Tag Archives: doctors

Depression Screening Early In Life


Can you relate to experiencing symptoms of anxiety, apathy, general discontent, guilt, hopelessness, loss of interest, loss of pleasure in activities, mood swings, or sadness? If so, you are not alone; over 300 million people around the globe struggle with depression. The above symptoms are painful to contend with and ignoring the disorder can lead to harmful behaviors. It’s no wonder that alcohol and substance use disorders frequently accompany coöccurring mental health conditions like depression; when individuals have no way of coping with their symptoms self-medication seems logical. Unfortunately, resorting to drugs and alcohol for managing mental illness can and does lead to addiction. What’s more, substance use exacerbates the intensity of depressive symptoms.

The road to addiction is often slow, it starts with an internal whisper and develops into a terrible roar. While use disorders are a form of mental illness, they’re usually rooted in or grow out of other types of psychological turmoil. There is no telling when pathologies will strike or in what order; it is not uncommon for addiction to predate depression. We could spend hours debating which came first, the chicken or the egg, but the sequence of onset is of little importance in the grand scheme of things. What is salient is that alcohol and substance use disorders be treated simultaneously with any coöccurring mental illness. If one condition goes without treatment, successful outcomes rarely result.

Knowing what needs to happen is only half of the equation to recovery, the other portion involves encouraging others to talk about their struggle. The latter isn’t an easy task, the stigma of mental illness is pervasive; on top of that, a large number of people who meet the criteria for depression don’t know that’s what they are facing.

Mental Illness Screening

The reason many depressives are unaware of the true nature of their feelings is a lack of screening. When individuals operate without a diagnosis, they can convince themselves that how they are feeling is normal, so they don’t talk about their symptoms with friends and family. Over time, sometimes slowly, mental illness worsens; self-defeating behaviors like drugs and alcohol stand-in for treatment and in a significant number of cases, suicidal ideations become ever-present.

There is a large number of people whose mental strife progresses quickly, requiring intervention at a young age. At PACE Recovery Center, we treat young men from all walks of life for alcohol and substance use disorder. It is not uncommon for clients to learn in treatment that drug and alcohol use is just a symptom of a more significant problem. Many of those same clients discover that they meet the criteria for a coöccurring mental illness like anxiety, depression, and bipolar disorder. In many cases, a client’s symptoms of depression were present when they were in middle or high school. While there is no sure way of knowing what people might have been spared had mental health screening occurred during adolescence, early diagnosis often prevents disease progression.

Given that 1 in 5 teenagers contend with symptoms of depression during adolescence, it’s critical doctors act. The American Academy of Pediatrics (AAP) shares the sentiment and updated its guidelines for pediatricians regarding screening, TODAY reports. Annual checkups for patients 12 and up should include one-on-one discussions about mental health. The organization encourages pediatricians to get more training in how to assess, identify and treat depression.

So many teens don't have access to mental health care," said family psychologist Dr. Jennifer Hartstein. "It has to start with their pediatrician, and these changes really point in that direction."

Spotting The Signs of Depression Saves Lives

Adolescence involves enormous changes in one’s mind and body. With puberty comes hormones and physical changes, every adult can remember how awkward life was at that time. Simply put, being a teenager isn’t defined by comfort, so it’s possible that someone can present symptoms of depression without actually being a depressive. Smoke doesn’t always mean fire, so it is up to physicians to be able to discern the difference between circumstantial and neurochemical problems. In either case, young people need support; they require an outlet to talk about how they are feeling without fear of judgment. If there is a fire, necessary steps toward recovery can follow.

When doctors address mental health concerns early on, they have a crucial opportunity to offer treatment options. Treating depression before unhealthy behaviors present themselves can spare young people from significant heartache and mitigate the risk of self-medication. Drugs and alcohol make any issue worse and can lead to premature death; early interventions are the most efficient way to prevent such outcomes.

There isn’t a cure for mental health disorders; however, with screening and treatment, it is possible to lead a fulfilling and productive life. We understand that millions of people are living with psychological disorders that their doctors were unable to spot, a broad cross-section is also dependent on drugs and alcohol. If that sounds like your story, please know that recovery is possible with the right help.

At PACE Recovery Center we specialize in the treatment of young adult males who struggle with a dual diagnosis, otherwise known as co-occurring disorders. We’re fully equipped to treat both presenting mental health conditions and give you, or a loved one, the requisite tools for achieving lasting recovery. Please contact us today to begin a truly life-changing journey.

Preventing New Opioid Use Disorders


As National Recovery Month quickly comes to a close it is important to talk, once again, about opioid use disorders. The use of which has resulted in the most serious addiction epidemic to ever bear down on the United States. Naturally, being in the field of addiction medicine, we’ve covered this topic at great length. From causation to consequence. While we can talk about such things ad nauseam, it is far more important to discuss some ways out this “perfect storm.”

In the immortal words of Robert Frost, “the best way out is always through.” So, and with that logic in mind — headfirst into the storm, we go. As has been pointed out, time and time again, the root of the epidemic rests with opioid prescribing practice standards. Which, up into recently, there were relatively few. But, even with greater utilization of prescription drug monitoring programs (PDMPs) opioids are still prescribed in great numbers. In fact, in many California counties, there more prescription opioids than people, according to the California Department of Public Health.

Case in Point: 2016 Trinity County population — 13,628 people. However, there were 18,439 prescriptions filled in the same year. The highest per capita rate of opioid prescriptions in California, in the fourth smallest county in the state.

The case of Trinity County is not unique to rural California, any more than it is to rural America. Prescription opioids may be a little harder to get or prescribed in large numbers. But, it has had very little effect overall. After all, more people died of overdoses in 2016 than 2015. The only real and notable difference is what people are overdosing on, and why.

Preventing New Opioid Use Disorders

Fewer people are dying from prescription opioids than just a few years, ago. Which is great. However, more people are dying from heroin and fentanyl, an even deadlier opioid analgesic. A New York Times analysis found that 15,400 overdose deaths could be attributed to heroin, 20,100 to fentanyl. The Centers for Disease Control and Prevention (CDC) indicates that 64,000 Americans died of drug overdoses during last year. Which means that more people are dying from illicit opioids than prescriptions.

Such numbers should not be read to mean that the focus of addiction prevention should pivot to illicit opioids. Especially when you consider that most people report starting down the path to opioid use disorder with prescription painkillers. The heroin and fentanyl problem in America has its origins in prescription opioids. And opioid use initiation most commonly begins with a prescription, still. The Trinity statistics are a clear indication that the business of prescribing is, good.

There is no question, making headway requires a multifaceted approach. Calling upon both lawmakers to enact common sense legislation and health leaders to push for more informed doctors. The better doctors understand addiction, the fewer patients who will be prescribed opioids. In turn, reducing the number of future opioid use disorders. What’s more, encouraging doctors to only rely on a prescription opioid when it’s absolutely necessary.

In the United States we’ve become so reliant on opioids, we ignore the alternatives. Non-opioid methods of managing pain, that in many cases can be more effective, and certainly less dangerous.

Opioid Addiction Can Be Avoided

Every time opioids are prescribed, there is potential for future opioid use disorders. You may be surprised to learn that with some forms of pain, opioids can exacerbate one’s symptoms. If “addictive” and “prolonging pain” is a possibility, it dictates that doctors should look elsewhere in many cases. You’d even think that doctors would welcome opioid alternatives, and in many cases, they do. But, there are still others who rely heavily on prescription opioids for all things pain. Despite the risk of opioid use disorders. The reason for this is often because of financial incentives to prescribe certain drugs by the pharmaceutical and insurance industry.

opioid use disorder

Apropos to this, attorneys general (AG) from 35 states sent a message to insurers encouraging painkiller alternatives, The Los Angeles Times reports. Addressed to the trade group America's Health Insurance Plans, the letter called for insurers to prioritize coverage of non-opioid treatments. As wells as, pain management techniques that include physical therapy and massage.

If we can get the best practices changed with insurance companies and the payment incentives are just a bit different than what they are today, I think that's going to continue to see the number of pills prescribed and dispensed drop dramatically," said West Virginia Attorney General Patrick Morrisey. "This is an important new front to open up."

Reducing prescriptions is just one step in reducing the prevalence of opioid use disorders, but it’s perhaps the most salient. With more than 2 million with opioid use disorders and rising, action is required now. Both the pharmaceutical and insurance industry can have a major role in ending an epidemic they helped create.

Opioid Use Disorder Treatment

Efforts to change prescribing practices are vital, but they don’t mean much to those already in the grips of addiction. Equally important to reducing our reliance on opioids, is increasing our reliance on addiction treatment. Tempering the storm of opioid addiction is best achieved through opioid use disorder treatment. Recovery is possible, and if you have been touched by the disease, please do not hesitate to reach out for assistance. At PACE Recovery Center, we are fully equipped to assist young men who are ready to break the insidious cycle of addiction. Please contact us today, and make this Recovery Month the beginning of your own recovery.

Prescription Addiction: Made in the USA

addictionThere is a lot of information, and unfortunately, deadly misinformation about prescription opioids circulating the internet and other major media outlets. Simply put, there is a lot that the average American adult is unaware of, and what they think they know isn’t always rooted in science. In the United States, we use the vast majority of the world’s supply of prescription opioids—despite the fact that we make only 5 percent of the world’s population. While prescription opioids are abused across the globe, America has the market share of the problem. In an attempt to shed some light on both the opioid addiction crisis and potential solutions—Dr. Sanjay Gupta joins Anderson Cooper of CNN’s "Anderson Cooper 360" for a town hall special—to discuss the prescription drug abuse epidemic in the U.S. The presentation, "Prescription Addiction: Made in the USA" airs tonight, May 11, 2016, at 9 P.M. EDT. It is likely to be more than informative and eye opening for many Americans. Dr. Sanjay Gupta has a remarkable understanding about pain narcotics, addiction and how opioid addiction became a pervasive problem in the United States. The Chief Medical Correspondent wrote an op-ed published today by CNN, which covers many aspects of the epidemic. But, perhaps most intriguing is his belief that doctors were responsible for creating the scourge we face, and it will fall on doctors to spearhead efforts for ending the epidemic. Gupta writes:
The fact is, we have accepted the tall tales and Pollyannaish promises of what these medications could do for too long. As a community, we weren't skeptical enough. We didn't ask enough questions. We accepted flimsy scientific data as gospel and preached it to our patients in a chamber that echoed loudly for decades.”
He points out that while the epidemic is the result of the medical community acting on opioid prescribing recommendations they were not based on fact, doctors continue to recklessly prescribe these deadly narcotics despite knowing that the drugs should be doled out as sparsely as possible. He cites a recent study published in the Annals of Internal Medicine which showed that 91% of opioid overdose survivors managed to obtain another prescription—usually from the physician who prescribed the narcotics the patient overdosed on in the first place. Gupta calls on prescribing physicians to:
  • Engage with patients and discuss treatment with them.
  • Set realistic expectations for patients.
  • Conduct follow-up conversations with patients to gauge treatment efficacy.
“It is not too late. In order for this American-made epidemic to finally end, however, it is the American doctors who must lead the way,” writes Gupta. Remember to tune in tonight, or catch it on DEMAND, to see CNN’s "Prescription Addiction: Made in the USA" May 11, 2016, at 9 P.M. EDT. Join in the conversation and share this family and friends. If you’d like, you can view a short trailer about the town hall meeting by clicking here.

Physicians Have Misconceptions About Opioids

doctorPhysicians who understand the nature of addiction are crucial in the fight against prescription opioid abuse. Unfortunately, a new survey indicates that many doctors have misconceptions about current opioids on the market and lack an understanding of opioid abuse, PsychCentral reports. The findings come from a nationally representative sample of 1,000 primary care physicians. The new survey, conducted by researchers at Johns Hopkins Bloomberg School of Public Health, showed that almost half of internists, family physicians and general practitioners believe that abuse-deterrent pills are less addictive than traditional opioid medications. The researchers contend that this error in reasoning may be contributing to the prescription opioid epidemic plaguing the country. While abuse-deterrent formulations may make it more difficult for addicts to tamper with pills to be used in unintended ways, such drugs are in no way less addictive than their forerunners.
“Physicians and patients may mistakenly view these medicines as safe in one form and dangerous in another, but these products are addictive no matter how you take them,” study leader G. Caleb Alexander, MD, said in a news release. “If doctors and patients fail to understand this, they may believe opioids are safer than is actually the case and prescribe them more readily than they should.”
The research showed that one-third of the physicians thought that the majority of prescription drug abuse occurs by means of injecting or snorting the medications, rather than orally, according to the article. However, a number of studies show that most prescription drug abuse occurs via oral use.
“Doctors continue to overestimate the effectiveness of prescription pain medications and underestimate their risks, and that’s why we are facing such a public health crisis,” Alexander said.
The findings were published in the Clinical Journal of Pain.