2014’s top posts: #1

A terrible loss for Dawn Farm and the field

(from 3.27.14)

644154_4046299231979_1957479813_nLast night (Wednesday), Pat Gibbons, Dawn Farm’s Medical Director and psychiatrist died suddenly. We’re stunned. He was just at Spera on Tuesday night seeing clients. It’s a terrible loss for Dawn Farm and our community.

Any words I can come up with feel entirely inadequate, but here goes.

He was a model of the power of recovery. He paid his debt forward as much as anyone I’ve ever seen.

  • He was a mentor and source of support for hundreds of recovering men.
  • He volunteered for Dawn Farm in several capacities over the years. His contributions were always quiet, but always important.
  • He provided free and inexpensive medical and psychiatric care to countless clients.
  • He helped establish and disseminate a protocol that helped benzodiazepine and alcohol dependent patients safely detox in non-medical settings.

Gibbons1-300x279Pat established himself as the most respected addiction psychiatrist in the region and served at University of Michigan, the Veterans Administration, Community Support and Treatment Services, the Health Professional Recovery Program, Pain Recovery Solutions and Dawn Farm.

Pat interacted with ALL of his patients in a manner that conveyed hope, many of whom had been discarded and neglected by other systems.

Facebook is being flooded with comments from friends, former patients and colleagues remembering his kindness, intelligence, wisdom, compassion, humility, sense of humor, patience and gratitude. People are giving him credit for their recovery, their careers and much more.

In the midst of all this, he was a proud father of six children.

We are grateful to have had him as part of our family. His death is going to be a terrible loss for the community. I can’t think of anyone who has done as much to improve medical and psychiatric care for our most vulnerable community members. We will miss him terribly. He was a very good man.

gibbons-&-santa

Demographics of heroin

 

Karen, a heroin addict w. her arms around boyfriend Johnny and his brother, Bro, who is also an addict, as they lie hopelessly on a hotel bed.
Karen, a heroin addict w. her arms around boyfriend Johnny and his brother, Bro, who is also an addict, as they lie hopelessly on a hotel bed. (Source)

images (3)A new article in JAMA Psychiatry reports on demographic differences in heroin use since the 1960s. These findings are entirely congruent with Dawn Farm’s experience:

And the “type” who’s addicted to heroin has shifted considerably over the years, according to the new study. In the 1960s, the average heroin beginner was 16 years old, a minority male, and from an inner city. Now, the average age of first use is 23, and more new users are men and women from suburban or even rural areas: 90% of new users in the last decade were white. And, the study found that most heroin users – 75% – had migrated to heroin from a previous prescription opioid drug addiction.

“Our earlier studies showed that people taking prescription painkillers thought of themselves as different from those who used heroin,” Cicero said. “We heard over and over again, ‘At least I’m not taking heroin.’ Obviously, that’s changed.”

The article is behind a paywall. It’d be interesting to see if it provides a more granular look at the trends. We saw a shift in the late 1990s as heroin purity rose and price came down. This allowed new initiates to snort and smoke the drug, rather than inject. This appeared to lower the threshold for experimentation.

Chemical Dependency & The Family – from the Dawn Farm Education Series

family 2This program will provide participants with a basic understanding of how addiction impacts each member of a family. The About the presenter will describe the roles and behaviors that family members often acquire when living with addiction, ways in which each family member is affected by addiction in the family, and options for family members to obtain help to cope with addiction in the family.

Handouts and other goodies:

Handouts:

Related reading suggestions:

Slides

Video

Chemical Dependency and the Family – 10/30/2012 from Dawn Farm on Vimeo.

Audio Only

About the presenter:

LynnLynn is the director of Eastern Michigan Universities 21st Century Community Learning Centers Bright Futures out-of-school-time programs.

Lynn has worked with challenged youth and their families, teaching, counseling, and leading for over 35 years in K-12 education as well as developing and directing an adolescent outpatient program for substance abusing youth and their families.  Lynn has a deep knowledge of the challenges of children of alcoholics, family systems as they relate to addiction and the process of recovery.  She is a strong supporter of 12-step recovery.

Lynn received her doctorate in educational leadership from EMU where she studied the culture, history and politics of local communities along the Michigan Avenue corridor in Southeastern Michigan.   She recently co-authored a book chapter published in Women as Leaders in Education (Praeger, 2011), entitled “Both Sides of Mentoring:  A Leader’s Story”.  She has two grown sons, a husband and two Shetland Sheepdogs, teaches graduate courses at Eastern Michigan University and is passionate about photography.

Failure to rescue

Atul Gawande found that hospitals have high rates of variance in post surgical complications but the reason is not what he expected.

But there continue to be huge differences between hospitals in the outcomes of their care. Some places still have far higher death rates than others. And an interesting line of research has opened up asking why.

Researchers at the University of Michigan discovered the answer recently, and it has a twist I didn’t expect. I thought that the best places simply did a better job at controlling and minimizing risks—that they did a better job of preventing things from going wrong. But, to my surprise, they didn’t. Their complication rates after surgery were almost the same as others. Instead, what they proved to be really great at was rescuing people when they had a complication, preventing failures from becoming a catastrophe.

Scientists have given a new name to the deaths that occur in surgery after something goes wrong—whether it is an infection or some bizarre twist of the stomach. They call them a “failure to rescue.” More than anything, this is what distinguished the great from the mediocre. They didn’t fail less. They rescued more.

This is something that Dawn Farm has invested a lot of energy into. I wonder if this is also what separates the best treatment centers from the rest?

[via Andrew Sullivan]

Opiate use soars

Ritalin

The AP has a story on the explosion of prescription opiate sales:

Nationwide, pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available. That’s enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States.

The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in New Mexico, Nevada, Utah, Florida and other states. Opioid pain relievers, the category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention says.

It’s a good thing that pain patients have access to pain medication and I’m glad to hear that they appear to be focused on monitoring distribution and working on strategies to address diversion without restricting access to people without hurting pain patients.

The other noteworthy thing is that there are growing problems with prescription drug related crime. Ryan Leaf serves as a high profile example. Recently, there were 3 people shot in Ypsilanti (home of Dawn Farm) during a prescription drug sale. Detroit’s police chief cites prescription drug sales as a reason for increases in homicides.  There are also growing numbers of pharmacy robberies and the thieves are not interested in the cash register, they are going for the opiates.

As I’ve said before, there is no such thing as a problem-free drug policy. We’d all be better off, if this was more frequently acknowledged in policy debates.