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Substance Abuse

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Please join us for today’s topic - Substance Abuse. Joining us is Dr. Paul Musson, a Flint physician board certified in Internal Medicine and Addiction Medicine.


0:01 Ilene Cantor

This Think Healthy, Think Hurley interview was brought to you by Hurley Medical Center, the region's premier public teaching hospital in Flint, Michigan. This Blog TalkRadio is another way Hurley is educating the Genesee County Community and beyond about health and wellness. For more than a century, Hurley has been providing the most comprehensive clinical and compassionate care for patients and their families. I'm your host Ilene Cantor and today's topic is Substance Abuse. Joining us now is Dr. Paul Musson, a Flint's physician board certified in Internal Medicine and Addiction Medicine. Dr Musson, thank you for joining us.

0:33 Dr. Paul Musson

Thank you for inviting me.

0:36 Ilene Cantor

Doctor, first question, what is and how is substance abuse defined?

0:41 Dr. Paul Musson

Well, substance abuse is in general, a category of illnesses related to, or disorders relating to intoxication, dependence, abuse and withdrawal. And it can be in general with respect to substances that you take internally or even behaviors that you engaged in. It's a very wide scope of disorders.

1:07 Ilene Cantor

What are the signs and symptoms for some of the most common type of substance abuse, say alcohol?

1:15 Dr. Paul Musson

Well, there are behaviors that people engaged in. You may -- from that standpoint of getting in accidents, having legal problems, drunk driving, getting thrown in jail because of using poor judgment at parties for instance, being unreliable in social commitment and relationships, having social difficulties, people wanting to avoid the person because of their types of behavior. As it relates to the individual experience themselves, they start using substances maybe in their youth just recreationally and then they begin to use it more and more. No one starts out using with the expressed purpose of becoming an alcoholic or an addict, but that's eventually what takes place for a sizable number of individuals. They start isolating themselves from people, using more resources to acquire the drugs and greater efforts to try to cut down. They finally become trapped and it begins to dominate their life and destroy.

2:23 Ilene Cantor

What are some of the common treatments because there is such a wide scope of substance abuse, doctor, but in your opinion -- professional opinion that in the patients you've work with some of the common treatments for the various kinds substance abuse, what can they include?

2:38 Dr. Paul Musson

Well, for drug treatment of substance abuse in the class of drugs such as Heroin, OxyContin, Vicodin and narcotics of that nature, methadone has been a longstanding treatment in approximately 40 or 50 years or so. And, it has done very well in helping people change their lives so that they're no longer committing major criminal acts to try to support their habit. Their lifestyle has changed. It's called harm reduction. And recently, Suboxone is a medication that has come on board in relation to doctors who in their own office can provide medication to help people who are struggling with opiate dependence, with pain pill dependence and needing to get off of those. Benzodiazepines like Xanax and Valium can be treated with phenobarbital, detox protocols. It's not a whole lot of treatment out there yet for marijuana we're still looking, cocaine, some antidepressants, alcohol is being treated successfully with a medication called Campral and recently naltrexone does very well and of course nicotine. We used Chantix and Wellbutrin. There are number of behavioral treatments. Cognitive behavioral therapy, psychotherapy, grief management, family therapy, lifestyle modification, etc. There are a lot of treatments available in any individuals are caught up in drug abuse or dependencies of any kind. It's not just drug abuse, Ilene. Also addiction to the internet, addiction to gambling, addiction to pornography, sex and food, various types of behaviors. High-risks behaviors. There are treatments available for these things.

4:34 Ilene Cantor

What should a loved one do, doctor? They start to notice a problem or addictive behavior developing or in some cases exacerbating getting worse. What should one do as far as the first step?

4:45 Dr. Paul Musson

The important thing, first of all, is to develop a relationship. This is basic human relation or behavior. Gaining trust with the individual letting them know of your love for them -- your concern for them. Being involved in their life and when you see them pulling away and when you see them doing things; however, destructive nature, because you have put in time. You have deposited money in a very emotional bank. You are able to make a withdrawal and spend that in the relationship because they know that you care and that you loved them. Rather than just standing back. Detached. Not involved and throwing stones at them because of their embarrassing behavior. It's important to develop relationship. We want doctors to do this and we need to do the same thing as family members, but if that doesn't work and you're trying to help them, then you need to get someone else in the family maybe who has that same rapport and try to pull at them. You don't want to run to the addiction community if the problem is not at the point where it is so dominating and life threatening that they're at risk of losing their lives, but as soon as you can intervene and get them to that point where they can accept your help and they admit to the fact that they have a problem that needs professional intervention, which is generally the case for everything. You will take them to someone who has expertise, whether it's a counselor, your family physician, an addiction specialist should get involved and lots of resources are available in this community.

6:33 Ilene Cantor

I was going to ask you doctor, were there some that you wanted them to highlight or mention as far as resources in general terms available in communities like ours?

6:43 Dr. Paul Musson

Well, if I can brag on Hurley Medical Center for a moment.

6:45 Ilene Cantor


6:46 Dr. Paul Musson

It has been a leader in the area of addiction recovery treatment for at least 50 years or so and a number of physicians have worked with us over the years in treating these individuals. I remember Dr. Clayton Stroup and others, but also there is Insight, which has recently become Hope Network, Sacred Heart, Salvation Army, Flint Odyssey House, Catholic Charities, Colombiere Residential Facility in Clarkston. We have Woodward Counseling here locally as well. New Paths, Auburn Counseling, CDI and Life Challenges. Lots of resources that are available for intervention.

7:35 Ilene Cantor

How important, doctor, you touch the panel earlier, but the important part that a support system will play for a patient?

7:42 Dr. Paul Musson

A support system is critical because individuals who are caught up in addiction because it is not normal, because it is not the baseline human condition, because it is a diversion from normalcy. The behaviors internally that go along with that the guilt, the shame, the self-deprecation and putting oneself down and isolation and feeling helpless and hopeless. It's important for an individual to know that they are accepted and loved because of who they are and not because of their behavior that they will have to have good behavior in order to be accepted, but they're loved just because they are human and especially, if they are a human in that same family. And family members, I don't want to be involved, if they don't have family members, there are a lot of people who are loners or families have moved away or they are not -- they burn their bridges. So, if they don't have family support, there are support systems available in the AA groups being mutual help, used to be called self-help groups now called mutual help groups, where you are getting help from others who had been down that same road, who had felt those same feelings of shame and helplessness and worthlessness, who had been able to pull themselves up with the help of others and it can it be done for them as well. Nobody needs to feel that they are worthless and that no one cares about them, there's lots of caring people out here to reach out a helping hand.

9:17 Ilene Cantor

What part do the holidays play in substance abuse? Do you usually see an increase, doctor?

9:24 Dr. Paul Musson

Certainly, there is an increase in the incidence of accidents, drunk driving, under the influence, violence and so on and so forth. During the holidays, the holiday certainly were -- if they were invented by anybody, would have been introduced to society as a way of people bonding and binding themselves together, but because of our tendency oftentimes to frivolity and high-risk behaviors during that timeframe, there is an increase in substance abuse and a risk to individuals and people who don't even use. As we know many times, people are killed by those who are driving under the influence and the driver under the influence may not get harmed at all, but during these holiday seasons, we have people who are lonely, people who are alone and drink, people who are looking for great time and don't know how to do that without being under the influence. I would say that for those of us who don't use, we have a wonderful time during holidays and weekends and we don't have to pursue substance use in order to have joy and these people can find that happiness too.

10:43 Ilene Cantor

And what are some final words of advice to be at someone that's coping possibly by themselves with a situation that is increasing or concerned family members, some final words of advice that as a physician you could pass along that you've experienced on the other side, doctor?

11:01 Dr. Paul Musson

In the treatment community, especially in the area of Addiction Medicine, we as physicians have had to recognize that we don't have the power to change these individual's lives in the 12 steps of alcohol, it's anonymous derived over the past 60 years ago and used since that time. There are 12 steps of recovery. Seven of which refer to spiritual matters and two or three of which mentioned the name of God directly. God as people understand him, not as others may try to force them to believe that there is a supreme being who a higher power, who cares and is able to help these individuals find sanity and come to an enlightened state of living, as opposed to being in their personal prison of emotional incarceration. They can find help and if anyone is listening out there, you can have help. Look up and help is on the way.

12:06 Ilene Cantor

Well, thank you so much for that inspirational and clinical advice and expertise, Dr Paul Musson, Flint Physician, as we said board certified in Addiction Medicine and Internal Medicine. Thank you so much for your time today, doctor.

12:20 Dr. Paul Musson

Thank you very much.

12:21 Ilene Cantor

This Think Healthy, Think Hurley interview was brought to you by Hurley Medical Center. If you would like to find a Hurley physician, call 888-611-4HMC.