America’s Game, America’s Addiction

The only thing hyped as much as the Super Bowl are its commercials. It was a highly publicized fact that a single 30-second advertisement would cost $5 million this year. That is serious money.

So, it would stand to reason that companies would only advertise if the message was geared to a huge audience, such as beer drinkers, automobile buyers.  Nearly halfway through the game, viewers were treated to an ad for constipation, specifically, opiate-induced constipation.

Constipation aside, is the opiate-consuming audience really that large? The answer is yes; in fact, opiate pain killer use is at an all-time high and deaths due to overdose now stand at epidemic levels throughout the United States, with the MVP being Oxycontin.

Just consider:

Sales of prescription painkillers in 2010 were four times higher than a decade earlier; according to the American Society of Addiction Medicine.

Health care providers write more than 250 million prescriptions for opioid painkillers each year, according to the U.S. Centers for Disease Control and Prevention.

Opioids are legitimate medications with legitimate indications for usage, such as certain surgical procedures, chronic and acute pain, or terminal illness. The problem is that they are being used frivolously, dangerously, without informed consent and for reasons that do not necessitate opioid-based pain management.

We have an epidemic of over-prescribing which has led to tremendous growth in prescription pill addiction. What we need now is a focus on access to good care for those currently addicted, education and accountability for physicians prescribing it, and education/awareness to the American public about the risks associated with use of opioid-based meds—the least of which is constipation. The worst and all-too-common risk remains addiction and death due to overdose.

What a sad state of affairs we have in our country that drug companies market to the general population about a drug that alleviates a side effect of pain medications. We are an over-medicated country and adding another drug to take care of a side effect of others hardly seems close to a solution.

I suppose if we don’t acknowledge that there’s a problem (Step1!), we are not in a position to even consider looking for healing, change, health or hope (Step 2). We stay stuck in our current ways of doing things, looking to pills (some of which have death as a side effect if we are honest about it) as our solution, our higher power, our God.

Medical Terrorists: Unethical and Uninformed Doctors Armed with Prescription Pads

It is an honor to be a physician. It is an even greater privilege to use my knowledge and ability at Timberline Knolls to help very ill girls and women recover from addictions, eating disorders, and other mental health issues.

Although I would prefer to believe that all professionals in the medical field have a deep understanding of the great privilege and responsibility that comes with being a doctor; that is unfortunately not the case.

Last month, an extraordinary blog entitled ”Killers in White Coats: Pill Mill Doctors Ignoring the Oath for Greed” appeared on a website, The Fix. It was written by a woman named MaryBeth Cichocki. MaryBeth is a registered nurse in Delaware; importantly, she is a mother, a mother of a son who was addicted to prescription drugs.

Galvanized by concern for her son, she launched an investigation into legal pill mills, where prescriptions were provided to anyone who had the cash to pay for them, with little attention to the risk factors and grave danger associated with the development of addiction. Each month Marybeth’s son, Matt, received prescriptions for a deadly combination of drugs that included Percocet, methadone and a generic muscle relaxer.

She filed a formal complaint against the so-called pain management clinic to the State Board of Medicine. The response: ”We find no fault with the prescribing methods of this practice.”

Throughout the blog, she repeatedly referred to the Hippocratic Oath, which was written by Hippocrates and is known to be the oldest binding document in history. It is a sacred oath that is still recited in medical school graduations. At the University of Chicago, we recited it during our White-Coat Ceremony at the very beginning of medical school, to highlight the seriousness of this oath and our responsibilities even as student doctors beginning our training.

The public at large is fairly familiar with the dictate to “do no harm,” but the promise also includes the statement: ”I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.”

Those in white coats who recklessly prescribe opiate-based medications without assessing addiction risk have quite intentionally deleted any memory of the Hippocratic Oath. They exist as the antithesis of all that true physicians stand for. They do harm every time they place pen to paper on a prescription pad, and dole out a potentially harmful medication, often times with no mention to the patient of abuse potential. Although some of them lack understanding and awareness of addiction, some are fully aware but press on all the same, motivated by one thing:  money.

People throughout the United States are extremely focused on terrorism these days and rightly so. However, we might want to ramp up our concern regarding the attack on an epidemic number of Americans by medical terrorists. The unethical, uninformed doctor with a prescription pad is spared the devastating outcome that families and friends are left to recover from–the untimely death of a son, wife, daughter or friend who succumbs to addiction and ultimately dies due to drug overdose.

Marybeth’s son was one of these victims; Matt overdosed and died.

The time has come for each of us in the medical community to take responsibility for the medications we prescribe, the amounts we prescribe them in, the risk assessments we perform on our patients and the informed consent we are obligated to give them. Knowing when not to prescribe and what the alternatives are to narcotic pain medications is our responsibility.

First and of greatest importance: do no harm.

 

 

 

Walking Strong into the New Year

So…2015 will soon come to a close. As I look forward to a new year, I often reflect on the past 12 months to consider what I have learned, how I have grown.

I always thought I knew what unconditional love was, and then I had Samuel. There is absolutely no condition placed on my love for him; it is a constant, abiding love. It is a nearly tangible emotion that says every second of every day, “I would lay down my life for you.”

I know now that the abundant love I have for this child is only a small reflection of how God loves you and me. It is a humbling truth.

To my extreme delight and fascination, Samuel has recently confronted a challenge brand new to his little-boy repertoire: walking. He is highly committed to mastering this skill. Simply standing is its own reward; he gets to view the world from an elevated perspective. Achieving equilibrium can be dicey, but nothing is quite as adventurous as taking that first, then second step. Every possible emotion is displayed on his little face—joy, trepidation, curiosity, expectation.

Naturally, David and I, as well as his older siblings, provide the enormous encouragement he both desires and deserves.

Walking often proves a tough business, so more times than not, a fall is inevitable; there have been scrapes, bruises, and the occasional bloody lip, but this fazes him not in the least. He gets right back up and gives ambulation another shot, usually without blinking an eye, and sometimes even with a big smile on his face.

How much is my son’s desire and difficulty with walking similar to our journey in recovery? Consider… we also started down on the ground, be it in a pit of depression, the bottom of a bottle, with heads in a toilet or consumed with very low or high numbers on a bathroom scale. But, we got clean and sober, or said a final goodbye to any number of things: an eating disorder, addictive drugs, self injury or the relentless pain of trauma.

With help, we stood up and also noticed that the world looked different from this unimpaired perspective. Through unconditional love, we found the courage to stand strong when we faltered.

Finding new balance, we took a tentative step in this new reality, then we took another. We were similarly fearful, yet filled with anticipation as to what this new journey might bring. Not unlike a child, we took our lumps along the way, maybe even returned to the ground for a time, but just like Samuel, we got back up and started over.

My son’s goal is fairly simplistic: he wants to go from point A to point B on his own two feet. Although adult issues are far more complex, at the end of the day, isn’t that what we all want? We want to be strong, competent, and capable of managing everyday life. We want to experience the world on our own two feet. We want to be able to take in the help and love that surrounds us in order to grow.

Learning to walk and walking out recovery are only different in one regard. For Samuel, those crawling days will soon be gone; he will be an official member of the walking world in no time. In fact, he will ultimately retain no memory of the months spent on “all fours.”

But, our memories will remain clear and that is a true blessing. Only by remembering where we have been can we fully appreciate where we are today. Each one of us has moved from A, a place of darkness, pain, loneliness and death, to B, a life of potential, health, freedom and abundance.

So…as 2016 unfolds, respect the past, live in the present, and know that the future is full of promise and possibility. And most importantly, be aware of just how much you are loved — without condition.

 

 

Apology or Amends?

Bloomingdales Winter 2015 Catalog Ad

In the new Bloomingdale’s 2015 holiday catalog an advertisement depicts a lecherous man peering at a woman with the caption: “Spike your best friend’s egg nog when they’re not looking.”

The suggestion of date rape threw catalog shoppers and the world at large into an understandable frenzy. As standard operating procedure in today’s marketplace, the New York department store issued an apology.

An apology? So what. This is not a radio or TV ad that can be pulled off the air. This is a print advertising message—one that remains in circulation until the publication is tossed or recycled, which is an action that should be taken right now.

This advertisement is more than offensive, despicable and beyond unacceptable. In what universe is such a message reasonable? Perhaps in a universe where men do what they want to get what they want, a universe in which intoxication is synonymous with easy sex.

The creators of this ad, and to a greater degree the people in charge of giving it the red light, might like to meet some of our female residents who had “a little something extra” put into their cocktails. These are women whose lives were nearly destroyed after being raped by a man, or many men. Let’s see how well that message sells in the marketplace.

The concept of date rape is bad enough, but did anyone at Bloomingdale’s pause to consider the ramifications of possible alcohol addiction? Imagine a woman in recovery sipping on pure egg nog, only to have her “best friend” spike it. “So, what’s the big deal; it’s just a little drop of booze.” Only one who has walked the arduous road of alcohol recovery can attest to the fact that any, even the smallest amount of alcohol, can undo years of sobriety—literally years.

Again, sometimes a plain old “I’m sorry” is simply not enough. We all know there is a difference between an apology (just words) and an amends (a healing action). Instead of a routine apology consisting of empty words, Bloomingdales might consider making an amend by donating a substantial monetary sum to a rape recovery organization or even to Alcoholics Anonymous. If their bottom line takes a little hit, perhaps they will think twice about the caliber and content of future advertising messages.

Cosmetic Surgery Hits a New Low

Are women in our society ever “good enough” just as they are? Evidently not.

Breast implants, liposuction, tummy tucks, face lifts, butt enhancements, fillers, Botox, fat sucked out of one area and injected into another—the list truly goes on and on.

The necessity for women of all ages to be beautiful, as narrowly defined by our culture, has been relentless for years. But now we have seemingly hit a new low, with low being the operative word.

According to the American Society for Aesthetic Plastic Surgery, during the last few years, demand for cosmetic labiaplasty, reconstruction of the female genitalia, has increased more than any other cosmetic surgery. In part, this is the result of altered grooming practices among women of all ages. In the past few decades, normal hair growth below the waistline has somehow turned into public enemy number one; therefore much attention has been given to shaving, trimming and waxing.

Women (and, possibly more relevantly, their partners) now see an area of their body that had previously remained concealed; alas, a whole new area to focus on and find fault with.

The female body is created the way it is for a reason. What is it about our culture that we just can’t leave it alone? Obviously, the lower half of a mature woman is not supposed to look like that of a prepubescent child. Unless of course, you live in a culture which idealizes pre-pubescent and ultra-thin as the sexual ideal.

Women, primarily in their 30s and 40s are requesting this reconstructive surgery, which costs on average between $3,000 and $6,000. Although some claim they want this surgery because they feel uncomfortable in tight clothing or embarrassed in swimsuits, I suspect many undergo this surgery to present a younger, more ideal “look” or feel to possible sex partners.

The fact that in certain markets this surgery is being promoted as “the Barbie,” only validates this suspicion. Indeed, there is a disturbing increase in teenage girls who are trying to get the procedure in order to achieve a prepubescent look. The results can be both disfiguring, and also potentially physically harmful.

While many plastic surgeons will provide the surgery on demand, others label the procedure as “a form of genital mutilation,” or “just another form of further exploiting the social vulnerability of women.”

At some point, every woman needs to discover that she really is good enough just as she is; her body is uniquely and divinely crafted to be exquisite and beautiful, AND quite capable of taking care of itself if everyone would just get out of the way!

 

 

New Research Regarding Psychedelic Agents

Psychedelics blasted their way into the public consciousness in the 1960s. They were all the rage among hippies and flower children of that era. Commensurately, they entered the field of drug research around that time; but due to myriad questionable practices, this research was suspended in the 70s.

Research regarding the efficacy of using psychedelics has returned. Several small studies have shown “success” in using these drugs to treat anxiety, depression, addiction, and post-traumatic stress disorder (PTSD) with very few discernible short term side effects. Current studies look at the benefits of using substances such as lysergic acid diethylamide (LSD), psilocybin (found in “magic mushrooms”), dimethyltryptamine (DMT), mescaline, and methylenedioxymethamphetamine (MDMA), which is known on the street as ecstasy. The thought is that as medical professionals we will be selling these alternative drugs as new options for treating mental illness and addiction in people who are not benefitting from traditional treatments and medications that are currently available.

The research regarding reduction in anxiety and depression utilized LSD and psilocybin. These studies were conducted in a specific population: those with end-stage cancer or other terminal illnesses. Participants showed improvement without any clinically significant adverse effects.

A variety of psychedelic agents are being studied for use in cocaine addiction as well as alcohol and tobacco dependence. MDMA in specific is being considered as a possible medication option for those with PTSD.

Of course, none of these studies have looked at long-term outcomes. Quick fixes for prolonged problems usually raise a red flag in the recovery professional community.

If we think we currently have a prescription drug addiction epidemic in our country, I shudder to think what is on the horizon when it becomes allowable, and even recommendable, for physicians to prescribe these types of drugs to their patients.

 

 

Fat Shaming in its Purest Form

In the past week, an abusive campaign was started–and thankfully stopped–on Facebook as well as Instagram.

Project Harpoon was launched supposedly to put an end to “skinny shaming,” claiming that: ”In current societal fashion, a recent trending surge of ‘pro-obesity’ and ‘fat acceptance’ have paved the way for many people to renounce exercise and personal healthcare in general.”

The alleged goal of this movement was to show people’s “thinner beauty.” Of course, to prove their point, they photo-shopped images of plus-size women to make them look skinnier. As if that was not offensive enough, beneath each post appeared an insulting, mean-spirited caption.

This is nothing but fat shaming in its purest form.

The irony is that the campaign itself was launched on the premise that size shaming, regardless of which end of the spectrum, is damaging and hostile to the parties who are targeted. And yet they engage in fat shaming and size shaming in their campaign against it for “skinny” people.

Fat shaming is real and extremely prevalent. Whether it’s celebrities on the red carpet who have not gotten rid of their baby weight fast enough, or young girls in high school who do not weigh 100 pounds, people, females primarily, are stigmatized, criticized and bullied every single day throughout our country due to their size.

Skinny shaming, on the other hand, if it does exist, exists as an extreme exception to the rule and on a small, skinny if you will, scale (pun intended). Skinny IS the ideal. It is what our culture pressures all women to be. It is what our society indicates is the answer to all issues. Want to be popular? Lose weight. Want to attract a husband, be successful at work, and be happy all the time? Wear a size zero. Want to be good? Go on a diet.

People are no more shamed for being skinny than for being wealthy. How many people are made fun of because they drive a top-of-the-line car, or wear a $5,000 watch? It just doesn’t happen.

In this project’s artificial zeal to encourage “skinny acceptance” through their campaign, they said: ”No shaming please. No hate speech please.”

The truth is if they had read their own words, Project Harpoon would have gone the way of similar detrimental ideas and never seen the light of day.

 

 

 

Treating Anorexia: Is Cannabis A Cure?

A recent issue of Cosmopolitan magazine included a lengthy article on the use of medical marijuana for those who struggle with anorexia. By and large, the article was positive regarding such usage and it provided several salient and supportive facts. These included such statistics as; medical marijuana is now legal in 23 states as well as the District of Columbia and a record 53 percent of Americans now favor the legalization of marijuana.

Through case examples, the article revealed that cannabis helped reduce anxiety and irrational thinking while facilitating food acceptance and consumption in those who used the drug. In other words, it helped women eat.

Here’s the problem. Anyone who has spent any appreciable time treating women with anorexia knows one simple truth: anorexia is not about eating. If it was, then effective treatment would be as easy as forcing a person to ingest X amount of calories each day. There would be no need to understand the “whys” behind the disorder, what purpose it serves in the individual’s life, how the family is involved, etc.

The truth is, anorexia is a highly complex psychiatric disorder, and as such, certain therapeutic interventions are necessary to help a person truly heal. If we do not examine and alter the underlying emotional and cognitive issues, the person is quite likely to eventually succumb to relapse or develop another self-destructive coping mechanism, very possibly addiction. We know that up to 50 percent of those with eating disorders also have substance use disorders.

Another issue that was frequently alluded to in the article related to perception. Several of those interviewed spoke of their dislike of pharmaceutical medication—they rebelled against taking pills. However, this antipathy did not extend to marijuana. The usual expressions, “it’s from the earth,” and “weed is natural,” were heavily relied on. The problem is, marijuana, even if it comes from the earth, is a drug; and in many markets today, it is not a well-regulated drug.

Are psychotropic drugs often used in the treatment of anorexia? Yes, but every physician knows, when using medications, certain general principles apply, such as choosing the drug that provides the greatest benefit with the least harmful side effects. When used chronically, marijuana has been shown to increase risk of depression; also it is neurotoxic, which means it kills brain cells. This makes it a less than ideal “medicine.”

One of the more disturbing aspects of this article was the reference to marijuana as a “cure” for anorexia; this reference was made by a physician. The only cure for anorexia is recovery. In fact, that is the ultimate goal of treatment. Recovery is synonymous with freedom. Freedom from being bound to a substance or a behavior to make your way through life. Being able to find and remain connected to the wisdom within, the Higher Power within that provides a sustainable power source to live abundantly.

This is true freedom. This is recovery.

Say No to the “J” Word

Ellen Leanse, Apple and Google alum, recently posted a commentary on the word “just.” She illustrated how often, and in what contexts, women utilize and rely on this word. Not only do women use the “J” word far more than men, but by and large, they do so in a deferential or apologetic fashion. “I was just wondering if …” or “I just needed a minute of your time …”

It seems that women still feel the need to continually provide justification for their existence and ask permission for their presence in the world.

I, and many of my female colleagues, found her post to be personally revelatory. Like untold thousands of other women who read the message, we are now monitoring the “the “J” word in our day to day texts, emails and conversations.

Yet, I could not help but take this concept to another level – the world of treatment and recovery.

How many women and girls come to us every single day because they have been told by parents, peers, advertisers, the media, that they are “just” not good enough. They are not pretty enough, smart enough, popular enough, and let us never forget, definitely not skinny enough. Then how many hours, days, even months do we work to convince them that they deserve to take up space in the world, to live BIG, that they are more than good enough, that each one of us has profound value and worth; that each individual is meant to be her unique self, not an “idea” of herself, the female she will finally be once she gets inflated lips, breast implants, and loses enough weight.

I encourage you to read this post, then consider dropping the “J” word from your interactions.

This is one example of a little word with big psychological implications. Be aware of what we say, how we say it and what that says about our sense of self. Make a change and drop the “J “word, or at the very least be conscious about using it. Little steps can and do lead to big changes.

 

My Story is Your Story

Motherhood immediately changed my perception of many previously held beliefs. For example, I quickly learned that sleep has far more value than money, showering every other day is reasonable, and wearing the same outfit two days in a row is more than acceptable.

But, it is in the months following childbirth that profound and life-changing truth is actually revealed, such as the intricate beauty and vastness of love.

Like most women, I have given and received love throughout my life. In recent years, my husband, step-kids and dog have been the primary recipients of my affection. David, William, Suzanna and especially, Lily, have returned that love in their own special ways.

I genuinely thought I had a solid grasp of what love embodied and entailed. Then my son entered my life, ushering in a whole new level and knowledge of love.

Often, Samuel naps on my chest. The simple sound of his breathing, the squishy weight and warmth of his body, the softness of his perfect skin all conspire to catapult my love into the 4th dimension. I feel such an overwhelming and fierce love for him that my heart actually burns. I love this child, not due to anything he has done or ever will do. I love him simply because he is him.

In these moments I often reflect on the love of my parent in Heaven. God loves me as I love my son, probably far more, which is beyond my capacity to fully comprehend. And God does so due to nothing I have done. God’s love is not for sale–it cannot be bought or earned. God loves because that is who God is and that is what God does.

This vast love serves as a message of extraordinary hope to every woman in recovery. I spent years severely abusing my body through alcohol and eating disorder behaviors. I hated my body—the feelings it held and the memories it stored. By any reasonable estimation, the harm I exacted on my physical being should have been profound and permanent. And yet, it is this very same body that offered safety, security and shelter to my son for nine months, and now continues to nourish him long after his birth.

For every woman who is in recovery, or moving toward it, please remember this: my story is your story. Whatever you have done in the past regarding your body, behaviors or choices in NO way defines you today. Those chapters are written, those pages are permanently turned. Our bodies and souls were created with a tremendous capacity to be born anew, to be fully restored to wellness.

In recovery, we are living a whole new chapter, with many more to come. Each of us has the ability to author the remainder of our story with power and positivity. Life can be abundantly good.