2016: 63,632 Drug Deaths. Double in 2017?

By Matthew E. Dash, LCSW Email Icons - Black245671 - reporter's byline envelope
December 27, 2017
Note: This was originally written 12/27/17 but not posted.  I was on a writing roll, but unforunately my verocity resulted in this unpublished post.  It’s never a bad time to consider the reality of the opioid crisis and finding this article has me thinking about what has actually been done since a State of Emergency was declared regarding this epidemic.  More on that to follow in a future post.  Stay tuned!


In 2016, the age-adjusted rate of drug overdose deaths in the United States was more than three times the rate in 1999.

Last month, In December, the U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics released NCHS Data Brief 294 (Hedegaard & Miniño, 2017). This 8 page report shook me to the core for many reasons. Let’s look at some of the the ‘Key Findings’: Read more ›

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Censoring the CDC Puts Americans in Danger

Office Space Common Sense Meme

DISCLAIMER: This is not a political article. Yes, it contains news related to politics, however, this article is meant to educate and be helpful by pointing out the potential impact for all of our well-beings – both individually and collectively. Within the facts that follow, should any opinion or statements that are taken or are personal opinion be found offensive, I urge you play through. It’s all part of the fun. Seriously though, I hope you read this in the spirit in which it was written – to be educational, enlightening, and helpful. Apologies for any misinterpretation. I have no agenda in this article beyond our well-being. That said, I hope we can all lighten up and focus on our health and the health of our children which can be impacted by law, policy and regulation. However, I’m not addressing those things as much as I am censorship as it relates to healthcare. Bottom line, it’s much easier to just read this article than have me pre-qualify its intentions. As always, I’m wishing you and yours health and happiness.
PS The George Carlin video contains language some may find offensive. If you click on his video below and are offended, what can I say except, it’s George Carlin! What did you expect!!!

Read more ›

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Kellyanne Conway Now Opioid Czar / Mickey Mouse to be Sec. of State

Conway vs Mickey

While I try to avoid political discussions here, sometimes it is unavoidable in order to adequately address issues related to mental health.

I have written much, here and elsewhere for over 5 years about the opioid epidemic. As I have stated more than predicted, this crisis is not going to get better anytime soon. This is a rare situation where I am sad to have been correct in my predictions.

Take preliminary 2016 numbers from the Federal Government:
An estimated 50,000 Americans lost their lives to opioids in 2016.

To put that number in perspective, consider that number is greater than:
– The number of Americans killed in combat in Vietnam.
– The number of Americans that died during the worst year of the AIDS crisis.
– The number of Americans that die annually from car accidents.
– The number of Americans that die annually from gun violence.

Read more ›

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1 in 5 US Children Solicited for Sex via Cyberstalking

Facebook peeking

While Cyberbullying is a term we have all heard many times in the news, usually in the form of horrendous incidents in which a group of teens have shown a mob mentality while encouraging a peer to go through with their thoughts of suicide.

Cyberstalking, on the other hand, is different and much more vague in its definition, but at its core, is predatory behavior and very frightening as it is historically under-reported.   Read more ›

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[HINT: It’s not Student Debt, Lack of Health Insurance, or Internet Addiction]



The drug industry spent $106 million between 2014 and 2016 lobbying Congress on a bill now a law, which removed the DEA’s long relied upon ability to freeze suspicious narcotic shipment from drug makers (and other legislation), The passing of that Bill removes the DEA’s ability to use one of its most effective weapons preventing prescription opiates made by pharmaceutical companies from getting to the streets.


Meanwhile, almost 60,000 people died of drug overdoses in 2016. In 2015, 87 children died of opiate intoxication, which occurred in many ways similar to those seen just a couple of months ago over the summer.

Here’s what horrible things can and have happened because of this epidemic over this past summer in Philly alone. A 9-month old died after rolling over onto a needle in their parents’ bed, a 20-month-old girl died after drinking methadone left in a water bottle in the family’s mini-van, and a 2-year-old boy died after taking 2 oxycodone (Vicodin) pills found in mom’s purse. Those 3 were just a few of the kids killed this year from opiates. In Milwaukee, 8 children have died of opioid poisoning since 2015.



1. Rep. Tom Marino-R, PA – who was given $100K from “Political Action Committees” repping the pharmaceutical companies that manufacturer opioid-based pain pills.

Rep. Tom Marino
2. Sen. Orrin Hatch-R, Utah – (wait, this f’er is still alive?), received $170k for his efforts as the bill passed after that creepy smiling d-bag who has clearly had at least a couple of nips and tucks on that mug of his, negotiated a final version after multiple revisions.
***Keep Reading as these two scumbags have had horrendous overdose deaths of their constituents.



Apparently, they needed to dig up Hatch after Marino “spent years trying to move the law through Congress.”

I guess he’s the only Marino who can’t get the ball into the end zone.

NOT FUN FACT: Marino, criminal and overall P.O.S. that he is, according to the article in the Washington Post, is Trump’s nominee to become the nation’s next Drug Czar. You gotta be f’n kidding me!

And that walking dance of the living dead Hatch (doesn’t matter how tight they pull your ass fat injected face, you’re still 83) and the fact that you’re from a State that has such a blatant Opiate Addiction problem makes you that much worse. Everybody remembers Utah, right? That would be that State with only 3 million people but yet its pharmacists filled roughly 7,200 opioid prescriptions per day in 2015. Orrin, it doesn’t bother you that in Salt Lake City, one ER doctor recently revived 4 overdosing toddlers in 1 night!

You know when you hear about teenage athletes who died due to taking some supplement from GNC or over the counter at one of the big pharmacies like Rite Aid, Walgreens, CVS and more.

Well, we can thank Hatch for the lack of regulations on supplements and their manufacturers ability to make outrageous claims on the bottle. The only advancement in reversing that is the good old statement that the FDA hasn’t reviewed these claims. Reminds me of the warnings on a pack of cigarettes. Or Parental Discretion Advised Stickers. These are the “No Shit” warnings that waste our money being debated about.

So Hatch being the Utah Senator that he is has been taking full advantage of the fact that Utah is “the Silicon Valley of the supplement world.” He was the chief author of the federal law enacted 23 years ago that allows companies to make general health claims about their products but exempts them from federal reviews of their safety or effectiveness before they go to market. During the Obama administration, the Hatcher repeatedly intervened with his colleagues in Congress and federal regulators in Washington to fight proposed rules that industry officials consider objectionable.

Tommy Boy Marino. I didn’t forget about your either. You are a State Representative of Pennsylvania. So, weren’t you concerned 4 years ago, before the height of this epidemic but an epidemic nonetheless when 22 of your constituents in Pittsburgh died in less than 2 weeks from Fentanyl laced heroin.

Asshole, Fentanyl is 100 times more powerful than morphine. 100 times. You know, 100. Like 100 thousand dollars you received to push a bill through congress.

If there’s any justice in the cosmos, these two will spend eternity in that special place in hell reserved for such caring humans. I’m hoping these two beauties wind up attached in a Human Centipede while being constantly overdosed, revived, with alternating denial of access to opiates inducing major explosion of bodily fluids from both ends. Essentially, they’ll be honking out of both ends in to each other. If you two want to get started early use these handy instructors from Ikea.



I originally started posting this on FB but it was getting too long but I linked to this on FB. Hopefully, they’ll take issue because I’d love to ask them if they saw South Park this week. If you haven’t, check it out. Lots of Mark Zuckerberg.

But I digress. In early August of this year an infant AND 3 Adult Emergency Responders were sickened by Heroin laced with CARFENTANIL, an analogue that’s 5,000 times stronger then Heroin. Touching or breathing in just a couple of salt sized granules of carfentanil kill an adult male.

But don’t worry congress, because as we speak, in China tons of this are being produced in dirty warehouses whose owners refer to them as labs, and then shipped in in 55 Gallon Drums to South America where it’s being pre-added to heroin.

I could care less if I get some negative comments for this post because some genius thinks that I’m writing this about politics. Put it this way, I barely scratched the surface on this issue especially about these infants dying, or left in a home or vehicle with dead parents. Anyone who wants to take a shot at me because of they are too damaged to be comfortable with themselves, have at it. Hopefully, you wind up in the Centipede.

Seriously, this story has been breaking all week in pieces and when you add all the other information I have or am aware of regarding the opioid epidemic, it’s going to take a lot more than a blog post just to organize the issues. Given the time sensitivity, with the Washington Post Article out now and 60 Minutes airing tonight, I just wanted to get something posted.

It’s a developing issue, and this epidemic is going nowhere so stay safe and take care of yourself and know where your kids are as well as who they’re hanging out with and you’ll get more from me as this develops further.

Take it light!

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MANY! This post will be updated to appropriately cite all references.


Depression & Suicide: A Match Made in Hell

Did a High Dose of A Benzodiazepine Put Chris Cornell in a Psychiatric or Psychotic Episode Likely Amnesiac?

Plus Excepts from The Rolling Stone Interview as “Superunknown” Turns Twenty:  Clear Evidence of a Musical Genius’ Tortured Soul



In 2014 Soundgarden, and their frontman, Chris Cornell sat for an extensive interview with Rolling Stone Magazine as it was the 20 year anniversary of the band’s hugely successful album, ‘Superunknown,’

He discussed a wide array of topics including topics including Depression, Isolation, Suicide. and the death of his friend Andrew Wood as well as the death of Kurt Cobain. Here are but a few excerpts that give insight into the musician’s psyche and the darkness he struggled with.

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Chris Cornell Acoustic Cover of Prince’s “Nothing Compares 2 U”

Coincidentally, the first ever “Guidelines for the Recognition and Management of Mixed Depression” were published in the April edition of Cambridge University Press’s CNS Spectrum, a peer-reviewed academic journal “covering all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology.” Cambridge University Press is one of the largest and most prestigious academic publishers in the world publishing 360 peer-reviewed academic journals and more than 30,000 ebooks for the global market” (Cambridge University Press, 2017).

These guidelines were authored by a panel of 18 experts in the above mentioned fields of Psychiatry, Neurology and Neuropsychiatry, from top medical schools across the United States, Canada, as well as the UK, Sydney, Italy, Spain and Japan. To say that these guidelines are overdue is beyond an understatement as 70% of the prescribed anti-depressants are dispensed by General Practitioners and others practicing areas of medicine other than Psychiatry.

I’ll elaborate more on this topic and the role Benzodiazapines may have played in Chris Cornell’s death, after the following excerpts from the Rolling Stone Interview with Chris Cornell from 2014 which follows immediately:

Chris Cornell: The Rolling Stone Interview
In 2014, Soundgarden issued a 20th anniversary edition of their landmark ‘Superunknown’ album. To mark the occasion, frontman Chris Cornell sat for two extensive, revealing interviews with Rolling Stone to reflect on how the record was made, his mixed feelings on grunge and where his head was at when the band was at its biggest.

Rolling Stone:   What was your headspace at the time of ‘Superunknown?‘
Chris Cornell:   A lot of the lyrics are dark. I don’t know if I would say I was in a particularly dark or moody headspace more than other times. I feel the lyrics have to be born from the music. Or if I had a lyrical idea, separate from Soundgarden music, I knew if it would work with the band because it tended to reflect what the music was and what the feeling of the music was – which was usually somewhat dark and somber or moody, or over-the-top, visceral, aggressive angry.

RS:   So it wasn’t an especially dark time?
CC:   No, not that I remember. No more than usual. I think that I always struggled with depression and isolation, so those could come out. I think that the mood of Seattle to me, and the way that I always interpreted that mood was something that was always a little bit introspective and dark. And I wouldn’t say “depressing,” but introspective in a way that could be moodier and darker.

RS:   This reissue includes several versions of “Fell on Black Days,” which is pretty dark. What inspired it?
CC:   Well, I had this idea, and I had it for a long time. I’d noticed already in my life where there would be periods where I would feel suddenly, “Things aren’t going so well, and I don’t feel that great about my life.” Not based on any particular thing. I’d sort of noticed that people have this tendency to look up one day and realize that things have changed. There wasn’t a catastrophe. There wasn’t a relationship split up. Nobody got in a car wreck. Nobody’s parents died or anything. The outlook had changed, while everything appears circumstantially the same. That was the song I wanted to write about.

No matter how happy you are, you can wake up one day without any specific thing occurring to bring you into a darker place, and you’ll just be in a darker place anyway. To me, that was always a terrifying thought, because that’s something that – as far as I know – we don’t necessarily have control over. So that was the song I wanted to write. It just took a while.

RS:   The song you workshopped the most was “Like Suicide.” In the liner notes, you say it kind of became a metaphor for how you were feeling at the time about late Mother Love Bone frontman Andy Wood.
CC:   Yeah, the lyrics were actually this simple moment that happened to me. I don’t know that I ever directly related it to Andy, though there are a lot of songs that people probably don’t know where there were references to him or how I was feeling about what happened with him. I just think that that was something that happened to me that was a traumatic thing and that I had a difficult time resolving it. I still never really have. I still live with it, and that’s one of the moments where maybe in some ways it could have shown up, but I’m not really sure specifically where.

RS:   You said the lyrics were literal?
CC:   Yeah, the narrative is not a metaphor. It’s a big moment that happened while I was recording the song. I had all the music and was recording a demo arrangement in my basement. And when I came upstairs, I heard a thud against the window, and it was a female robin that had fallen into the window and broke her neck, and was just laying there. I didn’t know what to do. So I ended up smashing her with a brick, putting her out of her misery. I didn’t want to sit there and watch her suffer. Then when I went back down to finish recording, I decided that would be the lyrics to the song. As much as it sounds like I’m singing about a person and the metaphor is sort of the bird in flight and then [it] dies … it was literal [laughs].

RS:   About a month after ‘Superunknown’ came out, Kurt Cobain died. How did it color that time for you?
CC:   I wasn’t one of his close friends……It was something in a way similar to losing Andy, or losing friends that died after that. It’s not so much the person and the relationship with them, but the creative inspiration that person has and I would get from that person. My perception of the world of music at large artistically shrank, because suddenly this brilliant guy was gone. I’m not even talking about what he meant culturally; I’m talking about his creativity. It was super inspiring from the very first demo I ever heard. It broadened my mental picture of what the world was creatively, and suddenly a big chunk of it fell off.

RS:   And that’s how you felt about Andy?
CC:   Yeah. The tragedy was much more than the fact that I would never see him again – it was that I would never hear him again. There’s this projection I had with Andy, Kurt, Jeff Buckley and other friends of mine that died of looking into the future at all these amazing things they’re going to do. I’ll never be able to predict what that is. All this music that will come out that will challenge me and inspire me – that sort of romantic, dramatic version of the perspective. When that goes away, for me in particular, it was a really hard thing. And it continues to be a hard thing.

RS:   There’s a large part of Soundgarden history, to me, that’s wrapped up in that conflict of losing these incredible creative lenses of what I imagine is this incredible, infinite world of the power of creativity. These were people, and people you could share experiences with while you’re learning what your power of that creativity is.

CC:   So part of my memory of every record, and certainly Superunknown, there’s an eeriness in there, a kind of unresolvable sadness or indescribable longing that I’ve never really tried to isolate and define and fully understand. But it’s always there. It’s like a haunted thing.

Then there were these miraculous moments existing around a similar time, one of which is Eddie [Vedder] showing up and starting a new band with your friends that just lost this amazing person and having that creative output and outpouring be so phenomenal. The degree to which it changed the face of rock music in the world is this pretty incredible thing. There were these huge, amazing ups, but also these difficult conflicts I’ve never been able to resolve.

Chris Cornell’s wife Vicky issued a statement speculating whether his suicide was the result of too much anxiety medication which I’ll explain and illustrate why this is a plausible reason.

Mixed Depression (cont):
As stated above, and it bears stating it again, that 70% of all anti-depressants prescribed are not by Psychiatrists. That’s a frightening number as more than a third of adults diagnosed with MDE (Major Depression / Major Depressive Episodes – and related disorders have depression with mixed features. In other words, other significant symptomology presents itself episodically, which can include such issues as mania, psychosis and often suicidality, which can be manifested in suicidal ideation, suicidal intent, plan, and/or gestures as well as engaging in high-risk and self-harmful behavior .

For kids with depression the number is far greater, with the majority of youths diagnosed with Major Depression experiencing mixed episodes. It’s what the panel refers to as the rule, not the exception.

The guidelines state clearly what many of us in the mental healthcare field know, that the “classic point of view” of patients with MDE (Major Depressive Episodes) with mixed features and the treatment of such individuals has long been outdated.  That point of view is based on initially treating patients presenting with any depressive episodes with anti-depressants, regardless if other symptoms are present. Hence the 70% of anti-depressants prescribed are done so by clinicians other than Psychiatrists.  For many who do not specialize in mental health, the first line of treatment has been shown to be dispensing antidepressants which can make the patient much worse, kicking them into mania rendering them vulnerable for self-harm, high-risk behavior or worse.

While I agree that antipsychotics have their problems, these days there are a much wider and greater range of both antipsychotics, atypical and otherwise as well as a much wider range of mood-stabilizers, which taken together has a strong track record in treating patients with Bipolar Disorder (and related disorders), especially as it relates to harm reduction.  The problem is that psychotropic medications are trial and error.  It’s not like antibiotics or medications for the treatment of illness in other areas of the body outside of the brain.

The guidelines also encourage clinicians to think about the possibility of mixed features in ALL patients with depression.  “You will not know if a depressed patient has (hypo) manic symptoms or a positive family history of bipolar disorder unless you ask. Ask every patient. Every time,” the panel advises.

“If you only look for depression, simultaneous symptoms of mania will be missed. And even with low levels of mania symptoms, you shouldn’t give an antidepressant, at least not first-line,” said Dr. Stephen Stahl, lead author.

These guidelines represent “expert consensus” on recognizing and treating mixed depression and is also a “call to action – that is, let’s do the best we can with the data that are available,” Stahl added.

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Audioslave Live in NYC on top of the Ed Sullivan Theatre – Letterman Show

Benzodiazepines & Self-Harm:
Chris Cornell, A High Dose of Lorazepam & A Possible Psychotic Episode?
Back to the loss of Chris Cornell. It’s no surprise that Mood Disorders have a high rate of co-morbid substance abuse disorders as well. Cornell, who had long been sober alarmed his wife the night he died, as he was slurring his speech while on the phone with her back at the hotel after performing. In her statement, Vicki Cornell elaborated that Chris’ bodyguard, is responsible for controlling and giving Chris his dosage of his prescription of the Benzodiazepine, Ativan (the brand name for Lorazepam), a controlled substance in the same family as Valium, Xanax, Klonopin, and many others.

Lorazepam has been considered by some Psychiatrists to pose less potential for abuse than other Benzodiazepines, especially for those who have a history of alcohol and/or substance abuse. In fact, Ativan is dispensed in emergency rooms, intravenously to treat acute alcohol withdrawal, preventing the potential neurological symptoms related to acute alcohol withdrawal which can be deadly.

That said, responsible Psychiatrists may treat anxiety with a Benzodiazepine, while many opt for a non-narcotic alternative, or permitting the controlled substance as part of a short-term course of treatment with the intention of titrating the dosage down before the patient begins to build up a tolerance which can lead to a pattern of abuse. Although Ativan has a much longer half life than other Benzodiazepines, such as Xanax, it still comes with very serious potential side effects.

Metaphorically, for a recovering alcoholic this classification of medication can open up some doorways and paths in the brain not active since the individual had achieved a period of sustained recovery / abstinence from alcohol. Benzodiazepines can cause the worsening of depression and have a paradoxical effect, causing excitement, and not necessarily the good kind, but aggression and severe lapses in memory and judgment. Individuals with a prior alcohol problem are specifically mentioned as a group that is at risk for experiencing these paradoxical negative side effects.

Lorazepam has been found to have a longer term effect on memory than other similar medications. Paradoxical effects are more likely to occur with higher doses, in patients with pre-existing psychiatric illness. Such memory impairment often exists at least 6 months after the use of the medication is discontinued.

Part of this paradox is that stimuli may trigger such reactions, despite the fact that the drug may have been prescribed to help the patient cope with such stressors and frustration in the first place. Paradoxical effects appear to be dose-related, meaning they are more likely to occur in a patient who ingested a higher dose than what is typically prescribed. Chris reportedly told his wife when asked about his slurred speech that he “may have taken an extra Ativan or two.”

Sadly, Benzodiazepines sometimes unmask suicidal ideation in depressed patients, possibly through disinhibition or fear reduction. The concern is that benzodiazepines may inadvertently become facilitators of suicidal behavior. Dosing guidelines indicate that lorazepam should not be prescribed in high doses and not as the sole treatment of anxiety or depression, but only with an appropriate antidepressant and/or other non-narcotic psychotropic medication(s).

Suicide in a Likely Amnesiac State?
So, from everything I had gathered about Chris Cornell before his shocking and far too early death, was that he struggled with alcohol and substance abuse years ago but had been sober many years and was a very devoted family man. Most recently, he flew home for the day, to celebrate Mother’s Day, spending time with his wife and two daughters whom he is quoted many times as being truly and utterly devoted to. My heart breaks for his family. A vocalist with a 4 octave range, he was known to be prouder for his status as a father. The world lost a great artist and worse, his wife and daughters lost their husband, father, and best friend.

"Tinker Bell And The Great Fairy Rescue" - Special Screening & Picnic

Chris Cornell with his two daughters several years ago.

For such a talented musician, voacalist and frontman of some of the most successful, powerful, and beloved bands, as well as a successful soloist, Chris Cornell was a humble man about his talents.  In the below video he could have easily outshined Linkin Park’s Chester Bennington, but instead harmonized during Chester’s vocals assuring that he didn’t steal the spotlight with his amazing four octave ranging voice.

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Linkin Park & Chris Cornell – “Crawling” Live

His music will live on and I’m grateful to have seen him perform live both with Soundgarden and as a solo performer. After learning of his death I watched YouTube videos of some of his performances. One in particular stood out. He was performing at the Beacon Theatre in NYC in 2015, playing guitar and singing backup vocals for one of his daughters as they covered Bob Marley’s ‘Redemption Song.’ He clearly and intuitively made sure to take a back seat to his daughter’s vocals. What was clear to me as I watched this performance, was that I probably never saw him look happier. I hope he is in a better place free of the turmoil and distress that plagued him throughout his life beginning with a well documented and painfully difficult childhood.

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Chris & Toni Cornell Cover Bob Marley’s “Redemption Song” – The Beacon Theatre

As I listened to his music almost non-stop over the past two days, his lyrics relating to sucidality chilled me, from the Soundgarden song, “Like Suicide” to the lyrics of the band’s “Blow Up The Outside World” (See Below Video – Soundgarden Live in London’s Hyde Park – 07/13/2012). The lyrics for that song, which taken in the context of Chris’ death, are particularly upsetting as I can’t help but wonder how much he suffered quietly, yet another senseless victim of the silent assassin of untreated or inappropriately treated and rarely discussed wrath of mental illness.

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Soundgarden – “Blow Up The Outside World” – Live in London’s Hyde Park 07/13/2013

If you know someone you are concerned might want to hurt themselves or someone else as a result of emotional or mental disturbance, you must say something. Contact a professional. Call the Suicide Lifeline and you’ll be connected to a mental health professional. It’s ok to call when there is not an emergency. If this is not an emergency situation, feel free to contact me anytime. I’m always pleased to help those in need either directly or by connecting them with the proper level of treatment.

Below is information as to how you can get help for yourself or someone else who you are concerned might be a danger to themselves or someone else. Take a minute and save this information as precious minutes save lives.

With grief and hope,

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If the matter is an emergency, do not contact me – precious minutes save lives!
Instead, please call 911 or go to your nearest Emergency Room!

National Suicide Prevention Lifeline: 1 (800) 273-TALK (8255)
(Even and especially if you or the person you are concerned about is not care not considering hurting yourself as you’ll get in touch with a counselor regardless when you call).

Callers are connected to a skilled, trained counselor in their area.
These professionals are available 24/7, and Spanish Speaking Professionals are available as well.
A wealth of information on suicide prevention and related topics from domestic abuse, bullying, dealing with distress from events of mass violence, and much more can be found at their website: www.suicidepreventionlifeline.org

There is no shame in having a problem, especially if you do something about it. Calls to the the lifeline are FREE and CONFIDENTIAL.

Again, for more information, either call the above number or visit them online at:
Don’t worry if by calling the Lifeline, that you might be over-reacting.  In fact the following message from their site indicates that you SHOULD call, without hesitation, if you or someone you know are in crisis:

“If you feel you are in a crisis, whether or not you are thinking about killing yourself, please call the Lifeline. People have called us for help with substance abuse, economic worries, relationship and family problems, sexual orientation, illness, getting over abuse, depression, mental and physical illness, and even loneliness.”
National Suicide Prevention Lifeline – Retrieved from: www.suicidepreventionlifeline.org


Edwards RA, Medlicott RW (1980). “Advantages and disadvantages of benzodiazepine prescription.” New Zealand Medical Journal, 92(671): 357–359.

Goldney RD (1977). “Paradoxical reaction to a new minor tranquilizer.” Medical Journal of Australia, 1(5): 139–140.

Grow, Kory. Chris Cornell Looks Back on 20 Years of Soundgarden’s ‘Superunknown’. RollingStone.com/Music. Retreived from: http://www.rollingstone.com/music/news/chris-cornell-looks-back-on-20-years-of-soundgardens-superunknown-20140527

Riker RR, Fraser GL (2005). Adverse events associated with sedatives, analgesics, and other drugs that provide patient comfort in the intensive care unit. Pharmacotherapy, 25(5 Pt 2): 8S–18S.

Scharf MB, Kales A, Bixler EO, Jacoby JA, Schweitzer PK (1982). Lorazepam-efficacy, side-effects, and rebound phenomena. Clinical Pharmacology and Therapeutics, 31(2): 175–179.

Stahl, S., Morrissette, D., Faedda, G., Fava, M., Goldberg, J., Keck, P., . . . McIntyre, R. (2017). Guidelines for the recognition and management of mixed depression. CNS Spectrums, 22(2), 203-219. doi:10.1017/S1092852917000165

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“The world is locked in a struggle between love and fear. Choose love. It is the world’s oldest medicine.”

The above quote was posted by Vivek Murthy, MD, better known as the Surgeon General soon after surprisingly being removed from the position despite having served only half of his 4-year term.

This is not a piece about politics as the Surgeon General position is one of the few that historically is not replaced when the the President who appointed them leaves office and a new administration even from the opposing party steps into power. Often that Surgeon General finishes out their term and the respect and importance of the position transcends party lines for the sake and health of Americans.

Certainly in the few instances when there has been such a change, that Surgeon General was not suddenly removed without notice changing the current SG from one moment to the next. I’m not aware of this occurring as it did in this case without a new Surgeon General stepping in to immediately provide some sort of stable continuity. Dr. Murthy was replaced by a temp. An “acting” Surgeon General who has to fill this giant role temporarily while a new Surgeon General is appointed by the President. At this point it is unknown whether there is a candidate in mind.

For now, the temporary Surgeon General is Sylvia Trent-Adams, RN, PhD, who fills this role (temporarily) coming from her position as the Deputy Surgeon General. I hope her experience serving as Deputy to Dr. Murthy, preserves the basic and historic tenants which were at the foundation of his abbreviated time as the Surgeon General.

The news about Dr. Murthy, only 39 but accomplished way beyond his years, was released in a not-so-glowing manner, except the often obligatory throw-in sort of compliment. The Department of Health and Human Services announced on Friday that Dr. Murthy was “asked to resign and was relieved of his duties” after reportedly “assisting the new administration in its transition.” I wonder how long this aiding in the transition lasted given that Dr. Murthy was surprised to be removed and with Dr. Georges Benjamin the Executive Director of the American Public Health Association reacting with surprise, going on to say, “I knew he anticipated completing his four years. He was expecting to do that.”

Dr. Benjamin continued to state that the Trump Administration’s removal of Dr. Murthy “is another way of politicizing the job, which is in appropriate.” Benjamin continued by stating, “the reason why the Surgeon General has a term [often not coinciding with that of the President] is to depoliticize the position.”

While the HHS did not provide a reason for relieving Dr. Murthy of his position, speculation includes and is focused on both his role in helping lead a successor group, “Doctors for America” that supported passage of the Affordable Healthcare Act and because of his declaring gun violence a public health issue. The latter of which enraged the NRA and its congressional allies.

Dr. Murthy accomplished a great deal in his abbreviated time as Surgeon General injecting a realistic view of the state of health related matters in America as well as injecting a youthful energy and proactive conduct.

He went after one of his top priorities as SG, which he referred to as “tobacco and drug free living,” by sending a letter in November of last year to more than a million prescribers of controlled substances, asking them to help battle the opioid epidemic through better prescribing habits (as a start).

That same month he released the historical report, “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health,” which was so comprehensive and truly tailored to Americans across the board, as the historic Report explained, in clear and understandable language, the effects on the brain of alcohol and drugs and how misuse can become a disorder.

It described the considerable evidence showing that prevention, treatment, and recovery policies and programs really do work providing examples. The Report also discussed opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person’s overall health, rather than a substance misuse or a physical health condition alone or in isolation. Additionally, it also provided further suggestions and recommendations for action that everyone—individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers—can take to prevent substance misuse and reduce its consequences Throughout, the Report provides examples of how individuals, organizations, and communities can partner to lessen and eliminate substance misuse. The report was adamant that these efforts have to start now.

This report was considered the most important and aggressive positive report by a Surgeon General on a Health Crisis while simultaneously providing solutions through all ranks of society since the landmark report on smoking issued in 1964.

Dr. Benjamin further expressed his disappointment saying that, “I thought he [Dr. Murthy] was visible on all the right issues.”

Along with the quote at the headline of this post, Dr. Murthy shared some brief but poignant reflections on his equally brief tenure as Surgeon General.

On his Facebook page, he wrote, “”For the grandson of a poor farmer from India to be asked by the president to look out for the health of an entire nation was a humbling and uniquely American story,” he wrote. “While I had hoped to do more to help our nation tackle its biggest health challenges, I will be forever grateful for the opportunity to have served.”

He listed a number of lessons he picked up on the job.

“We will only be successful in addressing addiction — and other illnesses — when we recognize the humanity within each of us,” he wrote. “People are more than their disease. All of us are more than our worse mistakes.”

Despite being publicly removed from a position which usually leaves politics out of the way (to the extent one could hope for), he remained positive and humble, wrapping up his thoughts with his quote that bares repeating, “The world is locked in a struggle between love and fear. Choose love. It is the world’s oldest medicine.”

Dr Murthy added in closing that, “the nation will be in capable and compassionate hands” with Dr Trent-Adams taking over as acting surgeon general.

I’m optimistic she will perform the role well, and was moved by her introduction to the above mentioned report released in November.

A 24-year veteran of the USPHS Commissioned Corps, Dr Trent-Adams has served as chief nursing officer of the USPHS and the deputy associate administrator for the HIV/AIDS Bureau in HHS. Before joining the USPHS Commissioned Corps, she was a nurse in the US Army and a research nurse at the University of Maryland.

She certainly will have her hands full, especially with the knowledge that at any tine, she too will be removed as her temporary role as Surgeon General has not been given a timeline beyond stressing that it is indeed temporary.

I have faith in her and hope she’s allowed the freedom necessary to perform the duties required. My faith is increased somewhat. I mean, after all she did go to University of Maryland.

Despite my attempts at making this news a little more light hearted, as a Clinician and a Parent, I worry about the future of healthcare across all disciplines. I’ll save some of the other disturbing news for another time and take this moment to thank Dr. Murthy for a job well done. It’s just too bad he got removed as he was really beginning to enlighten the public while attempting the next phase of his plans to impact us all for the better.


Like it has been and continues to be said in many 12-Step Programs and Treatment Facilities for many years across the world, “More will be revealed.”

Medscape, Vivek Murthy, MD, Replaced as Surgeon General.

Mounteney, J., Griffiths, P., Sedefov, R., Noor, A., Vicente, J., & Simon, R. (2015). The drug situation in Europe: An overview of data available on illicit drugs and new psychoactive substances from European monitoring in 2015. Addiction, 110 (11).

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016.

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ADHD’s Failing Formula = Ignore Behavioral Guidelines + Meds = Frustration [Circular Reference]


In 2011, the American Academy of Pediatrics (AAP) released clinical practice guidelines for the diagnosis, evaluation, AND treatment of ADHD in Children and Adolescents. Those guidelines advise clinicians to consider these youths as having special health care needs and specifically emphasize psychological services including behavioral therapy be used as first-line therapy.

A new report from the Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia, states that only 55% of Children and Adolescents with the disorder receive some sort of psychological service that may include behavioral therapy. The investigators at the CDC failed to find any increase in the use of psychological services overall. In fact, they found a small decrease in the percentage of children and adolescents receiving psychological services since the release of these guidelines in 2011.

According to the CDC, opportunities for children and adolescents especially those recently diagnosed with ADHD, to receive behavioral therapy, (which can be just as effective as medicine but without the risk of side effects) are being missed.

Investigators examined claims data from 5 to 7 million youths who were insured by Medicaid between 2008 and 2011 along with claims data from another million children who were insured through employer-sponsored insurance, the most common form of private insurance.

For the second year in a row, there has been an increase in the number of children and adolescents being treated with psychotropic medications overall, with….Wait for it….. ADHD medications compromising the majority of this increase in males. Over these past 2 years, there has also been an increase in Mental Health and/or Substance Abuse Treatment hospital admissions. Although the rate of growth for these hospital admissions is equal amongst girls and boys, girls continue to significantly outnumber boys in these hospital admissions.


DISCLAIMER:  Please know, I’m not hating on Meds.  They’ve come a long way and are a crucial part of many patients’ treatment.  Medication alone for the treatment ADHD is short sighted and has the potential to do more harm than good.   Oh yeah, it also goes against recommended treatment guidelines too.

According to a report published the Centers for Disease Control and Prevention, more than 6.4 million US children aged 4–17 years have had attention-deficit/hyperactivity disorder (ADHD) diagnosed. The percentage of US children diagnosed with ADHD has increased by 3%–5% per year since the 1990s. Relatedly, the percentage of children in this age group taking ADHD medication also has increased by about 7% per year from 2007–2008 to 2011–2012.

According to a report published the Centers for Disease Control and Prevention, more than 6.4 million US children aged 4–17 years have had attention-deficit/hyperactivity disorder (ADHD) diagnosed. The percentage of US children diagnosed with ADHD has increased by 3%–5% per year since the 1990s. Relatedly, the percentage of children in this age group taking ADHD medication also has increased by about 7% per year from 2007–2008 to 2011–2012.

Regardless of whether they are covered by Medicaid or employer-sponsored insurance, about 75% of children who are diagnosed with the disorder receive some sort of psycho-stimulant medication, the report indicates. Similar studies found the same trend in adolescents as well as children.

Examining the latest data from 2014, analyses indicated that for young children with ADHD who were covered under employee-sponsored insurance, 42% received some form of psychological service and that 76% received medication for ADHD.

To put it in clearer terms, less than half of children covered by employer-sponsored insurance in care for ADHD receive any form of psychological services. Increasing referral and availability of appropriate behavioral services could help many families with young children who have ADHD.

Behavioral Therapy is a form of treatment in which parents learn specific ways to help improve their child’s behavior. Children and adolescents with ADHD have challenging behaviors, and by the time their parents get to clinicians, they are tired and worried about their child. “It’s like having your own personal coach for dealing with challenging behaviors,” according to Dr. Georgina Peacock, director of the CDC’s Division of Human Development and Disability. “Behavioral therapy is a form of treatment in which parents learn specific ways to help improve their child’s behavior,” she added.

Behavioral therapy, as recommended by the AAP, strengthens the relationship between the parent and the child, while giving parents more effective tools for helping their child learn positive behaviors.

A Behavioral Therapist teaches parents how to provide positive attention and to set and communicate rules. Parents who use these strategies report that their child does learn to control their behavior better, and this, in turn, helps the child not only at home but at school and in the child’s relationships with others.

It’s important that parents understand that Behavioral Therapy does take some (often a lot of) work, time, and effort.  The painstaking efforts are often monumental and can change a child’s life trajectory, and these benefits can be lifelong.  It is a proven tool that can make a huge difference for a young child with ADHD.

It’s also important to remember that contrary to convention, the condition does not necessarily represent a learning impairment as much as it does a decision-making impairment according to a comprehensive evaluation of the neural processes of children with attention-deficit/hyperactivity disorder (ADHD) carried out by researchers at the University Clinics for Child and Adolescent Psychiatry, University of Zurich and University College London’s Wellcome Trust Centre for Neuroimaging. The scientists utilized functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) simultaneously. The combination of the 2 modalities allows for an evaluation that overcomes the weaknesses of either method.

One of the challenges in providing behavioral training to parents is that in many areas, there are no trained professionals to deliver the therapy. Parents may also lack the resources or insurance coverage to participate in behavioral therapy training.

According to Dr. George DuPaul a leading researcher of ADHD in Children at Lehigh University, “There is clear evidence, based on many controlled studies…that behavioral parent training should be the first choice for treating ADHD in young children.”

“When behavioral parent training is implemented consistently, it can lead to greater parent understanding of behavioral principles, increased use of positive parenting strategies, and enhanced parent-child relationships, and it may delay initiation of stimulant medication as well,” he added.

The mental health community along with pediatricians should respond to this issue by educating parents, as pediatricians tend to be the first line of healthcare for young children and often know these children since birth. Additionally, perhaps it’s time for revising the treatment guidelines to better communicate this issue with pediatricians and mental health clinicians. I’ve seen countless children who are brought to me for treatment after the ADHD medications that some pediatricians prescribe lack the efficacy required to break the circular reference and improve life for the entire family.
If your child or adolescent has ADHD and is 5 years old or older, feel free to contact me to schedule a consultation.



Gleason, M.M., et al. (2007). Psychopharmacological Treatment for Very Young Children: Contexts and Guidelines. Journal of the American Academy of Child and Adolescent Psychiatry, 46(12) 1532-1572.
DOI: 10.1097/chi.0b013e3181570d9e
Retrieved from:

Hauser TU, Iannaccone R, Ball J, et al. (2014). Role of the Medial Prefrontal Cortex in Impaired Decision Making in Juvenile Attention-Deficit/Hyperactivity Disorder. JAMA Psychiatry, 71(10):1165-1173. doi:10.1001/jamapsychiatry.2014.1093.
Retrieved from:

Public Health Law Research, (2015) Prior Authorization Policies for Pediatric ADHD Medication Prescriptions.
Retrieved from:

Subcommittee On Attention-Deficit/ Hyperactivity Disorder, Steering Committee On Quality Improvement and Management. (2011). ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/ Hyperactivity Disorder in Children and Adolescents. Pediatrics, 128(5), 1007-1022.
Retrieved from:

Visser SN, Danielson ML, Wolraich ML, et al. (2016). National and State-Specific Patterns of Attention Deficit/Hyperactivity Disorder Treatment Among Insured Children Aged 2–5 Years — United States, 2008–2014. Vital Signs, 65(17);443-450.
DOI: http://dx.doi.org/10.15585/mmwr.mm6517e1.
Retrieved from:

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US Suicide Rates Are At A 30-Year High

May Is Mental Health Awareness Month and it couldn’t have come at a more crucial time.

Consider that currently in the US:
– 1 in 4 Americans are living with Mental Illness.
– 22 Million Americans have a substance use disorder.
– Suicide in the United States has surged to the highest levels in nearly 30 years
– Treatment Guidelines for ADHD in Children and Adolescents continue to be ignored (More on this in an upcoming post).


As mentioned above, Suicide in the United States has surged to the highest levels in nearly 30 years according to a recent report released by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention, Department of Health and Human Services.

Increased instances of suicide from 1999 to 2014 were found in every age group except older adults. The rise was particularly steep for women and quite substantial among middle-aged Americans. The rise among middle-aged Americans is particularly alarming when one considers this group’s suicide rates had been stable or falling since the 1950s

The suicide rate for middle-aged women, ages 45 to 64, jumped by 63% over the period of the study (1999-2014), while it rose by 43% for men in that age range (the sharpest increase for males of any age). The overall suicide rate rose by 24% during this same period, according to the report.

The increases were so widespread that they lifted the nation’s suicide rate to 13 per 100,000 people, the highest since 1986. This rate rose by 2 percent a year starting in 2006, double the annual rise in the earlier period of the study (1999-2005).

42,773 people died from suicide in 2014, compared with 29,199 in 1999.

Researchers also found an alarming increase in suicides among girls 10 to 14, whose suicide rate is still very low amongst groups, but has tripled according to the report. The number of girls in this age group who killed themselves rose to 150 in 2014 from 50 in 1999

White middle-aged women are another group who saw their suicide rate increase tremendously, over 80%

African-Americans were the only racial group that saw a decline in their suicide rate. However, this decline was only found for one age group; African-American men and women over 75.

In terms of gender, again the above mentioned increase in suicide amongst women has narrowed the gap between the genders due to the women’s rates increasing faster than men’s. That said, men still kill themselves at a rate 3.6 times that of women. Although suicide rates for older adults fell over the period of the study, men over 75 still have the highest suicide rate of any age group — 38.8 per 100,000 in 2014, compared with just four per 100,000 for their female counterparts.

The rise in suicide rates has happened slowly over many years. According to the Federal Health Researchers responsible for the study, they said they chose 1999 as the start of the period they studied because it was a low point in the national suicide rate and they wanted to cover the full period of its recent sustained rise. The federal health agency’s last major report on suicide, released in 2013 found a sharp increase in suicide among 35 to 64-year-olds. But the rates have risen even more since then — up by 7% for the entire population since 2010, the end of the last study period.


There is some debate as to the reason(s) behind the increased suicide rates. For example, researchers at the Robert Wood Johnson Foundation, have identified a link between suicides in middle age and rising rates of distress about jobs and personal finances.

Other recent research has highlighted the plight of less educated whites, showing surges in deaths from drug overdoses, suicides, liver disease and alcohol poisoning, particularly among those with a high school education or less. The new above mentioned report did not break down suicide rates by education, but researchers who reviewed the analysis said the patterns in age and race were consistent with that recent research and painted a picture of desperation for many in American society.

Policy makers say efforts to prevent suicide across the country are spotty. While some hospitals and health systems screen for suicidal thinking and operate good treatment programs, many do not.

Funding may play a role as well. While the NIH’s funding for suicide prevention projects had been relatively flat — rising to $25 million in 2016 from $22 million in 2012 — it was a small fraction of funding for research of mental illnesses, including mood disorders like depression.

Social changes could also be raising the risks. Marriage rates have declined, particularly among less educated Americans, while divorce rates have risen, leading to increased social isolation. in 2005, unmarried middle-aged men were 3.5 times more likely than married men to die from suicide, and their female counterparts were as much as 2.8 times more likely to kill themselves. The divorce rate has doubled for middle-aged and older adults since the 1990s,

Dr. Julie Phillips, a Sociologist at Rutgers who has studied the suicide amongst middle-aged individuals, suggests another possibility as to the increase of suicides among male baby-boomers. She points to the disappointed expectations of social and economic well-being among less educated white men from that generation. “These men grew up in an era that valued ‘masculinity and self-reliance’ —characteristics that could get in the way of asking for help.”

Yet another possible explanation may be an economy that has eaten away at the prospects of families on the lower rungs of the income ladder. Dr. Alex Crosby, an epidemiologist at the Centers for Disease Control and Prevention, has studied the association between economic downturns and suicide going back to the 1920s and found that suicide was highest when the economy was weak. One of the highest rates in the country’s modern history, he said, was in 1932, during the Great Depression, when the rate was 22.1 per 100,000, about 70 percent higher than in 2014.

“There was a consistent pattern,” he said, which held for all ages between 25 and 64. “When the economy got worse, suicides went up, and when it got better, they went down.

Other experts were quick to point out that the unemployment rate in the latter period of the study had been declining, and therefore questioned how important the economy was to suicide.

If you or anyone you know is in a crisis, it’s imperative that professional help is sought. This situation is an emergency and requires immediate action. Call 911 or go to your nearest emergency room.

To schedule a consultation for non-emergency or non-crisis intervention, contact me.

If the matter is an emergency, do not contact me – precious minutes save lives!  
Instead, please call 911 or go to your nearest Emergency Room!  


National Suicide Prevention Lifeline: 1 (800) 273-TALK (8255)
(Even and especially if you or the person you are concerned about is not care not considering hurting yourself as you’ll get in touch with a counselor regardless when you call)

You’ll be connected to a skilled, trained counselor in your area.
These professionals are available 24/7 (Spanish Speaking Professionals are available).

A wealth of information on suicide prevention and related topics from domestic abuse, bullying, dealing with distress from events of mass violence, and much more can be found at their website:  www.suicidepreventionlifeline.org

There is no shame in having a problem, especially if you do something about it. Calls to the the hotline are FREE and CONFIDENTIAL.

For more information, either call the above number or visit them online at:

In fact, the following message from their site indicates that you SHOULD call if you or someone you know are in crisis:

“If you feel you are in a crisis, whether or not you are thinking about killing yourself, please call the Lifeline. People have called us for help with substance abuse, economic worries, relationship and family problems, sexual orientation, illness, getting over abuse, depression, mental and physical illness, and even loneliness.”
National Suicide Prevention Hotline – Retrieved from: www.suicidepreventionlifeline.org

J. Am. Acad. Child Adolesc. Psychiatry, 2007;46(12):1532Y1572.

www.pediatrics.org/cgi/doi/10.1542/peds.2011-2654. doi:10.1542/peds.2011-2654

Tavernise, S. (2016). “U.S. Suicide Rates Rates Surge to a 30-Year High” New York Times
Retrieved From: http://nyti.ms/212FMnr
Permalink: http://nyti.ms/26iji5S

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September Is National Recovery Month

Substance use disorders continue to be misunderstood and outside of few circles, are rarely spoken about. However, in a given year, substance use disorders will impact 22 MILLION people in the United States.

  • Research shows that family support plays a major role in helping to prevent mental illness and/or substance use disorders.
    • Family members can help identify when someone has a problem and connect them with the treatment, resources, and services they need to begin and stay on their recovery journey.
  • In 2013, 8.8 percent of youth aged 12 to 17 were current illicit drug users and 11.6 percent were current alcohol users.
  • Among 55.3 million adult binge drinkers, 44.0 million were employed.
  • Among the 16.4 million persons reporting heavy alcohol use, 13.1 million were employed.


Stamp Out Stigma is an initiative spearheaded by the Association for Behavioral Health and Wellness (ABHW) to reduce the stigma surrounding mental illness and substance use disorders. This campaign challenges each of us to transform the dialogue on mental health and addiction from a whisper to a conversation (Association for Behavioral Health and Wellness, 2014).


In recognition of National Recovery Month, Stamp Out Stigma will be hosting a Twitter Chat with The National Council for Behavioral Health to help spread a positive message about living in recovery. Their chats will not only raise awareness, but educate people to reduce negative perceptions of behavioral health, giving participants an opportunity to speak openly about their mental health, substance use disorders, and well-being.

Stamp Out Stigma

In the past year, millions of people have joined Stamp Out Stigma to reduce the stigma surrounding mental illness and substance use disorders. Help continue educating and motivating yourselves and others by talking about it with friends, family, and coworkers. Your story could change a life. Do you know how to talk about mental health and substance use disorders? Learn more here: stampoutstigma.com/get-educated.html.

SOURCE: Stamp Out Stigma

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