Learn How YOU Can Be a Life Saving Hero – Cape Optional!

Be a hero to prevent opioid overdose deaths
Be a super hero and save a life! Save opioid overdose deaths.

We need a hero! People are dying at alarming rates. Who is your favorite superhero? Have you ever dreamed of being a superhero? Can you picture yourself as a hero? [I’m curious, in your vision, are you wearing a superhero cape? What color?]

The need for a hero

The rate of overdose and overdose deaths is rising rapidly. It is hard to even fathom this epidemic. In particular, overdose rates with opiates are skyrocketing. Opiates are pain medications such as oxycodone, Percocet®, Oxycontin®, hydrocodone, Vicodin®, methadone, Fentanyl®, and more. An illegal opiate that is readily available is heroin. Now there are batches of heroin that are ‘cut’ with other drugs such as fentanyl and carfentanyl (used to sedate elephants). These mixtures are getting more and more dangerous.

The way these drugs are fatal are that they stop the breathing process. At low doses, for the treatment of pain, most people take prescription opiates and are fine. As the pain lessens, the use of the opiate should lesson. However, for some people the brain starts to beg for more and more. As the brain gets huge amounts of excitement through neurotransmitters such as dopamine, the rest of the body says, ‘Whoa, that is way too much!’ The body stops making its own supply of these neurotransmitters and it shuts down the receptors that move them along. So, it takes bigger and bigger doses to get the same effect. And, if someone suddenly stops taking the drug, withdrawal starts. This is a terrible feeling with nausea, vomiting, chills, agitation, anxiety, muscle aches, yawning, and more.

Not everyone who takes an opiate for their pain will ever feel this rush of excitement and have their brain demand more. One of the many problems right now, is there is no way to know who will get this rush of excitement that can lead to addiction and who won’t. People with a risk for addiction some in every age, gender, size, race, financial pattern, level of education, and geographic area.

There are many available statistics. Here are some from the Centers for Disease Control (CDC):

  • In 2014, almost 2 million Americans abused or were dependent on prescription opioids.
  • As many as 1 in 4 people who receive prescription opioids long term for noncancer pain in primary care settings struggles with addiction.
  • Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.

How you can be a hero

To be a hero, you just need to carry and know –

  • When
  • Why
  • How

to give Narcan® to someone who has overdosed on an opiate.

Naloxone is a medication that can block the receptors to opiates. When given, it puts the person is immediate withdrawal. If someone has overdosed and is either sound asleep and can’t be woken or has stopped breathing, naloxone can block those receptors and wake them up. If the overdose very recently occurred, it can help breathing start again. Naloxone can save the life of someone who has overdosed!

Outside of a healthcare setting, there are two products regular people are likely to use to save a life.

If you suspect an overdose, try to wake the person. When they don’t respond to shaking and talking to them, try rubbing their breastbone with your knuckles. If no response, TREAT!

  • Narcan® is a nasal spray
    • Put index and middle finger on either side of the nozzle
    • Put the nozzle in the nose
    • Push the plunger
  • Evzio® is an injection that goes into the thigh
    • The device tell you what to do
    • Remove the red cap
    • Put the device against the thigh
    • Push the button
    • Hold until the 5 second countdown is complete

The sudden withdrawal from the medication might cause the person to vomit or two be very surprised and angry. It does not feel good to be in sudden withdrawal.

It DOES feel good to be alive!

Call 911 to continue the person’s care and to help them into rehabilitation.

Note, depending on the opiate dose that was taken, after 2-3 minutes the person might need another dose if they go back to sleep. This is SUCH a brief description. Call us to talk about this in more detail at 410-472-5078, or e-mail me at michelle@medsmash.com, or contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

What is our role in this sad, alarming epidemic? Why is this happening? What are so many people struggling with addiction?

Are addicts bad people? Are they being punished? Are they ‘those people’? Before the addiction, were they different from you and your family?

I know many have these opinions about ‘them’.

I challenge you to respond with compassion and love for all people. Until a discovery is made of the ‘addiction gene’ or addiction identifier, each and every person prescribed an opiate beyond the time or dose needed for their pain or experimenting with an opiate could find him/herself instantly struggling with addiction.

I know some of you will disagree with the following, and I would love to hear from you.

I wonder how much of the current opiate addiction overdose epidemic is a sign of our stressed out time and how much is a challenge for us to demonstrate the length we will go to be compassionate and care for each other.

Ephesians 4:32 ESV

Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you.

Galatians 6:2 ESV

Bear one another’s burdens, and so fulfill the law of Christ.

Matthew 7:12 ESV

“So whatever you wish that others would do to you, do also to them, for this is the Law and the Prophets.

Zechariah 7:8-10 ESV

And the word of the Lord came to Zechariah, saying, “Thus says the Lord of hosts, Render true judgments, show kindness and mercy to one another, do not oppress the widow, the fatherless, the sojourner, or the poor, and let none of you devise evil against another in your heart.”

I encourage you to rise to the occasion to show compassion, learn more, and save lives. You can contact me at michelle@medsmash.com

Blessings,

Michelle

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Medication Reconciliation – Why it’s important to you

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Medication reconciliation can keep you safe.

Have you heard the term ‘medication reconciliation’? Probably not, it’s an insider’s term within medicine. But it’s an important concept, and I want you to know about it. I want you to ask about it any time you find yourself going into the hospital, going to the emergency department (ED), coming out of the hospital, going into rehab, switching doctors, having any major changes in either your health or who is monitoring your medications.

The term medication reconciliation (abbreviated ‘med rec’) means taking your whole medication list and understanding, how you are taking it and when you are taking. It is about making sure that information goes with you any time you are making a transition. So ideally, at the moment you enter a hospital someone figures out exactly what you take, how you take it, and when you take it. It is awesome if you come with this information. You could carry that information with you and have it ready to share with your health team. It is a huge safety factor in your care. If they know exactly what you take, how you take it, when you take it, they will make much more informed decisions in your care. This is true in the emergency department, the hospital, moving to rehab, moving to assisted living. I applaud the pharmacists who do this well in hospitals, clinics, and other settings around the country.

If you come in with it ready, you have saved them a lot of time and effort. And, you’ve helped assure your own safety. This important information will help guide the next phase when they will make any modification depending on why you are in the health system and what your needs are at that time.

If you’re in the ED or the hospital for a particular reason, there may very well be a need for a new medication to treat the reason you’re there. It is important that any of those changes are communicated all throughout your stay within and beyond the health system.

Formulary

A little caveat that’s important is another important term to understand – formulary. There can be a number of different medicines that do the same thing. We call them medication classes, and each class could have several medications that do the same thing in the same way. Rather than carry every medication on the market, a hospital will carry a few in each category.   It is possible that the one you typically take is not on their formulary. They will switch you while you are in the hospital to one that is on their formulary. The name, color, and size might not look familiar to you. Be sure to ask questions when you don’t recognize your medicine. This is not harmful; it will not put you in danger. Medicines within the same class work the same way as the one your doctor had you on at home. But, it is a source of confusion when you go home or move to another part of the health system. It’s one of the reasons this medication reconciliation process is so important.

It is critical that you know that another medication, similar to the one you take at home, is being used in the hospital. You want, when you go home, to be switched back to the medicine you came in on, the one that was prescribed by your own primary care provider.

Many, many patients have run into difficulty when they go home on the medication the hospital gave them and they continue to take the one they have at home. This is called duplication of therapy. You are getting twice the amount you need – you have the one you have at home and the on the hospital gave you that do the exact same thing. So, using blood pressure as an example, if you are taking the medicine you have at home plus the one in the same class that you got in the hospital, you could lower your blood pressure too much. You want to avoid duplication of therapy; be sure for that class of medicine you are on just one.

Be sure to ask at the hospital if you can go back on the one you were familiar with at home that does the same thing as the one you got while in the hospital.

It is important that several people know exactly the medicines you take when you go back home or get to your next destination. You are one of them, of course. It is also important that anyone involved in your care such as your spouse, child, or caregiver involved in your care; your primary care doctor; any specialists; and your pharmacist know exactly how your medications have changed while you were in the hospital.

It is important that any intermediate step before you go home, such as rehabilitation, knows your entire current medication regimen. But, it is most important that you understand exactly what to take when you get home.

Medication changes while you’re in the hospital

What if problems related to your medication led to you going to the hospital? That is very often the case. Then, the medicines that led to your admission will be stopped or changed. If the problem that took you to the hospital was something new, then it’s likely that new medicines were added to your regimen. Again, it is important that you know what changes were made, why they were made, and exactly what you should do when you get back home. Ideally, ask your questions while you’re in the hospital, but if you get home and have questions, don’t hesitate to reach out for answers.

Medication reconciliation is something we often do at Meds MASH. People get home and realize they don’t really understand what they are to do. They have a list from the hospital, a list from rehab, and their home list. They wonder if anyone has looked at all of the medicines – the old ones, the new ones, and some from other doctors.   At Meds MASH we look at all of the medicines and make sure they are all safe together. We catch those duplications and clear them up with your doctors. One of the things we will do, with your permission, is get information from all of your doctors and from the hospital and pull it all together. Then, after the thorough analysis, any changes will come from your primary care doctor who is the gatekeeper and the one person responsible for all of your medicines.

Three doctors recently wrote an important article about the need for accurate medication reconciliation. And they note that this process must be thorough to be meaningful. Several partial versions have been tried, and if it isn’t complete, it’s not helpful. It’s not going to keep people safe if it is not done right.

If a thorough medication reconciliation can keep you safe and healthy, please contact us at Meds MASH at 410-472-5078 or www.medsmash.com/contact.

BIBLICAL APPLICATION

This Biblical application might feel a little less associated with the health part. With medication reconciliation we are talking about making sure all of the information related to medication use is clearly communicated. If it is not done completely it isn’t effective. What about our compassion and how we reach out to others? How complete and effective are we?

Something has been weighing very heavy on my mind in the last week. It is the decisions we make about where our compassion lies. Who we can forgive and who we can’t. How do we spend our money and give our support and where we do we not? The thought that has been raised in my mind is – when we know someone is in need, and we do not know their sins, it seems to me it is easier to reach out and provide support for those needs. The example that got me thinking this is the refugee crisis. When you know there are millions of people who have been displaced, a lot of people have compassion for that and for their circumstances. What can we do to help those people and their dire circumstances?

The other things that made me think of this were more local. What are the needs of people who are making choices that are leading them to being in dire circumstances? It might be behavioral and lifestyle choices; it might be financial management choices; it could be self-care choices that lead them to circumstances where their life is not as secure as it might be. Their difficult circumstances are a ramification of lifestyle and self-satisfaction choices they have made.

I am connected to a place right now that serves the LGBTQ community and the HIV population. Some Christians find it easy to be very judgmental of this population and not share their compassion in this direction. Rather, they choose to share their compassion in other circumstances where the reasons and the choices are less known. Is this what Christ calls us to do? Are we called to show compassion or walk away?

Consider the story of the woman caught in adultery in Luke Chapter 8.

Luke 8:1-11 MSG

 Jesus went across to Mount Olives, but he was soon back in the Temple again. Swarms of people came to him. He sat down and taught them.

The religion scholars and Pharisees led in a woman who had been caught in an act of adultery. They stood her in plain sight of everyone and said, “Teacher, this woman was caught red-handed in the act of adultery. Moses, in the Law, gives orders to stone such persons. What do you say?” They were trying to trap him into saying something incriminating so they could bring charges against him.

Jesus bent down and wrote with his finger in the dirt. They kept at him, badgering him. He straightened up and said, “The sinless one among you, go first: Throw the stone.” Bending down again, he wrote some more in the dirt.

Hearing that, they walked away, one after another, beginning with the oldest. The woman was left alone. Jesus stood up and spoke to her. “Woman, where are they? Does no one condemn you?”

“No one, Master.”

“Neither do I,” said Jesus. “Go on your way. From now on, don’t sin.”

Her choices were well known, and she was being very degraded. She was called before the council having been caught in the act.   The council members were ready to stone her. Jesus said those without sin could cast the first stone. We are so quick to categorize sins, but it doesn’t seem Jesus categorizes sins. What are we called to do as Christians? I am struggling with this and I’m challenging others to struggle with this, too. This is not a blog with answers. It is a blog with challenging questions. I would love to hear what people think.

Luke 6:37 ESV

“Judge not, and you will not be judged; condemn not, and you will not be condemned; forgive, and you will be forgiven;

It has become clear to me as a practitioner that sex as defined in the Bible, as designed by God does not lead to trauma, whether emotional or physical, and it does not lead to disease transmission or to promiscuity.

But in society, especially in the current waive of rules avoidance and focus on self, sex is being used in a lot of other ways. When used outside the way described by God, it does lead to a lot of issues. We create our own problems when we are outside this definition.

Another example heavy on my mind is substance abuse. The numbers of people caught in addiction and dying of overdose are astounding. This is a tragedy of great proportion! Yet the local rescue mission is struggling to stay funded. People who have been caught up in abuse and addiction who are now reaching out for help to leave that lifestyle are encountering limited spots available for rehabilitation. Yet Christians are looking for meaningful outreach and missions opportunities.

I am in full support of refugee aid, international response to crisis, local response to crisis, support of children in underserved areas, teens on mission trips, college students on mission trips, medical missions, and so much more. In addition to all of this wonderful outreach, I encourage us to search our hearts and God’s leading for our attitudes about reaching those in circumstances in our own community that are harming them.

I propose when we limit our compassion or draw a line for how we will consider using our resources, it is similar to an incomplete medication review.  Completeness and effectiveness are limited.

James 4:12 ESV

There is only one lawgiver and judge, he who is able to save and to destroy. But who are you to judge your neighbor?

What is your response?

Blessings,

Michelle

 

 

 

 

Narcotic Addiction – the epidemic and new strategies

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Prolonged use at higher than necessary doses can lead to opioid (narcotic) addiction

Narcotic addiction is now at epidemic proportions. Drug abuse has been with us for all of recorded time. The specifics of the drug(s) most commonly abused change over time. Sometimes the most abused drugs fall out of favor for a while and then reemerge. Common examples from the past few decades include LSD, cocaine, crack cocaine, and inhalants.

Right now, prescription opioid pain medicines (narcotics) are being abused at an alarming rate.

According to the Centers for Disease Control (CDC), 2 million people abused or were dependent on opioid analgesics in 2014.

Refer back to last week’s blog. Terms are very important here. Dependence is a physiologic response to these medications. Anyone who takes them over time will have some changes in how their body handles pain signals. The body’s normal response takes a backseat to the medication. In order for the body to take over again, the medication needs to be titrated off slowly. If you stop the medication all of a sudden, the body goes through withdrawal. It can’t take back over the pain control that quickly. It needs time to gear up. NOTE, this type of dependence and withdrawal is different than ADDICTION.

Addiction

Genetic, psychosocial, and environmental factors all play a role in the creation of an addiction.

Addiction usually occurs when the opioid medication is continued after the pain has gotten better. Sometimes people keep taking the medication for the effects beyond the pain relief. Some people feel a euphoria or high while others are very laid back.   If they keep continuing the medication for this purpose, then addiction can occur. Not only are the body’s receptors letting the medication handle pain it is seeking these other effects. Over time it takes a higher dose more frequently to get the same amount of desired effect. So, doses keep going up and desire to take the medication is very strong.

The FBI and the DEA created a documentary about this addiction. If you would like to know more, I highly encourage you to watch this video. You can find it at this link: https://www.fbi.gov/news/stories/2016/february/raising-awareness-of-opioid-addiction/video/chasing-the-dragon-the-life-of-an-opiate-addict.

In March of this year (2016), the CDC released new guidelines for prescribing of these medications. If you would like to read them, you can find it at this link: http://www.cdc.gov/drugoverdose/prescribing/guideline.html . These guidelines are emphasizing less use.  Use only for moderate to severe pain.  Use at the lowest possible dose for the shortest time possible. There are other, non-addictive options for lesser pain.

When people addicted to prescribed opioid pain medications can’t get more prescriptions, they often turn to heroin. This is another opioid substance that is illegal but sadly, easier to get ‘on the street’. This allows the addicted person to keep getting the effects they are seeking. Note, at this point, addicted people realize this is a miserable, horrifying state. But the demands for more drugs override common sense. Again, I highly recommend watching the video created by the FBI and DEA.

So overcoming this epidemic is being addressed from the prevention side by the new prescribing guidelines. It is also being addressed through new medications and techniques to help people escape the addiction. So, there is hope for the future with this addiction!

If you would like to know more about narcotic addiction, new steps to address it, or similar topics, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Temptation has been part of our world since Adam and Eve, the very first people. It did not take mankind long at all to prove how difficult resistance to temptation can be.

I first want to send a loud, clear message that love, compassion, forgiveness, and constant support are key elements of walking away from addiction. Rather than avoid, isolate, and punish those who find themselves addicted, we have a calling to reach out in love and be part of that crucial support network.

Proverbs 17:17 TLB

A true friend is always loyal, and a brother is born to help in time of need.

1 Peter 4:8 NIV

Above all, love each other deeply, because love covers over a multitude of sins.

I want to write about temptation and the fact that it is a fact of life. God knows all about the temptations in our path. He is also there to help us through. And when we are entangled in a temptation that we did not resist, He is there to bring us back away from it.

1 Corinthians 10:13 ESV

No temptation has overtaken you that is not common to man. God is faithful, and he will not let you be tempted beyond your ability, but with the temptation he will also provide the way of escape, that you may be able to endure it.

1 Peter 5:8 ESV

Be sober-minded; be watchful. Your adversary the devil prowls around like a roaring lion, seeking someone to devour.

James 1:12-15 ESV

Blessed is the man who remains steadfast under trial, for when he has stood the test he will receive the crown of life, which God has promised to those who love him. Let no one say when he is tempted, “I am being tempted by God,” for God cannot be tempted with evil, and he himself tempts no one. But each person is tempted when he is lured and enticed by his own desire. Then desire when it has conceived gives birth to sin, and sin when it is fully grown brings forth death.

1 John 2:16 ESV

For all that is in the world—the desires of the flesh and the desires of the eyes and pride in possessions—is not from the Father but is from the world.

I pray you are always aware of the temptation around you and the help available to you at all times from God. I also hope you find opportunities to reach out to those who have fallen into temptation and love them back out of that snare. That love might be tough love, but the Bible is full of examples of that too. Check out Luke 6:27-49.

Blessings,

Michelle

Hate and Health

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Hate and negativity are bad for your health.

Holding grudges, blame, racism, oppression, and social isolation have all been linked to poorer health.

Having

  • friends to talk to
  • people who care about you
  • a sense of self-worth
  • forgiveness
  • security
  • conflict management skills
  • religion/spirituality

have all been linked with improved health.

Bad things happen to everyone. Some of these bad things are worse than others.

Every relationship has times of negativity. No person is perfect.

Prolonged negativity with no ability to cope has been linked to mental health and physical health decline.

Negativity can lead to heart disease, diabetes, depression, anxiety, fibromyalgia, and more.

The health effects of negativity are even more pronounced in people over age 65. All life phases introduce change. Post-retirement these changes can include social networks, family dynamics, physical mobility decline, vision and hearing issues, limited income, home downsizing, new diagnoses, and recognition of mortality.

When harbored resentments, self-pity, and rejection are included, the negative health impact can be dramatic.

Are you living in negativity?

What could you do to let go of hurts, find sources of happiness, and reclaim your health and contentment?

For more information about the link between negativity and health, contact us at www.medsmash.com.

BIBLICAL APPLICATION

The ‘Golden Rule’ holds the key for happy living. Imagine if everyone treated everyone else with the same kindness, understanding, and forgiveness they want for themselves.

Over 20 world religions have very similar versions of the Golden Rule. This concept of loving, honoring, and being tolerant of each other benefits everyone.

Matthew 7:12 NLT

The Golden Rule

Do to others whatever you would like them to do to you. This is the essence of all that is taught in the law and the prophets.

Not only are we called to treat each other as we like to be treated, we are called to love each other – even those who hurt us. Wow, talk about radical love!

Luke 6:35 NLT

Love your enemies! Do good to them. Lend to them without expecting to be repaid. Then your reward from heaven will be very great, and you will truly be acting as children of the Most High, for he is kind to those who are unthankful and wicked.

Ephesians 4:32 NIV

Be kind and compassionate to one another, forgiving each other, just as in Christ God forgave you.

Luke 6:37 NIV

Do not judge, and you will not be judged. Do not condemn, and you will not be condemned. Forgive, and you will be forgiven.

Then, we are called to go another step forward…

Romans 12:14-21 NLT

Bless those who persecute you. Don’t curse them; pray that God will bless them. Be happy with those who are happy, and weep with those who weep. Live in harmony with each other. Don’t be too proud to enjoy the company of ordinary people. And don’t think you know it all!

Never pay back evil with more evil. Do things in such a way that everyone can see you are honorable. Do all that you can to live in peace with everyone.

Dear friends, never take revenge. Leave that to the righteous anger of God. For the Scriptures say,

“I will take revenge;

    I will pay them back,”

    says the Lord.

Instead,

“If your enemies are hungry, feed them.

    If they are thirsty, give them something to drink.

In doing this, you will heap

    burning coals of shame on their heads.”

Don’t let evil conquer you, but conquer evil by doing good.

So we are called to love, honor, respect, and care for those who hurt us. God knows about each of those hurts. He will take care of the justice. Our role is faith and following God’s plan (which is way different than normal human response).

When we release the hurts and negativity, we are free to live unencumbered in true joy and peace.

Philippians 4:8 ESV

Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.

May this happiness and joy be yours!

Blessings,

Michelle