INTERESTING TIMES

3 stages of interview
1) relationship building, find common ground, acknowledge difficulty, give choices, touch the patient to facilitate connection
2) info gathering, open ended questions
3) education, negotiation, dx and tx, prioritize, starting place, bite sized piece
( notes on a wandering lecture )

Just finished reading this book. It is the most comprehensive analysis of literature, theory, science, opinion and politics surrounding addiction and drug law that I have found. I definitely need to read it again. He offers some great treatment ideas for addicts. He draws on Buddhism for his title and metaphor, and for many of his recommendations for addicts.


1/29/11 Book got a great review: http://addictiontreatmentmagazine.com/addiction/hungry-ghosts-book-review/

http://www.newstime.co.za/Health/Dutch_Centre_Gets_Alcoholics_Off_Booze_A_Draught_At_A_Time/8602/
http://www.google.com/hostednews/afp/article/ALeqM5ggAP_w12eS4TKljcvODgivEW7ZbA
http://guyism.com/2010/08/dutch-rehab-helps-alcoholics-by-letting-them-continue-to-drink-beer.html

The object is to keep their blood alcohol steady and their stress level low to avoid binge drinking. In this situation alcoholic patients are more likely to be amenable to consultations with doctors, psychologists, etc. Dr Mate would approve. Alcoholics are people too.

Open since last October, Centrum (Centre) Maliebaan in the central Dutch city of Amersfoort allows its residents to drink up to five litres of beer on the premises every day, with an hour between each 500 ml (half-quart) serving.

ASIDE: According to a recent Gallup poll 67% of US adults drink alcohol. This is a slight increase from last year and the highest fraction of the last 25 years. Beer is most popular.

The "rare syndromes" that are associated with multiple lipomas, according to my minor surgery notes, are "Gardner's syndrome and two benign conditions--multiple symmetrical lipomatosis and Dercum's disease. In the latter, the lipomas are painful". I had to look it up because my sister's husband is covered in them, and because in the last 2 years I've begun to develop them all over my body including strange locations such as over the biceps femoris tendon in my posteriolateral popliteal area--very small so far--I suspect a hormonal etiology. More occur in women after menopause, and familial types onset at adolescence. With some types there is an increased incidence of breast, endometrial and thyroid cancer. Sounds like it may be related with estrogen dominance. This would be supported by the increased incidence with obesity. There is also an association with multiple endocrine neoplasia type I (lipomas and pancreatic, parathyroid, pitutitary tumors). The list of hormonal associations increases the deeper I dig. There are also fat deposits associated with spina bifida. Looks like nobody has studied hormones in lipomatosis patients, but based on my short survey I have just now formed the opinion that is expressed in the title of this entry.
( notes: fyi, when something is marked with triple questionmarks it means that the source is not convincing and I kinda doubt it, but I'm recording it for future reference anyway )

Well so we already knew that drugs that increase serotonin levels decrease bone density over time. Medscape's new report says that osteoporosis is associated not just with SSRIs, but with benzos and some mood stabilizers other than lithium. Tricyclic antidepressants are protective for bones, but they have other gnarly side effects.

They've also found that mental disorders themselves have significant bone correlations. Dementia, schizophrenia and alcohol dependence are associated with reduced bone density. Depression is associated with less osteoporosis---which makes sense if you think that a lot of depression is due to low serotonin levels. Bipolar disorder and drugs other than alcohol were not found to have any correlation with osteoporosis.

Aside: FDA has released new warning that Tramadol (an opioid) increases suicide risk.

(whoda thunkit)

Beer Bones and Hops
Jacob Schor
March 2010

The online version of this article contains abstracts of all papers referenced and may be found at:
http://denvernaturopathic.com/beerandbones.htm
( Text here: great article from Denver Naturopathic on effects of Humulus lupulus and more. )

SIDS = Sudden Infant Death Syndrome. It is a "wastebasket diagnosis" for any infant death not pegged to some other cause. Based on this study we can say that many cases of SIDS are due to parental discombobulation. You know what discombobulation is, right?
( risks of sudden death much higher for babies of parents who have been hospitalized for any psychiatric reason, and when parents abuse alcohol or drugs )