Is it addiction or dependency?

Addiction vs dependency5Dr. Michael J. O’Connell, Healthcare Consultant, New Hampshire commented that the distinction between addiction and dependency is constantly mangled by the press, lay people and even many professionals.  The difference between dependency and addiction is not withdrawal.  Withdrawal is a phenomenon common to both.

Addiction marks a transition into pathology; the chemical, activity or behavior to which one is dependent (oxycodone, heroin, alcohol, THC, sex, eating, extrovertism/introvertism) becomes harmful…physically, psychologically and/or functionally, to the individual.  Withdrawal or craving is not necessarily a pathology and therefore not necessarily an indication of addiction.

One would be hard pressed to declare a weekly snorter of heroin or cocaine an addict.  If a person dreams much about food, craves certain tastes or dishes, but lives a functional work and social life and is not obese, this can hardly be defined as an addict.  If another has elevated liver enzymes, presence of abdominal fat in an otherwise slender body, is thinking about drinking alcohol much of the day, has a couple DUIs, occasional blood in the stools, and yet persists in drinking alcohol, this is most likely an addict.

If a chronic back pain patient has had a laminectomy and then fusion, still requires pain meds but goes into intense withdrawal with sweating, shakes, diarrhea, and piloerection, when away on a trip forgetting meds at home, this is dependency, but unlikely addiction.

 

Gender inequality and income…

pay inequality 3Dr. Michael J. O’Connell, Healthcare Consultant, Barrington, New Hampshire commented that the media is once again exploding over the issue of gender inequality regarding income.  So no better way of making the case than parading out Jennifer Lawrence, the eminent female star of the Hunger Games series et al, who earns a paltry $14 million per film.  Apparently that’s not as much as what a star leading man commands.  Who knew?  What a damn shame.

Why is it, Liberals are so quick to aim their weapons at CEOs and Wall Street tycoons, and the perceived glass ceilings, and yet ignore the conspicuously wealthy in Hollywood?  Could it be that what really matters to them is the politics of the fat cats?  The horror of a stockbroker earning $200,000 a year…this deserves Liberal protests, chest pounding and screams of outrage.  But the fact that Oprah earns $200,000 a month does not cause them a stir.  Interesting.

Liberals have always given the entertainment industry a pass on its arrogance and innumerable individual misdeeds, and the industry rewards this nod by donating its celebrity (and celebrity dollars) to Liberal politicians.  If Hillary Clinton and Bernie Sanders are truly committed to reversing the earnings’ disparities, as they both claim in their debates, maybe they need to start including those glaring examples that are among their very donors.

 

Kudos to Papplebon!

PapplebonDr. Michael J. O’Connell, Healthcare Consultant, Barrington, New Hampshire commented that last October we witnessed on the professional baseball field something that doesn’t happen but once in a blood moon.  A ballplayer (Jonathon Papplebon) called out a teammate (Harper) for not hustling his run to first base on a routine fly ball.  The two argued briefly in the dugout, then scuffled with a few punches flying briefly, all caught on televised broadcast.

Such laziness and lack of hustle is commonplace in baseball in particular (showing late for practice is commonplace in football).  In decades past this behavior was met with fairly severe measures including counseling by the manager (on and off the field), fines imposed by the team, possible suspension.  This discipline never happens nowadays, partly due to the union influence, partly due to our politically correct society.

The real travesty though is not Harper’s lack of hustle, that’s expected, but the fact that Papplebon was suspended.  Not Harper… Papplebon.  Jonathon should be rewarded for having the balls to do what today’s coaches/managers/owners are scared to death of doing. For what the players are paid, for such incredibly narrow talents/skills, they should run out all fly balls – run like they mean it.

Open letter to the Republican Party….

Republican Party TwoDr. Michael J. O’Connell, Healthcare Consultant from Barrington, New Hampshire commented:

  1. I understand the need to pander to the religious right, especially during the primary season, but let’s make sure we have a solidly right/centrist candidate for the general election – Mitt Romney where are you? Let’s not embarrass ourselves with a cretin like Trump or Cruz.
  1. Can you please forget Obamacare? It’s here to stay and it makes all Republicans look petty and desperate with these efforts to repeal.  There is no way legislation would successfully override a presidential veto, so it’s all window dressing.
  1. Likewise window dressing is the stance on debt with this menace, the monthly debt crisis – get things squared away after a Republican is in the White House.
  1. Gun Control – Let’s pull away from the NRA finally and ensure that assault weapons are banned. Sure they are plenty fun to shoot, but remember the Ford Pinto was pulled off the market?  It was fun to drive but turned into an inferno when rear ended.
  1. Abortion – I’ts here to stay. It’s a protection afforded by the Supreme Court.  Let it go—see #2
  1. Fiscal Responsibility – Definitely, Liberal spending must stop.
  1. Defense – Absolutely necessary to have a strong mobile force.
  1. The country, nah the world, needs measures to control population growth – the poor in this country are often ill-prepared to have more babies – Planned parenthood is the best tool to assist them in more thoughtful family development. Stop efforts to defund Planned Parenthood – again makes the party look stupid and totally alienates the left.
  1. Climate Change – WAKE UP REPUBLICANS – it’s occurring – only a few loony bin pseudo scientists reject – let’s admit to global warming, regardless of the cause. To deny is to look like a Monkey’s Ass

 

Opioid addiction among more young pregnant women…

opioid addiction pregnant2Dr. Michael J. O’Connell, New Hampshire, recently commented that as addiction to various forms of opioids is becoming prevalent, more young women than ever are presenting for delivery on methadone, heroin, oxy and other drugs.  This causes a considerable nightmare for these newborns and for those healthcare workers administering to them.

Neonatal abstinence syndrome (NAS) is the withdrawal of the baby from the drugs mom abused before and during pregnancy.  The treatment for the newborn is a continuation with gradual weaning from some form of opioid, often IV morphine.  The process can take weeks in the hospital and costs are staggering.  The treatment for the mom is less complicated and requires little additional hospital stay, but is just as unpalatable from a societal perspective.

There are few answers to this gestational addiction problem, but buprenorphine Opioid Addiction among young pregnant womenis a solid drug to address the issue while society figures out the underlying problem.  If the pregnant addict confesses to her addiction, and converts to buprenorphine (Subutex, Suboxone) early in pregnancy, the NAS is markedly reduced to just a few days.  The problem is how to convert the mother from the methadone, or oxy or whatever potent opioid she is taking to the buprenorphine?  Many studies are now emerging that support the safety of doing this in a gradual manner during the first trimester.  The process must be monitored by a provider experienced in such a transition, is very familiar with buprenorphine, and also has access to urine tox screening and quantitative LCMS.

Dr. Walter Palmer…

Dr. Palmer 5Dr. Michael J. O’Connell, New Hampshire stated, “I am not a hunter; I have never intentionally killed anything bigger than a hornet, though I have been absolutely ruthless with houseflies.”  Dr. O’Connell commented that this Dr. Walter Palmer brouhaha is getting out of hand.  The crowds outside his private dental practice in Milwaukee were calling him a ‘murderer’ for killing a popularized lion on a recent safari to Zimbabwe, Africa.  One of his guides had apparently lured the lion out of a protected park so the killing could occur.  Given that lions are a protected species due to dwindling numbers, and the notion that he should have checked things out much more carefully before he pulled his bowstring, I think he should have been heavily fined, and he probably will be.  But jeez, extradition, a murderer?

Do these protesters understand the realities of the life and death struggle playing itself out every second, in every corner of our world?  Have these naive people ever seen videos of lions making a kill on a zebra or gazelle?  Ripping the flesh of a still alive and trembling prey?  It’s ugly stuff to watch.  But it’s life.  Have these folks watched that now infamous Planet Earth video in which a killer whale leaps out of the water to grasp a frantically fleeing seal in its huge razor-tooth maw?  THAT is murderous stuff.  Do these same folks concern themselves with the millions of slimy but unidentified bugs that smear their windshields on a warm summer night?  Do they rue the ants they themselves put to death with the malathion powder they sprinkle along their home foundations?  Or the benign appearing ant “cups” that invite the insect to carry poison back to their colonies?

I want to be very clear.  I am much in favor of outlawing hunting everywhere in the world, except in those regions where wild game is plentiful and proteinaceous calories are needed.  But, my rationale does not include that it is cruel and unusual punishment for a lion to accept an arrow to the heart for its demise.  How could it get crueler than what nature stages?  To have your neck crushed in the jaws of a lion.  Give me a break.

Confederate flag…

Confederate flagDr. Michael J. O’Connell, New Hampshire, commented that in the wake of the tragic Charleston shootings a few months ago, Confederate flags that dotted the south have mostly come down.  My first reaction, I assume consistent with that of the majority of Americans, was one of surprise that the flag was still commonplace, and even in public arenas.  As Obama said in his eulogy, the flag, among other things, is a symbol of a failed government, one based on the institution of slavery.  Why retain the symbol, some 150 years after the regime’s demise?  The answer to this must be very complex as to elude the comprehension of most Americans.

Unfortunately, removal of the flag may do little to expunge whatever deep seated sentiments have promoted its endurance.  I suspect these sentiments involve notions that blacks continue to lag behind in experiencing the rewards of our great society, despite affirmative action, equal opportunity, and burgeoning welfare state.  I suspect the fact that violent crime is much more common among the black population than any other groups contributes significantly to these sentiments.

Finally, the south and more than a few entities in the north, have removed a symbol of repression and hatred.  Good riddance.  I hope the Confederate flag is gone for good.  The animosity behind that flag will not so easily retreat, however, and that is apparently an enduring problem.  Until the black race is seen as working hard to better itself without over-dependence on handouts, such sentiments will remain.  As the prominent black figure Thomas Sowell has said “self-respect can seldom be gotten from even a successful playing of a parasitic role in the name of a make believe equality.”

Jon Stewart…

Jon Stewart4Dr. Michael J. O’Connell, New Hampshire, recently commented that the quick witted Daily Show host Jon Stewart has departed.  Praise the Lord, or whichever non-sectarian higher power is responsible for this gift.

There is no more polarizing political figure than this liberal highly Jewish talking head.  I get that – it’s his shtick, right bashing satire attracts a certain audience, and for sure the stodgy conservative religious folks provide much fodder for his biting remarks and pointed jokes.  I have watched his show sporadically for years, and would totally enjoy his product if not for his singular target theme.  Its wears a little thin.  What has always puzzled me though is his unwillingness to admit to the wildly unbalanced nature of his show.  He readily criticizes Fox News for its unbalanced content, and ‘fair and balanced’ message, yet doesn’t see this same incongruity in himself.  There is so much on the left side of life that can provide equal opportunity for shits and giggles.  Oh, every once in a while he castigates a lefty for some wrong-headed action (our VP for example), something so egregious it can’t be ignored even by Stewart, but this always comes off to me as window dressing.  Something to demonstrate that unlike the far right Fox News, his show is not far left.  But he is wrong and I believe he totally knows it.  Jon Stewart is a proud standard bearer for left wing politics.

Stewart’s replacement seems to be hinting at significant change.  We’ll see.  It will take considerably more courage than what Stewart has displayed for the past 16 years.  Again I call for more debate of the issues that emanates from a centrist position.  I’ve had quite enough of Rush Limbaugh, and now Jon Stewart.

Race relations and police…

Race relationsDr. Michael J. O’Connell, New Hampshire commented that the country seems to be finally cooling off regarding the issues of race and police, as the media is taking a breather.  Rationality is taking hold; that is until the next act of perceived brutality is splashed on Headline News.  The standard opinion portrayed by the media, and assumed by the viewer, is that police subject blacks to a disproportionately high rate of arrest and of course violence, this despite available data/evidence.

A review of every major publicized case of brutality this past year (Ferguson, Staten Island, Baltimore, Charleston) reveals that none would have resulted in a death, or even minor injury had the subject simply complied with arrest and not violently resisted.  All cases would have resulted in no charge, minor fines or at most overnight jail time had the victim simply complied with arrest.  There is no justification for the shooting in Charleston, however two cases resulted in outcomes supported by grand juries, and one case is still pending but likely to erode as facts are revealed.  The stories of accused (two black cops among them) should be very interesting.

No one wants a police state.  We want security without oppression.  But, compared to many other countries, we have a very low visibility force.  Admittedly there is a concentration of enforcement in inner city, high crime areas.  Shouldn’t there be?  Are the police wrong for patrolling more frequently in such areas?  Is it their fault that blacks often inhabit high crime areas?  No, the residents of these areas have full responsibility.  Attitudes among black youth are notoriously rebellious toward police.  This must change, and black “leadership” must take responsibility for reeducating, reorienting, and reprioritizing.  Cranks like Al Sharpton with his tiresome persecution complex must be marginalized by black followers.  The problem is not the police.

Is it addiction or dependency?

Addiction vs dependency6Dr. Michael J. O’Connell, New Hampshire commented that the distinction between addiction and dependency is constantly mangled by the press, lay people and even many professionals.  The difference between dependency and addiction is not withdrawal.  Withdrawal is a phenomenon common to both.

Addiction marks a transition into pathology; the chemical, activity or behavior to which one is dependent (oxycodone, heroin, alcohol, THC, sex, eating, extrovertism/introvertism) becomes harmful…physically, psychologically and/or functionally, to the individual.  Withdrawal or craving is not necessarily a pathology and therefore not necessarily an indication of addiction.

One would be hard pressed to declare a weekly snorter of heroin or cocaine an addict.  If a person dreams much about food, craves certain tastes or dishes, but lives a functional work and social life and is not obese, this can hardly be defined as an addict.  If another has elevated liver enzymes, presence of abdominal fat in an otherwise slender body, is thinking about drinking alcohol much of the day, has a couple DUIs, occasional blood in theAddiction vs dependency3 stools, and yet persists in drinking alcohol, this is most likely an addict.

If a chronic back pain patient that had a laminectomy and then fusion, still requires pain meds but goes into intense withdrawal with sweating, shakes, diarrhea, and piloerection, when away on a trip forgetting meds at home, this is dependency, but unlikely addiction.