12 Voices in 12 Hours Dr. Sanjay Gupta and Mia Thornton

Wednesday, May 23rd
Chief Medical Officer and Director of Outpatient Services of Brylin Behavioral Health System.

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We are joined by guests in store here we're continuing our twelve boards in twelve hours I believe this maybe to open thirteen. Actually yes I think we're giving people thirteen voices. And talk well that your we have witnessed in studio David doctor Sanjay goo who is the chief medical officer at brylin behavioral health system also medical director. Endeavor health services. And he consults to debt we also what is in the studio B port and who is the director of outpatient services. Let them and things to the book review for joining us. Something that has not come up rules for up with doctor group. It's I have a theory that people. If it's something I didn't think the committee of the people. Our actual police itself replicated in four under indictment notes that they'll list they know it is something that in this thing. And ability to feel better but don't feel depressed that it. Good date and thanks to happening in there yet hippies are actually correct. Big difference in the game in Jupiter's. It is it's we can at bats to it and all of the symptoms do a couple of and it. People usually. Get accessed from being used drugs through fresh and some of these little. That one Jack moved from being small lift them up and wanna just on the entry. And then it goes in there. And and yes strategy and keeping it from an. I don't even buy these. In the open champ is the case. And then why bring you just put that in the is ultimately. Ultimately. They get the name of god and an attachment happens to me it's on X Batman connection. With these. There's this it's a physical old patent it's a Medicaid patient as I was pleased cycle budget for. It actually ends up but it is just like let's pay. Some predict that in a book on a cigarette right. Some people and I have the habit that haven't been completely up to happens at us. That's when it except a lot of but outfit that lives then then it's up and it will be needed in. In the body. And the blood pressure but now. That's where I can before that the program and I was with a candidate that just having that penalty and when it brought up. Which is you know we talked about OPEC delegates and what sort of schizophrenic. And play him. A lot that would come to open because they're what way what is because people go for work and get help as possible. Again we don't have a little platoons with them doubled between. Think if we tend to call people who. App next job you this and turn it really because I have turned him in the best tactic and productive. I think. Huge Contra productive. I problem is that it on the texts you know. And at this point I think that it'd become that does these things but put in terms is. And then call it the people of athletics corporate and gentler to bite sense a Dick at X so fanatics this happened that happen. What happens just. It was announced in this kind of the script in an age and that we can build on the recall adaptive techniques that we don't thank. We happen it is big issue second amnesty open tonight from apropos so let's. But what happens today and spend as. In particular. Addiction or spin it a problem on other Chemical Ali. None of it used to being pitched from society and become like where I end. It took to get just that such an important point that the company that even if it's like relate to who. Don't waste your. I. They forced it. But no pictures that. We should. Cancer these people coach who's. In the lead but and let's be objective truth though and kind of just how the so what this thing. I think. It's between us and that is that it's I looked up. I'm addicted because of maybe that will just be there at that particular that something else. They're. Just page please see. So that your. Approach it. And an extra edge in people use it for example. And it does begin in one of them but is it. The complex. But it is gone so we will have some movements and along with. Him. The and victims of the east and it's not like this and complex. Decades to the doctor. And he's been approached in. That company was there and in the hospital system and so forth and Wednesday that it. Had been it's been. And evil beasts my. And it shouldn't say it's just management of I've got beaten him a happy about it does not know. Paula that I that it is going to be oh. What stops the clock in an action. Against activists. Such as a pitcher has let it but this. Acts to com thanks in equity. And ultimately. Then you go out. And if it's urgent. I. I asked. Him to be pleased with it and it just a different attitude people. I've gotten treatment equipment. If what school all of these little. It is this or that on and on the fifth why don't sign. That's been out of smoke that fits the lack Edelstein an I did you do not a vaccine that if I. The smiley face and I Cheney team at mid Atlantic Ocean going down. But. For me. But I'd like it. And would stay in the middle of the pack if there's an and it. That it was. An open net but I mean if there's. A judge. So what happens the power to make the question. Is that the doctor is that it has we talk about that. It shouldn't come. Apart perhaps if they actually public so so I'll tell you you know. That makes it easy and it does have already stepped it. Prescriptions. You know that the first shipment of food program and for the state that it Bennett street there's it's. Or. On to beat it and I missed it from that day at. A conference. And it just out of the so it's a huge problem if it tonight it's. You missed it let's set. The aid it and produced and that's it. Other statistic that sticks in which I think I was to to stick ons that age content and issues. Right the response of 51 point as it all the interest of thinking about that yet. Bet it's that's that that's you know and Everett that that. There's an outpost just. Those are impetus to Kentucky yeah if I don't want to let you just stuff that got caught up about it now. So think about this you know they've accomplished it was two. Depiction of the box. Right now we can be changed and it's under the terms of its. The supply. Not to. If so I think this is much different directions. What you need is. So like the dog it. I think that summer you missed I missed. If somebody that as a pet therapy and yes but as the volatile ups that the rapper albums ever is. So the patient and left in Kabul you know individual. And that is. That's it and got off. A lot of it Medicare and what happens. They've had it. It's not as good but I think at least it and then there's. An Egyptian. Drop out of the medical system. What happens. Then. BC some people unfortunately losing their lives. Wanted to pitch swinging. The Angela into the picture of the European studio with doctors subject good we also with this video from private MB director of outpatient services Miette Thornton. Doctor Sanjay Cooper at you and you're the one with the medical degree. And it it strikes me I mean you you you've you've been through your medical training you've done your residency you have paid your dues you are a duly licensed physician according to this New York State Department of Education. Department of professional licensing. Is it not somewhat offensive to you that some guy who or lady who does not have the qualifications. You'd do. Is coming in to the medical world and telling you what you are doing wrong. Wind and and you just get it is Stanley what you're referring to link is some guy is coming in and telling Willis we have. Personally I want we have at least one local Doctor Who as you know was called good nothing less than any drug dealer by a United States government agency and he was called a drug dealer by a guy with great bought agree not a medical degree -- he had a lot of doctors. Doctor drew to his I'm sure you're aware a lot of doctors. Are very hesitant at this point to write scripts for open yours so what they're doing is they are sending their old Buick patients or their pain patients. Two doctors that specialize in the treatment of chronic pain. Now in vet a urologist rights are a lot of scripts for Viagra and a cardiologist writes a lot of scripts were in trouble all. It's logical that pain specialist is going to be writing a lot of scripts for opiate pain medication itself it's and it's somewhat offensive that you get people from the law enforcement law enforcement community. Focusing on doctors whose specialty is paying were doing their jobs. So I think that what happens is you know this is this is a kind of a controversial area. And and what happens is people look at things outside two standard deviations outside the norm you know. For example. A few years back there was a doctor Niagara Falls who was writing all kinds of maintenance okayed and he was taken off. Rail line. And and and I know I don't really need to know all the details I don't know any of the deep field except for what happened in the newspaper really. So so I think being specialists that many many beans specialists. And I really don't want to point fingers at anybody or anything I think that he is. People usually find one or two teams which we made crossed the line. And that lab results in the huge investigation. Okay. And and it's very hard sometimes. You're trying to be in the helping profession. And it's very hard for people in the medical profession. Social work and others to actually see no. That's the stuff on it and so I think that then leads to sometimes. Practices that. And out in trouble in 08 in one Leo the other. But you know we talked about that pendulum B network dragging back and forth and I mean whether it's. Even for legitimate pain patients because they don't wanna go on the radar of yes I think. I think that that is I agree that legacy they've got the law enforcement so you know and practice of medicine for its law enforcement is not trained as your. Yeah but I think there's supposed to keep things in check do you know. I wanna bring me authority appears to director of outpatient services at Bryant would be in favor of health system and she's scary to me make me very comfortable. Have an outspoken giants their me anytime I hear it. Let me ask you a question I hear a lot of people with OPO eight issue is that the talk to us and they always talk about how it's so difficult to find. Accessibility to help. How much of that it is someone who's addicted to something that doesn't really want to help is there were a tree is there truth of the matter that. You have up so much demand that you can't be that needs. People in the community or is that just so we're saying look I don't actually wanna get help with some would need help is their place they go right now. Well I think if you look at this am. Openly crisis. Nationally. There aren't as many prescribe errors I'm as Doctor Who dissent earlier but that didn't really meet the need. And so in many cases. And and all kids are highly addictive and so you already setting someone to fail. Develop it we are part of twelve voices in twelve hours this has been an all day extravaganza. I'm hoping you Lloyds. And there will be a public meeting tonight it is free it is open to the public you may attend 6 until 8 o'clock at top of one high school. And in studio with us right now we have media Thornton from brylin the director of outpatient services and doctor Sanjay goo Libby chief medical officer of brylin medical director. Endeavor health and a consultant. To dent and you know we've been obviously talking about opiates and David. We will we're talking during the break we're we're seeing you know we focus all our attention on young people. We want your twenty euros have yet where they get this stuff for a well now all were seen. Addiction is no longer for twenty year olds at thirty girls which I don't people over age 67 Euro people. Yes exactly actually need the border dolls are also very prone to addiction because. They already have. A lot of chronic mean. I'll write this joint problems. Other problems. And then they a lot of them also have depression to some of them have depression such kind of as the C loving hand phenomenon. And that could leave the problematic. The clock about the chronic pain and addiction and been mad is that. Kids visit their grandparents. Or peaceful. That went to a seventeen year old age group is a rapidly cooling. Age group of experimenting with opiate painkillers. No on prescribed. Painkillers. And so what happens is they go to their grandparents' home and read the closet and it you know. Opiates in the old days people when I got some whiskey. Put water in the bottom right hand then now now it is those things have changed and people getting the you know payments from the grandparents do. Anybody it is true it's interesting holdings of liquor and mom and dad's life yeah Holland you know got. With the way the way I look at old Buick is especially. If that happens in particular the papers you literally got to treat the which were for our interest that after you catch this it was the tree and I. Yeah I thought he got you locked up I think that's put an attitude and you have to be kept up. And I think both. And that's an excellent and now it's okay. You're accused of business I deal Olympic ideal type. And they'll be a tropical systems all the hours and you parades and wouldn't let the pretty WB and we don't care if he squeaked into placed in the background that would that would happen from time that we do not apologize for that. Still. Talk to which for the important part was about. I. And I didn't exists. And what what hope is there for parents participant or people listening who apparently. To come to terms with the fact that all I got up in the but what would happen to me but I think we've probably talked it was about the work to brylin. Little brightly and outpatient services Stan is the programming system that I run. Eight consist of a mental health clinic at the substance use disorder clinic. Thomas doctor Cooper spoke about earlier so often times. Individuals our experience in court what it. Meaning that the presence of two disorders so. When I sit down with families specifically then are talking about. I'm nick T seen or adolescents use often times there on the dedicating other symptoms and it's only through an assessment process. Those things are identified. Can you explain that again that though I co morbidity I knew you were talking about but some people. Might not understand that apartment to. Yes just as president. I'm more than one. Disorder and so on its opponents with the law and disorder that is often. Associated with substance use disorder. On because most individuals. Who are addicted are often times on. Trying to regulate themselves and north and an opportunity. On to protect coping and so with teens specifically. At that that time we have raging hormones you have transitions into adulthood is a lot of stress. Comments of many of that teens that we see within our program their high performers. Who are experiencing issues around whom have been dating. And what that would doctor what would we were just same route was that that is where we're seeing fifty over 50% of OP or users coming from folks that. Have the mental illness in. And I would just put in. You know sometimes humor is helpful. And I would call what she said as double trouble you know sure well Mildred export to markets self yeah. Double trouble so it's you know local morbidity dead while one and one less feeds are back the other would have held candid and funny yes but a. Order. But the good stuff. Not so I'll take good went with it in. Italy just. This look. I understand go. Go out of late and I think you medicine is both an art and eighties science. With all the crap I've been through in the last five months. But at what point does somebody go from being a responsible. User physician prescribed and monitored pain killers. To what a lot of people would page or call eight junkie. Yeah so I guess what happens is. Let's say you give somebody a thirty day supply for Madison all the columns are accurate everything is done none of that that he. Is just lasting 2015. Days and believe me BC that not just Google the alleged other man listens to. Then that's a problem okay that's clearly a problem. Or. Let's let's say let's have as a physician and he's prescribing. Some painkillers was golf and that's a problem for bolt for the physician and the paint and a dolphin bolt. And and these things do happen. The F do we go to the other way to look at it is. It becomes a problem if it is being sold. Okay that's another problem and that does happen to for example. Patients tell me. And cabinet of OxyContin on the street is maybe a 120 dollars you know something like us. I want to. Stations that tunnel and so heavily there's a lot cheaper is like twenty or thirty dollar one of the unit is so so you see that slide that drifted cutters. But all these factors come into play the other of why it is lets it become a public that somebody's going and stealing it from somebody else okay. All are let's say if somebody takes his sister is painkillers you know. Those are all problematic areas. Off our our calls up the doctrine says. You know I just. I just draw opted in the time able it get happened maybe once but you know if it happens a lot. Tablet once. Since 1980. Yes I'm happy to get my new prescription in Mexico hotel room was lost my bottle would you Bruce's memory yet. Think this happened but if it happens a lot you know and I think once you get them yeah there norm rhetoric. What we know about the studies on what. People's bodies can lead to pour more and more OP would ever meant to be taken for fifty years we may no question we know what that does someone. We know that the hue and body is very resilient okay. And OP side. Be a dire measured in many milligrams of morphine that's kind of the standard. And I was just talking the man friend in California in the end the day. And he'd be like a pain specialist okay. So he was telling me and a patient who has I'm talking on the equivalent of 14100 milligrams of morphine you know. So is just like some people walk in profit into the hospital. And a call level useful EP as they're talking. So the human body is very resilient they ate all raised from one person that you were gonna mention my years of experience but that battle at one point he. And the point is that let's say somebody goes to an inpatient detox okay they come out now a free awful be okay. And they didn't respond Bob Barr does this now they're free there are set does that Greg stated that tolerance is gone. Now they goal and they have a relapse remember I said certainly lapsing illness like diabetes. They have thirty dictate the same amount as it took biffle that becomes lethal. So it's kind of. This is what they win when they order it taken in every day the F took this about yes and they stop and then go right back to a party about the skills to that site in patient is very limited. That's why you wanna how outpatient long inpatient only 28 days. What happens after that on the parties are over so you don't see any. This is kind of like a long dumb. Treatment strategy. But but there are other I mean we're we're just talking about you know constipation no. We're talking about the amount of them there liver EU member and brain and kidney all that happens yet yet constipation can be managed. Right but all the other stuff that sentence if if told to us so that's why it's kind of a look at it from. Yeah they 83. It thinks it put them are sick and indictment not when I think of anyone else to write that pretty much the I have so different the reports the post mortem for one house. And I think that that is the general of the consensus if she was clean for all the damage it left is Doctor Who does she agree that are partly level and it is it dinner and at the age of 26 years old the end of his the second thing is being you know you you look at these pictures. The very quick to mention of somebody's appearance when they start what was and the body because you know it's not just the psychological component but also the yeah oh lead over doctor -- that we're talking obviously about opening Lloyds and you start up for discussion by talking about what your effort to as the class diversity of the teenage brain ergo the increase susceptibility. To long term damage from the use. Of all buicks can you please take that bought further. And you know put that into some perspective for parents and grandparents bread after we do traffic on that her. Yeah so so actually the teenage brain. Is Lenny is back up a little bit. So teenagers these days begin to look like adults but does that there's a big dichotomy. They may look like announced that the brain is not mature likened about bringing. And and some of that is due to nutrition and other factors. But it doesn't it showed that about 2425. Brain matures then begin to decline actually. So so the point being that we talked about elasticity. The brain you know is a process called pruning. Excessive new Iran's taken out this and that growth. And followed the environment plays into. The brain cells and those experiences. Also affect the brain. And even something. Adds. What he may call. Simple and on com well as marijuana. Off the sixties and unload their on after days in a different Merrill of the sixties. Is known to clause. Cognitive impairment and loss of gray matter. So so it affects functioning on psychological tests so if that does that would easy opiates would do right. Did they amend the effect there receptors in the brain that's a deal it's do this this intercepted on the new orders and they kind of go on that. So the wind really is that. And marijuana can do that silt or opiates are even worse I mean. Now a lot of teenagers these days stink I smoked some marijuana. But it's really not what was in the sixties. Now than it was 3% concentrated. Now it's fourteen blocks blasts its least at center and then I don't know what else you know. So let's let's Betty very different reactions hole. His I'm coming to us a single psychological illness called schizophrenia. Can be brought out in susceptible people made use of marijuana today that's been established. Bet is you casual look slot angering Bittermann from you could be a closet beam schizophrenic. Nano doesn't really know they're not humor. None and what you get one thing a marijuana can actually trigger that out. Well yeah you see you may have that susceptibility. But you never smoked it and you read UN embassy but then you went out with friends and tried some stuff the homeless and boom. When you go when you look at your career and you think of where we are right now with this crisis. With -- it. Isn't anything to compare this to have we ever seen anything like this where there was you know whether it was morphine that got out there or something that was powerful I mean Michael Jackson was using something no person should ever go to sleep. Yeah that wasn't hit nick though is that Qaeda knows of one until people look at what else is everywhere in this is. Like nothing seen before believe me and it still evolving it has enabled fully. It's still evolving actually so you'll continue to see it you've got to get grips on this Leon that's the thing. Me important to get that you were the director of outpatient services. When you're dealing with teenagers everything back to group managers said about the elasticity of the brain and even hot and susceptible individuals and let them know there's can trigger. Schizophrenic here. Does that pose special challenges when you were dealing with the outpatient side of Riley because you've only got four hours. Asked absolutely there is always needs to establish what we call a baseline. So we passed them strongly encourage. All of our participants and are adolescent program to stop using because that's the only way that we can see. And or assessed on the air sentimentality. Whether or not there's a mental health issues. Because other than that you could be looking at the symptoms. What they're. And not necessarily getting a clear read on. On how they're hoping and it until I'm in general. Fascinating doctor coop first that we're gonna ask you this question because I'm sure we of people filtering at the top one school right now for more information on best. What is urging work can you offer parents. Of children they suspect. Using opiates and for those adults who may have crossed that threshold from used to abuse. So encouraging words would be to recognize the problem soulful parents I would say have good open communication with the kids okay. You've got to be a better but he also going to be a friend NM. Sometimes it's not being a pattern now is very different than being a pattern in the sixties after CNET as they different. And so you've got to have the kids linked with the UMBL able to open up and things like that. And and that is hole that's for sure. The idea as to seek help. And be persistent. The trouble lid psychiatric disorders and and and problems psychological problems as this that noncompliance. Is a huge problem but we have. Other things now say you know it's very hard for people to date medicines it's not like you'd think. Antibody Kenya are. Infection is done this is like diabetes and it minister and then inning ending. So we happen now. Medicines that can get on them monthly bases and he did it I see there not three and 65 days a month that. Unfortunately. We you. Something we should. Come this feature don't speak what is the peace movement but they start feeling better late than Ottawa that the pills anymore it seems that there's got to be a special area of the brain with it schizophrenia and severe mental opus. Mean it or didn't thank you so much for joining us in studio doctor Sanjay group they're both from brylin. We're very grateful and indebted for their time now right now it's an displeasure well it has been a mutual pleasure.