Markham's Behavioral Health

Lethal drug overdoses in the year ending in April 2021 killed 100,000 people.

Lethal drug overdoses in the year ending in April 2021 killed 100,000 people.

 

In my practice I know far more people who have died from drug overdoses than from Covid-19.

 

The interesting observation is that people have much more control over lethal drug overdoses than they do of Covid-19 in the sense that the exposure to the agent of death is under the individual's control.

 

What are the factors that contribute to the high level of substance misuse in the United States?

What can we do as psychotherapists do to ameliorate the suffering that contributes to this phenomenon?

Fentanyl is a killer drug in 50% of opioid overdoses.

Fentanyl is 10 times more powerful than heroin. Gets mixed into street heroin and kills users by unintentional overdoses.

Children in U.S. 3xs more likely to be prescribed psychotropic medications than in Europe

Science Daily reported on September 25, 2008 on a study which will appear in an upcoming issue of the journal, Child and Adolescent Psychiatry and Mental Health, which found that children in the United States are three times more likely to be prescribed psychotropic medications than children in Western Europe. The authors speculate on the reasons for the difference in practice. If you would like to read more click here.

Coronary Heart Disease Deaths And Decreased Smoking Prevalence in Massachusetts, 1993-2003

According to a study published in the August, 2008 issue of the American Journal Of Public Health in the ten years since the implementation of the Massachusetts Tobacco Control Program in 1993, the smoking prevalence rate dropped 29% and the coronary heart disease mortality rates dropped 31 %  with 425 fewer deaths which resulted in 3,365 extra life-years.

As a public health intervention, controlling tobacco use in populations has big health dividends. However, they raise interesting moral issues such as should people be able to engage in life damaging behaviors such as smoking? Should this be an individual choice or should governmental intervention make such choices difficult?

Here is the abstract from the AJPH.

We used the previously validated IMPACT coronary heart disease (CHD) mortality model to estimate the CHD deaths attributable to reductions in smoking prevalence following the introduction of the Massachusetts Tobacco Control Program (MTCP) in 1993. A 29% and 31% decline in smoking prevalence and CHD mortality rates occurred, respectively (from 1993 to 2003). A total of 425 fewer CHD deaths, which generated approximately 3365 extra life-years, were attributable to decreased smoking prevalence. With these results in mind, a comprehensive tobacco control program should be sustained and supported.

Coronary Heart Disease Deaths And Decreased Smoking Prevalence in Massachusetts, 1993-2003 -- Kabir et al. 98 (8): 1468 -- American Journal of Public Health.

Money For Nothing, the book

Edward Ugel has written a light breezy memoir entitled, Money For Nothing: One Man's Journey Through The Dark Side Of Lottery Millions. Ugel describes his career as a lump sum salesman to lottery winners who rather than wait for the annual annuity check decide to sell their win to a financial investment company for a lump sum.

Ugel describes how the lump sum salespeople prey on the weaknesses and character defects of winners to make their sales and collect thousands in commissions. Turns out Ugel has a gambling problem himself and so part of what makes him a successful salesman in this bussiness is that "it takes one to know one."

The thing that makes this book palatable is Ugel's self denigrating stance, his humor, and his humility. He is aware of his problems and he knows that at once they are his greatest assett and his greatest deficit. He makes no bones about it and seems honest in a way that is refreshing and kept me reading to the end.

The book is disjointed and written like a high school term paper, but enjoyable nonetheless and gives the reader an inside glimpse of the underbelly of state lotteries, the people who play them, and the people who prey on the unfortunate winners.

Prom and graduation season

1/3 of the 1,700 kids, aged 18 - 14 killed each year from accidental injuries (including motor vehicle crashes), homicide and suicide occur during prom and graduation season.

Because of this heightened concern and awareness I have been asked to give some presentations at some of the local high schools. I have three scheduled this year, and the last two days I have given two, and next week I will do the third. These presentations are given to high school assemblies of seniors,  and in some cases seniors and juniors, about DWI and making "good choices". This has been less than satisfying for me for a whole bunch of reasons. However I have been given an opportunity to review some of the data and I thought I would share some of it here because I think it is instructive in many ways of the kind of society we are living in.

1 in 3 12th graders report, on survey, that they have binge drank (5 or more drinks on a single occasion) in the last two weeks. This data is pretty consistent in Genesee County,NY, New York State  as a whole, and across the country.

Goofing on the 150 or so juniors and seniors I talked with this morning, I asked them to raise their hands if they had binge drank in the last two weeks. Surprisingly about twenty hands went up and one kid shouted out laughing, "Yeah, I got wasted!!!", the kids around him laughed.

I asked them why they think so many kids binge drink and they shouted, "Because it's fun."

I guess it is to a point. BUT.............................................................

90% of the estimated college rapes per year (97,000) occur when the victim, perpetrator, or both are intoxicated. I live in a college town and I remember a few years ago seeing an article in the college newspaper reporting that 11 rapes had been reported to campus security that year. I was startled. Is that high, low, under reported? I thought rape was a serious felony crime and rapists, if convicted, go to prison. Are college student rapes on a college campus reported to campus security handled differently? Is this a different type of crime?

25% of sexually active college students , or about 400,000 college students between the ages of 18 - 24 per year, report having unprotected sex per year while under the influence. Studies have found that 20- 25% of young women are infected with a STD like chlamydia and/or gonorrhea without knowing it.

11% of college students report perpetrating property damage while intoxicated.

25% of college students report symptoms of academic failure ( missing classes, late papers, doing poorly on exams) because of alcohol.

Living in the downtown area of a college town in Brockport, NY, on Saturday morning when I walk the two blocks from my house to my office to see clients, I have to walk around the piles of vomit on the village sidewalks. Last week I could actually see the elbow macaroni and beans from Jimmy Z's garbage plate in the vomit. There were three piles on the corner of King Street and Main Street. This is a common occurrence. I pointed out to the kids this morning that alcohol is poison and your body tries to reject it and if the body cannot, alcohol poisoning leads to coma and death.

Alcohol is readily accepted in our society and glamorized in commercials and advertisements constantly. Is it any wonder that "getting wasted" and "to party" have become synonymous?

After my two kids were killed in a drunk driving crash, perhaps I am over sensitive, but the tragedies and heartache caused by alcohol, it seems to me, far outweigh its benefits and pleasure especially when used to excess as the youth in our society seem to do in significant numbers.

Here is my daughter Brigid in her Irish dancing dress before a performance when she was 5 about a week before she was killed.

Brigid Kathleen Markham

04/11/87 – 03/10/93

Here is my son Ryan in his Irish dancing outfit before a performance about a week before he was killed .

Ryan John Patrick Markham

05/09/84 – 03/10/93

Here is the 18 Wheeler tractor trailer that smashed into the car driven by my wife and with four of my children in it. It was the driver's third DWI.

   

This is me, a tired old man, talking about it after 15 years. Had they not been killed at age 5 and 8, Brigid would be 21 today, and Ryan would be 24. I miss them terribly. They were great kids and would have been outstanding adults. Our world is poorer for not having them in it.

Missing child now a prostitute

Another Onion satire that can make you cry as well as laugh.

Age progression techonology indicates a missing run away child is a prostitute by now. Today Now with Tracy Gill. Video lasts 2:49

Age-Progression Technology Indicates Missing Child A Prostitute By Now

Americans are addicted to TV.

Americans are addicted to TV. This is Turn Off TV week, April 21-April 28. 2008.

First you've heard of it? Did you expect to see this on TV? Of course not. Advertisers would not pay for advertisements if no one was supposedly watching them. The materialistic, capitalistic enterprise that we have come to know as American democracy would be cut off at the roots for a week.

The majority of Americans could not go a week without TV anyway. We have become so addicted, TVs now appear in our restaurants, sports arenas, camping grounds, shopping malls, churches, everywhere. If someone were to swear off TV like an alcoholic swears off alcohol, where could you go where your addiction would not be triggered?

There are real withdrawal symptoms. The kids become irritable and fight more initially. Mom and Dad are out of sorts and their anxiety and tension goes up. Cravings become pronounced the first few days as your mind is full of vivid images of your favorite shows and you become distressed about what you are missing.

If you doubt my statement that Americans are addicted to TV, I encourage you to test the statement for a week and shut the TV off. Let me know how it goes.

Here is a brief video on how to break TV addiction. It lasts about 1 minute.

NIH Research Suggests Stimulant Treatment for ADHD Does Not Contribute to Substance Abuse Later in Life

According to a April 1, 2008, press release by the National Institutes of Health, NIH, recent studies indicate that the use of stimulate medication to minimize symptoms of ADHD in youth does not contribute to substance abuse. Here is a brief snippet of the release:

Treating children as early as age six or seven with stimulants for Attention Deficit Hyperactivity Disorder (ADHD) is not likely to increase risk of substance abuse as adults, according to two studies funded by the National Institutes of Health (NIH). However, the studies also showed treatment with stimulants did not prevent substance abuse later in adulthood. The studies, conducted by researchers at New York University School of Medicine (NYU) and the Massachusetts General Hospital/Harvard Medical School (Mass General) are being published in this month’s American Journal of Psychiatry.

Link: NIH Research Suggests Stimulant Treatment for ADHD Does Not Contribute to Substance Abuse Later in Life, April 1, 2008 News Release - National Institutes of Health (NIH).

George W. Bush and his war on Iraq

George W. Bush - Do you want this man to answer that call at 3:00 AM?