Shrinks In Sneakers

Tag: diagnosis of addictive disorders

Major Federal Healthcare Cuts: What Physicians Need to Know and How We Can Respond
A devastating blow to public health: More than $12 billion in federal grants—funding that supported infectious disease tracking, mental health services, addiction treatment, and other critical programs—has been canceled as part of recent federal budget cuts.

These cuts threaten early detection of outbreaks, access to psychiatric care, and lifesaving addiction treatment programs—all areas where we, as physicians, see the impact daily.

Key Areas Affected:

🚨 Infectious Disease Surveillance – Reduced ability to track emerging threats like COVID-19, flu, and antibiotic-resistant infections.
🧠 Mental Health Services – Fewer resources for crisis response teams, community mental health centers, and psychiatric services.
💉 Addiction Treatment – Less funding for MAT (medication-assisted treatment) and harm reduction programs at a time when overdose rates remain high.
🏥 Public Health Preparedness – Cuts to pandemic readiness and emergency response training for healthcare workers.

What Can We Do?

🔹 Advocate – Contact legislators, professional organizations (APA, AMA, ACP), and demand restoration of funding.
🔹 Educate – Inform patients and communities about how these cuts impact their care.
🔹 Mobilize – Work with hospital leadership and local organizations to find alternative funding sources.
🔹 Collaborate – Strengthen interprofessional partnerships to sustain services despite budget constraints.

We’ve seen what happens when public health is underfunded—it costs more lives and more money in the long run. We can’t afford to be silent.
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March 30, 2025
The Hidden Risks of Sports Betting: Alcohol and Gambling
In recent years, sports gambling has exploded in popularity, with mobile apps and online platforms making it easier than ever to place bets on everything from football to tennis. While sports betting can be an exciting pastime, research is beginning to reveal a concerning link: frequent sports gambling is positively correlated with alcohol-related problems over time.

The Research Behind the Connection

A recent survey study found that individuals who frequently engage in sports gambling are at a higher risk of developing alcohol-related problems. The study tracked gambling habits and alcohol consumption over time, revealing a strong correlation between increased betting frequency and worsening alcohol-related consequences.

But why does this connection exist? Several factors could be at play:
1. The Social Environment – Many sports gambling settings, such as bars, casinos, or watch parties, encourage alcohol consumption. Betting while drinking can lead to impaired decision-making and increased risk-taking.
2. Impulse Control and Addiction – Both gambling and alcohol can activate the brain’s reward system, leading to compulsive behaviors. Someone prone to impulsive gambling may also struggle with moderating alcohol intake, and vice versa.
3. Coping Mechanisms – For some, gambling and alcohol serve as escape mechanisms from stress, anxiety, or financial difficulties. Unfortunately, these behaviors can reinforce each other, creating a cycle that’s hard to break.
Why This Matters

With the rise of legalized sports betting, it’s crucial to understand the potential risks. Problem gambling and alcohol misuse can lead to financial hardship, strained relationships, mental health struggles, and long-term health consequences. Awareness is key to preventing these issues before they spiral out of control.

Responsible Gambling and Drinking: What Can You Do?

If you enjoy sports betting and drinking, consider these tips to keep things in check:

✅ Set Limits – Establish a gambling budget and a drinking limit before you start. Stick to them.

✅ Avoid Drinking While Betting – Alcohol impairs judgment, which can lead to reckless betting decisions.

✅ Recognize Warning Signs – If you find yourself gambling or drinking more than you intended, or if these habits are negatively affecting your life, it may be time to take a step back.

✅ Seek Support – If you or someone you know is struggling, reach out for help. Resources like gambling helplines and alcohol support groups can provide guidance and support.

Final Thoughts

Sports gambling and alcohol can both be enjoyed responsibly, but it’s important to be aware of their potential risks. As research continues to uncover the connection between these two behaviors, taking a mindful approach can help ensure they remain entertainment rather than a problem.

What are your thoughts on this issue? Have you noticed a link between gambling and alcohol in your own experiences? Share your insights in the comments! ⬇️
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March 22, 2025
🚨 New Study: Cannabis Use Disorder Linked to 3X Higher Mortality in Hospital & ER Patients
A major new study has uncovered a staggering risk: Patients diagnosed with Cannabis Use Disorder (CUD) in hospitals or ERs had nearly THREE TIMES the mortality rate over the next five years compared to those without the disorder.

🔎 Key Findings:

🛑 Patients with CUD had a significantly higher risk of death within five years.

🛑 Cannabis use was associated with worse health outcomes, even after adjusting for other factors.

🛑 Findings challenge the assumption that cannabis is a “harmless” substance.

💡 Why This Matters:

As cannabis use becomes more common and legalized, we can’t ignore the potential long-term health consequences—especially in vulnerable populations. This study raises urgent questions about how cannabis impacts physical and mental health in the long run.

📢 What do you think? Should we be taking Cannabis Use Disorder more seriously in medical settings? Drop your thoughts below! 👇

🔗 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829914

#Cannabis #PublicHealth #Addiction #ER #Medicine #addictionmedicine #addiction #cannabisusedisorder #addictionpsychiatry #medical #doctor #medication #marijuana
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February 7, 2025
🚨 Cannabis & Brain Function: Short- & Long-Term Effects You NEED to Know 🚨
Cannabis use is everywhere, but do we truly understand its impact on the brain? 🤔 A growing body of research reveals short- and long-term effects that can’t be ignored. Let’s break it down:

🧠 Short-Term Effects
🔹 Impaired memory & attention
🔹 Slower reaction time
🔹 Altered judgment & coordination
🔹 Increased anxiety or paranoia (in some users)

But here’s where it gets even more concerning…

🧠 Long-Term Effects (Especially with frequent or early use)
🔻 Structural brain changes in memory & executive function areas
🔻 Persistent cognitive impairment in heavy users
🔻 Increased risk of psychiatric disorders (psychosis, depression, anxiety)
🔻 Lower IQ in adolescent-onset users

💡 The Takeaway? While cannabis has potential therapeutic uses, chronic or early use can have lasting effects on brain function—especially in young people. Understanding these risks is crucial as legalization expands.

🔬 Have you seen changes in cognition or mental health in cannabis users? Let’s discuss below! 👇 #Cannabis #BrainHealth #Neuroscience #MentalHealth
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February 7, 2025
Liam Payne and Pink Cocaine: What You Need to Know About the Party Drug
Pink cocaine, also known as tucibi or 2C-B, is a synthetic hallucinogen from the phenethylamine family, first synthesized in the 1970s. Despite the “cocaine” in its street name, it is chemically unrelated to cocaine. It usually comes in powder form but can also be found in tablets. It’s popular in party scenes for its euphoric and stimulant effects, which are often compared to a combination of MDMA and LSD.

Key Points for Addiction Psychiatrists:
1. Effects:
  - Euphoria, enhanced sensory perception, hallucinations.
  - At higher doses, it can cause anxiety, paranoia, and dissociation.
  - Effects can last from 4-8 hours depending on the dose and mode of administration (oral, nasal).
2. Health Risks:
  - Cardiovascular issues, including hypertension and tachycardia.
  - Risk of psychosis and mood disorders, especially with repeated use.
  - Hyperthermia and dehydration, especially in party environments.
  - Possible neurotoxic effects, though research is limited.
3. Addiction and Dependence:
  - While physical dependence is not common, psychological dependence can develop due to its euphoric effects.
  - Patients may use it in cycles with other substances (e.g., MDMA, alcohol), leading to polysubstance abuse.
4. Withdrawal:
  - No specific withdrawal syndrome has been documented, but patients may experience depression, anxiety, and cravings after discontinuation.
  - Management may require addressing underlying mental health issues or substance use patterns.
5. Treatment:
  - Cognitive-behavioral therapy (CBT) or motivational interviewing may help address compulsive use.
  - Monitor for concurrent use of other drugs, especially stimulants or hallucinogens, as polysubstance abuse is common.
  - Referral to harm-reduction programs may be beneficial for patients unwilling to quit completely.
6. Legal Status:
  - It is illegal in most countries, classified as a Schedule I drug in the U.S. However, enforcement is inconsistent, and it continues to be accessible in underground markets.
For addiction psychiatrists, it’s crucial to recognize tucibi use, especially in patients with party-drug histories. Understanding the psychological effects and potential for dependence will aid in developing a comprehensive treatment plan. Monitoring for concurrent substance use and educating patients on the risks is key.
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October 23, 2024
U.S. Overdose Deaths Hit Historic Low: A Turning Point in the Opioid Crisis
A recent NPR exclusive reveals a significant and unexpected decline in U.S. overdose deaths, marking the first drop in decades. Data from the Centers for Disease Control and Prevention (CDC) shows a nationwide reduction of roughly 10.6% in overdose deaths. Some states with rapid data collection have seen declines as high as 20-30%, suggesting the possibility of saving up to 20,000 lives annually.

This turnaround follows years of increasing fatalities, largely driven by fentanyl and other synthetic opioids. Experts credit the broader availability of life-saving treatments, such as naloxone, and improvements in support systems for people at risk of overdosing. While the overall number of overdose deaths remains high, many in the public health community are cautiously optimistic, believing the worst of the crisis might be over for now
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September 20, 2024
Rethinking the Concept of Addiction: Beyond the Brain Disease Model
When it comes to treating addiction, the prevailing idea is that it’s simply a chronic brain disease. But in reality, few experts fully subscribe to this view in isolation. We understand that not everyone who uses drugs, alcohol, or gambles ends up with a life-destroying addiction. Many individuals manage to engage with substances or behaviors without it overtaking their lives—they maintain jobs, care for their families, and function in society. This suggests that addiction is much more than a biological condition; it’s an intricate interplay of biology, social influences, environmental factors, and personal choices.

It’s worth pausing to consider what labeling addiction as a chronic disease implies. On one hand, it suggests that even if you strive for change, addiction remains a lingering presence—one that can pull you back into destructive patterns at any moment. This can foster a disheartening and pessimistic outlook, as it positions addiction as an inescapable burden. The concept of a chronic disease also reinforces the idea that ongoing, lifelong treatment is necessary, often with medications like buprenorphine, which may be prescribed for years, or even indefinitely, to prevent relapse.

While I absolutely recognize the biological underpinnings of addiction and the life-saving role medications like buprenorphine play, we must look beyond just biology to truly understand and address addiction. The motivations behind substance use and the social contexts in which it occurs are equally important. Humanity’s long history of seeking altered states of consciousness suggests that drug use is often a response to emotional pain or difficult circumstances. People frequently use substances as an escape, and understanding these personal and social factors is key to effective treatment.

At its core, successful addiction therapy must focus on uncovering the reasons behind substance use and helping individuals develop healthier coping strategies. Treatment that focuses solely on the biological side—without considering the psychological and social aspects—often falls short. It’s critical to provide not just medical interventions but also hope and optimism, which are fundamental to any healing process. Addiction may not be a simple choice, but it certainly involves choices, and it emerges from a complex web of circumstances in a person’s life.

In the end, we should avoid oversimplifying addiction as merely a chronic brain disease. True treatment requires a holistic approach, considering all the elements—biological, social, environmental, and personal—that create the conditions for addiction to thrive. Only then can we offer meaningful, lasting solutions for those struggling with addiction.

Link to the article:

https://www.nytimes.com/2024/09/03/health/addiction-disease-choice.html
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September 4, 2024
Unproven Lifeline? Nalmefene’s Missing Tests in the Synthetic Opioid Era
It seems we may have spoken too soon about the nalmefene hydrochloride auto-injector for opioid overdoses. It turns out no one really knows if there’s enough clinical data to support its use in the current landscape of high-potency synthetic opioids. That’s a pretty big oversight for a company releasing an opioid reversal agent. There are also concerns about severe and prolonged withdrawal due to its long half-life of 10.8 hours.

And, in a twist of irony, this drug is produced by the same company that devastated countless lives with OxyContin—Purdue Pharma. You have to hand it to them; they really have no shame. While I’m always eager for new tools to save lives, it’s shocking that they didn’t properly test the medication against the very synthetic opioids flooding the market. I guess we’ll soon find out if this new option will be helpful in emergency situations.
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August 28, 2024
Hands Off the Hand Sanitizer: It’s Not a Cocktail
Have you ever noticed that hand sanitizer is sometimes locked up in certain areas of the hospital? The reason for this is that individuals with severe alcohol use disorder may attempt to drink it. One of the highest blood alcohol levels (BAL) I’ve ever encountered came from a patient who found an unlocked dispenser, opened it, and consumed an entire bottle of sanitizer. Their BAL was an alarming 600 when we tested them. This highlights the dangers and societal impact of risky alcohol consumption—something I’ve witnessed firsthand in the inpatient setting.

https://www.medscape.com/viewarticle/hand-sanitizers-and-alcohol-abuse-dangerous-cocktail-2024a1000f7o?ecd=WNL_trdalrt_pos1_240821_etid6766231&uac=267049CZ&impID=6766231
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August 22, 2024
Drug Overdose: The Epidemic Stealing Parents from Their Children
After a few years of treating patients with opioid use disorder, it becomes painfully clear how much addiction affects not just the individual but their entire family. I’m always particularly concerned when a parent with severe opioid use disorder comes in for treatment, especially if they have one or more children. We know that relapse is common, and each instance of relapse carries the risk of death due to the potency of modern opioids.

A recent study explored the heartbreaking question of how many children have lost a parent to an overdose. The findings are staggering: from 2011 to 2021, over 320,000 children lost a parent to an overdose. This loss significantly increases the economic, social, educational, and health burdens on these children, perpetuating a cycle of harm that could affect them for the rest of their lives.
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August 18, 2024