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Is this an over medicated society

Feb 20, 2013|

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Transcript - will not be 100% accurate

Welcome to -- right turn radio. WRKO. Six -- -- what he's been on the fan on here -- my cohosts. -- -- licensed social worker in the two clinical directorate right turn out patient services. Kyra they have. -- -- remember me yeah at all so does mr. Jung told him addiction specialist over right turn her engine on how I would behind every. And so you're listening to right -- radio it's a weekly talk show its new England's foremost addiction and mental health. Program and so. So hey guys this is our second show. I -- content here here at this new at our new home and -- you know it and it's good to be here founder and so. Let's let's talk about tonight's theme. When we're going to be talking. Of doubts. The over. Per script you know -- over. Prescribing. Of prescription medications. We'd like to hear from you give us a call 617. 2666868. If if this is something that you have had experience when. See we we Kimmel put the show because we have a medical director who is currently and leave but he felt like everybody in America wants a pill for everything. He said and it was one of his things he's really really -- of that and we always wanted to do the show. So I thought it was a really key topic because. People really really trying to solve all their problems. The best they can only go to doctors and doctors try to do -- the best they can and they end up with prescriptions for all sorts of things. And when lots of China. Well as a result. Well is that we are in in trouble as a result of this that you know and it's interesting because there're there're several areas of medications. That are prescribed. And sometimes overprescribed and sometimes. Some are prescribed. Without. You know with as kind of the first line of defense in treating something. Any menu to talk about this everybody talks that painkillers. Camera make everyday says no pain television and it -- in the taxi cotton and but there -- a lot of medications that get overprescribed. But why is this a problem. Well why is it a proud. Because I hope it's get people opiates -- of the paint their three areas that get prescribed eleven medications the opiates. Which of the painkillers. Everybody knows about them. Because you've heard of them because they're invited in -- set when you for the dentist if you have surgery all of those things you often get prescribed it. There's also the stimulants. Besides caffeine. So they're all the people of the things people are prescribed for ADHD. Middle Lynn and patter all around and those and then there's the -- of depressants which are the ones that relax people the anti anxiety medications. Blake. Xanax and climate thin up there all street names are all these things. Yeah and so I mean it's uninteresting piece and in the end and Ambien of course and and it's an interest in peace because. You know part of our discussion tonight will be about. These types of medications and how they're prescribed and sometimes overprescribed and the end but also that sounds sometimes people rush in to a diagnosis. And then the other thing is so so you -- lake suppose you go in you go to the dentist. And they keep feet when he by kingdoms and you take -- And then it's in and then it's in your medicine cabinet and to. You know your kid comes -- he's sixteen or or in my case. One day they weren't there Brit Andy you know was that the cleaning people listen. Enough so. You know so. It becomes part of the illegal drug use also because people take them even though they're not prescribe and -- tenth two problems one -- is a lot of prescription. And there's a lot of people diverting. Yeah you know it's interesting how about because you know we want them we want this you know be very clear here. That there are medications that doctor prescribe a doctor was described but there are also drugs that. An -- that you can buy off the streets and and let's be clear that some of these medications end up on -- since so tonight in our conversation let's let's be very clear when we talk about medications. Let's say medications. This part of this portion of the program has brought to you by foundations. Recovery network. Abby looks let's talk about our guest we have a guest tonight. Yes we have Jane Ballantine who I was selling. Who's. She's at the university of the march to Washington in Seattle she's a pain specialist. And she's a professor of anesthesiology. And pain medicine but she also is part of a group that is why we really think she's amazing. It's -- the physicians for responsible opiate. Prescribing. And she's gonna come on she's gonna talk to us about which she's trying to do get this piece of ten of them over prescription painkillers. Dealt with tenement and national level. So before we go to our guest John let's go to the news. Hey I got a couple interest thing. Interesting pieces here one is you know how can we just so marijuana become legal. And Colorado you know where they're having and legal issue here we call middle -- so what's gonna happen now is also you're gonna start to have new laws created in this is real new frontier vote. How do you tell if someone's impaired. While they're driving on marijuana so they have to create you know new things and there's a couple studies that came in this one that just came -- move. British Medical Journal recently. That states that acute care of -- consumption nearly doubles the risk of a collision resulting in a serious injury -- death. Well it's -- so acute that means not had condemning -- recent use yes that's great. Because what people say is oh I was on the influence -- you know I spoke four days ago. It just happens this'll be in my. And -- you know somebody was smoking in the car and say hey -- well this is gonna come up for people who were driving it's also gonna. You know you can suspect that's gonna come up in employment in cases of employment as well bright red right. And that's and so this is a new frontier really firm through months -- -- judicial system. And they're trying to find you know how what is the point 08 Massachusetts -- There's no limit. They're trying to find know what's gonna be first of all the way to measure in them what's gonna be the limit her. Through different states and its into the big thing the other thing that caught my -- in the news. I'm speaking of prescribed medications that. You know we process these medications. Dumb and -- in our system our system they come out especially anti anxiety medication comes out. Still as a -- a day as appearances it's that it's so it's being released into our. And through our water because he is you know the treatment players know that when it's still. Stays pretty much the same as when it comes out of it and so there's a recent study done in Sweden on fish. To see how the fish reacted. To you know they took the control group of -- didn't and then you you know of these drugs to the water and then they took another so how did the history -- -- fairly short little finesse and finish the fish it turns out. First of all they start over even. Our -- And then they they become -- they go into areas where they would not normally look clean and there are little more aggressive. And they and they become I'm a little a little more adventurous but also there's some you know they're overeating and stuff like that -- -- thought that was a real interest in -- This is a big issue. It is -- there really went Blake goes through that's comes out in the water system and there's a lot of us well let's go also as as we've addressed on the show before when people flush medications. Like birth control pills like pain medications. Down the down the toilet. Then then we have big problems we wanna hear from you we only hear. If you've struggled with addiction from pain medications give us a call at 6172666868. So yeah and also you know not just pain medications. Prescription medications any prescriptions have they gotten you in trouble. Suck it up prescription medications now that's again let's review. The trends that as a theme which is the the anxiety medication and also a lot of people have gotten in trouble with Lou nest and some of the sleeping thank her. -- -- -- mark -- NEC Ben's so late then so write -- -- than -- -- and as a means so we have pain medications we have anxiety medications but we also have the stimulants. Down which are being prescribed. For. They DD JDH of -- -- They help people with focus and made the you know. All of all of these medications are totally Clinton and Medicaid runs much of the time and -- -- it's just that. You know that a lot of people get these medications prescribed. And don't and you know who who's gonna finish sixty well we know who's fit into sixty vacant and -- you know who's gonna finish. Right everyone is done and we wanna say if you are taking medications and end in a responsible way. Then that's important that you take these medications and responsible way and we want who -- we don't want you to feel that -- we would not support that. My concern at the -- Is that -- when he is that Saddam a lot of people Russians prescribing medications. As the first line of defense. For -- for treating. Conditions then they'd treat these symptoms with medications supposed to. Treating the conditions credit. I -- other thing that's really scary -- statistics statistics just coming out saying that one in six teenagers. Have the used to prescription medication to get high. I'm -- and that's -- -- I mean that's because that is prescription medications as a new gateway drug. They're the first thing a lot of people tracked. Say that again the in my dvd just different access -- health and what's that percentage complete so one in sixteen ages. That's teenagers that -- nineteen and under you have to have used and a prescription medication to get -- and after marijuana prescription medication as the most commonly used medication. Com for teenagers. -- -- -- well they're great you know what is medically and he is -- yeah yeah. So get title when we come back we're going to be talking to our guest again our guest Jane Ballantine. -- doctor -- -- and she was in People Magazine three weeks ago to give us a call 6172666868. Will be right back with fewer calls. Arm yourself with the truth they should CD WRKO. Stance talks -- Attitude. Hi I'm John -- and musicians and addiction counselor right turn the creative place for recovery from alcohol and drug addiction and -- For some people struggling with -- right turns intensive outpatient treatment can provide the tools needed for recovery. For others the end structure of our support posting program may be beneficial. This program house's seven men and beautiful renovated Historic New England house and water tonight. Our goals to help residents of the queen consumer support networks and develop life skills for sober living. Expressing individual creativity is an important part of recovery here -- That includes a fully equipped music rooms weekly jam sessions and an opportunity for -- performance. For more information -- turned supporter posting from and call me at 7816463800. Or visit right -- turned out toward. That's 716463800. 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Changed world we are KM 680 WRKO. Talk station. As what we do we run. As a medical community has convinced this is scared us into thinking we need a pill for everything we do. Nobody can go to sleep who's -- crap has no stroke there's no little off. Perhaps propeller -- -- don't like your job as a little blue velvet pictures. You know we weren't teamwork under yeah. You are only 35 you started taking an anti depressants you know. Can shout out. Just a little bit for the folks who went before us. We're blowing up Iraqis live railroad track stuff in the middle and I can't finish kindergarten and a rarity today I'm. Sad. All the time and I don't know why yeah. Well sadly -- -- 530 weeks. Welcome back to right turn the radio my name is what -- geez man I'm here with -- dean and John Minko handing -- listening to right -- Radio One. WRKO 680. We wanna hear from you give us a call 617. 2666868. Our topic tonight did Billy Darnell 'cause I -- today as Billy Aaron Hill yeah you're fifth traditionally are adelgid summon up that these aren't enough or is perfect here. That was Billy -- all the star -- of Mike and Molly on the on television. Talking a little bit about prescription medication. So I introduce and Jane downtime after Jane Valentine she's done up as we mentioned she's a pain specialist. And a professor anesthesiology. And from University of Washington. In Seattle. So thanks for calling him doctor. Mario welcome good evening would be good evening having. So so I -- I didn't know it's going to be calling in and then Friday somebody handed media People Magazine where your picture wasn't meant to -- That was brought month. Yes so -- -- tell a little about it. What do you do and how you came to be concerned about the over prescription of pain medications. So -- anesthesiologists. -- I'm actually most pain specialists are anesthesiologists. And I've been practicing payment for instance the late 1918. And that was at times that. We began -- to teach that. So -- should be used for the treatment of chronic pain which they hadn't previously being. Used to those indications because people are so frightened of addiction. So they need eight to ten the ninety. You door and tremendous increase in the amount of opiate that was huge for the treatment of chronic pain. And then in the late nineties. -- -- -- -- Began to notice that the people were being treated was doing particularly well and that was really the beginning of my interest in what exactly would be -- doing and themselves. Where they effectively treating the paying. Because it seems that a lot of these patients. Still had very severe pain despite being on opiates and sometimes despite being known really launch date is that they pitch an old says that they were with seeming to be. Dependent on the pitch that is even though they weren't getting pain relief. We couldn't take them off very easily can that how I became. Interested in the issue of what exactly were we doing in Ethiopia. Similarly doctor and a doctorate sounds like that that that we were you -- These symptoms were being treated by medication -- not necessarily. The condition was being treated that is that what I'm hearing from you. Well you know pain medication always treats symptoms. It. Sometimes paying doesn't have like a killer -- -- sometimes you can help I would say juries sometimes you can help it. By taking the primary condition and sometimes you can help with the injections. But when you used pain medications they're always treating the symptom of paint. May I remember the changes to work and met and I apology floor. Here and they would only put people on and opiates when there you know in real you know in the end stage is because they're afraid people can get addicted. And I remember the switchover in most amazing to see. But it it I felt like it was it -- -- moved along so that you know. People get prescribed it much more easily you know first injuries for dental procedures for things like that. Well when do you remember that change oh and it worked in the hospitals in the eighties I think -- military mid may actually be -- especially. Yes exactly so when I started practicing led them. We used to opiates both surgical pain call off a trauma and they used to pitch to treat people who would dying. And cancer in those states people did die pretty quickly now of course they don't die quickly from Kentucky but. We never use that for chronic pain because there was. That's -- of addiction and then in the eight days. People started to say this wasn't bad to their chronic pain patients they -- suffering unnecessarily. And we should stop being frightened of addiction. And that was the teaching that I've received in fact it was playing I gave because it was teaching I received until we began -- that maybe that wasn't. Truth. So what what what are we say what you seeing today. I mean. Well today in my -- on the other end of the spectrum because I I practice in this state of Washington I don't know if you know that the state of Washington. It's the first state in the nation to actually have a little. That. Puts a limit on that day simply -- that people couldn't describe. At their positions can describe. What if they had Sheffield and a well I think. It's having some positive effect. I don't think there's any any measure we can take now that's not going to have some. Unintended consequences than the unintended consequence of fat lore is that. Positions and how frightened to describe a tool to mix catching people off. Two or they become dependent on the pistons that's not particularly good either. You know one thing is that that that just kind of came about in New York City is the entertain the idea that if someone has been on pain medication. Four condition for -- a period of time. And has been they've been treating the pain with medications to an extent. That the wanna put a ceiling on this and say it's time for a second opinion. And move this person on two -- pain specialist and that's probably in the case of a primary care physician. Yeah well that's what then that's what the Washington State lol. Says to accept that you don't have to do anything other than get -- consultation. From a especially if you don't have to hand over cash to accomplish. But you know that. You know one of the results since people are just being cut -- And the one of the one of the unfortunate. Consequences of -- over prescribing is we've now got thousands of people who become dependent on those kids. And and they need to and very specialized care. So so what kind of things have you what what kinds of things have you implemented near practice and are trying to get the word out about the. Well I mean we have a very. Big effort to not. Knit university and the university hospital in departments particularly. To. Educate primary care physicians about how to manage pain. Without using -- people when it's appropriate -- to opiates because it didn't might do. Probably 90% of the pain that's currently being treated for their kids. Should not be particularly -- -- patrol. But people need to be empowered to use other means of spent treating pain because are the means of taking pain not just medical means. But and in terms of behavioral therapies and particularly physical therapy. How much how much training. Do new physicians get. In this field in other words of prescribing opiates and hand them the proper way to prescribe them how to. How do us but you know behaviors that might be drugs we can. Almost none and that's what's -- great tragic cases that. People are prescribing dangerous medications settlements and no training on how to do it. And that's something people -- -- him dressing and it's part of fought prop this organization that I belong to his. Trying to promote its you know better education that I that's. Just through. Getting at the end of the chief of education but also. Possibly through a certification. Through the DA. Because they DA at the moment for get to provide certification for prescribing controlled substances but there's no education attached to that certification. Well -- the -- also we hear you I think that you're trying to open. Our eyes a little bit more to alternatives of treating. Conditions that involve pain medications. Media holistic approach. Exactly. I mean there are a lot of very common pain conditions say it's. It's what we call actually a low back pain that -- back pain in the as the lower back that's sort of mid line doesn't radiate anyways thank you. Due to anything identified. And identifiable. Well obviously it's an apology. And is probably due to this strain injury means. And it doesn't really respond well to medications responds much benefit to. Physical therapy particularly cold strengthening exercises sensitive holistic approach to -- weight loss proved. That tension that dietary factors. Just let it -- improved. Lifestyle. So it's a -- and I love that and I appreciate that because we can't just through medications. You know -- static condition and we need to try to treat the condition and I I so much appreciate that. This portion of our show was sponsored by foundations. Recovery network give us a call 617. 20666868. We're talking about. Prescription medications. We're gonna have to hear more from the doctor when we come back from our break stay tuned. 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Think the critics and naysayers wrong. Never he continued we are okay. RKO. Boston's talk station and. Yeah. It's. Our -- welcome back to right turn from radio this is woody he's been on here with. Caddie dean John code and and we have June Ballantine on the phone with us and we're talking about. About medications. Or over prescribed medications in the doctor was just making a terrific point. About the trick or treating the condition. Instead of just throwing medication. Yeah I know lady this is your personal thing it's like -- -- Come on people you know it's OK to have feelings they have never killed anybody is OK two and be anxious is -- to feel. A little pain exercise is a really good thing election. We see so many people. And our place that the comments that have. You know these expectations that every piece of uncomfortable in the lead in their life is going to be men accused some way. And in a lot of ways it has been before they got to us play. So it's it's a paradigm does that there's that whole generation who's been raised and. -- sure and if someone comes to me with with. Joint pain that I say I'm sorry that must be awful. But let's talk about losing a little bit of weight to ease the pain I know that sounds awful doesn't it that's it I'm sorry if especially if it's a gentle conversation. But it is so true you know I mean it's like so many years I've been sitting around saying take yourself and I don't you get plates the week I do these things so I can now -- -- So does your Valentine one of the questions I had is. Hmmm how do you. How do you have talked to people about these other things because I know that often when people come in CU they're looking for. There in pain and how do you deal with the same -- these other options to. Well you know that the patient and I see myself but usually already on the opiates and so my conversations about it. How they could. How I can predict at this stage we're able to come off -- pit. They're paying will probably wouldn't change and that's when we start the conversation about all the other things they can do to help campaign. And in fact when they come off -- kids they usually do. A hundred times better I think they feel so much better because. -- they're accustomed to the opiates -- not actually helping that much that -- such -- suppressed in the making them feel that there are enough falcons and often touts their personality changes and they're aware of that. So they feel that they you know their heads clear than they've restored -- Themselves. Through their normal personality and that's when we stop encouraging them take you until these other things. If you're not in the position if you're in the primary test that can -- your in the position of being able to decide right in the beginning whether you should put more non opiate. And -- the possible commitment for a long time that when it's easier I think to have the conversation about. The only other thing they can do to help themselves witch hunt them not to at least see this taking medication met and another baby for the patient goal for the position in fact because that. Nothing quicker than writing a correction. But. You know I think the conversations can be had them at the end of the day. You know the patient feel much better -- they have to seek -- Kuwait did they have to be empowered because. You know it's not an easy thing to do. -- doctor that's such that such a great point I love that. Can you let's go to our doctors okay if we go to a caller here we -- we are call in format. Weren't what we're gonna go to our first caller you're Paul Paul you're live on the air without being woody. Craig can agree healing your guys I love the question Torre they're not a -- out and yes unless the box location currently movies and I had every spend. Trauma and definitely -- -- afterwards that kayaks and it's nice boat people didn't. Meet doctor -- turtles that here on something that makes you either -- -- -- It for you or the albeit not getting on board and I tracked fierce scurrying -- and hole. And they couldn't figure out there now what we do enough that he should be working and it and it just skidded and and I guess there are trail -- what they're -- but it's just really unfortunate that I -- wonder if you're young very. -- is such a doctor -- Paula I love that questions such a great question can we deferred to the doctor Valentine to answer that. Yes so. If the box send it to really useful -- but anybody is dependent on that as appealing. But when you have you know exactly that the case you describe when you have. Trauma -- unexpected. Pain. And you're on the box send. The only way that you can get pain relief if he is very high doses of -- so very unexpectedly high doses. Because the books and has set a different drug it actually cling to the receptive very strongly much more strongly than morphine -- council. That's very hot some morphine can knock it off the receptive. And then nor the ticket paying really if you need -- really high doses. And so a lot of positions them. You know necessarily know that and maybe don't give. A high enough -- to people on the box and in fact if you having elective surgery -- you having surgery most people would. -- take you off the soapbox and -- for exactly that reason for about a week before having century. So SO ME I think this is just another one of your area I mean one of the examples of you when you wish people had. Physicians -- get more training and more information. So are there other medications that you see this I mean I know you -- specialty is pain. But do you also have to deal with people around some of the other medications like the anti anxiety medications and in. Sleep medications. And do you work with them about that too. Yes in fact you know they -- they have says. Did they have their problem they can just video pitch. And many of the patients to have -- -- -- for a long time have cold -- being on -- they've got a fifteen for a long time. And the combination. Is often more dangerous then. I -- drive by itself. So as he now has there had you know addiction isn't the only problem -- fare hike interest rates. They're managing with a prescription drug thing and so the combination is actually. A lethal combination. And both. Both types of drugs have very difficult to put patients to get off -- spend their days opinions even more difficult to get out from there opiates. So we we usually tackle this one at a time we don't trying to take people off so so we try and take them off one and then the -- -- so how do you think we got here and what do you think the solutions are. I think it was a combination of well meaning people who saw you know exactly what they said at the beginning that there is. No need for people to suffer needlessly and that as an addiction isn't that -- tremendous problem when you're treating pain I think that was. A mistake but that's what people believe. I think another really. Powerful factor has been. That pharmaceutical industry who came up with you spoke kids. Particularly when did what I would call to China and -- particularly they yes we are acting drugs like OxyContin. And I remember working in -- we have -- people saying to clients telling us line that is this is very addictive and this is great stuff long before the physicians and humanity. Yes well history tells us it's very addictive but then we believe you know I don't know what whatever the reason why is that that you know there was. Well there were a few. -- -- to keep papers that were published that bad actually. Stated strongly that there was an experience for treating chronic pain and -- these patients didn't become addicted. But in fact it was inadequate because it was that he has that -- One paper published by. Restful night from New York and Richard you know very potent factor in persuading people. -- -- associate patients -- well so was it. Yeah and the other feeling the other thing is you don't really know -- the problems until years later because initially that treatment looks really good. So it's very seductive because it stopped taking it can do you feel great here and paying feels much better. And you you don't really developed. The problems so that tolerance independents. Or he may not develop them until. You know years to -- street. Right but doctor before we go way -- break we have one more caller here Mike you're alive. On the air with -- and woody did you have a question. Yeah and bitter comment the American medical establishment. Creative marched up. That would tell the people had to warn you don't we wish for a number of years. -- -- tell you notice a change of policy you're not -- enough for -- -- the -- Without any what they'll appreciate an easy letdown or operation to go to get off the addiction. And does subsequently. These people that would -- to the curb by the American medical establishment. Resort to other drugs whether -- -- win. There's some -- -- crying. Can we do rejection. You know much I appreciate your question I I appreciate your comment there and I think that the best thing that we can do as doctor -- time has suggested is. That we began the process of educating. All of our providers. In not only the use of medications. But also the treatment of conditions -- and in the you know I'm alternative ways to look at this as well. Thank you so much and keep listening. So you're listening to right turn radio we'd love hearing from you all give us a call 617. 2666868. When we come back from the break down we'd like to. Continue our conversation with doc -- time it's but we would like to have. Branch out a little bit -- would you say and start to talk about other medication and solution and solutions will be right back. With more. You champions we're celebrating. Our Boston. Then we are and AM six CD WR zero. If you -- family member are affected by alcoholism or drug addiction the first step to getting treatment and be an intervention. Hi I'm Whitney Houston the board registered interventionist and founder and CEO of right turn and innovative substance abuse program. My kind and gentle approach to intervention helps make the transition from addiction to treatment less stressful for the chemically dependent person. And his or her family. If you are in the situation that feels out of control with a loved one who needs help fighting addiction. Knows that you were not alone. I can help and -- helped. Call me at 6173659. Force -- and learn more about the intervention process. 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I'm doctor -- time what what are you working on right now to make sure things change. Well. I. Feel up to be the question before. The last break and it. You -- trying to get through Puerto solutions. And I think they're. -- Cute solutions one is we have to teach people how to manage. Paying them that. Conditions without over relying on medications now in a medication that's sometimes have a role but we've got to over rely on them. And that's just to turn around the way we practice in the affected area -- think he'd be at the moment probably 90% to. -- that -- could live with their peers should be treated to. With by other means such an effect and -- thing we need to do is to recognize that we've now created a population of opiate dependent. And individuals. I feel quote coalesce -- compete you know that's a terrific problem and I don't blame people for being angry at the medical profession and one thing I think the medical profession -- to do. If somehow those services to these. Unfortunate people who become dependent on these drugs because just cutting them off is not the solution. Does the pharmaceutical. Industry girl little burden on that. I don't know if I mean -- I think we mentioned it before one of them probably one of the potent -- this is the extent. The problem is is aggressive marketing best but I don't know whether -- So what extent they -- their responsibility I mean they do make efforts to. Educate people about substance abuse -- -- I don't think that's enough. It's not not done enough to say that we have to. Screening for that abuse still -- mechanisms -- recognizing. Abuse once it's because. It's more a question no. You know a concerted educational effort that it has to manage pain and other conditions rationally and without an indication. Well I mean that's an interesting point in here in Massachusetts -- starting at the level of emergency rooms were trying to. Educate you know we -- without an opportunity here. To educate our our doctors and emergency at that level of care and help them understand. You know. The use of medications for people coming at them with a -- -- reported pain. It's an interest in peace. So thank you doctor Valentine's thank you for your time and thank you for your you know your wonderful perspective. And -- play him good luck in getting all these changes put in place thank you very much we'd love to have you back on the show another time doctors. Thank you so much. So great stuff you know. Lebanese and they know I love that it's you know who. We're listening the issue of not just the pain medication but. You know we see a lot of people that come with addictions to stimulants convictions anti anxiety medications. And is that overprescribed. I I think I think she said it beautifully is that people need to look at different ways of handling these. Problems not just paint but all the problems that people face in the world. Billy Guerin those problems now. Unfair but but the pain or things -- different cults or. You know a lot of people list afraid of having feelings of worry and others to put whatever but he we have to figure it. Have they give people permission. To have feelings just Wear them out and not have stuff you know. -- yourself every tiny have a feeling. Well but Don Imus speaks that a little bit too only give up on my big box here and I just say that we have people who Russian to a diagnosis. Too quickly. And a lot of times I think then you end -- at the NI. At our practice that right turn have found that people have received the diagnosis but. It's kind of them. And misdiagnosed. It's -- yeah I mean it's like or -- diagnosis that was appropriate yes can't -- -- half years -- a million Sony may have been really anxious -- May have been in a lot of pain or may end you know had some kind of -- you know you know focusing thing. But maybe meditation. And to. Something else would've helped them more than getting on the medication they can't figure out how to do without panel. Seen that when now you're starting to to talk like the doctor here aren't you in other words don't just throw medications. At some things but. My concern done John is that. People have seen something that might be a symptom of eighty. An eighty dean is on a spectrum of DD DD kind of ADHD and then did that you know it might be a symptom consistent with AT&T. But it might never end so it's the people are too quick to rush in and without really taking history. And looking at this person and kind of getting down to move this person has before you start to label them and medicate -- And treat and help them find other ways to treat the symptoms. I think it's been a great discussion I think there's a lot more we can say about it but and then will fit and analytic will look at -- absolute I have anything to do with. Well you know it's been a really terrific show on that level so but we wanna talk to you we want to talk to people about things that they can be doing besides medication and you know one thing that we do it right turn John. It didn't create it is is is -- ticket is creativity. You know any shows coming up just. You know that really does help though and and then people respond positively to so we have a right turn -- which happens every Saturday at great turn. To 99 Broadway in Arlington. Next Saturday night at the -- do Obama this new blues rock band is going to be performing units a bunch of good. Musicians in and friends of return there are commonplace and music and then the second half of the evening there's going to be an open -- so if you're blues musician. Wanna come rock bring your axis. Close fancy musicians like the call it. And yeah we'll only get control -- -- And -- come on down play some music march 23 our own Jack wins are very good friend. Is gonna have some comedians come down to -- through you say this is exactly what I'm talking that's that and laughter. Is less medicine is one of the best medicines you know what else is a good medicine love is a big -- Okay. Things. But yeah. And love can fix a lot of things not everything not everything but it certainly doesn't hurt but laughter DR left there lender is your neural pathways absolutely when Jack lynch gets up on stage and makes people laugh I know that people feel better you know. I certainly do -- so what else what else we have here. -- -- -- Finish -- -- -- let's go to our web -- learn more about us tell us what you think. What does this FaceBook is this new addiction thing that I want to know that and show coming up in this -- -- -- daughter right turn FaceBook and like us because. These heavy legs to be liked you. And we wanna say thank you so much for the callers we wanna think youths say thank you to the doctors -- wanna say thank you. For everyone for taking time out of their busy schedule. Will be back next week we were here every week be safe and ask for help -- And ask for help. Rush Limbaugh here join me weekdays noon to three this is AM six JD WRK. Obama.