Self-harm in Wayne County

Self-harm is a rising problem among young people all over and Wayne county NY is not immune.  In fact, I have known a handful of people from Wayne county, in my life, who have suffered this epidemic. Canandaigua, NY has even implemented some means of prevention in their schools. They have a prevention specialist who works with middle school students on issues such as this.  The Wayne Post recently had an article about self-harm that highlighted the stories of many young people and some adults who had battle this issue. The article points out that self-harm is a very multidimensional problem that can be driven by a number of different things. The common thread among the different stories in the article was the need for control. The article states, "Self-harming is actually a self-medicating coping mechanism that comes from a normal, good desire to feel better...For some, self-injury provides a way to manage intolerable feelings or a way to experience some sense of feeling, she said. It is also used as means of coping with anxiety or other negative feelings and to relieve stress or pressure." This is a very common issue that primary care physicians need to be equipped to handle. As we learned in our RMED article this week, mental health knowledge is lacking among primary care physicians, and this is one more reason that we need to fill in that gap.  

http://www.waynepost.com/article/20140216/NEWS/140219706?refresh=true

Drunk Driving in Wayne County

I came across an article about drunk driving in my hometown paper recently (http://www.waynetimes.com/news/why-are-they-still-drinking-and-driving/).  It got me thinking that alcoholism is a public health issue that I don't think gets enough attention. Alcoholism is rampant especially in rural areas. As we have learned through various RMED articles, certain street drugs are less available in rural areas and thus, rural people are limited in what they indulge in.  With the popularity of Breaking Bad and other mainstream media, crystal meth has been highlighted as a drug of choice in rural areas.  However, I think alcohol is a much bigger problem.  Alcoholism is a problem in urban areas too, but in rural areas, most bars requiring driving, which is not the case in urban areas.  Public transit is scarce in most of rural America, forcing the rural alcoholics and bar enthusiasts to drive to their bars and liquor stores. I think this is a dangerous combination that often ends in driving while intoxicated.

There is another problem with alcoholism, though.  How do doctors treat it? Alcohol consumption is a very sensitive subject for many who abuse it, and while a good physician can read between the lines and estimate alcohol consumption, many alcoholic patients underplay their intake. This is not just a problem of trust building between patient and physician, but also an issue of self-denial.  Therefore, how are we to deal with alcoholism when some alcoholics don't even believe they have a problem? This is an issue that rural physicians absolutely must face.

As a future rural physician, I believe that the best way to deal with this issue is to be completely honest with patients, as well as nonjudgmental.  With this approach, one can hope that patients will respond with trust and honesty, so as to open up conversation about solutions to alcoholism and drunk driving.

http://www.waynetimes.com/news/why-are-they-still-drinking-and-driving/