Medication assisted treatment for opiate addiction saves lives and more

Related to another project I am working on, I was researching medication assisted treatment for opiate addiction today and came across some interesting points. Most importantly, I think, medication assisted treatment (MAT) for opiate addiction has been demonstrated to save lives, save money and positively impact society. The efficacy and effects of MAT beyond the individual patient have been studied extensively for 30 years.

This treatment is effective for opiates like heroin as well as prescription opiates like oxycontin and hydrocodone. The major problem seems to be that there is a limited supply of quality programs and so it has not reached its full potential.

All of the society benefits of MAT seem obvious when you look at them and there are studies to back up the observations (a nod to the American Association for the Treatment of Opioid Dependence). Participation in MAT is associated with a decrease in use of all illict drugs by that individual. MAT results in a dramatic decrease in crime committed by the individual in treatment. Fewer of the individuals in treatment become infected with HIV (yes, it is still out there, although we seldom hear about it anymore). The lives of the individuals in treatment improve, to their own benefit and to the benefit of society. Their family and other social relationships improve. In addition, their rate of successful employment increases. In addition to positive effects on the social fabric, all of these things demonstrate a great return on investment in MAT, if you want to boil it down to economics.

Most importantly, individual lives are saved by MAT and their quality of life (and the quality of society) improves. I have had some questions after our investigation aided the DEA and IL Dept. of Professional Regulation in stopping the practice of a few physicians, where could folks hooked by those practices get treatment. I, sadly, had to say I don’t know. The number of programs are limited (a local one has a 1 year waiting list), even into Chicago.

ID by Pacemaker

I went to speak at a local high school this morning. I was told that it would be a couple of 10 minute presentations with 30 minutes in between and only a small number of teens would attend. Well, it was a bit different. First, each discussion was about 40 minutes long. Second, about 80 kids filed into the room I was to speak in, it was a computer resource room and really not made for presentations like this. Apparently some of the science teachers heard I was going to speak and brought their classes. There were about 20 in the second group, a better fit for the room. An energetic bunch and while they had some distractions amongst themselves, they really got into my talk and it was a lot of fun as usual. I was able to discuss what we do as Coroner and I also got a few death prevention plugs in.

One of the things I discussed was a current case we are working on. Without discussing who, I told them about some skelatalized remains that were found last evening. They were found in a field not all that far from the office. One of the interesting facts about the case, and the part that I discussed with the students, was that we identified him by means of his pacemaker. We were able to get a serial number of the pacemaker and checking with the manufacturer we got his name. Several other things about the remains were consistent and so we were able to contact his family based on that information.

So many details contribute to death investigations to get straight and to keep straight; it can be quite the challenge (in a good way). That’s why we are called medicolegal death “investigators”. (His autopsy is going on now, but likely his was a natural death, without “foul-play”.)

Lack of Sleep Peaks Emotions

I certainly have noticed it in my kids and others, lack of sleep stirs the emotions. It is indeed as Matthew Walker is quoted as saying:

"It's almost as though, without sleep, the brain had reverted back to more primitive patterns of activity, in that it was unable to put emotional experiences into context and produce controlled, appropriate responses,"

They become bears.

When you consider that this would be added to the effects of lack of sleep I talked about a few days ago, it becomes a potentially deadly combination. Add anger and poor impulse control to the drunk-like effects and it is easy to imagine that lack of sleep can have a pervasive effect, probably a bigger effect than is usually really thought about.

Take driving while drowsy and throw in a little rage and consider the consequences. It isn’t much of a stretch to conjecture that impaired impulse control mixed with the poor judgment from drowsiness could contribute to violent action and escalation, as well.

Get good nights sleep and/or take a nap. It is good for you and good for the rest of us and your interactions with us.

Personal Livestock

I ran across an interesting posting about dust mites today (I am going home and clean and vacuum tonight). Did you know that there are 42,000 of them in every ounce of dust and that in addition to dead skin cells they feed upon “hair, pollen grains, fungal spores and bacteria, as well as cigarette ash and tobacco, clothing fibers, fingernail clippings and filings, food crumbs, glue, insect parts, paint chips, salt and sugar crystals and even graphite”. Just like when someone used to come into the ER complaining about scabies, just the thought of it makes you itch.

Even more itch inducing was a quote later in the post:

What was amazing was what happened to the Archbishop’s corpse, as described in Hans Zinsser’s 1935 epic book, "Rats, Lice and History", beginning with Zinsser’s description of the dead Archbishop’s robes of office. When he was murdered Becket was wearing, "...a large brown mantle; under it, a white surplice; below that, a lamb’s wool coat; then another woolen coat; and a third woolen coat below this; under this, there was the black, ...robe of the Benedictine Order; under this, a shirt; and next to the body, a curious hair-cloth, covered with linen." As Becket’s corpse grew cold the successive layers of robes also cooled, and all the little creatures that had been living within the folds and pleats started looking for a new home. Wave after wave of various fleas, ticks, spiders, pincher bugs, and other creatures flowed out from the corpse, "...like water in a simmering cauldron" producing in the hushed mourners gathered in the dim cathedral, "...alternate weeping and laughter...’".

Bugs you got to love them, particularly the personal livestock variety. We do run into this sort of livestock from time to time, never quite this graphically.

Thoughts on Teen Suicide Prevention Program

I was putting together some materials for our Lake County Suicide Prevention Task Force meeting tomorrow and thinking about 2 articles I read yesterday, they do relate (at least somewhat).

I had posted the goals of the Task Force back in March, 2006 on my blog so it was easy to cut and paste the goals to redistribute as a “hard copy” for discussion tomorrow. Two of the comments to that post mention the importance of peer-to-peer intervention (one directly and the other infers). That is where the articles come in.

While the articles are about impacting substance abuse, I have no doubt that they similarly would be true of suicide intervention. The first was about a recent study that looked at the utility of peer-led substance abuse programs (or another article on the study) and found them more effective at changing behavior than those led by adults. The second article referenced a study that demonstrated the effectiveness of teaching “competence skills” (refusal skills and decision making skills) in preventing future substance abuse.

Taken together I think this lays out a great framework for suicide prevention program for teens. It would begin first with training a cadre of teens to be educators. The education program would begin being presented to other teens in middle school and repeated throughout the remainder of school, possibly into college. It would be a peer-to-peer experience (with adult supervision and input) focusing on competence skills as they apply to suicide and life skills in general. Also the program should work to reduce the stigma of seeking or recommending that someone get help, as well as teaching how to recognize someone in trouble and how to “intervene” effectively. A last significant part would focus on where (and how) to send someone for help and/or where to get it yourself. After a conversation I had today, those already in treatment and/or with significant symptotology would only participate in the program with supervision of their (mental) healthcare provider.

Such a program would be easier said than done.

Drowsy Driving Kills

To steal a phrase from David Letterman; “I wouldn’t give my troubles to a monkey on a rock.” Busy craziness, anyway…

I recently joined a listserv pertaining to child death review. I have gotten interesting information on several topics and so it seems like it will be a good source of stuff (unlike some others I have joined and quit). The other day I got a notice about an upcoming “Drowsy Driving Prevention Week”, November 5-11.

According to studies, being awake for 17 hours impairs your judgment, coordination, and reaction time comparable to a blood alcohol of 0.05. Having seen some crashes and death related to driving drowsy, I can easily believe that that is the case. The National Highway Safety Administration reports that there are 1550 deaths and 71,000 injuries in crashes related to driving drowsy each year.

Drowsiness-related crashes are most common in teens and young adults who have the propensity to sleep too little and drive at night. So it is particularly important to get this information to them, let your teens know. Also keep it mind for yourself. You are only human. You can only push yourself so far.

Driving drowsy kills just as surely as does driving drunk.

Johnny Doe vidi-mentary

I got this link emailed to me today and thought I'd share it. It is a "vidi-mentary" on You-Tube about an unidentified toddler found dead in DuPage County. It is a nicely done piece.

It is worth watching, although the subject matter can certainly pull at the heart.

"Johnny Doe- Little Boy Blue"

TV, Salmonella, Violent Death, oh my

Posting has been a bit light lately, but it has to compete with everything else that is going on.

Last Friday I was whisked off by a limo to Chicago to do the Nancy Grace Show (about a recent homicide here in the county). There were 2 of us in a small studio in Chicago and it seemed like 10 others in various other places feeding into the story. It is somewhat strange doing these things. You sit in a room that is black walled and ceilinged (actually everything in the room is black except the stools and the wall behind us) and stare at a camera (the camera was robotic and moved at someone’s direction). You have to stare at the camera because you never know ahead of time when they might cut to you or catch you making some sort of face you don’t want on camera. I could listen to all of the conversation and interview, but couldn’t see what anyone looked like or their facial expressions. It is a bit strange talking with someone without that normal feedback. Our segment was about 20 minutes long, I got to answer 3 or 4 questions. I think it went pretty well.

Saturday was a good day, primarily because of what I didn’t do. I went shopping with my 9 year old and we picked up some food for lunch. I had actually picked up chicken pot pies to heat up, but put them back for other selections. Good thing or I might have had a serving of Salmonella I learned on the 10 o’clock news last night.

Monday, Columbus Day (although I have to agree with several folks’ comments that I don’t know why we still celebrate Columbus Day since we know he didn’t discover America and may have been a fairly unsavory character) I sent off a book proposal to an agent who agreed to look at it and consider representing me in that endeavor. We will see what develops.

Yesterday, I went to a meeting in Chicago, the Illinois Violent Death Reporting System Advisory Committee. I got fairly creative about my route down so the trip only took 2 hours each way. They are getting some interesting data from the first 3 counties participating (I will highlight some soon) and I look forward to our being able to join in the project after our county IT department gets the software loading and working here. If you want to see at least part of the data before I put more in the blog you can check out this link.

Next Generation of Blogging

I’ve been invited to serve on a small (3) panel of presenters/discussion leaders at a conference put on by the Metropolitan Chicago Healthcare Council. The panel discussion is entitled “News Media: The Next Generation of Blogging” (got the flyer today). I am honored and look forward to participating.

Apparently they see my blog as “next generation” in that its primary purpose is informational and authoritative (i.e. factual). I do think there are several things that blogs can be used for that may be “next generation”. I do support the expanded use of blogs to give out information and allow feedback (filtered to weed out the spam that comes in and the “naughty” words), opening discussion, expanding knowledge, relationally.

The conference is in a few weeks, I’ll let you know how it goes.

Sorry this is a bit short and only a few posts this week. It has been a busy week for a number of reasons and I am off soon to do the Nancy Grace Show.

Coroner Death Investigation

Why does your office do its own investigation of an individual’s death?

There are a number of reasons. First, since we are the agency that must make a decision as to the cause and manner of death, it just seems to make sense. We certainly work in tandem with and parallel to other law enforcement agencies. We use the information they gather and they use the information we gather. It is a synergy that just plain works. But our medicolegal investigations may take a bit of a different tack or have a slightly different focus so we can arrive at the conclusions that we must to make our ultimate decisions.

In addition, if an autopsy is done the forensic pathologist needs answers to a number of questions as she proceeds through the autopsy. If we have done our own investigation we get answers to those questions and have them available as we assist with the autopsy. Such things as exactly how was the decedent lying when found, whether they were lying against something that might have left a certain mark, all can make a difference to know as the post-mortem progresses.

Another reason is that often two sets of eyes are better than one. We may pick up a detail that another investigator glossed over inadvertently. Or we might think to document something that the other investigators don’t. Recently, for example, among the agencies investigating a death, ours was the only one that took photos of the crash scene in daylight and those photos became an important element in subsequent legal proceedings.

My deputies are all trained in death investigation, evidence tech work, and all the skills needed to do a “class” investigation. The number of cases we investigate is certainly sufficient to keep up their proficiency as well. We are proud to use our skills and talents to do the job necessary to arrive at the cause and manner of death in our cases. And as I said we use the investigations of others as part of our “tool set” in these investigations. Death investigation is a cooperative effort, with each of us doing our part. As is often the case, here too the whole is often more than just the sum of the parts.

Death of an identity thief

Our electronic fingerprint submission capability, a recent addition to the office, has really proven to be a benefit. A couple of days ago we were able to submit an individual’s prints and got confirmation of his identity in about 10 minutes. Then we were able to go and inform his family, confident that he was who we thought he was. Let’s just say we were less than confident on making the identification based on visual comparison with his photograph.

Another interesting incident pertaining to our fingerprint submissions occurred recently. In reviewing the responses from the IL Bureau of Identification one day we noted that an individual was identified that we did not have in our morgue storage or case files. It was a name that was familiar to me as someone who was still alive and who worked for a local agency, certainly not someone who had been through our office. When we called the individual whose name appeared he was indeed still alive and he related that he was aware that an individual had used his identity as cover because of run-ins with the police. The identity was taken after he had helped the now deceased individual on several occasions. So not only were we able to resolve the investigation into the cause of death of one individual through our usual practices, we were able to resolve a case of identity theft as well.

Death case provoked dream?

I had a weird dream last night. As I have said I do end up taking some of the job home with me, at least in my head. I think the dream sprang from a case conference we had Monday that involved the drug-related death of an individual. In the discussion and review of the scene photos, it was revealed that the victim used a homemade aluminum foil pipe (would there be such a pipe other than a homemade?) for smoking drugs.

When I googled to check on the prevalence of using aluminum foil to make a pipe. I was surprised just how common a practice it is for crack, heroin, marijuana, the whole gamut of drugs. There was even an answer to a question posed about the safety of smoking in such a devise and the risk of the aluminum inhaled. Although it would seem to me that most folks using such a device would not be overly worried about the aluminum and most of the substances smoked would be more harmful than the aluminum.

Anyway to my dream, in it I was watching a TV show, much like Saturday Night Live in the old days, and a commercial came on for a product called “Six Pack O’ Crack” that came pre-loaded in pipes. As far as I know no such product exists and would likely be pretty lethal. I mention it to demonstrate just how strange a place the world of dreams is, particularly mine at certain times.

Killing in fiction

I cruised back to a website I visited before, one that appears to give out, shall we say, not the most accurate information pertaining to forensics mixed with some good stuff and found some more not fully accurate information and an opportunity to throw in my 2 cents worth.

The question sent in by an author:

I've got a man in his 60's who is dying (I gave him cancer, but really it could be anything convenient for the scenario I'm describing). He is being cared for at home by his wife and his niece (who is a nurse), along with help from a local hospice group. He has trouble breathing and sometimes needs a mask put over his face (oxygen, I'm guessing), to help him out. The oxygen is in a tank behind his bed.
One afternoon he needs the mask, but when they put it on him, he dies anyway. His death seems natural. It's not until autopsy that they realize he was murdered: There at the end, he wasn't breathing oxygen through the mask at all but some other substance that had been put into the tank (or that tank was switched out for another) and the substance killed him.
What deadly substance was substituted for the oxygen? Would it have a smell? How would the autopsy reveal that this is what happened?
I'd like the fatal gas to be as simple as possible, something easily attainable by any of the 5 suspects. It would also be fine if someone could've just changed the settings on the oxygen or some other gas that would be present anyway and that's what killed him. The most important part of the scene is that they have to think it was a natural death until autopsy (though a whiff of some strange odor would be fine.)

The answer posted:

There are several possibilities but three that would be very easy for your killer to employ.
1—Simply not turning on the oxygen and having him continue breathing only room air. If he were very ill with severe lung disease, and particularly if he was taking pain meds, which would suppress his respiratory drive, this alone could make him gradually slip into a coma, stop breathing, and die.
2—If he had what we call Chronic Obstructive Pulmonary Disease (COPD), which is basically emphysema and similar diseases, he would be very sensitive to high oxygen (O2) levels. The physiology here is complex but the bottom line is that people with severe COPD can slow or even stop their breathing if exposed to high levels of O2. So your killer could turn up the oxygen. Normally these tank masks combinations are set at a flow rate of 2 liters of O2 per minute. If the valve on the tank were turned up to say 10 liters/minute the victim would gradually slow his breathing and eventually stop and die from asphyxia. This could take anywhere for 15 minutes to a n hour so you have a bit of leeway here.
If the gauges were returned to normal after the victim died and before he was seen by investigators or other witnesses, then the cause of death might never be determined since there are no laboratory or autopsy findings in these situations.
3--Carbon monoxide (CO) would also work. The killer could extend a small hose—or a garden hose—from a car tail pipe in the garage or the driveway just outside the window to the mask the victim was wearing. This is a very deadly situation that comes from the unique chemistry of CO…
(the website writer goes on to actually fairly well discuss the toxicity of CO and some findings after death)

Because the questioning author listed their website I dropped her an email:

Not to be a butt-in-ski, but I ran across your question on Dr Lyle’s site and I feel there are some errors in the answer he posts.
1) Having the flow of oxygen to his mask turned off would cause him to rebreath his exhalations (and carbon dioxide) and could/would ultimately result in his death. Remember that the air hunger he would experience would get quite strong, so he would have to be pretty incapacitated to not reach for the mask.
2) Oxygen through a mask is always set at a minimum of 10 liters per minute, never at the 2 liters that a nasal cannula is set, so this one starts out wrong. High flow oxygen and the loss of hypoxic drive in severe COPD is a theoretic possibility, but is very seldom seen in real life.
3) Carbon monoxide does not normally come in tanks, but I suppose you could fill one with it. A more “natural” choice here would be nitrous oxide, used by dentists and others for anesthesia. It is lethal when used in concentrations greater than about 30% (it is normally mixed with oxygen in a “machine” for administration). Given straight it would be quite lethal and might be noticed as a sweet smell. It could be found after death when a blood gas is run found to have a very low blood oxygen content.

Maybe I should get into author consulting; I guess I have done a bit of that already. I have since corresponded with the author who sent the question above, her story has changed and I think I helped her a bit in agreeing with her new plot twist on how to kill a fictional character (kind of fun).

The Coroner biz is an amalgam...

The Coroner biz is an amalgam of many fields of the arts and sciences. It involves biology, chemistry, physics, medicine, psychology, sociology, logic, criminal and social justice, communication, writing, math, and a bit of philosophy.

Biology and chemistry gives us the ability to do toxicology testing. Physics allows us to look at the mechanics and kinetics of accidents, as well as using parts of the light spectrum and phosphorescence to look for evidence. The mercurial nature of health and illness often impact the deaths under investigation. We learn from psychology and sociology how individuals and groups of individuals act, contributing to death as well as life. Justice is our goal, not in the sense of fault finding, but ensuring the most humane conditions for society. The ability to communicate well, in all its forms, is critical to successful completion of our business. Philosophy is to help us in dealing with it all and in helping the survivors of the deceased individual.

Weekend reading with an eye to those related to death

Yesterday’s Chicago Tribune had several interesting articles:

Front page article about: “…hospital is the first in the Chicago area to disclose extensive information online about the quality of its care…” It seems to me that universal postings like this could go a long way not only in keeping patients and potential patients informed, but in pushing hospitals to ensure their quality of caring. Armed with information and with hospitals living up to quality standards, maybe we can prevent a few deaths by “medical misadventure”.

In the Q section there was a small bit on preventing hospital (medical caregiver) acquired drug-resistant bacterial infections that suggested folks:

"Politely ask hospital staff members to wash their hands before touching you if you don't see them doing so.” And
“Ask the doctor or nurse to clean the stethoscope before using it on you.”

They seem like really good points to remember and worth a mention to your healthcare provider. Although these infections cause more morbidity that mortality, they can kill and, at least some, are preventable with simple techniques.

Lastly, Mary Schmich wrote an interesting column that contained a discussion of some of the “mysteries” of death by suicide. Just because I do that sort of thing I posted a reply to her column:

You are so right when you wrote: “But another of suicide's mysteries is this: Exactly what happened is unlikely to be discovered, even if the clues add up.”

Death by suicide seldom “adds up” for those that survive individuals who choose to end their pain with suicide or choose to go on to another place where they hope that the pain is less.

Despite you column being focused on Mr. Jones, I hope that folks read your comments on death by suicide, that that reading provokes some though on their part (and maybe a little discussion), and that that awareness makes it seem a bit less of a mystery for another family member survivor of death by suicide.

Thank you for writing about death by suicide, a subject with much taboo in our society.

Life skills can prevent death

Earlier today while tidying up some stuff I came across a list that I vaguely remember copying down quite a while ago with the intent of writing about them. The list is entitled Life Skills (sorry I'm not sure who to cite, all I have is a list on a small piece of paper):

Problem solving
Conflict resolution
Understanding/Managing emotions
Empathy
Tolerance of others
Working in teams

Looking at them today I do think that they are critical life skills needed to become a mature, functioning member of our society (most societies that I know about). If we could inculcate these into all members of our communities we could go a long way to solving our problems with violence, as well as other problems that lead to preventable deaths in our community. I intentionally used the fancy word “inculcate” because it communicates the essence of how I think this “stuff” must be taught (inculcate = to impress on the mind by frequent repetition or instruction).

Problem solving without resorting to drugs, managing emotions so that they neither flare toward others or consume from within, working together to address problems and work toward solutions.

Kids need to be taught these skills at home, but they must also be taught and reinforced in the community in general by lesson and example. It must be a part of what is taught in schools, both subtly in literature selection and more obviously in things like social studies. It must be “taught” in the work place, by doing. It must be shown by example on TV, in other media, and in everyone’s day-to-day actions and interactions.

What a way to buff up society and grow community members with functional life skills. What a way to impact violence and the death and mayhem that results from it. What a great way (yes, rather grandiose, although we can start with a few) to forestall death.

Accidental Infant Asphyxial Deaths

Last Thursday and Friday I was at the 12th Annual IL Symposium for Child Death Review Teams. In addition to a couple of “business” meetings there were lectures on issues of child death.

The first lecture was about a constellation of deaths that, in the past, were often confused with SIDS. But these deaths are preventable, so it is important to look for us to look for them in investigations and based on the growing body of related information, it is incumbent on those of us involved in the investigation of these deaths to get warnings out to parents about them.

I have written some about it in the past. These tragic, accidental deaths occur while these children are in bed, most often in an “adult” bed. Broadly, they are suffocation or asphyxia deaths. They can occur with:

“Overlaying”, bed-sharing adult or child unintentionally lays upon the child either totally or partially, it only takes about 4 pounds of pressure on the neck for asphyxia to occur,

Asphyxia related a child’s face becoming trapped in soft bedding (infants are unable to move their heads out of position),

Asphyxia related to getting wedged into a space in which the chest and lungs cannot expand (often seen with trapping between mattress and wall or, as we have seen, between 2 couch cushions)

Suffocation when bedding or similar materials cover the child’s head and mouth

These deaths are way too common and are preventable. The “Back to Sleep” program to prevent SIDS has been very successful. Next we must push the information that bed-sharing is incredibly dangerous. [One point that the speaker brought up is that one of the major reasons for bed-sharing is the inability to afford a crib. A child dies because of poverty. That should not happen.] The other point that must be stressed (in part already out there, but it needs to be emphasized) is that children should only sleep on appropriate sleep surfaces, not soft surfaces, not buried in bedding, not with stuffed toys, and on a surface without the possibility that the infant might become entrapped.

We must work to prevent death and this is a great potential target for prevention.

"procured"

Hawaiian’s have a saying that “words move mana (energy)”.

This can become obvious in many ways, but most recently when a word I used was misconstrued and generated problems because of the “value” assigned to it by someone reading the report. An individual died tragically and because of the type of gentleman he was his organs were donated to save the lives of others. When asked by the media I gave what I thought was a fairly neutral and thought-out statement in response to questions regarding his organ donation, already known to at least some of the reporters, and the fact that he was pronounced dead over 24 hours after the crash. Apparently, my choice of words was not neutral. In response to their request for an apology or retraction, I have sent the following to the paper with a request that they print it soon:

My use of the phrase “organs were procured”, recently, has caused some confusion and concern and, most unfortunately, pain. The statement was used in the online version of a Daily Herald article on September 5. This is the terminology used by agencies and others involved in organ and tissue donation when organs are obtained by donation for transplantation and recipient use. This is most readily evidenced by the name of the Association of Organ Procurement Organizations, a national organization dedicated to ethical organ and tissue donation. It may be jargon, but it is the correct terminology in these instances.

I apologize that the use of this unfamiliar term created concern and pain for the family of this individual who died tragically. The word “procured” was used without any intent to denote the illegal, and unethical, action of buying or selling organs that has happened in other areas of this country and elsewhere.

I and the Lake County Coroner’s Office strongly support organ donation and celebrate the lives that organ donation is able to save.

Again my apologies to those who may have been offended.

Shielding kids with community

There was an article in last Sunday’s Chicago Tribune using the availability of bullet-proof backpacks for kids going back to school to make some good points about keeping kids safe at school.

The crux of the matter is laid out well in about the middle of the article:
So, as the new year gets under way, how do we keep our kids safe? By building caring school communities, where everyone is made to feel valued and people are vigilant about disturbing behavior.

Curriculum must push in-school community building, encouragement of diversity, and the teaching of (over and over again) the social skills necessary to value “the other” and to know what to watch for and how to report what you see so that intervention can take place earlier for individuals caught in escalating problems (violence, suicide, etc.).

We also must ensure that those kids in need of counseling and psychiatric help have access to that help. While it may make sense to some to cut the availability of these services as school budgets get tight, it is a terrible idea. There is no doubt that the need for these services in schools is growing. That is reflected in deaths by suicide, violence in our schools and outside the schools as a carry-over from school, as well as the not as obvious growing incidence of mental health issues amongst these individuals.

These are community problems that require community solutions, not “band aids” (even those as big and heavy as armored backpacks).

Fish for your brain

My mother always told me that fish was “brain food”. Of course the form that it took in my diet at the time was fish sticks. Although I do still crave them from time to time, there are lots of other forms more readily available these days.

Some recent studies bear out that fish is good for your brain (the studies looked primarily at fish oil supplements, although fish in the form of fish is better for you). A recent article summarized several of those studies. Studies in prisons demonstrated a decrease in violence coincident with supplementing with fish oil. Other studies showed improvement in depression. And still others demonstrated improvement in ADHD and autism symptomatology.

Omega-3 oils, one of the major components of fish oil, appear to facilitate the function of certain neurotransmitters improving cellular communication in the brain, which leads to the salubrious effects mentioned above.

So for your brains sake, eat fish regularly. At the very least supplement with fish oils, maybe even the cod liver oil that was used on kids routinely years ago. Of course eat a good, balanced, varied diet as well. Stay healthy and live longer. And, Lord knows, we can all use just a little something “extra” for our brains.