The line between chronic pain and addiction to painkillers is a delicate balance that should be treaded carefully, especially for those with a history of addiction. The majority of people who take prescription painkillers can safely take their medication as prescribed without fear of addiction, but that’s not always the case. Those who suffer from chronic pain, especially those with a history of addiction, run the risk of becoming physically dependent upon the drug.

Chronic pain is defined as any pain that persists or progresses over a long period of time, usually more than three months, and can range from mild to debilitating pain. Those who suffer from chronic pain usually turn to prescription painkillers to help them get through their daily lives. The most commonly prescribed are opiate or narcotic pain medications such as Vicodin, Hydrocodone, Norco and OxyContin. Opiates can be highly addictive, especially when taken for long periods of time, and sudden discontinuation can result in severe withdrawal symptoms that can last up to two to three weeks. Early symptoms of withdrawal often mimic the flu and include muscle aches, runny nose, sweating, insomnia, anxiety and agitation. Late symptoms of withdrawal include diarrhea, nausea, vomiting, abdominal cramping, back and bone pain and intense craving for the drug. Withdrawal is not life threatening but can be extremely painful. Those who become physically dependent on the medication often mistake withdrawal symptoms as the chronic pain, causing them to continue taking the medications long after they’re prescribed. This leads to a vicious cycle between chronic pain and addiction.

The time it takes to become physically dependent on opiate painkillers varies from person to person. Many people fear that taking medications such as Vicodin for chronic pain will lead to a dependency problem, but the truth is that the majority of people will never have to worry about addiction. In fact, the American Pain Society reports that less than 3% of all patients suffering from chronic pain and without a history of drug abuse will show signs of physical dependence or abuse when taking these medications for pain relief. Another study by the National Institute on Drug Abuse reports that only 7% of patients who are prescribed narcotic or opioid medications to treat chronic pain will become addicted. This means that many chronic pain sufferers can safely treat their condition with opiate-based painkillers without fear of addiction or abuse.

While the majority of chronic pain suffers won’t become addicted, it’s a very real threat for those with a personal history or family history of addiction. If you or a family member has ever had an addiction problem, it’s important to discuss this with your doctor and come up with alternative treatments for treating your chronic pain. Luckily, most forms of chronic pain respond to non-opioid pain relievers and anti-inflammatory drugs, such as aspirin, ibuprofen, acetaminophen and naproxen. Alternative treatments such as physical therapy and cognitive behavior can also lessen chronic pain and should be used to supplement pain medication whenever possible in order to lessen the risk of addiction.

Chronic pain and addiction does not need to be an inevitable path for those suffering from persistent pain. If you feel that you’re at risk for becoming physically dependent on prescription painkillers or you are noticing the early symptoms of abuse, it’s important that you discuss alternative treatments for your chronic pain with your doctor.  There are many ways to treat chronic pain without turning to opiate-based medications, and a multi-faceted approach to pain relief is often more effective in the long run. If you feel like you’ve developed an addiction to opiate painkillers, talk to your doctor to see what options are available.

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Athletes are often viewed as extremely strong and fit individuals — the ultimate picture of health. The sad truth is, though, that many are hurting their bodies through anorexia and bulimia in order to shed weight and improve their performance. Athletes and eating disorders are a dangerous combination that is often overlooked or swept under the rug. If left untreated, however, it’s a dangerous combination that can lead to serious health consequences down the road.

Eating disorders such as anorexia and bulimia among athletes is more common than most people think. According to several studies of college athletes, nearly one in three female athletes has some type of eating disorder. Female athletes participating in sports in which they’re judged on how their body looks or in which they wear revealing uniforms are more at risk, including those who participate in dance, cheerleading, gymnastics and figure skating. But females aren’t the only ones at risk; many male athletes also suffer from eating disorders. Regardless of sex, athletes who participate in sports that emphasize appearance or weight or that focus on the individual rather than the team are more likely to engage in risky behavior. These sports include diving, swimming, bodybuilding, running and track and field. Perhaps the most common sport in which athletes engage in anorexia or bulimia, but one that is often overlooked, is wrestling. Wrestlers are constantly shedding and gaining pounds in order to fit within a certain weight class. Often these practices include severe caloric reduction and even purging of food, which can lead to severe dehydration and other complications. In 1997, the extreme and unsafe methods of weight reduction among wrestlers gained national attention when three college wrestlers died within 32 days of one another due to cardiorespiratory death after they tried to make weight for a competition.

While the pressure to lose weight is many times a personal conflict, athletes are often encouraged by their coaches to start dieting in order to enhance their performance. Losing weight as a runner, for example, might make the athlete lighter and faster, while a gymnast could improve her scores by presenting a more lean and toned physique. Weight loss can initially improve performance, but if taken too far or for long periods of time it can actually hinder performance. Athletes with eating disorders can suffer from fatigue, weakness, stress fractures and depleted muscles, and often have a higher risk of medical complications because they are putting their body through extremely strenuous activity. This can lead to more serious complications, such as electrolyte imbalances, cardiac arrhythmias and even death. One of the most famous athletes to die from an eating disorder was Christy Henrich, a world-class gymnast in the late ’80s who was told that in order to make the 1988 Olympic team she would have to lose weight. At 4′10″ and already only 90 pounds, Henrich began a long battle with anorexia that ultimately led to her death in 1994 due to multiple organ failure. She only weighed 60 pounds at the time of her death.

Luckily, there are many warning signs that an athlete is suffering from an eating disorder. In addition to the usual symptoms of extreme dieting, excessive weight loss, chronic fatigue and light-headedness, athletes with eating disorders will often withdraw from teammates, exercise excessively outside of normal practice time and may be unable to complete normal workouts due to fatigue or weakness. Coaches and trainers can play a pivotal role in preventing athletes and eating disorders by educating themselves and their athletes on the warning signs and dangers of eating disorders and how proper nutrition is key to a strong body.

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By Dr. Maryann Rosenthal

Over 11 million prescriptions were written last year for kids with depression. That did not include those who didn’t even see a doctor.

Growing up is never easy. It is a time of upheaval and emotional storms. The very openness children exuded and were rewarded for seems to invite penalties as they grow beyond adolescence They are exulting in their hoped-for independence even as they are frightened by the demanding, often-uncaring world of adulthood. During this confusing period, they end up changing from one mode to the other so often and so rapidly that it confounds their parents. Teenagers often turn to actions that provide emotional stimulation to counteract feelings of self-induced emptiness and low self-esteem.

All kids get sad or upset about things now and then: getting a bad grade on a test, arguing with a friend, being grounded, or being without a date for a big dance. These temporary disappointments are not necessarily depression, but stress in its many forms and the inability to deal with stress is a major factor in creating and exacerbating the problem.

Changes in behavior are normal as our kids try to figure out who they are and what they believe in. Most depressed kids are troubled by who they are, how others perceive them, and what parents, peers, and the world at large expect of them. Researchers believe depression affects 3 percent to 5 percent of preteens and up to 15 percent of adolescents with girls suffering from depression at twice the rate of boys. In an alarming study by Seventeen magazine, 28 percent of girls said they feel depressed every day or at least a few times a week. Girls are looking to peers for validation and it is often hard for them to retain a positive self-image. Adolescent girls undergo more life changes than boys and for yet unknown reasons, they are more vulnerable to negative life events, while the sources of stress in boys are more commonly school performance or other factors outside of social relationships, such as a move to another home. The good news is that serious depression in our children is treatable but it is often difficult to diagnose. The symptoms may be mistaken for Attention-Deficit Hyperactivity Disorder (ADHD) causing misdiagnosis and incorrect treatment.

What should parents and teachers look for?
You really have to tune in and judge the signs of depression against your child’s usual and normal behavior. Depression is different from “the blues” because it is longer in duration and more intense. Parents, friends, and teachers are crucial allies in the treatment of childhood depression. Don’t ignore your instincts and if you think there’s something wrong with your child, chances are you’re right. It’s a real danger sign when stress becomes too much to deal with and a child just feels like giving up, where life becomes overwhelming and hopeless.

If your child experiences two or more of these symptoms for two consecutive weeks, it might be depression and not just “the blues”:

• Decline in school performance
• Change in eating/sleeping habits
• Persistent unhappiness
• Inability to concentrate
• Irritable or angered easily
• Aggressive, impulsive, or reckless behavior
• Excessive guilt or anxiety
• Withdrawal from people and activities previously enjoyed
• Physical aches and pains
• Talk about death or suicide-this should always be taken seriously

Tuning In!
Fortunately, there are effective treatments for childhood depression. First, you must overcome any discomfort or embarrassment that you might feel about the problem. A real key is to be able to talk calmly with your child about it.

Your physician can offer guidance and help with a referral to a mental health practitioner A good mental health evaluation should include discussions with teachers and other family members.

Psychotherapy, especially cognitive behavioral therapy should be part of every treatment plan and may be all that is necessary. Medication can be a powerful weapon against depression but should be prescribed only by an experienced physician in close consultation with family. Medication doesn’t work for everyone and may make some depressed kids feel worse.

Clinical depression has biological origins and has been linked to an inherited imbalance in brain chemicals, although family environment is a contributing factor. Depression is in part a disorder of relationships. The depressed person withdraws and breaks connections with the larger traditions of which we are a part, such as family, culture, and religion. Part of the antidote is strengthening those relationships.

All of the medications and therapy in the world will not help a child if their home environment is a root cause of problems. In other words, depression is a family matter that involves everyone. Nurturing a child’s self-esteem and confidence, staying active, exercising, and developing good eating habits can help alleviate stress and depression in our children.

It’s important that you look out for serious depression and doubly important that you heed the great deal of research that shows that the more family-like connections a person has, the more inoculated against depression they are.

Dr. Maryann Rosenthal’s new book “Be A Parent Not a Pushover is available in bookstores everywhere. Dr. Maryann tells how to find a balance between loving your children and setting limits for them, to generate trust, confidence, resilience, and integrity.

You can read the original article here.

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