The Experts Speak - An Educational Service of the Florida Psychiatric Society

Achina Stein, D.O., explains the many advantages when mixing these two concepts. Functional medicine has an extensive approach exploring for other causes of illness, including valuable searches for what are often not initially obvious infections or inflammatory states, the role of nutrition, toxin exposure, a detailed history of the illness, lifestyles, etc., and then using that data for directed treatment methods, which may also include traditional medicine use and verbal therapies. Intriguing, grounding, worthy of much study, especially with complex and inadequately responding patients. July 2024

Rachel Earls, Ph.D., outlines the roles, science, and limitations of this powerful clinical tool for the selection of medication. They guide us on how a person metabolizes many medications, and so it helps get proper doses for better efficacy and fewer side effects. It does not predict outcome, but greatly assists with treatment choices. She speaks to the differences between labs that require a medical prescription versus the direct to the consumer labs. This is a fascinating scientific utensil. July 2024

Stuart Isaacson, M.D., neurologist, explains TD, the role of dopamine in psychiatric and then this treatment induced consequential movement disorder, proper diagnosis, how both psychiatric and neurologic treatments are very helpful, but he also weighs the risk-benefits of now the increasing use of antipsychotics for mood disorders. He further talks of the VMAT2 systems empowering the two new medications. Important material. May 2024.

In 1937, NBC aired this episode of the radio series ‘The World Is Yours.' It is a theatrical style reporting of the history of several medicines. Interesting, educational, and an easy review of medical discovery and treatment. A lighter listening episode than our usual variety. Posted here February 2024.

Chris Pizzute is a music therapist at the Louis Armstrong Department of Music Therapy Center at the NY City Beth Israel and Mt. Sinai Hospitals. He explains the history and then the powerful roles, styles, and designs of music therapy. Entertainment and music psychotherapy both use music but in different contexts, of cultural inputs, how to help navigate through events and emotions, the ‘song of kin' function (music we grew up and connect with), video game music, asking about one's link to music, etc. Music takes us to places deeper than our conscious memory. Music is transcending yet weighty.

Connie Siskowski, R.N., Ph.D., and a CNN Hero award recipient, works to help the millions of children who go home to be essential caregivers, and who therefore have special caring needs, miss a lot of normal adolescence, and so absolutely require help and acknowledgement. She started the American Association of Caregiving Youth to face this task. The efforts include integration with local schools, of social workers that go into the homes, getting laws to address the funding needs, that some states can remove and place the caregiving children into foster care, etc. But in particular is the focus to help these children not to feel alone, frustrated, etc. This is too quiet a reality for many children.

Ivan Cichowitz, M.D., explains the FDA approved VNS science to treat depression. He outlines the history, process, and theory, that it is used very often with medications, its increasing insurance coverage, how to know when and if it should become a treatment option, etc. VNS is a strong additional utensil in the treatment of resistant depressions. Learn and ask about this very promising mechanism.

Todd Sack, M.D., without hesitancy, speaks to the needed but daunting challenge of changing individual CO2 footprints, age and generational differences, real and specific ideas on what to do that do require self-discipline and commitment, that ‘green' can save money, the critical ‘ballot box climate change', that positive undertakings and adjustments are occurring but perhaps not fast enough, to make it a non-partisan opportunity because we all live on the planet, of resiliency, etc.

Jay Kuchera, M.D., pain management, speaks to barriers to proper pain management, the ethical, clinical, political and regulatory domains, medication and treatment costs, CDC and other guidelines, the need for proper clinical management, how cultural acceptances of suffering differ and set expectations, that improper treatment evokes the disease of desperation, differences in pain management now versus 25 years ago, that better patient quality of life is possible, etc. A very crux-of-the-matter discussion.

Tommy McGee, psychotherapist, addiction counselor, clergy, and black, takes us on a revealing tour of life in the black communities, how many black patients view the medical system, the barriers this produces in even approaching the system for prevention and treatment, insurance barricades, the role of the churches with this and other mental health problems, the need to ‘translate' their culture, and to morph their tangible needs into real action and policy, etc. Honest and unrestrained comments from his personal and professional lives.

Fish biologist Dave Cannon candidly discusses his personal fears and emotions plus his professional responses to climate change, his preceptive ‘bush Alaska' perspective, challenging our species to cooperately make real changes, solastalgia (loss of our homes), the need to commit with examples of personal changes to reduce our CO2 footprints, etc. Thought provoking, genuine, helpful.

Aldo Morales, M.D., psychiatrist and addictionologist, provides from experience a no-nonsense and balanced overview of cannabis use, issues with quality control of dispensary products, understanding addiction levels, the need for research and the topics being explored, worries if used in a still developing brain, the cannabis abuse disorder, etc. August 2023

Linda Reihs is an educator, author, and substance abuse counselor. She promotes non-drug use with ‘knowing' and not just ‘saying no', teaching resilience, parents' and siblings' roles, not getting help to needy students especially when they move into middle school, keeping kids on a good track, the experiential preventive mode, literature to create ego-building strengths, framing designs for each day, of ‘no failures-just delayed successes,' etc. This is a valuable perspective from many in-school experiences.

Two different systems for psilocybin use. Wired Magazine posted an excellent podcast, presented here. Many clinical and political concerns. Worth a careful listen and discussion. June 2023

Jeff Singer, M.D., senior fellow at the Cato Institute, who gave Congressional testimony, speaks to the fascinating Iron Law of Prohibition issue, the need to overcome old mythologies, nuances, and stigmas about the problem, etc. A very lively, pithy, yet necessary historical and contemporary offering of hard reduction and other key insights and thoughts. In conjunction with the Palm Beach County Medical Society.

John Dyben, Ph.D., with a primarily psychosocial approach to addiction, but also of appropriate medication use, discusses that kids grow up and mature too quickly; of essential family and system treatments; that addiction is a chronic illness; of social-cultural message influences; to make ‘healthy' the new norm; to connect to the whole person; the power of fellowship and conjoint family activities, etc. A reflective listen. In conjunction with the Palm Beach County Medical Society. May 2023

Daryl Shorter, M.D., offers functional and pragmatic contexts of addiction, of what leads to successful remission, the key essentials of biological versus psychological origins, that all substance use is not always abuse, etc. April 2023

Sarah Kawasaki, M.D,, details mixing buprenorphine and fentanyl. The mere number of fentanyl overdoses, be it knowing or not knowing fentanyl was consumed, requires preparing for possible clinical dangers of too rapidly using buprenorphine. Definite protocols are used and are being studied. Important information.

Kimberly Aquaviva, Ph.D., M.S.W., begins with her family experiences and why they refused hospice care for her partner. She then gives a overview of current discriminations, inadequate training, and other challenges when hospice and LGBTQ+ patients should function together. She is also pleased some of the problems are slowly resolving.

Heather Howard., PhD, MSW,speaks to her study of how to address stigma, from those who express it to those who receive it. She talks to how this can impede a readiness to ask for help Leaves insights and thoughtful drives to action. Much of her work as been with shame, past traumas and /or substance abuse in women during pregnancy. Easy to understand yet scholarly.

This old medication is finding a place in the treatment of psychiatric disorders. This is an overview of it's history and current use, especially now as an antidepressant.

Benjamin Bowser, Ph.D., sociologist, gives the legacy's history, that it still remains a very potent contributor to racism, of the cultural based post-traumatic slave syndrome, of what slavery did to the psychology of the slaves and how much of that still lives to this date, and of the origin and legacy of whiteness, Jim Crow, etc. Intriguing, captivating, perhaps painful, but so necessary to study and discuss. February 2023

Stefan Pasternak, M.D., on how the therapist-patient relationship is the cornerstone of psychotherapy, and about the challenges of developing a goal for the therapy, the physiologic and medication aspects of therapy, of coming to an accurate diagnosis, cognitive versus psychodynamic techniques, psychological mindedness, when a change of therapist may be needed, etc. January 2023

These Wires Carry Words! - Broadcast on July 1, 1946, by Advances in Research, this 15 minute radio piece is an excellent, fluid and valuable historical review of our developing communication tools, with stories about, and credits to, the scientists and thinkers who started the process that brought us to our ever-expanding dependence on electronic communications. It has a delightful 1940's flare. From the public domain.

From the February 1937 Liberty Magazine interview, as told to George Viereck, the distinctive inventor accurately predicts much of our current world, on war, the changing of women's roles, energy, environmental and social shifts, computers, the internet, etc. He was incorrect on some items, but perhaps only as of yet. 11 Minutes. Observant & thoughtworthy. Adapted from YouTube and Magellan Streaming. October 2022.

A 14 minute audio from the National Association of Manufacturer's 1950's educational and advocacy piece of the then appreciations and concerns with useable and sustainable water, including draughts and floods, in our community lives and our biosphere. Imagine what the producers would say now, over 65 years later

Rakesh Jain, M.D., gives its history, how it works, why it is so different and its enticing future, the roles of glutamate and GABA, nasal versus intravenous forms, the value of concurrent psychotherapy, etc. Succinct and thorough. November 2022

Larry Bush, M.D., infectious disease specialist, details the history of this virus, its characteristics, hosts and vectors, the already existing treatments and unique aspects of the monkeypox vaccine, the relationship to smallpox, how to approach such an infection, the reappearance of polio and measles, and a true overview and insightful look at the three real and desired endpoints of vaccine development and use.

For Doctor's Day, 2022, at the West Palm Beach VA Hospital, psychiatrist Abbey Strauss spoke that physicians must accept they are also regular people with the full inventory of emotional problems, how to deal with compassion and other fatigues, the high physician suicide rate, to not be alone, how to get and use help, and the decisive value of keeping themselves healthy, honest, and not embarrassed or scared. These themes actually apply to everyone.

*Climate Change Questions That Psychiatrists Need To Ask Both Themselves and Their Patients - Psychiatrists Beth Hasse and David Pollack pose such questions, including those about eco-anxiety and when to - or not to - bring these issues into the treatment activity. Very timely given the current worldwide heat waves. Much talk of how vital and evolving diagnostic and treatment strategies are developing to proportion treatments to all existent domains of life, which now include climate matters.

Carl Fisher, M.D, psychiatrist at Columbia University, argues that ‘disease' is the wrong concept as he outlines the urge leading to addictive behaviors, that it oversimplifies, what is the place of free will, the three broad reasons fostering addictions, various social mitigators, long term outcomes, and his own recovery from alcoholism. Posted also with the Palm Beach Medical Society Opiate Task Force.

Maria, using only her first name, candidly shares her feelings and life being the parent of the adult mentally ill. She discusses the process of learning and accepting this reality, the parental pain, the differences between she, whose children are still alive, and those whose children died by suicide or otherwise, the importance of helping others and getting support groups, to find the right questions to ask, of when one must let go for a period, of one's personal life, etc. She is a platform from which to gain insight and strength.

Former US Drug Czar Robert DuPont, M.D., in 1997, outlines the theories of all addictions, what it does to the brain, the roles of pleasure, honesty, character, family and background, risk-taking aversion or comfort, preventions and treatments, the importance of AA and NA, the relative risks of some becoming addicted or not, nicotine and alcohol use, etc. He wrote “The Selfish Brain.” This interview contains so much wisdom about the same problems that continue to exist after 25 years. Recorded in 1997; reposted June 2022.

Priti Kothari, child psychiatrist, outlines how the different age groups suffered differently during the pandemic, the educational and social pressures and delays, the need perhaps of a gap year to catch up, disruptive behaviors with the reasoning fundamental to treatment approaches, etc. Thoughtful concerns about what happened and how to offset any setbacks.

Tara Gomes, epidemiologist in Ontario, Canada, speaks to enlightening research that larger quantities of take home Buprenorphine and methadone, and as such are multi-day dose packets, can be safe and productive in stabilized patients. The project was partially in response to covid caused travel restrictions. Some of the results was that this strategy reduced barriers, the fears of increased overdoses were unfounded, and it maintained treatment. This is like the U.S. methadone maintenance clinic model but within the Canadian structure.

A forensic psychologist gives insight into many cases in which he examined people who committed deadly violence. This includes young teenager offenders as well. His data and opinions come from a mixture of hard experience with these defendants.

Bill Durston, MD, emergency room physician and former US Marine marksman, gives a necessary overview of gun violence statistics and his thoughts on how to reduce the suffering.

Steve Keen, M.D., gives a very detailed discussion of his real-time, on-going emergency room program, with specifics on how to rapidly stabilize, start medication assisted treatment, give psychosocial interventions and follow up referrals, deal with shame or patient's hesitancy, the challenging omnipresence of fentanyl and related new drugs, etc. Done with the Palm Beach County Medical Society Opiate Task Force.

Journalist, and former opiate abuser Maia Szalavitz, defines harm reduction as keeping people from getting hurt rather than stopping them from getting high, that needle exchange encourages treatment, of needing good coping skills before giving up the substance, what changed her life, her work to promote harm reduction, etc. An honest and energetic discussion. Done with the Palm Beach County Medical Society Opiate Task Force.

Elizabeth Evans, PhD, associate professor at the University of Massachusetts - Amherst, reports that giving Suboxone to jailed opiate using prisoners significantly reduced legal recidivism and other post release relapse and morbidity. Listen to the encouraging details of her the study, and to her current and related future work. Done in collaboration the Palm Beach County Medical Society Opiate Task Force.

Roz Malmaud, PhD, and Andy Rosen, PhD, note that patients are now focusing more on the pre-Covid, usual problems. Both discuss, however, issues with telemedicine's legal and insurance matters, being unable to give patients questionnaires to complete or handouts for them to use, to see how they interact in the waiting rooms, the real paradigm shifts away from traditional therapy arrangements and schedules, and of how patients must learn how to tolerate social uncertainty, etc. The need for telemedicine during the pandemic brought many therapeutic methods to new notions that need refinement and integration insofar as to how we now communicate and interact. The tools are different.

Elizabeth Evans, PhD, associate professor at the University of Massachusetts - Amherst, reports that giving Suboxone to jailed opiate using prisoners significantly reduced legal recidivism and other post release relapse and morbidity. Listen to the details of her the study and her current and related future work. Done in collaboration the Palm Beach County Medical Society Opiate Task Force.

Roger Ekirch, PhD, a historian at Virginia Tech, on our different sleep patterns that were normal before the industrial revolution. A fascinating look at sleep patterns, the first and second sleeps, and the social and biological drives and basis of how we sleep.

Lynn Webster, M.D., discusses issues of over and under use of pain medications, his research on dosing and response issues, the critical psychological components in pain management, the correct use of non-opioid medications and non-medicinal pain treatments, changing attitudes towards pain management, etc. An articulate and experienced based discussion. Done in collaboration with the Palm Beach County Medical Society

Lori Ann Post, Ph.D., describes the dramatic recent increase in overdose deaths in this group, gender and other demographics, causes, interventions, and the on-going studies to better define and reduce this horrible social and emotional affliction. Done with the Palm Beach County Medical Society. February 2022.

Luke Elms, M.D., straightforwardly addresses ERAS's (Enhanced Recovery After Surgery) beneficial medical and psychological strategies for compassionate pain control, of faster recovery with fewer complications, to help patients emotionally prepare for surgery and how this may reduce post-surgery pain leading to subsequent improper pain medication use, surgery and pain control in patients with opiate use problems, etc. Done with the Palm Beach Medical Society Opiate Task Force

Larry Bush, M.D., from Florida, explains mutations, monoclonal antibodies, vaccine history and use, boosters, B cells and T cells, and the safe use of the potentially game-changing arrivals of the Pfizer and Merck medications.

Steve Chambers, M.D, will hire these physicians to help them return to a fuller and productive life. He talks of the joy, pitfalls, rules, approaches, and real gifts evolving from these opportunities. Part of the Physician's Wellness Project of the Palm Beach County Medical Society.

Darci McNally, M.S.W., Director of Support at the Lynn Cancer Institute in Florida, speaks of how they address patients with cancer, the emotional needs, the psychological fatigue, different interventions, community supports, etc. This is a heartfelt, valuable, and seasoned guide for patient's and their families during the cancer experience

Ludmila de Faria, psychiatrist, conveys her approach to explaining and treating this disorder, its historical and biological origins, the diagnostic nuances, and the necessary interaction of the medical and psychological domains. She also comments on what happens when marijuana is added to this condition.

Lynn Kohan, M.D., an anesthesiologist, speaks to the attitudes towards, and the effectiveness and strategies of, using buprenorphine to obtain pain and psychological relief in both treated and untreated opioid using surgical patients. She discusses the MOUD - a acronym for the Medication treatment of Opioid Use Disorder - in regards to both the critical medical, surgical, and psychological clinical treatment concerns and protocols, discharge planning, etc. Produced in collaboration with the Palm Beach County Medical Society