Thursday, January 22, 2015

AMERICAN SNIPER ~ A Conversation Starter

Winter is here...

Between the New Year, the State of the Union, the State of the States, Super Bowl Madness...this is also the award season for feature films, television productions, and documentaries. On January 15, 2015, the Academy of Motion Pictures Arts and Sciences announced their nominations for both feature films and documentaries. Within minutes the controversies over who made the cut and who appeared to be snubbed began. Then this past week most of the conversation has turned the lens on Clint Eastwood's AMERICAN SNIPER.

Movies can be are reviews

We often talk about movies. A few months back we talked about Roger Ebert and his contribution to this art form. He was the one who offered that "cinema is a machine that generates empathy." He would most likely enjoy the conversation that AMERICAN SNIPER has generated to date. Here are just a few reviews, which you may or may not want to read before seeing the movie:
To read a more complete selection of reviews, you can visit the MetaCritic website. As is usually the case, each reviewer brings just a touch of their own life experience to their writing, not unlike the average moviegoer.

You can see the movie without having read the reviews, you can see the movie if you haven't read Chris Kyle's bestselling autobiography American Sniper. You'll find you can see the movie if you have never been in the military, never gone to war, and you can see the movie even if none of your relatives served in the military or have gone to war. On the other hand, watching this movie may be difficult for some who have served and for those whose relatives went to war and didn't return or came home with either physical or emotional handicaps, or both.


If you are having trouble viewing the video, you can see it here.

Is this movie about post traumatic stress disorder?

If you just watched the trailer, then you might jump to the conclusion that the movie is all about post traumatic stress disorder (PTSD). But one reviewer offered a different take on what was really going on with Chris Kyle and what he alluded to in his autobiography. Richard Roeper's review for the Chicago Sun- Times was well thought out and interestingly concluded:
"But this man doesn’t suffer from Post Traumatic Stress Disorder. We see signs the disorder is kicking in while he’s still in uniform."
The movie does hint that Kyle's PTSD may have started even when he was a young child. It brings to mind the findings of the Army STARRS survey which was published in March 2014. One notable statistic from this report: "More than 8% of soldiers entered the Army with intermittent explosive disorder, characterized by uncontrolled attacks of anger. It was the most common disorder in the study, with a pre-enlistment prevalence nearly six times the civilian rate. The researchers found that despite screening, pre-enlistment rates of depression, anxiety, bipolar disorder and substance abuse were on par with civilian rates."

Some final thoughts...

It is important to note that even though about 50% of this movie takes place in a war zone, the other half takes place here in the United States. Chris Kyle writes in his book that he felt guilty leaving the Navy. He discusses that he suffered from depression and did not take care of his physical health and abused alcohol. However, Eastwood's production does provide hope regarding his mental anguish and how Kyle was able to recover and heal. In many ways this is the story of one man's hope to help his country, be a good husband and father.

Perhaps Tim Long of The Detroit News said it best:
The movie is meant to entertain, to stimulate discussion, to cause discomfort (as it obviously has) and possibly inspire. It does not contain every lunk-headed thing Chris Kyle ever said or did – why would it?
Movies do not tell the truth, even documentaries. Movies tell stories. "American Sniper" is one angle on the story of Chris Kyle, and that angle is nowhere near as simplistic as its critics are making it sound.

Wednesday, January 21, 2015

Project Vision Empowering Rutland Vermont

Project Vision - Rutland, VT
One city's vision to deal with the heroin epidemic

Last week we brought our readers up to date on the State of Vermont's efforts to deal with the heroin epidemic in which they found themselves engulfed during the past few years. At that time we mentioned we would write this week about the City of Rutland's Project Vision. 

Rutland, Vermont, is located in the mid-central part of the state, just 65 miles north of Massachusetts and 20 miles east of the New York state border. The population hovers around 16,500 and it is probably best known for its now closed marble quarries.  A little more than three years ago the former commander of the Vermont State Police Jim Baker became the Police Chief of Rutland.

In December Chief Jim Baker resigned his position in Rutland to accept a new job working for the International Association of Chiefs of Police in the Washington, D. C. area.

Chief Baker leaves a legacy in Rutland - Project Vision

Project Vision was started with the assistance of Chief Baker to put in place innovative ways to combat Rutland's heroin crisis. Here is NECN's report on Chief Baker and Project Vision.

If you are having trouble viewing the video, you can see it here.

Learning more about Project Vision

Project Vision was established to bring change about in the community with collaboration, coordination and cooperation. According to their website:
"Project Vision is a diverse coalition of over 100 social and health service agencies and organizations, schools, colleges, business organizations, the City of Rutland, local, county, state and federal probation, parole and law enforcement agencies, faith based groups, volunteers and neighbors. We have united to address the drug related challenges facing our community with the goal of making Rutland one of the healthiest, safest and happiest communities in America."
As Chief Baker reiterates Project Vision has two core values: "Collaboration for the greater good" and "a renewed focus on the positive - I believe in Rutland." Visit their website and check out their Facebook page and their Twitter feed

Rutland's Project Vision might be a one of a kind experiment, but it can be the blueprint for other small towns and cities across America. Taking the first step is always the hardest, but recovery is possible, not just for one person, but a whole community.

Rutland started the conversation with Chief Baker's help...will your community?

Friday, January 16, 2015

State Of The State: Vermont One Year Later

A look in the rear view mirror...

If you're a regular reader of our blog, you may remember it was a year ago this week that we introduced you to Governor Peter Shumlin who used his entire 2014 State of the State address to speak to Vermont citizens about the heroin epidemic.

Governor Shumlin's remarks last year garnered a lot of attention, not just in his state but across the nation. He asked that everyone get involved and to start by watching the documentary THE HUNGRY HEART. 

The film was by Bess O'Brien and it followed the day to day life of a Vermont pediatrician. The film had an impact on many people and has served as a powerful resource for many organizations. This past December it was announced THE HUNGRY HEART will be awarded the 2015 Media Award from the American Society of Addiction Medicine (ASAM) at their national conference in Austin, TX in April 2015.  

So now the question is, "What is the state of the opiate addiction epidemic today?"

Specifically, when Governor Shumlin took to the podium last week to deliver his 2015 State of the State address, did he talk about the heroin epidemic? The answer to that question is NO! But Mark Davis who reports for Vermont's Independent Voice did some research to determine how much has changed since last year.

Here's a bit of what Mr. Davis was able to determine about the current state of Vermont's hub-and-spoke system which they use to treat drug addicts (the hubs are regional centers the spokes are primary care doctors):
  • Since January 2014 the state spent $6.7 million on additional hub staffing
  • In January 2014 there were 994 people waiting to be admitted for treatment, today that number is 523
  • The number of patients being treated at these hubs is currently 2,517, while last year at this time it was 1,482
  • Since last January every State Trooper and ambulance crew is equipped with Naloxone, which is used to revive overdose victims (this saved 100 Vermonters in 2014)
  • $760,000 was pledged to create programs for nonviolent drug addicts, keeping them out of the prison system and in treatment
Going forward the next step will be to increase the number of primary care physicians and have them complete the education needed to be able to dispense buprenorphine. According to the article:

'Locally, officials say that more must be done to eliminate the treatment waiting list: Both the Howard Center and West Ridge are at full capacity. To ease the burden in 2015, more primary care doctors — the "spokes" in the system — are needed. "There is a shortage of primary care physicians in Chittenden County who are willing," [Bob] Bick said. To dispense buprenorphine, doctors must complete an eight-hour online course given by the federal government. Fewer than one in five primary care physicians in Vermont have taken that step, according to the health department. "Our challenge in the next year is developing those spoke resources in the community in order to keep our front door open," McKee said. "The model we would like to see is much more integrated ... all primary care doctors need to do it."'

Some final thoughts...

It's a new year. Most of us have made resolutions. Some of us want to lose weight, some want to start a new career, some want to read more books, or volunteer in some capacity in their communities. Some of us just want to be able sleep better or get along better with our children and our spouses.

It is interesting to see how much the State of Vermont has been able to accomplish in just one year. Check back next week and we will share one more interesting highlight of Rutland, VT's Project Vision.

Wednesday, January 14, 2015

Guilt And Mental Illness - Could There Be A Link?

“The human capacity for guilt is such that people can always find ways to blame themselves.” Stephen Hawking, The Grand Design

Longitudinal study examines excessive guilt 

Researchers at Washington University of St. Louis have been conducting a 12-year longitudinal study to determine if there is a connection between childhood guilt and eventual onset of mental illness. This past week the results of their study were published in the journal JAMA Psychiatry: Anterior Insula Volume and Guilt Neurobehavioral Markers of Recurrence After Early Childhood Major Depressive Disorder.

Study's parameters...

  • 145 preschool age children were involved in the study
  • Each was assessed for depression and guilt between the ages of three and six
  • Each had fMRI brain scans every 18 month between the ages of seven and 13

Study's findings

  • Of the 47 preschools diagnosed with depression, over half displayed pathological guilt.
  • Only 20% of the non-depressed preschoolers exhibited pathological guilt.
  • Children with high levels of guilt, even sans depression, had a smaller anterior insula volume.
  • Children whose insula volume was smaller in the right hemisphere (which was related to either depression or guilt) later in life were more apt to have repeated episodes of clinical depression.

What makes this study different...

Joan Luby, one of the study's authors, is quick to point out that while there have been other studies with children concerning guilt, almost always these were behavioral studies. Her team considers this to be one of the first that links physical changes in the brain to excessive guilt feelings. The researchers intend to continue to study these children for at least five more years.

According to the January 5, 2015, issue of The Atlantic:
"In addition, this research provides neurological evidence for what researchers have been starting to suspect: Guilt in early childhood has negative effects on children and may cause later life depression and anxiety. In a study published in 2013 by scientists at the University of Jyväskylä, Finland, researchers found that parenting tactics that created feelings of guilt in children caused children to feel an increase in distress and anger for many days afterward. In another study published in 2003, scientists found that children whose parents used guilt-inducing tactics were far more likely to internalize their problems. Depression and anxiety are classic examples of internalizing disorders."

Some closing thoughts...

This study has really started an online conversation. When the researchers reference future mental illness, they are including depression, anxiety, obsessive-compulsive disorder and bipolar disorder. So it is not surprising that readers are engaging in comments, particularly on the Huffington Post article and The Atlantic article.

Many people, after reading about this research, will undoubtedly think back to their own childhood or even consider their own parenting habits. Guilt is part of every society. For many it is an intricate part of their religious training. Guilt can be found as the main theme in literature of all types.

Now the research will continue and perhaps we will discover new ways to intervene and prevent these disorders.

Friday, January 9, 2015

Alcohol Poisoning Deaths In the United States Reach Six Per Day

Signs of alcohol poisoning
Signs of alcohol poisoning (Photo credit: Wikipedia)

Did you notice the headline on alcohol poisoning?

If you didn't notice the January 6, 2015, headline "alcohol poisoning kills six Americans every day,"  then there is a good chance you will still catch one of these headlines, as more and more news outlets are continuing to report on this news. (See Related Articles below).

Of course, there is more to this headline and we will provide the details, but it is amazing that more people aren't motivated by this headline to do something. Keep in mind the headline says alcohol poisoning, not alcoholism.

CDC Vitalsigns™ reports on alcohol poisoning deaths

The Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) for January 9, 2015, included statistics for Alcohol Poisoning Deaths - United States 2010-2012 (See page 1238). This report, in turn, became featured in the January 2015 CDC's Vitalsigns™.

Here are some highlights of the report:
  • 76% of alcohol poisoning deaths are among adults ages 35 to 64
  • 76% of those who die from alcohol poisoning are men
  • Most alcohol poisoning deaths are among non-Hispanic whites
  • A smaller share of the US population, American Indians/Alaska Natives have the most alcohol poisoning deaths per million of any of the races
  • Alaska has the most alcohol poisoning deaths per million, while Alabama has the least
  • Alcohol dependence (alcoholism) was identified as a factor in 30% of alcohol poisoning deaths.

See NBC News Report on deadly drink

If you are having trouble viewing the video, you can see it here.

These are preventable deaths...

The truth is at least 70% of these deaths are easily preventable with education and vigilance. Here is what the CDC recommends:
  • Avoid binge drinking - if you do drink alcohol stay within the dietary guidelines of no more than 1 drink per day for woman and 2 drinks per day for men.
  • Avoid drinks with unknown alcohol content.
  • Avoid mixing alcohol with energy drinks.
  • Remember caffeine can mask alcohol's effects and cause people to drink more than they intend
  • Get help for anyone experiencing life-threatening signs of alcohol poisoning
Most important is if you feel you do have a problem with alcohol or one of your loved ones may have a problem, talk to your primary care provider. These deaths are preventable.