Addictions to Rx pain medication in teens: What parents need to know and what they can do

From Dr. Fortuna’s regular blog on from May 19, 2016: “Narcotic painkiller addiction is currently diagnosed in teenagers…which brings the risk of cross-addiction to heroin. More on prevention programs and what parents can do here.”

Prescription opioid addiction, mental health illness and treatment for teens

From Dr. Fortuna’s regular blog on from February 8, 2016: “A featured article from Dr. Lisa R. Fortuna, MD, MPH, expert on teen addiction who helps outline mental health issues for parents. Here, she considers the research on the social and neuro-developmental factors related to teen substance use disorders and mental health, and translates that into everyday language and practical recommendations.”

ADHD and teen smoking: What parents should know

From Dr. Fortuna’s column on from January 8, 2016: “A featured article from Dr. Lisa R. Fortuna, MD, MPH, expert on teen addiction who helps outline mental health issues for parents. Here, she considers the research on the social and neuro-developmental factors related to teen substance use disorders and mental health, and translates that into everyday language and practical recommendations.”

Race, Truth, Human Rights and a Child Psychiatrist

I am a Latina who identifies as Afro-Latina, at least that is what a young woman recently pointed out to me. She asked me if I was Afro-Latina, she has asked me if I have ever straightened my short curly hair. I had to answer yes that I identify with my connection to the African Diaspora. Yes I have straightened my hair in the past. I feel a bit liberated from that now (just not my choice to do so anymore). But what I take away from the encounter is that racial identity, and all that potentially means, does matter in the child and adolescent psychiatrist’s office. We live in a society where it is often suggested that if one focuses too much on race then one is racist. The young girl asking me questions, her peers, youth in this country are experiencing challenges as well as making sense of their racial identity.

The aggressive societal message is that people of color should get over it and stop focusing on race. The scientific community is clear that race is a social construct. But a powerful social construct it is indeed.  Children identify race pretty early on. A preschooler will often notice if they are brown and others are not. They will ask questions about why there are differences in skin color, and when they begin to receive messages that are suddenly negative about race and color then it starts to be a real and tangible issue. We each have a variety of social locations. We identify with gender, socioeconomic status, sometime a faith tradition, ethnicity etc. Race is clearly among these and it is a very intimate and powerful identification because it does mean so much in society. How we relate to the societal construct of race in our communities makes a difference in our integrity. Then there is racism:

Racism–a belief or doctrine that inherent differences among the various human racial groups determine cultural or individual achievement, usually involving the idea that one’s own race is superior and has the right to dominate others or that a particular racial group is inferior to the others.

Well that has a whole set of other implications for the well being of children. The fact that we have to declare that Black Lives Matter says a lot about the messages youth of color are living with that suggest to them that certain lives don’t matter as much…that their lives are not valuable.

Sometimes I find myself walking into my office needing to hold together a youth who already depressed has to bear media messages like, “all Mexicans are rapists”, or has to see black churches burning down or black young boys shot down in the middle of the street. We may not even speak all of that out loud right then and there…but it is there and can’t be ignored.

What does that mean for the well-being of our children?

What does a child psychiatrist like me do with that reality? What do we all do with it?

Speak the truth and listen to the truth. We need to be honest about the realities of the racial injustices that are present in our society. It is not a color blind society and youth know that –so let’s be open and real and allow them to ask the questions and bear the truth with us.

Understand that racial injustice, racism can have the power to make us sick. Science shows that racism may be implicated in heart disease, depression, anxiety, low birth weight babies born to African American women.  If anyone says racism and oppression can’t be poisonous and deadly then reconsider.  Joaquin Luna was only 18. The senior at Juarez Lincoln High School in Mission, Texas, dreamed of going to college. But since he was in the country illegally, that was nearly impossible and so he killed himself. How many young people of color drop out of school due to a combination of poor educational systems and a sense of just wanting to give up because it seems that no one cares? Human rights and dealing with social justice issues is part of good medicine. Being real and truthful and listening to the good, the powerful and the ugly realities of race in America is part of our work as those who care, wish to heal and to bear compassionate and transformative witness to what our young people face, and what we all face. In the end we have to declare that we won’t tolerate and stand by while our children are being moved to despair… we’ll show it in our practice, our actions, our commitment to join them in the truth.

Teacher, do you not care that we are perishing?

When evening had come, Jesus said to his disciples, “Let us go across to the other side.” And leaving the crowd behind, they took him with them in the boat, just as he was. Other boats were with him. A great windstorm arose, and the waves beat into the boat, so that the boat was already being swamped. But he was in the stern, asleep on the cushion; and they woke him up and said to him, “Teacher, do you not care that we are perishing?” He woke up and rebuked the wind, and said to the sea, “Peace! Be still!” Then the wind ceased, and there was a dead calm. He said to them, “Why are you afraid? Have you still no faith?” And they were filled with great awe and said to one another, “Who then is this, that even the wind and the sea obey him?”

I include Christian scripture in this blog this time because I feel I need to speak from my tradition and faith in these moments. The killing of nine people in Charlestown, in a church, in the name of hate is painful. But hate is not the last word. It does feel as if we are perishing. But death is not the last word.

A saw a friend and colleague of mine at an event tonight. She let me know that a young man she had been trying to have me meet so that he might get help since she was sure he suffered from traumatic stress and he was having such a hard time…that young man was one of the first to be murdered this year in Boston. It does feel as if we are perishing. But I have to remind myself, death will not have the last word. I won’t be afraid and I will persist through my faith.

Put in the most practical terms we have to act. If you reader are a person of any faith, if you are a humanist, if you are in any way someone who cares about humanity and what is good and right, I ask you to dig deep and consider the following as some possible and important action.

  1. Join others in speaking against racism, hate and the oppression against any human being.
  2. Join others in demanding better gun control legislation. I don’t want any more dead kids!
  3. Speak up for the provision of a good education system, which is made available to all.

Help that be the choice instead of supporting the proliferation of prisons and the feeding of the prison pipeline (disproportionately fed by people of color and the poor).

  1. Say no to legislation that disproportionately favors the already privileged and further disenfranchises everyone else.
  2. If you are a health provider in mental health or other field of healing…don’t prioritize the financial interests (of our health system) over your vocation to serve your community, your patients our kids.

In the storm that we are in, act with love and justice… hate be still!”