Mark's Musings - January 21

Below is an aggregation of the stories I posted on LinkedIn since my last edition. I curate them through the prism of an "intersection of chronic pain and appropriate treatment" and so they come attached with my opinion.

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One dead, 12 hospitalized in mass overdose in California (226 views)

A sad story from Chico CA (already in the news in 2018, unfortunately, due to the wildfires) - "mass casualty incident" of #fentanyl #overdoses. The good news is that the responding police officers were carrying naloxone (a practice they started last year). This follow-up article quotes the police chief that he had been "waiting, and have been waiting unfortunately, for this to happen in the sense that we knew fentanyl had been moving west." Lessons? Fentanyl is an unfortunate game-changer. It's everywhere. And without #naloxone the mortality statistics would be even worse than they already are. Don't just take my word for it:

I, Surgeon General of the United States Public Health Service, VADM Jerome Adams, am emphasizing the importance of the overdose-reversing drug naloxone. For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life.

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This is why the federal government has a hard time regulating prescription opioids (427 views)

An interesting opinion on how difficult it is for the federal government to help with the #opioid epidemic, taking history into account. I suggest you read the entire article to gain the full context, but the high-level points the author makes are reasonable:

1. The FDA focuses on keeping unsafe drugs off the market, rather than regulating them after they are approved
2. The government lacks forceful tools for changing physician and consumer behavior
3. Organized interests fight stronger regulation
4. Attacking illegal drugs is much easier than regulating legal ones

Does that mean the feds can't help or shouldn't be involved? Absolutely not - their role is incredibly important (even with these obstacles and especially with illicit opioids). But it does point out how the feds can't be THE answer to the problem. The solution is ALL of us, everywhere, doing what we can to help people. Let's make it personal ... How can you help?

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Actor Rob Lowe: I was my sick mother's caregiver, don't underestimate the stress caregivers face (277 views)

Are you a caregiver? That's the person who doesn't have the medical condition but takes care of someone that does. Who worries more about the person they're caring for than themselves. Who can feel overwhelmed, unappreciated, and isolated. Whose stress, anxiety and even depression may exceed that of the person for whom they're caring. And all of that can create a sense of hopelessness during a time you're trying to provide hope. Especially if the caregiving is not short-term. This op-ed from Rob Lowe - yes, the rich and famous actor - outlines how being a caregiver for his mom impacted him and the lessons he learned from the process for which he is now actively advocating. He indicates there may be 40M others like him in the U.S. His advice? "To effectively care for someone else, we caregivers must first remember to take care of ourselves...The person you’re caring for needs you to be at your best." I remember being the caregiver of a caregiver (my Mom) as my Dad dealt with Parkinsons until he passed away in 2014. So many questions. So much information. My role was to try and be the objective party, to help both of my parents understand the implications of treatment, to be dispassionate in a passionate circumstance, to support my Mom and offload as much as I could so she could be in the moment. All while my Dad was dying. It was not easy for her. It was not easy for me. But I do remember being cognizant of my personal needs for sleep, nutrition, community and in some cases distance. I used writing - updates to family and friends - as my therapy (someday I may turn it into a book). I knew if I was a wreck then I couldn't do what I needed to do. If you're in that situation, please don't hesitate to ask for help. It's not a sign of weakness - it's a sign of strength.

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(1,009 views)

Did you have great plans for January, determined the "right track", but feel like you're "getting run over"? Maybe it's because you didn't go from planning to execution. Change doesn't happen by thinking - Change happens by doing. Granted, doing the right thing is more important than just doing something. But sometimes we don't do anything because we're not sure we know with certainty what the right thing is. If you've ever driven the hills of downtown San Francisco, you know you're either going forward or backwards - staying in the same place is actually more difficult to accomplish. Plan - Execute - Adjust. Hoping for your situation to change without actually doing anything to make the change happen is just ... hope. And hope is not a winning strategy.

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Barr signals support for ending marijuana legalization (305 views)

Ignore the sensationalized headline that is only partially true (imagine that). Attorney General nominee William Barr's argument is "the current discrepancy between federal law and state laws is untenable" and "either we have a federal law that applies to everybody or ..." He didn't get to finish his sentence but I can imagine he wanted to say "...applies to everybody or not." Common sense. Everybody knows federal law supersedes state law. But when it comes to #marijuana the reverse is assumed by many to be true (because the federal law is largely being unenforced). The bottom line - "Barr said it is incumbent upon Congress to decide whether marijuana law will be established and governed by a federal government or state-based system." Yeah, good luck with that given our current "legislators" ...

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5 Ways to Help Injured Workers Avoid Opioid Misuse (726 views)

Words of wisdom for my employer friends. Read more details about my perspective in this excellent Risk & Insurance magazine article by Michelle Kerr published on August 20, 2018 entitled "5 Ways to Help Injured Workers Avoid Opioid Misuse." The five methods are certainly easier to say than to do, but every journey starts with a single step. Here they are to hopefully entice you to read the full article:

1. Educate your workforce
2. Manage expectations
3. Increase resiliency with wellness
4. Have a robust return-to-work program
5. Work with treating physicians.

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The Impact of Substance Use Disorder on Professionals and their Employers (169 views)

"Workplace substance use disorder (SUD) can very easily create a toxic corporate culture and puts other employees in immediate danger." Unfortunately, SUD is not isolated to just a few workplaces or industries - it is prevalent (and given the statistics probably even in your workplace). There are obviously financial implications of not addressing this properly, but also human costs in lost productivity and reduced company morale. The best approach to manage it is NOT to ignore it or fire the employee but to HELP them. "Helping guide the employee toward treatment is a proactive, compassionate and ultimately cost-effective course of action that lets them know they’re a valued part of the organization." It sends a message throughout the organization that employees are more than cogs in a machine - they are valued human beings that help the employer (and each employee) achieve their goals. Some in workers' compensation call it an advocacy-based claims model. I just call it being human(e).

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The ripple effect of Eric Berry (579 views)

"Fear nothing and attack everything." That kind of attitude is the epitome of #Resilience. It can help you overcome, but don't overlook that how you address life's difficulties (including #ChronicPain) can be a +/- influence on others. Thanks to Eric Berry for thinking beyond himself, and not just talking the talk but (quietly) walking the walk. What is your "ripple effect"?

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In addition, I published two blogposts:

• "Mark's Musings - January 14" on January 14
• "Update on NY Work Comp Drug Formulary" on January 17

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"It's Never the Wrong Time to do the Right Thing" - Martin Luther King, Jr.

#PreventTheMess + #CleanUpTheMess = The Answer.