Prescription drug

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Say Yes to Medication And No To Drugs

Please don’t call them drugs.

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Today I spent eight hours in the company of many neuroscientists.  Smart folk.  People I look up to, want to emulate and learn from.  It was an honor.  We covered different stimulating topics about serving our patients, diagnosing better and the development of our field of practice.  We connected collegially, ate too much chocolate, exchanged cards and talked about each other’s families.  I hope to meet them again soon at future related conferences and continue learning from their experiences and study.

The one thing I do not like about any of these meetings however, is hearing people who know better (if they thought about it) naming our good medications “drugs.”

Drugs.  Yuck.  What do you think of when you hear that word?  I think of stigma, addiction, substance abuse, ruined families, fathers who do not come home, needle marks or powder on mirrors, low-living, illegal behavior, dealers, hepatitis and so much more – very little of which is good.  Drugs.  I cannot number how many patients I have spent oodles amount of time on talking them away from the stigma attached to medications because they thought of them as “drugs.”  Blah.  It is not anyone’s fault but we can start over when ever we want to, so let us.  It is time.

Who thinks of anything that actually improves us when thinking of drugs?  Who thinks of life-saving remedies, disease cures, hope, ability to feel pleasure again, forgotten shame, ability to hold a job, restful sleep, speaking well in public, desire to live restored or a mother who no longer wants to drown her baby?  Do you think of that when you hear drugs?

Let’s get together on this and forget the word that carries so much loaded negative meaning.  It is a disservice to ourselves – physician, scientist, grocer, student, surviving family of a suicide victim, newborn baby, patient and all of us who have any connection whatsoever to disease and treatment.

Drugs.  I think of First Lady Nancy Reagan‘s famous campaign in the 80’s, “Just Say No!”  That is not what we want to say or hear when we write or receive a prescription to treat and to heal what can be healed from a debilitating disease.  Just say yes, please.

Medication.  Not drugs.  A word does matter.  A word carries emotion on it like the smell of cookies baking in the oven or the toilet that was not flushed.  A word can start a war or inspire forgiveness.  Words matter.  Words can be part of what helps us be better friends to ourselves.  Why not use them to our advantage?  Let us change our culture and decrease stigma with this simple word – “medication.”

Maybe when I am able to get together with my colleagues again, maybe next year even, we will be using the word “medication.”  Maybe it will be because of the shift in culture people like you and I can start now.

Self-Care Tip:  Please forget about the misunderstood word, “drugs,” and say yes to medication.  Be a friend to yourself.

Questions:  What do you think of when you hear “drug?”  vs. “medication?”  Is there a difference to you?  To you think it would matter to culture and your “Me” if we used “medication” to refer to prescription therapies?  If so, how?  Please tell me your story.

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Blog-Jacking – by Rick C.

Hi Everyone… I thought I would kind of write a guest blog today (call it blog-jacking even) DQ did not specifically asked me to do this, however, I do not have any clear recollection of her specifically asking me not to do this either. With this in mind, I would like to let you know about my unique relationship with DQ (I am just going to write DQ because I have a very limited attention span and am likely to have two or three great ideas flow through my brain by the time I type Dr. Sana Johnson-Quijada and then I also start wondering if she has a middle name too and how she fits all those letters into those forms that have the little boxes on them). Anyway… I communicate with DQ on a regular basis and get interesting insight on a variety of topics. This makes me feel unique and special until I realize that most of the people reading this have the same opportunity. Then I kind of ask myself… “What kind of group have I joined?”

To begin, I would like to talk a bit about my psychiatric qualifications. I spent six years attending college. Technically, these were at a community college, but I did take at least one psych course while I was there. In addition, I am an alcoholic and drug addict in recovery who has previously attempted suicide. I take medications for both depression and ADHD. I had to go through a variety of medication to find the right combination because almost every medication I tried made me sweat profusely and/or break out in a rash. As part of my ongoing training, I am going through a nasty divorce which has caused me to be temporarily unable to see my son or live the life that I have become accustomed to. In addition, I have just lost my job of fifteen years due to cutbacks. All of this in the same month that I turned forty and should be free to seek out a quality midlife crisis.

The fact that I am laying in bed with my shoelaces in my possession in a nice room that I am free to come and go from as I please over two weeks after the divorce/job loss week most likely indicates that I am totally delusional and only think that I am happy or that I actually am. Either way, I am content in the place that I am at. This, to me, is pretty amazing.

I am grateful for that I have been through all the things that I have been through in my life because they have given me the strength and experience to go through what I am going through. Even though I did not do real well in school, I somehow did well enough with a big corporation that they are willing to give me a severance package that will basically pay me for the next four months as long as I do not get a job or accept one of the positions they have offered me. Basically, a bunch of paperwork and legal terms that say to me “Paid, vacation!”

Being an alcoholic and a drug addict have led me to become involved in a program that connects me with others who have previously tried to use alcohol and drugs as a solution for coping with life. These people are a great source of support and experience. As for the prescribed drugs, I am not even really sure that I need them all the time; however, I sure as heck am glad that I was on them when my “Perfect Storm” kicked off. Oh yeah, as part of my challenging week, I found myself with no place to live and immediate access to very little money. A little rational thought and I realized that I have an amazing amount of airline miles from years of travel. In fact, more than enough to take up residence in a nice beach front condo for the next month.

Why am I sharing all of this? For several reasons — First and foremost, I am newly almost single and think that this is a great way to meet ladies without having to ever think about the awkward point in a relationship where I will have to explain my past. In addition, the fact that everyone here is reading this most likely means that you have experience with challenges like mine and I can always use others that I can relate to. Lastly, I have found out that when I have felt that I have a very unique situation, I am usually wrong and that I am actually just not in a group of people who feel comfortable sharing their experiences. It would be kind of cool if everyone just wore a signs with their three biggest “issues” on them. I have a feeling that if everyone formed a group with only the people who had at least one issue in common with them… we’d all be in the same great big group called life.

Thanks for reading to this point. What do you think about this? Are you female and single or considering becoming that way? Could this really be a worse idea than matchharmoneyfinder.com or whatever it is called? Keep on and be a friend to yourself and stuff.

Oh yeah….DQ, please get better soon because this blogging stuff is cutting into my busy schedule!

 

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A Little Bit is Not Enough – Claim Full Health

The good news is, I just ate 3 chocolate chip cookies.  You already know the bad news.  Has nothing to do with my post.  I’m just sharing it for the sake of your own

Schadenfreude 🙂

…Onward.  Question:

Does emotional disease get worse even while on medication therapy?  Sometimes.  It does so more often when the disease process is treated but only partially treated.  Read a little more about this in this post if your interested.  A primary care physician recently told me, “I think the term ‘Partial Responder’ is a marketing gimmick to get physicians to prescribe more medications.  I don’t think it even exists.”

There’s a lot to be said about interview skills in sussing out the partial responder.  If I asked someone if they felt better, many things play into their response. Everyone’s responses are biased of course.  We don’t have sterile minds.  For example there’s the patient who wants to please their physician.  “Yes I’m better!”  i.e. “Yes you’re a good doctor!”  There are the patients who don’t want to be patients and minimize whatever they’re going through.  There is the physician who leads the interview.  “So, you’re feeling better?”  “The medication is helping?”

Partial response means that at the end of a full treatment initiation period, there is some disease remaining but a reduction of disease.  For example, in depression, I may no longer be suicidal, but I still have trouble feeling pleasure in life.  In cancer it means that there is tumor reduction of at least 30%.

Now why would a physician presumably agree that there is a partial response in cancer, but not agree that it happens in mental health?  Anyways….  (Ahem.)  When we partly respond to mental health treatment and don’t push further for full response, about 70% will relapse.  Versus maybe 25% in those who reached their pre-disease baseline emotional health through treatment.

Don’t get lost in this.  The point is, get treated and get fully treated.  Mental illness is progressive and causes changes at the cell level.  The brain is connected to the rest of our body.  The brain is human.  A bit better, is not enough.

Self Care Tip #61 – Go all the way!  Claim health.  Be a friend to yourself.

Question:  Did you find this to be true in yourself or someone you know?  Please tell me your story.

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Afraid of Meds

A colleague told me,

I want to get off my sleep meds because I don’t want to be dependent on anything.

Dependence.  Lazy, pass-the-buck, unimaginative, immoral, chemical abuser.  Maybe even doctor-shopper depending on who is speaking.  When someone says it, before we talk about medication use, biology, etc… we need to know what is behind that word.  Working with the tip of an iceberg of prejudice might sink us before navigating much treatment.  Even physicians after 25+ years of education and more of medical practice, find it hard to shed these cultural prejudices about psychotropics (medications used in psychiatry).  What does the word dependence mean to you?

To psychiatrists, substance dependence means that the body has become accustomed to something.  We don’t get as much physical or emotional boost we used to using a substance, such as to nicotine, alcohol, illicit drugs, or prescription medications.  We now need more to get the same effect we would have gotten before with less amount.  It includes physical and emotional cravings – like sweating, shaking and yearning.  A lot of time is spent to do whatever it takes to get it.  Can’t cut back.  Keep doing it even though spilling into personal and professional space.  Keep using even though aware body and mind are worse for it.

Was this a description of my “dependent” colleague?

How about abuse?  Substance abuse is when we do dangerous, mean, and/or irresponsible things when using.  Was he hitting his wife when he was under the influence of a sleep medication?  Was he taking sleep medications when he was at work because he liked how they made him feel?  Driving with them?  You get it.

This guy is no dummy.  Yet he felt guilt and shame about appropriately using a medication for a medical reason.

I was seeing a woman for the first time in my clinic.

“Doctor is this medication going to make me addicted?”

We spoke about her fears.  Turns out, she thought her medication would prejudice the world against her.  Change her personality.  Make her crave it if she ever wanted to stop.  Steal from her geriatric mother and eventually, who knows?  Panhandling?  Now how am I supposed to work with that?  How she ever got the courage to come and see me in the first place with all that on her back, must be pure grit.

So here’s the dirt.  Some medications have no dependency risks.  Some medications do.  Some people abuse any medication they can get their hands on.  There are rave parties where there is a kitty – a bowl full of whatever pills anyone in attendance donates to.  They take them out randomly and swallow to get whatever surprise awaits them.  Is one class of medication more often abused than another?  Yes.

As a prescribing physician, I have sworn to not intentionally do any harm.  As a patient, you contract with me to take your medications as prescribed and safely. We’re in this together.  We will talk about any recommendations and you will hear the risks and benefits to treatment.  You will decide.  There is no conspiracy to turn Americans into bad citizens through psychotropics.

Self Care Tip #52 – Find out where your fear is coming from.  Be a friend to yourself.

Question:  What are your fears about psychotropics?  Agree or disagree with this post?

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