I worked at emergency department on the weekend...

I worked ER on the weekend.
I was asked to see a 25 year old that was agitated and aggressive having had her opioid overdose reversed with naloxone. She said she wanted to leave. I asked her what is she going to do about her addiction. She said she wants to get out of here and go get her hamburger at McDonalds (she has a coupon) and then go home. She said she won’t have money to.. till Friday. I asked her what is her specialness. She then for the first time looked at me and said that she is good to others. I asked her if that means she feels others pain; and that she escapes her pain by using substances. She then started to tear up. I told her she is stuck but it does not have to be so.
I share the following perspectives with her.
1. Neurodiversity
2. Ability to choose the object of attention can be increased through meditation.
3. Object of her attention dictates her experiences… suffering or otherwise.
4. Anapana meditation by Goenka.
5. Vipassana retreat at Egbert Ontario.
She continue to cry and told me that she will study it. I emailed her a invitation to attend my weekly groups.
I believe I can easily be overwhelmed by the crisis and overlook non-pharmacological opportunities that can truly address the cause. So I remind myself that to effectively address the opioid crisis, a clear understanding of the root cause and its solution is necessary. 
On the whole, I believe opioid crisis is just one fatal symptom of a culture that is unwell. It is by no means the only fatal consequence ( Type 2 Diabetes, Increased Suicide being two more…) of a culture that has for some time forgotten the importance of individual and social responsibility. It is just one that is for now screaming at our collective conscience.
According to University and College Health Association:
65 percent of students reported experiencing overwhelming anxiety in the previous year (up from 57 per cent in 2013).
46 per cent reported feeling so depressed in the previous year it was difficult to function (up from 40 per cent in 2013).
13 per cent had seriously considered suicide in the previous year (up from 10 per cent in 2013).
2.2 per cent reported attempting suicide in the last year (up from 1.5 per cent in 2013).
Nine per cent reported attempting suicide sometime in the past (not restricted to last year).
Mental health challenges seem to be the norm rather than the exception; and does not seem to go away with time.
According to CAMH:
By age 40, about 50% of the population will have or have had a mental illness.
The Canadian health care budget is already in excess of $250 Billions. It would seem that some wellness perspectives are fundamentally lacking in the contemporary mindset.
I believe, as physicians we are all blessed with great minds, society’s love and trust deserved and sometimes undeserved and the precious perspective of self-empowerment. We collectively hold the power to heal our culture of illness and lead the transformation to a cultural of compassion and wellness.
I believe to do that I must be on the wellness journey myself. Then as a family physician, I have enormous influence on many individuals at every echelon of society. People with enormous influences come to me at their moments of suffering, open to new perspectives and mostly willing to take actions. What a privileged position with wonderful opportunities!
I think an effective and affordable solution may begin by challenging everyone to have wellness conversations at every opportunity:
1. Wide adoption of Mindfulness training programs (such as Mindfulness without Border Ambassador Program) and robust nutrition education at every level of the education system: schools, colleges and universities.
(I facilitate resilience groups for medical students and will speak at a local school parent teacher meeting on “addictions and mindfulness training”)
2. Wellness role modeling and promotion by our political leaders, community leaders, celebrities and other opinion makers.
( I will speak at a community garden club on “pain, suffering and illness”)
3. Wellness programs in government and private organizations.
(I am looking for opportunities to start “employee wellness programs” at the hospital)
4. Expanded availability of group psychotherapy in primary care and beyond. (I run several weekly groups for patients in my practice and community. If you like to learn to run these groups; just ask me how!)
Thanks for reading!

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