Compassion in the Midst of Addiction...Why the Future of Medicine Is About Kindness and Compassion...
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COMPASSION IN THE MIDST OF ADDICTION A Doctor's Journey of Turning Grief Into Education"
Transcript of Compassion in the Midst of Addiction...Why the Future of Medicine Is About Kindness and Compassion...
COMPASSION IN THE
MIDST OF ADDICTION
A Doctor's Journey of Turning
Grief Into Education"
I a sk tha t you …empath ic dur ing th i s
presenta t ion
“I have no conflict of interest in giving this
presentation and I am not getting paid to do it”
However,
This presentation today is dedicated to my son
Adam and my colleagues (couple) son’s Alext
Galatea and to all of those whose legacies (in
fighting the disease) we will spend the rest of our
lives trying to show that they are bigger than their
short life span. It is also dedicated to all those young
people everywhere especially Rams in Recovery who
struggle every day with the burden of the disease,
and of staying in recovery.
OBJECTIVE!!
Change the narrative about “Addiction”
Through
Practice of Compassion. i.e…
A case for compassion
• In faiths
• In Humans
• In medicine
Why in addiction?
My own journey with compassion
Why Compassionate is needed to treat addiction
My Personal journey.
FORMAT OF CONTENTS
Readings
Stories (case presentations)
A Prayer
• No singing……(Friday, Saturday and
Sunday came to early..
“There is a beauty all around us. We may
just have to rise high to be able to see it”
COMPASSION IN
FAITHS
“When Jesus landed and saw a large
crowd, he had compassion on them
and healed their sick.” Matthew 14:14
“When he saw the crowds, he had
compassion on them, because they were harassed and helpless, like sheep without a shepherd.” Matthew 9:36
“Because of your great
compassion you did not abandon
them in the wilder ness. By day
the pil lar of cloud did not fai l to
guide them on their path, nor the pil lar of f ire by night to shine on the way they were to take .” NEHEMIAH 9 : 19
“It is a mercy from Allah that you were gentle with
them. If you had been rough or hard of heart, they
would have scattered from around you. So pardon
them and ask forgiveness for them, and consult with
them about the matter. Then when you have reached
a firm decision, put your trust in Allah . Allah loves
those who put their trust in Him. “ (Sura Al’Imran,
159)
“Then will he be of those who believe,
and enjoin patience, (constancy, and
self-restraint), and enjoin deeds of
kindness and compassion.” (Surah Al-
Balad, 17
COMPASSION IN “US”
Leigh Tremaine - Finding Inner Wellness
COMPASSION IN US
“Compassion is a natural instinct within all of us,
but it is stifled when we lack mindfulness and are
mot present to life. This is why the practice of
compassion results in numerous health benefits
for the givers as well as the receivers of
compassion…...
COMPASSION IN US
....Compassion is ultimately the
embodiment of realization that all life is
one continuum, and that what benefits the
authentic wellbeing of others also benefits
ourselves”.
COMPASSION IN
MEDICINE
Why the Future of Medicine Is
About Kindness and Compassion
BY JENNIFER DOBNER
JULY 07, 2015. SAN FRANCISCO, CA
– in: Dignity Health
COMPASSION and MEDICINE
Jennifer Dobner is a Salt Lake City-based independent award-winning
journalist and writer and a regular contributor to Reuters, The New
York Times, WebMD, and NBC’s Today Show.
COMPASSION IN HEALTH
CARE
“What if the future of medicine comes not only
from advancements in science and technology,
but also from something simple and intuitive --
something that draws on both the deep roots of
the human experience and early medicine. What
if it comes from compassion?”
Dr. James Doty, a neurosurgeon, and the director and
founder of the Center for Compassion and Altruism Research
and Education (CCARE) at Stanford University
“At the beginning of medicine, when our
knowledge was frankly limited or absent,
what is it that we were able to provide?.....It
was not cure. It was not intervention. The
only thing we could provide was care and
comfort.”
“Compassion isn't entirely gone from
health care -- those working in the
profession are still driven by a desire to
ease suffering -- but in practice, it's a tenet
that seems to have been lost or pushed
aside over time”.
"We've become enamored with the technology
and the power of science," he says. "Certainly,
they've had a huge impact on health and health
outcomes. But we also have seen the result of
negating that and what we have learned is that
there is immense power to demonstrating
compassion and caring to individuals who are ill."
"I always tell people that while science
and technology have probably saved
millions of lives, the fact of the matter
is that kindness and compassion have
probably saved more," says Doty
Lack of understanding of addiction (ignorance) is the
root of stigma that is associated with addiction
Stigma associated with addiction has lead to lack of
compassion to patients affected with addiction
Stigma and lack of compassion surrounding
addiction are barriers to appropriate diagnosis and
Treatment
WHY COMPASSION IS
NEEDED IN ADDICTION?
So, Why Compassion in
Medicine is lost when it
related to addiction ?
CAP PROFILES
Assistant Professor of Psychiatry and Behavioral
Sciences Program Director for the Stanford University
Addiction Medicine Fellowship, and Chief of the
Stanford Addiction Medicine Dual Diagnosis Clinic
“……, doctors are not educated in the treatment of
addiction. Only 20–30% of primary care physicians feel
“very prepared” to detect risky substance use, yet 80% feel
“very prepared” to tackle hypertension or diabetes. Even
psychiatrists are poorly trained in screening and treating
substance use disorders, and they often turn away patients
with addiction. Among practicing doctors, less than 1%
identify as addiction medicine specialists.”
“What happens when primitive defenses like denial no
longer work, for example, when the prescription drug–
monitoring database shows overt drug-seeking, and the
doctor is forced to acknowledge that she has been
supplying drugs to an individual who has been misusing
them? At this point, the doctor is unmasked as nothing
more than a gatekeeper of goods and services, or worse
yet, a drug dealer, and she experiences a narcissistic
injury…
….. A narcissistic injury strikes at the heart of her sense of
competence and self-esteem. It is extremely painful to
experience, and the reaction is primordial, reflexive, and
hostile. Jim’s doctor’s reaction—his unbridled rage and
rejection of Jim—is a classic example of a narcissistic injury
followed by narcissistic rage and retaliation. The idealized
response, by contrast, is compassion and professionalism
even in the face of these challenges.”
MY JOURNEY WITH
COMPASSION 2013-2016
2013: Case 1:
My first encounter:
addiction and no
compassion
Case (Story) 2: Adam
Abubaker April 9, 1993- October 2, 2014
Meeting it….
MY JOURNEY WITH
COMPASSION 2013-2016
MY JOURNEY WITH
COMPASSION2013-2016
2014:
Story 3, Learning More of it
International Programme in Addiction Studies(IPAS)
The International Programme in Addiction Studies (IPAS) is a unique collaboration of three of the
world's leading research universities in the field of Addiction Science: King's College
London, the University of Adelaide, and Virginia Commonwealth University. This
partnership offers three nested graduate program options available to students from around the globe via distance learning
technologies. Students are introduced to the latest information on topics ranging from the biological basis of addiction to addiction
treatment, prevention thro and policy ugh lectures produced exclusively for IPAS by an international Who's Who of experts in the
field.
August 215-May 2016
M Y J OU RNEY WITH COM PASSION 2013 -2 0 1 6
G R A D UA T E C E R T I F I C A T E I N
I N T E R N A T I O N A L A D D I C T I O N S T U D I E S :
I N T E R M E D I A T E C O N C E N T R A T I O N
• T hr ee 4 - c r ed i t cour ses ( 12 c r ed i t s ) :
• Bio log ica l bas i s o f add ic t ion
• Psychosoc ia l i s sues and appr oaches t o
t he t r ea t ment o f add ic t ion
• Publ i c hea l t h i s sues and appr oaches t o
add ic t ion
LESSONS LEARNED
1. “Addiction is an organic brain disease,
and is not a moral or spiritual weakness”
DOE S ADDICT ION FIT INTO T HE
DISE ASE DE FINIT ION?
A disease is:
A disordered or incorrectly functioning organ, part,
structure, or system of the body, resulting from
The effect of genetic or developmental errors,
infection, poisons, nutritional deficiency or
imbalance, toxicity, or unfavorable
environmental factors; illness; sickness; ailment.
Addiction is primary chronic relapsing disease of
brain systems of reward, motivation, memory,
judgment, and related circuitry.
There are genetic predispositions,
environmental factors, sociology, organ (brain)
susceptibilities, physiology, and individual behaviors
that factor into the development and course of this
disease.
Dysfunction in these circuits leads to
characteristic biological, psychological, social
manifestations that frequently result in
destructive and life-threatening behaviors
(Symptoms).
Ventral Tegmental Area
2. Addiction is like many other
chronic relapsing diseases”
• Just like other diseases,
such as heart disease,
addiction disrupts the
normal, healthy
functioning of the
underlying organ, has
serious harmful
consequences, and is
preventable and treatable,
but if left untreated, can
last a lifetime.
Source: From the laboratories of Drs. N. Volkow and H. Schelbert
3. Addiction is more common than
many other systemic diseases
How Bad Is Addic t ion as a
Disease?
Addiction affects 16% of the US population,
about 40 million people (32%, 80.4 million)
engage in risky use of addictive substances
Heart disease 27 million
Diabetes 26 million, Cancer 19 million.
How Bad Is Addic t ion as a
Disease?
Disease burden due to addiction exceeds
half a trillion dollars annually.
In 2010, only 1% of the total health care
budget went to treating addiction
5. Accepting addiction as a disease made it
easy for me to practice COMPASSION as a
tool in approaching patient with addiction.
Treating patients with addiction as all other patients
with other chronic diseases (i.e.just like we treat all
other patients).
Show empathy and concern for their disease listening
and not judging (Compassion); (Remember: Doctors
diagnose and not judge).
Show understanding of their illness and offer
resources for help
COMPASSION IN COMBATING
ADDICT ION
Treat patients with addiction as all other patients with
other chronic diseases (i.e. just like we treat all other
patients).
Show empathy and concern for their disease listening
and not judging (Compassion); (Remember: Doctors
diagnose and not judge).
Show understanding of their illness and offer
resources for help
COMPASSION IN ADDICTION
MY JOURNEY WITH
COMPASSION2013-2016
2014: Case 4
Practicing it.
MY JOURNEY WITH
COMPASSION 2013-2016
2016: Case 4,
Teaching It!!!
PRAYER
History Question:
Amazing Grace hymn is written by a
1. A slave?
2. An African American?
3. A white activist?
4. A slave trader (former)
P R A Y E R : M A Y T H E L O R D R E S U R R E C T
C O M PA S S I O N I N O U R P R O F E S S I O N T O
H E L P C O M B A T A D D I C T I O N
Amazing grace! How sweet the sound
That saved a wretch like me!
I once was lost, but now am found;
Was blind, but now I see.
