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Medical Students Highly Prone to Burnout and Alcohol Abuse


Author: Shernide Delva

The medical field is notorious for being a stressful and overwhelming environment. After all, it deals with saving the lives of sick people. Surely, that has to take a burden.  Therefore, it should come to no surprise that medical students were found in a recent study to be more vulnerable to burnout and alcohol abuse than their peers not attending medical school. Young, single students with high amounts of debt were found to be the most prone to alcohol abuse.

The study published in the journal Academic Medicine indicated that there is a need to raise awareness of this issue:

Our findings clearly show there is reason for concern,” says Liselotte Dyrbye, M.D., Mayo Clinic internist and senior author of the paper. “We recommend institutions pursue a multifaceted solution to address related issues with burnout, the cost of medical education and alcohol abuse.”

To gather results, Mayo researchers surveyed 12,500 medical students, and approximately one-third of those students responded. Nearly 25% of students surveyed revealed that they had experienced clinical alcohol abuse or dependence.  Compared to only 16 percent of peers not in medical school, those numbers reveal a significant issue in the community. Feelings of burnout were highly associated with alcohol abuse or dependence among medical students for numerous factors.

The five factors associated with alcohol abuse in medical students were:

  • Emotional exhaustion
  • Feelings of depersonalization
  • Younger age than most peers in medical school
  • Being unmarried
  • Amount of student loan debt

In the past two decades, medical school costs have increased by 209 percent at private colleges and 286 percent at public schools. The average physician graduating from medical school will owe 180,000 dollars in educational debt. Medical students face some of the most strenuous educational requirements out there. They endure four years of undergraduate school, four years of medical school and a three-year residency program. The educational requirements mean that medical students spend long hours in the classroom and at home studying and preparing for exams. As a result, the culture of medical programs can often promote the use of substance to cope with stress.

Drinking patterns among medical students affect the general population because physicians and future physicians play such a crucial role in our society and are important leaders. Also, a medical student’s drinking behavior could negatively affect their education. A medical student who abuses alcohol might have harmful ideas about drinking. There is a correlation between personal practices and counseling practices that could alter how they approach treatment for drug addiction.

Addictive substances are readily available to physicians. The increase in availability explains why the rates of substance abuse are higher among physicians than  the general population. Doctors have been caught that were using illegally self-prescribed medications for years, even decades.

The lack of accountability among students further contributes to the risk of addiction. Medical Schools tend to be close nit communities. Therefore, even if student was known for abusing substances, chances are slim that they ever get caught. This is known in the medical community as the “conspiracy of silence,” and unfortunately, not much can be done to change it.

Fortunately, a study like this encourages conversation about the need for programs to address the temptation to abuse substances in medical schools. Through addressing this concern in the early stages, programs can be implemented that prevent this cycle of abuse. The last thing the medical world needs are new doctors entering the workforce with substance abuse issues.

What kind of programs could be implemented to lower this risk? Ultimately, that is the question this study raises. Alcohol abuse and burnout are serious concerns that need to address with an effective treatment program. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-561-951-6135.

Abusing Cough Syrup: The Dangers in Doses

Abusing Cough Syrup: The Dangers in Doses

Author: Justin Mckibben

It truthfully isn’t anything new, although many people don’t often understand how prominent abusing cough syrup has become. There have been news stories and headlines before about teens abusing cough syrup, parents being warned of how to spot this kind of risk behavior, but still people don’t all seem to understand the gravity of this abuse.

Names like “sizzurp” AKA “purple drank” have been popularized by pop-culture, but these pertain to the cough syrup combination of codeine and promethazine, a harder to obtain mixture.

However medicine containing DXM is frequently sold over-the-counter. Although in some states, you need to be 18 years old to purchase it, it does not require a prescription which increases their general accessibility to those looking for a “household high.” The truth is, even over-the-counter this drug is deadly.

Abusing Cough Syrup

Cough syrup has been abused as a cheap high, but the dangers in the doses are so much more than many people suspect.

Dextromethorphan (DXM) is the active ingredient in many brand-name cough suppressants such as:

  • Coricidin
  • NyQuil
  • Robitussin

DXM has long been abused by young adults to achieve a high, but abusing cough syrup means users must take multiple times the doses recommended for treating colds. Some abuse cough medicine by consuming an entire pack of gel caps or even multiple bottles of syrup.

The reality is that most people underestimate abusing cough syrup because it is legal and such a common thing found in almost every medicine cabinet across the country. However the danger in these doses makes abusing cough syrup a potentially lethal legal high.

The effect experienced from the abuse of DXM is typically categorized into four stages:

  1. Mild stimulation
  2. Euphoria and hallucinations
  3. Dissociative out of body state
  4. Complete dissociation with unresponsiveness

Different DXM Drug Effects

Chlorpheniramine, the antihistamine in Coricidin, causes “anticholinergic” effect in high doses, which has effects including:

  • Agitation
  • Tremors
  • Delirium
  • Hallucinations
  • Coma

Acetaminophen appears as the last active ingredient in Coricidin, as well as myriad other over-the-counter and prescription medications. This ingredient is frequently taken with other medications sometimes also containing the drug, making accidental overdoses a fairly frequent occurrence.

An overdose of Acetaminophen can cause delayed liver damage and can do enough damage to require an organ transplant.

The combination of cough syrup abuse and other substances often exaherbates the effects of the DXM and other drugs included in the cough syrup’s formula. This puts those abusing these over-the-counter meds at an even more elevated risk of causing some devastating damage.

Stacking the SAMHSA Stats

The Substance Abuse and Mental Health Services Administration (SAMHSA) has taken some interest in cough syrup abuse, and according to their stats:

  • 1 million youth and young adults in the United States, ranging from ages 12 to 25, misuse over-the-counter (OTC) cough and cold medicines that contain dextromethorphan each year.
  • Non-medical abuse of DXM results in approximately 6,000 emergency department visits annually in the U.S.
  • Adolescents (ages 12 to 20) accounting for almost 50% of these emergency department visits

This phenomenon appears to be increasing throughout the country, even though cough syrup has never been as well known as other narcotic drugs. with potentially lethal consequences for those who partake.

A Medical Toxicology fellow at UCSF named Annie Arens stated calls to the California Poison Control Center concerning teens abusing Coricidin have jumped from 3% to 25% of all calls to the Center in the past few years, with no signs of slowing down.

Some teens are aware even of the dangers of acetaminophen overdose, purposely purchasing Coricidin to abuse that is acetaminophen-free. Yet they willingly take on the threats of overdosing on DXM and chlorpheniramine. Some are aware of the increased hazards of taking DXM with alcohol.

What many young people don’t seem to know is that when taken with antidepressants like MAO inhibitors or SSRIs, even in a regular daily dose, DXM may produce a life-threatening serotonin syndrome.

Either way despite all that has happened, some parents are still very unaware of the potential of abusing DXM cough syrups and how fatal it can be. Many parents and acquaintances often leave these substances around the house, oblivious to the perils that are blended into the medicine when young adults and teens misuse it to catch a cheap buzz. The truth is the buzz can kill, and the cost of life definitely should never be as cheap as a bottle of over-the-counter cough syrup.

Whether a drug is a street narcotic, prescription medication or an over-the-counter medicine drug abuse is dangerous and can even be deadly. Abusing drugs often leads to addiction and often stems from a much more complex problem, but there is real help out there. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135


How Heroin and Aspirin Are Related

How Heroin and Aspirin Are Related

Author: Justin Mckibben

Yea… got your attention, huh?

Kind of curious to see how this one plays out? Well it is kind of weird to even consider the idea that the world’s most popular and successful legal drug ASPIRIN would be distant cousins (twice removed even) to one of the most dangerously addictive and infamously lethal illegal narcotics out there, HEROIN. Sure we have seen how prescription medications can get out of hand, but not everyone knows how common and even legal most illicit drugs used to be.

It’s like hanging out with a guy who wears tailored suits and talks spiritual principles, while driving his Mercedes to a charity event he hosts for starving children… and then meeting his brother, the lying drug dealer who robs little old ladies and doubles as a disease spreading hit-man.

Why do I feel like Martin Scorsese is directing this?

Well believe it or not, this is a story or metaphor based in fact to a chemical level, and it’s weird to find out how.

The Relation

German pharmaceutical company Bayer had a moment of sheer victory back in 1999 when it celebrated a century of success for Aspirin. Both Heroin and Aspirin are drugs synthesized by adding acetyl groups to already existing natural compounds.

  • Aspirin is produced by adding 1 group to salicylic acid, found in willow bark which had long been used as a traditional remedy for pains and fever.
  • Heroin is produced by adding 2 acetyl groups to morphine, the active constituent of opium.

If you look at the acetyl groups in a formulae graph, you can see the similarity plain as day; while the one for heroin is a much more complex chemical build up.

History of Heroin

Back in Europe in the 19th century opium was the first widely used painkiller, then morphine, and a non-addictive painkiller was desperately needed. At this point while both compounds were already know, aspirin was the first of these two to be synthesized in a form pure enough for medicinal use, and the Bayer pharmaceutical company could have been launched it in 1897.

Heinrich Dreser, the head of the testing department, had already begun testing the much stronger drug heroin on himself as well as several others who said it made them feel HEROIC (hence the name). Dreser rejected aspirin on the grounds that it would “weaken the heart” after realizing the commercial potential of heroin, and the company then launched heroin not so much as a painkiller, but as a cough remedy.

At the time it made sense, since even the 19th century saw tuberculosis and pneumonia as common threats to public health, and the severely ill patients desperately needed something that would give them a night’s sleep, so of course such a powerful drug would seem like a very marketable remedy.

It only took one year for some patients to begin showing “tolerance” to the drug. By the beginning of the 20th century, recreational use and addiction to heroin was already on the rise and only gaining momentum. It soon became clear that this was one cough medicine that was geared to tear people apart far more than it would ever hold them together, and that was just the tip of the iceberg.

Dreser himself died in 1924 of a stroke after he had apparently become addicted to his own heroin, which he was using to treat his discomfort.

Aspirin Aspirations

In 1913, Bayer stopped marketing heroin. It took that dog out of the fight taking heed to the rising issues, and they quickly swapped out their front-runner with aspirin in the painkiller game.

After the Second World War aspirin did lose a little bit of its popularity, partly because of damage to the stomach suffered by people taking overdoses. But it made a solid come-back, especially since the discovery that instead of weakening the heart like Dreser used to claim, it was determined to actually help to prevent heart attacks or strokes.

So while aspirin was never intended to be the Bayer companies claim to fame, they had to use what little clout that bought them, especially considering they developed a drug that now ravages the nation as one of the leading causes of addiction and overdose death.

Some people may have heard stories about how heroin was once used as a house-hold product for all types of ailments, and people willingly sold it and administered it to all age groups as a miracle medicine. Now we know better. What many people may not know is that Aspirin was close kin to heroin, and if the research had been thorough at the time Aspirin could have maybe even sidestepped the rise of heroin.

Drug abuse has a history, and a lot of drugs were believed to be a lot less dangerous than they are now known to be. Most addicts don’t suspect the drugs to have the power they have until it’s too late, but there is always hope in recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135


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