Thomas N. Dikel, Ph.D.

06/01/2024

For many years, PTSD has been treated with selective serotonin reuptake inhibitors (SSRIs). We are always hearing about "evidence-based treatments." I always wonder about that evidence. By the way, SSRIs have been used to treat PTSD at least since 1990, which is nearly 35 years. I have heard some psychiatrists refer to it as the medication of choice. Well, what are the data, really?

According to FDA staff, response rates with SSRIs rarely exceed 60%, and typically, less than 20%-30% of patients achieve full remission.

Gee. doesn't sound like a f--king wonder drug to me. But I am a skeptic, I spoze.

11/13/2021

We have enough confrontation and brainwashed mentality that people who don't agree with our politics are the ENEMY. And that the Russians are our friends.

01/18/2021

We all tend to be familiar with the phrase "Fight-Flight Response" in reference to the stress response, from the work of Hans Selye (e.g., The Stress of Life). However, that is only 2/3 of the actual stress or potential catastrophic threat response, which is fight-flight-immobilize (or freeze) response.

Many people face additional suffering if they did not (or "failed" to) fight back or at least run. But the truth is that the freezing response is more ancient and basic than fight or flight.

This was put together to help people who have been assaulted and have either suffered self-critical thoughts and feelings or has faced similar - in this case purely ignorant if not vicious - queries from defense attorneys. Unfortunately, there are still some in law enforcement who don't understand and they too ask similar questions of victims of assault. They need training, badly.

11/30/2020

T-MOBILE MAKES 988 EMERGENCY LIFELINE'S CRITICAL MENTAL HEALTH SUPPORT SERVICES IMMEDIATELY AVAILABLE TO CUSTOMERS

As COVID-19 mixes with a particularly stressful Holiday season and NATIONAL VETERANS AND MILITARY FAMILIES MONTH, T-Mobile will be the first major wireless network provider to make the 988 emergency lifeline available immediately to its customers. T-Mobile customers who dial 988 will have free access to some 180 crisis centers offering professionally trained mental health counselor services beginning today.

The National Su***de Prevention Lifeline is available at 1-800-273-8255 (1-800-273-TALK) and for online chats.

Veterans and service members may reach the Veterans Crisis Line by pressing 1 after dialing, as well as by chatting online at www.veteranscrisisline.net or texting 838255.

10/10/2020

The American Medical Association Takes on the CDC 2016 Opioid Guidelines

This is an article written by Richard A. Lawhern, Ph.D., with the Alliance for the Treatment of Intractable Pain. It was published by Dr. Lynn Webster, former President of the American Academy of Pain Medicine, in her American Medical Association blog and is reposted here for the benefit of readers.

09/03/2020

From the story:
Under the law, physicians and pharmacists are required to consider the “individualized needs” of pain patients, treat them with dignity, and ensure that they are “not unduly denied the medications needed to treat their conditions."

Under the New Hampshire law, “all decisions” regarding treatment are to be made by the treating practitioner, who is required to treat chronic pain “without fear of reprimand or discipline.” Doctors in the state are also allowed to exceed the MME limit, provided the dose is “the lowest amount necessary to control pain” and there are no signs of a patient abusing their opioid medication.

--Critically important, from the New Hampshire Law:
For those patients who experience chronic illness or injury and resulting chronic pain who are on a managed and monitored regimen of opioid analgesic treatment and have increased functionality and quality of life as a result of said treatment, treatment shall be continued if there remains no indication of misuse or diversion.”

--According to a retired California pain management specialist:
“The tragedy of the recent over-reach to control opioid abuse, diversion, and overdoses has caused immense suffering for legitimate, chronic pain patients, an epidemic of suicides among deprived pain patients, and the forced retirement of many worthy physicians (including yours truly). All this ugliness would have been prevented with the New Hampshire law.”

--To get an idea of what the real data regarding prescriptions, overdose deaths, and involvement of medial vs. street opioids:
According to the CDC, New Hampshire physicians wrote 46.1 opioid prescriptions for every 100 persons in 2018. That’s well below that national average of 51.4 prescriptions. That same year, 412 people died of drug overdoses in New Hampshire, the vast majority of them involving synthetic opioids such as illicit fentanyl and other street drugs. Only 43 of those 412 deaths involved a prescription opioid.

By Pat Anson PNN Editor Patient advocates around the country are looking with keen interest at a new law in New Hampshire that stipulates chronic pain patients should have access to opioid medication if it improves their physical function and quality of life. HB 1639 was signed into law by Gov.