The problem of symptoms
and signs
One of the first things you learn about in medical school is
the difference between symptoms and signs. Symptoms stem from patients’
subjective experiences — how they’ve been feeling or what seems off to them.
For example, “my stomach hurts,” “I feel tired,” or “my arm itches.” These
complaints cannot be verified by lab tests or imaging. We simply have to rely
on the patient’s word. On the other hand, there are signs. Fever. Rapid heart
rate. Abnormal white blood cell counts. Doctors and nurses can objectively
identify these characteristics, using everything from physical exams to
high-tech gadgets. These findings independently clarify the patient’s condition
from both inside and out. As medical students, we spend our four years learning
to match the sets of symptoms with the right signs. When a patient presents
with chronic headache, we take a neurological exam or recommend a brain scan.
If others come in with shortness of breath, we listen to their lungs for
crackles and other sounds. But what happens when there’s a complete mismatch
between symptoms and signs? When the patient’s feelings defy every swab, blood
culture, and beeping hospital machine? It’s a situation that neither physicians
nor patients want to find themselves in. And one that pushes medicine to the
limits of its design. Please
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Alcoholics Anonymous vs.
the Doctors - Could new addiction medications replace mutual-help groups?
Alcoholics Anonymous is, by far, the largest and most
venerable addiction recovery group in the world. Founded nearly 80 years ago,
AA now boasts 2.1 million worldwide members, many of whom attribute their very
survival to the organization. In the United States, where the 12-step program
originated, AA is viewed by many as a national treasure of sorts. Social
workers send patients to AA meetings. Judges condition people’s freedom on
meeting attendance. Desperate spouses condition marriages on it. Everyone loves
Alcoholics Anonymous. Or almost everyone. Please
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New Thinking on Women And
Alcohol
Alcoholics Anonymous is commonly considered the gold
standard for helping people control their drinking problems.
But there’s a growing school of thought that there are
problem drinkers who can cut back — as opposed to severely dependent drinkers
who must cut out drinking altogether. There are new tools, such as medication
and online support. Severely alcohol-dependent people should consider an abstinence
program, Glaser tells Here & Now’s Robin Young, but research has shown
there are far milder to moderate problem drinkers than severe problem drinkers.
Please click
here to read the rest of this story.
Fact Check: Is Marijuana
Safer Than Alcohol?
This fall, voters in Oregon and Washington will decide
whether to legalize marijuana. Washington’s Initiative 502 would allow pot to
be sold in state-licensed stores. So would Oregon’s Measure 80. But it would go
one step further: The Oregon ballot measure would allow people to grow their
own marijuana. In both campaigns, there's no shortage of claims about the drug.
Chris Lehman has been fact-checking two of those claims. Today, he takes on
this question: Is marijuana a safer drug than alcohol? To Paul Stanford, this isn't
really a question. "Marijuana by any measure is much safer," he says.
Please
click here to read the rest of this story.
Anti-Pot Group Regrets The
Repeal Of Alcohol Prohibition
The anti-pot group Project SAM was not pleased by President
Obama’s recent observation that marijuana is less dangerous than alcohol. “We
take issue with the President’s comparisons between marijuana and alcohol,”
says Project SAM Chairman Patrick J, Kennedy in a press release. He does not
argue that Obama’s statement was inaccurate—just that it was unhelpful to the
prohibitionist cause. Kennedy explains that “two wrongs don’t make a right:
just because our already legal drugs may have very dangerous impacts on society
it does not mean that other drugs should follow the same path.” Note that the
first “wrong,” according to Kennedy, was making alcohol legal. Please
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Colorado Shop Owners Can't
Keep Marijuana Edibles in Stock
Colorado residents may wind up with "pot bellies"
if they keep filling up on marijuana edibles at this pace. Ever since
recreational marijuana sales began in the state on Jan. 1, many shop owners
said they have been unable to keep pot-infused candies, cookies and sodas in
stock. "Edibles have been really huge with the recreational market,"
Linda Andrews, owner of LoDo Wellness Center in Denver, told ABCNews.com.
"They're great if you're not a [marijuana] connoisseur and you want
something more palatable," she said. "And they are certainly more
discreet." Andrews estimates edible sales are up 300 percent at her store,
which previously only served medical marijuana patients. Please
click here to read the rest of this story.
Adults Who Use Illicit
Drugs More Likely to Think About Suicide: Survey
Thoughts of suicide are more common among adults who use
illicit drugs, compared with the general population, according to a new
government survey. The Substance Abuse and Mental Health Services
Administration (SAMHSA) found 9.4 percent of people using illicit drugs had
suicidal thoughts, compared with 3.9 percent of the general population,
HealthDay reports. The rate of suicidal thoughts varied depending on the type
of drug people use. The survey found 20.9 percent of people who use sedatives
for nonmedical purposes had suicidal thoughts, compared with 9.6 percent of
people who use marijuana, 13 percent of people who use pain relievers
nonmedically, and 14.7 percent of people who use cocaine. The survey included
about 70,000 people ages 12 and older. “Suicide takes a devastating toll on
individuals, families and communities across our nation,” Dr. Peter Delany,
Director of SAMHSA’s Center for Behavioral Health Statistics and Quality, said
in a news release. “We must reach out to all segments of our community to
provide them with the support and treatment they need so that we can help prevent
more needless deaths and shattered lives.”
Dangerous new trend: kids
snorting Smarties candy
There's a dangerous new trend that involves the popular
candy Smarties. Instead of eating them, kids are snorting them. They're
crushing the candy and inhaling it, in videos seen all over YouTube. The
motivation behind the crushing and snorting of Smarties isn't known. The
bizarre trend is happening across the nation, including at a Rhode Island
middle school, where the principal sent an email about it to students. And a
health expert is warning about the dangers. "Anytime you snort or inhale a
substance into your lungs that is not meant to be it is definitely hazardous to
your health and could have significant health consequences for
individuals," said behavioral care expert Rebecca Boss. Some of the
negative side effects of snorting Smarties include infection and scarring of
the nasal cavity.
One Question May Gauge
Severity of Unhealthy Drug, Alcohol Use
Primary care physicians seeking to determine whether a
patient's drug or alcohol use is problematic often have to rely on lengthy
questionnaires containing dozens of items with multiple response options. Please
click here to read the rest of this story.
Krokodil Crock: How Rumors
Of A 'Flesh-Eating Zombie Drug' Swept The Nation
By now you probably have heard that krokodil, a nasty
homemade version of the narcotic painkiller desomorphine, is starting to catch
on in the United States. Having eaten its way through the flesh of myriad
Russian opiate addicts, the caustic concoction—notorious for the ghastly side
effects caused by its corrosive contaminants, including abscesses and
gangrene—is reportedly burning its way through Arizona, Texas, Nevada, Utah,
Oklahoma, Colorado, Illinois, Missouri, Ohio, Pennsylvania, and Massachusetts.
“The monster has crossed the ocean,” Time declared last month.
Please click here to read the rest of this story.
Should there be a word for
an 'almost alcoholic'?
Everybody thinks they know what an "alcoholic" is,
but what about those who drink too much but fall short of the common
definitions of alcoholism? Should there be a word that bridges the gap between
alcoholic and non-alcoholic? The term alcoholic - on its own to denote someone
addicted to alcohol - was first used in 1852 in the Scottish Temperance Review.
Since then, millions of heavy drinkers have been confronted by friends and
families with the stark question: "Are you an alcoholic?" And
millions have denied it. Rejected the label. Confessed only to maybe, possibly
drinking too much. But utterly denied the A-word. Alcoholics are people who
fall asleep in skips. Alcoholics get into fights. Alcoholics start the day with
a shot of whisky. Alcoholics are drunk all the time. Alcoholics can't hold down
jobs. Please click here
to read the rest of this story.
Science, Save Medical Marijuana!
In 1998, the voters of Washington state said yes to the question “Shall the medical use of marijuana for certain terminal or debilitating conditions be permitted and physicians authorized to advise patients about the medical use of marijuana?” by passing ballot proposition I-692. In 2012, the voters passed a measure that “removes state-law prohibitions against producing, processing and selling marijuana, subject to licensing and regulation by the liquor board.” Now the state liquor board assumes powers over the regulation of medical marijuana, regulation that could essentially eradicate the voter-approved measure and force patients to become consumers of the commercial marijuana industry. Please click here to read the rest of this story.
In 1998, the voters of Washington state said yes to the question “Shall the medical use of marijuana for certain terminal or debilitating conditions be permitted and physicians authorized to advise patients about the medical use of marijuana?” by passing ballot proposition I-692. In 2012, the voters passed a measure that “removes state-law prohibitions against producing, processing and selling marijuana, subject to licensing and regulation by the liquor board.” Now the state liquor board assumes powers over the regulation of medical marijuana, regulation that could essentially eradicate the voter-approved measure and force patients to become consumers of the commercial marijuana industry. Please click here to read the rest of this story.
Does Plan to Require
Tougher Controls on Painkillers Go Too Far?
Proposed tighter monitoring of opioids and other dangerous
drugs has doctors and others worried that it may result in unnecessary
suffering for patients who really need the powerful painkillers. Those concerns
were front and center at a recent meeting of the State Board of Medical
Examiners, whose members raised concerns about requiring all doctors who
prescribe potentially addictive painkillers to check on whether their patient
has already gotten the drugs from another source. Please
click here to read the rest of this story.
Pot is not ‘more dangerous
than alcohol’? Science lacking on Obama’s claim
When President Obama declared in a recent New Yorker
magazine interview that he doesn’t think pot “is more dangerous than alcohol,”
he seemed to contradict his own administration’s policy that’s firmly against
the legalization of marijuana. He also seemed to indicate that the pot smoking
he did in his teens had no major health impact. “I view it as a bad habit and a
vice,” he told the New Yorker’s David Remnick, “not very different from the
cigarettes that I smoked as a young person up through a big chunk of my adult
life.” That’s a position a lot of teens take today, judging by the fact that
more teenagers smoke pot than cigarettes, according to a 2012 survey from the
federal Centers for Disease Control and Prevention. But there’s a scarcity of
research to determine just how risky it is to use marijuana purely for
recreational purposes—which is legal in Colorado and will be soon in
Washington. Please
click here to read the rest of this story.
Surge in Synthetic
Marijuana Emergency Room Visits Reported in Denver
Emergency rooms in Denver, Colorado reported a surge in
visits related to synthetic marijuana in the late summer and early fall,
according to the Los Angeles Times. Experts say similar patterns may emerge in
other parts of the country. Between August 24 and September 19, area emergency
rooms saw 263 patients, mostly young men, with symptoms related to synthetic
marijuana. Most patients were treated in the emergency room, but seven were
admitted to intensive care units. Synthetic marijuana is sold under names
including K2, Spice and Black Mamba. It is made with dried herbs and spices
that are sprayed with chemicals that induce a marijuana-type high when smoked,
the article notes. The products are widely available, despite laws prohibiting
them. In September, the Colorado Department of Public Health and the Centers
for Disease Control and Prevention announced they were investigating whether
three deaths and 75 hospitalizations were caused by synthetic marijuana.
Short-term effects of using synthetic marijuana include loss of control, lack
of pain response, increased agitation, pale skin, seizures, vomiting, profuse
sweating, uncontrolled/spastic body movements, elevated blood pressure, heart
rate and palpitations.
Researchers suggest
effective ways to mitigate drinking problems among new students in colleges
A new systematic review of data published in more than 40
studies of freshman alcohol interventions finds that there are many effective
ways for colleges to mitigate common drinking patterns and problems among new
students. Based on their findings, published online Jan. 20 in the Journal of
Consulting and Clinical Psychology, the team of researchers at Brown University
and The Miriam Hospital recommend that colleges screen all freshmen within
their first few weeks for alcohol risk and offer effective combinations of
interventions for those who report drinking. Please
click here to read the rest of this story.
A winding spiritual path
Raised in a strict Jewish household but then living for
years as what he describes as a largely non-spiritual cynic, Mitch Feld
continues on an intriguing journey that has returned to faith. Now an ordained
rabbi in South Florida who offers spiritual counseling to addicts and
non-addicts alike, Feld happily acknowledges that he still doesn’t have
everything figured out when it comes to the spiritual. “The victory is in the
effort, not the result,” Feld is fond of telling his clients, and this rings
true in his own life. In fact, he doesn’t even use precise language to describe
the major turnaround moment he experienced, when he awoke in 1988 from a
two-week coma after a high-speed car accident that was the culmination of years
of alcohol and cocaine abuse. Please
click here to read the rest of this story.
A most stigmatized
population
Addiction professionals are well aware of the controversy
surrounding diagnostic changes for addictive disorders in the DSM-5. Some are
not aware, however, of an equally vociferous controversy regarding the
diagnosis of gender identity disorder (GID), which was changed to gender
dysphoria in the DSM’s most recent edition. This change harkens back to the
1973 removal of homosexuality from the field’s diagnostic manual. According to
Robin Rosenberg, a clinical psychologist and co-author of the psychology
textbook Abnormal Psychology, “The concept underlying eliminating homosexuality
from the DSM was recognizing that you can be homosexual and psychologically
healthy or be homosexual and psychologically screwed up. Being homosexual didn’t
have to be the issue.” In the same way, the new DSM recognizes that there are
many transgender individuals who are living healthy and productive lives. For
those who aren’t, it is not necessarily because of their transgender identity
but possibly a result of living in a culture that stigmatizes those who do not
conform to traditional norms. . Please
click here to read the rest of this story.
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