Advice For Parents - Rx Drugs

Many parents are at a loss about what to do concerning drug abuse. The drug culture today poses new, daunting problems. The abuse of prescription drugs is at epidemic proportions.Prescription drugs are widely available and easy to obtain. These drugs provide young people with an easily accessible, inexpensive means of altering their mental and physical states.

 

Because these drugs are so readily available, and many teens believe they are a safe way to get high, teens who wouldn't otherwise touch illicit drugs might abuse prescription drugs. And not many parents are talking to them about it, even though teens report that parental disapproval is a powerful way to keep them away from drugs. (Partnership for Drug-free America, Partnership Attitude Tracking Study, 2007)

Every day 2,500 youth age 12 to 17 abuse a pain reliever for the very first time. More teens abuse prescription drugs than any illicit drug except marijuana. In 2008, more than 2.1 million teens ages 12 to 17 reported abusing prescription drugs. Among 12- and 13-year-olds, prescription drugs are the drug of choice. (Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2008)

Prescription drugs - what mind set contributes to their wide acceptance? Consider the following prevalent attitude that teens develop concerning over-the-counter medications:

"Today's teens have grown up learning about the dangers of street drugs. They are much more likely than teens of the past to believe that there are social, financial, and health risks involved with drug use. Our children know that using drugs may result in family conflict, losing friends, relinquishing their driver's licenses, and missing out on opportunities for college financial aid and subsequent employment. They are also aware of some of the health risks of street drugs like marijuana, such as disruption in short-term memory and a potential for cancer down the road.

"But today's young people have also grown up in a society in which there is a pill to cure every ailment - aches and pains, sleep disturbances, overweight, anxiety, and even impotence. Many of these medications, such as cough syrups, diet pills, and sleep aids, can be purchased over the counter, and they are available for little or no cost in a variety of locations - in grandma's purse and mom and dad's medicine cabinet, or even on the Internet.

"Because OTC (over-the-counter) medications are both readily available and widely used, it may be hard for children to comprehend why they are appropriate to take in one situation but not another, which may lead young teens to begin experimenting with them. Children may not even use OTC medications to get high, but to relieve stress or pain, or just to relax. It's important for parents to understand how and why kids get involved in OTC drug use so they can recognize the problem and help their child stay drug-free." ("Teen OTC and Prescription Drug Abuse," Aspen Education Group, www.teenoverthecounterdrugabuse.com, 2008)

What the Experts Say

 

Research shows that certain approaches to parenting can often make a difference. Grandparents and other non-traditional caregivers also can benefit from better understanding, communicating and connecting with the teen in their lives.

Prescription drug abuse among teens is a growing and serious problem that many parents are unaware of.  Here’s some important advice:

• Get the facts. More teens abuse prescription drugs than any illicit drug except marijuana. In 2006, more than 2.1 million teens ages 12 to 17 reported abusing prescription drugs.

• The most commonly abused prescription medications are painkillers, like OxyContin® or Vicodin®. These produce sensations of euphoria and pleasure and are highly addictive. They can easily lead to overdose when crushed and snorted or mixed with other drugs, such as alcohol. 

• Depressants, such as Valium® or Xanax®, are also commonly abused by teens. These drugs make users feel calm and reduce anxiety and tension. They are addictive and can be deadly when used in combination with prescription pain medications, some over-the-counter (OTC) cold and allergy drugs, or alcohol.

• In addition, stimulants, such as medications for ADD and ADHD – Ritalin® and Adderall® --are being abused by many teens to “help study better” in response to excessive pressure to do well in school or to suppress appetite for weight loss.  These medications can be addictive, cause feelings of fear or paranoia and lead to serious health problems.

• Some OTC medications, such as cough medications containing dextromethorphan, are also abused by teenagers. 

 

Dr. Drew Gives Some Advice
 

Dr. Drew Pinsky, host of the television series Celebrity Rehab with Dr. Drew, offers some advice to parents: 

("A Back To School Chat With Dr. Drew and the Nation's Drug Czar," Parents. The Anti-Drug, www.theantidrug.com, 2009)

Dr. Drew: First of all, get the pills out of your medicine cabinet. Make sure that substances such as pharmaceuticals are treated in your household with the care and safeguarding that reflects your understanding as a parent of just how dangerous these substances are. Include your children in the information on why you’re doing this. They shouldn’t be able to open the medicine cabinet and see Vicodin left over from your wisdom tooth extraction or sleeping pills from your airplane trip. The medicine should be under lock and key, or out of your house.

Dr. Drew: ... helping raise the levels of perceived risk is critical. More often than not, that is about how we live our lives. So treating medication casually, using alcohol and cigarettes without careful education and structure, is extremely problematic. We must walk the walk as well as talk the talk.

Dr. Drew: Kids want you to do your parenting. They may not like it, but they want it. There’s some sort of peculiar leftover from our own adolescence in history when there was much more of a need to cast off the yoke of a past generation. This generation tends to look to adults as more of an asset. It is a normal, elemental behavior to fiercely fight against the limits placed on them by parents and then deeply appreciate the parents’ efforts to not be afraid of doing the right thing. Do not be afraid of doing your job.

Dr. Drew: ... the Internet is a dangerous place, and there is ample opportunity for people to access medications of various kinds. Most importantly, I would urge parents to use technology to monitor young people, know what technologies they’re using, have all their passwords, monitor their histories. Follow this downstream, and see what other kids are saying about yours. Don’t be afraid of the Internet, it can be a great tool.

Dr. Drew: (How do parents get through?) There’s no magic potion for that one except to say to spend time. Know where your opportunities lie. For instance, just before bedtime tends to be a quieter time of day, particularly for adolescent females, and they are more open to conversation. So merely going into a child’s room, late at night, and sitting down. Making sure you have at least one meal together. Make a point of seeking out your children. Driving in a car is a great opportunity – they can’t run away. Another opportunity, again, is when other kids are around. Don’t assume you have to retreat because their peers are in the vicinity.

Dr. Drew: (Warning signs about a problem with a child that may involve drugs?) ... change in appearance, sleep patterns, peer group change, isolating, lying, disappearing for periods of time, outbursts of anger or irritability, hygiene changes. These are signs of global mental health problems; there are no specific signs for prescription drug use, per se, but a child manifesting these symptoms needs attention.

Dr. Drew: I sympathize with parents trying to raise a family in today’s economic time; it’s not easy. But we’ve given you lots of ideas about monitoring and employing school and community resources. Use what’s available. The care of your children has got to be a priority. If it is not, I would reconsider your priorities, and think very carefully about where you want to put your attention. In terms of what makes people happy, it’s usually family life or relationships – not that they should have spent more time at the office.

Substance Abuse Treatment Facility Locator

The Substance Abuse and Mental Health Services Administration (SAMHSA) is pleased to provide this on-line resource for locating drug and alcohol abuse treatment programs. The Substance Abuse Treatment Facility Locator lists:

*  Private and public facilities that are licensed, certified, or otherwise approved for inclusion by their State substance abuse agency 

*  Treatment facilities administered by the Department of Veterans Affairs, the Indian Health Service and the Department of Defense.


The Substance Abuse Treatment Facility Locator:  http://dasis3.samhsa.gov/

Testing Rock Trivia

It's time for some rock trivia. Sorry if the test seems dated: the questions are largely '60s oriented. I guess that's what happens when a geezer compiles a trivia quiz. The questions are pretty trivial, but I thought you might enjoy some "off the beaten path" info. Do your best. Don't cheat -- the answers are provided after the quiz. Report your scores if you like. Have fun.

Test of Rock Trivia

1. What soul singer was criticized for performing at Richard Nixon's 1969 inaugural?

2. Whose address did the Rolling Stones borrow for the title of "2120 South Michigan Avenue"?

3. Strat and Hendrix, Rickenbacher 12-string and Rober McGuinn. Over the years, certain big-time musicians have been closely identified with specific instrument brands and models. Name the guitar most associated with Brian Jones of the Rolling Stones.

4. Prior to backing Paul McCartney in Wings, Denny Laine was the guitarist/vocalist in another group. He sang lead on that band's 1965 international smash. Name the group. Name the song.

5. What loud professional wrestling manager (World Wrestling Federation and others) sang with the Gentrys of "Keep On Dancing" fame? He was also on Hulk Hogan's Hulk Rules album as part of the band The Wrestling Boot Band and helped write and sing many of the album's songs.

6. This group is considered the Netherlands' most successful and longest-lived rock export. The group's drummer led a group of 1,000 drummers who performed on pontoons in the harbor of Rotterdam, Holland, for an ultrapercussive version of their biggest hit. Name the group and their big hit song.

7. Signe Anderson married one of the '60s Merry Pranksters, and she sang on this durable, volatile group's first major album. But, she left the group in the summer of '66 because to have a baby (and some say because of group hostilities towards her husband). Name the group.

8. This guitar player vehemently denies this story about the explanation for his flashy, effects-laden playing style, but it is a great rock legend. So, here it is. Allegedly, while a teenager, he was in Montreal hospital recovering from illness, drug overdose, or an auto accident (depending upon the version of the story) when he lapsed into a deep coma. Upon awakening several days later, he claimed he had been visited by the spirit of Jimi Hendrix. Although a nonmusician, he then picked up the guitar and began playing a lot like Jerry Garcia and Jimi Hendrix. Name him.

9. This rocker pounded his overamped Hammond organ and screamed his vocals, backed only by an enormous, awesome drummer called Frosty (Bartholomew Eugene Smith-Frost). Frosty and he toured as a duo and sold out major halls across the U.S. in the late '60s until Frosty left to form his own band Sweathog. This performer kept at it and had two hits in 1971 Name the artist. 

10. He was ranked 8th on Rolling Stone magazine's list of "The 100 Greatest Guitarists of All Time."A virtuoso on fretted instruments -- slide guitar, mandolin, banjo, Mexican tiple -- this artist claims to have provided the main riff for the Stones' "Honky Tonk Women." Name the guitarist.

11. This bluegrass/rock band from the Ozarks helped pave the way for country rock. On a 1965 tour with the Byrds, they reportedly helped Roger McGuinn arrange vocal harmonies on "Mr. Tambourine Man." By then their lineup included national fiddling champion Byron Berline. Name the band.

12. A seven-piece group with horns from the suburbs of Chicago, they were often accused of being Blood, Sweat and Tears or Chicago imitators, but they had actually formed long before BST or Chicago. They had their one big hit in 1970 with a song penned by James Peterik, who over a decade later hit the charts with Survivor's "Eye of the Tiger."  Name the band. Name their hit song.

13. Jimmy Webb wrote a song about his work -- the work of a singer/songwriter that tended to be largely dismissed. Still, this artist along with partner Steve Barri wrote songs that included "Eve of Destruction" for Barry McGuire and "You Baby" for the Turtles. He even wrote surf songs and disguised himself with the group the Fantastic Baggys (big in South Africa). Name him.

14. This band was formed by sixteen year-old Steve Cropper along with bassist Donald "Duck" Dunn in 1957. They helped develop the Memphis sound, and, of course, Cropper and Dunn later became a part of Booker T. and MG's. Name the band. 

15. After hearing him sing one of his songs, Little Richard reportedly remarked: "My! You sing good for a white boy!" At a press conference for the launching of the Apple label, John Lennon and Paul McCartney were asked who their favorite American artist and group were. They gave this artist's name for both answers. Name him.

16. Always a huge proponent of an anti-drug lifestyle (but, in his younger days, he did confess to be addicted to women), this artist grew up in Detroit, and by the time he was 14, he and his band, the Lourdes, played Cobo hall and opened for the Supremes and the Beau Brummels. Name him.

17. This American country-rock band was originally named after a famous comic strip character but had to change its name after cartoonist Walt Kelly objected to the use of the name and threatened to sue. Name the band. Extra credit for defining the meaning of the band's name.

18. The leader of this band, who was never photographed without sunglasses, claimed to be a Martian who lived with dinosaurs in a past life. He legally changed his name to a symbol (long before Prince). To this day, he has never revealed his background. From Bay City, Michigan, his band was likely the first Latino group to have a mainstream hit record in the U.S. and were perhaps the first band to be described as Punk Rock.They were a "one hit wonder."  Name the band and the hit song.

19. He collaborated with Norman Whitfield on many of the songs that revolutionized Motown's sound in the late '60s and early '70s -- "Ball of Confusion," "Papa Was a Rolling Stone, "Just My Imagination," "Smiling Faces Sometimes," "War." His only big hit as a singer was "Money" in 1961. Name him.

20. She was a member of the '60s group the Sweet Inspirations. She first sang with a family gospel group, the Drinkard Singers, which sometimes included her nieces Dionne and Dee Dee Warwick. She was the first to record "Midnight Train To Georgia," which became a huge hit single for Gladys Knight. Name her.

Answers:

1. James Brown. Brown also endorsed Nixon's reelection campaign and took even more heat for that move.
2. Chess Records in Chicago. The Stones recorded at Chess Studios in June 1964 (12x5 album).
3. Vox Phantom, commonly known as the Teardrop. He later switched to a Gibson Firebird.
4. Moody Blues. Denny Laine was an original member, and he sang on "Go Now!"
5. Jimmy Hart, the Mouth of the South.
6. The band-- Golden Earring, the song-- "Radar Love," and the drummer-- Cesar Zuiderwijk.
7. Jefferson Airplane.
8. Frank Marino (Mahogany Rush).
9. Lee Michaels. The hits were "Do You Know What I Mean," (#6) "Can I Get a Witness" (#39).
10. Ry Cooder.
11. The Dillards.
12. The Ides of March. The song -- "Vehicle."
13. Philip (P.F.) Sloan. 
14. The Mar-Keys.
15. Harry Nilsson.
16. Ted Nugent.
17. Poco (Changed from Pogo). The name comes from a musical term meaning "a little" or "by small measures."
18. ? and the Mysterians. The song -- "96 Tears."
19. Barrett Strong.
20. Cissy Houston

Sources: 

Holly George-Warren and Patricia Romanowski, The Rolling Stone Encyclopedia of Rock and Roll, 2005. 
Ira Robbins, Test Your Rock IQ: The '60s, 1993.

The Real Rx Experience

In the last eighteen months many people have messaged me and spoken to me about their experiences with rx drugs. Most are reaching out to find a better personal understanding of the rx health epidemic. These people desperately seek help - most of the time for those they love and sometimes for themselves. Some want to share their stories of success. Some want to witness by sharing their stories of tragedy.

All of these people have experienced the horrors of addiction first hand. Their stories have had a profound effect on me. I listen, read, and learn. At times, I feel helpless when I cannot offer them anything but hope. Sometimes, I am able to help them with pertinent information and suggestions for treatment. I learn from them, and I attempt to better shape my own understandings from their experiences.

I thought I would share some comments today. All of these comments are real. All of these are from different individuals. Of course, I have omitted all names and specifics for obvious reasons. I did not put these in any particular order. I hope the post will make a difference to someone.

People have shared these things with me. Yes, they were personal, but I have decided to share bits of the information with you so that you can better understand the extent of a serious problem.

"He told me that he was a runner for these pill mills. He said he made thousands of dollars just driving people to the doctor offices."

"My stepson is a drug addict. He has been through expensive rehabs, jail, prison, you name it and is still using. He, as well as many others, comes from a good family and it is heartbreaking." 

"My elderly brother is one of the unfortunate few elderly people that has become addicted to this medication. We were able to intervene, and he was admitted to the hospital."

"My son is a drug addict. He's lost almost everything and took his last suboxine on Thursday. He's looking for someone to give him more and wean him off of it. He's been seeing Dr. X to get it and they let him run up a $2000 doctor bill then cut him off without at least $200 a month payment, then a $400 prescription on top of that. He's as much as homeless with a beautiful wife who works everyday and three precious daughters (8, 10, and 11 years old)." 

"I fought my own demons with alcohol, cocaine, and a variety of other drugs. No one starts out to be an addict. But at some point you realize that the bad decisions you made finally caught up. For a long time I hid my drug use from family and friends but as my life began falling apart there was no hiding it any longer."

"I lost three family members due to rx abuse, including my own mother. I broke my neck at age 14 and began getting "help" at the age of 17 from Dr. X. Even though I had legitimate physical problems, this doctor chose to medicate rather than rehabilitate, thus planting the seeds of addiction in a young and naive girl. Talk about a tsunami! Ive been clean nearly five months... dismissed MYSELF from a doctor because he had me on massive doses of five different meds at once. My own doctor was my dealer."

"I lived in Southern Cal where I was born and raised. When I first came here I thought I was in heaven but boy was I wrong I never ever thought this was an area where it was worse then where I came from. I know you're wondering if I'm still sober. Yes, sir, I am."

"I just found out my daughter is on oxys about 3 weeks ago. Needless to say I'm shocked!!! Such a beautiful, bright girl who knew all about the danger of the drug."

"I did these things myself but I have been clean now for four years and I am in college. I still talk to a few people that I used to use with and they don't use any more either but most of the people that I did hang out with are still using."

"My son was addicted to drugs by the time he was a senior in high school. He overdosed twice, near death, his senior year. He went to rehab instead of going on a senior trip. Thanks to God and that rehab program he has been clean for three years and six months. He is now a senior in college and an honor student."

"I'm desperate to try to get help for my daughter's father. He, like many others, is hooked on pain pills and recently he has started stealing from his mother and uncle and has stolen from them in the past. When I met him, he told me, I hate the way I'm living my life. I hate being on oxys. I want to change."

"I did learn the hard way (jails, institutions, residential treatment facilities, just to name a few). I was a thief, a liar, and a terrible parent. I am one of the lucky ones that made it through, Thank God. Now with all the knowledge that I have and through my experience, I can pass the info on to others. My addiction was kicked off when I started going to a pill mill myself, a one Dr. X. I know how hard it was for me, but it was even harder on my family members and loved ones. I can't even count how many friends that I have lost to this terrible disease."

"For me, it started 10 years ago when Dr. X became my fiance's best friend so to speak. My fiance became extremely addicted to pain pills and started selling them to support his habit...two sons later and several years of trying to quit using...he left town. He was so addicted to oxycontin by that point that I could no longer stay with him and be a responsible mother at the same time. My children haven't seen or heard from him in several years."

"I have a younger sister who is severely addicted to pain pills. She's been in quite a few wrecks over the years and one especially came close to her dying. I don't know when or how she got started on them, but the last time I spoke to her I told her that I would not help her in any way unless she's ready to get help. She's a very smart woman and used to hold an executive job in X. Then she moved back home and she looks like a bag of bones and she's lost her job here and has no money."

"Last week my son was with his best friend. They went two blocks over to his friend's dad's house so he could visit him, When they got there, they found him dead on the floor from an overdose of IV oxys. My brother and my mother are both addicted to xanax and oxys."

"Approximately two years ago, my brother overdosed. After I lost my brother, I realized that I had to get my own life straight for my brother, for my children, and for my mother and father, but especially for myself."

"I have three children and I don't feel safe letting them play outside. They can't play with other kids in the neighborhood because to go to anyone's house would be going to a drug dealer's house...so I don't let them around anyone in our neighborhood. I'm doing everything I can to eliminate their exposure to that nonsense...but educating them along the way as to why they should never touch it in the first place. It's a difficult time to raise kids; I wish the oxy pill manufacturer would just take that stuff off the market."

Please, Don't Let Me Be Misunderstood

One day you wake up and realize there is something that needs to be done.You contemplate how you can help effect this needed change, and you decide to take on a new endeavor to help accomplish the task at hand. You willingly put yourself into a team position that requires total participation.With a high degree of self-assurance, you fully dedicate yourself to this worthy cause -- something, though difficult to achieve, that you know you can help accomplish.

With no further hesitation, you launch yourself into action. As you labor intensively with teammates to facilitate the project, you handle complications and problems that arise, and you keep your noble goal in mind as you work through these stumbling blocks. Your investments of time and effort continue to mount as you begin to realize your goals.

Then... someone misinterprets your motives. 

You are devastated as you stand accused. You can't believe anyone could find fault in what you are doing and in how you are doing it. Try as you might to understand the alleged flaws in your position, you just cannot see what you have done wrong. You feel betrayed.

Some Research About Miscommunication

Sue Dyer, the first woman in the U.S. to head a major collective bargaining unit for the construction industry and author of the award winning book Partner Your Project, has done considerable research concerning what makes a project fail and what contributes to the successful completion of a project. Many people she interviewed (95%) said good communication was the main reason for success.

But, Dyer believes that what people conceive to be a “communication” issue is actually a symptom of the real problem – or root cause. Dyer states, "When a team identifies their problem as one of poor communication and then works to try and resolve the issue, significant improvement could not be made. Only by understanding and addressing the root cause was any improvement seen." (Sue Dyer, "The Root Causes of Miscommunication," dyerpredictions.typepad.com, April 3 2007)

Dyer believes there are seven different root causes for team failure that the project teams misidentified as poor communication. Here they are:

1. Fear – Fear makes team members feel the need to protect their own interests. When we feel to the need to protect we are not going to be open, therefore communication is going to be stifled. To overcome fear you must work to develop trust among the team members....Trust erodes when someone feels they are being treated unfairly. 

2. Misaligned expectations – When the team members each have a different expectation on how things are supposed to work (usually about roles, responsibilities and authority), you have misaligned expectations.

3. Confusion – When there is confusion, chaos will break out. Again, this can be over roles and responsibilities, or over processes.

4. Loss of Momentum – When everyone on the team is not in the boat, facing the same direction, and rowing toward project success, the project loses momentum. The more frustration there is, the more loss of momentum you will have.

5. Dissatisfaction – Research shows that when project teams dread going to their jobs (the level of the job satisfaction is low) the project is in deep trouble.

6. Lack of Commitment – When people aren’t really committed to the success of your project or if there are inadequate resources, you can have “slack.” This is like slack in a rope. You don’t have a strong team focused on what it will take to succeed.

7. Unconscious Incompetence – Inexperienced staff can face a very steep learning curve. They focus on what is available to them: The specifications, contact and drawings. Documentation becomes the focus instead of problem solving.

Sue Dyer's article in Dyer Predictions: http://dyerpredictions.typepad.com/dyer_predictions/2007/04/the_root_causes.html

Conclusions

When people begin to solve problems and move from a given state to a desired goal, they must employ some very difficult problem-solving techniques. Abstraction, brain-storming, hypothesis testing, lateral thinking, reduction, research, trial and error, proof finding -- these techniques are often used. Most prove very difficult to employ. No one person is a master, or even a good practitioner, of all.

Each person working to solve any problem has personal talents and personal interests. As a person applies his or her attributes in a direction that seems most comfortable, the person gains confidence with each small success. The individual feeds upon these successes to sustain his or her industry.

It is easy for an individual to lose sight of a common goal in the midst of action. Also, it is also easy for a person to misunderstand the thoughts and actions of another who goes about "skinning the same cat" in a somewhat foreign manner.

When someone accuses a fellow worker of performing his duty in an unbecoming manner, injury is likely to occur. How many times could this injury be avoided if people took the time and effort to better understand the workings of people's individual brains? Often, a little more communication might enlighten those who interpret things from a singular stance. People must learn to find the root causes of communications problems and work together to correct them.

Understanding the motives of others and looking within them for answers is very difficult. These things are so hard that many prefer to avoid doing them at all. They prefer to wear blinders as they rush headlong into a difficult journey. And, even then, people tend to see those things more clearly that they can easily comprehend.

Suffice it to say that anything cause worth fighting for demands that the combatants survey the entire battlefield. And, while doing this, it doesn't hurt for them to offer common respect for the efforts of all their comrades. Some miscommunication and misinterpretation are inevitable, but these mistakes must not destroy the major battle plans.

"The delusions of self-love cannot be prevented, 

but intellectual misconceptions as to the means 

of achieving success may be corrected." 

-George Henry Lewes

The Now Open Hillman Letter

Attorney Steven Hillman, who has been involved with several pain clinics and a pharmacy, sent a letter to Lisa Roberts, RN, of the Portsmouth City Health Department. Roberts is a prominent member of the Scioto County Prescription Drug Action Team. (Frank Lewis, "Hillman Asks To Meet With Roberts," Portsmouth Daily Times, June 18 2011)

Mr. Hillman is quoted as saying the following:

“I have become increasingly concerned that you are being identified as a source of incorrect information. I find it hard to believe that the individual that I met would ever intentionally publish false information,” Hillman writes. “I can only assume that you are receiving information about Dr. Temponeras and Unique Pain Management that is incorrect. I believe that it is past time for all concerned citizens to get on the same page about the illegal distribution of controlled substances.”

“There are sincere professionals who wish to help those in chronic pain to deal with their pain so that they can function in society,” Hillman said in the correspondence. “Innocent hardworking people are being given undeserved labels, which are adversely affecting their personal and professional lives.”

“The current law enforcement method assumed that all patients receiving pain medications are criminal abusers and their fate is not a concern,” Hillman goes on. “This goes against all medical obligations and the Hippocratic Oath.”

“I invite you and any interested persons to sit down and begin by helping Scioto County and setting a template that others can follow that will respect all people’s rights and move Scioto County towards being the leader in civil action to control its problems,” Hillman wrote. “It is not and never has been appropriate for civilized people to fight when they are really on the same side.”

“Please consider this an open invitation to meet as soon as possible,” Hillman said. “I will come to your office or meet at a place, which you select. If your motivations are as I believe then this invitation will be accepted by you and we can more forward.”

Let's see if we can break down the communication in simple terms.

1. Hillman claims Lisa Roberts has been identified as a source of incorrect information.

Does Mr. Hillman believe the Ohio State Medical Board, the Ohio State Pharmacy Board, the Bureau of Workers Compensation, the Ohio Attorney General, the Legislature of the State of Ohio, the Governor of the State of Ohio, the U.S. Department of Justice, and the President of the United States distribute the same incorrect information? He must because they do distribute the exact information.

2. Hillman claims Lisa Roberts received and published incorrect information about Dr. Temponeras and Unique Pain Management.

What, specifically, is "incorrect"? The DEA release stated that Dr. Margy Temponeras is "one of the largest dispensers of controlled substances in the United States."

Assistant Attorney General Tracy Greuel told the Ohio Board of Pharmacy that Temponeras had a former employee of the Scioto County Sheriff’s Office running her dispensary. "There is a problem if any unlicensed healthcare professional can have complete access to drugs. It's not permitted by law," said Agent Kevin Kinnear. The Sheriff’s Office has since clarified that the man in question was only a Volunteer Special Deputy from 1978-1997 under a former Sheriff. 

One must assume that this is the information that so disturbs Mr. Hillman. Lisa Roberts has no connection with the DEA or with the Ohio Board of Pharmacy.

3. Hillman claims Dr. Temponeras is a sincere professional who helps those with chronic pain.

The Ohio Board of Pharmacy denied a request by Dr. Margy Temponeras to have her license to buy, store and dispense controlled substances reinstated. The unanimous decision was made following a nearly four hour meeting in Columbus earlier this June. This decision affirms that the doctor was not operating with the best intentions.

4. Hillman claims people like Lisa Roberts gives innocent, hardworking people undeserved, damaging labels. 

Mr. Hillman does not concern himself about the damage done by pill mills. He chooses to defend the rights of those alleged to be rogue doctors and pharmacists and put their rights to distribute drugs above health concerns. Issues such as addiction, illegal distribution, and deadly overdose must play second fiddle in his band. 

5. Hillman claims that current law enforcement agencies employ methods that assume that all patients receiving pain medications are criminal abusers and that enforcement is not concerned about patients' fate.

This claim is totally ridiculous and flies in the face of increased enforcement efforts to stop crime as it relates to the deadly epidemic of rx drug abuse. With this generalization Hillman basically says "law enforcement wants to arrest all people in legitimate pain management programs, put them in jail, and throw away the key." He does a great disservice to the FBI, the DEA, the Ohio State Patrol, the county sheriffs, and the city police among others. He should be praising their brave, selfless efforts.

6. Hillman implies that those in Scioto County do not respect people's rights, and the populace in Scioto is not acting appropriately to lead civil actions and to control its own problems.

In the last two years, the citizens of Scioto County have risen up and taken a huge stand against rx drug abuse. Their grass roots efforts have captured the attention of the area, the state, and the nation. There is no need to list all those responsible for this people's rights movement. The groups and individual players are well known. Every day others around the country look to Scioto County for help with their rx drug problems. Many of these people seek the help of Lisa Roberts.

7. Hillman places the onus of accepting an invitation to meet and "set a template that others can follow"on Lisa Roberts.

This ploy is posturing by Mr. Hillman. He is trying to deceive others and to impress them by offering HIS version of an "olive branch" to Lisa Roberts. By saying "if your motivations are as I believe then this invitation will be accepted by you," he is attempting to ally his intentions with Roberts' intentions to make it look as if they are "on the same page about the illegal distribution of controlled substances." They are not on the same page. Roberts has no intention of meeting Mr. Hillman to discuss HIS version of pain managment. HIS version of pain management is pill mill pain management. Nothing positive could come of that encounter.

Evidently, Attorney Steven Hillman does not know Lisa Roberts as well as he thinks he does. She and the many others in the Scioto Rx Drug Task Force are not willing to take a step backwards while kowtowing to his efforts to whitewash wrongdoings. Federal, State and local agencies have uncovered much of the rx drug abuse malignancy that has devastated Scioto County, and now, thanks in large to the media, the public is witness to the deadly operations.

Hillbillies we may be, but we detest those who would judge us as ignorant and who would attempt to use us. In fact, the Appalachian character shows great distrust at the first hint of deceit. And, most Billies will defend their right to protect their own with all their might. Perhaps Mr. Hillman would like to reside in Scioto County and experience firsthand the terrible effects of the pill mills. I think he may need a new perspective that would be conducive to learning a thing or two.

Bath Salts - Outside the Tub

Snow White, Vanilla Sky, Red Dove, White Lightning, Hurricane Charlie -- new drinks at the local bar? No, these are bath salts. And no, not bath salts for soaking in a tub, but potentially deadly combinations of chemicals such as mephedrone and MDPV intended to be snorted, smoked, or injected. Bath salts are the most recent substances abused and labeled designer drugs that are fast becoming an international epidemic.

These so-called bath salts are intended to be snorted, smoked or injected. Cathinone, the parent substance of the drugs, comes from a plant grown in Africa. They produce hallucinations and physical manifestations that can be fatal. Doctors have reported some people who have taken bath salts experience paranoia for weeks after the initial dose.

Particularly appealing to teens and young adults because they are easy and inexpensive to obtain, these products are becoming a growing problem here in Ohio.

In Ohio, bath salts are sold for up to $80 each (On example - a small plastic container with 500 milligrams costs $20 in Muskingum County.) The salts come in plastic bags the size of tea bags and in canisters the size of a quarter. The package of the substance actually has a  label that reads "not for human consumption."

The Drug Enforcement Administration does not regulate bath salts, but they are under federal scrutiny, as the effects of these salts are comparable to methamphetamine abuse, according to poison control centers and other law enforcement agencies. So, right now it's legal to sell, buy and use the products, and bath salts have even being marketed on the Internet as legal cocaine substitutes.

Until we get some teeth, our abilities are pretty limited," said Ohio Special Agent Scott Duff, who runs the meth unit for the Bureau of Criminal Investigations."It's kind of unfortunate that this stuff can continue to be marketed as bath salts, knowing full well that the people marketing this stuff and peddling this stuff know what folks, mainly kids, are doing with this stuff."

A study by the Centers for Disease Control and Prevention found bath salts skate around existing laws by including that warning that they are not for consumption.

"Classes of designer drugs like 'bath salts' are intended to have pharmacological effects similar to controlled substances but to be chemically distinct from them, thus avoiding legal control," according to the CDC study.
(Rick Rouan,"Ohio Legislation Would Make Bath Salts With MDPV Illegal," Mansfield News Journal, May 23 2011)

ONN's Lot Tan reported bath salts emergency room visits and poison center calls are increasing in Ohio. Three people in Montgomery County died recently after using bath salts.

"I had found 60 cases in about a month and a half," said Cindy Jennings, a registered nurse with Miami Valley Hospital. Jennings has spoken at seminars about the dangers of bath salts. She said her child first told her about the drug. "I have a 13 year old. When I started investigating this, I asked him directly, he goes, 'oh yea, we've heard of those, mom.' He knew about it before I did," Jennings said. ("Use of 'Bath Salts' On the Rise In Ohio," Ohio News Network, June 17 2011)

  
Ohio Legislature and Bath Salts

Ohio lawmakers are attempting to join at least 10 other states in banning the substances. Bills to ban six derivatives of cathinone have been proposed in both chambers of the Ohio legislature.

Attorney General Mike DeWine applauded the efforts of State Rep. Clayton Luckie, D-Dayton, on the bill he introduced to make certain chemicals found in bath salts a Schedule I controlled substance under Ohio law. ("DeWine Applauds Bill to Make Bath Salts a Controlled Substance," www.ohioattorneygeneral.gov, March 1 2011)

"Ingesting bath salts is a new way for people to get the same kind of high as they would from doing cocaine. Bath salts are far too easy to buy and the after effects can be deadly," said DeWine. "I am committed to working with Rep. Luckie to help pass this legislation to get these bath salts out of the marketplace."

"By banning the addictive substances in bath salts, this is just one more measure to ensure that our young people will not be harmed by products that are so easily and readily available," added Rep. Luckie.

There will always be a designer drug of the moment. Entrepreneurs constantly monitor the trends in street drugs and exploit these demands in order to brand and sell new products. Bath salts -- pretty unbelievable? Believe it. What will the be the designer drug of tomorrow? We must deal with the root causes of drug use through education, prevention, intervention, and treatment to stop this crazy drive for designer drugs.

CBS News on Bath Salts:

http://youtu.be/xUgoVfbjcRE

A Case Of RSD And Pain Treatment

According to Oxford Journals, Reflex sympathetic dystrophy (RSD) is a condition characterized by localized or diffuse pain, usually with associated swelling, trophic changes and vasomotor disturbance. Allodynia (pain due to a stimulus which does not normally provoke pain), hyperhydrosis (a condition characterized by abnormally increased perspiration), and nail or hair growth changes may also occur. Motor abnormalities have been reported, in particular, tremor, involuntary movement and muscle spasm. (A.T. Marshall and A.J. Crisp, "Reflex Sympathetic Dystrophy," Rheumatology Volume 39, July 2000)

RSD is a chronic, painful, and progressive neurological condition. It can occur in any part of the body, but it most commonly occurs in an arm or leg. Generally, the pain is intense and continuous. The pain gets worse over time, rather than better, and may spread.

The cause of reflex sympathetic dystrophy syndrome is not known, but it is often related to an injury (ankle fracture, broken leg, etc.) or infection, which may inflame a nerve. In rare cases, an illness, such as a stroke or heart attack, may be the cause. In some cases, no precipitating event can be identified. The pain of reflex sympathetic dystrophy syndrome is generally greater than the severity of the injury that caused it.

Carolyn Shelton and Dr. James Lundeen

49-year-old Ripley resident Carolyn Shelton has reflex sympathetic dystrophy. She was a patient of Dr. James Lundeen, a doctor who was recently decertified by the Ohio Bureau of Workers Compensation and, as a result, had his license suspended by the State Medical Board of Ohio.

Although the BWC recently rescinded its decision, it also has planned on decertifying Lundeen because he now has no medical license. (Frank Lewis, "Through the Cracks: Woman Claims She Suffers Without Pain Clinic Doctor," Portsmouth Daily Times, June 18 2011)

Shelton feels she has "slipped through the cracks" of the pain treatment system since action has been taken against Dr. Lundeen. When Lundeen was practicing (prior to the March 16 raid), she traveled from Ripley to Portsmouth to see him. Then, his practice was primarily handling Workers’ Compensation patients.

Shelton claims Dr. Lundeen had her in remission. “The only medications I was taking were Percocet and demerol. He was always checking to make sure you were doing what you were supposed to be doing.”

“I don’t have a doctor. No one will treat me because I have long-term RSD,” Shelton said. “Right now, since Dr. Lundeen has been out, they have overdosed me on morphine.

“They did it at a pain center that is taking some of his patients in Columbus. He gave me a medication (Opana). I told him I was highly allergic to morphine. He told me there was no morphine in it. And I told him they had tried me on it before and there was morphine in it. He said they changed the formula. I took it and while I was home alone, and I was going into antiphylactic shock.”

Who Is To Blame?

I do not doubt anything Carolyn Shelton says. I feel terrible that she received some very bad treatment in Columbus, but I do, however, have problems with the fact that she blames those responsible for taking action against Dr. Lundeen for contributing to her suffering.

I think Shelton must consider the facts. Here are a few that pertain:

1. The BWC acted against Dr. Lundeen because he needed to be punished. Tom Wersell, director of Ohio Bureau of Worker's Compensation investigations, said the agency was very concerned about the unusually large number of prescriptions being written to injured workers at Lundeen's two offices. The BWC suspected the doctor was responsible for 61 percent of all Scioto County narcotics prescriptions in the BWC system.

"I think it's safe to say that he is among the highest not only in the county, but in the whole state," BWC Administrator Steve Buehrer told reporters. (Cary Ashby, "Doc: Office Raids Were 'Swift Retaliation...,'" Norwalk Reflector, April 3 2011)

Involved in the action taken against Lundeen were the Scioto and Huron County sheriff and prosecutor, Ohio State Medical Board and Pharmacy Board, Medicaid, Department of Taxation, Ohio Department of Insurance, Ohio Alcohol and Drug Addiction Services, FBI, Drug Enforcement Agency and the U.S. Attorney General.

Melissa Vince, spokesperson for BWC, said there are five factors that led to the decision by the Bureau to decertify Lundeen.

“Prescribing high levels of narcotics to injured workers; unsanitary conditions at practice locations; lack of proper medical equipment; lack of private examination and treatment areas where injured workers are seen; and improper disposal and care of injured workers’ confidential patient records,” Vince said. “This decision came down from our administrator and the Department of Medical Services Division,” Vince said. “We have an ongoing investigation, and our investigators have collected more than a hundred boxes of evidence. And they are currently reviewing that.” (Frank Lewis, "BWC Decertifies Lundeen," Portsmouth Daily Times)

2. Shelton, herself, made the decision to go to a pain center that took Lundeen's patients. Dr. Leak, the physician there, has his own problems. According to the State Medical Board of Ohio website database, Dr. Leak’s license was revoked by the Board in 2008, but he has been practicing, pending appeals. However, since a ruling upholding the revocation by the 10th District Court of Appeals in May, he has not been allowed to practice. He filed an appeal with the Supreme Court of Ohio.

3. Shelton, herself, refuses to have an operation that would involve installation of a nerve stimulator. According to Shelton, The Bureau of Workers’ Compensation is trying to force her to have such an operation.  She has refused to get the operation because she believes it would make things worse, and she believes that after such an operation she would still need the same amount of pain medication.

“With RSD, if they cut me it will make it worse than it is. The one thing I have had in my favor is that I didn’t let them operate on me. They told me when I got it I was in a study, and I even seen doctors from France. It was a very technical program. They told me, ‘You do not let them operate.’”

4. Shelton, herself, denies the need for treatment from a pain center. She has just come back from the University of Cincinnati, which she says has one of the best pain centers in Ohio. She claims that the staff at the pain center told her she didn't need their help.

“They told me I did not need a pain center,” Shelton said. “All I need is a doctor that will treat me, because the medications that I am on, it is obvious that I am not somebody that abuses medication.”

Sheldon says Workers Compensation has her employer believing that she is refusing treatment but she claims she is just refusing the stimulator and medication that will kill her.

I, personally, am at a loss for a logical explanation as to why such a prestigious center would tell Shelton that she didn't need their services. Evidently the center doesn't believe she meets their qualitifications? I would think they are in business to help every patient with RSD. What kind of treatment did they offer her, and why didn't she take it? These are questions I cannot answer.

Bottom Line As I See It

I understand the terrible plight of Carolyn Shelton. She suffers horrible chronic pain. She desperately needs help so she can live a decent, normal life. Also, I completely understand her frustration with the system. But, I don't believe the actions against Dr. Lundeen caused her problems. 

Shelton doesn't want to take potentially lethal doses of medications. I respect that so much. I pray she finds the help she needs from new, highly skilled, concerned doctors who can help her get relief from her terrible RSD pain. I trust these physicians will offer her effective treatment for her condition.

Here are a few treatments that do offer help to RSD patients:

• Physical therapy: A gradually increasing exercise program to keep the painful limb or body part moving may help restore some range of motion and function.
• Psychotherapy: CRPS often has profound psychological effects on people and their families. Those with CRPS may suffer from depression, anxiety, or post-traumatic stress disorder, all of which heighten the perception of pain and make rehabilitation efforts more difficult.
• Sympathetic nerve block: Some patients will get significant pain relief from sympathetic nerve blocks. Sympathetic blocks can be done in a variety of ways. One technique involves intravenous administration of phentolamine, a drug that blocks sympathetic receptors. Another technique involves placement of an anesthetic next to the spine to directly block the sympathetic nerves.
• Medications: Many different classes of medication are used to treat CRPS, including topical analgesic drugs that act locally on painful nerves, skin, and muscles; antiseizure drugs; antidepressants, corticosteroids, and opioids. However, no single drug or combination of drugs has produced consistent long-lasting improvement in symptoms.
• Surgical sympathectomy: The use of surgical sympathectomy, a technique that destroys the nerves involved in CRPS, is controversial. Some experts think it is unwarranted and makes CRPS worse; others report a favorable outcome. Sympathectomy should be used only in patients whose pain is dramatically relieved (although temporarily) by selective sympathetic blocks.
• Spinal cord stimulation: The placement of stimulating electrodes next to the spinal cord provides a pleasant tingling sensation in the painful area. This technique appears to help many patients with their pain.
• Intrathecal drug pumps: These devices administer drugs directly to the spinal fluid, so that opioids and local anesthetic agents can be delivered to pain-signaling targets in the spinal cord at doses far lower than those required for oral administration. This technique decreases side effects and increases drug effectiveness.

Do You Have a Chemical Imbalance?

First of all, let me say that I have battled clinical depression and obsessive-compulsive disorder for well over twenty-five years. I know firsthand the devastating effects of these mental illnesses. I would not wish the conditions upon anyone. They have taken a toll on my health and on my life in general as they have interfered with my ability to work, sleep, eat, and enjoy once pleasurable activities.I continue to deal with these disorders and their impact today.

Mental disorders are widely misunderstood. The prevailing attitude toward depression is "Keep a stiff upper lip, have a drink, maybe it will go away." Of course, this advice is ludicrous. People suffering from severe depression need profession psychiatric evaluation and good medical treatment including psychotherapy.

Many doctors have helped me with my illnesses. They have prescribed me many different medications to help me deal with my problems. All the meds have risks and some unwanted side effects. I have weened my way off prescriptions at various times during my decades of dealing with depression and OCD. I am most happy when I feel good without the aid of medications. But, I have suffered relapses, and I have had to resort going back on drugs to maintain mental health.

My doctors have told me that my mental disorders are most likely caused by a combination of inherited and environmental factors that affect brain chemicals called neurotransmitters.These doctors said that my mental disorders result from a chemical imbalance in my brain. I have accepted the doctors' diagnosis and prognosis of my diseases. This post will put a shocking twist on what, for me, has been a might struggle.

I Am Not Alone

Want a startling fact? Mental illness is now the leading cause of disability in children, well ahead of physical disabilities like cerebral palsy or Down syndrome, for which the federal programs were created.

How about this finding? A large survey of randomly selected adults, sponsored by the National Institute of Mental Health (NIMH) and conducted between 2001 and 2003, found that an astonishing 46 percent met criteria established by the American Psychiatric Association (APA) for having had at least one mental illness within four broad categories at some time in their lives. The four categories are anxiety disorders, mood disorders, impulse-control disorders, and substance-use disorders.

  
Speaking of Chemicals and Mental Illness

Three new books reviewed in an article by Dr. Marcia Angell titled "The Epidemic of Mental Illness: Why?" in The New York Times Review of Books (Angell was the first woman to ever be editor-in-chief of the prestigious New England Journal of Medicine) raise startling possibilities about the truth behind the explosion of prescriptions of pharmaceutical treatments for mental illness.

All of the authors of the new books agree on two thought-provoking viewpoints:

"1. Our understanding of categories of mental illness and their treatments has been influenced by drug companies, through both legal and illegal marketing.
 
"2. Mental illness is not caused by chemical imbalances in the brain." 

(Elizabeth Landau, "Are Antidepressants Glorified Placebos? thechart.blogs.cnn.com, June 16 2011)

These views, however controversial, are documented well, Angell says.

For instance, even though the goal of psychoactive drugs is to alter levels of neurotransmitters - brain chemicals - which affect mood, scientists have not found good evidence that it's the chemicals themselves that cause the mental illness. Before treatment, neurotransmitter function seems to be normal, they say.

Here are the books that were reviewed by Dr. Angell.

The Emperor's New Drugs: Exploding the Antidepressant Myth
 by Irving Kirsch                                                  
Basic Books, 226 pp., $15.99 (paper)  http://www.amazon.com/gp/product/0465022006?ie=UTF8&tag=thneyoreofbo-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0465022006

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America
by Robert Whitaker                                                  
Crown, 404 pp., $26.00 http://www.amazon.com/gp/product/0307452417?ie=UTF8&tag=thneyoreofbo-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0307452417

Unhinged: The Trouble With Psychiatry--A Doctor's Revelations About a Profession in Crisis 
by Daniel Carlat                                                  
Free Press, 256 pp., $25.00  http://www.amazon.com/gp/product/141659079X?ie=UTF8&tag=thneyoreofbo-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=141659079X

Irving Kirsch, a psychologist at the University of Hull in the UK, found that placebos were three times as effective as no treatment. That didn’t particularly surprise him. What did surprise him was the fact that antidepressants were only marginally better than placebos. As judged by scales used to measure depression, placebos were 75 percent as effective as antidepressants.

Kirsch was also struck by another unexpected finding. In his earlier study and in work by others, he observed that even treatments that were not considered to be antidepressants—such as synthetic thyroid hormone, opiates, sedatives, stimulants, and some herbal remedies—were as effective as antidepressants in alleviating the symptoms of depression. Kirsch writes, “When administered as antidepressants, drugs that increase, decrease or have no effect on serotonin all relieve depression to about the same degree.” (Marcia Angell, "The Epidemic of Mental Illness: Why?" The New York Review of Books)

Robert Whitaker, a journalist and previously the author of a history of the treatment of mental illness called Mad in America, concludes that antidepressants and most of the other psychoactive drugs are not only ineffective but harmful. He begins by observing that even as drug treatment for mental illness has skyrocketed, so has the prevalence of the conditions treated:

"The number of disabled mentally ill has risen dramatically since 1955, and during the past two decades, a period when the prescribing of psychiatric medications has exploded, the number of adults and children disabled by mental illness has risen at a mind-boggling rate. Thus we arrive at an obvious question, even though it is heretical in kind: Could our drug-based paradigm of care, in some unforeseen way, be fueling this modern-day plague?" (Marcia Angell, "The Epidemic of Mental Illness: Why?" The New York Review of Books)

What Does the Future Hold?

National Institute of Mental Health (NIMH) Director Thomas Insel, M.D., recently said it's time to fundamentally rethink mental illness. A surprising finding from genomic research is that mental illnesses appear to be related to extremely rare but potent genetic mutations that are not associated with any specific disorder but with a variety of phenotypes categorized as mental illness. (Mark Moran, "Brain, Gene Discoveries Drive New Concept of Mental Illness," American Psychiatric News Volume 46, June 17 2011)

Perhaps new research will find new and better treatments. For example, studies show that a combination of therapy and medication usually works better than using either one alone. Some studies claim a new treatment is zapping the problem away without the nasty side effects of drugs. Transcranial Magnetic Stimulation (TMS) activates certain parts of the brain by using electrical energy passed through a coil of wires to create a powerful magnetic field. (Maureen McFadden, "New Treatment Offers Hope For Those With Major Depression," www.wndu.com, June 1 2011) 

James Hunter ("Research On Depression," National Institute of Mental Health, psychcentral.com, 2010) offers some insight on the future of work on depression. 

Hunter says research on the causes, treatment, and prevention of all forms of depression will remain a high NIMH priority for the foreseeable future. Areas of interest and opportunity include the following:

• NIMH researchers will seek to identify distinct subtypes of depression characterized by various features including genetic risk, course of illness, and clinical symptoms. The aims of this research will be to enhance clinical prediction of onset, recurrence, and co-occurring illness; to identify the influence of environmental stressors in people with genetic vulnerability for major depression; and to prevent the development of co-occurring physical illnesses and substance use disorders in people with primary recurrent depression.

• Because many adult mental disorders originate in childhood, studies of development over time that uncover the complex interactions among psychological, social, and biological events are needed to track the persistence, chronicity, and pathways into and out of disorders in childhood and adolescence. Information about behavioral continuities that may exist between specific dimensions of child temperament and child mental disorder, including depression, may make it possible to ward off adult psychiatric disorders.

• Recent research on thought processes that has provided insights into the nature and causes of mental illness creates opportunities for improving prevention and treatment. Among the important findings of this research is evidence that points to the role of negative attentional and memory biases -- selective attention to and memory of negative information -- in producing and sustaining depression and anxiety. Future studies are needed to obtain a more precise account of the content and life course development of these biases, including their interaction with social and emotional processes, and their neural influences and effects.

• Advances in neurobiology and brain imaging technology now make it possible to see clearer linkages between research findings from different domains of emotion and mood. Such "maps" of depression will inform understanding of brain development, effective treatments, and the basis for depression in children and adults. In adult populations, charting physiological changes involved in emotion during aging will shed light on mood disorders in the elderly, as well as the psychological and physiological effects of bereavement.

• An important long-term goal of NIMH depression research is to identify simple biological markers of depression that, for example, could be detected in blood or with brain imaging. In theory, biological markers would reveal the specific depression profile of each patient and would allow psychiatrists to select treatments known to be most effective for each profile. Although such data-driven interventions can only be imagined today, NIMH already is investing in multiple research strategies to lay the groundwork for tomorrow's discoveries.

Facing Up to Your Own Facebooking

Consider this declaration by Thomas Baekdal (www.baekdal.com, February 25 2010) of the First Rule of Privacy as it relates to Faceook:

"I am the only one who can decide what I want to share."

Baekday continues, "The rule really is that simple, and it also the only rule that applies to privacy - and it covers any situation. No company, group, automated system, code algorithm, or other person can decide what I want to share. Just as none can decide that I should share something with an external party. I am the only one who have that power. And you can say the same. You are the only one who can decide what you want to share. Nobody else can do that. I cannot decide what you want to share, just as you cannot decide what I want to share."

Facebook friends, whose responsibility is lack of privacy?  In this age of the Internet, privacy is a genuine concern. When you sign up on Facebook with the intent to share personal information over the net, you choose to disclose whatever exclusive material you post. But, isn't it amazing you become so outraged at the idea that your intimate information might get to destinations you didn't intend it to go?

What Information Can Be Accessed?

Jaime Summers ("Facebook Controversy Part 1: Lack of Privacy," www.examiner.com/ny-in-new-york, August 11 2009) reminds you, "Everything that is ever posted on the Internet can be retraced and accessed, thus even when you think you’re deleting something embarrassing, it is never gone for good. The April 2009 deal between Facebook and the GSA (General Services Administration) cleared the way for federal agencies to use the social-networking tool (fcw.com). Don’t forget about the controversial 2001 Patriot Act, which allowed the government to access personal information on almost anyone without court approval (il.aclu.org). It is rumored that this included tracking methods as intimate as wiretapping, so why wouldn’t they be monitoring the Internet as well?"

Does Facebook Guarantee Privacy? 

Don't you believe that Facebook has no choice but to continue to test the boundaries of privacy? After all, its business model depends on people divulging things about themselves. 

Rob Enderle, an analyst at Enderle Group reports, "[Facebook] makes their money from advertising and selling information on their users, so full privacy is contrary to their business model. If they promise something they can't deliver, they just burn trust, so they may think it best to just leave the subject alone. They shouldn't overpromise and never provide the contents of the e-mail to anyone, including unauthorized internal employees. That last [one] will be very difficult to pull off, as Google discovered." (Sharon Gaudin, "Privacy Questions Trail Facebook Messages," Computerworld, November 16 2010)

And, Why Can You Be Misunderstood Even When You Decide To Share Information?

The changes for online miscommunication are great. Information listed on your Facebook page may be interpreted in a variety of ways given its frequent lack of context.

In one study, participants were asked to send an email conveying either sarcasm, humor, seriousness or sadness. They then sent the email, and the receivers had to guess what the sender was trying to express.

90% of the time, the sender thought the receiver would get their intended meaning. But, only 60% of the time the receiver could accurately guess which emotion the sender was trying to portray. (Nathan A. Heflick, "The Dangers of Email, Facebook and Twitter," Psychology Today, May 14 2011)

Of course, the sender is in a unique position of being able to know exactly what he or she is meaning. In turn, what makes sense to the sender doesn't necessarily make sense to the receiver because the receiver has less information, but the sender thinks it does.

On the receiver side, it is also extremely difficult to discern what someone means without non-verbal cues. Shrugs of the shoulder, hand expressions, and facial reactions play a huge role in normal oral communication. But, none of this is available on Twitter or Facebook or in an email. And, calamity can issue.

Do Your Friends Share Your Personal Information With Others?

A study conducted by Alan Mislove and his colleagues of Northeastern University  at the Max Planck Institute for Software Systems found,“The privacy story on these sites (Facebook) is more complicated that we like to think, as your privacy is not just a function of what you provide, it’s a function of what your friends and community members provide as well.”(Erik Hayden, "Why Privacy on Facebook is Virtually Impossible," www.alternet.org, May 15 2010)

Researchers concluded that it wasn’t “sufficient” to just give users access to privacy controls for their own profiles; the option to censor friend lists should be given to make sure that private information cannot be inferred.

The Bottom Line

Baekdal's First Rule of Privacy is in effect. When it comes to sharing personal information, only you control the outcome. When you "put it out there," you have only yourself to blame when sharing causes you difficulties. Is a little notoriety with your friends worth the embarrassment of yourself and your family? Some might even ask if you should befriend family members or colleagues on Facebook at all. 

Maybe we should write a few truths for Facebook fanatics:

1. People are extremely curious, so they are going to look at it ALL your posts.


2. People love to be awed, so the more questionable your content, the MORE people are going to examine it and want to see even more shocking revelations.


3. People judge others as a survival mechanism; thus, they are going to make JUDGMENTS about you based on what they see in your posts.


4. People are gullible, and they assume what you posts are exactly what you ARE.


5. People love to gossip, and they are going to SHARE your life with others.

Whatever you choose to reveal online about your personal life is recorded and saved for others to peruse. In a perfect world, you could rest assured that no one would use that information to detract from your character. Unfortunately, no guarantees concerning the intent of Facebook friends, or even Facebook execs, exist. Any information that presents a risk is best left unposted.

Weiner Ad Nauseam

Rep. Anthony Weiner! What about his X-rated texting and X-rated chatting? What is the representative thinking? Why would the New York lawmaker act in such an irresponsible manner? Should he resign? Let me see...

First of All, What Did Weiner Do?

Weiner admitted that he'd spent the past three years sending and receiving dirty online chat messages from six women. Some of those sessions included the exchange of X-rated photos -- including one featuring Weiner's penis -- and lewd messages.

Weiner acknowledged he had exchanged online messages with a 17-year-old girl in the state of Delaware. He said nothing improper had passed between the two of them. Nor was there even an allegation that Weiner had a physical relationship with any of the women with whom he maintained virtual relationships. That made his case a departure from the norm, a sex scandal without sex. ("Weiner Seeks Treatment, Leave of Absence From the House," Today News, Associated Press, June 11 2011)
 
According to Weiner, some of the X-rated online chat sessions took place after his marriage last July to Huma Abedin, an aide to Secretary of State Hillary Clinton. Since Weiner's admission, five women have emerged, detailing how they friended the congressman on Facebook and carried on dirty chat sessions with him. (Kevin Fasick and Clemente List, "Weiner Says He Has No Plans to Resign Following Sexting Scandal," New York Post, June 9 2011)

Just recently more photos surfaced that show Weiner standing in front of a mirror, his BlackBerry pointed forward snapping shots of bare chest, often with just a towel draped over his genitals. There are also shots of him in the middle of the exercise room, with empty elliptical trainers behind him. (Jake Sherman and Jonathan Allen, "More Anthony Weiner Photos Surface Online," www.politico.com, June 12, 2011)

Weiner Lies

For more than a week (May, 2011), Weiner lied about his online habits, claiming that a picture of him in his boxer-briefs posted online under his account was the work of a hacker or prankster.

Weiner even joked about the account being hacking on Twitter, asking whether his kitchen blender would be next to "attack" him.

Ultimately, he owned up to having posted the picture of himself. He said this was an inadvertent airing of an image that was meant to be sent directly to another Twitter user.

Weiner Is Sorry

Weiner said, "I betrayed a lot of people and I know it and I'm trying to get back to work now and try to make amends to my constituents, and of course to my family of course," he added. "I'm going to go back to my community office and try to get some work done."

"As I said when I spoke at the press conference on Monday (June 6) that I exchanged inappropriate things with people and, I think that I've now got to deal with those consequences," he added.

"I was completely honest on Monday after I hadn't been for a while," Weiner said outside his lawyer's office in Midtown.

Weiner has decided to take a leave of absence and seek professional treatment while he charts his next move.

"Congressman Weiner departed this morning to seek professional treatment to focus on becoming a better husband and healthier person," Weiner spokeswoman Risa Heller said in a statement. "In light of that, he will request a short leave of absence from the House of Representatives so that he can get evaluated and map out a course of treatment to make himself well. ("Weiner Seeks Leave of Absence For Treatment Amid More Resignation Calls," Fox News, June 11 2011)

What About Social Accountability?

Social accountability comes with social media. Indeed, employers will look at your Facebook and Twitter pages before and after hiring you; if you don’t want someone to know everything you’ve done, don’t put it out there. 

* If you're engaging in any questionable activity, don't put it out there.

* If a photo reveals less-than-complimentary behavior, don't put it out there.

* If your message (though fashioned as a funny, even witty remark) may be construed to be injurious, don't put it out there.

So Why Do People Like Weiner Do It?

People love "awe-inspiring" (often emotional) content that involves the opening and broadening of the mind, which then motivates transmission of that information. Generally, if a person comes across something that changes the way they understand something, that person will naturally want to discuss what it means with others. (Elise's Review, www.elisesreview.com)

People attempt to draw attention with shocking, awe-inspiring posts. Even if these posts are intended to be private and are privately posted to friends, they are often shared with third parties and, eventually, with scores of others.

Researchers Jonah Berger and Katy Milkman at Penn's Wharton School discovered from their study of 3,000 articles from The New York Times that the more emotional stories were shared the most. They found that the emotion of “awe” was one of the strongest drivers of sharing.

They defined awe as “an emotion of self-transcendence, a feeling of admiration and elevation in the face of something greater than the self.” In essence …the feeling that the world is a broad place and I am so small.

There are two criteria for an awe inspiring story

1. Its scale is large
2. It requires mental accommodation by forcing the reader to view the world in a different way.

If people cannot write something awe inspiring to share, then the researchers found that five other emotional factors that promoted sharing were

• Anxiety
• Anger
• Disgust
• Sadness
• Surprise

People share their emotions online. They do this to build relationships and to get something in return like more blog comments or more tweets. People also like to show off to friends, to show others how well-informed they are about what they consider to be relevant information.

And, naturally, some are just into self-promotion and impressing their friends -- "I have a blog or an account, and I want to be 'seen.' I'm going to share my information via social media whether it's awe-inspiring or not."

What Weiner Worries Mean To Me

I do not respect the antics of Anthony Weiner. He dallied online, and, when first caught, he chose to lie about it.

How serious are his transgressions? I honestly don't know. Politicians and public reaction will eventually determine the price he must pay for his mistakes.

Arguments will continue over social accountability. But, let's be concrete about the current state of affairs. Online correspondence (texting, chatting, posting) can reveal very unsavory character traits and open anyone up to public scrutiny. For many reasons people continue to share private, emotional, awe-inspiring information. For just as many reasons others will continue to uncover this information and share it with strangers. 

"When it comes to privacy and accountability, 

people always demand the former for themselves 

and the latter for everyone else." ~David Brin