Category: Psychiatry/addiction therapy

The Netflix Late Reviewer: American Sniper missed the mark

TV-screen-with-feetJuly 4, 2015- by Steven E. Greer, MD

I finally saw the acclaimed Clint Eastwood film American Sniper. Bradley Cooper played the character of decorated Navy SEAL sniper Chris Kyle, for which he was nominated Read more »

The super cool new drug: Marijuana

May 31, 2015- By Steven E. Greer, MD

I was watching Green Day give their Rock and Roll Hall of Fame acceptance speech and the singer made some references to smoking pot, as if it was his generation’s thing. I have wondered to myself Read more »

Did antidepressants cause the Germanwings pilot to commit suicide and mass homicide?

Germanwings debrisMarch 30, 2015- Opinion by Steven E. Greer, MD

The facts are now becoming known in the Germanwings Flight 9525. The co-pilot, 27-year-old Andreas Lubitz, was being treated with antidepressants for an “extended period of time” before flying Read more »

How pain pills almost killed my mother after elective knee surgery

OxycontinMay 21, 2014- By Steven E. Greer, MD

My mother is in her 70’s and in good health except for debilitating knee arthritis. After considerable research and second opinion (a bad spine surgeon misdiagnosed her knee pain as sciatica), she underwent elective total-knee replacement of her left knee with a Stryker Triathlon implant. Her surgeon was Dr. Vivek Sahai who operates out of Riverside Hospital, in Columbus, Ohio.

The surgery went well. Several days after surgery, she was eating and tolerating physical therapy, but was taking Oxycontin. I am too aware of the dangers of opioids, and that worried me. Read more »

Dr. Drew Pinsky defends his show after five deaths on Celebrity Rehab

Update on the DEA’s efforts to curb the “pain pill mill” problem in Florida

March 7, 2012  By Steven Greer, MD

We previously interviewed Special Agent Mark Trouville, the DEA agent in charge of tackling the rampant abuse of prescription opioid pain pills in Florida, and the “pain pill mill” system. Since then, the State of Florida passed laws making it harder for doctors to operate the illegal clinics, and the results have been dramatic.

In one year, the number of oxycodone pills ordered by physicians has declined 97%. Most of those pills were traveling out of the State of Florida to the rest of the country. In addition to bad doctors and the dispensing pain pill mill clinics, the DEA has also addressed higher up the food chain and shut down a Cardinal Health distribution center for allegedly looking the other way, still shipping to CVS pharmacies that were distributing too many pain pills to reasonably meet the demand of the region.

In this video interview, Special Agent Trouville gives us an update.

Florida’s Pain Pill Mill Problem

Update April 19, 2011

President Obama’s administration announced plans to make it more difficult to abuse prescription pain pills. Many critics say that it lacked teeth and that his FDA has not gone far enough with mandatory education and compliance changes for prescribers. Meanwhile, narcotic pain medications are the third largest category of total prescription drug sales in 2010 according to this IOM report.

April 7, 2011

Florida is the source for almost all “Pain pill mills” providing oxycodone prescriptions to addicts and “dope dealers”. Shady strip mall offices with armed guards will serve long lines of drug buyers with license plates from Ohio, Tennessee, Massachusetts, etc. The Miami division of the DEA recently made a series of busts arresting those doctors writing the prescriptions, many of whom drove exotic sports cars and lived in gated communities.

Of all the doctors in the country, 98 out of the top 100 prescribers of oxycodone are from Florida. An average of seven victims a day die in Florida alone from prescription pail pill overdoses.

Special Agent Mark R. Trouville of the DEA Miami Field Division discusses the Florida problem and what they are doing about it.

 

Should Tiger Woods fire his inner circle?

Update, May 31, 2011

The New York Post is reporting that IMG has fired Tiger Woods’ agent, which is a good move, in our opinion (see below)

April 9, 2010

By Steven Greer, MD,  Op-Ed, The Healthcare Channel

Tiger Woods roared back to competitive golf at The Masters after taking a five-month hiatus to repair his marriage and undergo rehab for an undisclosed addiction. In true champion form, he posted his best first round ever at the tournament. The fans cheered him and welcomed him back. America could use a nice role model and comeback story at this time of economic gloom and high unemployment.

Lurking behind this good story, however, is an inner circle of people around Mr. Woods who may have enabled his past indiscretions and abuses. If true, should Tiger make some changes to his staff?

Contradicting statements made by Mr. Woods that none of his closest staff knew about his numerous episodes of philandering, the current Vanity Fair reports otherwise. The article asserts that Byron Bell, President of Tiger Woods Design, may have assisted Tiger in arranging his affairs with young women. It also asserts that Tiger’s agent, Mark Steinberg, assisted on at least one occasion of covering up an affair once a national paper learned about it. Also, some of Mr. Woods’ few personal friends include infamous gamblers and womanizers Charles Barkley and Michael Jordan.

The New York Times reported that Tiger’s inner circle of staff and friends are fiercely loyal and that he has fired previous staff when they sought personal recognition. Has Tiger now just really assembled a team of enablers to his addictions? Can he possibly recover with these people still closely attached?

Walking off with Tiger after the 18th hole of Augusta on the first round was Mr. Woods’ sports agent. Why does a sports agent need to even attend the Masters, much less be so close to him during play? The rest of his circle is also at the Masters including Mr. Bell, his publicist, and a reported 90 bodyguards. Charles Barkley was in the media for “reaching out” to Tiger after his rehab. Jack Nicklaus, Bobby Jones, and Arnold Palmer never had such an entourage at major tournaments.

Addiction expert George Kolodner, MD, co-founder and Medical Director of the Kolmac Clinic, one of the most respected rehab facilities in the East Coast, commented, “We encourage our patients to establish a sober social network. We ask them to look at their current relationships and decide which people are understanding and supportive of their recovery and which ones are not and are unlikely to change. It is the last group that we suggest the patients keep at a distance until their recovery is more stable.”

The fact that Tiger Woods has made no changes to his inner circle of staff and “friends” who were around during his dark days of abuse is very concerning for his prospects of a long-term recovery. The similarities to the opportunists surrounding Howard Hughes, Elvis Presley, Michael Jackson, Anna Nicole Smith, etc, are eerie. Do Tiger’s closest friends know too many details about his bad behavior making them difficult to fire?

The only close confidantes that Tiger Woods should have around him are his caddy, swing coach, doctors, reputable accountants, wife and family. A priest or Buddhist monk might help as well. The recidivism rate for some addictions is 90% and he needs all the help he can get.

Bankole Johnson, MD: Topiramate (Topamax) for alcohol dependency therapy

Dr. Bankole Johnson, Chair of Psychiatric Medicine at the University of Virginia and addiction therapy specialist discusses his paper in JAMA regarding the use of Johnson and Johnson’s Topamax to treat alcohol dependency.


Pain pills cause celebrity strange behavior

Michael Jackson will be missed by billions of fans. In addition to his talent, his strange behavior in the second half of his life is well documented. He earned the nickname “Whacko Jacko”. His obsession with plastic surgery, altering his skin color, Neverland Ranch activities, odd purchases of material objects, dangling his baby over a balcony, etc were bizarre indeed. Was it the fame that made him strange or something else?

The police are investigating Michael Jackson’s death for being possibly caused by a drug overdose. MJ was known to have had a problem with prescription pain pills. Opioid pain pills were likely the largest contributor to MJ’s erratic behavior.

The class of opioid pain medications are known to cause psychiatric side effects of agitation, depersonalization, depression, emotional lability, and hallucination. This is listed in the labels (see page 19). Michael Jackson exhibited almost all of these traits later in life.

Other famous figures in history addicted to prescription pain pills have also demonstrated these psychiatric traits. Many have died from the drugs. Howard Hughes became a recluse and died while hooked. So did Elvis Presley and Heath Ledger. Britney Spears and Paula Abdul are just a few more examples of labile behavior.

It is not well appreciated that female celebrities on the West Coast begin taking opioid pills to lose weight on the “Hollywood Diet”. They become anorexic in many cases, then the psychiatric pathology becomes evident in the media. Pain pills have been good for the business and circulation of tabloids.

With the death of Anna Nicole Smith, the police began to treat the irresponsible prescribing of restricted pain pills as a criminal act. Her doctors were arrested. Michael Jackson’s doctor will likely be arrested when he is found. The FDA is also finally taking action. The are planning the largest ever REMS, or risk evaluation and mitigation strategy, to overhaul and restrict the way doctors prescribe Opioids.

Prescription pain pills are now the most commonly abused drug; more than marijuana. With these high-profile deaths and changes underway at the FDA, this problem might be addressed.

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