The Past, Present and Future of the Opioid Crisis

Opioid overdose has recently become the leading cause of fatal injuries in the U.S. as rates of abuse have been steadily increasing over the past decade. Rising statistics of emergency room visits, deaths and dependency related to opioids results in an alarming trend which has the government seeking solutions. The opioid crisis is a national problem that is now on every politician and lawmaker’s mind in order to reduce the impact that this drug has had on our country.

Abuse of opioids has not always been such a tremendous problem and it is only recently that numbers have reached epidemic levels. When opioids were first introduced in the form of morphine and opium, the drug became rampant until a law regulating its production and sale in 1914 worked to dramatically decrease opioid use. Opioid use was minimized by government laws for years studies were published in the 1980s claiming that opioids were not as addictive as previously believed.

These papers actually encouraged the long-term use of opioid for pain management and noted a low risk of addiction in patients with chronic pain. The study was cited in many cases in support of opioid use in spite of its limitations in using a small sample size and very low doses of opioids. When Oxycontin was introduced in 1995, aggressive marketing tactics were used that often cited this flawed study as evidence that opioids were not addictive.

Throughout the mid-90s the pharmaceutical industry heavily advertised opioids like Oxycontin to both providers and patients. Pharmaceutical companies also provided contributions to regulatory organizations such as the Federation of State Medical Boards and a number of others so that they would encourage opioid use to reduce pain. Physicians were urged to treat pain aggressively with opioids while organizations helped to spread the belief that opioid use would not result in dependence.

An Increase in Prescriptions

All of these tactics employed by the pharmaceutical industry resulted in physicians becoming more lenient about prescribing opioids to patients. Doctors were more permissive in allowing people to use medications such as Oxycontin without much regard to possible consequences. This trend continued into the early 2000s as more studies suggesting a low risk of addiction continued to mislead physicians and patients alike.

Rates of chronic pain began to rise and boundaries to treat these disorders also expanded. Pain advocacy groups promoted aggressive diagnosis and management for pain. The FDA was also passive in developing risk evaluation and mitigation strategies for opioid addiction.

All of these issues combined led to a dramatic increase in the number of people being prescribed opioids for pain and subsequently an increase in opioid dependency. Opioid use became normalized over time but ultimately use of the drug progressed very quickly.

Reaching the Point of Crisis

Opioid addiction rates continued to grow throughout the 2000s until in 2007 drug overdose deaths surpassed car collisions as the number one cause of death by injury. The Centers for Disease Control documented how prescription opioids were to blame for these deaths more than any other drug.

Addiction to opioids is particularly an American problem. The U.S. is responsible for more than three quarters of the world’s opioid use in spite of representing only 5% of the global population. In 2014, overdose deaths in the U.S. were more than 2.5 times the rates in 1999 and were the highest they had been in over 15 years.

Dependency on opioids can occur in different ways but research indicates that 50.5% of individuals engaging in non-medical use of these drugs obtain them from an acquaintance while 22.1% obtain them directly from a physician.

In spite of the early studies that helped to drive the increase in opioid use, the reality is that nearly all individuals using prescription opioids will develop a dependence. This means that they experience withdrawal symptoms at the cessation while many others also struggle with impaired control over their drug use. It is also common for opioid users to switch to heroin once they become addicted.

The Future of Opioid Use

Now that opioid use has reached epidemic rates, efforts are being made to attempt to reduce the problem. Responses from local, state and federal levels have led to an increase in prevention, education and enforcement to combat high mortality rates. Prescription drug monitoring programs are being put into place to prevent over-prescribing by physicians and “doctor-shopping” by people abusing opioids.

Education programs for prescribers now help promote safe prescribing and and prevention of adverse outcomes. First responders are now more often equipped with naloxone, a medication that helps prevent death from overdose. The Affordable Care Act also expanded treatment for opioid addiction, although under the new administration it is unclear whether this access will continue.

The post The Past, Present and Future of the Opioid Crisis appeared first on The Gooden Center.

source https://www.goodencenter.org/past-present-future-opioid-crisis/

Back to School Anxiety: From Elementary to College Students

Going back to school in the fall can be a difficult transition for most kids who have become adjusted to freedom of summer over the past few months. They might feel nervous about starting a new school year and dealing with new teachers, harder classes and a busy schedule. No matter what age, everyone experiences some type of anxiety about going back to school.

It can be very normal for children to feel worried about going back to school and it can even build up into tears, tantrums, trouble sleeping and other signs of anxiety. Kids can even have physical symptoms of anxiety such as stomach pains or headaches or emotional responses such as becoming withdrawn, irritable or angry. Even kids who are usually pretty easy going can have some of these symptoms in the weeks leading up to their first day at school.

Younger children such as early elementary students may experience separation anxiety from mom and dad. Certain transitions can be especially hard for students such as switching from preschool to kindergarten or for older kids, transitioning from elementary to middle school. Even as we grow up most people experience anxiety on their first days of high school and even their first days in college.

For parents it can be especially challenging to help kids cope with the changes they are going through and the worries that they have about a different environment at school. You might even have your own feelings of stress about getting back to your old routine and a busier schedule for your kids. To make the transition back into school go a little more smoothly you can find some coping methods for dealing with anxiety.

Listen to Your Child’s Worries

If your kid has certain issues about school that are bothering them, make sure to really pay attention to what’s going on in their mind. You might feel tempted to brush them off and say they are just back to school jitters but it is helpful for kids to be understood. You should make yourself available to talk and make sure you are not too busy to listen if they have concerns.

Your kid may have specific worries such as a having a new teacher, more homework, or not having their friend in a class with them. Don’t dismiss any of these fears and try your best to acknowledge the validity of what they feel so that they can be more secure. You can also try to give them some confidence by providing advice or strategies on how they can handle the situations that worry them.

If your child doesn’t naturally bring anything up about school but you suspect they are feeling anxiety then you can casually check in. Don’t ask them questions that imply they are anxious but instead ask about their classes or teachers and see what they talk about. They might open up and reveal some of their nervousness about the coming school year.

Strategies for Easing Anxiety

Once you find out what is bothering your child you can start to help them come up with solutions. Ask them what they think would make them feel better so that they can learn to solve issues on their own. You can help them by role playing some tough situations so that they can practice handling it.

If your kid is attending a new school then you can help them get adjusted by showing them the building, letting them walk down the halls and find their classroom, the cafeteria and the playground. You might even introduce them to their new teacher so that they know what to expect and will feel more comfortable in the environment. When kids are exposed to what will be their new routine it removes the element of the unknown that may be at the core of their anxiety.

If you think your child may have separation issues then talk to the teacher and other adults at the school asking them to keep an eye out. It can be helpful for teachers to know about certain issues with kids right away so that they can use the information in class. They might try to give your child more confidence or come up with their own strategies to help them feel more comfortable.

It is always a good idea to help your child feel prepared for school by getting them new supplies and making sure they have everything they need before the first day. Buying school supplies, new clothes or letting them pick out a new backpack can be a fun way to get them ready. Even older kids going to college benefit from having their parents help them buy stuff for their dorm room.

The key to dealing with back to school anxiety is simply providing whatever support your child needs to feel comfortable and ready to start the new school year.

The post Back to School Anxiety: From Elementary to College Students appeared first on The Gooden Center.

source https://www.goodencenter.org/back-school-anxiety-elementary-college-students/

Internet Addiction is Real

Addiction is an issue that is usually characterized by compulsive behavior and it can occur in many different patterns from drug abuse to gambling and even shopping addiction. But more recently, people working in addiction treatment are beginning to see these issues develop more often on the internet. The types of symptoms most often associated with drug abuse can occur with internet addiction.

People who exhibit symptoms of internet addiction are often more vulnerable because they also have problems with depression and anxiety. As is usually the case with substance abuse they may use the internet as a way to ease their emotional symptoms. People with internet addiction may become consumed by their obsession and will be physically unable to stop checking their phone or using their computer.

Initially there was some debate in the field of mental health as to whether internet addiction was a “real thing”. However it has been gaining ground especially due to numerous cases of compulsive internet use which can at times become debilitating. Although it has not yet been officially recognized as a disorder in the DSM, mental health counselors are working to help patients cope with their issues with internet addiction.

In spite of its unofficial status, the amount of people being treated for their internet problems continues to increase. Some studies suggest that internet addiction may affect up to 38% of the general population in the U.S. and Europe. Numbers vary due to differing research methods and a lack of standardized criteria for the disorder but there is a substantial number of people affected in most western areas.  

Lack of standardization has negatively affected the ability to study this disorder and determine its true impact. It has been generally accepted that internet addiction is a subset of technology addiction in general which can include issues such as video game addiction, television addiction and other types of media. However in the digital age, internet addiction has quickly become the most prevalent of these types of addictions.

Recognizing Symptoms of Internet Addiction

As with any addiction, compulsive use of the internet often leads to negative consequences in a person’s life. When someone uses the internet to the point where they cannot stop themselves in spite of its effect on their health, relationships or financial situation then it can be considered an addiction. There are a number of different symptoms in terms of the emotional and physical manifestations of the disorder including:

-depression

-dishonesty about internet use

-feelings of guilt

-euphoria when using the computer

-inability to prioritize time or keep schedules

-isolation and loneliness

-avoidance of work and procrastination when using the internet

-agitation and other mood swings

-boredom with routine tasks

Physically a person with internet addiction have symptoms of poor health as a result of their excessive computer use such as:

-backache

-carpal tunnel

-insomnia

-poor nutrition and personal hygiene

– dry eyes and vision problems

When someone uses the internet so obsessively that they begin to harm their own physical and mental health then it is time for them to seek professional care. What can make treatment for internet addiction difficult is that most people use their internet or smartphone for many of their personal needs. It becomes hard to avoid the internet when it has become such an ever-present part of modern life.

Understanding Internet Addiction

Even though the average person checks the internet daily and may use it often to connect with other people they do not necessarily have an addiction. Internet addiction can happen in a few different categories since the internet can encompass a lot of different things. Addiction can come in the form of online gaming, social networking, email, blogging, online shopping and inappropriate use of online pornography.

Addiction to certain aspects of the internet are not necessarily due to the amount of time spent in these activities but rather how they are used. When internet use becomes risky or causes social impairments and otherwise interferes with normal life then it can be considered an addiction. People with internet addiction often become dependent on their internet use and find it difficult or painful to stop.

Researchers theorize that internet addiction is caused by the same type of issues that can cause other addictions such as substance abuse. Like other addictions it can affect the pleasure center of your brain and release dopamine, the feel good chemical. People feel they experience certain rewards in their internet use and become dependent on the pleasurable feelings that they get when spending time online.

In order to treat internet addiction, patients must seek a therapist and a support group where they can learn to minimize their internet habits. It can be difficult and nearly impossible to completely abstain from using the internet. With treatment addicts, can start to use the internet for necessities only and learn to control their compulsive behavior.                                                                   

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source https://www.goodencenter.org/internet-addiction-real/

The 7 Best Books for Depression

If you have been diagnosed with a mental problem or simply struggle with symptoms of depression from time to time there are sources available for help. Some people don’t know enough about depression to understand what they are going through or why they are experiencing certain feelings. If you are seeking help for depression you should look for every resource you have to get better beginning with professional treatment.

In addition to attending regular therapy sessions you might find it helpful to read some books on the subject of depression to give you some information you need to cope. The more you understand about the symptoms of depression, why they happen and how to recover, the better you will be able to handle your disorder. Spending time doing research can help your depression seem less overwhelming and more manageable.

These are some of the best books you can find to help you learn more about depression:

1. Healing the Child Within by Charles Whitfield

One way to understand and heal from depression is to process some of the traumas you may have been through in childhood. If you had a dysfunctional upbringing then you may need to get in touch with you inner child and heal your pain from the past. This is a classic book that has helped people handle their depression through understanding their most difficult memories.

2. Control Your Depression by Peter Lewinsohn

This book is a practical guide to understanding depression and developing self-help techniques that will combat your symptoms. It provides insight into what depression is and how it manifests itself differently in certain people and situations. It also gives readers ways to reduce depression through relaxation, self-control techniques and ways to modify self-defeating thinking patterns.

3. Feeling Good by David D. Burns

Focusing mainly on cognitive behavioral therapy and how it can alleviate depression, this book helps readers understand how to change their moods. It describes how distorted thinking can fuel depression and what you can do to reduce negative thinking and ease suffering. Challenging negative beliefs and self-image issues can quickly help depressed people feel better.

4. The Noonday Demon: An Atlas of Depression by Andrew Solomon

A longtime sufferer of depression himself, the author takes both a personal and intellectual approach to examine the disorder and understand its intricacies. He draws on his own experiences with depression as well as interviews with fellow sufferers, doctors and scientists, drug designers and philosophers. The book provides insight into various aspects depression and helps to define the illness from multiple perspectives.

5. Undoing Depression by Richard O’Connor

Another author who has gone through bouts of depression himself, O’Connor is also a licensed therapist who understands how to minimize symptoms through changing personal habits. He describes the type of patterns that develop for people with depression and how to replace those habits with new skills. The book encompasses many schools of thought and ultimately provides readers with useful approaches so that they can begin to“undo” their deeply ingrained patterns of depression.

6. The Mindful Way through Depression by J. Mark Williams

Most people are at least familiar with mindfulness as a method of handling stress but this book describes mindful methods as a way to help break the cycle of unhappiness. In this book four experts explain how people can spiral into further depression even as they try to change their own habits.

Using a combination of eastern philosophy and cognitive therapy the author shows you how to avoid habits like self-blame and rumination by being more mindful of your emotions. Mindfulness allows you to pay attention to your emotions and truly experience them instead of letting avoidance worsen your depression.

7. Learned Optimism: How to Change Your Mind and Life by Martin Seligman

The author of “Authentic Happiness” and one of the founders of positive psychology, Seligman has spent more than twenty years researching how optimism can change people’s quality of life. He believes learning a more optimistic attitude can be one of the key factors in overcoming depression. The book explains how to breaking the habit of giving up on things because of pessimistic beliefs and start the process of creating a more positive interior dialogue.

8. Listening to Depression by Lara Honos-Webb

This book explains depression in a way that most people wouldn’t think to consider. It suggests that depression is not just a disease but a warning signal that your life has gotten off track and you need to heal.

The author argues that we too often try to cut off our emotions and ignore problems instead of listening to our feelings and what they are telling us about our lives. She reframes depression as a kind of gift that helps us understand what we need to change or adjust to improve our situation.

The post The 7 Best Books for Depression appeared first on The Gooden Center.

source https://www.goodencenter.org/books-for-depression/

Google’s Depression Assessment Tool

When you type in the word “depression” on Google, you might find resources explaining the disorder and its symptoms but soon you will also be prompted with a self-assessment tool. Google is partnering with the National Alliance on Mental Illness to make depression screening a part of searches on the subject. Google announced that when you search for “clinical depression” you will have the option to tap a button saying “check if you’re clinically depressed” which will bring you to page with a questionnaire.

Although the health screening questionnaire is clinically validated to test a person’s likely level of depression, the assessment tool has already caused some controversy. Some mental health experts are worried that the tool will lead to overdiagnosis of depression and possibly over-prescription of antidepressant medications. One professor claimed that the Google tool was actually funded by the major drug company Pfizer which profits from sales of antidepressants.

The goal of Google’s assessment test is not necessarily to provide a diagnosis but to encourage people to take the results to a psychiatrist for a proper assessment. The search company asserts that they worked closely with NAMI to ensure that the questionnaire is accurate and useful. In a NAMI news release it was noted that 1 in every 5 Americans will experience an episode of depression in their lifetime while only half of them actually seek treatment.

NAMI’s intention in partnering with Google for the tool was to help people become more aware of depression and seek treatment instead of allowing the symptoms of their mental illness to worse over time. According to the organization, people wait an average of 6 to 8 years before getting professional treatment for symptoms of depression. The intention is to motivate people to get help if the quiz indicates that they might have some mental health issues that need to be addressed.

Mixed Response from Mental Health Experts

Some experts are on board with the assessment tool and others are concerned about the possible effects of people scoring high for depression on the questionnaire. While NAMI’s claim that the tool could help people take the extra step into getting the necessary help is promising for many experts hoping to reduce depression numbers, others worry that may lead to over-treatment. The test results include links to materials and phone helplines for people with higher scores to set up with treatment immediately.

Experts who believe the tool can be helpful emphasize the fact that it is not meant to be an actual diagnosis. People with high depression scores will only receive treatment if they are get a professional diagnosis from an actual psychiatrist. They believe people taking the quiz will simply be more informed and empowered to get the help they need.

Others in the field of mental health are concerned that unregulated screening could be ineffective and end up causing more harm than good. Some believe that Pfizer was involved in funding the tool and that data generated from the quiz could be used to market antidepressants. Google says that the questionnaire will not threaten privacy because it does not store or log any results.

Aside from privacy issues, some experts are concerned that people will take the quiz and mistake temporary psychological distress that they are experiencing in that moment with a more pervasive clinical disorder. Google has received some criticism from experts for bypassing the usual checks and balances that are in place for screening tools in order to prevent the risk of overdiagnosis. Certain clinicians even believe that this type of unregulated screening tool will cause harm rather than improve people’s health.

One of the criticisms of the questionnaire itself is that it uses outdated ways of thinking about mental health in assessing depression. It focuses on physiological and biomedical symptoms, placing an emphasis on dysfunction and framing distress from the outset as an illness. If someone is distressed following a certain event, they may score high on the quiz even though their symptoms may not be connected to an actual disorder.

Screening for Depression

Google and NAMI assert that their intentions for their screening tool are to get more people the help that they need for depression. Some experts argue that this type of screening is generally inaccurate and could lead to a lot of false positives. Others such as the US Preventative Services Task Force have found evidence that screening improves the accurate identification of patients with depression.

The tool is meant to educate users and prompt informed conversations with clinical professionals so that patients can get an accurate diagnosis. If people use the Google tool as a starting point for treatment that they really need then it could be helpful in preventing gaps in depression recovery. To prevent overdiagnosis and over-prescription of antidepressants people should follow up the test with an accurate clinical assessment from a professional.

The post Google’s Depression Assessment Tool appeared first on The Gooden Center.

source https://www.goodencenter.org/googles-depression-assessment-tool/

Trauma of a Natural Disaster

People can experience trauma in a number of different ways depending on how they handle certain events in their life. Trauma can occur following the death of a loved one, witnessing a terrible accident, or fighting in a war. One of the less common types of trauma can happen when a person experiences a natural disaster.

Any overwhelming and distressing experience can trigger trauma in an individual no matter what age or prior life experience. Natural disasters can be especially traumatic because they can involve people seeing multiple accidents and even deaths in many cases. Experiencing a natural disaster can cause you to fear for your own safety and can often lead to symptoms of post-traumatic stress disorder.

One of the worst aspects of natural disasters like hurricanes, floods, earthquakes, landslides and tsunamis is that they can cause widespread trauma to the population of people that experienced it. Natural disasters can also cause issues such as “survivor’s guilt” that can make people feel wrong about surviving when others didn’t. Trauma can especially be caused by natural disasters because they are usually sudden and overwhelming.

Responses to a Natural Disaster

Initially most people that experience natural disasters respond through shock and may have trouble functioning the way they normally would. They might feel a sense of numbness or denial and may avoid talking about the event. Because they are in shock at first they might seem unemotional or appear stoic about what they have been through.

Once the initial shock wears off they might enter a more emotional state and have trouble controlling their feelings. They might experience very high levels of anxiety, guilt or depression for a period of time. People that have lost loved ones in a natural disaster will be coping with both symptoms of PTSD and the stages of grief as they try to adjust after the event.

Immediately after a disaster people may feel helpless and not know how to move on especially if they are living in a shelter or their home has been damaged. They must cope with the disaster itself and the aftermath of finding a new place to live or repairing their home.

One of the issues that many people have following a natural disaster is a loss of spirituality and faith or the sense that they have been “betrayed” by God. It can be difficult to understand how a higher power would allow that kind of devastation to happen in their lives. They may feel an emptiness or believe that the world is a hostile place because they have lost their faith.

PTSD Symptoms Following a Disaster

People may have different levels of emotional response after a natural disaster but there is a strong possibility that survivors will experience PTSD. Some of the symptoms of PTSD associated with a natural disaster are:

• Intense, unpredictable feelings
• Repeated flashbacks of the events of the disaster
• Physical reaction to flashbacks or vivid memories such as rapid heartbeat or sweating
• Confusion or trouble making decisions
• Insomnia or loss of appetite
• Constant fear that the disaster will occur again
• Changes in social relationships such as more conflict or withdrawn isolation
• Nightmares about the event causing sleeping issues

Victims of natural disasters may not always exhibit these symptoms immediately after the event but they may gradually develop over time as they attempt to return to normal life. In fact many survivors may seem perfectly fine right after the disaster ends and will show no signs of emotional problems. However, this could be a coping mechanism due to shock and symptoms will later begin to progress.

Treating Natural Disaster Trauma

Although PTSD can be a very debilitating mental health issue, it is also very treatable with professional help. If someone finds it difficult to regain control of their life after experiencing a natural disaster then they might benefit from seeking a psychologist to receive a diagnosis. If they are identified as having PTSD there are a many treatment programs available that can help them recover.

People who have been through the effects of a natural disaster need to find a way to feel safe again and heal from the things they have seen. Talking with a therapist can help them process the events of the disaster and discuss the feelings that they have been struggling with. People with PTSD may also benefit from medication but cognitive behavioral therapy is the most important element of treatment.

It can also be very healing for them to talk about their issues with people who experienced the same disaster. Joining a support group or speaking with friends and family members who were there during the natural disaster can help build strong connections. It can help people with PTSD to feel less alone as they hear other people’s stories that may be similar to theirs.

The post Trauma of a Natural Disaster appeared first on The Gooden Center.

source https://www.goodencenter.org/trauma-natural-disaster/