The Experts Speak - An Educational Service of the Florida Psychiatric Society

Maria, using only her first name, candidly shares her feelings and life being the parent of the adult mentally ill. She discusses the process of learning and accepting this reality, the parental pain, the differences between she, whose children are still alive, and those whose children died by suicide or otherwise, the importance of helping others and getting support groups, to find the right questions to ask, of when one must let go for a period, of one’s personal life, etc. She is a platform from which to gain insight and strength.

Former US Drug Czar Robert DuPont, M.D., in 1997, outlines the theories of all addictions, what it does to the brain, the roles of pleasure, honesty, character, family and background, risk-taking aversion or comfort, preventions and treatments, the importance of AA and NA, the relative risks of some becoming addicted or not, nicotine and alcohol use, etc. He wrote “The Selfish Brain.” This interview contains so much wisdom about the same problems that continue to exist after 25 years. Recorded in 1997; reposted June 2022.

Priti Kothari, child psychiatrist, outlines how the different age groups suffered differently during the pandemic, the educational and social pressures and delays, the need perhaps of a gap year to catch up, disruptive behaviors with the reasoning fundamental to treatment approaches, etc. Thoughtful concerns about what happened and how to offset any setbacks.

Tara Gomes, epidemiologist in Ontario, Canada, speaks to enlightening research that larger quantities of take home Buprenorphine and methadone, and as such are multi-day dose packets, can be safe and productive in stabilized patients. The project was partially in response to covid caused travel restrictions. Some of the results was that this strategy reduced barriers, the fears of increased overdoses were unfounded, and it maintained treatment. This is like the U.S. methadone maintenance clinic model but within the Canadian structure.

A forensic psychologist gives insight into many cases in which he examined people who committed deadly violence. This includes young teenager offenders as well. His data and opinions come from a mixture of hard experience with these defendants. Recorded in 2008, much still true today. From our archives.

Bill Durston, MD, emergency room physician and former US Marine marksman, gives a necessary overview of gun violence statistics and his thoughts on how to reduce the suffering.

Steve Keen, M.D., gives a very detailed discussion of his real-time, on-going emergency room program, with specifics on how to rapidly stabilize, start medication assisted treatment, give psychosocial interventions and follow up referrals, deal with shame or patient’s hesitancy, the challenging omnipresence of fentanyl and related new drugs, etc. Done with the Palm Beach County Medical Society Opiate Task Force.

Journalist, and former opiate abuser Maia Szalavitz, defines harm reduction as keeping people from getting hurt rather than stopping them from getting high, that needle exchange encourages treatment, of needing good coping skills before giving up the substance, what changed her life, her work to promote harm reduction, etc. An honest and energetic discussion. Done with the Palm Beach County Medical Society Opiate Task Force,.

Elizabeth Evans, PhD, associate professor at the University of Massachusetts - Amherst, reports that giving Suboxone to jailed opiate using prisoners significantly reduced legal recidivism and other post release relapse and morbidity. Listen to the encouraging details of her the study, and to her current and related future work. Done in collaboration the Palm Beach County Medical Society Opiate Task Force.

Roz Malmaud, PhD, and Andy Rosen, PhD, note that patients are now focusing more on the pre-Covid, usual problems. Both discuss, however, issues with telemedicine’s legal and insurance matters, being unable to give patients questionnaires to complete or handouts for them to use, to see how they interact in the waiting rooms, the real paradigm shifts away from traditional therapy arrangements and schedules, and of how patients must learn how to tolerate social uncertainty, etc. The need for telemedicine during the pandemic brought many therapeutic methods to new notions that need refinement and integration insofar as to how we now communicate and interact. The tools are different.

Elizabeth Evans, PhD, associate professor at the University of Massachusetts - Amherst, reports that giving Suboxone to jailed opiate using prisoners significantly reduced legal recidivism and other post release relapse and morbidity. Listen to the details of her the study and her current and related future work. Done in collaboration the Palm Beach County Medical Society Opiate Task Force.

Roger Ekirch, PhD, a professor of history at Virginia Tech, on our different sleep patterns that were normal before the industrial revolution. A fascinating look at sleep patterns, the first and second sleeps, and the social and biological drives and basis of how we sleep.

Lynn Webster, M.D., discusses issues of over and under use of pain medications, his research on dosing and response issues, the critical psychological components in pain management, the correct use of non-opioid medications and non-medicinal pain treatments, changing attitudes towards pain management, etc. An articulate and experienced based discussion. Done in collaboration with the Palm Beach County Medical Society

Lori Ann Post, Ph.D., describes the dramatic recent increase in overdose deaths in this group, gender and other demographics, causes, interventions, and the on-going studies to better define and reduce this horrible social and emotional affliction. Done with the Palm Beach County Medical Society. February 2022.

Luke Elms, M.D., straightforwardly addresses ERAS’s (Enhanced Recovery After Surgery) beneficial medical and psychological strategies for compassionate pain control, of faster recovery with fewer complications, to help patients emotionally prepare for surgery and how this may reduce post-surgery pain leading to subsequent improper pain medication use, surgery and pain control in patients with opiate use problems, etc. Done with the Palm Beach Medical Society Opiate Task Force