Some think that because marijuana isn’t a “hard” drug it doesn’t cause problems. The reality is that although drugs like methamphetamine and the opiates can be devastating and even a single use might be too much, regular use of marijuana can also exact a high price and wreak havoc on lives in various ways. The full text of my latest post on Psychology Today can be found here:
See the post on my blog Almost Addicted on Psychology Today:
A news source reports that the NRA said it was “prepared to offer meaningful contributions to help make sure this never happens again.”
Meaningful will have to mean a total ban on assault rifles for the public and background checks for anyone wanting to buy as much as a BB gun.
If the NRA insists on these “contributions” then I will be impressed, even though I will not forgive it for its obstructionist, insane stances on gun issues to date.
Any organization that opposes having background checks for those who purchase weapons ought to be shut down. Any organization that supports the sale of weapons that include the words “automatic” or “semi-automatic” in their name needs to be banned. And any organization that supports the sale of assault weapons for sale to the general public should be considered a terrorist organization. Will sanity trump the money that such organizations pump into US politics?
The folks who are rewriting the diagnostic manual in psychiatry have often built their careers on the diagnosis in question and/or have received money from Big Pharma, so that the diagnoses they craft are potentially fraught with conflicts of interest and bias. Even though the folks rewriting the diagnostic manual in psychiatry tried to rectify matters, their efforts fall short.
Read the whole post at : http://www.psychologytoday.com/blog/almost-addicted/201212/what-exactly-went-my-psychiatric-diagnosis
I became a crossword aficionado roughly 6 months back and I barely rate. I subscribe to the New York Times, know that Monday’s puzzles are the easiest and Saturdays are the hardest, and over the last half year have exactly once solved a Thursday puzzle. (When I say “solved” I mean without looking at references, searching the web, etc., to help solve the puzzle.) I still occasionally can’t finish Tuesday puzzles and am approaching 50% on Wednesdays.
Today’s–a Tuesday– puzzle has several answers that are two words, the first beginning with “P” and the second beginning with “G”–which includes “Proving Ground,” “Princess Grace,” and “Peanut Gallery,” among others.
A couple of my usual sources for enlightenment about these puzzles said that the theme of this puzzle is “Rated PG,” but given that “PG” is an old fashioned way of talking about pregnancy–along with the fact that “Princess Grace” was the answer for one clue and “Diana” was the answer for a clue for “the mother of William and Harry”–tell me that this puzzle isn’t about Princess Kate’s presumed pregnancy . . .
My contentment will be short lived, no doubt because Wednesday might pose problems, Thursday might be nearly impossible, and Friday and Saturday will both go way past the “nearly” mark . . .
Hope you have a good weekend given that I, no doubt, won’t. Cheers.
Hey all! I have just begun to write a blog for Psychology Today and here is my inaugural post.
http://www.psychologytoday.com/blog/almost-addicted/201211/almost-addicted
More to follow . . .
Several more states voted for gay marriage last week. I now repeat something I have publicly said before: At some point in the near future the issue of whether gays should be allowed to marry will be as controversial as the question of whether blacks and women should be allowed to vote.
Because of this, at some people are going to look back at opponents of gay marriage much the way we do at historical figures who opposed women’s rights or endorsed slavery: anachronistic at best; misguided, immoral, and/or oppressive at worst.
If an insurance company requires health care workers to call them every time they deem a patient in need of psychiatric care, and the call can take anywhere from 10 minutes to several hours for the clinician, health care workers are going to think long and hard before they decide to seek inpatient admission for a psychiatric patient, even if the end result is almost always that the insurance company authorizes (i.e. agrees to pay for) the admission.
This is what I call “rationing by hassle factor,” a term I first heard used by my colleague Steffie Woolhandler, MD, MPH.
This kind of rationing happens all of the time and your insurance company profits as a result.
We deserve a health care system that is not driven by the profit motive. Stay tuned for more in upcoming weeks on this topic, including a paper to be published in the medical literature.
In our Journal of Addiction Medicine piece just published (which you can access here), co-author John R. Knight MD and myself discuss ethical and managerial considerations regarding state physician health programs (PHPs). These are programs that work with physicians who have various kinds of health related issues, including substance use disorders and mental health issues. As we note, “For most physicians, participation in a PHP evaluation is coercive, and once a PHP recommends monitoring, physicians have little choice but to cooperate with any and all recommendations if they wish to continue practicing medicine.” As we note, the fact that they have high success rates does not obviate the need for scrutiny of PHPs and does not excuse abusive practices when they exist. Such an argument is a weak utilitarian argument. Separately, to argue by analogy to airline pilots does nothing to alter the facts that some PHP practices are abusive and ethically indefensible. (See http://www.asam.org/publications/president’s-blog/asam-president’s-blog/2012/10/16/how-to-achieve-an-80-percent-recovery-rate)
What are some examples?
For one, as we point out in our essay, some PHPs report physicians for positive test results when the PHP knows that these test results do not indicate relapse or ANY problematic behavior by physicians. What’s the big deal? Well, getting reported to one’s board of medicine is almost uniformly terrifying and can require retaining legal help to address the issue, coming out of practice while the “false positive” test is being investigated, and significant psychological distress. One physician told me that one of these days a physician is going to commit suicide after one of these reports.
In addition, as we point out in our piece, PHPs often have complicated, financially intertwined relationships with the programs they send physicians to for evaluation and treatment. And these are just a couple of the problematic issues about PHPs.
As we conclude in our Journal of Addiction Medicine piece, “Since PHP practices are unknown to most physicians prior to becoming a client of the PHP, many PHPs operate outside the scrutiny of the medical community at large. Physicians referred to PHPs are often compromised to some degree, have very little power, and are therefore not in a position to voice what might be legitimate objections to a PHP’s practices.” Because of this, to argue as some have that we can just let the legal system deal with any potential abuses of PHPs is either naïve or an attempt to allow some unethical practices to continue without scrutiny. We conclude our piece by recommending that the broader medical community begin to reassess PHPs.
The time for action is upon us.