25% Off All CEU Courses Ends Tonight at PDResources

The first part of our Week of Giving Thanks – 25% Off ALL CEU Courses – ends tonight at PDResources! Check our homepage tomorrow for special a special Turkey Day treat. :)


Use coupon code Thanks2015 at checkout to enjoy 25% off all of your online continuing education needs. Valid on future orders only. Sale ends @ midnight.

Wishing you and yours all the best this holiday season.

Your friends @ PDR,
Gina, Carmen, Cathy & Leo




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Five Lies Ruining Your Mental Health

By Amy Morin

jin-li-683231_1920One in five Americans experience a mental health problem in any given year. Yet many people suffer with their symptoms in silence.

The stigma that continues to surround mental health problems prevents individuals from getting the help they need.

It’s a common problem I’ve seen in my therapy office. People often waited years to seek help. Even though their symptoms were treatable, they were afraid to tell anyone about the symptoms they were experiencing.

Some of them feared a mental health diagnosis could affect their careers. Can I still teach if I have depression? If people know I have anxiety, will they assume my business is failing? Do I need to tell my boss I’m taking medication?

Others worried that they’d get labeled as crazy. Will other parents let their children come to my home if I go to counseling? If my neighbors see me in the waiting room, will they treat me different?

Many of them had legitimate concerns. Despite ongoing efforts to educate the public about mental health, many misconceptions remain. Before the stigma can be stopped, these five mental health myths need to be debunked:

1. You’re either mentally ill or mentally healthy.

Similar to the way a physically healthy person may still experience minor health issues-like bad knees or high cholesterol-a mentally healthy person may experience an emotional problem or two. Mental health is a continuum and people may fall anywhere on the spectrum.

Even if you are doing well, there’s a good chance you aren’t 100% mentally healthy. In fact, the U.S. Department of Health and Human Services estimates only about 17% of adults are in a state of optimal mental health.

2. Mental illness is a sign of weakness.

As someone who trains people to build mental strength, I sometimes receive backlash from individuals who claim the phrase “mental strength” somehow stigmatizes mental illness. Those comments come from people who automatically assume people with depression, anxiety, or other mental health conditions are “mentally weak.”

Mental strength is not the same as mental health. Just like someone with diabetes could still be physically strong, someone with depression can still be mentally strong. Many people with mental health issues are incredibly mentally strong. Anyone can make choices to build mental strength, regardless of whether they have a mental health issue.

3. You can’t prevent mental health problems.

You certainly can’t prevent all mental health problems-factors like genetics and traumatic life events certainly play a role. But everyone can take steps to improve their mental health and prevent further mental illness.

Establishing healthy habits–like eating a healthy diet, getting plenty of sleep, and participating in regular exercise–can also go a long way to improving how you feel. Similarly, getting rid of destructive mental habits, like engaging in self-pity or ruminating on the past, can also do wonders for your emotional well-being.

4. People with mental illness are violent.

Unfortunately, when mental illness is mentioned in the media it’s often in regards to a headline about a mass shooting or domestic violence incident. Although many violent criminals are frequently portrayed as being mentally ill, most people with mental health problems aren’t actually violent.

The American Psychological Association reports that only 7.5% of crimes are directly related to symptoms of mental illness. Poverty, substance abuse, unemployment, and homelessness are among some of the other reasons why people commit violent acts.

5. Mental health problems are forever.

Not all mental health problems are curable. Schizophrenia, for example, doesn’t go away. But most mental health problems are treatable.

The National Alliance on Mental Illness reports between 70 and 90% of individuals experience symptom relief with a combination of therapy and medication. Complete recovery from a variety of mental health issues is often possible.

Getting Rid of the Mental Health Stigma

Even though suicide is the tenth leading cause of death in America, most public service announcements and government education programs focus solely on physical health issues, like cancer and obesity. Raising awareness of mental health issues and debunking the common misconceptions could be instrumental in saving lives.

Amy Morin a psychotherapist, keynote speaker, and the author of 13 Things Mentally Strong People Don’t Do, a bestselling book that is being translated into more than 20 languages.


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Posted by on November 24, 2015 in General, Mental Health



Treating PTSD With the Fear Reducing Effects of Exercise

By Jessica Glenza

mexico-88768_1920American psychologists are hoping to treat veterans with post-traumatic stress disorder (PTSD) with a recommendation so well-worn by family physicians, it almost seems mundane: exercise.

The nascent field of research has found reason to hope that physical activity can improve outcomes for those diagnosed with the persistent psychiatric disorders. Doctors hope that physical activity will eventually become part of the widely accepted psychotherapy and medication routines used to treat the condition synonymous with war that causes flashbacks, nightmares and hypervigilance.

“We’ve been studying exercise for the treatment of depression for maybe about 10 years,” said Jasper Smits, a licensed psychologist and professor at the University of Texas at Austin. His studies, as well as others by doctors such as Michael Otto, a Boston University researcher studying the impact of exercise on mood, eventually veered from studying depression and exercise to PTSD.

“It’s not always possible to go see someone who practices [cognitive behavioral therapy],” said Smits about a form of psychotherapy. “So, we thought maybe exercise has some of the same ingredients as this kind of psychotherapy.”

Some of the most widely accepted treatments for PTSD include cognitive behavioral therapy and prolonged exposure, where patients are gradually exposed to more stressful experiences. But residual symptoms of PTSD can persist even after “successful” treatment, a cause for serious concern among clinicians because PTSD can severely affect marriage and employment, and increases the likelihood that people are diagnosed with other psychiatric disorders.

“If we had people exercise for three times each week for six exercise sessions over the course of two weeks … we found that the reduction in fear in bodily sensations was about the same as we see in 12 weekly sessions for [cognitive behavioral therapy],” said Smits. “That encouraged us to do more work in this area.”

The National Institutes of Health estimates that PTSD affects 7.7 million Americans, including 11% of veterans of the war in Afghanistan and 20% of Iraq war veterans. For the Veterans Administration, this has translated to a tsunami of new PTSD cases. Between 2001 and 2007 the administration experienced a 60% increase in new cases.

Most current therapy includes a combination of psychotherapy and exposure treatment. For example, a PTSD sufferer with panic attacks might be asked to complete increasingly challenging runs, the idea being to raise the body’s overall stress tolerance.

The most prominent recent study on exercise’s impact on PTSD therapy was conducted at the US Department of Veterans Affairs itself. Dr Kimberly Babson, a researcher at the Palo Alto VA hospital in California, asked a group of 217 male veterans to cycle on stationary bikes while they underwent between 60 and 90 days of psychotherapy.

The obvious flaws of the study are worth pointing out. Patients self-reported their sleeping patterns, level of depression and PTSD symptoms. Data about cycling was collected from odometers, meaning intensity didn’t factor into findings.

In other words, the study is observational, not a clinical trial, the way most studies for new medication are conducted.

Some nonprofit groups have already incorporated this exercise research into their mission. Team Red, White and Blue, an athletics club that seeks to reconnect veterans to their communities, specifically references the power of exercise in its mission.

“At the end of the day, we want to be able to grow, but grow in a way to show we are truly impacting, enriching veterans’ lives,” said Dan Brostek, spokesman for Team RWB. “To do that we’re going to base it on science, and base it on data.”

Researchers maintain a mood of cautious optimism about the results, which found those who cycled had less severe PTSD symptoms both when they went into treatment, and when they left. “Exercise,” researchers wrote, “holds both empirical and theoretical promise.”

Theories for why positive impacts on PTSD symptoms have been observed by multiple researchers are manifold – exercise could stimulate the endocannabinoid endorphin system, and thus stimulate better sleep.

That would mean exercise triggers the same receptors as marijuana, another PTSD treatment currently being investigated. Others, such as Otto, have theorized that exercising in a team setting is therapeutic. In Babson’s study, cycling was done in a group setting, for example, and she theorized that it may have been the connections, not the actual exercise, that improved outcomes. Still others have wagered that it is exercise’s impact on sleep that aids PTSD sufferers.

“An important next step is to look at randomized controlled trials of exercise for sleep, as well as for anxiety disorders among veterans and among community members as well,” said Babson.

“The mechanism by which exercise may be impacting symptoms is something that we don’t know right now, so a lot more research needs to be done to find out what is it about exercise that might be making a difference.”

Related Continuing Education Courses

Providers, and those who listen empathically to the trauma stories of others, are at risk for reactions known collectively as vicarious traumatization (VT). This course outlines some of the basic differences between primary traumatization, secondary traumatization, VT, and compassion fatigue; discusses many of the signs and symptoms of VT; provides questions for self-assessment of VT; and provides coping suggestions for providers who are involved in trauma work or those who may have VT reactions. This course offers providers and others who listen empathically to the trauma stories of others, a basic understanding of the possible effects of “caring for others” and discusses ways to monitor oneself and engage in positive self-care.


Part I of this course provides an overview of cognitive-behavioral interventions for PTSD. It describes some basic aspects of CBT, outlines cognitive-behavioral theories of PTSD, discusses key trauma-focused CBT interventions, and provides some tips for using CBT to encourage behavior change. Additional resources related to the topic are identified. Part II has two principal objectives. First it will review the psychobiology of the human response to stress in order to establish the pathophysiological rationale for utilizing different classes of medications as potential treatments for PTSD. Second it will review the current literature on evidence-based pharmacotherapy for PTSD. New medications currently being tested will also be discussed. The speakers’ original lectures included in this course are transcribed verbatim with minor editorial modifications.


Substance abuse problems are commonly experienced by those who have experienced trauma. This course discusses the complex relationship between trauma/PTSD and substance use disorders and provides a background for understanding comorbid PTSD and substance abuse. Topics covered include assessment, practice guidelines, common issues and their implications for treatment, and empirically-based treatment considerations in traumatized/PTSD individuals.

Professional Development Resources is approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.


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Celebrate a Week of Giving Thanks at PDResources

As the holiday season swings into high gear, we at PDR would like to show our gratitude with a Week of Giving Thanks – because we are thankful for YOU.

Now through Wednesday, please enjoy 25% Off ALL CEU Courses!


Use coupon code Thanks2015 at checkout to enjoy 25% off all of your online continuing education needs, now through Wednesday. Valid on future orders only. Click here to save now. Check our home page on Thursday for a new offer!

Wishing you and yours all the best this holiday season.

Your friends @ PDR,
Gina, Carmen, Cathy & Leo


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Surviving Depression and Anxiety as a Caregiver

By Andrea M. Risi, LPC

Caregivers and Depression and AnxietyAre you caring for a family member who has a chronic illness?

Are you perhaps even part of the so-called “Sandwich Generation”—taking care of your children and your aging parents?

Be honest: are you struggling with anxiety, depression, or other mental health issues because of your caregiver role?

Caregiving can take a toll on the caregiver because of the demands a chronic illness can create. Regardless of whom you’re caring for, there’s no doubt you feel the pressure of these demands. Chronic illness is especially challenging because of daily stresses such as medication management, doctor appointments, therapies, etc., not to mention the unpredictability of symptoms. These burdens can cause caregivers to feel anxious, depressed, resentful, or even angry, all of which are normal reactions.

Caregiving can be time consuming, physically challenging, and emotionally draining. Giving of one’s time and energy can be exhausting, and many caregivers find themselves experiencing burnout. Signs of burnout, much like signs of depression, can include irritability, changes in sleep patterns, sadness or hopelessness, weight gain or loss, and withdrawal from others.

Research shows that 40% to 70% of caregivers experience anxiety and/or depression. Let’s hit that home: 10% to 12% of people in the United States report depression at any given time, so it’s significant that nearly half of caregivers report depression or anxiety. It shows just how much of a toll caregiving can take.

Is this your experience as a caregiver? How do you combat depression, anxiety, and other issues? Here are six caregiver “survival” tips:

  1. Take care of yourself first: You can’t help anyone if you’re sick, tired, or drained. You can’t pour from an empty cup! Taking time to care for yourself is of the utmost importance.
  2. Ask for help: Caregiving does not have to be just your responsibility. In fact, the more you do, the more others expect you to do. Getting support to share the responsibilities can help you avoid caregiver burnout.
  3. Be realistic: The more you know about the diagnosis, treatments, and prognosis, the more empowered you will feel. Ask your doctor questions and search the web on reputable medical websites.
  4. Access respite care: Respite care is a service that allows caretakers to have a break. The break can be from a few hours to a few days. You can also ask another family member or a friend to give you some time off.
  5. Find emotional support: Having someone to share your feelings with can help ease the burden of caregiving. You don’t have to feel alone and helpless. Find a trusted and compassionate person who allows you to talk without giving advice or judging the situation.
  6. Seek therapy: If you’re still struggling, find a therapist who is knowledgeable about chronic illness. Working with a therapist can help you learn to better cope with caregiver challenges.

There is no doubt caregiving for a family member with chronic illness can have adverse effects on the caregiver, but there are ways to combat issues such as anxiety and depression. Most importantly, caring for yourself will allow you to have the resources to continue caregiving.


Continuing Education Courses on the Topic of Caregivers

The emotional stress of caring for persons who are aging, chronically ill or disabled can be debilitating for family members as well as professional caregivers. This course addresses caregiver depression and grief and provides a three-step process that can help develop an attitude of creative indifference toward the people, situations and events that cause emotional stress. It offers suggestions for dealing with preparatory grief, an experience shared by families and professionals as they cope with the stress of caring for someone who will never get well. In the process, it also explains the differences between reactionary depression and clinical depression. By gaining insights into the process of losing someone over an extended period of time, the mental health professional will be in a better position to understand the caregiver’s experience with depression and grief and provide both empathy and strategies for implementing a self-care plan. This course includes downloadable worksheets that you can use (on a limited basis) in your clinical practice. The course video is split into 3 segments for your convenience.


This course is presented in two parts. Part 1 offers strategies for managing the everyday challenges of caring for a person with Alzheimer’s disease, a difficult task that can quickly become overwhelming. Research has shown that caregivers themselves often are at increased risk for depression and illness. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. Many caregivers have found it helpful to use the strategies described in this course for dealing with difficult behaviors and stressful situations.Part 2 includes tips on acute hospitalization, which presents a new environment filled with strange sights, odors and sounds, changes in daily routines, along with new medications and tests. This section is intended to help professionals and family members meet the needs of hospitalized Alzheimer’s patients by offering facts about Alzheimer’s disease, communication tips, personal care techniques, and suggestions for working with behaviors and environmental factors in both the ER and in the hospital room.


The emotional stress of caring for persons who are aging, chronically ill or disabled can be debilitating for family members as well as professional caregivers. This course addresses caregiver anger and guilt, and provides a three-step process that helps caregivers develop an attitude of what is described as “creative indifference” toward the people, situations and events that cause them the greatest amount of emotional stress. By gaining insights into how degenerative and progressive diseases affect the life of the caregiver, the mental health professional will be in a better position to empathize with the caregiver’s situation and provide strategies that will help them manage the stress of caring for someone whose situation will never improve. The significance of honoring and supporting caregivers’ feelings and helping them understand the importance of self-care can not only improve their physical and emotional well-being, but can also have a huge impact on the quality of care they are able to provide to their care receiver. This course includes downloadable worksheets that you can use in your clinical practice.


Caregiver Help: Sex and Dementia explores how Alzheimer’s and other dementia-related diseases impact the brain in ways that can cause some surprising, challenging and inappropriate behaviors. Some people with dementia may develop a heightened interest in sex – even to the point of aggression; experience a waning or complete loss of interest in sex; become addicted to pornography; lose the ability to understand what kind of behavior is acceptable; have a different perception of place and time and a different interpretation of reality from their caregivers; get agitated and upset when their caregivers don’t communicate with them effectively; and behave in ways that are confusing and upsetting to family members and professional healthcare workers. Even so, the patient deserves to be treated with respect and every effort should be made to maintain their dignity. The course video is split into 2 parts for your convenience.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590);  the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).


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Turn to People Not Computers when Dealing with Depression

By Lynne Shallcross

People and DepressionAlmost 8 percent of Americans 12 and older dealt with depression at some point between 2009 and 2012. With that many of us feeling blue, wouldn’t it be nice if we could simply hop on the computer in our pajamas, without any of the stigma of asking for help, and find real relief?

Online programs to fight depression are already commercially available, and while they sound efficient and cost-saving, a study out of the U.K. reports that they’re not effective, primarily because depressed patients aren’t likely to engage with them or stick with them.

The study, which was published in The BMJ on Wednesday, looked at computer-assisted cognitive behavioral therapy and found that it was no more effective in treating depression than the usual care patients receive from a primary care doctor.

Traditional cognitive behavioral therapy (CBT) is considered an effective form of talk therapy for depression, helping people challenge negative thoughts and change the way they think in order to change their mood and behaviors. Online CBT programs have been gaining popularity, with the allure of providing low-cost help wherever someone has access to a computer.

A team of researchers from the University of York conducted a randomized control trial with 691 depressed patients from 83 physician practices across England. The patients were split into three groups: one group received only usual care from a physician while the other two groups received usual care from a physician plus one of two computerized CBT programs, either “Beating the Blues” or “MoodGYM.”Participants were balanced across the three groups for age, sex, educational background, severity and duration of depression, and use of antidepressants.

After four months, the patients using the computerized CBT programs, or cCBT, had no improvement in depression levels over the patients who were only getting usual care from their doctors. “Uptake and use of cCBT was low, despite regular telephone support,” the study authors wrote. Almost a quarter of participants dropped out within four months, and patients noted the “difficulty in repeatedly logging on to computer systems when they are clinically depressed.”

“It’s an important, cautionary note that we shouldn’t get too carried away with the idea that a computer system can replace doctors and therapists,” says Christopher Dowrick, a professor of primary medical care at the University of Liverpool, who wrote an accompanying editorial. “We do still need the human touch or the human interaction, particularly when people are depressed.”

The lack of patient engagement in this study means these programs aren’t the panacea that busy doctors and cost-conscious health care officials might be hoping for, Dowrick wrote in the editorial. Yet it’s important to note that the study was conducted in a primary care setting, he says, because many other studies on cCBT that show some benefit have been conducted in psychological settings, where patients might be more motivated to engage with these kinds of online programs.

Despite the unenthusiastic findings of the study, Dowrick says that do-it-yourself treatments like cCBT can still be effective. But they’re more likely to succeed when people have relatively mild symptoms of depression or are in a recovery stage – the participants in this study were mostly in the category of moderate to severe depression, he says. Computerized CBT is also more likely to succeed, he adds, if the patients are open to seeking help on a computer and when they have a “reasonable amount” of guidance as they go through the program, preferably from a therapist. In this study, he says, participants each totaled roughly six minutes of telephone support and guidance.

Being depressed can mean feeling “lost in your own little small, negative, dark world,” Dowrick says. Having a person, instead of a computer, reach out to you is particularly important in combating that sense of isolation. “When you’re emotionally vulnerable, you’re even more in need of a caring human being,” he says.


Continuing Education Courses of Interest

Lewy body dementia (LBD) is a disease associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, movement, behavior, and mood. LBD is one of the most common causes of dementia, after Alzheimer’s disease and vascular disease. Dementia is a severe loss of thinking abilities that interferes with a person’s capacity to perform daily activities such as household tasks, personal care, and handling finances. Dementia has many possible causes, including stroke, tumor, depression, and vitamin deficiency, as well as disorders such as LBD, Parkinson’s, and Alzheimer’s. Diagnosing LBD can be challenging for a number of reasons. Early LBD symptoms are often confused with similar symptoms found in brain diseases like Alzheimer’s. Also, LBD can occur alone or along with Alzheimer’s or Parkinson’s disease. This course is intended to help people with LBD, their families, and professionals learn more about the disease and resources for coping. It explains what is known about the different types of LBD and how they are diagnosed. Most importantly, it describes how to treat and manage this difficult disease, with practical advice for both people with LBD and their caregivers.


Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness. Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression.Some types of depression tend to run in families. However, depression can occur in people without family histories of depression too. Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors. In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Other depressive episodes may occur with or without an obvious trigger.This introductory course provides an overview to the various forms of depression, including signs and symptoms, co-existing conditions, causes, gender and age differences, and diagnosis and treatment options.


What is aging? Can we live long and live well—and are they the same thing? Is aging in our genes? How does our metabolism relate to aging? Can your immune system still defend you as you age? Since the National Institute on Aging was established in 1974, scientists asking just such questions have learned a great deal about the processes associated with the biology of aging. Technology today supports research that years ago would have seemed possible only in a science fiction novel. This course introduces some key areas of research into the biology of aging. Each area is a part of a larger field of scientific inquiry. You can look at each topic individually, or you can step back to see how they fit together, interwoven to help us better understand aging processes. Research on aging is dynamic, constantly evolving based on new discoveries, and so this course also looks ahead to the future, as today’s research provides the strongest hints of things to come.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590);  the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).


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Just How Medical is Marijuana?

By Aaron E. Carroll

Medical MarijuanaIt is becoming easier to get marijuana, legally. In the last 20 years or so, 23 states, as well as the District of Columbia, have passed laws that make it legal to use marijuana for medical treatments. So have some countries, like Austria, Canada, Finland, Germany, Israel and Spain.

Advocates believe that this has allowed many with intractable medical problems to receive a safe and effective therapy. Opponents argue that these benefits are overblown, and that advocates ignore the harms of marijuana. Mostly, opponents say that the real objective of medical marijuana is to make it easier for people to obtain it for recreational purposes.

Both sides have a point. Research exists, however, that can help clarify what we do and don’t know about medical marijuana.

A recent systematic review published in The Journal of the American Medical Association looked at all randomized controlled trials of cannabis or cannabinoids to treat medical conditions. They found 79 trials involving more than 6,400 participants. A lot of the trials did show some improvements in symptoms, but most of those did not achieve statistical significance. Some did, however.

Medical marijuana was associated with some pretty impressive improvements in complete resolution of nausea and vomiting due to chemotherapy (47 percent of those using it versus 20 percent of controls). It also increased the number of people who had resolution of pain (37 percent up from 31 percent). It was shown to reduce pain ratings by about half a point on a 10-point scale, and to reduce spasticity in multiple sclerosis or paraplegia in a similar manner.

Those aren’t insignificant results and they are supported by other studies that have confirmed that marijuana and cannabinoids can help with refractory pain. But most researchers stress that they should be considered only when other therapies have failed.

There’s a little bit of evidence that marijuana might help with anxiety disorders and with sleep. The trials are at high risk of bias, though, and there are very few of them. The combined trials did not show that it helps with psychosis, glaucoma or depression. Reviews show that trials also failed to support its use for dementia, epilepsy, Tourette’s syndrome or schizophrenia.

There are also side effects of marijuana to consider. They include dizziness, dry mouth, nausea, fatigue, drowsiness, vomiting, disorientation, confusion, loss of balance and hallucination. There’s also the potential for abuse. Those need to be weighed against any benefits. Let’s be frank: There’s just no way that the Food and Drug Administration would approve any other drug with these side effects and the relatively scant evidence, mostly from small studies, of any health benefits.

Or course, arguing that no evidence currently exists is not the same as arguing that no evidence could be found. For too long, the federal government has made studying the use of marijuana nearly impossible. The Drug Enforcement Administration has classified marijuana as a Schedule 1 drug, meaning that it has no medical value and a high potential for abuse. Even if researchers jumped through the many hoops to get research approved, it was almost impossible for them to obtain the drug.
The only place scientists can get marijuana for research in the United States is the University of Mississippi, which has an exclusive contract with the federal government to grow the plant for study. Regardless of how many studies could be done, the university has until recently been allowed to grow only 21 kilograms annually, enough for about 50,000 joints.

Last year the government raised that quota to 650 kilograms. Research became even easier last month when the federal government removed an extra hurdle of approval researchers needed in order to study marijuana’s medicinal purposes.

This means that large trials, like those done by pharmaceutical companies, might be possible in the future. These will take years to complete, though. It’s still likely that for the majority of things that marijuana is prescribed for now, evidence will be unavailable for some time.
Many of the drugs that are approved for chronic pain, such as opioids, don’t have a lot of evidence supporting long-term use. These drugs are also extremely dangerous. Just recently, researchers published a paper that argued that deaths from painkillers are lower in states that have approved medical marijuana.

Because of that, marijuana’s benefits seem to outweigh the potential harms for people who have intractable nausea and vomiting caused by chemotherapy, or severe and intractable pain from chronic illnesses that won’t respond to other therapies. But people who fall into those categories are not typically the people asking for medical marijuana.

The vast majority of patients who seek a doctor’s authorization for pot do not have cancer, glaucoma or other serious illnesses. In Oregon, “severe pain” is reported as a condition requiring treatment in 93 percent of patients, while fewer than 6 percent had cancer. Most people are getting prescriptions for conditions where cannabis is not clearly effective, and for symptoms that are very subjective and potentially faked.

When Prohibition became the law of the land, one of the only ways to get alcohol was to get a prescription from a physician. In 1921, a coalition of brewers, doctors and the public tried to lobby Congress that beer was a “vital medicine.” The American Medical Association disagreed, using the same arguments they use today to argue that marijuana shouldn’t be handed out as therapy. They said it was not proved to work, that it was not a targeted therapy, that most people who asked for it didn’t meet strict criteria and that doctors should not be in the business of doling it out.

Promising research continues that might support possible use of marijuana in certain areas. For other afflictions, further research would be needed to justify any prescriptions. Should marijuana become legal, however, it’s likely that many of these debates will just go away, as they did for alcohol.

Continue reading the main story

Related CE Course for Mental Health Professionals

In spite of the fact that nearly half of the states in this country have enacted legislation legalizing marijuana in some fashion, the reality is that neither the intended “medical” benefits of marijuana nor its known (and as yet unknown) adverse effects have been adequately examined using controlled studies. Conclusive literature remains sparse, and opinion remains divided and contentious. This course is intended to present a summary of the current literature on the various medical, legal, educational, occupational, and ethical aspects of marijuana. It will address the major questions about marijuana that are as yet unanswered by scientific evidence. What are the known medical uses for marijuana? What is the legal status of marijuana in state and federal legislation? What are the interactions with mental health conditions like anxiety, depression, and suicidal behavior? Is marijuana addictive? Is marijuana a gateway drug? What are the adverse consequences of marijuana use? Do state medical marijuana laws increase the use of marijuana and other drugs? The course will conclude with a list of implications for healthcare and mental health practitioners.

Professional Development Resources
is approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the AlabamaState Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

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Posted by on November 16, 2015 in Mental Health, Substance Abuse




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