Archives for Stigma

addiction

What we’re missing in treating addiction

Addiction is a disease of the brain. Over and over and over we heard this at the recent National RX Drug Abuse & Heroin Summit in Atlanta.

The president said it. His drug czar Michael Botticelli, said it. Dr. Nora Volkow, head of the National Institute on Drug Abuse, said it, along with the heads of the Centers for Disease Control, the Substance Abuse and Mental Health Service Administration,...
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General

Buprenorphine: How many patients is too many?

Last week the Department of Health and Human Services published in the Federal Register a notice of rulemaking for medication assisted treatment - MAT - for opioid abuse that would increase the maximum number of patients a practitioner can treat from 100 to 200.

The proposed rule would apply specifically to buprenorphine, also known as "bupe"among drug users. The drug is used to wean addicts off prescription and street opioids, such as oxycodone and heroin. Buprenorphine joins methadone and naltrexone as the only three drugs approved by the Food and Drug Administration to treat opioid addiction.

The irony of the government's efforts to regulate patient limits for buprenorphine, is that there are no limits on the number of patients a practitioner can treat with the prescription opioids that feed addition. In fact, there is no other prescription medications with patient limits.
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Alcoholism

How private are a drug addict’s treatment records?

The confidentiality of alcohol and drug abuse patient records is under the government's microscope.

The Substance Abuse and Mental Health Services Administration - SAMHSA - has filed notice of rule-making for such records. The proposed changes to 42 CFR Part 2- HIPPA - were published in Federal Register on Feb. 9.

It's been 29 years since there have been any substantive updates to the Confidentiality of Alcohol and Drug Abuse Patient Records regulations. A lot has changed, especially the recent push for an integrated, continuum of care and the use of electronic medical records.

I say changes are needed because you have a bunch of 20-something-year-old newly recovered addicts owning and operating some of the HIPPA-protected treatment programs, such as intensive outpatient programs, called IOPs. They, in turn, share a patient's health condition with their "clinical staff" - who are also newly recovered 20-something-year-old addicts who have little or no formal training and often no more than a high-school diploma.
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General

Why you don’t know how much mental illness and drug abuse is really in your community

It's Sunday night. I am sitting at my desk in the newsroom. I am a reporter and every couple of months I pull a weekend shift. The newsroom is quiet and I can hear the police scanners clearly.

During the day, with all that's going on in the newsroom, the scanners are just white noise. The cop reporters pay attention but to the rest of us, they are annoying.

If you want an idea of how much mental illness and substance abuse is out there, listen to the police scanners in a major metropolitan area, like South Florida, where I work. Some agencies use human dispatchers but many of the calls are announced by a computer with a Siri-esque voice.
Rescue 12. Responding to area 19. Overdose intoxication. 123 Main Street. Tac 2a.
Rescue 6. Responding to area 12. Suicide attempt. 456 Main Street. Tac 6.
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Alcoholism

Top 5 comebacks when asked why I don’t drink alcohol

For some reason, people want to know why I don't drink.

If you offered me Brussels sprouts and I said "no thanks" and you said, "are you sure I can't get you some Brussels sprouts?" and I said, "No thank you, I don't eat Brussels sprouts," would you ask, "How come you don't eat Brussel sprouts?"

Probably not. But when I say I don't drink alcohol, people what to know why.

Why is that? I haven't figured that out yet, but...
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Public Policy

Mental health groups ask Kenneth Cole to remove billboard

Twenty-three mental health organizations delivered a letter to fashion designer Kenneth Cole this morning, protesting the bizarre billboard Cole posted on a New York City highway in August that was supposed to support  mental healthcare reform and gun reform.

Two comments:

1. Thank God the country's most prestigious mental health organizations have taken a strong, united stand in urging Cole to take down the billboard.

2. What the hell was Cole thinking?

When the words mental illness...
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Alcoholism

How my depression nearly killed my sobriety

This month I celebrate 17 years of sobriety. Let me say that again. This month I celebrate 17 years of sobriety.

I can't believe I just said that because it seems so impossible and sounds so weird coming from my mouth.

17 years.

How the heck did that happen?

One day at a time. I also followed suggestions, especially from a doctor friend who told me about 12 years ago that I was in a major depression and needed antidepressants.
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Coping with Depression

Crying to prevent my depression

My life improved when I accepted crying as a body function - like blowing your nose or peeing. I never worried that someone might think I was a wuss because I blew my nose. So, why is water coming from my eyes considered a weakness and peeing is not?

I got to pondering this enigma after a major depression that followed the death of my parents - 16 months apart - and then the death of my dog 8 months later. It took a couple years after these losses for the depression to really kick in. But when it did, it kicked in hard.

What I learned in my recovery was that I hadn't grieved properly. When sorrow smothered me, I stuffed it. When sadness came on me at work, I flung myself at a project to stop the tears. I was not going to cry - at least not in public. Of course, it's okay to cry right after someone dies or at the funeral. But not two months or two years later.

Get a grip. Suck it up. Enough already.
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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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In My Experience

Should airline pilots – and lawyers – reveal their mental illnesses?

As the world ponders the sensibility of psychological testing of airline pilots before we even know the diagnosis of GermanWings pilot Andreas Lubitz, comes word that the Civil Rights Division of the U.S. Department of Justice is investigating the Florida Supreme Court for the state Board of Bar Examiners' policy of evaluating applicants for mental health diagnosis or treatment.

According to the South Florida Daily Business Review, the investigation began in December and focuses on the Florida Board of Bar Examiners, an agency of the Florida Supreme Court, which oversees bar admissions and determines whether applicants should be admitted to the Florida Bar by reviewing lengthy character and fitness files.

Among the questions asked: Has the applicant ever been diagnosed with a mental illness, such as bipolar, depression or psychosis, according to the article.

Florida isn't the only state that asks mental health questions and the Justice Department has made it clear it doesn't like the questions.

The Justice Department has gone so far as to write a letter to officials Vermont and Louisiana - states that also ask such questions - saying the questions are illegal. While questions about conduct are appropriate, "questions based on an applicant's status as a person with a mental health diagnosis do not serve the court's worthy goal of identifying unfit applicants, are in fact counterproductive to ensuring that attorneys are fit to practice and violate the applicable civil rights laws," the letter stated.
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