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How Corporate Health Care Leaders Maintain Their Impunity: The Case of Purdue Pharma's Funding of the Washington Legal Foundation to Attempt to Weaken the Responsible Corporate Officer Doctrine

The ongoing epidemic of narcotic (opioid) abuse, and the resulting rise in the deaths due to overdoses, has focused attention on pharmaceutical companies' aggressive promotion of these drugs which minimized their substantial risk. A recent article in the Intercept showed how the leadership of one such company tried to insulate itself from responsibility for such actions even while such promotions were continuing. Background: Impunity of Top Leaders of Big Health Care Organizations For years, we have railed against the impunity of top leaders of health care organizations.  We have noted that despite numerous legal settlements made by health care organizations of alllegations like fraud , bribery , and kickbacks , almost never do top leaders who presided over these actions face any negative consequences.  Lack of deterrence caused by such impunity appears to be a major cause of  the epidemic of continuing unethical behavior, crime and corruption on the part of large health car

Health Care and Psychosis

Do you know someone who has lost touch with reality? Not just because they don’t want to deal with a particular situation, but because they have seemingly lost their mind? Have you ever wondered why certain people cannot deal with everyday life and appear to retreat into their own world? This type of psychological problem is known as psychosis—a dangerous state of mind for anyone who has it, or anybody who is around anyone who exhibits it.

Psychosis refers to an abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality". People with psychosis are described as psychotic. People experiencing psychosis may exhibit some personality changes and thought disorder. Depending on its severity, this may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out daily life activities.

The two main symptoms of psychosis are:
·         Hallucinations  where a person hears, sees and, in some cases, feels, smells or tastes things that aren't there; a common hallucination is hearing voices
·         Delusions  where a person believes things that, when examined rationally, are obviously untrue  for example, thinking your next door neighbor or someone perhaps not even near you is planning to kill you.

The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion and behavior. Although real to the person experiencing psychosis, psychotic experiences are not experienced as real to others.

Psychosis is more common than many people think. Symptoms may come and go or be relatively constant. It is often associated with mental health disorders like depression, bipolar disorder, and schizophrenia.  However, psychosis can also occur for many other reasons, including substance abuse, brain injury, seizure disorders, or conditions of extreme sleep deprivation or isolation. 

According to the National Institutes for Health (NIH), a person with psychosis may have any of the following:
·         Disorganized thought and speech
·         False beliefs that are not based in reality (delusions), especially unfounded fear or suspicion
·         Hearing, seeing, or feeling things that are not there (Hallucinating)
·         Thoughts that "jump" between unrelated topics (disordered thinking)

Psychiatric evaluation and testing are used to diagnose the cause of the psychosis. More information can be found at this site: http://www.nlm.nih.gov/medlineplus/ency/article/001553.htm . Also, laboratory testing and brain scans may not be needed, but sometimes can help pinpoint the diagnosis. Tests may include the following:
·         Blood tests for abnormal electrolyte and hormone levels
·         Blood tests for syphilis and other infections
·         Drug screens
·         MRI of the brain

Psychosis is usually reported to a healthcare professional by a family member, friend or caretaker of the person who is ill. Most patients are, themselves, unaware of their condition. Diagnosis is made by a psychiatrist, through talking tests that are performed to assess the severity of the condition. Treatment for psychosis usually involves a combination of medication called antipsychotics and talking therapy or counseling. While medication can relieve the symptoms of psychosis, talking therapy can address the underlying cause of the psychosis.

Cognitive behavioral therapy (CBT) is one example of talking therapy that is commonly used to help people with psychosis. Aside from psychological therapy and medication, people with psychosis also require support from people in their family and social circles. More information about this mental disorder can be found at this site: http://www.news-medical.net/health/What-is-Psychosis.aspx .

There is no cure for psychosis, but there are many treatment options. In some cases where medication is to blame, ceasing the medication can stop the psychosis. In other instances, receiving treatment for an underlying condition may treat psychosis. This is another reason why getting treatment help is important: discovering a potentially life-threatening medical problem.

Some people may only need short-term treatment. Others may need long-term treatment with antipsychotic medication. A doctor might recommend psychological therapy or addiction counseling. It depends upon the cause of the psychosis. More information can be found at this website: http://www.psychguides.com/guides/psychosis-treatment-program-options/.

Learning to manage stress is important for a person with psychosis. Not only does the psychosis itself create considerable stress but this stress can in turn provoke symptoms and result in a relapse. You, like everyone, has stress within your environments – some of which you can control and some things you cannot. When you have little control over the stress, you can change how you respond to it. Managing stress starts with learning to recognize stress.

Stress symptoms include many mental, social and physical changes. Common symptoms of stress include feelings of exhaustion and fatigue, irritability or anxiety, changes in appetite or sleep patterns, headaches and/or muscle tension in the back and neck. Increased use of alcohol and/or drugs may also be a sign of poor coping.

Each person's response to stress is unique. By anticipating stress, a person can prepare for it and work out how to control it when it happens. Much more detailed information about psychosis can be located at this website: http://www.earlypsychosis.ca/pages/diagnosed/assessment-of-psychosis.

The New York Times Health Guide also has some very good info about how to deal with psychosis: http://www.nytimes.com/health/guides/disease/psychosis/overview.html. Call your health care provider or mental health professional if you or a member of your family is losing contact with reality. If there is any concern about safety, immediately take the person to the nearest emergency room to be seen by a doctor.


Until next time.

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