Monday, May 31, 2010

Words Are All I Have

 
Some people would claim that words, carefully chosen and delicately placed on the page are nothing other than a human attempt to justify indefinable emotions and largely unproven intentions. To these people, words cannot express the stark feelings and inner connotations experienced in a world of physical reality. Their eyes read the words; however, no matter how well written, these words never strike purpose or change heart. In fact, after complete digestion, the reader receives no nourishment from the symbols, and they are expelled as just that -- used words.

Humans use words as written symbols of meaning to draw mainly favorable comments through writing, a systematic means of communication. When words fail, writers, at best, can compose metaphor or comparison to offer expression. For example, the unpleasant feeling of being caught in pelting rain is described by writer Enid Bagnold as the following: "The rain came down in long knitting needles." Metaphor draws upon comparison and sensory appeal to push its sensory power. It relies upon experience and imagination to unleash its effects.


Yet, what about those people without reference or without inclination to believe in words? All the skills and tools available to the writer are lost when cast upon those without reference. To put the predicament simple, these people answer problems, mistakes, and dilemmas with this statement: "Words are not going to get it done." They confess that the gap between damage and resolution is too large to expect symbols on paper (or speech) to have any positive effect. To them, words are, and will always be, just letters without feelings.

All of us have reached such a point in our lives when human interpretation has failed. The heart opens; the brain calculates; and the words expel. But, the spirit of another wages complete rejection. Words slam into these brick walls of nonacceptance until any further advance is folly and the author sounds retreat. Lying broken and ineffective, these shapeless words lose all future recognition and expire.The symbols were doomed from their conception due to the total insulation of reception by someone else.


I do feel sorry for those who have never experienced total rejection. It strengthens the foundation of the believers of words. They understand the helplessness of human situations that seem to require communication for resolution. Rejected believers of words experience loneliness in all its various ebony shades and hidden states. They, without peers of similar rejection, are capable of feeling utter helplessness in request and supplication. As their reality caves in around them, they fear less because their own words serve to comfort them while others refuse to change.

I believe that some wisdom does exist in the "words are just words" profundity. "Have a nice day" and "How are you?" are examples of exchanges of meaningless verbal daily pleasantries. And just as tragic as a written "I love you" in a one-way affair, similar sacred words are abused and misused on a regular basis. Some words are written as valueless ornaments void of purpose. They occupy pages much as wasted minutes occupy time.

Still, I value the power of words. I view words as the means to keep this civilization and any future civilizations from total devastation. How could I discount the deepest uttering of a human heart or the most calculated measurement of a human brain? Even when incapable of communicating emotion and intention, I find myself turning to words for expression. I wish that others might understand snags and faults in the process because I lack the necessary precision to supply often-desired perfection, a perfection that will remain unattainable.

"Words are alive; cut them and they bleed." -Ralph Waldo Emerson



Sunday, May 30, 2010

Pray, State Legislature



Summer Prayer For the Ohio State Legislature

Lord, give me strength to lay down the fight,
To drive away from my load unencumbered
To my hallowed summer retreat
And enjoy my well-earned holiday
With those closest to me.

Father, let not the specters of those now afflicted
And the souls of those long cold
Frequent my daily thoughts
And remind me of my duly sworn promises
To uphold the public good.


As my suffering Southern contingent 
Sweats through another sweltering, humid summer
Accentuated by the overflow of casualties
And mournful cries of ruined mothers,
Pray I can utter, "This fall we will bring them justice."

As Thy kingdom has yet come and Thy will is not yet done
In the depressed, poisoned poverty fields of Appalachia,
Where overdosed addicts and hepatitis victims free roam,
Make me comprehend that my thorough, immediate action
Is never really expected in this Land of Lost Hopes and Promises.


And, Father, forgive my tabled trespasses and lobbied transgressions,
For I am serving my closest appointed interests of State to earn my daily bread.
Please lead me not into temptation to close my eyes on the distant poor
And cast them to visions of opening my carefully measured resources
To buckeye kingdoms of greater population and political influence.

Finally, Lord, help restore unto me my power and glory
When my rest is done and new assemblage has come.
After the much-debated pain clinics have run amuck
And heavily fertilized hilly grounds with their lawless carnage 
In the name of this crippling State-sponsored suicide.

Saturday, May 29, 2010

Surviving a Death to Drugs



One thing I have witnessed over and over lately is the incredible toll taken on an individual upon the sudden death of a single loved one. The survivor's grief staggers comprehension and continues each day without soothing relief. Even remnants of sweet moments together barely console the living because of the tragedy's sharp edges that continue to cut through seeping wounds.

Those left to suffer the grievous pain often relive past times in hopes that their recollections will somehow open avenues for their departed angels to have one more priceless, desperate grasp at life. And, even if this bitter-sweet exercise poses inner hope for a while, reality soon returns rudely to shake the dreamers from their brief respite.



I Died a Drug Addict

I died a drug addict.
But I once laughed and played by your side
And held onto your warm, safe hand at the street corner
Or ran short races together through our sheltered innocence.

I died a drug addict.
I had planned on college and a job and children:
Those nice things to get ahead and rightly claim
My slice of the good life ahead.

I died a drug addict.
I thought I was too strong and too beautiful
To let any common devious master chain me
To its powerful prescriptive powers

I died a drug addict.
I craved something missing in my life
As humans most often do
But, instead of treasure, I found a faithless, dependent dream.

I died a drug addict.
I lost love as I courted pleasure,
And you cursed my wild fantasy
To prevent my costly consumption of intoxication.                                                               

I died a drug addict.
As I devoured fix after fix until I demonized myself
And began turning violently inside out
Through a dealer's greed and unimagined abuse.

I died a drug addict.
I lived defiled, stained, and unclean
While ruthlessly stealing and abusing
Anything and anyone for my next short-lived, satisfying fix.

I died a drug addict. 
But you forgot I was once your bright-eyed doting one
Of honor rolls, of sports teams, and of school programs,
Worthy of community adoration and pride.


I died a drug addict.
But you forgot I wasn't always an incorrigible whore.
Born not a psychopath, nor a manic depressive, nor a kleptomaniac
But instead induced into a chemical monstrosity by choice.

I died a drug addict.
But you thought I might defeat the illness
With every slight improvement
And regain full control, unbound by my restrictive chains.

I died a drug addict.
But you prayed for assurances of the past

When I used to want to tell you the truth. 
And place the burden for my poor choices in your hands.


I died a drug addict.
But you forgot saying, "God, please stop!" no longer worked,
Before a deluge of toxic consumption 
Drowned me under its poisonous waters. 

I died a drug addict.
Left in helpless, writhing agony
On a dark, lost highway
As some forgotten, filthy refuse.

I died a drug addict.
For the sins of the lazy politician,
For the sins of the poverty-abusing, rich business people,
For the sins of the greedy medical professionals,
For the sins of the crooked law enforcement officials, 
For the sins of the unethical criminals and gangsters,
For the sins of the foul pushers and dealers,
For the sins of the abusing fathers and mothers,
For the sins of the meek silent majority who witnessed and did nothing,
For the sins of the other diseased drug addicts,
For the sins of my dreadful, weak self.

I died a drug addict.
Remember me with compassion and not contempt.
Use soothing words and kind actions in my name
To save one whom you most detest.

Frank R. Thompson


Crying out in anger or in grief is not enough to stop the madness of death around us in Appalachia. People have not joined together in mass to fight the powers that be. Without thousands of those willing to dedicate themselves to the elimination of this problem, drug abuse (in particular Rx drug abuse and pill mill deaths) is not going to be actively corrected in time.

I thank everyone so much for joining the "Fix the Scioto County Problem of Drug Abuse" group, but now, we must write the Ohio legislature before they break for the summer because they do not reconvene until much later this year. Unless we put mass pressure on our legislators, we will not have a bill passed before summer break. This means many more people will die needlessly. Please, in the next couple of days, look for our addresses and write letters to the proper legislators. I beg you - this is the way to make the law become a reality. Scioto County is leading the way as a model for a grass roots reaction for many other localities in the nation suffering with this problem. Look for our addresses soon, then please fire off those letters - hopefully thousands!

We must understand our problem and dilemma better. Please attend with Jo Anna Donini Krohn's SOLACE group at the event below. Not only will you understand the position of the Scioto County Rx Drug Action Team, that of the Fix the Scioto County Problem of Drug Abuse, but also that of many concerned citizens. This event will emphasize the reality of the state of our county.

SOLACE Support Group invites EVERYONE to come to a Memorial Service for those we have lost to a drug-related death. Take a stand against drug abuse and join us to pay tribute to those we have lost. Saturday June 5th at Cornerstone United Methodist Church, 4:30 - 6:00. Pastor Kym James will be leading the service, and Dr. Clyde Fenton will be in charge of the music. We want all the church bells in Portsmouth to chime together at 4:00.

Thursday, May 27, 2010

Dreams and Ambitions and Reality


Youthful declarations of ambitions and dreams once filled our notebooks, our high school annuals, and our hopeful thoughts. We carefully chose class superlatives and wrote prophecies about our friends based upon their scholastic achievements, sports prowess, popularity, and early success. As reality began to replace the safety-net world of high school, we attempted to adjust our desires and discover new methods for attaining future lives that fit our changing circumstances. Many found it difficult to leave a Disneyland existence to step into a job, a college, or a raging war.

For many people, this sudden requirement to change meant altering the pace and the desire of achieving their earlier plans for life. And, eventually, many of us merely changed our dreams because we made new realizations of whom we really were and what skills and resources we really had. For most, cold reality meant a stinging "smack in the face" and a recalculation of our versions of the elusive "American Dream," a promise given as a birthright in the United States.

As major decisions occurred in our lives, we merely made them, hoping at the time that we had chosen the right course to a successful tomorrow. Planning and thought went into these life-altering steps into an obscure future, but usually still a high degree of uncertainty remained after we chose the new-charted course. Often, today, we look back at career and social moves made in relative haste with thanksgiving that our prayers had allowed us to choose a risky option correctly. And still, exactly how we chose our individual paths remains a mystery.


Factors Affecting The Dreams of Youth Today

Now, most maturing Americans want their realities to strike a healthy balance between their public and private lives: between the lure of fame and glory, and a love of home and hearth. For their part, many women fully expect to do their share as breadwinners, though not necessarily out of personal choice so much as financial need.

Also, the fear of divorce hangs heavily over young men and women. Nearly three-quarters of those in a Time Magazine poll said that having a good marriage today is difficult or very difficult. More than half would not choose a marriage like their parents', and 85% think they are even more likely to see their marriages end in divorce than did their parents' generation.

Speaking of the new generation, Leslie Wolfe of the Women Policy Studies Center says, "I think they are more savvy than we were, about sexism, about discrimination, about balancing work and family, about sex." They may be wiser, too, about seizing fresh opportunities without losing sight of tradition. ("The Road to Equality: The Dreams of Youth," Time, November 8 1990)


What Does It Mean?

I wonder if the same fateful moments the Baby Boomers faced are occurring and will continue to occur with the Millennials, or Echo Boomer generation. Since everything seems more structured, planned, and sequenced now, will these young people still face many unknown fates or will they travel more charted waters as they seek their futures? Much of society certainly believes that they are capable of withstanding the stresses and complications of adulthood earlier in life than the Baby Boomers and that they can face it without passage through innocence.

I preferred our method of trial and error. Even though we possessed a ton of misinformation and sketchy detail as well as lacked the electronic resources available to young people today, we most often "fell" into some comfortable, fruitful positions in life. Sometimes, I marvel at just exactly how this occurred. And, true for some, their decisions left them cold and unprotected, yet many of these same people long for a return to a slower maturation for their own young adults. Different decisions do different lives make and also different preferable conditions of living.

Somebody once said the most appropriate question about a great life should be "Are you happy?" An article in Men's Health ("Are You Happy?" 2010) asked: "What makes people happy? Why do millionaires often seem wretched, whereas slum dwellers in Calcutta profess to be content? Why do we find satisfaction in activities that are painful in the actual experience, like running a marathon or rowing a 5000-meter crew race -- or being branded in a tribal ritual?" Read the article and ask yourself the question after your review. You may be quite surprised.

http://www.menshealth.com/men/health/stress-management/are-you-happy/article/f83a74647ac98010vgnvcm200000cee793cd


The Hopes and Dreams of Youth
By Katie Davis
(Contact: JCLivesNme05@aol.com)

As I sit here,
I feel like an old woman,
Looking back on her life,
Her eyes full of pain,
Her mind heavy with regret,
Her soul filled with the pain of missed chances,
Her heart cut to the quick with loneliness.
I feel like an old woman,
Filled with remorse,
And knowing it's too late,
Too late to start over,
Too late to go back,
Too late to change the future,
Too late to change the past.
I once was a girl filled with hope.
I am now a woman,
Filled with knowledge.
Knowledge that nothing will ever be,
What it could have been.
Knowing that there will always be hope.
And knowing that the very things you hope for,
Will never be.
And knowing that as hard as you might try,
The hopes and dreams of Youth,
Will never again be there,
Will never again be filled with the promise,
Will never again be filled with real hope.
As I sit here,
I feel like an old woman,
Whose tears that fall,
Don't really matter.


Wednesday, May 26, 2010

How Large Is Your Family?


People grace their loved ones with prayer, concern, and attention. And, this is how it should be. Yet, how often do these same people think of a larger family of mankind other than to acknowledge their problems and to comfortably view their plight from a safe distance? From family to friend to casual acquaintance to stranger -- not only bonds loosen with less acquaintance but also concerns about those less known lesson. Geography also encourages lack of concern as ties diminish from home to town to state to area to nation to world. To expect small group coherence is one thing but to even suggest loving large groups is often considered unpatriotic and absurd.

Most people push stereotypes of strangers to those around them to solidify the advantages of sameness. As people age, they show this conditioned distrust of certain racial, social and national groups. Sacred beliefs or religion even pull people apart when they collide. And, personalities? Certain folks don't "look right" or "dress right" or "act right." Any true family of mankind quickly learns that the accepted "family" in the phrase contains conditions and limitations. But should we limit our help and accept our appointed place in the scheme we inherit?


Age actually feeds ignorance in this manner. Resistance to things foreign is illustrated in the cliche' "You can't teach an old dog new tricks." The gap implied here is accepted by most individuals as proof of the frivolity of attempting to change those minds set to certain understandings reinforced by life experiences. The limitations become a mindset and supply ammunition for stunted thinking. Herein lies a trap.

What if the contributions to a family of mankind were actually as important, or in some cases even more important, as the contributions to close family and friends? How might this ranking of priorities affect the relationships of people dealing with other people? Would it upset the friendly small units of familiar friends or would it serve to make them stronger in a sense of a larger community?


As I consider these questions, I consider the complete strangers who have positively influenced my life by taking an interest in me for little or no apparent reason. Without these people, I am sure I would have missed valuable lessons and tremendous opportunities to advance. Without taking some risks with strangers, I would be less of a person today. I am quite certain I owe this same assistance to many I am yet to meet. I pray I may repay, at least in part.

I have seen every valuable human quality displayed in some of the most unusual places by some of the least worthy individuals. Not all wonderful people have every positive asset although many think so. Some have many, some a handful, and some just one. I can't help but wonder that, with support and help, many of the least of people would become many of the best of people. In fact, I know this is true. I have seen the evidence.

In conclusion, my sincere advice is to open up an opportunity or two to reach beyond a comfort zone. If, for no other reason, you may find others will "reach beyond" with you. Maybe a complete stranger will also identify your faults and apply a needed salve. I have no use for perfection and no belief in its existence in this world. I would rather offer a little rougher edge to work with good people with faults of their own.

Tuesday, May 25, 2010

Another Man Done Gone - Factors in Male Prescription Abuse


Prescription Drug Abuse Research

A statement from the United States Department of Health and Human Services by Director Nora D. Volkow, M.D. before the Subcommittee on Criminal Justice, Drug Policy, and Human Resources on July 26, 2006: 

 
"The recent increase in the extent of prescription drug abuse in this country is likely the result of a confluence of factors, such as: significant increases in the number of prescriptions;1 significant increases in drug availability;2
aggressive marketing by the pharmaceutical industry; 3 the proliferation of illegal Internet pharmacies that dispense these medications without proper prescriptions and surveillance;4 and a greater social acceptability for medicating a growing number of conditions. The fact that doctors are prescribing these drugs legitimately and with increasing frequency to treat a variety of ailments leads to the misguided and dangerous conclusion that their non-medical use should be equally safe. This misperception of safety may contribute, for example, to the casual attitude of many college students towards abusing stimulants to improve cognitive function and academic performance." 

1 See, e.g., Zacny et. al., College on Problems of Drug Dependence taskforce on Prescription Opioid Non-Medical Use and Abuse: Position Statements, Drug and Alcohol Dependence 69 (2003) 25-232; and Compton and Volkow, Major Increases in Opioid Analgesic Abuse in the U.S.: Concerns and Strategies, Drug and Alcohol Dependence 81 (2006) 103-107. These citations include information from IMS Health's National Prescription Audit.
2 See, e.g., McCabe et al, Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs, Journal of American College Health 54 (2006) 269-278.
3 See, e.g., United States General Accounting Office, Prescription Drugs - Oxycontin Abuse and Diversion and Efforts to Address the Problem, GAO-04-110, 12/2003
4 See, e.g., Forman et al, The Availability of Web Sites Offering to Sell Opioid Medications Without Prescriptions, American Journal of Psychiatry 163 (2006) 1233-1238.


Men Who Misuse Opioids

Recent research reports that women who misuse pain drugs tend to display signs of emotional issues and affective distress, compared with men. Men, on the other hand, tend to show signs of worrisome behaviors, such as association with other people who abuse drugs and alcohol and engage in criminal behavior. (R. Jamison, The Journal of Pain, April 2010) The research recommends that men who are being treated with opioids need closer monitoring of known or suspected behavioral problems, frequent urine screens, pill counts, and compliance monitoring to help reduce risks for drug misuse.

At Boston University School of Medicine, researchers have identified clinical characteristics associated with prescription drug use disorder (PDUD) in primary care patients with chronic pain. The study found that by identifying characteristics of prescription drug abuse, primary care clinicians can identify those at risk and provide appropriate treatment. This study was funded by the National Institute of Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. (Jane M. Liebschutz, Richard Saitz, Roger D. Weiss, Tali Averbuch, Sonia Schwartz, Ellen C. Meltzer, Elazabeth Claggett-Borne, Howard Cabral, Jeffrey H. Samet, "Clinical Factors Associated with Prescription Drug Use Disorder in Urban Primary Care Patients with Chronic Pain," The Journal of Pain, 2010)

In a study to examine the clinical characteristics of individuals with lifetime PDUD, among a population of primary care patients with chronic pain, the researched compared those afflicted with PDUD to individuals with other substance use disorders (SUD) as well as those without any history of SUD. Participants recruited for the study experienced chronic pain for more than three months, and they reported use of prescription or non-prescription pain medications. (reported as "Researchers Define Traits Associated With Prescription Drug Disorders In a Primary Care Setting," ScienceDaily, May 14 2010)

Of nearly 600 participants studied, researchers found that 18 percent had lifetime PDUD of which in this subgroup 90 percent had an additional substance addiction. More than 24 percent had an SUD other than PDUD, and 57 percent had no lifetime history of any substance problem. Of note however, only 60 were female, and 60 percent were of African decent and likely to be unemployed and poor.


The study identified a number of factors associated with PDUD and SUD:

1. Jail Time,
2. Severely Disabling Pain,
3. Cigarette Smoking,
4. Family History of Drug Abuse,
5. White (Not For SUD),
6. Male,
7. Post-traumatic Stress Disorder.


The study identified factors not associated with Substance Use Disorders:


1. Insurance,
2. Employment,
3. Income,
4. Education,
5. Age.

"This data strongly suggests that physicians treating patients with pain should assess for SUD prior to prescribing opioid analgesics," lead author Jane M. Liebschutz, MD, MPH, FACP, an associate professor of medicine and social and behavioral sciences at BUSM and a physician in the section of General Internal Medicine at Boston Medical Center. "This research may help direct care, including treatment for pain substance use disorders, as primary care physicians may not be as aware of the overlap between pain and addictions.

In particular, physicians may not think of assessing for time spent in jail, which was the largest predictor of having PDUD," said Liebschutz.

Prescription Abuse - Why Begin? Special Issue on Women


Why? Why did this beautiful young person choose to risk addiction by taking illegal prescription drugs? That is the question that is repeated time and again by relatives and friends throughout areas of severe addiction. Nothing could possibly hurt worse than the unexpected loss of a loved one due to the evil control of addictive prescription drugs. The grief is unthinkable for those left in the wake. I believe no one answer to this question exists; however, we need to be vigilant and aware of danger signs.

A sobering reminder of the problem shows an analysis of 168,900 autopsies conducted in Florida in 2007 found that three times as many people were killed by legal drugs as by cocaine, heroin and all methamphetamines put together. According to state law enforcement officials, this is staggering evidence of the burgeoning prescription drug abuse problem.When will it peak or will it even peak at all?
   
"The abuse has reached epidemic proportions," said Lisa McElhaney, a sergeant in the pharmaceutical drug diversion unit of the Broward County Sheriff's Office. "It's just explosive."

"All this stuff is poison," Tuolumne County, Calififornia, Sheriff's Office Deputy Dan Crow Crow said. "Your body will fight all of this stuff." Tuolumne County Health Officer Todd Stolp agreed. A prescription drug taken recreationally is "much like a firearm in the hands of someone who's not trained to use them," he said. 

So, why do people subject themselves to this absolute form of Russian roulette played with pharmaceutical bullets?


Harvard Study

In recent research from a study involving 662 chronic noncancer patients taking opioid drugs for pain relief, Robert N. Jamison, PhD, a clinical psychologist at Harvard's Brigham and Women's Hospital, found misuse of prescription drugs by women seemed to be closely related to psychological distress while prescription pain drugs were more likely to be misused by men who had social and behavioral problems.

Jamison wrote that women in the study tended to display signs of emotional issues and affective distress, compared with men. For women, a history of sexual abuse was an issue in later misuse of prescription drugs. "These results are in agreement with past research that highlighted the importance of sexual and physical abuse history in predicting opioid misuse." said Jamison. "These same studies also showed that women with a significant history of anxiety and depression tended to do less well in properly managing opioids prescribed for pain, possibly because of the tendency to self-medicate a mood disorder using opioids." (Robert Jamison, The Journal of Pain, American Pain Society, vol. 11, April 2010)

The research also concluded that past studies had suggested that women might be more likely to be open and truthful about behaviors and more likely to seek psychological help than men.


Men who misused prescription drugs tended to show signs of worrisome behaviors, such as association with other people who abused drugs and alcohol and engaging in criminal behavior.


"Given the prominence of sex differences in a variety of pain-related processes, we may eventually arrive at a method for tailoring risk assessment and risk-reducing interventions in part as a function of gender," the Jamison and his fellow researchers said, adding that more research is called for by their study.


University of Michigan Study

Seven percent of college students have used prescription stimulants for non-medical purposes over their lifetimes and 4 percent have used in the past year, according to a study of students at 119 four-year colleges and universities nationwide published in the January issue of the journal Addiction. The study was supported by grants from the Robert Wood Johnson Foundation and the National Institute on Drug Abuse.

Science Daily (January 13, 2005) reported seven percent of college students have used prescription stimulants for non-medical purposes over their lifetimes and 4 percent have used in the past year, according to a study of students at 119 four-year colleges and universities nationwide published in the January issue of the journal Addiction. ("7 Percent Of College Students Used Prescription Drugs As Stimulants For Non-medical Purposes," ScienceDaily, January 13 2005)
   

This national study, led by a University of Michigan researcher and based on data from the Harvard School of Public Health College Alcohol Study, found that past year rates ranged from none to 25 percent at individual colleges and universities. Students attending three historically black colleges reported the lowest rate (none) of non-medical prescription stimulant use.

Reported use was higher among students who were male, white and members of fraternities. The study also showed that abuse of non-medical prescription stimulants was higher among women who are members of sororities.

The study also found that students who use prescription stimulants non-medically are more likely to abuse other substances such as alcohol, marijuana, ecstasy and cocaine. "They are also more likely to engage in other risky behaviors such as driving after heavy drinking," said Sean Esteban McCabe, lead author of the study and assistant research scientist at the University of Michigan Substance Abuse Research Center.

In a rather astounding finding, researchers said non-medical prescription stimulant users were over 20 times more likely to report cocaine use in the past year. They were also over five times more likely to report driving after heavy drinking than college students who had not used prescription stimulants non-medically.

The highest rates of non-medical use of prescription stimulants occurred on college campuses in the Northeastern region of the United States, schools with highly competitive admissions criteria and those college campuses with higher rates of binge drinking, the study finds.

The study concluded males were nearly twice as likely as women to report the non-medical use. (Notice, this is in contrast to findings by Jamison's 2010 study.)

White students were also more likely than Asian and African-American students to report non-medical use. Grade point was also associated with non-medical stimulant use.

Students with grade point averages of B or lower were two times more likely to use prescription stimulants non-medically than those earning a B-plus or higher grade point average.


Research About Women - Reasons For Psychological Distress In Gifted Women

1. Emotional issues become apparent to some women who have become nvolved in serious relationship in the college or graduate school years, or who had children later in their lives.

2. Older women resolve many personal issues relating to ability and social issues experience by younger girls. And some dilemmas shift or are resolved due to changes in a woman's life, such as maturation of their children, the dissolution of a relationship, the reemergence of their relationships, or a change in environments at work or at home. Some dilemmas simply cannot be resolved to the satisfaction of everyone involved.

3. Many young women believe they can "do it all" or "have it all," while many older women have learned they cannot -- ambivalence about their future caused hopes and career dreams to waver.

4. Almost from birth, females find themselves in a world of limiting stereotypes and barriers to achievement. Research has identified external barriers that seem to negatively influence the development of talents and gifts in some gifted girls and women. These barriers include the role of parents, school, and the environment in general, as well as the need to develop a set of philosophical beliefs that is essential to the development of creative and academic potential. In a male-dominated society, a female may have difficulty developing her own philosophical beliefs.

5. Parents' beliefs about children's abilities may have an even greater effect on children's self-perceptions than previous performance (Parsons, Adler, & Kaczala, 1982). Phillips (1987) confirmed this finding in her study of high ability students, and a recent study of parental influence on math self-concept with gifted female adolescents as subjects found consistently significant correlations between parent expectations and student math self-concept (Dickens, 1990). Messages about opinions sent by subtle and not-so-subtle verbal and nonverbal interactions may encourage or discourage girls for life.


6. Kramer (1985) found that teachers were usually able to identify gifted boys, but were often surprised to learn that a girl was considered smart. The gifted girls in her study were very successful at hiding their intelligence and in silencing their voices. In another analysis of research about adult perceptions of girls' intelligence, Myra and David Sadker (1994) stated that "study after study has shown that adults, both teachers and parents, underestimate the intelligence of girls" (p. 95). Kissane (1986) found that teachers are less accurate in nominating girls who are likely to do well on the quantitative subtest of the SAT than they were in naming boys who were likely to achieve a high score. Both male and female teachers regarded smart boys as more competent than gifted girls in critical and logical thinking skills and in creative problem-solving abilities, while they thought smart girls were more competent in creative writing.

7. Teachers have been found to believe and reinforce one of the most prevalent sex stereotypes-that males have more innate ability, while females must work harder. Fennema (1990), commenting on the role of teacher beliefs on mathematics performance, reported that, in a study she conducted with Peterson, Carpenter, and Lubinski, "teachers selected ability as the cause of their most capable males' success 58% of the time, and the cause of their best females' success only 33% of the time." Girls may internalize these lowered expectations very early in life.

8. Personality factors that influence women include: dilemmas about abilities and talents; personal choices about family; choices about duty and caring and nurturing the talents in oneself as opposed to putting the needs of others first; religious and social issues which consistently affect women across their lifespans; poor planning; hiding abilities and differences; perfectionism; attributing success to luck rather to ability; poor choice of partners; and confusing messages from home about politeness (Reis, 1998).

9. Some research and reviews of research (Arnold, 1995; Bell, 1989; Cramer, 1989; Hany, 1994; Kramer, 1991; Leroux, 1988; Perleth & Heller, 1994; Reis & Callahan, 1989; Subotnik, 1988) have indicated that some gifted females begin to lose self-confidence in elementary school and continue this loss through college and graduate school. These girls may grow to increasingly doubt their intellectual competence, perceive themselves as less capable than they actually are, and believe that boys can rely on innate ability while they must work harder to succeed.Thus, they lose their enthusiasm for learning and speaking out.

10. Some research indicates that gifted girls believe it is a social disadvantage to be smart because of the negative reactions of peers. Fearing their peers' disapproval, bright young women may deliberately understate their abilities in order to avoid being seen as physically unattractive or lacking in social competence. In other words, they may "play dumb." (Bell, 1989; Buescher, Olszewski, & Higham, 1987; Eccles, Midgley, & Adler, 1984; Kerr, Colangelo, & Gaeth, 1988; Kramer, 1991; Reis, 1987, 1995; Reis, Callahan, & Goldsmith, 1996)

11.Perfectionism can cause talented women to set unreasonable goals for themselves and to strive to achieve at increasingly higher levels. It also can cause women to strive to achieve impossible goals and spend their lives trying to achieve perfection in work, home, body, children, wardrobe, and other areas. (Hamachek;1978) They developed a fixation about making mistakes. Unlike the healthy female perfectionists, they viewed their parents' perfectionism negatively, and perceived parental expectations as demands to be perfect in everything they did.

Sources Used by Dr. Sally M. Reis, SENG Newsletter, 2 (3)1-5 2002

"Social and Emotional Issues"
Dr. Sally M. Reis




Arnold, K. D. (1995). Lives of Promise. San Francisco: Jossey-Bass Publishers.

Bell, L. A. (1989). Something's wrong here and it's not me: Challenging the dilemmas that block girls' success. Journal for the Education of the Gifted, 12(2), 118-130.


Buescher, T. M., Olszewski, P., & Higham, S. J. (1987). Influences on strategies adolescents use to cope with their own recognized talents. (Report No. EC 200 755). Paper presented at the biennial meeting of the Society for Research in Child Development, Baltimore, MD.

Callahan, C. M., Cunningham, C. M., & Plucker, J. A. (1994). Foundations for the future: The socio-emotional development of gifted, adolescent women. Roeper Review, 17, 99-105.

Cooley, D., Chauvin, J., & Karnes, F. (1984). Gifted females: A comparison of attitudes by male and female teachers. Roeper Review, 6, 164-167.

Cramer, R. H. (1989). Attitudes of gifted boys and girls towards math: A qualitative study. Roeper Review, 11, 128-133.

Dickens, M. N. (1990). Parental influences on the mathematics self-concept of high achieving adolescent girls. Unpublished doctoral dissertation, University of Virginia, Charlottesville.

Eccles, J. S., Midgley, C., & Adler, T. F. (1984). Grade-related changes in the school environment: Effects on achievement motivation. In J. Nicholls (Ed.), Advances in motivation and achievement (Vol. 3, pp. 283-331). Greenwich, CT: JAI Press.

Fennema, E., Peterson, P.L., Carpenter, T.P., & Lubinski, C.A. (1990). Teachers' attributions and beliefs about girls, boys and mathematics. Educational Studies in Mathematics, 21, 55-69.

Hamachek, D. E. (1978). Psychodynamics of normal and neurotic perfectionism. Psychology, 15, 27-33.

Hany, E. A. (1994). The development of basic cognitive components of technical creativity: A longitudinal comparison of children and youth with high and average intelligence. In R. F. Subotnik & K. D. Arnold (Eds.), Beyond Terman: Contemporary longitudinal studies of giftedness and talent (pp. 115-154). Norwood, NJ: Ablex.

Hess, R. D., Holloway, S. D., Dickson, W. P., & Price, G. G. (1984). Maternal variables as predictors of children's school readiness and later achievement in vocabulary and mathematics in sixth grade. Child Development, 55, 1902-1912.

Kimball, M. M. (1989). A new perspective on women's math achievement. Psychological Bulletin, 105, 198-214.

Kissane, B. V. (1986). Selection of mathematically talented students. Educational Studies in Mathematics, 17, 221-241.

Kline, B. E., & Short, E. B. (1991). Changes in emotional resilience: Gifted adolescent females. Roeper Review, 13, 118-121.

Kramer, L. R. (1991). The social construction of ability perceptions: An ethnographic study of gifted adolescent girls. Journal of Early Adolescence, 11(3), 340-362.

Leroux, J. A. (1988). Voices from the classroom: Academic and social self-concepts of gifted adolescents. Journal for the Education of the Gifted, 11(3), 3-18.

McGillicuddy-De Lisi, A. V. (1985). The relationship between parental beliefs and children's cognitive level. In R. Sigel (Ed.), Parental belief systems (pp. 7-24). Hillsdale, NJ: Erlbaum.


Parsons, J. E., Adler, T. F., & Kaczala, C. (1982). Socialization of achievement attitudes and beliefs: Parental influences. Child Development, 53, 310-321.

Perleth, C., & Heller, K. A. (1994). The Munich longitudinal study of giftedness. In R. F. Subotnik & K. K. Arnold (Eds.), Beyond Terman: Contemporary longitudinal studies of giftedness and talent (pp. 77-114). Norwood, NJ: Ablex

Phillips, D.A. (1987). Socialization of perceived academic competence among highly competent children. Child Development, 58, 1308-1320.

Reis, S. M. (1987). We can't change what we don't recognize: Understanding the special needs of gifted females. Gifted Child Quarterly, 31, 83-89

Reis, S. M. (1995). Talent ignored, talent diverted: The cultural context underlying giftedness in females. Gifted Child Quarterly, 39(3), 162-170.

Reis, S. M. (1998). Work left undone: compromises and challenges of talented females. Mansfield Ctr., CT: Creative Learning Press.

Reis, S. M., & Callahan, C. M. (1989). Gifted females: They've come a long way-or have they? Journal for the Education of the Gifted, 12(2), 99-117.

Reis, S. M., Callahan, C. M., & Goldsmith, D. (1996). Attitudes of adolescent gifted girls and boys toward education, achievement, and the future. In K. D. Arnold, K. D. Noble., & R. F. Subotnik (Eds.), Remarkable women: Perspectives on female talent development (pp. 209-224). Cresskill, NJ: Hampton Press, Inc.

Reis, S. M., Hébert, T. P., Diaz, E. I., Maxfield, L. R., & Ratley, M. E. (1995). Case studies of talented students who achieve and underachieve in an urban high school. Manuscript in preparation.

Sadker, M., & Sadker, D. (1994). Failing at fairness: How America's schools cheat girls. New York: Charles Scribner's Sons.

Schuler, P. A. (1997). Characteristics and perceptions of perfectionism in gifted adolescents in a rural school environment. Unpublished doctoral dissertation, University of Connecticut, Storrs.

Stevenson, H. W., & Newman, R. S. (1986). Long-term prediction of achievement in mathematics and reading. Child Development, 57, 646-659.

Subotnik, R. (1988). The motivation to experiment: A study of gifted adolescents' attitudes toward scientific research. Journal for the Education of the Gifted, 11(3), 19-35.

Sunday, May 23, 2010

Pills and More Pills



Who Knows Where Illegal Drugs Originate and Who Acquires Them?

Over many years, pharmaceutical abusers have typically acquired drugs through doctor-shopping, forged prescriptions, or unscrupulous physicians and pharmacists working alone or in association; however, many of these individuals have been dissuaded from using these methods because of prescription monitoring programs (PMPs) and increased law enforcement scrutiny. So, of course, many ever-resourceful abusers have shifted to other means of obtaining pharmaceuticals such as theft, purchases from Internet pharmacies, or acquisitions from retail distributors.



EHR Debate

The debate over electronic health records (EHRs) has been gaining great attention. Some people are concerned about privacy while others are worried that EHRs will help the government with a takeover of healthcare. But few have focused on the potential benefits to patients. (Emily Singer, www.technologyreview.com, February 23 2009)

Technology Review reports some benefits to EHRs:

1. Hospitals with the most effective electronic medical record systems had healthier patients--they saw fewer deaths and complications--and lower bills. Researchers at John Hopkins University School of Medicine found that hospitals that rated highly on automated note taking had a 15 percent decrease in the odds that a patient would die while hospitalized. Hospitals with highly rated decision-support systems also had 20 percent lower complication rates. The researchers also found that electronic systems reduced costs by about $100 to $500 per admission. In summary, hospitals with automated notes and records, order entry, and clinical decision support had few complications, lower mortality rates, and lower costs. (Ruben Amarasingham, MD; Laura S Plantinga, ScM; Diener-West, PhD; Darrell J. Gaskin, PhD; Neil R. Powe, MD; Arch Intern Med; 169; 2009)


2. Electronic systems also seem to improve preventative medicine by boosting screening. A study from Harvard Medical School found that patients who were sent reminders for colorectal cancer screenings, which were generated from electronic medical data, were more likely to get themselves screened. Electronic reminders sent to physicians had no effect on screening rates, suggesting that patients may be an untapped resource in their own preventative healthcare. (Thomas D. Sequist, MD; Alan M. Zaslavsky, PhD; Richard Marshall, MD; Robert H. Fletcher, MD; John Z. Avanian, MD, Arch Intern Med.; 169; 2009)
  
3. Also, in the first study of its kind, Richard Tannen, M.D., Professor of Medicine at the University of Pennsylvania School of Medicine, led a team of researchers to find out if patient data, as captured by EMR databases, could be used to obtain vital information as effectively as randomized clinical trials, when evaluating drug therapies. (Karen Kreeger, "Penn Studies Show How How Electronic Medical Records Can Be Used to Test Drug Efficacy," www.eurekalert.org/pub, February 6 2009) According to research published in the British Medical Journal, statistical analysis of electronic medical record databases mimics results of clinical trials, predicting which drugs work best. This kind of data wouldn't replace clinical trials, but some scientists say EMRs could be used to supplement clinical trial data, to look at a drug's effectiveness in a more diverse population, for example. 

4. People might also have access to their own health data online through EMRs -- seeing their weight along with their cholesterol and blood pressure measurements plotted out over time, for example, is a good impetus to keep these measurements in check.

If these records showed all meds prescribed and purchased it would help pharmacists and physicians to curb prescription drug abuse. The information could be exempt from use in prosecuting the patient, but used to track providers who were over prescribing controlled meds. Prescription drug abuse is about as prevalent as illegal drug abuse. Many people sell their prescription drugs on the street for cash. Doctor shopping is a common practice, and is a real problem for ERs and providers, not to mention a nightmare that facilitates drug addiction.



Resistance To Changes

Here is an description of another fight for tracking of prescription drugs in California. (Andrew Pollack, "California Delays Time to Track Prescription Drugs," The New York Times, March 26 2008) California regulators agreed to delay by two years a requirement that all prescription drugs be electronically tracked as a means of thwarting counterfeiting.

"Pharmaceutical manufacturers told the California board that putting a unique serial number on each container would require changing their packaging lines, which would cost millions of dollars and take years. 

In a reprieve for the pharmaceutical industry, California regulators agreed on Tuesday to delay by two years a requirement that all prescription drugs be electronically tracked as a means of thwarting counterfeiting.

The California plan was to take effect next Jan. 1. And given California’s size and the ambitiousness of its plan, some experts expected the California system to become the de facto standard for the nation.

But in a meeting here on Tuesday, the California State Board of Pharmacy voted to delay the requirement until Jan. 1, 2011.

The vote was a response to complaints from drug manufacturers, distributors and retail pharmacists that they could not possibly be ready by next January. And rather than violate the law, they said, they would have to stop selling drugs in California.

“The vast majority of product will not move starting Jan. 1, 2009,” Ronald N. Bone, a senior vice president at McKesson Pharmaceutical, a large distributor, warned the board before its vote. He said only 100 of 650 drug manufacturers surveyed by McKesson would be ready to put the tracking system into effect by the deadline.
Some board members were skeptical of the industry’s arguments, saying a delay would leave patients at risk of getting fake or adulterated drugs.

“All I’m getting is ‘We can’t do it, we can’t do it, it’s too expensive,’ ” said a board member, D. Timothy Dazé. 

“And I ask, ‘What value do you folks put on a life?’ ” (Pollack)

Ohio Tracking

Even as Governor Strickland's new task force looks for better ways to stifle prescription abuse, law enforcement already has some tools. Doctors, pharmacies and law enforcement have a database they can check to see if someone is receiving the same or similar prescriptions from several doctors. Strickland charged the task force with pursuing additional strategies to increase the use of Rx reporting by doctors and pharmacists.
The Ohio Automated Rx Reporting System (OARRS) tracks every time an opioid or opioid derivative, which includes most painkillers, are prescribed or dispensed. If a registered authority types in the name of the person receiving the prescription, the OARRS will tell them what doctor prescribed it and what pharmacy gave it to him.

OARRS in Ohio is voluntary, not mandatory. So, it is a tool but cannot, in itself, be used as evidence in court. Hard copies will be required. So, the effectiveness against pill mill operations is very insignificant.

While all doctors and pharmacists report into the system, only one in five use it when filling prescriptions, according to Strickland's office. One of the goals of the Ohio Prescription Drug Abuse Task Force (OPDATF) is to increase the number of doctors and pharmacists who use OARRS.

Saturday, May 22, 2010

Proud In Appalachia

I Am a Proud Appalachian


I am 22 million of America’s finest but most-ridiculed minority.                                                      
Call me Scotch, Irish, English, Huguenot, Native American, Melungeon, African American or European
And know me as a proud Appalachian:                                                                                       
Not as a hillbilly, not as a redneck and not as a cracker.

Many outside my geographic area stereotype me with comic common values, traits, or characteristics.                                                                                                                      
They prefer to keep me within the boundaries of their neglect and shallow despair    
While blaming me for my just rewards due to my own laziness and stupidity.

In truth, even if my pockets are light, my cultural heritage is among the richest in the land.                               
I have lived so long with lies and half-truths about my ancestors                               
That I occasionally laugh at my own dialect when others believe it reveals my lack of higher education.  

I am known for neighborliness, humility, sense of humor and modesty,                  
And, I am quick to respond to a needy neighbor in any emergency or trouble,                        
But I ruffle easily when others disrespect my religion, my independence, my self-reliance, and my patriotism.


I, as an Appalachian, believe in a real and functioning society,                                                                   Not in a world that would have me put on airs and display them in public                                                    Or boast about getting above my common rural raising.
                                                                                                                                                                                                                                                                                                                                                                                                                         Instead, I prefer to be a leveler who acknowledges universal friendship.               
With the tip of my cap, a wave of my hand, or a little white lie from my mouth that prevents a tenuous argument,                                                                                                           
I am bound to appease others and help them along their way.

Yes, I love to laugh at practical jokes and to tell tall stories                                         
Because these things can help lighten the burdens of friends                                                   
Or take their minds from problems that seem to abide so profusely in their homes.

I mostly believe in the “what will be will be” regarding social problems and public responsibility.   
Call me a fatalist or a Calvinist because I understand labels are just cheap dressing,                                    But tradition and dark history have taught me to embrace hopelessness as a natural human condition.

I, in my native Appalachia, would rather do things for myself to reap my own benefits.                                 
I often learn my lesson through trial and error given the room to experience failures.                
Some mistake my lags of slow behavior for ignorance, but others see through my deep distrust of new deals amid broken promises.




I am a proud Appalachian.                                                                                                    
I once was an Archaic hunter-gatherer,                                                                                  
Then, a Shawnee or a Cherokee member of the tribes of the land.                                                   
Later, I traveled with the Spanish under Narvaez and de Soto.                                                   
And, as an Ulster Scot and a German, I journeyed west through the Cumberland Gap.                 
Today, I am a proud Appalachian.                                                                                                     
I expect to be nothing more and nothing less.


Frank R. Thompson                                                                                                                            
May 22, 2010



Thanks to research by the following:

Ambrose, Heather and Roger D. Hicks. (2006) "Culturally Appropriate Counseling and Human 

Services in Appalachia: The Need and How to Address It," http://counselingoutfitters.com/Ambrose.htm.

Arnow, H. S. (1996).  Flowering of the Cumberland. Lincoln: University of  Nebraska Press.
Caudill, H. M. (1962).  Night comes to the Cumberlands: A biography of a depressed area.  Boston: Little, Brown, and Company.
Hicks, R. D. (2004) Clinical supervision of counselors in Appalachia: A culturally appropriate model.  Unpublished Manuscript.
Jones, L. (1994).  Appalachian valuesAshland, KY: The Jesse Stuart Foundation.
Kimbrough, D. (2002).  Taking up serpents: Snake handlers of Eastern Kentucky. Macon, GA: Mercer University Press.
Lee, W. M. (1999).  An introduction to multicultural counselingPhiladelphia: Taylor and Francis Group.
Loganbill, C., Hardy, E., & Delworth, U.  (1982).  Supervision: A conceptual model. Counseling Psychologist, 10, 3-42.
Raitz, K. B. and Ulack, R.  (1984).   Appalachia: A regional geography. Boulder, Colorado: Westview Press.
Slone, V.M.  (1979).  What my heart wants to tellLexington, KY: The University Press of Kentucky.
Smith, R. D. (2000). Can’t you hear me callin’: The life of bill Monroe, father of bluegrass.  Boston, MA: Little, Brown, and Company.
Still, J. (1975).   The wolfpen rusties: Appalachian riddles and gee-haw whimmy diddles.  New York: G. P. Putnam’s Sons.