Substance Abuse

"Steer clear of hallucinogenics / To get high I just do calisthenics." (K.Flay - Just Say No).

Our last week of BMB included a few days on substance abuse. Despite being pharmacology heavy, I liked these lectures. Illicit drugs are interesting in that they change from generation to generation; ravers in the 90s "rolled" with ecstasy (they were first distributed in tootsie rolls) but today's kids go "pharming" for prescription drugs. It's actually fascinating to me that drugs have entire cultures and economies built around them; we learned that pacifiers are often seen with "E" users because E can cause your jaw to clench down (it acts on serotonin, the part of the serum that increases muscle tone).

Furthermore, it is important to identify substance abuse and dependence, especially since alcoholism is so prevalent in our society. But drugs are complicated - we have to learn to identify signs of acute overdose, withdrawal, chronic use, and combinations with other drugs.

We also had a poignant speaker talk about the effect of drug use on physicians. Physicians indeed have a higher rate of substance abuse than the general population. This may be related to many things such as ease of access, understanding of mechanism of action, or a lack of societal awareness that doctors can be vulnerable to drug use. Nevertheless, drug use has a huge impact on the physician, affecting not only his personal life but also those of his patients. And only recently has there been a greater awareness and push to find and treat impaired physicians. I think that being a professional with high socioeconomic status in a position of power makes doctors vulnerable to drug use, addiction, and denial. Indeed, it is fundamentally important for us as medical students and future peers to watch out for each other.