Thursday, May 03, 2018
Doctors Perspective
Bring back just say no

By Dr. Anthony Policastro
Back in the 1980s, Nancy Reagan used the Just say no slogan in the war on drugs. The idea was to get the youth of America to not try drugs in the first place. We are now in the middle of an opioid epidemic in this country. Perhaps we need to bring back the Just say no campaign. We know that about 1 out of every 6 individuals who gets prescribed opioids later becomes a chronic user. The statistics are worse for young people. About 1 out of every 3 adolescents who uses opioids before the 12th grade becomes a chronic user. We went through a long period of not treating pain well enough and then the pendulum swung the other way. We started to overdo it. As you know, doctors ask if you have pain at every office visit. Sometimes we forget that there are many ways to treat pain and we do not always make use of them. For example, acute injuries are best treated with the acronym RICE. That means to Rest the injured part. If you do not use it, then it will hurt less. Ice to the injured area will help decrease the pain by numbing the pain nerve endings. Compression and Elevation of the area will decrease the blood flow that results in less swelling which can cause pain. A second non-medical approach is using other forms of mind over body techniques. These can be in the form of distraction by doing something else. These can also be in the form of relaxation therapy or breathing techniques. A third aspect of treating pain is to recognize that everyone has a different degree to how they sense pain. For some people pain is more of an issue due to their underlying anxieties. Depression can also affect sensation of pain. Treating the underlying issue can help decrease the sensation of pain. When medication becomes necessary, a variety of pain relievers are available that are not opioid based. They include Tylenol (acetaminophen) and anti-inflammatory agents such as those that are ibuprofen (Motrin) based or naproxen (Naprosyn) based. The anti-inflammatory agents not only relieve the pain but also treat the underlying inflammation that causes the pain. A lot of people do not respect these over the counter medications. They think that these medications are not that strong. However, study after study shows that these medications relieve pain a lot better than most people think. Opioids should only enter into play when other methods are not satisfactory. For example, we know that after major surgery, opioids are often necessary. The issue is not necessarily their use but the length of time they are used. Most people no longer need opioids after two to three days. However, most prescriptions tend to be for about seven days worth of medication which creates another set of problems.

Two-thirds of chronic opioid users started using opioids from excess medication that was properly prescribed. The bottom line is the best way for each individual to approach opioids is to Just say no. That might not always be possible but it remains the best philosophy.

Alzheimers Programs Easter Seals, 22317 N. DuPont Blvd. in Georgetown, is hosting a series of educational programs presented by Jamie Magee, coordinator for the Alzheimers Association. The following free programs are being offered: Friday, May 18, 10 a.m. Noon - Memory Loss, Dementia and Alzheimers The Basics. Register by May 13. Wednesday, June 6, 10 a.m. Noon - Effective Communication Strategies. Register by June 2. Friday, June 8, 10 a.m. Noon - Understanding and Responding to Dementia Related Behaviors. Register by June 5. Friday, June 22, 10 a.m. Noon - Healthy Living for your Brain and Body. Register by June 15. To register, call 800-272-3900 or email Sharon Jarnette at

Squelching skin cancer: detection and prevention As summer is approaching, everyone needs to be aware of the dangers of the suns ultraviolet rays. On Friday, May 18 at 3 p.m., please join Lawrence Chang, MD, a Board Certified Plastic Surgeon and Dermatological Surgeon of Rehoboth Plastic and Dermatological Surgery to learn the importance of skin cancer vigilance. Dr. Chang will speak on detecting and identifying skin cancer, as well as methods to prevent skin cancer. This educational and informational program will be held in Tunnell Cancer Centers Conference Room on the ground floor of the Medical Arts Building. Moving With Melanoma will be on hand with information. Please register at 645-9150 in advance to reserve your spot in this free workshop. All programs offered at Cancer Support Community are offered free of charge to people affected by cancer and their loved ones. The Sussex facility is located at 18947 John J. Williams Hwy., Suite 312, Rehoboth The Cancer Support Community is part of a national nonprofit organization that provides support, education and hope to people with cancer and their loved ones. Through participation in professionally led support groups, educational workshops and mind/body classes, people affected by cancer learn vital skills that enable them to regain control, reduce isolation and restore hope regardless of the stage of disease. At the Cancer Support Community Delaware, all programs are free of charge. More information about the Cancer Support Community is available on their website at