Tuesday, May 8, 2012

Al Capone and Patient Power

We finished neuro this week and now we're on to behavioral medicine and psychiatry. After this first week of psychiatry I have to say that the teachers are much more engaging and enthusiastic. The presentations that the psychiatrists prepare are stories about the craziest cases they have seen with a little bit of diagnostic criteria. Since there are no lab studies to diagnose depression, bipolar, schizophrenia, etc psychiatrists rely on patient presentation meeting Diagnostic Manual criteria to attach a diagnosis to a person. 

The most interesting lectures so far have been about drug addiction. I did research with a drug addiction expert during undergrad and it's been rather close to my heart since then. The professor who runs an alcoholics intervention clinic told us that 5% of drinkers consume about 35% of the alcohol and 10% of drinkers consume more than 50%. One in ten people who ever try alcohol will go on to lose their life, spouse, or job. One in six who ever try cocaine will become addicted. I asked him after he told story upon story of terribly addicted alcoholics and the extremes he's gone through to keep people clean what he thought about prohibition, decriminalization, and legalization of drugs. He said prohibition of alcohol would be futile - we'd return to a system in the 1920's where everyone is a criminal and only the Al Capone's would prosper. The data on alcohol price elasticity is: a 1% increase in price leads to a 0.3% decrease in beer consumption, 1% decrease in wine consumption, and 1.5 % decrease in liquor consumption. As far as legalizing drugs, last year 440,000 people died from tobacco-related complications, alcohol accounted for a low estimate of 100,000, and all other illicit drugs combined added up to less than 20,000 deaths last year. He seemed to think the war on drugs was serving its purpose.

What I did not enjoy was the section about domestic abuse. It made me sick to my stomach. Studying the terrible things one person can do to another person is like studying the etymology of curse words - you read and internalize what you'd rather skip.

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