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Drugs

Treatment and Support for Substance Use Disorder

  • Posted Apr 16, 2019
  • hchadmin

Are you concerned that you, a family member or friend may have a substance use disorder (SUD)? SUDs occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. It's necessary that you educate yourself about the support that may be available to you or that you may need to provide to others in order to achieve a sustained recovery.

The National Institute on Drug Abuse (NIDA) offers the following information if you think you might have an addiction:

•It's important to know that addiction can be successfully treated. Contact your primary care physician who can help coordinate your care and refer you to a specialist, if needed. If you don’t have a primary care physician, just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions. Or, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website for more information and resources.

•It takes a lot of courage to seek help because there is a lot of hard work ahead. However, treatment can work, and people recover every day.

•Your treatment approach must be tailored to address your specific substance misuse pattern and also your substance-related medical, psychiatric and social needs.

•There are different kinds of addiction specialists who will be involved in your care, including doctors, nurses, therapists, social workers, and others.

•Behavioral treatment (also known as "talk therapy") can help you engage in the treatment process, change your attitude and behaviors related to substance misuse, and increase your healthier life skills.

•Medications are available to treat addictions to alcohol and opioids (heroin and pain relievers). Other medications are available to treat possible mental health conditions.

•Self-help groups can extend the effects of professional treatment. These groups can be particularly helpful during recovery, as they are a source of ongoing communal support.

If you have an adult family member or friend who is struggling with the misuse of alcohol and/or drugs, NIDA offers the following tips:

•Recognize that you can't fix the problem by yourself. If someone you care about has asked for help, he or she has taken an important first step. If that person is resistant to help, perhaps you can at least convince him or her to get an evaluation from a doctor.

•You can always take steps to locate an appropriate physician or health professional, and leave the information with your friend or family member.

•Emphasize to your friend or loved one that it takes a lot of courage to seek help for a drug or alcohol problem because there is a lot of hard work ahead. But assure them that you will be supportive in their courageous efforts.

•The pressure of family and friends sometimes compels people to enter treatment. However, it's better that you focus on creating incentives to at least get the person to a doctor.

•If your friend or loved one was previously treated and then relapsed, they have already learned many of the skills needed to recover from addiction and should try it again. 

•People being treated or recovering from SUDs relapse about as often as do people with other chronic diseases such as hypertension and diabetes. Treatment of any chronic disease involves changing deeply imbedded behaviors, and relapse sometimes goes with the territory.

•Encourage your loved one to participate in a self-help group during and after formal treatment. These groups can be particularly helpful during recovery, as they are a source of ongoing communal support.

You may also consider contacting your site Employee Assistance Program (EAP).  Your EAP is a confidential resource that provides counseling, information and referral services to help address personal, family or work-related concerns. These services are provided to you and your family members free-of-charge as one of your employee benefits.

As your trusted health partnerf or life, Holy Cross Hospital is committed to providing resources that promote well-being though body, mind and spirit and is dedicated to helping you Live Your Whole Life.


[Disclaimer: Trinity Health is a Catholic health care facility that is firmly committed to maintaining fidelity to its Catholic identity by closely conforming to the Ethical and Religious Directives for Catholic Health Care Services (ERDs). The links provided here are independent sites and have no obligation to provide information that is always congruent with the ERDs. Trinity Health cannot guarantee their content and ask for your discretion when using information from these sites]

 

Signs and Symptoms of a Possible Substance Use Disorder

  • Posted Apr 09, 2019
  • hchadmin



The misuse and abuse of alcohol, over-the-counter medications, illicit drugs, and tobacco affect the health and well-being of millions of Americans. Drug and alcohol dependencies can lead to other chronic diseases such as diabetes and heart disease. Addressing the impact of addiction is estimated to cost Americans more than $600 billion each year, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

It is important to recognize the signs and symptoms of alcohol and drug misuse early. If you’re worried about your own drug or alcohol use, or that of a friend or family member, the National Council on Alcoholism and Drug Dependence (NCADD) provides the following warning signs that you should look for:

•    Loss of Control: Drinking or drug use more than a person wants to, for longer than intended, or despite telling themselves that they wouldn’t do it this time.
•    Neglecting Other Activities: Spending less time on activities that used to be important (hanging out with family and friends, exercising, pursuing hobbies or other interests) because of the misuse of alcohol or drugs. Also a drop in attendance and performance at work or school.
•    Risk Taking: More likely to take serious risks in order to obtain one’s drug of choice.
•    Relationship Issues: People struggling with addiction may act out against those closest to them, particularly if someone is attempting to address their substance problems. Additionally, there may be complaints from co-workers, supervisors, teachers or classmates.
•    Secrecy: Going out of one’s way to hide the amount of drugs or alcohol consumed or one’s activities when drinking or using drugs. There may also be unexplained injuries or accidents.
•    Changing Appearance: Serious changes or deterioration in hygiene or physical appearance such as lack of showering, slovenly appearance or unclean clothes.
•    Family History: A family history of addiction can dramatically increase one's predisposition to substance use disorder (SUD).
•    Tolerance: Over time, a person's body adapts to a substance to the point that they need more and more of it in order to have the same reaction.
•    Withdrawal: As the effect of the alcohol or drugs wears off, the person may experience symptoms such as anxiety, trembling, sweating, nausea and vomiting, insomnia, depression, irritability, fatigue, loss of appetite and headaches.
•    Continued Use Despite Negative Consequences: Even though it is causing problems (on the job, in relationships, for one’s health), a person continues to misuse alcohol and drugs.

If you are struggling with a SUD, don’t hesitate to reach out. Help is available. Contact your PCP who can help coordinate your care and refer you to a specialist, if needed. If you don’t have a PCP, just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your trusted health partner for life, Holy Cross Hospital is committed to providing resources that promote well-being though body, mind and spirit and is dedicated to helping you Live Your Whole Life.

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Awareness is Key to Addressing Substance Use Disorder

  • Posted Apr 03, 2019
  • hchadmin

The numbers are sobering. In its 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes — United States, the Centers for Disease Control and Prevention (CDC) reports that, in 2016, an estimated 48.5 million persons in the U.S., or 18 percent of persons aged 12 years and older, reported use of illicit drugs or misuse of prescription drugs in the past year. This estimate includes use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, and methamphetamines, and the misuse of prescription drugs. During that same year, a total of 63,632 persons died from drug overdoses. This number has nearly doubled in a decade.

Substance use disorders (SUDs) occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school or home. Addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to.

Awareness about the scope of SUD and the physical, mental, emotional and spiritual toll it takes is one component, along with prevention and treatment to improve the lives of affected individuals.

There is good news regarding prevention. National Institute on Drug Abuse (NIDA)-funded research has shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction.

Treatment for SUDs generally isn’t a cure. However, addiction is treatable and can be successfully managed. According to NIDA, treatment should be ongoing and should be adjusted based on how the patient responds. Treatment plans need to be reviewed often and modified to fit the patient’s changing needs.

If you or a loved one is struggling with the misuse of drugs or alcohol, don’t hesitate to reach out. Help is available. Contact your PCP who can help coordinate your care and refer you to a specialist, if needed. If you don’t have a PCP, just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your trusted health partner for life, Holy Cross Hospital is committed to providing resources that promote well-being though body, mind and spirit and is dedicated to helping you Live Your Whole Life.

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Awareness is Key to Addressing Chemical Dependency

  • Posted Apr 17, 2018
  • hchadmin

 pile of coloful pills

The numbers are sobering. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported that, in 2016, approximately 20.1 million people aged 12 or older had a substance use disorder (SUD) related to their use of alcohol or illicit drugs in the past year, including 15.1 million people who had an alcohol use disorder and 7.4 million people who had an illicit drug use disorder. Additionally, according to the Centers for Disease Control and Prevention (CDC), in 2016, more than 64,000 Americans died from overdosing on illicit drugs and prescription opioids. This number has nearly doubled in a decade.

SUDs occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school or home. Addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to.

Awareness about the scope of chemical abuse and dependency and the physical, mental, emotional and spiritual toll it takes is one component, along with prevention and treatment to improving the lives of affected individuals.

There is good news regarding prevention. National Institute on Drug Abuse (NIDA)-funded research has shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction.

Treatment for chemical dependency generally isn’t a cure. However, addiction is treatable and can be successfully managed. According to NIDA, treatment should be ongoing and should be adjusted based on how the patient responds. Treatment plans need to be reviewed often and modified to fit the patient’s changing needs.

If you or a loved one is struggling with chemical dependency, don’t hesitate to reach out. Help is available. Contact your PCP who can help coordinate your care and refer you to a specialist, if needed. If you don’t have a PCP, just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your trusted health partner for life, Holy Cross is committed to providing resources that promote well-being though body, mind and spirit and is dedicated to helping you Live Your Whole Life.

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Prevalence of high blood pressure

  • Posted Jun 29, 2010
  • Alan Niederman, MD, FACC, FACP

beating-anginaThere has been a great deal of discussion recently about the problems with various drugs for hypertension.  None of this discussion puts this disease into context.  Perhaps the greatest difficulty with hypertension is helping patients understand the concept of “saving now for retirement later.”  What I mean by that is the vast majority of patients have no symptoms from their hypertension yet the medicine can impart some problems.  If ignored by patients, hypertension can lead to heart, kidney and brain problems.  You don’t know it’s a problem until it’s too late.  If you take your medicine and “save now”  you can “retire” later because you won't have had a stroke or be on dialysis or have heart difficulties.

An article published in JAMA titled US trends in prevalence, awareness, treatment and control of hypertension highlights these concerns.  This data was derived over the years 2007-2008.  It showed that only 50% of those treated had their pressure controlled.  This 50% number was significantly better than the 2000 number which was 31%.  The prevalence of hypertension in the population remains fairly constant at 29%.

Let’s do the math.  It’s estimated that 70 million people in the United States have hypertension; 20% don’t know they have it.  Of the remaining 80% or roughly 56 million people only 50% have their pressure adequately controlled.  It’s enough to give you hypertension thinking about it.  Clearly much more can and needs to be done.

One of the first efforts is to prevent the problem.  It is felt that many patients would not be hypertensive if they controlled their weight and salt intake. This salt restriction idea is getting a significant amount of press lately and New York city may make a big effort to ban salt just as they did smoking and the use of trans fats in cooking.  Just try getting a decent hot dog soon.

One last note. As I have often mentioned in these blogs, we as a nation are not getting any thinner.  Weight gain often brings on hypertension.  It is felt that we are using better drugs to offset the gains in weight that patients are presenting with and we as physicians are using more drugs to get patients “to goal.”  Help us out.  Lose weight, limit you salt intake, get some exercise, and don’t smoke.  You have heard it all before. 

Is it starting to sink in?


No “right” answers

  • Posted Jun 25, 2010
  • Alan Niederman, MD, FACC, FACP

When it comes to prescribing drugs, doctors must weigh the risk of giving any drug versus the benefits of those drugs.  Common drugs that we use today have significant and at times fatal reactions. 

Guess the drugs that correspond to the following side effects:

Side effects: Anaphylactic shock and death. Drug: Penicillin. 

Side effects: fatal bleeding, anaphylactic shock and asthma with severe respiratory distress.  Drug: Aspirin.

Side effect: respiratory depression with cessation of breathing. Drug: morphine. 

I could go on and on.

This is the practice of medicine.  You have a disease and need a treatment.  Doctors try and find a treatment which is not worse than the disease.  The drugs reported on in this study were being used in the disease of congestive heart failure.  Congestive heart failure, when it is Class 3 or 4, has almost 100% mortality at five years.  This class of drugs when used in this disease state significantly increases your chance of living and improving your quality of life.  Is it worth it to take the drug?

It is true that the same benefit is received when you take angiotensin converting inhibitors but many patients have side effects from those drugs.  The angiotensin converting enzyme blockers are better tolerated.  They are also much more expensive and many patients are given angiotensin converting enzyme inhibitors first and then when they are not tolerated switched over.

What this study really does is to provide a starting point for further evaluation.  There is a wealth of data that the FDA has and these studies are meant to serve as a means of impelling them to review their data or providing it to people who will.

In the next weeks the public will hear about the diabetic drug Avandia which has been in the news over the past year.  It is very possible that this drug which already carries a “black box” warning, which is the highest level of warning the FDA has, maybe removed from the market.  We will have to wait and see.

In the meantime, if you are taking these drugs continue them and discuss this with your doctor.  If you really don’t want to get lung cancer don’t smoke.  In London, the cigarette packages say smoking kills in large print.  Better than our warnings.


About Holy Cross Hospital

Holy Cross Hospital is a nonprofit, Catholic hospital in Fort Lauderdale, Florida, dedicated to innovative, high quality and compassionate care. For nearly six decades, Holy Cross has continuously expanded its services to provide leading-edge care for their patients in Florida and for those from elsewhere in the United States. Holy Cross also offers an International Services program to ensure that patients from outside the U.S. receive the care they need.

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