘Coming Out’ – Gay teenagers in their own words” by Sarah Kramer.

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. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.