Friday, June 24, 2016

Training Dentists to Safely Prescribe Opioids

prescription opioids
We cover the use of prescription opioids quite often, due to the fact of both over prescribing and over reliance on drugs like oxycodone has resulted in an unprecedented epidemic in this country. While prescription opioids take the prize as being the most effective form of pain management, the risks of prescribing such drugs often times outweighs the benefits.

Now, over a decade and a half into this insidious opioid crisis, both health experts and lawmakers continue to fight an uphill battle in an attempt to stem the tide. That is not to say that strides have not been made, but in all reality it is still quite easy to go to a doctor and walk out with a prescription. In fact, many doctors are resistant to guidelines and recommendations from national agencies, such as the Centers for Disease Control and Prevention (CDC).

Hopefully, in time, more and more doctors will come to realize that the future of this epidemic is in their hands. Setting over-prescribing aside, it is worth pointing out that many doctors fail to mention the dangers associated with opioid analgesics before handing their patients prescriptions. Patients often think that because a drug came from a doctor, it must be safe. It goes without saying that prescription opioids are the furthest thing from safe, as is evident by the fact that over 2 million Americans abuse that class of drugs.

When discussing opioid narcotics, most people think of primary care physicians, pain management specialists and emergency department doctors; however, there is another field of medicine that is often overlooked—that of dentistry. Anyone who has ever had a toothache or needed to have their wisdom teeth pulled, knows all too well that the mouth can be a great source of pain. It is not uncommon for dentist to use opioids for surgery or to write prescriptions for Percocet post-op.

In fact, a Harvard research team found that dentists are one of the top prescribers of prescription opioids, NBC News reports. What’s more a number of people with prescription opioid use disorders began their use with a prescription written by their dentist. It is vital that dentistry students, and medical students alike, be given specific training about safe prescribing practices and how to inform future patients about the risks that come with opioid use.

At the University of Pittsburgh School of Dental Medicine, dental students are being taught to explain to their patients how to take opioids as safely as possible, according to the article. Writing a two-week prescription that is not refillable is a measure being taught to the students.

“I think we find today that prescribing needs to include both education as well as dispensing,” said Dr. Paul Moore, professor of pharmacology and anesthesiology at the University of Pittsburgh School of Dental Medicine. “We teach all of our students here if you’re going to write a prescription for an opioid it is important to follow our checklist that includes the kinds of information that you need to provide that patient.” 

Please take a moment to watch a short video on the subject below:

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

Thursday, June 23, 2016

Stories of Triumph Over Trauma

Surviving trauma


Over the past week or so, many of us have wondered aloud how will those traumatized by the latest mass shooting survive? How will their day to day lives change? Will they be able to move on from their personal trauma? With 24-hour news media coverage we are able to witness the grief and pain...as well as, survivors being able to share their stories. And we come to realize that allowing one to tell their story can be the first step in trauma recovery.

The Essence of Resilience: Stories of Triumph Over Trauma


This October 11, 2016, a new book The Essence of Resilience: Stories of Triumph Over Trauma by Tanya Lauer and Kathleen Parrish will be available via Amazon and you can pre-order copies now and have them available for friends and family.

According to Amazon's overview, Lauer and Parrish seek to assist those dealing with trauma by offering answers as to why some survivors find a "gift in their wound."

"When trauma enters the lives of the unsuspecting, it steals from their very soul. It not only robs them of peace and joy, it can take years and decades from their lives while they desperately try to fill the hole in their heart, pretending that their soul isn't leaking out of it. No one is ever prepared for trauma and no one is ever left unchanged by traumatic events. In the face of such adversity, what allows one person to find the gift in their wound and another to suffer endlessly?"

Trauma and PTSD Treatment at Cottonwood Tucson


It is not unusual for people to suffer trauma...it can be an accident, a sudden unexpected death of a loved one, a physical assault, the loss of a pet, witnessing a crime. Trauma changes us, but sometimes we need assistance in working through these changes and those of post traumatic stress disorder (PTSD). At Cottonwood, we understand the neuroscience of PTSD, and treat the disorder in an environment of safety and support. In a comprehensive PTSD treatment plan, group therapy is helpful in reducing isolation and social stigma related to the disorder. Cognitive behavioral therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) can also help to reprogram brain circuitry so that patients can recall traumatic events with less emotional resonance.

Meet the Authors


Tanya Lauer, MC, LPC


Tanya is a therapist and has been part of the Cottonwood Tucson team since 2008. Tanya grew up in
Tanya Lauer
the Bay Area and received a full scholarship to San Diego State University where she was a nationally ranked tennis player. She earned a Master of Counseling degree in 2002 and is licensed by the State of Arizona as a Licensed Professional Counselor. Tanya has gained a reputation throughout the United States and Europe as a skilled behavioral health therapist who has special expertise in using mindfulness practice in the treatment of mood disorders, chemical dependency and trauma. She also trains other therapists in integrating mindfulness into the holistic treatment of behavioral health disorders. Tanya is also the mother and, in her spare time, runs marathons. 

Kathleen Parrish, MA, LPC


Kathleen is Cottonwood Tucson' Clinical Director and has been part of the team since 2002. Kathleen
Kathleen Parrish
grew up in Tucson, and graduated from Tennessee Temple University with a B.A. in psychology. After a few years of working in social services as a case manager, Kathleen returned to school and got a combined M.A. and M.F.C. from Southwest Baptist Theological Seminary. She has been in the field of behavioral health treatment for over 17 years. Kathleen has written articles for Addiction Professional and Arizona Together magazines, and has presented seminars on trauma, eating disorders and substance abuse in the United States and Europe.

A Team of Caring Experts


Cottonwood Tucson prides itself in gathering a team of caring experts who specialize in the treatment of addiction and behavioral health disorders. Our staff is encouraged to participate in continuing their education and to contribute to research projects in their selected mental health fields. This work often culminates in published research articles and representing Cottonwood Tucson by attending professional recovery events throughout the year as exhibitors, keynoters and presenters.

Indeed, we are very proud to announce that both Kathleen Parrish and Tanya Lauer will be part of the faculty at the 29th Annual Cape Cod Symposium on Addictive Disorders (CCSAD) taking place in Hyannis, MA, September 8 -11, 2016.

Wednesday, June 22, 2016

Child Psychiatry Lacks Popularity

child-psychiatrist
In the United States, we have a long history of leaving people with mental illness behind. Two of the major causalities for this is the fact that there is a huge stigma associated with mental illness and it is an extremely difficult to gain access to adequate care. The result is that millions of Americans not only fail to get desperately needed treatment and, unlike other common medical conditions, those suffering from mental health disorders often times are made to feel like their condition is somehow the fault of their own.

Mental or behavioral health services treat a wide range of conditions, from depression to addiction. In recent years, in light of a dramatic rise in opioid abuse, it has become ever apparent that the country is wholly unequipped to diagnose and treat every case that exists. The U.S. not only lacks mental health/addiction treatment facilities, there is a serious shortage of physicians and counselors as well. It is widely accepted that the best opportunity we have at combating both addiction and other mental health conditions, which if co-occur, is expanding access to addiction treatment services.

Last month was Mental Health Month, events were held throughout the country to raise awareness about potentially life threatening mental illnesses, work to break the stigma surrounding such conditions and to encourage people to seek help. While we are now approaching the end of June, it is crucial that we keep the conversation alive. However, now we would like to discuss one demographic that has arguably had the hardest time accessing adequate mental health care—adolescents.

A look at the numbers makes it ever so clear that not only isn’t there enough child psychiatrists, it does not appear that there will be anytime soon. In fact, for nearly two decades there has been a staggering shortage of people trained to treat psychological disorders among children—leaving it up to pediatricians and other primary care physicians to pick up the slack, NBC News reports. As you might imagine, this reality can have deadly consequences.

Despite the fact that both adolescent depression and suicide are on the rise, there are only 8,500 child psychiatrists in the U.S., and an estimated 15 million children who require the services of doctors in this field, according to the American Academy of Child and Adolescent Psychiatry (AACAP).

People under the age of 17 who are unable to receive a diagnosis or treatment are at great risk, such as problems including:
  • Dropping Out of School
  • Unemployment
  • Drug and Alcohol Abuse
  • Violence
  • Teen Pregnancy
  • Suicide
“In some parts of the country, there’s not a child psychiatrist within a 100-mile radius,” said Wun Jung Kim, Director of the Division of Child and Adolescent Psychiatry at Robert Wood Johnson Medical School in New Jersey.

The AACAP calls for 47 child psychiatrists for every 100,000 adolescents (one for every 2,127 children), yet not one state meets the requirement. In Wyoming, there is only one child psychiatrist for every 22,960 children, according to the article. So, you may find yourself asking, what accounts for the shortage? With existing child psychiatrists reaching retirement, they are not being replaced because, simply put, medical students do not want to work in the field. The reasons for this are varied, but the major deterrents often cited are the fact that child psychiatry requires more years of schooling and demands less pay.

After four years of medical school, those looking to go into the field are required to complete a three-year residency working with adults—followed by a two-year residency with children, the article reports. If a medical student makes it through all the training, child psychiatrists earn about $200,000 a year, compared to a surgeon who can make around $500,000 and may have had to complete far less training. It is hard to incentivize medical students to join the field.

At Cottonwood Tucson, we treat a number of adolescent females who struggle with drug, alcohol and behavioral health problems. If you believe that your teenage daughter is in need of assistance, please reach out to us for help. Our 90-day Sweetwater Program for teen girls ages 13 - 17 has been designed to help girls and their families recover and make necessary changes to improve the quality of their lives.

Monday, June 20, 2016

6 Types of Anxiety Disorders

overcoming anxiety
Overcoming Anxiety


If you have anxiety, you aren’t alone. Anxiety disorders are the most common mental disorder in the United States, affecting more than 45 million people and are most likely to affect people under the age of 35 living in North America and Western Europe.

Risk Factors  

Women are twice as likely to experience anxiety as men, which could be attributed to the ways men and women handle stress differently, or due to differences in brain chemistry. Anxiety disorders often run in families with up to 50% of children raised by anxious parents turning out to be anxious in adulthood. Trauma and a history of addiction also make people more susceptible to suffering from anxiety.

Six Types of Anxiety Disorders

Although some classes of anxiety may have similar symptoms, anxiety disorders tend to fall into one of six categories:

Generalized anxiety disorder (GAD): If you experience persistent, intense worries in several areas of your life that keep you from performing normal daily activities, you could have GAD. This disorder can cause irritability, difficulty with concentration and sleep disruption.

Social phobia: People with this type of anxiety deal with the intense fear of being judged, criticized or humiliated by others, even in the most casual of situations. Physical symptoms can include stammering while speaking, nausea or trembling.

Obsessive compulsive disorder (OCD): Anxious recurrent thoughts that trigger unhealthy behavior patterns can take over the life of someone suffering from OCD. Often people with OCD may wash their hands dozens of times a day, have a need to keep all their belongings in a very specific order, hoard old items or check to make sure the stove isn’t on multiple times in a row.

Panic Disorder: Suffering from recurrent panic attacks, where you have a paralyzing feeling of fear, increased heart rate, light-headedness, intense perspiration and difficulty breathing, is an indication that you may have a panic disorder.

Specific phobias: Some people have irrational fears about specific objects or situations. Their terror is far more intense than the thing they are fearing, but their reaction or panic attack associated with this fear is uncontrollable. A person who never travels long distances due to a paralyzing fear of flying, likely has a specific phobia.

Post-traumatic stress disorder (PTSD): Following a traumatic event, individuals with PTSD have a set of reactions that are similar to the feeling of fear or panic that they felt when they were traumatized. Surviving a car crash, being tortured or living in a war zone can all trigger PTSD.

Getting Help for Anixety


Anxiety disorders can be debilitating, but with successful inpatient treatment you can learn how to manage it and have lasting recovery. Cottonwood offers treatment for anxiety disorders for adolescent girls, young adults and adults. For more information, contact Cottonwood Tucson at 800-877-4520.

Thursday, June 16, 2016

CDC Youth Risk Behavior Survey

risky behavior
Most parents probably think that they have a good idea about the things their kid(s) are up to, and in many cases that may be the true. However, those whose adolescent years are behind them probably have memories of engaging in risky behavior, so it stands to reason that at times parents find themselves unaware as to the day to day activities of their teenagers. It is important that parents never forget that adolescence is when children spread their wings, making new friends and experimenting with the things they have been cautioned about—such as: alcohol, cigarettes, drugs and sex.

By and large, the majority of teenagers who engage in risky behavior move on to adulthood unscathed, yet there is a significant number of teenagers whose choices end up having a lasting effect. The teenage brain is still developing, and is highly prone to impulsive decisions. The combination makes teenagers particularly susceptible to addiction. Every year, a number of teenagers require substance use disorder treatment. Those whose unhealthy relationships with drugs and alcohol goes unchecked, are likely to struggle with addiction for many years to come—derailing whatever life goals or plans one may have from their childhood.

It is extremely important that researchers track teenage behavior in order to develop effective prevention measures. Such findings will not only help teenagers, it equips parents with tools to spot signs of trouble and intervene. The Centers for Disease Control and Prevention(CDC) recently released its Youth Risk Behavior Survey, which looks at 118 health behaviors, CNN reports. Laura Kann (PDF), chief of the CDC's School-Based Surveillance branch, says that the survey:

"Helps us identify newly emerging behaviors and monitor long-standing youth risk behaviors over time. While overall trends for the 2015 report are positive, the results highlight the continued need for improvements in reducing risks among teens." 

Altogether, 15,000 students from across the country took part in the survey, according to the article. There were a number of important findings in 2015, such as:
  • Cigarette smoking is down, but e-cigarette use is on the rise.
  • 17% of students took a non-prescribed drug such as Adderall, OxyContin and Xanax.
  • Car accidents remain the leading cause of death (23 percent) for people ages 10 to 24.
At Cottonwood Tucson, we treat a number of adolescent females who struggle with drug, alcohol and behavioral health problems. If you believe that your teenage daughter is in need of assistance please reach out to us for help. Our 90-day Sweetwater Program for teen girls ages 13 - 17 has been designed to help girls and their families recover and make necessary changes to improve the quality of their lives.
CARF - Commission on Accreditation of Rehabilitation FacilitiesNATSAP | National Association of Therapeutic Schools and ProgramsNBCCNAADAC