Dr. Henry Paul, MD

Psychiatrist, Author and Educator

WAITING FOR REHAB TO TAKE YOU

September 16th, 2015

“Wait time is among the most commonly cited barriers to access among individuals seeking entry to substance abuse treatment, yet relatively little is known about what contributes to it.” The American Journal of Drug and Alcohol Abuse

Copyright: mybaitshop / 123RF Stock Photo

So what do you do if you are put on a waiting list to get into rehab? Worse yet, what do you do if you are a parent waiting to get your child into rehab? Waiting to get into drug rehab is a very stressful situation for the addict as well as their family and friends. The shortage of beds is due to the growing opiate and heroin epidemic.

Just this week, NBC News reported some startling numbers on the wait list for federally-funded rehab. States like Massachusetts, Florida and Ohio have waits that span from weeks to months. In Maine, according to the NBC report the wait is as long as 18 months. More startling is that our prisons are becoming detox facilities. Most certainly you will detox in prison, but there is no support system in there for helping you find the tools to stay clean and put your life back together when you get out.

The shortage of rehab beds and the growing opiate and heroin epidemic have created a crisis in this country. One that will have to be seriously addressed by the medical community, as well as our elected officials. In the meantime, until a solution arises, I support referring patients who can’t get into rehab to a lower level of care such as an outpatient drug program. Outpatient rehab is a temporary solution but right now next to getting into a rehab it’s the only real option for many addicts.

Look, it certainly isn’t the ideal solution, but it does offer the professional oversight and the support that is needed to help an addict start recovery. These outpatient programs now allow for drugs like Subutex and Suboxone to be dispensed. Before these two drugs were added to the outpatient treatment programs drugs like methadone could only be dispensed in specialized addiction treatment centers where you were admitted.

The FDA website confirms that “there are not enough addiction treatment centers to help all patients seeking treatment. Subutex and Suboxone are the first narcotic drugs available under the Drug Abuse Treatment Act (DATA) of 2000 for the treatment of opiate dependence that can be prescribed in a doctor’s office. This change will provide more patients the opportunity to access treatment.”

Subutex and Suboxone help with opiate addiction because they both contain the active ingredient, buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence.

The American Journal of Drug and Alcohol Abuse did a 2012 study that said that nationwide, only 11 per cent of substance abusers get help from treatment centers. According to the study the primary reason that number is so low is because the wait time is too long.

The NBC story references another study that says “Even when people sign up for wait lists, they will only tolerate one month on average. 40 per cent of people on a wait list will drop off in two weeks, according to a 2008 study.” Click here for the full NBC Story “As Heroin Epidemic Grows, So Does Rehab Wait” by Charlie Giles, September 6, 2015.

If you have questions about rehab placement in the New York area please email me at drpaul@henrypaulmd.com.

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.

HE DIED OF A HEROIN OVERDOSE!

July 20th, 2015

A growing number of obituaries of people who have died of heroin overdoses refer to their addiction, The New York Times reports. In the past, these obituaries tended to say a person died “unexpectedly” or “at home.” Partnership for Drug-Free Kids “More Obituaries Refer to Addiction as Heroin Overdoses Increase”

Heroin again! I have written blogs about painkiller and heroin addiction for the past year and the need in this country for more awareness. Now I applaud families who are opening up about their loved one’s addiction, particularly in obituaries. In the past, obituaries referred to overdose deaths as an “undisclosed” or “sudden” illness. Now 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.
“This is part of a trend toward a greater degree of acceptance and destigmatization about issues pertaining to mental illness, including addiction,” said Dr. Jeffrey A. Lieberman, Chairman of Psychiatry at the Columbia University College of Physicians and Surgeons, in the Partnership for Drug-Free Kids article.

He added, “If a family chooses to do this, they can have a cathartic experience that facilitates the grieving process. When the person was alive, they may have been enabling, and they couldn’t acknowledge it. But this allows them to begin that process of coming to terms with the fallibility of the family member and their own limitations in not having been able to deal with it while the person was alive.”

I found a comment posted by “Charlie” to the Partnership for Drug-Free Kids article said it best, “No one plans on being addicted. They think they are stronger than that. Heroin messes up how your brain processes things. It messes up your entire system. These are people that made a bad decision once or maybe twice and the addiction took hold of them.”

The news media is reminding us every day that we have a serious painkiller and heroin epidemic in this country. All teenagers will be exposed to drugs and alcohol at some point. Studies show that about 65 percent of teenagers try marijuana in high school, but for many children drug experimentation begins even earlier, in grade, middle or junior high school. Parents need to understand that alcohol and marijuana are gateway drugs. What I am concerned about is that there are still so many parents and teens that don’t understand the dangers. Teenagers are known for risky behavior. It is part of their development. Many teens don’t think about the cause and effect correlation of drugs and alcohol with the greater likelihood of becoming involved in criminal activity, suffering from suicidal tendencies, or facing other life-threatening dangers such as death from overdose.

We need to work together to do a better job at keeping our at-risk population safe from drug addiction. It really is a matter of life and death. For more information on addiction you can visit:

YOU CAN MAKE A DIFFERENCE IN THE GROWING HEROIN EPIDEMIC

HEROIN AGAIN!

Why heroin is spreading in America’s suburbs — The drug has followed prescription painkillers into new neighborhoods, forcing police and parents to confront an unexpected problem. By Kristina Lindborg, March 2014, cover story.

Nice coalition. Look for coalitions in your area. Powertotheparent.org

KIDS ONLY PRETEND NOT TO LISTEN

July 9th, 2015

I want to start by saying parents do have a lot more influence with their children than they think. Don’t be fooled by your kids appearing not to listen to you. They’re listening. And when it comes to preventing substance abuse what you say is important.

In 2013, SAMSHA (Substance Abuse and Mental Health Services Administration) reported that “according to the 2004 to 2011 National Surveys on Drug Use and Health, 1 in 5 (22.3 percent) parents of teens aged 12 to 17 thought that what they said would have little influence on whether their child used drugs. Nearly 1 in 10 parents of teens (9.1 percent) said they did not talk to their child about the dangers of using alcohol, tobacco, or other drugs in the past year. Nonetheless, among the parents who had not talked to their child, the majority (67.7 percent) thought what they say would influence whether their child uses drugs.”

A 2013 study by the MetLife Foundation and The Partnership at Drugfree.org reported, “Teen prescription drug misuse and abuse continues to be a significant health problem threatening the well-being of American youth. Currently, one in four teens (24 percent) admits to having misused or abused a prescription drug at least once in their lifetime. It is a bigger problem than many parents know or really understand.

Parent permissiveness and lax attitudes toward misuse and abuse of prescription medicines, coupled with teens’ ease of access to prescription medicines in the home are linked to teen medicine misuse and abuse. The availability of prescription drugs (in the family medicine cabinet, in the homes of friends and family) makes them that much easier to misuse and abuse, and the new survey findings stress that teens are more likely to misuse and abuse prescription medicines if they think their parents are okay with it.”

I have stated over-and-over again that the line of communication between parents and children, particularly teens, needs to be a good one. Whether discussing drugs, sexual preference, depression, peer pressure or any of the many other stresses that affect kids and teens today, you have to engage in the conversation. As important as talking to your kids is listening to them. Listen to their concerns and try to understand how they feel. Do your homework too. Read up on substance abuse and teens. Understand how difficult it is for a teen to “come out”. Seek support when you need it. There are plenty of groups including drug awareness and substance prevention coalitions that will help you.

The MetLife Foundation and The Partnership at Drugfree.org concluded that “Parents and caregivers are missing a key opportunity to play an active role in helping curb the trend of teen medicine misuse and abuse. Parents can safeguard prescriptions in their home, educate themselves about the dangers and risks of this dangerous behavior (for their teens and themselves), and communicate those risks to their children.”

Lastly, I want to remind parents that communication isn’t always verbal. Body language and actions can speak volumes about what is going on in a teenager’s life. Know the signs of substance abuse, bullying, eating disorders and more. The more you understand what your kids face growing up in the world today the better able you are to help. A number of my blogs deal directly with teen struggles with sexual identity, learning disorders and drug and substance abuse. Take a look. Another good reference is the SAMSHA handbook, “Navigating the Teen Years: A Parent’s Handbook for Raising Healthy Teens”. Check it out.

Read the study: The MetLife Foundation and The Partnership at Drugfree.org

Disclaimer
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.

SIGNS YOUR TEEN IS TAKING CLUB DRUGS

June 12th, 2015

There are a lot of club drugs being used on the Rave dance scene. As a parent it is important to know what a Rave is (click here for more on that) and what drugs are available at Raves and the dangers of them. Rave clubs seem to be attracting adolescents and young adults in their mid-to-late 20’s to a place where there is plenty of dangerous substances and drugs. For a list of those drugs you can click here. Read on for the signs that your teenager may have taken club drugs and what you should do.

Signs that your teenager or loved one is using club drugs include:

Severe memory problems
Pronounced lack of coordination
Confusion
Depression
Chills and sweating
Slurred speech
Dizziness
Nausea
Bizarre speech or behavior
Fainting

What to do:

Most important is to let your teen know that you are informed about these drugs and let them know what the dangers are in detail.
Make sure you have a way to contact your teen when they go to a club, party or rave. Call them at regular intervals and set a curfew. Know where your child is going and with whom.
If your teen returns and appears to be under the influence of any drug, don’t scold but instead monitor the symptoms closely and if the symptoms appear to be severe seek medical help.
If drug use continues seek therapeutic and/or drug counseling. These drugs can be addictive.

Here is a link to the National Institute on Drug Abuse. There are also drug and substance abuse coalitions in many communities throughout the United States. Here are a couple that I found informative:

POPULAR RAVE DRUGS

June 10th, 2015

What substances are being used on the Rave dance scene? Rave clubs that seem to be attracting adolescents and young adults in their mid-to-late 20’s are known to be connected to a variety of substances and drugs. Here is a list of some of the most accessible and dangerous drugs often available at a rave.

Ecstasy is the most popular and well-known club drug. It is also referred to as “Molly”, E, X, “Adam” and “clarity”. It is a synthetic drug similar to amphetamines and mescaline (a hallucinogen). It both stimulates and causes psychedelic or hallucinogenic effects. It is most popular in a tablet or capsule form, and its effects typically last for three to six hours. It increases heart rate and blood pressure, and because it enables its user to dance all night, it often causes dehydration. Ecstasy can lead to heart and kidney disease, brain damage, and in rare cases can cause a marked muscle breakdown, high body temperature, heart attacks, strokes and seizures.

GHB (gamma hydroxybutyrate) is also known as “G”, liquid ecstasy, and “Georgia Homeboy”. It is a very common drug at Raves that is often made with mail-order ingredients. It is ingested as a liquid, powder, tablet or capsule. GHB is both a sedative and a euphoriant. This is a drug that effects the central nervous system causing its user to feel relaxed and sedated. At high levels, it can slow breathing and heart rate to dangerously low levels. Overdose with this drug can occur quickly and be fatal. GHB is often used with alcohol, and this can be a deadly combination.

Rohypnol, in the same family as Valium and Xanax, is known as the “forget me pill”. It is usually taken orally and is easily slipped into drinks. Rohypnol is a popular date rape drug because it causes memory loss from the moment it is taken. It lowers blood pressure, causes dizziness and confusion, as well as urine retention.

Methamphetamine is known as speed, meth crystal, glass, “Tina” and “Chalk”. It is very common at Rave parties. It acts as a stimulant and causes memory loss, uncontrollable aggression and violence, psychosis and nerve damage. It is an extremely disinhibiting drug and its users frequently engage in unsafe sex that often exposes them to sexually transmitted diseases, such as HIV and Hepatitis C.

Ketamine, also known as “special k”, “vitamin K” and “new ecstasy” is also known as angel dust. It is similar to the dangerous drug PCP. It is sometimes snorted or smoked with marijuana or cigarettes. Some people inject it, too. It causes serious neurological, blood pressure and breathing problems.

LSD, familiar for decades, is also known as acid. It wreaks havoc with your perceptions, thoughts, and feelings. It is taken as a pill, liquid or on a saturated blotted paper. LSD can cause severe psychotic reactions that can last long afterwards.

I’ll discuss what to do if you suspect that your child is taking these drugs in my next blog.

My Teen Wants to Go to a Rave. What’s a Rave?

MY TEEN WANTS TO GO TO A RAVE! WHAT IS A RAVE?

June 5th, 2015

If you’ve got a teenager in the house than you need to know about “raves.” A rave party is typically an all-night, ear-splitting underground party that features electronic music. Ever heard of Daft Punk? Now Grammy Award winners, they got their start as a “rave” band.

These raves are held in places like warehouses, rental halls, barns, and open-air spaces where kids go crazy and, almost always, find drugs in abundance. The drugs available at raves may not be familiar to you, but they ought to be. Their effects are alarming and potentially life threatening.

The rave party phenomenon has been around for more than 20 years. It started in the UK and quickly spread to the US; particularly to the West Coast. It didn’t take long for it to spread across the country. The drugs offered at the raves primarily keep kids (yes, they are marketing to kids) energetic and dancing all night. Club drugs, as they are known, are dangerous, and parents need to know what they are and what the signs are that their kids may be taking them.

Most of the club drugs are made illegally, come from unknown sources, and are made with various mixes of unknown chemicals. On their own or mixed with alcohol and other drugs, they can be catastrophically toxic and sometimes fatal. Adding to their danger is that little is known about their toxicity making it difficult to treat overdoses.

Many of these drugs are colorless, odorless and tasteless posing a serious threat for young unsuspecting teens. Since some of these drugs cause amnesia, date rape and unrecalled sexual assault is one frequent outcome. Teens who take these drugs may often engage in risky sex that they don’t remember, and that exposes them to contracting sexually transmitted diseases including HIV and Hepatitis C.

Research has shown that club drugs have long-lasting effects on muscle tissue and the brain, especially memory functions. Combined with alcohol, as they often are at rave parties, their effects become potentially fatal. In 2013, there were four deaths linked to the club drug Molly. These deaths opened a nationwide dialogue about the use of illegal stimulants at concerts, raves and electronic dance music shows. It also shed some light on the music venues and the difficulties encountered by organizers to keep those substances out.

Last year, I wrote about the club drug Molly and its dangers. I will highlight some of the other drugs (cocaine, meth, LSD, etc.) that are popular with teens in my next blog. I’ll also discuss what to do if you suspect that your child is taking these drugs.

Learn more about Molly:

Molly: Why the Club Drug is so Dangerous
Club Drug ‘Molly’ Eyed in Four Deaths
There’s Something about Molly

HEROIN AGAIN!

March 19th, 2015

“New York City is now the “nation’s most significant” heroin hub,” according to city Special Narcotics Prosecutor Bridget Brennan. NY Post, 3/16/15, NY is now heroin central: narcotics prosecutor

I have been writing about heroin now for over a year in my blog, and the heroin situation just continues to get worse. Heroin is an epidemic that has taken America by storm. I cannot impress enough on parents that they need to educate themselves about the dangers of prescription painkillers and the rising use of heroin. These threats are particularly dangerous to our teenagers and young adults.

Here are some facts on Heroin from the DEA’s Prevention4teens:

Narcotics (such as heroin, morphine, OxyContin, etc.) are used to dull the senses and reduce pain. Narcotics can be made from opium (from the opium poppy) or created in a laboratory (synthetic and semi-synthetic narcotics).”
Heroin is a narcotic which can be injected, smoked or snorted. It comes from the opium poppy grown in Southeast Asia (Thailand, Laos and Myanmar— Burma); Southwest Asia (Afghanistan and Pakistan), Mexico and Colombia. It comes in several forms, the main ones being “black tar” from Mexico (found primarily in the western United States) and white heroin from Colombia (primarily sold on the East Coast). In the past, heroin was mainly injected. Because of the high purity of the Colombian heroin, many users now snort or smoke heroin. All of the methods of use can lead to addiction, and the use of intravenous needles can result in the transmission of HIV.
Heroin Effects: Euphoria, drowsiness, respiratory depression, constricted pupils, and nausea.
- Overdose Effects: Slow and shallow breathing, clammy skin, convulsions, coma, and possible death.
- CSA Schedule: Heroin has no legitimate medical use: Schedule I.
- Street Names: Horse, Smack, Black Tar, Chiva, and Negra (black tar).
Denial Can Make the Problem Worse: Some parents may be afraid to confront the realities of drug use, so they may deny the truth, even to themselves. You may have heard some adults say: “My kid doesn’t use drugs.” “It’s not a problem for our family.” “I used drugs and survived.” “Drug use is a normal part of growing up.” “We’ll never solve the drug problem.” “Alcohol is more dangerous than marijuana.”

I recommend that you attend a forum at your local high school or a community coalition awareness forum to learn more about the substance and heroin abuse in your community. Many local coalitions are forming around the country to educate the public, parents and teens about the dangers of heroin and the painkillers that often are the “gateway” drug to it.

Some of the latest newspaper stories about the heroin epidemic:
Schumer Moves to Reverse President’s Cut in Critical Drug Trafficking Program
Man accused of stashing heroin in daughter’s diaper
4-year-old hands out heroin at daycare
Cops seize $2.5M worth of heroin in Bronx raid
Schumer slams Obama’s proposed cuts to anti-drug program

Disclaimer

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.