My Essential Question

How can I portray the addictions to and withdrawals from addictive substances to the community and my peers in such a way that they realize the dangers of the addictive substances?

Why did you select this as your essential question?  What excites you most about finding the answer to this essential question?  Do you feel that this question accurately reflects a desire/need that you have to find out more about this topic?

After seeing the painful process of detoxification from substance abuse at my mentorship, I have realized that many of my peers are headed toward this outcome in their lives. Substance abuse is so prevalent among my age group and in this community. I feel that finding the answer to this question will not only benefit me, but also benefit others that see it. Substance addiction is a problem that has a solution, but to be able to prevent it would eliminate the problem in the first place. It can cause huge problems, financially, emotionally, relationally, and physically. I think if people can see the problems that addiction causes and the process  one has to go through to get over the addiction, they might reconsider the choices and decisions they make in these areas of their lives. I'm really excited to begin working on this project and see how it turns out.

Article Review

My article was titled "Management of Drug and Alcohol Withdrawal". It was a broad overview of the different treatments and their effectiveness for the three different classes of drugs: sedatives, opioids, and stimulants. In my mentorship, I get to witness the process of withdrawals from many drugs, and I have to wonder if people knew how painful withdrawals are, would they even take the drug in the first place? I have decided to do my mentorship project on withdrawing from substances, and this article was a good starting place for that.

Before treating any type of withdrawal, a history should be taken from the patient, including the time of their last use and a toxicologic screening to determine if any other substances are have been taken. The initial symptoms for withdrawal from all three classes of drugs are the same, and include dysphoria(dysphoria, nausea, insomnia, tachycardia, and hypertension. But there are different complications to withdrawal for the different drug classes, so treatment differs among them.

Sedatives consist of alcohol or benzodiazepines (ex: Xanax, Valium). Benzos are meant to treat anxiety, and alcohol achieves the same effect, but both can be abused and are addictive. The difference in withdrawals between the two is that withdrawal from alcohol is much more dangerous than withdrawal from benzos. Alcohol withdrawal can be complicated by seizures and delirium, so it is best to undergo withdrawals supervised by an experienced doctor. The symptoms for alcohol withdrawal are monitored with the Clinical Institute Withdrawal Assessment(CIWA), and high scores indicate the need for medication. In studies, it has been found that benzos are the best treatment for alcohol withdrawal, starting at a higher dose and tapering off dosages as symptoms decrease. The main problem with treating with benzos is that they obviously are addictive, too, and using them must be monitored.
Withdrawal from benzos produces more autonomic nervous system signs, but the symptoms aren't as dangerous as alcohol withdrawal. To treat withdrawal from benzos, the dosage of the drug being abused must be either tapered or replaced with a longer acting benzo.

Opioids are drugs like Heroin, Morpine, or Lortab that are meant as pain killers, but are very addictive, and withdrawing from them is a very painful and dangerous process. It is similar to a severe case of influenza. If a person chooses withdraw in an inpatient facility, they will most likely be treated with opioid medications like methadone or buprenorphine, and the dosages of these drugs will be tapered over a period of several days. If a patient is withdrawing in an outpatient setting, they will be administered nonopioid medications, like clonidine or lofexidine. It was found in studies that the optimum treatment for outpatient treatment of withdrawals was buprenorphine combined with clonidine or lofexidine. There are also rapid and ultra-rapid detoxification methods of withdrawing from opiates. The most effective rapid withdrawal treatment was a combination of buprenorphine, clonidine, and naltrexone. The withdrawal takes place in three days, but is very costly. Even more costly is the ultra-rapid detox, which requires the patient to undergo anesthesia. They are then given naloxone, which causes the acute withdrawal symptoms to occur. The opioid will be out of their system in 24 hours, but the withdrawal symptoms will most likely persist.

Stimulants like cocaine or amphetamines increase alertness, energy, and attention. They stimulate your body, so withdrawal will do the opposite. Symptoms of withdrawals from stimulants include symptoms normally seen in patients with depressive disorders. Unfortunately, no one treatment has been deemed effective in reducing the symptoms of  stimulant withdrawals, although some studies have shown certain drugs work for specific types of withdrawals.

It is also important to note that substance-dependent patients typically have other health problems, albeit medical or behavioral, so it is important to screen them for nicotine dependency, HIV, liver disease, appropriate immunizations, and abuse, among other things.

Update!!!

“Mental illness is nothing to be ashamed of, but stigma and bias shame us all.”--Bill Clinton

What President Clinton expresses here is something I have found to be true in my mentorship at Laurelwood. Many of the patients that I see there have nothing to be ashamed of, yet they have learned from society that they are outcasts because they are not the social norm. This is one of the frustrations that I experience at my mentorship.

But it's one of the very FEW frustrations that I experience. I love the time I spend at Laurelwood and am so excited and passionate about everything I've learned there so far. It's incredible to me to know just how much power the human brain has over a human being and how delicate the balance is of chemicals and hormones in the brain to keep a human healthy and functioning. 

So far, I have a seen a multitude of illnesses in a multitude of age groups, and it's very interesting to me to see the approach taken in treatment depending on the age and nature of the patient's illness. I have seen multiple cases of patients trying to detox from illegal substances and alcohol. If you ever want to see the damaging effects of these things, take a visit to Laurelwood. The effects are enormous - not only physically, but emotionally and relationally as well. The addictions and abuse pervade every area of these patients' lives. I've also seen some more severe cases of mental illness, like schizophrenia, bipolar disorder, psychosis, and PTSD. These are patients that will live their entire lives with these disorders. That is why coping skills, like journalling, artwork, and reading, are VITALLY important. 

Some other interesting aspects of my mentorship include visits to the ICU and ER at the main hospital. Here, I get to see a different area of healthcare while still maintaining the psychiatry perspective. I'm learning to read lab reports, EEGs, EKGs, CT and MRI scans, and so much more. My mentorship has strengthened my interest in the field of mental health, and I look forward to continuing education in that area.

Laurelwood

My Sentence

Some Things Happening in the World of the Brain

This is a new research project recently launched at one of the colleges that I'm applying to. It's called the "Human Connectome Project". Think Human Genome Project, except in the brain. Scientists are mapping the brain and trying to find out what all the different connections mean and do. Very Interesting!

WUSTL Human Connectome Project

I've also become very interested in bipolar disorder, and I think that this image is a good descriptor of the illness.

What's New...

Since my last post, I have started working with my mentor at Laurelwood, and I have loved every minute of it. But I'm not sure love is exactly the right word to use to describe it. Seeing these patients are definitely those experiences that makes you realize how much you really do take for granted. I'm now incredibly grateful that I wake up every morning and have the motivation to get out of bed because some people simply don't. I'm grateful that my mind works correctly and I'm not dependent on others to do the simple things for me. But I think the one thing that my mentorship has done for me so far is just to encourage me that this is what I really want to do. I think I have found my niche in the world, and my mentorship has just solidified that. Prior to starting at Laurelwood, there was definitely fear that I would be so completely overwhelmed and realize that this was not at all anything for me. I'm so glad that's not the case.

On a lighter note, homecoming is quickly approaching here at North Hall, and as Student Council President the stress is getting a little more intense with each passing day. But I'm so grateful that I have an amazing council working with me to make this homecoming awesome. It's definitely going to be a night to remember.

Just last week, I finished all of my applications and submitted them: a HUGE relief. Now all I can do is wait to hear if I'm accepted or not, but at least my part is over. I still don't know where I want to go, but I do know that wherever I go will be a place that challenges me to step out of my comfort zone, and I eagerly anticipate leaving next fall.

So far, that's what's new in my life. Until next time...

My Mission Statement

My mission is to continually grow intellectually, physically, spiritually, and emotionally, and to encourage others to do the same. I aim to try my hardest at everything I do, and persevere until I have achieved far beyond the goals I set for myself.

Talk 20%. Listen 80%.

The "Getting to Know Your Mentor" sheet was very informative. Once again, it reiterated that I leave my cell phone off, and preferably in my car. I think this is an important tip to remember because I know that my mom has interviewed people for jobs, and they have looked at their phones during the interview! That was a huge turn off to her, and needless to say, they weren't hired. 
I was also reminded in the document to keep the focus on me, not on my friends and family. I know my mentor personally, so it will be hard to do this, but now that I am aware of this, I will try.
The podcast was also very informative. The part that stuck out to me was about not getting attached to the office gossip or slacker. TALK 20%, and LISTEN 80%. I also liked the part where it talked about dressing professionally, even if it is a casual day in the office because you never know when you might meet the CEO. 
There were plenty of other good points from the document and podcast, but these were the points that stuck out to me.
I'm looking forward to beginning my mentorship and implementing these new things I have learned!