A stellar time at Bellarmine

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On Thursday, September 24, 2015, I had the pleasure of serving as a guest “professor” for about sixty or so students at Bellarmine University, Louisville, KY. I promised them I would post some of the major points discussed along with some links for reference.

Here we go…

(1) We have a big problem in this country with drug abuse. To illustrate, a recent 2014 government survey found that about 1 in 10 Americans (12 years or older) have used an illicit drug in the past thirty days! About two-thirds of the abuse drugs are pharmaceuticals.

Ref: http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf

(2) Drug overdose deaths continue to increase and are now the leading cause of deaths from injury in the United States, even outpacing deaths due to motor vehicle accidents.

Ref: http://www.medscape.com/viewarticle/846636

(3) While drug overdose deaths have been on the rise for the past two decades, the number of drug overdose deaths from heroin use has skyrocketed recently – up by 39% over the past 3 years.

Ref: http://www.cnn.com/2015/01/14/health/heroin-deaths-increase

(4) Obviously, prescription drugs help many people. Take for example the most abused class of drugs – opioids (i.e., morphine-like drugs). Opioids are powerful painkillers that many suffering people need to have any quality of life. Pain is a big problem in this country too. Here are some pain facts, courtesy of our government:

-Pain affects more Americans than diabetes, heart disease and cancer combined.

-Pain is cited as the most common reason Americans access the health care system.

-One in every four Americans, have suffered from pain that lasts longer than 24 hours and millions more suffer from acute pain.

-Chronic pain is the most common cause of long-term disability.

Ref: http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=57

Note: There is evidence to suggest treating previously drug-naïve chronic pain patients with opioids is associated with a very low risk of addiction. The presence of ongoing pain appears to lower rather than increase the risk of opiate addiction.

Ref: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073133

(5) The majority of individuals abusing opioids (usually young people) are getting “high” taking grandma’s Oxycontin, stealing it or buying it from their friends or relatives and do not get them from their physician.

Ref: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073133

(6) Words matter. Here are some important words to understand:

Tolerance– the body adapts to the drug, requiring more of it to achieve a certain effect

Physical dependence– the body adapts to the drug, eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). This can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction.

Ref: http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence

Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal.

ADDICTION: a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

The FOUR C’s of ADDICTION

CONTROL, LOSS OF

COMPULSIVE USE

CONTINUED USE DESPITE HARM

CRAVING

Ref: http://www.asam.org/for-the-public/definition-of-addiction

(7) Risk factors of developing addiction:

Genetics: Addiction tends to run in families. Heredity is a major risk factor for addiction. In fact, scientists estimate that 40 to 60 percent of a person’s risk for addiction is based on genetics.

Age: The younger the user is, the more likely he or she is to become addicted.

Environment: Where one lives, works, and plays can be factors.

Mental health: Underlying mental health issues can increase the risk of addiction.

Drug of choice: The object of the addiction can play a role.

Speed to reach the brain: Drugs that are smoked or injected into the body tend to be more addictive than those that you swallow.

Ref: http://www.healthline.com/health/addiction/risk-factors#Overview1

These are just some of the major points that were covered. The class was engaged, attentive, and focused. I am certain I was speaking to future leaders and policymakers as well. I truly believe that the world in which I will soon live belongs to them. I feel this group now better understands the complexity of balancing preventive and therapeutic drug control with the necessity to allow effective pain care for the suffering.

I humbly thank the students for their earnest attention and their professor, Dr. Marylee Jamesfor the invitation.

I look forward to their thoughts and actions.

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And thanks for the Bellarmine swag!

Go KNIGHTS!

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