Saturday, June 10, 2017

A Real Life Patient Experience

I got this message via my website from my patient this morning. The reason I'm posting it here is because this is a typical patient experience when it comes to opiate abuse/dependency issues. Typical. People NEED to know treatment is easy and EFFECTIVE. STOP suffering and get help. Most of the time this CAN be done through a doctor's office. My patient is on top of the moon! Maybe you can be too.

"Dr. Bacchus I just wanted to thank you so much for all you've done for me. I cant begin to tell you how excited I am. You know when I was searching for a dr to help me with my addiction issues. I've seen multiple doctors thruout my long runs on acquiring pills. You are the first one that... forgive my language but "took no shit". I needed that. Maybe the others saw right thru me but didn't care enough. Tough love. I know I can call you in between appointments if I ever needed anything or somthing wasn't right. I also learned real quick when my meds ran out early not to call. Which ultimately put the ball in my court. The first doctor that didn't enable my addiction. All's I'm saying is I thank you so much. Thank you for your patience with me. I know I am an intense person. When all the meds are stopped I still would like to see you for underlying causes along with weekly therapy with you ( if my insirence would cover it) or a sliding scale alternative therapist. I feel I have came along way but I also know my behavior as an addict is still here. A lot of work to do. Somewhat discouraging. Well I woke up this morning and stuck to your instructions and I no longer miss/ want the suboxone. ANYMORE! :-) I'm sorry for ranting again I just wanted to thank you for everything you've done with me. Your a tough doctor man. Respect! Thanks again see you next month"

Sunday, April 16, 2017

Are You Buggin?

Take these simple tests...

Not sure if you need to see a psychiatrist? I find most of patients really don't know. I find most therapists and medical doctors that my patients often see don't know either. My patients are busy trying to do what it takes to be better but something is still "buggin".

The most common undiagnosed mental illnesses I see are anxiety and mood disorders. In fact anxiety is so common 1 out of every 4 people suffers. You might be that one. Even with intensive psychotherapy you will still be symptomatic. Never fear, psychiatrists have "skills" rather, tests that you can do on your own that can tell us a lot. Listed below are my quick and easy faves.

The PHQ-9 is a standard self test questionnaire. This test has great reliability (sensitivity and specificity) for picking up depression. If you score 15 or more on this test, see me-or see any psychiatrist for that matter. I even suggest you start with your primary MD. Word of note though, if your regular doctor starts something and you don't get relief, see a psychiatrist. It just saves time, energy and the exhaustion of suffering.

My next goody is the MDQ which is my new go to for diagnosing more complicated mood disorders like Bipolar Spectrum Disorders. I've enclosed in the link how to score but it might be best to do this test, then take it to your psychiatrist (me) for a clear possible diagnosis. Again the specificity of this exam is greater than 95%.

Another great test is the GAD-7 which is good for generalized anxiety disorder but also for panic disorder, social phobia and post traumatic disorder. Again reliability is over 85%. These ARE the most common disorders I treat. Go ahead take the exam and score. Greater than 10? Score an appointment with a psychiatrist (me) while you are doing therapy.

Do you drink? Take this test, the AUDIT-C, you might be surprised. Three simple questions can identify at risk drinking.

I still use the CAGE questionnaire to identify substance abuse and dependency. Four basic questions can make the difference between life or overdose death.

OK, cool-you now know what's real and what we shrinks look for and use. Take these short tests and let me know what you think. Treatment is easy (seriously) and effective.

Saturday, February 4, 2017

By KENNETH CRAIG CBS NEWS January 19, 2016, 12:33 PM

Monthly Vivitrol treatment helps fight heroin addiction

My office offers this highly effective treatment and accepts Anthem, Optum and Anthem insurances without extra costs. Call us today at (310)829-4640.

Sean Lyman has a standing appointment at his doctor's office every 28 days. Like clockwork, the recovering heroin addict is injected with an emerging treatment drug that he says has turned his life around.
"The shot is just... I don't know how to describe it, besides it's a miracle," Lyman told CBS News.
The 25-year-old Vermont resident has battled addiction for years; he was hooked on prescription painkillers before he moved on to the more powerful and cheaper alternative, heroin. Lyman says he's been in and out of jail and more than half a dozen rehab programs that haven't worked.


Now Lyman is among a small, but growing number of opioid addicts embracing Vivitrol. The monthly injection is the first treatment that's kept him clean. Doctors and the drug maker, Alkermes, recommend users go through detox first. Then, the injection stops cravings and blocks the body's opioid receptors, so even if users try to get high they don't feel it. Vivitrol is not addictive like other treatments can be, including suboxone and methadone, and there's no black market for it. Lyman said not long after he began the injections, he put it to the test.
"I actually tried... to get high because I was having a hard time and the shot stopped it." Lyman said. "At the time, I was very angry that I didn't get high. But the next day, I was so thankful. I can't even describe it. And I haven't even thought about sticking a needle in my arm since then."

Sean Lyman.

Lyman lives in White River Junction, Vermont. Since he started his Vivitrol injections 15 months ago, he says six of his friends have died from overdoses. Like much of the country, Vermont is in the grips of a drug crisis that prompted Gov. Peter Shumlin to devote his entire 2014 State of the State address to the heroin epidemic. The number of people treated for heroin abuse there has quadrupled over the past decade. Shumlin has been candid and outspoken about the problem and is leading the call for new solutions. He believes Vivitrol may be one of them.
"The first thing we're doing is approving it in all of our treatment centers. And we've been building out treatment centers like mad in Vermont. So then we also want to try it in our prisons because that's frankly a good place to do it," Shumlin said.
The state is rolling out a pilot program this month where recovering addicts coming out of the Marble Valley Correctional Center in Rutland will be offered the shot. If successful, state leaders plan to expand it to all of the state's seven prisons, which could help as many as 350 inmates.
"Let's start providing treatment and medicines that can actually get people back to productive lives," Shumlin said in an interview.
The pilot program is funded as part of a three-year, $3 million grant from the U.S Department of Health and Human Services/Abuse & Mental Health Services Administration. Outside of the program, the shot can cost more than $1,000 a month, but many insurance companies and Medicaid cover it.
Vivitrol was first approved to treat alcohol dependence in 2006. Since the FDA approved the injection for opioid dependence in 2010, Alkermes says there are now around 100 programs using it in 30 states. Since its approval, sales have jumped from more than $18 million in 2009 to more than $106 million in the first three quarters of 2015 . While the company said programs in Michigan, Missouri, Maryland, New York, Massachusetts, and Ohio were some of the earliest adopters, it believes Vermont is the only state that has approved it for use statewide.
"It is gratifying to see use of VIVITROL increasing across the country. It has taken time - VIVITROL is a new approach to treating opioid addiction and it requires new behaviors by physicians, counselors, nurses and other elements of the treatment system," Alkermes CEO Richard Pops said in a statement. "In many ways, the expansion of these programs has been somewhat organic, meaning that the success of one program in a particular county may spur another county to develop their own."
Lyman says he will keep taking Vivitrol until he is comfortable enough to stop. But for the first time in years he says he's happy. He now has a full-time job and he and his girlfriend have a baby daughter. He says she is a constant reminder of why he's fighting to stay clean.
"Knowing I can live a life sober, and not have to depend on that. I can't stop smiling thinking about it. It's just crazy."