SCHIZOPHRENIA SIGNIFICANTLY EASED BY TALK THERAPY – LANDMARK GOVERNMENT STUDY


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FRONT PAGE NEW YORK TIMES 

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TALK THERAPY FOUND TO EASE SCHIZOPHRENIA

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 WITH 20 TO 50% FEWER DRUGS.

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 “…The findings, from by far the most rigorous trial to date conducted in the United States, concluded that schizophrenia patients who received smaller doses of antipsychotic medication and a bigger emphasis on one-on-one talk therapy and family support made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.”
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“….The report, to be published on Tuesday in The American Journal of Psychiatry and funded by the National Institute of Mental Health, comes as Congress debates mental health reform and as interest in the effectiveness of treatments grows amid a debate over the possible role of mental illness in mass shootings.” [that’s in blue because it’s a peaceful thought, not an active link.]

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“….Dr. Kenneth Duckworth, medical director for the National Alliance on Mental Illness, an advocacy group, called the findings “a game-changer for the field” in the way it combines multiple, individualized therapies, suited to the stage of the psychosis.”

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.J

Just announced :

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UN set to call for drug legalization, end to ‘war on drugs’ Sir Richard Branson
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….”The United Nations is on the verge of calling for governments around the world to end the “war on drugs” by decriminalizing the use and possession of illicit narcotics, according to businessman Sir Richard Branson.”

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“In a surprise post on the website of his company, Virgin, the entrepreneur and drugs campaigner said the UN Office on Drugs and Crime (UNODC) is about to announce a “refreshing shift” in direction.”
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Branson claims he broke a global media embargo to make the announcement, as the news was due to have been launched at a conference on Sunday. The Virgin chief said he feared the UN would bow to political pressure and withdraw the statement at the last minute….

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“In an as-yet unreleased statement circulated to the BBC, myself and others, the UN Office on Drugs and Crime, which has shaped much of global drug policy for decades, calls on governments around the world to decriminalize drug use and possession for personal consumption for all drugs,” Branson wrote.
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“This is a refreshing shift that could go a long way to finally end the needless criminalization of millions of drug users around the world. The UNODC document was due to be launched at the International Harm reduction conference in Malaysia yesterday.”

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“Branson went on to say that at least one government was already putting an “inordinate amount of pressure” on the UNODC over the announcement.”

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“Let us hope the UNODC, a global organization that is part of the UN and supposed to do what is right for the people of the world, does not do a remarkable volte-face at the last possible moment and bow to pressure by not going ahead with this important move,” he said.”

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“The war on drugs has done too much damage to too many people already.”

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Risk Assessment Tools for Addiction


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“Anyone can become addicted to drugs.”

National Institute on Drug Abuse (NIDA)

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Addiction is a life-threatening and progressive disease that is multidimensional, often hereditary, characterized by three things: craving, compulsive use, and use despite harm.

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Monitoring Misuse, Diversion, Abuse

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Monitoring may depend on assessment of risk and may include:

1. Urine drug testing (UDT)

2. Prescription Drug Monitoring Programs (PDMPs) that are state-run programs for federally controlled substance, the CURES program in California.

3.  Medication monitoring. Accounting for remaining doses of prescribed medication – pill or device counts, and counts of used units when applicable

4. Validated short instruments are often more practical in a clinical setting, e.g. ORT, COMM***, CAGE-AID, SOAPP.

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Screening tools

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Screening tools are not lie detector tests.

It is helpful to meet with family or friends.

It may be the addict who finds reasons that this is not possible.

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The American Academy of Pain Medicine has a set of tools on one page from various sources including information on drug metabolism.

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Opioid Risk Tool (ORT)

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This tool, created by Lynn Webster, MD, includes history of preadolescent sexual abuse and history of psychological disease including ADD. Predictive validity. To assess risk of prescription opioid misuse in a patient being considered for opioid therapy.

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COMM

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Identify aberrant behaviors associated with misuse of opioid medications in a patient currently on opioid therapy.
“Includes questions developed using input from a panel of experts and concept mapping® analyses.
Scale designed to over-identify misuse rather than fail to identify patients who are actually abusing their medication.
May be useful for providers who need to document patients’ compliance with opioids.
May reduce physicians’ concerns related to prescribing opioids.
May keep patients more cognizant of their need to be responsible with opioids.”

A score of 9 or above is a positive indicator, ie, patient has been identified as misusing his/her medication and is at an increased risk of abuse, and the patient may require additional precautions and/or monitoring if treated with long-term opioid therapy.

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CAGE-AID QUESTIONNAIRE (pdf)

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The is the familiar CAGE questionnaire for alcohol, now adapted to include drugs.

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DAST-10 (pdf)

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“The Drug Abuse Screening Test (DAST-10) is a 10-item brief screening tool that can be administered by a clinician or self-administered. Each question requires a yes or no response, and the tool can be completed in less than 8 minutes. This tool assesses drug use, not including alcohol or tobacco use, in the past 12 months.”

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NIDA Quick Screen Question (pdf)

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Includes alcohol, tobacco, all drugs including steroids, over lifetime use, the past year use, and recent use. Scoring stratifies by level of risk with treatment recommendations. If IV use, it recommends testing HIV and Hepatitis B/C.

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Other tools and resources at NIDA

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Please see their website. Drug abuse is a vast field. A busy site, difficult to find tools for screening.

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Clinical Resources: Prescription Opioids

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DrugAbuse.gov is a busy site with many useful resources.

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Screening Drug Use in a General Medical Setting (pdf)

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 An excellent tool guides all the way through to treatment. “Advise, Assess, Assist and Arrange.”

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Screener and Opioid Assessment for Patients with Pain SOAPP (pdf)

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This self-administered questionnaire takes just minutes to complete and score.  Clinicians can use the results to:

  • Better predict a patient’s likelihood of misusing or abusing opioids.

  • Document decisions about a recommended level of monitoring for a patient.

  • Justify referrals to specialty pain clinics.

    • Available to clinicians at PainEDU.org® (questionnaire, background information and scoring instructions may be downloaded at no charge).

    • Comes in four versions: 5, 14, 24 questions and the Revised SOAPP: SOAPP-R.

    • May be self-administered at or prior to an office visit, or completed as part of an interview with a nurse, physician or psychologist.

    • May help differentiate those patients who require more or less clinician monitoring while on long-term opioid therapy.

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This applies to addiction as much as to pain:.

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“We must begin to (explore) the meanings of pain in order that we do not reduce human suffering to the dimensions of a mere physical problem for which, if we could only find the right pill, there is always a medical solution….medicine alone cannot possibly resolve all the questions raised by pain.”

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David Morris, The Culture of Pain, UC Press 1991

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Help now: Spread awareness of Complex Regional Pain Syndrome, also known as Reflex Sympathetic Dystrophy


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This alert has been just received from RSDSA – Reflex Sympathetic Dystrophy Association.

I am not affiliated with them, but they fund research into treatment of intractable pain of all causes.

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The RSDSA is very special. Unique among philanthropic organizations. The best of the best.

RSDSA with Mission

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Dear Nancy
Color The World Orange is an annual event held the first Monday of November each year to spread awareness of Complex Regional Pain Syndrome, also known as Reflex Sympathetic Dystrophy. This year’s event is Monday, November 2, 2015.
The easiest way to Color The World Orange on November 2nd is to wear orange and post pictures to social media with the hashtag: #CRPSORANGEDAY.
Across the globe CRPS/RSD patients and supporters will be wearing orange, as well as planning events to spread awareness of CRPS, and raising funds to support research of this debilitating condition. All donations to this page will go to RSDSA for research.
Color The World Orange is a day for the whole community to join together and show that even though we are in pain, we are strong! For more ideas on how to Color The World Orange, visit the Color The World Orange Website or Facebook page. Please see the links below.
 
Best of health,
JWbroatchnew    
Jim Broatch, MSW
executive Vice President, Director  

RSDSA-New

Be sure to visit the RSDSA website for the latest CRPS/RSD information including new treatment options, valuable resources, upcoming, events, and Support Group in your area.

Click Here to Visit Now!

  • SUICIDE CRISIS INFORMATION
    If you or a loved one are in crisis
    • Please call 1.800.SUICIDE (800.784.2433)
    • Hope Line or The National Suicide Prevention Lifeline
    • 800.273-TALK (8255) – (888-628-9454 en Espanol)

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      I know some of you ignore this, but I must repeat:

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      The material on this site is for informational purposes only.
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      It is not legal for me to provide medical advice without an examination.

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      This material is not a substitute for medical advice, diagnosis or treatment provided

      by a qualified health care provider.

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      This site is not for email and not for appointments.

      If you wish an appointment, please telephone the office to schedule.

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      For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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