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How to halt and even reverse aging ! The Telomere Effect.

How to halt and reverse aging!

1329410057_kim-richards-sandra-bullock-lgDo you ever look at someone and wonder what age they are?  Are you often surprised how some of your high school friends have aged terribly and how others appear to have found the fountain of youth?  We often blame it on our genes, on the hand we were dealt but an amazing new book, The Telomere Effect explains to us how we can maximize the hand we are dealt and minimize the aging process (the crow’s feet, aching joints and sagging skin)

I am always researching and reading the latest and greatest health news.  I have a responsibility as a Nurse Practitioner to stay abreast of the latest research and knowledge as it pertains to my practice.

I have just finished reading The Telomere Effect by Elissa Epel and Dr. Elizabeth Blackburn.  Dr Blackburn discovered telomerase and the role that it plays along with telomeres themselves in not only halting but also reversing the aging process.  Dr Epel is a lifestyle psychologist who specializes in showing how specific lifestyle and psychological habits can improve quality of life slowing down the aging process by direct protection of telomeres.

There is so much crammed into this book that it is hard to pick just 5 Top Tips to halt and reverse aging but here are 5 Snippets and hopefully many of you will buy the book or stay tuned for the Synergy Health and Wellness Seminar Dates!   The premise of the book is that shorter telomeres are an indication of premature cellular aging and what we do or don’t do in terms of diet, exercise, stress, depression and even environmental toxins have a direct effect on telomere length.

Stress:

imagesI love the observation that “Cells are listening to your thoughts”.  According to Epel and Blackburn a small dose of stress does not damage or shorten telomere length but subject the individual to chronic long term stress, stress that is not resolved and these individuals have noticeably shorter telomere length.  Those people who are caretakers or suffering from job burnout or going through a protracted divorce, for example are all subject to severe and prolonged stress.  We all know that inflammation is bad for us but did you know that shorter telomeres promote inflammation.

Recommendation:  Try stress reduction exercises such as meditation, yoga, journaling to reduce the amount of stress in your life.  Even better identify stress triggers and try to negate or minimize them.

Depression & Anxiety:

Like stress depression and anxiety wreak havoc on telomeres and studies show that they shorten telomeres.  The more severe the disorder (think mild versus major depressive disorder MDD) the shorter the telomeres.  More than 350 Million people worldwide suffer from depression and studies show that telomeres are shortened in those with depression and there is also a link to the duration of the depression or anxiety episode.  Telomerase, an enzyme that is secreted in response to shortening telomeres is increased in depressed individuals in an attempt to counteract telomere shortening.

Recommendation:  Early identification and treatment for depression and anxiety is essential.  Treatment modalities such as mindfulness based cognitive therapy and mindfulness itself can also be used in treatment and again modalities such as yoga and meditation have been shown to be effective in the treatment of both depression and anxiety.

Exercise:

images-4Its well known that exercise helps with stress reduction, improves symptoms of anxiety and depression and aids in weight loss – so it’s a no brainer to exercise daily.  What The Telomere Effect reports is that HIIT type exercise programs (think of all the programs available at Synergy Fitness Boca) increase telomerase activity helping to increase telomere length.

Recommendation:  HIIT exercise programs 5 times a week for 30-45 minutes a time will help protect telomeres.  Add in resistance training to your program as well.

 

Diet:

images-3What’s the best diet to protect your telomeres, increase their length slow or reverse the aging process?  Easy!  Fruit, vegetables, wholegrain, fish, chicken, Omega 3 rich foods, alcohol, fat, processed food avoidance.  Also avoid those foods that cause inflammation (these may differ from individual to individual) but cow’s dairy, fatty red meats, cheese, soda, processed and cured meats.

Recommendations: Follow a clean diet with fruits, vegetables and whole grains.  Mediterranean and Okinawa diets are good examples.  Limit alcohol, processed and refined foods!

Vitamins, Minerals, Supplements:

Epel and Blackburn would rather that we get the majority of our Vitamins and minerals from our foods eating those foods high in antioxidants.  But we may not get enough of certain vitamins and minerals from our diets and they suggest that adequate amounts of Vitamins D, B (folate) C, E and Omega 3’s promote telomere length and telomerase.

Recommendations:  Eat plenty of fresh fruit, vegetables, nuts, wholegrain, legumes and low fat proteins such as chicken and fish.  Eat Omega 3 rich food and reduce foods that cause insulin resistance and inflammation.

Sleep:

images-1Lack of sleep, insomnia and sleep deprivation all lead to shorter telomeres.  If you are tired during the day you are not getting enough sleep – Simple as!  But lack of sleep is implicated in depression, anxiety and so much more.  Sleep should be of good quality, the same time each day and for an adequate amount.

Recommendations:  Go to bed at the same time each night, if you tired during the day go to bed earlier.  Avoid alcohol and drugs and for more sleep information check out my previous article on sleep. (http://bit.ly/2dE7N45)

There is so much more in this book than mentioned above and I urge you all to buy it and implement the strategies included.  Stay tuned as we will be doing a more comprehensive lecture on how to halt and even reverse aging by promoting telomere friendly strategies in all areas of our lives.

The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer by Elizabeth Blackburn and Elissa Epel is published by Orion Spring unknown-1

Synergy Health and Wellness   Dolores@synergyhealthandwellness.net

For more confidential help or if you have a topic you would like discussed – you can call me at 561-866-1211.  Thanks Dolores


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Goals & Intentions for 2017

 

unknown-2Setting Goals and Intentions for the New Year

5 Great Goal & Intention Setting Tips

We’re a little over one week into the New Year and already people are falling back on some of their resolutions or goals.  What are some of the ways that we can ensure that we succeed at goal & intention setting so as to achieve all we desire in 2017.

  1.  I don’t care what anyone says. To be successful you HAVE to write your goals down and also keep them in a place were you can glance or refer to them frequently. Get a diary and just jot down all the amazing things you would like to achieve in the next year.  This list is random and creative and it should flow but doesn’t necessarily have to have any rhyme or reason.  Don’t worry if it seems hard to start just stick with it a bit.  You can muse on areas of love, career, spirituality, home, family as some general headings to get started.
  1.  Light a candle or incense or even smudge the area you are sitting in with sage. “Clear” the space or pray to a higher being for peace and guidance. Smells and sounds often help to calm the person as they are getting ready to set the tone for intentions. th-1
  1. Be realistic about your goals and while we often use the acronym S.M.A.R.T. to refer to goal setting – I like to be a not more “loose” with the specifics and timing of goals allowing the Universe to provide (as it always does) in the divine timing that it has set. You do have to be realistic about goals – setting a goal to lose 50 lbs in 1 month is neither realistic or healthy, a better goal would be to break the task into smaller more achievable pieces such as a weight loss of 10lbs per month.
  1.  Set goals that motivate you and set you on fire. You shouldn’t set goals just for the sake of setting goals. Goals should motivate and excite you set you on fire and ostensibly improve you in some area of your life!
  1.  Make an action plan. Its great to make goals but the next step is crucial you need to make plans to achieve those goals. If your goal is to travel to Iceland or Machu PIccu get travel brochures, enquire about airfare and hotels, pick a date and plan on saving every week. Sites like SmartyPig allow you to save for your goals and will direct debit a set amount on a set schedule.  Its great to have goals and dreams but the plans and steps to get there are equally important.
  1. Dream Big – OK this may be counterintuitive to the “be realistic” part of SMART goals – But go on have fun dream big.  What would you really like to accomplish if someone told you you couldn’t fail.  That beautiful farm & studio in Leitrim It will be yours (well mine) ! Running your own company, writing that novel or producing that movie.  All are within reach !

Happy 2017 Dare to Dream Great Dreams – and make them all real in 2017 !th-2

For more confidential help or if you have a topic you would like discussed – you can call me at 561-866-1211.  Thanks Dolores

Synergy Health and Wellness   Dolores@synergyhealthandwellness.net


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New Years Resolutions Prep (Part 1)

5 Great New Years Resolutions Prep

unknownResolution Prep

Clear the Pantry (and the fridge and other cupboards)

Just about one week until New Years and everyone seems to be making all of those New Years resolutions.  Did you know, that statistically most people will have abandoned their New Years resolutions and goals by the 3rd week of January.

Do you want to be more successful beyond the first few days ?  Here are some tips that you can do prior to “D” Day or “R” Day to stave off temptation.

Clear the Pantry ! And the Fridge and other Cupboards !

  1.  What are your goals.  Decide what your goals are ! For example if your goals are to try to eliminate sugar from your diet that means that all cookies, high sugar cereals, even cereal bars and those highly processed foods will have to be dumped.  Throw out the quick boxes of cake and cookie mixes, dump the high sugar yogurts and the cookie dough and lets not talk about pop tarts, ice cream and other frozen treats.  These are the obvious culprits but even unobvious foods like processed apple sauce, ketchup, granulated sugars and sweeteners are all culprits – Stay tuned until tomorrow when we will discuss your replacement food list.  Here are the top 10 offenders:

Granulated Sugars and Sweeteners, Drink Powders and Sodas, Candies, Dried Fruits, Cookies, Cakes, Pies, Jams and Preserves, Cereals, Oatmeals (Packaged), Cereal bars, Ketchup, Ice Cream, Canned Fruits and Syrups

Also check your food labels for the following r high fructose corn syrup (HFCS), genetically modified organisms (GMOs), hydrogenated fats, artificial sweeteners, sugar as the 1st or 2nd ingredient, mono-sodium glutamate (MSG.) and carrageenan and chuck them all.   (Also see my article on Sugar- The other white powder (http://bit.ly/2gczuA2)

thGoal Setting:

  1. Eat Less Sugar, Eat less processed foods, Eat less packaged or boxed items, Eliminate meat, dairy, gluten from my diet, eat less fat.

You can also say that I will eat more fruits, vegetables, nuts and legumes or I will eat clean, I will pack my own lunch for work or school, I will eat clean, I will eat out less often.  These goals are just specific to your diet and eating but you should evaluate, explore and determine goals in all aspects of your life !   Join us on January 7th for a great Goal Setting and Vision Board Class (https://www.facebook.com/events/1530477190301339/) and I will post this class online after January 7th, 2017

Be Brutal

  1. Yes you have to have a heavy hand and a cold heart when cleaning out your pantry (or even closet).  Everything goes.  Be determined and unwavering do everything at once and don’t go back to complete the task – leave no stone or hiding place unturned.

Get a garbage bag – A big One !  

  1. Dump everything that does not comply with your eating and health goals and when you are finished put the garage bag outside.  There is something extremely psychological and detrimental to removing food from a garbage bag or pail.  If you have an issue with waste see number 5

Pick a Food Shelter!  

  1. Pick a food shelter – Look at local shelters and see can you drop off food supplies to the shelter.  But be aware that most places will only take unopened packages.  So all opened goods will still need to be tossed.  Alternatively ask a friend or family member if they want to take your items.

Check Expirations!  

  1.  While you are purging your items check the expiration dates on those items that you are keeping.  Packages of rice and beans that you are keeping may be beyond their shelf life and also need to be tossed.

 

Next Up – A look at those items that you will stock in your fridge and pantry !unknown-1

For any questions or comments you can contact us at www.Synergyhealthandwellness.net or 561-866-1211 or Dolores@synegryhealthandwellness.net


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Sugar ! The “other” White Powder

2619f2b6b8454582_187481430Sugar (and Spice) May not be all things Nice –

 Let’s not Sugar Coat it!

Sugar, has now become the “other” white powder and is associated with systemic inflammation tooth decay, increases in diabetes both in adults and children.  It contributes to Metabolic Syndrome X and obesity.  To add to the problem, in an attempt to substitute with other alternatives a large number of people are turning to sugar substitutes which have been shown to contribute to cancer.   On average Americans consume a staggering 130 lbs. of sugar yearly.  Sugar is found in nearly every food and manufactures of processed foods often sneak in sugar substitutes using names such as malt, high fructose corn syrup, fructose, maltodextrin to name a few.

What is it: a sweet crystalline substance obtained from various plants, especially sugar cane and sugar beet, consisting essentially of sucrose, and used as a sweetener in food and drink. It’s a short chain, water soluble carbohydrate.

Where is it Found:

  1. White Sugar – Calories 16 in a Tsp, 0 g of fat, cholesterol. Sodium, potassium, protein,  2g of Carbs all Sugar with no trace vitamins or elements.  How is it manufactured?  From Sugar cane which is then shredded mixed with water and sometimes a saturated syrup then its crushed between rollers redissolved with chemicals, char filtered and evaporated further then boiled and crystalized removing its color and rendering it right.   Sugar, especially highly processed sugar is used in processed foods, candies, cereals etc.  While we need glucose for energy any excess gets converted to fat by the liver.images
  2. Brown Sugar – Brown sugar is a sucrose sugar product with a distinctive brown color due to the presence of molasses. It is either an unrefined or partially refined soft sugar consisting of sugar crystals with some residual molasses content, or it is produced by the addition of molasses to refined white sugar. Calories 17 in a Tsp, 0 g of fat, cholesterol. Sodium 2 mg, potassium 16mg, protein,   43g of Carbs all Sugar with no trace vitamins or elements.  Basically same refining process except that residual molasses is left behind
  3. Coconut Sugar Mahava  – Calories 15 in a Tsp, 0 g of fat, cholesterol. Sodium, with trace magnesium, zinc and iron, potassium,  0g of Carbs all Sugar with no trace vitamins or elements.  This product is Non-GMO, Organic, its sustainable and unrefined but the bottom line is it is essentially still a sugar.  images-1
  4. Honey – Calories 20 in a Tsp, 0 g of fat, cholesterol. Sodium, potassium, protein, 17g of Carbs but because it is sweeter than sugar the theory is that people use less.  It contains small trace amounts of vitamins and minerals and there is only one processing tip and that is heating the honey which cuts out 3 refining steps of sugar.
  1. Agave Calories 20 in a Tsp, 0 g of fat, cholesterol. Sodium, potassium, protein,   2g of Carbs all Sugar with no trace vitamins or elements.  Agave comes from the Agave plant and most Agave in the US comes from the Blue Agave Plant BUT it is as highly processed as high fructose corn syrup, is extremely sweet and at the end of the day while it is a “fructose” its still a sugar and if in excess in the body it does get converted to fat.
  1. Stevia – Calories 20 in a Tsp, 0 g of fat, cholesterol. Sodium, potassium, protein, 2g of Carbs all Sugar with no trace vitamins or elements.  Stevia comes from the Stevia Plant and its active compound steviol glycosides are sweeter than sugar are calorie free and are effective for those on calorie/carbohydrate controlled diets as steviol does not increase blood glucose levels but beware for most commercially prepared stevia products there are 40 steps in the process using chemicals such as methanol, acetone, ethanol and isopropanol. Many of these chemicals are known carcinogens.   Most brands also use erythritol which is generally obtained from fermented genetically modified corn.
  1. Aspartame & Saccharin & Sucralose – Sugar Substitutes – Used as substitutes to sucrose to sweeten foods and drinks.  Usually zero calorie with no nutritional properties but with links to cancer (with the exception of sucralose) in lab animals prompting FDA warnings that these products are harmful to your health.  I usually do not recommend these products to any patients as a substitute.

images-2

 Recommendations

Sugar is a sugar is a sugar!  In excess it will convert to fat by the liver and be deposited and stored.   Advice use the least processed sugar possible in the smallest amount necessary and always stick with “natural” products and not the sugar substitutes!

For more confidential help or if you have a topic you would like discussed – you can call me at 561-866-1211.  Thanks Dolores

Synergy Health and Wellness   Dolores@synergyhealthandwellness.net

 

 

 


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The Importance of Vitamin D & the dangers of Vitamin D Deficiency

 

unknownVitamin D Deficiency and 5 Conditions

 

 

 

The Sunshine Prohormone & Vitamin

 

Often called the “sunshine drug” Vitamin D is produced as the skin responds to sunlight activation.  Sadly, low levels of vitamin D have been implicated in stage III Colorectal, lung, breast, thyroid and prostate cancers, immunity responses, mental health, and now obesity.  Clinically I see Vitamin D Deficiency in nearly all of the patients I treat I therefore test for Vitamin D levels routinely in all patients.

 

When I test patients I request a 25-hydroxy vitamin D as this is the most accurate way to measure how much vitamin D is in your body.  A normal range is above 30 ng/ml and I will treat below that number.  Abnormal results are usually due to lack of sunlight and great adherence to sunscreen (yes we do a great job of that in Florida), not enough D in the diet, chronic kidney and liver disease (which I see a lot of in my patient population of Heroin addicts and alcoholics) plus medications such as dilantin, phenobarbital and malabsorption in gastric bypass patients.

 

Deficiency:

 

  1. Immunity: In studies done on Japanese schoolchildren supplemented with Vitamin D versus placebo those supplemented with Vitamin D had 40% lower occurrence of Flu during winter months. Early treatments for TB consisted of light treatments and colds and flus are highest during winter months in Northern climates when Vitamin D levels are lowest and sunlight is shortest supporting a “seasonal stimulus”

 

  1. Cardiovascular– If your Vitamin D Levels are low, studies suggest your chances for heart disease are much greater.    Men with low levels of Vitamin D are at greater risk for Heart Failure, Sudden Cardiac Death, Stroke, Cardiac Disease and more.  Vitamin D is associated with the functioning of calcium which of course is linked to vascular health, blood pressure and artery health which does explain the link

 

  1. Psychiatric– Recent studies have shown a strong link between depression, fibromyalgia, bipolar and low levels of Vitamin D with symptoms improving with supplementation.  Seasonal affective disorder, commonly seen in Northern countries such as Norway, Sweden, Ireland probably have higher levels of hypovitaminosis than countries located on the equator.  Sadly, according to Dr James Greenblatt Vitamin D deficiency (levels less than <20 ng/ml) are regularly seen in schizophrenia, psychosis, elective mutism and anxiety.

 

  1. Orthopedic- Vitamin D is important for people with osteoporosis. Studies show that calcium and vitamin D together can increase bone density in postmenopausal women. Vitamin D also helps with other disorders associated with weak bones, like rickets.

 

  1. Endocrine – This is actually a little complicated so I will try and simplify it here – please feel free to call or text me for clarification if you need – Simply put in Type 2 Diabetes patients were found to have low levels of Vitamin D indicating to researchers that there was a possible link between low levels of Vitamin D/Type 2 Diabetes/ Pancreatic Beta Cell Function.  Additionally, low levels of Vitamin D also played a part in insulin function and inflammation.   Researchers think there is a “switch” in Vitamin D that that turns “on” Pancreatic Beta cells making them work to secrete Insulin.  So Low Levels Vitamin D – No Beta Cell Activation – Low Levels Insulin – Increased Sugar Levels – Increased Diabetes – Increased Obesity Levels (Disclaimer – this is a VERY simplistic, translated explanation) Take away – Helps with Weight Loss

 

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Outlook:

The take away from this is have your Vitamin D25 Level Checked and supplement accordingly with between 600 -800 IU Daily this is assuming that you are getting 450 IU of Vitamin D from food sources (not often easy to do).  Good Vitamin D Food Sources are Salmon, Fish, Mushrooms, Eggs, Fermented Milks, Vitamin D3 Only Capsule 600 – 800 IU daily but please consult with your health care professional.

vitamin-d-reduce-infographic

Sunlight:  Get 20 – 30 Minutes of Sunlight Daily .

 

For more confidential help or if you have a topic you would like discussed – you can call me at 561-866-1211.  Thanks Dolores

 

Synergy Health and Wellness   Dolores@synergyhealthandwellness.net


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Don’t Panic – but so many of us do !

images

5 Tips to decrease possibility of Panic Attacks!  Don’t Panic ! but so Many of us Do!

Most people don’t know that I suffer from debilitating panic attacks and I have done so for about 5 years.    Panic attacks can happen to anyone and for no apparent reason.  They come on completely unexpectedly and can also leave and subside the same way.   Some attacks can be mild and you can get them under control while some are so debilitating that sufferers can and do end up hospitalized.  Nearly 6 Million people (females more than males) suffer from Panic disorder so its not unusual when you admit to panic attacks that many people will tell you that they too suffer!

What does a Panic Attack feel like?

Symptoms such as palpitations, chest pain, shortness of breath, dizziness extreme fear and anxiety, numbness and tingling, feeling as if you are disconnected, trembling, sweating, shivering, inability to articulate words – but mostly there is a sense of overwhelming fear or impending doom, a complete disconnect from reality, a fogginess and “blackness !  The following are 5 Things that we all should be doing that help keep Panic Attacks at bay.  If the attacks are debilitating and severe, though, you should see your healthcare professional for additional strategies to understand, treat and control attacks.

  1. Water – What happens when you’re dehydrated. Your blood pressure drops and the body compensates by increasing your heart rate to pump fluids faster to essential organs.  That feeling of increased or racing heart actually mimics the feeling of panic and in addition with a faster heart rate most people feel “light-headed” which contributes to fear and anxiety.  If you are dehydrated cells are not being nourished and in addition hormones are not being effectively transported to cells – in short the body is not functioning optimally at any level.  The trick is to not get to the point of dehydration.
  2. Food– Alcohol, coffee, excess sugar, processed foods, energy drinks should all be avoided as all contribute to anxiety symptoms. You should consume foods that are rich in B Vitamins such as chicken, leafy greens and legumes, rice, nuts and eggs.  In addition, foods high in tryptophan’s are precursors to serotonin a calming neurotransmitter so turkey, oats, soy and nuts are good sources (though studies do not prove whether this crosses the blood/brain barrier).  Eat salmon and foods high in Omega 3’s which are proven to boost mood and proteins which also boost mood such as eggs, soy, beans and nuts.  Are you seeing a pattern here?  No processed foods, foods are low in sugar and are in their natural states – so avoid dyes, additions and chemicals!
  1. Sleep – One of the most debilitating things is lack of sleep. Being tired makes you feel edgy, irritable and anxious.  You see lack of sleep fires up the brains amygdala which is responsible for emotional processing.  Repeated sleep deficit actually causes a cumulative effect.  Studies at Berkeley have shown that Sleep Therapy can actually reduce or ameliorate anxiety and panic (http://news.berkeley.edu/2013/06/25/anticipate-the-worst/).  So what can we do?  In a previous article we discussed sleep http://bit.ly/2dE7N45 so please look at sleep strategies here.  But try to go to bed earlier and a pre-determined time, avoid alcohol and heavy food before bed, keep room cool and dark for better sleep.
  1. Exercise – So where do you start? Exercise is a no brainer in that it reduces stress, releases endorphins, improves mood, decreases stress and tension.  For those that suffer with panic attacks exercise can relieve the associated tension and pent up nervous energy and jitters.  Done regularly, exercise can keep panic attacks at bay decreasing both frequency and intensity.  In addition, exercise has been demonstrated to improve how people see and feel about themselves – the better you feel about yourself the less likely you are to let thoughts of panic and fear invade your mind. 
  1. Supplements – Supplements such as Omega 3, B Vitamins especially thiamine (B1), B12,) Maca, & Magnesium all help to ward off depression and anxiety. Valerian Root, St. Johns Wort and Kava have also been shown to decrease stress, nervousness and irritability.  As with any medication you should consult with your nurse practitioner or doctor prior to starting any of these supplements as a comprehensive review of all your medications should be done to ensure there are no adverse interactions.

I call the above 5 items my “Back to Basics” list for panic attacks.  If you consistently improve each of these areas, you should also decrease the intensity and frequency of your panic attacks.  If you feel that your signs and symptoms are not improving, then you absolutely need to see a healthcare professional.

Outlook:

From a personal stand point, there is hope and effective treatments available but it can take time to see a difference.  My approach is to try and implement all five of the above strategies into your life.  If you follow them consistently you should see improvement.  If, however you don’t then you will need to follow up with your health care professional.  While doing the above it is also a good idea to have your labs checked especially thyroid and B vitamin levels amongst other things.

For Loved ones or significant others:

Unfortunately, when a person is in the midst of severe panic attacks it is often hard to reason or rationalize with the sufferer that everything will be ok.

Try to be empathetic and understanding

Try to get the individual to focus on something such as breathing or distract them

At all costs ensure that the person suffering from the panic attack understands that you are “there” for them and that they are safeimages-2

Don’t judge

Don’t patronize (you’re being ridiculous)

Don’t minimize

For more confidential help or if you have a topic you would like discussed – you can call me at 561-866-1211.  Thanks Dolores

Synergy Health and Wellness   Dolores@synergyhealthandwellness.net

 

 

 


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5 Drugs we’re seeing in ED & Psych right now and what you need to know.

5 Drugs we’re seeing a lot of right now!  What you need to know!

Images of parents and grandparents passed out from Heroin overdoses and their child (grand child) in the back seat flooded Facebook and social media platforms in the past few weeks.  This drug epidemic is not isolated to the northeast, California or far removed areas – this drug epidemic is seen in all locales, countries and cities and is absolutely non-discriminatory affecting all races, religions, socio-economic backgrounds, ages and sexes.  The following is a list (in no order) of the 5 most common drugs we are currently seeing in Emergency Departments and Psychiatric facilities, especially here in Palm Beach County.

  1. Heroin – We have seen an explosion in the number of heroin addicts in recent months and years some of which can be attributed to the closure of pill mills but truly many of my patients were introduced to heroin through “friends” in school and college. Sadly, much heroin today is being “cut” with dangerous fillers such as Fentanyl, Dibutylone, Carfentanil and even Flakka which is why we are seeing so many overdoses.   These added substances directly affect the patients breathing so much that patients cannot support their own breath.
    1. Class Opioid
    2. How is it used: Snorted, Smoked, Injected, Inhaled?
    3. Signs/Symptoms: Overdose, “nodding” excessive sleepiness,
    4. Additional Problems: Hep C, HIV, Abscesses, Septicemia, Endocarditis, physical dependence – many of these life threatening.
    5. Treatment: Buprenorphine (now also implantable), Detox and Rehab, Methadone
  1. Cannabis – While medical marijuana can be extremely beneficial for certain conditions we are seeing a rise in patients being seen in psychiatric facilities more for the side effects of excessive use than sheer numbers of those addicted. For example, of all substances addicted to cannabis patients have the lowest level of encounters in Emergency Departments or Psychiatric facilities.
    1. Class: Cannabinoids
    2. How is it Used: Smoked, Dabbed, Inhaled (Vape), Ingest (edibles)?
    3. Signs/Symptoms: Extreme Paranoia, hallucinations, depression, Dry mouth, dizziness, coughing
    4. Additional Problems: Has been linked to increased schizophrenic breaks, Tachycardia (sustained heart rate at 120 beats per minute).
    5. Treatment: Abstinence! and treat the symptoms hydration, possible arrhythmic if elevated heart rate persists, watchful monitoring.  Patients can return to normal in most cases by refraining from use.
  1. Synthetics – Remember the face eating patient in Miami a couple of years ago and most recently the cannibal patient in Jupiter, both patients had apparently used “synthetic” drugs, drugs mostly manufactured in China, in large commercial factories. This is a really hard class of drugs to detect initially as drug developers stay one step ahead of drug tests. But the behavior we see is unforgettable. Patients often arrive combative, with superhuman strength, paranoid with dangerously elevated temperatures and its not unusual for them to remain in this state for 2-4 days and more. Unfortunately, some patients do not recover!
    1. Class: Synthetics
    2. Common Names: K2, Spice, Flakka, Gravel
    3. How is it Used: Smoked, Injected, Inhaled, Ingested, Snorted?
    4. Signs/Symptoms: Extreme Paranoia, hallucinations (visual and auditory), delusions, superhuman strength, elevated body temperature (remember the pictures of patients running in traffic and stripping off their clothing) aggression, violence, seizures, chest pain.
    5. Additional Problems: Rhabdomyolysis, a dangerous condition affecting the kidneys and often requiring the patient to have to undergo dialysis.  Chest pain leading to heart attack, self harm and suicide, Hyperthermia
    6. Treatment:  Initially our main concern is medical stabilization of the patient.  Treat the rhabdo, hyperthermia and other medical issues such as trauma and then treat the addiction with inpatient detox and rehabilitation
  1. Prescribed Medications This is a huge category and everyday we see patients addicted to prescription medications that include Opiates such as Percocet, OxyContin, Fentanyl, Dilaudid.  Benzos such as Valium, Klonopin, Ativan, Xanax.  Anti-Epileptics such as Gabapentin and Neurontin and while these medications are supposedly not “addictive” we do see misuse and signs of withdrawal with psychoactive effects.  Patients will increase dosages to get better effects, can seize if they miss a dose and will purchase medications on the street (Yes, Gabapentin does have a street value). Miscellaneous Analgesics – Tramadol (non narcotic with narcotic like properties) but now a scheduled drug.
    1. Class: Multiple Opiates, Benzodiazepine, Anti-Seizure, Analgesics
    2. Common Names: OxyContin, Klonopin, Gabapentin, Tramadol
    3. How is it Used: Oh yes we have seen Smoked, Injected, Inhaled, Ingested, Snorted, insertion (rectal and vaginal)
    4. Signs/Symptoms: Depending on drug type Opiates will mimic the signs and symptoms of heroin such as drowsiness, sleep, decreased respirations.  Benzos are much like opiates we also see slurred speech and lack of coordination.  Anti-Epileptics – weakness, loss of balance, headaches, slurred speech and seizures/   Analgesics – headache, nervousness, anxiety
    5. Additional Problems: Liver toxicity, Seizures, end organ damage.
    6. Treatment:  Our main concern is medical stabilization of the patient as there are so many side affects associated with withdrawal not least of which is seizures and falls.  We will treat all medical problems and in addition try and make the patient more comfortable throughout the detox process.  Nausea and vomiting will be treated with antiemetic’s such as Zofran.  Persistent Diarrhea with antidiarrheal such as Imodium and withdrawal symptoms with Librium and Clonidine, a blood pressure medication with anxiolytic properties.  In some cases, we will actually use a taper benzo schedule so that patients do not seize.  Following medical stabilization inpatient detox and rehabilitation programs guide the patient through out the rehab process but that is only if this is an option for the patient due to expense.  Outpatient programs are great options too, but again they can be costly and NA and AA are available free of charge and in my personal opinion offer great hope to all addicts.
  2. Alcohol Last, but by no means least, along with Heroin abuse this drug is one of the most abused on the planet. Many of the alcoholics we see in psych facilities are there because they have been Baker Acted in the ED.  Many of the patients we see in the ED are there due to traumatic injury, because they have been found passed out or because they are suicidal (therefore they are Baker Acted).
    1. Class: Alcohol
    2. Common Names: Beer, Liquor, Wine, Hand Sanitizer, Mouth Wash
    3. How is it Used: Ingested?
    4. Signs/Symptoms: Slurred Speech, lack of coordination, poor judgment, loss of memory, loss of consciousness
    5. Additional Problems: Liver toxicity, Seizures, end organ damage.
    6. Treatment:  Our main concern is medical stabilization of the patient.  As stated in the ED we see a lot of alcoholics as trauma patients who have been hit by a car while walking in traffic, head injuries, assaults on the street.  Also alcohol withdrawal related seizures are probably the most violent seizures I have ever had to treat, usually occurring 6-72 hours after drinking has stopped.  We will treat all medical problems and in addition try and make the patient more comfortable throughout the detox process.  Nausea and vomiting will be treated with anti-emetics such as Zofran.  Persistent Diarrhea with antidiarrheal such as Imodium and withdrawal symptoms with Librium and Clonidine, a blood pressure medication with anxiolytic properties.  In some cases, we will actually use a taper Librium schedule so that patients do not seize.  Following medical stabilization inpatient detox and rehabilitation programs guide the patient through out the rehab process but that is only if this is an option for the patient due to expense.  Outpatient programs are great options too, but again they can be costly and NA and AA are available free of charge and in my personal opinion offer great hope to all addicts.

Picture of a Drug Addict  This could be your brother, sister, mother, father, friend.  It’s the banker, the nurse, the student, the teacher, the rich socialite, the impoverished homeless person.

Treatment  

  1. Recognition
  2. Intervention
  3. Stabilization

Treatment facilities with Inpatient, PHP (Partial Hospitalization Program) or IOP (Intensive Outpatient Program), Half Way House.  The draw back with these programs, especially in the US is expense and in other areas of the world sheer lack of availability.

AA:  Alcoholics Anonymous – Free Program with like minded members addicted to Alcohol.  http://www.aa.org  find meetings here.

NA:  Narcotics Anonymous – Free Program with like minded members addicted to Narcotics.  https://www.na.org find meetings here.

Outlook:

From a personal stand point, we are losing the “war on drugs”.  Is our current strategy working? Are we seeing less patients?   With a continued lack of connection to each other this problem is only going to persist. For a different perspective on the war on drugs http://chasingthescream.com.

For more confidential help or if you have a topic you would like discussed – you can call me at 561-866-1211.  Thanks Dolores

Synergy Health and Wellness   Dolores@synergyhealthandwellness.net

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