RECREATIONAL MARIJUANA

Many folks have asked me about my position on recreational marijuana. Those who are for legalizing the drug say it will normalize use and make it unattractive to young people, because there is no risk involved in procuring it. On the opposite side are those who state that a drug is a drug and marijuana is no exception. So it should remain illegal to buy or use. For me, this is a slippery slope. In a state where it is legal, if an adult wants to have a small amount on a Friday night instead of alcohol, then so be it. The problem comes when folks over use the substance, just like alcohol. Or they need more of it to create a feeling that they want. The second challenge is keeping it from young people under the age of 25. That is the age when the brain is properly developed. So it is important for all of us to be substance free until that time. We have no Marijuana Police. In fact, we have no policies that make any sense around the drug. States are in a quandary. Legislators do not have much education on substance use and abuse. And those who want to make it legal for their own profit are professionals at marketing propaganda about marijuana and its medicinal benefits. We have no longitudinal research data on recreational marijuana use. As a professional in the field, I cannot imagine it would add any beneficial aspects to an already full life. But the jury is out. I suggest we get organized before letting this horse out of the barn.

KROKODIL KILLS

Last month three people died in Illinois from the deadly street drug Krokodil. For that reason, I am taking the time to educate the readers on this unusual drug. First, it is a street drug from Russia. The parent molecule is Desomorphine which is a morphine derivative. The dealers combine codeine and iodine and phosphorus into a powder and then take it to the street to sell. Not many folks in Russia or the Ukraine die, and the reason why is simple. When Krokodil gets stateside dealers want to make more money and include additives such as lighter fluid, paint thinner and a host of other substances which are lethal. The drug causes gangrene after the skin becomes scaley and turns a greenish hue. Limbs are often necrotic and need to be amputated. Death is a real possibility. In addition, some codeine may contain Diphenhydramine which potentiates opioids. The feeling lasts about and hour and a half, withdrawal begins immediately, and this is a sure way to play Russian Roulette with life. Although I rarely say 'Don't use drugs', this is one time when I highly recommend you stay away from this substance for two reasons: First, why give drug dealers a way to make more money? And second, why take the risk involved for an hour and a half of questionable pleasure, unless you have a death wish!

ADDICTION: DISEASE OR CHOICE?

Last year, the American Society for Addiction Medicine adopted a new definition; that 'addiction is a chronic, often relapsing brain disease.' Many specialists like myself, took issue with this definition. We were resistant because such a definition may negate personal responsibility. For example: no one sits on your chest, puts a funnel in your mouth and pours alcohol down your throat. Not too many people grab your arm and stick a needle in it to fill your system with heroin. The point is, that we each make a choice to drink and/or abuse drugs. We see an Opioid in someone's medicine cabinet and think..."hmmm. If I just take one, no one will notice and I could just try it." Or as a young person, we find alcohol in the house and sneak a drink - just because we can. We need to take responsibility for that initial action, as well as those that follow. That being said, there is more than one way to become an addict. A family history, or genetic predisposition makes us vulnerable to addiction. The "Over use over time theory" (McGowan 2005)is another way. The overuse of anything over a period of time effects brain chemistry. What about folks who receive medication for pain? Can they become addicted? THE ANSWER IS 'NO". They become dependent, but that is not addiction. When they use painkillers when the pain has ceased, they are on a slippery slope that will end in addiction. That is because the body and brain recognizes that which is pleasurable and wants more of it. So we use alcohol or drugs again - just one more time. The more we use, the more we need and then tolerance begins and we are inside a merry-go-round that is extremely difficult to jump off. The best way to end addiction is not to begin the process at all. Since that is unrealistic for most people, at least reflect on why you do certain behaviors. Do you drink because it makes you feel better or because you like the taste or because it helps you come out of your shell? Do you abuse medication or use illicit drugs so you can forget about troubles or because everyone else is doing it? Reflection is merely a first step. Honesty is part of the step as well. If you come home from work and have a drink everyday because it is the only way you can relax, you have a problem.If you smoke marijuana everyday for the same reason and have started to enjoy smoking alone, you have a big problem. If you are stealing from someone's medicine cabinet or a patient's med case you have a huge problem. RECOGNIZE IT! Don't stop - JUST GET HELP!!!!

BENZO FURY ADDTIONAL LINKS

FOR SOME REASON THE LINKS TO ADDITIONAL ARTICLES WRITTEN BY EVE HARDING DID NOT TRANSFER WITH HER PUBLICATION. WE ARE MAKING THEM AVAILABLE FOR ALL OF YOU TO ENJOY. MANY THANKS! Some of my recent pieces: http://www.lose-weight-diet.com/2012/03/21/dukan-diet-fad-fat-buster/ http://blog.boostherbs.com/post/2012/03/06/PCOS-Herbal-Healing.aspx http://fibroviv.blogspot.co.uk/2012/03/writing-visual-journal-for-stress.html AJM

BENZO FURY IN THE UK!

Writer Eve Harding has submitted the following piece for our Blog. Formerly from Maryland, she now resides in the UK where she is keenly aware of the drug issues> Benzo Fury’s Stimulant and Addictive Properties Make it as Dangerous as Amphetamines At least one legal high – a substance that gives a euphoric feeling similar to that of illegal drugs, but is not governed by laws relating to misuse of drugs – enters the market each week. This was reported by the United Nations International Narcotics Control Board in March of this year. Although legal highs are often viewed by those who use them as a safer alternative to the likes of cocaine and amphetamines, this is not necessarily the case. Certainly at the beginning of April, concerns were raised about the party drug Benzo Fury – known scientifically as 5-(2-aminopropyl)benzofuran or 5-APB for short. The drug Benzo Fury has quickly become one of the most used legal highs in Britain, but is also becoming popular in the United States. A synthetic chemical, it has been designed in a laboratory to induce euphoria and to be hallucinogenic; it is readily available for sale online, though also widely sold in night clubs and festivals, and at typically $15 per pill, is very accessible. Worries regarding this latest craze are based on the findings by a team of researchers at the University of Roehampton in Britain, which they shared at the British Neuroscience Association conference on 9th April. Research findings The research investigated the effects of 5-APB on the brains of rats in comparison to the stimulants cocaine and amphetamines, hoping to give an indication of not just its properties, but its relative danger. Pathways of addiction are not dissimilar in rodents and humans, making rats a good choice for this study. It was found that Benzo Fury acts as amphetamines in that it has the potential to be a stimulant, hallucinogenic and addictive. Jolanta Opacka-Juffry, who led the research, said it was this combination of features that made it so dangerous. Unlike substances that have purely hallucinogenic properties, which it is not possible to become hooked on, as they don’t raise dopamine production like amphetamines and cocaine, Benzo Fury also promotes this, having the potential to be addictive and induce dependency. Mechanisms of action Their work highlighted that 5-APB works through serotonin receptors in the brain, those responsible for providing intense feelings of pleasure experienced during a high. However, it also indicated that the dopamine system is involved. The dopamine transporter protein, which facilitates the return of dopamine to nerve cells in the brain, ceasing dopamine’s action, appears to be altered, leading to reverse dopamine transport; without reuptake this has the potential to cause damage to nerve cells and result in cravings and reliance upon Benzo Fury to function normally. Taken numerous times for its psychedelic effects increases the chance of this dependency occurring. As any addict knows, once this stage has been reached, not only does it significantly impact on your life, but kicking a drug habit habit becomes increasingly more difficult. By this point, wanting to quit and having the support of friends and family is usually not enough, requiring the help of specialist drug treatment centers from Maryland to California. Getting the message out about the addictive nature of Benzo Fury is therefore vital. Adverse effects Acting on serotonin receptors not only leads to changes in mood, but also means Benzo Fury may cause narrowing of blood vessels, raising blood pressure, increasing the likelihood of a heart attack or stroke, further adding to the potential adverse results from taking it. There is also evidence that the drug reduces appetite and triggers paranoia, having consequences for long-term feelings of well-being. It should additionally not be forgotten that there has been at least one reported death following its use; a 19 year old male died after taking the drug at a music festival in the summer of 2012. Changing attitudes In comparison to illegal drugs, it is clear that Benzo Fury is not the safe pill that many consider it to be, displaying similar properties to those considered to be lethal. If more people knew the dangers, this and other legal highs would perhaps not be so popular. With many party goers not aware of what they are taking and what might be considered a safe dosage - indeed if there is one – along with their addictive nature, at present it’s purely a matter of luck if they take these and don’t have adverse effects. Although the relative chance of serious problems occurring is currently unclear from research to date, further studies are required to determine its potential for addiction, nerve cell damage and impact on the cardiovascular system. Looking beyond animal studies to gather information from people who have used the drug previously will also shed further light on the impact of Benzo Fury. However, with so many other legal highs out there and more being created the whole time, this is a growing area of research.

DANGERS OF MOLLY

Recently, I met wih a group of parents concerned about a 'new' drug in their area. The street name for the drug is 'Molly'. Their children spoke about it as if it were "not all that bad - and at least it wasn't cocaine." Well, they were right about one thing - it is not cocaine. But it is a dangerous drug when taken for recreational use. Molly is MDMA - or Ecstacy. It is both an amphetamine and phenethylamine. That means it gets your heart speeding, reduces some anxiety and makes you feel a sense of intimacy with people around you. For many years it has been a Club Drug used to enhance sexual feelings. Although the drug is banned in numerous countries, there is a body of research studying possible low dose use of the drug in psychotherapy. That aside, there is an even more striking fact about the sale of this drug in the U.S. Obviously, it is not regulated by the FDA, so anyone selling or manufacutring the drug can add adulterants or additives to extend the amount. In many cases talcum powder or ibuprofen (among other things)is added to Molly. This makes more money for the drug dealer. So it is in his or her best interest to add substances that look like the white powder and/or can be formed into a pill. The problem is that no one knows what the mixture contains. In some cases there is no MDMA at all, but a drug called PMA which has been associated with many deaths. At first use, the user may experience a heightened sense of euphoria, hallucinations and disorientaion. They also feel jaw tension and may exhibit convulsions. The drug reaches its peak in 1.5 - 3 hours after use. But long after the drug has peaked it remains in the system. If another dose it taken tolerance is developed and the brain struggles with the way seratonin needs to be regulated. The bottom line is this - Molly, MDMA, is a dangerous drug. Until proven otherwise, it is not safe to use. Tell your teens that it may not be cocaine, but it may do irreversible damage to the brain, and prolonged use may lead to death.

WHY AUTISM IN AN ADDICTION BLOG?

If you are wondering why I posted a a few paragraphs about Autism and the new website ModernProdigy.com, it is because last year for the first time, I had parents of children with autism and two adults on the spectrum, with addictions. For some reason any link between addiction and families managing children with autism never crossed my mind. But the pressure some folks are feeling when they have a child with autism causes depression and anxiety. In turn, they seek medication for relief. In some cases this becomes a dependence and may even lead to abuse. Combined with alcohol it can be lethal. We use drugs and alcohol to change the way we feel. I have written many times that once in a while this is not harmful. But when we rely on substances to help us escape from our responsibilities, we are on a slippery slope. The first duty of a parent is not to love their child, but to keep them safe. That means being in the moment, fully present at all times. And if the child has special needs, it is even more important to know what is going on. As this website develops, I will keep you in the loop. And if you have any questions about parenting and addiction, feel free to write to me.

MODERN PRODIGY - AUTISM

modernprodigy.com is being developed to offer a different perspective to the way we think about Autism. Many see it as a disability; a frightening abnormality without any cure or possibility for complete recovery. Children diagnosed on the spectrum, most likely cannot communicate. They do not engage with other children and adults. They often exhibit stereotypical movements. They are not easy to reach emotionally. These things make them different. And when something is different and difficult to understand we shy away from it.

Modern Prodigy presents the child with autism in another light. They do communicate, just not the way we are used to seeing. They do think, just not in an organised fashion similar to our thinking. These children do not look us in the eye because they are seeing things in a larger visual field using their peripheral vision. Because they do not respond the way we want them to does not mean that they do not understand.
We  are asking, you the reader, to open your minds to the possibility that these are the child prodigies of the future. Our job is to try to welcome them as a gift to society.

SHOPPING ADDICTION

When we talk about addiction, we often think about drugs and alcohol. But some behaviors have just as many negative consequences when we depend upon them to fill a void within us. Shopping is one of those behaviors. A national study three years ago identified 17,000,000 people in the United States - or about 6% of the poplation as having a compulsive shopping disorder. Some of my patients who come in to address prescription abuse or alcohol dependence reveal more than one addiction. Compulsive shopping is very common as a crossover addiction. Shopping as a way to avoid feelings related to everyday struggles, and buying things a person does not need to substitute one feeling for another is a problem. Not paying rent or utilities and squandering monies on frivolous purchases only sets the stage for more struggles. Depression sets in because the person is not dealing with responsibility and they shop more. It becomes a vicious cycle. Watching a recent reality show about folks who are compulsive shoppers, I was struck by the fact that short-term intervention to change the shopping behavior was seen as the panacea to the problem. The reality, however, is that it takes more than an intervention on a 60-minute show. The important piece of the puzzle is to find out what preciptating event started the shopping behavior in the beginning. Was it something in childhood, or something more recent? Is the patient able to cope with crisis? Does the person have the skillset to manage his or her life. Behavior change takes a good year of weekly therapy to uncover causes for compulsive shopping. Some patients may need pharmacotherapy. Others will benefit from self-help in addition to therapy. But it is imperative to weed things out and make changes slowly. 60 minutes is a necessary time frame for a television show. But television only reflects reality. It is not reality - though the lines are definitely blurred

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2013 ADDICTION CENTRAL UPDATE

Hello readers! Last year, we covered a variety of addiciton topics. Everything from Whitney Houston's passing to parents who give their young children Marijuana. This year will be no different. We will look at teens and drug abuse, veterans and the mix of alcohol and suicide rates, and pregnant women who drink. I welcome your feedback and any questions you may have. Just a note about the lack of information after August 2012. In September I had surgery and a wealth of complications. In fact, I almost died twice. By Thanksgiving I was out of the hospital and on my way to Chicago. It was a long haul, but I am better than ever and ready to re-group. I am looking forward to a healthy, sober and addiction-free 2013. And I wish the same for all of you. Sincerely, Dr. McGowan

MENTAL HEALTH VS. SUBSTANCE ABUSE

For the past twenty years professionals have debated whether it is more efficacious to treat mental health and substance abuse together or one at a time. We have tried it both ways. The mental health folks have spent months trying to stabilize clients before turning them over to the addiction specialists. And the substance abuse people have done the same, concentrating on assisting their clents to be clean and sober before dealing with their anxiety or bipolar disorders. The perspective that is most difficult for professionals to understand is why we would not treat the whole person at once. Is this a case of dualing egos or perhaps an unfamiliarity with co-morbidity therapies? In either case, we must look at patient wellness first and foremost. Meeting the patient where he or she is, may mean motivating someone to enter detox, while developing a plan that includes medication for mental health stabilization and individual therapy that addresses both issues. Whatever works, may sound simplistic. And someimes that means abandoning a particular therapy for a more eclectic approach that is comprehensive in areas of mental health, substance abuse, pharmacotherapy, exercise and spirtuality. As non-traditional as this may sound, it may be what works for your particular patient.

BATH SALTS AREN'T FOR BATHING!

Last year at this time I visited a 16-year-old boy in the hospital. He could not speak or walk or control any motor movements. He had been in a coma for three days and was then awake. Blood test results showed no known drugs or alcohol in his sytem. However, after interrogating his close friends, they admitted the boy had snorted bath salts at a party the night he collapsed. The words and the labeling are innocuous enough. Bath salts are meant to be a soothing additive to warm, soaking tub water in an attempt to relax us and lower our blood pressure. But these are not the common relaxing agents of our parents' generation. Today's product being sold in small shops and corner markets, can be purchased legally since they are labelled - 'not for human consumption'. Ingredients in bath salts include three toxic chemicals that were banned by the DEA last year. They are MDPV, methylone and mephedrone. They cause paranoia, psychosis, agitation, a stimulant-like effect and hallucinations. They also have been associated with delayed suicidality. The question becomes, why do young people abuse something with such potentially fatal consequences? The answer is complicated. Some do not have skills to deal with real life. Some blindly follow others. Some want to change the uncontrollable feelings within themselves that prevent their personal happiness. It is time for us to stand up and support an across the board removal of Ivory Wave, Vanilla Sky, Bliss and other bath salt products from all stores. It is too late for the 16-year-old I visited. But it is not too late for others like him.

PHARMACOTHERAPY HAS ITS PLACE

When working on recovery with my patients, I often recommend that they attend AA/NA/GA, go to meetings, join a home group and pick a sponsor. This is very therapeutic, but it is not therapy- it is adjunctive. Yet, I know that the more positive support a patient has, the better off he or she will be in long-term recovery. Whatever works is the prescription I adhere to. The patient's success is paramount. What puzzles me is the negative reception many of my patients receive when they go to AA/NA and members find out that they are on medicines to assist their recovery. Abstinence may work for many people but it is not the only way to enter recovery. Pharmacotherapy, or the use of medication to cut down on urges or cravings, is another method. We often find people who have relapsed numerous times when attempting abstinence. These are the folks who are better off taking medication to help manage their lives, then to chronically feel like a failure. Revia helps with Pathological Gambling. Suboxone works with Opioid Dependence. And both Vivitrol and Campral help with Alcohol Dependence. If folks are suicidal, we recommend their PCP use an anti-depressant. All of these of course should be combined with substance abuse treatment on a weekly basis and frequent contact with the prescriber. Folks in AA/NA/GA adhere to the abstinence model. They learn about acceptance, gratitude and surrender. What they need to learn as well is tolerance and a non-judgemental way of accepting others who struggle with addiction.

FEELING NO PAIN, USING COCAINE

We don't talk much about cocaine anymore. The emphasis these days is on opiates and prescription drug abuse. Yet just as many Americans use cocaine as they do heroin. The difference is that cocaine is 'marginally socially acceptable' in many wealthier circles. For that reason, discussion about it does not peak interest. Cocaine was more or less 'normalized' by high-level executives and celebrities. It is available at parties and bars and folks don't see it as an addictive substance. Even detoxes do not accept clients who only abuse cocaine. The problem however, is cocaine causes serious damage to the brain. Using it with alcohol, even socially, can produce cocaethylene which can be fatal. Smoking cocaine in crack form, causes Dopamine flooding and a slower re-uptake. That means that it is all but impossible to stop smoking until the crack runs out. It goes to the reward center of the brain and produces such a pleasurable effect that people do not want to stop smoking. So the question becomes, why do people smoke cocaine or snort it if it is damaging? Are they addicted? There is no one answer to these questions. People use illicit drugs for many reasons. But they are not addicted to the substance cocaine. They are addicted to the feeling they get when they use this substance. It takes them out of the everyday world that surrounds them and puts them in a different emotional state where no one can demand from them. They do not have to live up to anyone else's expectations. But, damage from cocaine abuse clearly outweighs the good feeling that users get when they are high. It is a negative tool to avoid reality and responsibility. In between use, folks become irritable and anxious. And combined with other drugs it can be fatal. Although not a gateway drug, rarely do we meet clients who only use cocaine. Patients come to us when their life is out of control. When the cocaine/crack use has financially devastated them. And when they have alienated their family and friends in favor of their on-going affair with the drug. Cocaine abuse is a serious problem in America. We should not turn our heads and ignore it when family members use the drug. We should encourage them to get help before they lose everything that is important to them.

NURSE, HEAL THYSELF FIRST

In the past seven years I have treated dozens of nurses. Some have come to us for alcohol dependence. But the majority have been Opioid Dependent. That's correct. These professionals that we depend upon to hold our hands and minister to us when we are sick, are often very ill themselves.

They begin by taking Percocets for stress, then a little Oxycontin for back pain and many of them progress to Dilaudid to get through their shift. The sad part of this behavior is that they more often than not, they take medicine from their places of work - hospitals, nursing homes and even hospice. Some even substitute placebos for the actually pain medications, leaving their patients in distress.

Although this is the minority of people in the nursing profession, it still begs the question, WHY? Is the job too stressful? Do we not provide enough down time for our most valuable caregivers? Are there folks in the profession with no regard for a work ethic and who leave their co-workers to run back to back shifts because they feel like calling in sick? Do some people enter the profession with a predisposition towards drug addiction?

I do not have the answer. What I do know is that this is becoming a problem that we need to address. I also think that support for recovery is a better idea than punishment. We need nurses. They deserve our help, if not for humanitarian reasons, than at the very least because it is good Karma.

CHILDREN DRINKING AT HOME

This morning's special news segment addressed the question about whether or not parents should introduce alcohol in the home, so that children will understand how to drink when they reach majority age. The issue with the question posed, is that there is an assumption made, that parents themselves understand how to drink reasonably.

The problem is that children and teens are not physically capable of handling alcohol. Developmentally, they need pure foods such as fruits, nuts and vegetables, grass-fed beef and poultry, for brain growth. They do not need alcohol at a time when the brain is learning and expanding its knowledge base.

They also do not need to emulate the drinking behaviors of adults around them. Especially when most do not understand that a woman should drink a maximum of 3-4 (one ounce) drinks in an evening at most, and a man about 5 ounces. A standard size glass of wine in America is over the three ounces to begin with. And watching parents who come home and have a beer to relax each night sends a negative message that alcohol is an acceptable tool to use to unwind.

Whether the drinking age is 21 or 18, teaching people how to drink is a great idea. Waiting until the brain and body can handle alcohol is an even better idea!

MARIJUANA PARENTING

Today, I attended a conference that focused on the damage drugs and alcohol can do to the adolescent brain. Most people in the audience were not worried about the effects of marijuana; they were focused on alcohol and 'hard' drugs. In fact, some even defended the position the MA DCF has taken - that removal of children for parental abuse of marijuana is not going to happen.

Yet, these attendees learned today that marijuana may not be a 'gateway' in the traditional sense, but it is harmful nevertheless. It takes approximately 18-24 months for a person to stop depending upon marijuana after discontinuing abuse through harm reduction. And in fact, withdrawal really happens; including mood swings, depression and irritability during protracted withdrawal.

The adolescent brain is not fully formed and smoking marijuana at a young age impedes the user's ability to hold memories and interpret cognitions properly. Smoking causes cognitive distortions.

Developmentally , using drugs and alcohol does not allow the user to progress from adolescence to adulthood emotionally. They get stuck - something we refer to as arrested development.

Most young people begin smoking cannabis around 11 or 12 years old. Research demonstrates that if a 'father figure' is smoking in the home when a child is 6 years old, the child will most likely grow up smoking marijuana as well within 5 or 6years. That makes me wonder whose idea it was at DCF to decide not to consider marijuana as a serious issue.

Smoking marijuana is a serious issue. It is not the cannabis of the 1960's; but cannabis that is ten times stronger. It is not a joke, or a casual source of entertainment. It is a substitute for skills we have not taught our young people. Skills that will help them manage their lives in a more balanced way.

IS MARIJUANA A GATEWAY DRUG?

The question on most folk's minds about addiction is what is wrong with smoking marijuana. It is natural. There is no data on overdose by smoking. And most smokers agree that it is not addictive. While these things may be true, the real question is why do people continue to smoke cannabis on a daily basis. And why is there so much negative press?

The answer is that smoking marijuana changes the way we feel. It numbs us, it clouds our depression, it shifts our focus from everyday stresses to an ethereal experience which takes us out of ourselves. Is the substance itself addictive? NO. Is cannabis a gateway drug leading to more intense addiction and highly volatile drug behaviors? No. So what is the problem?

The problem is that we become attached, dependent and/or addicted to the feeling. To the escape and the method of detachment. Using this method on a daily basis keeps us from doing other things. It does not allow us to develop other coping mechanisms which we need to manage our lives. It prevents us from becoming involved in family and friendships. The loss that we experience is a loss of time. Something we cannot recover.

Marijuana may not be a gateway to other drug use. But it definitely is an obstacle to living life to the fullest.

ADDICTION ELITISM

An elegant looking, well-dressed woman in a designer suit and handbag that cost more than most people's weekly salary, came to see me the other day. She wanted to 'interview' me to see if the treatment my staff and I could provide for her young daughter was up to speed. Her husband had already called and asked about our credentials, years of experience and schools. So this was the in-person visit.

Her daughter was not present. She was at home where she stayed while in the midst of a Percocet-heroin run. Her mother proceeded to tell me that the 17-year old was not like those 'other people' who came to us for treatment. She was not 'that kind of person'; she was from a 'good' home. And could we treat the daughter at home so that she did not have to come in contact with any of the types the mother had seen in our waiting room.

It takes a lot of restraint not to say what is close to the tip of my tongue when folks take such an elitist stance about addiction and treatment. It is an equal opportunity disorder. Addiction knows nothing about socio-economics, or skin color or age. Treatment is not dependent upon the price of a designer bag or the education level of the parents. It is a condition. It can happen to anyone. It is treatable.

As for the therapy most of us in this profession provide, it is not dependent upon the patient's income. It is dependent upon the patient's needs. We work hard regardless of who the patient is or where they come from in an effort to promote wellness - it's that simple.

OVERDOSE PREVENTION

Of course we all know that the best way to prevent drug overdose is not to take any illicit drugs or medications that do not belong to us. Yet each day young people die needlessly by taking large quantities of Opioids such as Percocet, Vicoden, and Heroin. Their friends see that the overdose results in respiratory distress and they become frightened. They either leave the struggling friend or they dump them outside an emergency room door.

But time is crucial when it comes to saving someone who has taken too many drugs or has abused someone's prescription medication. When the respiratory system is depressed by too many opioids the person gasps for air. It does not take too long for death to come.

But there is a substance - Naloxone(Narcan) that average people can be trained to administer that will save lives. Naloxone reverses respiratory failure in seconds. In a study in California where a survey of 48 communities who are trained to use NALOXONE responded, there were 10,171 persons saved with NALOXONE.

Rather than opposing methods of harm reduction in favor of strict abstinence, I encourage communities to seek out hospitals and clinics who are willing to train and give access to Naloxone in an effort to reduce deaths by opioid overdose.