Category Archives: Prescription Drugs

Lecture: Pain and Addiction: Challenges & Controversies

Past Lecture: Frontiers in Addiction Lectures Series

Presented by Thelma McMillen Center

Pain and Addiction: Challenges & Controversies

May 19, 2015

Hoffman Health Conference Center, 3315 Medical Center Drive, Torrance, CA

8:30 AM Breakfast

9:00 – 11:30 AM Lecture

Speaker:

Mel Pohl, M.D. Medical Director
Las Vegas Central Recovery
Las Vegas, Nevada

Attendees Will:

  • List examples of the complicated co-occurring diagnoses of chronic pain and addiction when they both occur in an individual
  • List implications for treatment interventions with chronic pain with specific discussion of central pain syndromes
  • Describe and show brain mechanisms for the experience of pain and suffering

FREE CMEs and CEUs
FREE Continental Breakfast Provided

RSVP not required.
Call (310)-257-5758 for further information.

Location
Torrance Memorial’s Health Conference Center
3315 Medical Center Dr. Torrance, Calif. 90505 (off Skypark Dr; between Hawthorne & Crenshaw)

FREE Parking in the MAIN HOSPITAL STRUCTURE
(off Lomita on Hospital & Technology Dr.), near the Emergency area. SHUTTLE AVAILABLE.

Target Audience: MDs and Psychologists (*), RN (BRN Provider #300), LCSW & MFT (PCE #1881), CAADAC (2S-02-489-0716), CAADE (CP20955C0816) and allied health professionals.

Torrance Memorial Medical Center is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians.

Torrance Memorial Medical Center designates this live activity for a maximum of 2.5 AMA PRA Category I credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This credit may also be applied to the CMA Certification in Continuing Medical Education.

Click here for Torrance Memorial Medical Center events.

Addiction Should be Treated as Public Health Issue: Kerlikowske

Addiction should be treated as a public health issue, National Drug Control Policy Director R. Gil Kerlikowske told participants of a conference on prescription drug abuse Thursday. Addiction is a brain disease, and should not be treated as a moral failure, he said.

Drug overdoses kill more Americans than traffic crashes or gunshot wounds, he told the group. He praised prescription drug take-back events for removing drugs from the home that might otherwise fall into the hands of young people and others who may abuse them, the Associated Press reports.

Kerlikowske touched on a range of issues, including medical marijuana, cocaine use and heroin use. He said the popularity of medical marijuana sends the wrong message to young people, and noted there has been a 40 percent drop in cocaine use since 2006.

There has been a decrease in the number of people abusing prescription drugs, from 7 million in 2010, to 6.1 million in 2011, he said. Kerlikowske expressed concern about the rise in heroin use.

Source: Join Together

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Parenting 101

January 2013

1.  My husband and I suspect that the father of one our son’s friends might be using steroids.  He’s abnormally “buff” and his moods sometimes seem way over the top.  How can we approach our son about this to ensure he doesn’t think it’s cool to use steroids without harming the relationship between he and his friend?

It is important to see these as separate issues.  One is about your concerns that the father of your son’s friend “may” be using steroids, and the other about the use of steroids and your own son.
The second concern can be better addressed by casually bringing up the topic of performance enhancement drugs like steroids and HGH.  You may want to bring up the current situation with Lance Armstrong, asking your son what he thinks.   Research some information online about how many great individuals, including Olympic athletics fall victim to the temptation of performance enhancement drugs and stress how important it is to avoid all use of such things.

While it surely may be true that this father is using steroids, without specific proof of this, any accusations could easily turn into a hostile situation that could reflect poorly on the two of you.  This may be best left alone.   Any suggestion you make between steroids and this boy’s father may go straight to the father, making a hostile situation for you and your family, especially if he has altered moods.   However, if you feel it needs to be addressed specifically doing that research becomes even more be helpful in becoming familiar with the dangers of steroid use,  both to the user and those close to the user.  If you make a short list of the biggest concerns,  noting that there can be many other problems as well,  your son will more likely to be receptive to the information and more likely to retain it.  You will want to make clear that you are pursuing a concern, not an attack on his friend or his friend’s father.  As you will find in your research, steroid abuse leads to severe damage to the body and brain and can be a huge contributing factor to homicides, suicides and other violent and aggressive behaviors.  If the idea that his friend’s father may be using steroids shakes him up or concerns him then  make sure he is aware of the dangers if the father goes into a “roid rage” and plan appropriately for his safety.  If he defends steroid use itself, you will have a lot more work to do with more research done together, serious discussions of his thought process in thinking they are in any way o.k. and possibly professional counseling.

2.   My 15yo daughter is having significant mood swings.  She’s always been a bit dramatic, but lately she get extremely angry or weepy over the smallest things.  And then 10 minutes later she’ll be her old laughing, good-natured self.  I don’t have insurance so getting her to a counselor or therapist will be next to impossible.  What can I do to help her?

One of the biggest challenges for parents, and in reality, therapists as well, is distinguishing when adolescent behaviors are normal and when they may be pathological.  This entire stage of life is noted for instability of mood, mind and will, which makes this period of time often the least favorite of life’s stages. You stated that having her see a therapist is next to impossible.  This practically rules out the possibility of having a professional diagnosis and leaves it all in your hands.  The biggest worry is that this behavior will somehow hinder her growth both emotionally and academically.  Check with her teachers, school counselor, and adult friends and ask them if they are concerned about her behaviors with them or in public.  If she is progressing at school academically and socially, without any of the people who interact with her being concerned, then allow yourself to step back and become an observer as well as her biggest supporter and see where it goes.  However, if you do discover issues that are holding her back, please reconsider the counseling option.

Specifically,  be aware that any expression, verbally, in writing, or in behavior of a desire to harm herself or others needs to be taken seriously and professional help engaged.  Angry or weepy (minus destructive behavior) is fairly normal for a 15 year old girl. The quick rebound to her normal laughing self even sounds fairly healthy, different than the manic glee of a substance induced rebound.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention.  The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth.  For local resources or more information, please visit our website www.thefutureiswatching.org or if you have questions you’d like our experts to respond to, contact: events@sbcoalition.com.

Parenting 101

October 2012

My husband and I are currently separated and share joint custody of our 15yo daughter.  My issue is this – I do not want my daughter drinking at all but my husband believes that if he allows her small amounts of alcohol at home, she won’t feel the need to drink outside with friends.  I strongly disagree.  I don’t know how to get my husband to agree on this.

Research (including very recent research) shows that supervised drinking at home has opposite effects to those intended.  For instance a 2011 study, lead-authored by University of Minnesota professor Barbara McMorris, found that teens whose parents allow supervised drinking are more likely to have problems discontinuing alcohol use, have problems at school, problems at home, get into fights, suffer from injuries caused by alcohol, experience “blackouts” or unconsciousness due to extreme intoxication, and have sexual experiences they later regret. This and multiple other studies have shown that allowing in- the- house drinking for teens increases their risks. We would encourage a conversation with your husband based on science and data rather than opinion.  Look up and print out the research and ask him what information he had based his opinion on. Offer to take a parenting class together or see a family therapist together, if necessary, to get on the same page with this issue. Let him know that you know that this is an extremely serious issue for your daughter’s welfare.  It’s essential to remember that when parents, either living together or apart, do not provide a united front, they send contradictory messages to their children.  The result is a huge compromise to the parental front and leadership. Your ex-husband is most likely coming from a place of personal belief that hopefully can be modified by him reading up on the statistics of parents who believe in this model.  Most parents who believe the same as your ex-husband are attempting to win their child’s respect by being the ‘cool’ parent.  No matter what your husband continues to do, always keep in mind that even if your children don’t like that you are too strict, they will, in the end, have more respect for you because they will eventually understand how much you care for their safety.

Our 16yo son participates in several sports and is very popular with this teammates.  I have a growing concern about the number of his friends who’ve mentioned the “meds” they take for pain and injuries suffered during  their games.  He says they don’t share but I’m very suspicious that that is not true.  What is the best way to ensure that he doesn’t use his friends’ medications?  I’m not even sure how to tell if my son is using their meds.

There is no way to absolutely ensure that your son does not use his friends “meds.”  Some “meds” will show up on urine drug tests and some will not. There are some important pieces of information that would be needed to give you the best and most complete answer.  For example, are his friends talking about the “meds” in front of you and naming them? If so,  what “meds” are they taking? Are there reasons for your suspicions that he may have taken the “meds”?  A one-on-one conversation with a knowledgeable local drug and alcohol counselor, or therapist who works with youth, may well have a good return on investment  in helping you find clarity and the best approach to take.  Above all, it is critical that you do your best not to compromise your trust in your child by making unfounded accusations about possible drug use.  Until you have proof, assume the best.  But, do sit down and address your concerns being careful to use ‘I’ statements.  ‘You’ statements almost always come across as accusations.  Explain to him you need a way of finding reassurance that you do not need to worry about the drugs you have heard about.  Ask him for suggestions.  Suggest that maybe he would agree to enroll in the voluntary drug program at school (most high schools now have them).  However, most importantly, keep your communication open and truthful.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention.  The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth.  For local resources or more information, please visit our website www.thefutureiswatching.org or if you have questions you’d like our experts to respond to, contact: events@sbcoalition.com.

Parenting 101

May 2012

1. My 16 year old daughter was at a friend’s house and had a pretty bad headache so her friend’s mother gave her ½ Vicodin which really bothers me. My daughter is begging me not to contact her friend’s mom. How best to handle this?

You absolutely need to contact your daughter’s friend’s mom. You would also do well by setting a firm boundary that your daughter is never to be in a situation where this woman is the sole adult caretaker present. Illegally distributing narcotics (and make no mistake Vicodin is a strong narcotic) to minors is an extremely serious matter, one in which you would be well within your rights to involve the police. Regardless of whether the mother that gave her the medications is completely unaware that she just acted as a ‘dealer’ of illegal drugs, or whether she understands and doesn’t have any regard for the laws – she is acting irresponsibly and needs to be informed before she either gets into trouble with the law, or inadvertently contributes to illegal drug use by minors. Both would send her to jail. Yes, as a teenager, your daughter is likely to be embarrassed and want to avoid dealing with the issue, but to send any other message than that this is an extremely serious matter would be gravely irresponsible parenting. Prescription drugs, in particular opiates (of which Vicodin is one) have become one of the leading causes of addiction and overdose in this nation, in large part due to society’s tendency to view them as safer than street drugs. Deaths from overdoses of prescription opiates happen nearly six times as often as those from Heroin, and from 1997 to 2007 the number of opiates prescribed increased over 400%. The Center for Disease Control has classified prescription drug abuse as an epidemic. Your daughter needs to be clear that prescription drugs are extremely dangerous as this will unfortunately not be her last opportunity to take them illegally. Problems that are not addressed only grow, address this one strongly. Here is a great resource page for more information: http://ncadd.org.

2. Our daughter is leaving for college this year. Both her father and I have been in recovery for many years and we’re not sure what to say to prepare her for her first real taste of freedom and the drinking that may go along with that. And is it possible for us to monitor her behavior when we’ll be so far away?
If you and your husband are both in recovery from chemical dependency, it would certainly be time to talk with your daughter about her substantially increased risk of dependence if she indulges in mind altering substances. Your daughter is old enough now for you to share with her your struggles with recovery (always be honest, but it is not necessary to go into details, and it would be helpful for her to know that neither one of you ever thought your choices would wind up in a lifetime change). It may be especially helpful for your daughter to hear that her parents are ‘not perfect’ individuals that you have challenges like everyone else. This is a good time to reiterate that her freedoms are only restricted by the choices she makes when she is on her own. It is your responsibility to make sure that she is aware of the dangers and to help her plan for her own safety, but make sure listening is as much a part of the interaction as talking. By this age, she most likely has already had to make many decisions surrounding substance use and her thoughts, beliefs and mindset will be the most influential factors in the decisions she makes while off at college. Unless she has already made dangerous decisions regarding substances, direct monitoring would be not only extremely difficult and unreliable, but counterproductive to her continued growth and maturity and most certainly her relationship with you. Visit her if possible, talk by phone frequently (texting or e-mailing is not the same when it comes to knowing someone is o.k.), make sure any expenses being paid by you track closely with a pre- determined budget and keep a dialogue open about her academic progress and the new life experiences she has. Care and love deeply, but know that you cannot control her, only your contribution to her process.

Responses to the above parent questions have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention. The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth. For local resources or more information, please visit our website www.thefutureiswatching.org or if you have questions you’d like our experts to respond to, contact: events@sbcoalition.com.

Parenting 101

June 2011

1.   Our 16yr old daughter has started dating an 18yr old “boy” who we hear has been known to drink and use drugs. Although our daughter exhibits no symptoms or behaviors suggesting she’s using too, we are anxious and worried about how to handle this situation. What should we do?

You have good reason to be concerned. Teens who socialize with others who drink and use are far more likely to do so themselves, but the danger does not stop there. If this boy is drinking and using, she’s at much greater risk for being involved in an automobile crash, being a victim of dating violence and/or rape, or facing legal consequences secondary to being around illicit substances or intoxicated minors. The first step should be to sit down and have an “adult” conversation with your daughter. Do your best to use only statements that start with ‘I’ and avoid saying ‘you’ – this will prevent you from making any accusations, either intentionally or unintentionally. If your daughter does not feel attacked, judged or criticized, she will be much more likely to listen to what you have to say. Carefully share your concerns about the situation, including the legal ramifications for him, if anything should happen to her.

Use statements such as: ‘I understand that older boys are more attractive because they’re more mature and experienced, however, I also understand that he is in a different place in life, that he is considered an ‘adult’ legally, and will want to seek out adult activities and interests which are not appropriate for someone who is 16”; and other statements like, “ I cannot know for sure, but the word from others is that he is not making very good decisions and chooses inappropriate activities.  It would devastate me to learn that he may try to involve you in these activities.”

Then allow her to talk and carefully listen to see if she seems fully aware of the issues that are involved with dating an older person.  Based on what you daughter tells you, you can decide whether to restrict this relationship.  It’s obvious that any unsupervised time they spend together is potentially dangerous.  While it’s not necessarily true that she is joining in his activities, it is true that he is not to be trusted.

Discussions of the same nature with this young man (and his family) are also in order. If he denies drug use, ask him to take a urine drug screen (most effective if done without prior notice). Although these measures are certainly not the most comfortable to take, you owe it to your daughter to do all in your power to protect her. She is still a child and it’s your responsibility to provide that protection.

2. The other day as I was putting away my 14yo son’s laundry, I discovered plastic baggies in his drawer – one contained several different kinds of pills and the other had what I assume to be marijuana. I haven’t said anything to him yet – I’m terrified of his response. His behavior has been somewhat rebellious lately but nothing I would consider uncharacteristic for a 14 year old boy. I don’t know how to handle this. Help!

98% of the time in this type of situation the young person is definitely involved in using illegal substances and has been for some time but has successfully deceived his parents.  What allows this behavior to not only continue but to also develop, is the fact that most parents have this same reaction – they are terrified and do not know how to proceed without fear of losing their loving relationship with their child.  His response is likely to be extreme, substance abusing or addicted children are volatile far in excess of the already significant amount 14 year olds are. Those who begin using drugs by age fourteen have a strong chance of developing an addiction, far greater than if that use does not start until later years. His current use is doing serious damage to the development of his brain, which is in a critical stage at this period of his life.

We strongly suggest you seek professional help.  Both parents should not waste any time in taking this child to an adolescent drug treatment center, where each person will be interviewed and the teen will be drug tested (so don’t tell your son ahead of time).  He will likely not understand or grasp any of this and be highly resistant, but remember he is a child and he needs you to be a parent, which means often being unpopular with your child. If his reaction is extreme, look at it and ask yourself this: Is this a child in control and healthy, or is this a child in desperate need of help? The center will provide assessment, evaluation and suggestions.  This process is free at many centers in the area and works best because it is far more objective in the evaluation and suggestions.  It will avoid arguments about what is true and not true because chances are great that your child will deny any ‘accusation’ you make.  It is critical to know that the longer parents wait the more difficult it will be to remediate the situation.  It will not be a pleasant experience for you, but it is your duty to deal with this and it will be far less unpleasant than attending his funeral or sentencing. Please confiscate the drugs and call your local treatment center immediately for a referral and/or assessment!

The questions above are from parents who live in the South Bay. The responses have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention. The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth. For local resources or more information, please visit our website www.thefutureiswatching.org or contact: events@sbcoalition.com

Hello Kitty Says Hello to Alcohol

Hello Kitty—the iconic cartoon image gracing thousands of children’s toys and clothing throughout the globe—is now promoting alcoholic beverages. Wine with names like “Hello Kitty Angel” (white) and “Hello Kitty Devil” (red) will be available for purchase in May.

The Rosé label features Hello Kitty in a little black dress, winking and holding a glass of wine. The “Devil” and “Angel” wine labels show Hello Kitty with a devil’s tail and angel wings, respectively, and heart-shaped tattoos on each of their behinds. The Brut Rose label displays Hello Kitty in a pink onesie with hearts, and has a special prize hanging on each bottle: a little Hello Kitty pendant on a chain.

Italian winemaker Tenimenti Castelrotto, along with with Camomilla, an Italian fashion company, collaborated to sell the wine with the Hello Kitty brand worldwide. Their rationale for this campaign: “Hello Kitty is not just for children. She is a recognized cult fashion icon among teenagers and adults around the world.”

The Hello Kitty Wine website also lists recipes for mixing the wine with distilled spirits, juice, and/or sugar to make special cocktails. They look like recipes for homemade Hello Kitty alcopops.

The CEO of Innovation Spirits, the company in charge of marketing the wines in the U.S., said that they see the Hello Kitty brand identity as somewhat mature and open to various product interpretations. Their tagline for the wine products is “Our favorite girl has grown up,” to indicate that Hello Kitty, in her 35 years of existence, has crossed over to being a brand for children and adults alike.

The little kitten advertising the alcohol does not look like mature. Her face looks like a young kitten, not a 35-year-old wine drinker. Children will immediately recognize Hello Kitty on the bottles, and want to have one of the pendants. Teenage girls, not legally able to obtain alcohol, are also attracted to the Hello Kitty brand.

Hello Kitty’s portfolio may have expanded from inexpensive coin purses for girls to include luxury fashion bags for women, but alcohol is not like any other product. It is not for children and adults alike, and should not be advertised as such.

Original article from www.MarinInstitute.org.

Colleges Confront Misuse of Prescription Drugs

Misuse of prescription drugs is a growing problem on college campuses, where the drugs are used recreationally as well as to aid in studying, the San Diego Union-Tribune reported February 15, 2010.

College prevention programs used to dealing with alcohol and illicit drugs are devoting more attention to drugs like Ritalin and Adderral, but with limited success. Richard Clark, director of medical toxicology at the University of California at San Diego, said that the drugs are being used as mood-lifters and appetite suppressants as well as to improve concentration.

Students say these drugs are easy to obtain on campus for a few dollars and that there is no stigma attached to their use. “I think it’s far more widespread than studies suggest today because the drugs work and because it’s so easy for people to get the drugs in this country,” said Clark.

The drugs are virtually undetectable, unlike alcohol or marijuana, and are obtained from friends, not drug dealers.

“A good chunk of college drug-prevention programs don’t actually do any good,” said James Lange, director of drug and alcohol programs at San Diego State University. Ironically, what has helped reduce misuse of prescription drugs at SDSU has been the economically driven decision to stop the campus health center from diagnosing attention-deficit disorders and prescribing drugs to treat the condition, said Lange; a campaign to address alcohol problems also may have helped because many prescription-drug users also are heavy drinkers.

Original article from www.jointogether.org.

What’s Driving Teens To Abuse Prescription Drugs?

There is a new and disturbing trend parents need to know about. Teens are abusing prescription and over-the-counter (OTC) drugs in an effort to get high – the same kind of high obtained from illegal street drugs like marijuana or cocaine.

Teens and substance abuse experts say that there are many different reasons for the rise in prescription drug abuse by young people. As discussed in “The Changing Face of Teenage Drug Abuse: The Trend Toward Prescription Drugs” in 2006 New England Journal of Medicine, there is a misperception that prescription and OTC drugs are medically safer, and therefore the abuse of such drugs in order to get high is not as bad as abusing street drugs.

Teens also point to personal or family-related stress as another major reason why they abuse prescription drugs. Other reasons include:

* Escape and boredom
* Preservation of friendships, romantic relationships, and family life
* Competing for college admission, including competition for Advanced Placement and Honors courses in high school
* The balance between school work, grades, and extracurricular activities like sports and clubs; and,
* The desire to have the “ideal” physical appearance.

Some students try to dial down the pressure by abusing painkillers and sedatives. Teens are also abusing stimulants, such as Ritalin, a drug used for attention deficit hyperactivity disorder (ADHD). These teens don’t realize that prescription drugs, if used outside doctor’s orders, can pack a very hard – sometimes lethal – punch. They can be just as addictive as street drugs and abuse can create similar health effects, such as paranoia, seizures, and cardiac arrest. Many people don’t realize the harm associated with prescription drugs until it is too late.

Talk to your teen about the dangers of abusing prescription and OTC drugs, and educate yourself on signs and symptoms of abuse. Follow the tips below to prevent prescription and over-the-counter abuse among teens:

1. Keep Track of Quantities: Take note of how many pills are in a bottle or pill packet and ask other households your teen visits (such as grandparents or friends) to do the same. Don’t forget about refills. If you find you have to refill medication for a chronic condition more often than recommended, there could be a real problem – as someone may be knowingly stealing your medication.

2. Talk to Friends, Relatives and School Administration: Make sure your friends and relatives know about the risks, too, and encourage them to regularly monitor their own medicine cabinets. If you don’t know the parents of your child’s circle of friends, then make an effort to get to know them, and get on the same page about rules and expectations. Follow up with your teen’s school administration to find out what they are doing to address issues of Rx and OTC drug abuse on campus.

3. Follow Directions Carefully: Make sure you and your teen use RX drugs only as prescribed by a medical doctor and take only the recommended dosages as indicated for both Rx and OTC drugs. If you are directed to finish the prescription, then do so as advised. If you have any questions about how to take a prescription drug, call your family physician or pharmacist.

4. Discard Old or Unused Medications: Unused prescription drugs should be disposed of in the trash. It is best to add an undesirable substance (like used coffee grounds or kitty litter) and put the mixture in an impermeable, non-descript container like an empty can or bag. Unless the directions say otherwise, DO NOT flush medications down the drain or toilet because the chemicals can taint the water supply. Also, remove any personal, identifiable information from prescription bottles or pill packages before you throw them away.

5. Be Observant: If you find your teen is quickly going through cough syrup, or you find empty bottles and pill packages among your child’s personal effects, talk with him/her, listen carefully, and determine if there is a problem. If there is a problem, call your family physician immediately.

6. Find Other Ways to Relieve Stress and Have Fun:
Many teens point to personal and family stress, as well as boredom, as reasons they abuse Rx and OTC drugs. Help your teen find other ways to relieve pressures, for example through positive activities that interest your child, positive friendships, or by simply listening and offering guidance. Also, help your teen find constructive ways to pass time and set a good example yourself.

The above information from TheAntiDrug.com, is brought to you by the South Bay Coalition and the Manhattan Beach Police Department. The South Bay Coalition (www.sbcoalition.com) is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth. If you would like a copy of the South Bay Coalition’s Parent’s Guide To Preventing Substance Abuse, please visit our website or email: events@sbcoalition.com.