Archives for Dual-Diagnosis

Alcoholism

Government scrubs substance-abuse data but doesn’t tell researchers

What if the government decided to withhold the data it gathers on an insidious mental illness that affects nearly one in ten Americans and did not bother to tell researchers it had done so?

It happened. The data are collected by the Centers for Medicare and Medicaid Services. The mental illness - substance abuse.

The New England Journal of Medicine exposed these shenanigans and explained the consequences in an article published in April: Protection or Harm? Suppressing Substance-Use Data, by Austin B. Frakt and Nicholas Bagley. According to the authors, the CMS began to withhold from its data sets, called the Research Identifiable Files, any Medicare or Medicaid claim with a substance abuse diagnosis.

Why? Patient privacy concerns. Why didn't the CMS tell researchers? Good question.
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Alcoholism

Medical malpractice in treating dual-diagnosis

In September 2013 I had the unpleasant assignment of covering the memorial service of 10-year-old Alexandra Brooks. The service was held in the gymnasium of her school, where my daughter had also been a student. It was the same gymnasium where I sat through many  Christmas pageants and spring concerts.

The little girl's father, Bradley Brooks - who found his daughter's lifeless body - sat sobbing in the front row of the bleachers. The girl's mother, Pamela, who stabbed her daughter and then killed herself with the same knife, was not mentioned - although everyone quietly wondered...why?
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Bipolar

The tao of depression for a journalist

About 15 years ago the newspaper where I work sent me to a number-crunching boot camp, where I learned how to analyze data. I became a geek.

As journalism morphed from the old fashioned pen, notebook and musty records at the courthouse to the internet's ability to gather mountains of data in the blink of an eye, my geekiness blossomed. I attended more bootcamps on advanced statistics and mapping.

I added SQL, shapefiles and string functions to my arsenal of reporting skills. My brain changed, too. I could feel it. A portion of my brain that had been slacking was now firing. I thought differently. It's hard to explain.

The analytical side of my brain teamed up with the creative side and my thinking became three-dimensional. The skies parted and I realized that 3+2 and 4+1 both equaled 5. There were suddenly many solutions to the same problem. This revelation came fast and hard and not without severe consequences.
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Alcoholism

Depression, obsession and rumination

I once heard a guy say that he tries to wear his life like a comfortable old t-shirt. I like that and I've been trying to do it lately but I think I must have shrunk that t-shirt in the dryer because it's tight as hell right now.

From the outside you might not notice that my comfy t-shirt has morphed into a corset. But from the inside, it feels like it has. I'm carrying around this intensity right now - for work, for working-out and even for finishing the entire seven-season series Sons of Anarchy.

I am driven. I can't seem to slow down my thoughts. One thought leads to another and another and another. It makes me good at what I do - newspaper reporting - but it's not good for my mental health. It's a constant tugging - intellectually I want to slow down - instinctually I want to speed up.
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Bipolar

Pulling the plug on my mania and CrossFit

Mania is a luscious, exhilarating state of mind. All the fatigue and weariness in your bones and soul vaporizes. Your muscles feel bigger and stronger and ready to strike. Your thoughts are clear and brilliant. You are like a racehorse in the gate, wide-eyed and pawing at the ground with your hoof. There is no off-switch.

Medications give you a dimmer but you still have to have the desire and willingness to use it beyond the involuntary waning it induces.  You have to make the decision to turn the dimmer nob further to the left.

That is where I find myself today - turning the nob to the left. I am - of my own volition - taking my life down a notch. I don't want to but I need to. It's hard for me to believe I'm doing this. But years of therapy and the wisdom that comes with 56-years of f#*king up my life have taught me it's time.

I have bipolar II - called hypomania. It's bipolar lite. My ups and downs are not nearly as intense as those poor souls with bipolar I. Of course, fueling my mania with drugs and alcohol for decades enhanced those ups and downs. But I know I am blessed to have this lesser form of bipolar.
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Alcoholism

I have depression and alcoholism. So what?

I find people generally have three reactions when I tell them I am a recovered alcoholic with Bipolar II. They either tell me that they or a loved one has struggled with a mental illness, begin talking about the weather or look at me like I just told them I have a stripper pole in my bedroom - which I don't.

I can pretty much tell how they feel about mental illness by their reaction. When someone responds with their own experience, I listen. It's such a comfort to have someone else willing to share their own experience. As for the weather response, I chime in with my own thoughts about the weather.

The last thing I want to do is make someone uncomfortable discussing mental illness. I figure I've planted a little seed in their mind that it's okay to talk about mental illness. It's their responsibility to let it grow - or die.

The stripper-pole response? Well, that's a little trickier. I take into consideration the context in which the topic arose during our conversation and the person's attitude before I made my revelation.

If they were being a smart-ass about someone else's mental illness or treatment, I throw it right back at them. I've always been what my father called a weisenheimer, (think Curly in the Three Stooges.)
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Alcoholism

Mentally ill now and forever…amen.

Every now and then I get a glimpse of what my mental illnesses look like.

It's been a long time. I have taken my medications without fail for years.  I exercise, eat healthy foods, get as much sleep as I can, visit my psych-nurse practitioner every three months and I get on my knees every night and thank God for my sobriety. In other word, I do what I am told - an unnatural act for me.

But for the last two weeks I have been under an unconscionable amount of stress. I say "unconscionable" because I allowed it to happen.

As a reporter for a daily newspaper, I am accustomed to stress. For nearly 30 years I have lived with a deadline hanging over my head. I took six weeks off to have a baby, 8 weeks for my last major depression but other than the one- or two-week vacations, I have had a deadline over my head.

Recently, I accepted  an assignment which today I realize I should not  have done. I agreed to leave my home and my dog, suspend my exercise routine and healthy eating habits and forego nights of 8-hours of sleep to cover the Florida legislature's last two-weeks in session.

I did this once before, nearly 30 years ago when reporters were only expected to write a story for the newspaper. Now, we must also Tweet, blog and make videos. Despite my degree in political science, after 30+ years in journalism, I'm kinda disallusioned with politics.

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Alcoholism

Bullying people with mental illnesses

Imagine a bulletin board on the internet that allowed anyone to comment - anonymously - on your job performance.

Anyone can say whatever they want about the work you do. Some praise and thank you. Others mock you and trash a project that you painstakingly researched and produced. You must always always put your name on your work and claim it as your own. Still, anonymous critics swipe away at your work, leaving you unable to confront your accuser.

That's what it's like to be a newspaper reporter these days. It used to be that when readers wanted to criticize or comment on your story they would write a letter to the editor. Newspapers didn't publish anonymous letters. They called the author and confirmed the person actually wrote the letter.

Then came the internet. Anyone can anonymously say anything about your work - and you - without any consequence. It 's unfair but as my mother used to say - "Life isn't fair."

You were right, mom. Life isn't fair.

I am also an alcoholic. An alcoholic journalist. It's been 15 years since I had  my last drink but I am still an alcoholic and still a journalist. Always will be. I'm not ashamed of being an alcoholic or a journalist. I understand there is still a lot of stigma associated with being an alcoholic. But I am at a point in my career, life and recovery where I am comfortable with who I am. I don't hide either but I don't mix the two in reporting the news.
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Dual-Diagnosis

Should This Doctor be Billed for Supplying Addicts with Drugs?

In July I blogged about Dr. John Christensen, a West Palm Beach doctor who was charged with two counts of first-degree murder for the overdose deaths of two patients he treated at his clinics, which investigators described as "pill mills."

Now we have learned that prosecutors intend to seek the death penalty against Christensen. 

I am not a fan of the death penalty but not for the usual reasons. As someone who has sat through murder trials, walked down death row, interviewed condemned killers, actually sat in the electric chair and witnessed an execution - I have decided that capital punishment is futile, immoral and a monumental waste of tax-dollars.

If you really want to punish someone, lock them in a 6 x 9 foot cell for 30 or 40 years. The average length of stay on Florida's death row is 13 years and many killers will tell you they would prefer to die than live out their lives in a box.

Although research has shown that the death penalty is not a deterrent, I suspect that executing a physician who knowingly prescribed massive doses of drugs to an addict who then overdosed, would be a deterrent to other physicians. A really, really big deterrent.

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