Prescribing the Correct Medications to Our #1stresponders

By Safe Call Now Board Member Dr. Michael Genovese, MD, JD

As first responders do we know anything about medication when it is prescribed to us from our doctors?  The side effects, if it will actually work or not?  This is great information you need to know for your health and wellness.  Stay safe out there!!!

Dr. Michael V. Genovese, M.D., J.D.
 

With the advancement of medicine and the multitude of available options, psychiatrists face numerous challenges in tailoring the appropriate course of individualized treatment for patients. Pharmacogenomics is the study of how a person’s individual DNA affects his or her response to medications and a scientific method of evaluating which medications a patient is likely to tolerate. The primary role of pharmacogenomics is to develop rational means to optimize drug therapy, with respect to the patient’s genotype, to ensure maximum efficacy with minimal adverse effects.

There are many factors involved in the decision making process of administering medication such as efficacy, side effect profile, compliance, cost, family history, and the patient’s previous medication trials. Approximately 50% of patients do not respond to their initial medication treatment and up to 30% discontinue due to intolerable side effects. Additionally, nearly 70% of patients are non-adherent to their prescribed medication schedule, with adverse reactions representing the most common cause. The statistics reveal the demand for an individualized approach to patient care and a treatment plan specific to the patient’s needs.

Pharmacogenomics provides an evidence-based approach to improving customized treatment outcomes. This personalized approach to medicine is safe and easy to accomplish. It minimizes patient frustration associated with a trial and error approach to pharmacology. Testing a patient is as simple as collecting cells from the inside of the cheek with a cotton swab. The cells are sent to a lab and results are generally available within a week. A detailed report provides patient specific information regarding the genes that code for enzymes that are responsible for metabolizing medication and regulating its activity at the neuron.

For #1stresponders... Is It Burnout or Depression???

By Safe Call Now's Dr. Laura Brodie Ph.D.

Something that is not recognized by many in the civilian world is that our First Responders as a whole are more psychologically healthy than the general population at the time of hiring. How can I say this?  Well, very few careers require the psychological screening and assessment that First Responders have to pass in order to obtain their job.  In doing such a screening, the hope is to protect the public from someone who is unsafe, but the hidden benefit is to hopefully protect the individual doing the job from many of the psychological disorders that can develop from this type of work.  So, if we use the premise that First Responders are more psychologically healthy than their civilian counterpart, why are we seeing the psychological problems we are seeing within First Responders?   Problems like substance abuse, high divorce rates and suicide?  Theoretically, this should not be happening, but it is rampant. Why?

Mental health professionals are very familiar with issues such as depression and have many tools in their therapeutic toolbox to help. What they are not nearly as educated in understanding is the environment of the First Responder and the issue of burnout.  Research has shown that the leading cause of stress in First Responders is not the day to day rescues and arrests they perform.  Those chores are why the individual signed up to do the job and there is clear understanding of those tasks through the academies and ongoing training.  What is not spoken of is the organizational stress that is killing First Responders. Yes, it’s the slow, ongoing, and constant organizational stress that is doing more damage to our First Responders than any other factor within the job.  As a professor, I have chaired several dissertations that have shown this stress and the gradual breakdown of the individual does not depend on the age, sex or rank of the individual. It appears that the seven-year mark is where the stress can eventually become the most significant issue for the individual and coping breaks down.

Organizational stress is from the departments and the fall out from the public. It is the gradual wearing down of the individual in all the tasks that have to be done to cover one’s posterior through paperwork, to handle the misconceptions and accusations of the media and public and the management of troops when management classes and courses are not offered as a way to help the individual learn how to manage.  Moving up the ranks many times is based on how one does the First Responder job, not how one manages people. These are two different tasks and require a different set of people skills. Both the manager and those below are set up to fail in system that does not allow the training of management of personnel to be as important as the training to fire a weapon, put out a fire or rescue a trapped person. It is set up to fail. 

Cop Dreams...

By Safe Call Now Board Member Betsy Smith

I wrote an article a few years ago for PoliceOne.com titled “Cop Dreams.”  The feedback was immediate and unexpected.  So many people were surprised to find out that they weren’t alone in experiencing these vivid, sometimes terrorizing dreams, and it wasn’t just the cops who were having them. 

When I was a high school senior I worked evenings as a police dispatcher for my local sheriff’s department.  One night I had a terrible nightmare. It was so real!  One of my deputies was yelling for backup but no matter how many times I pushed the “transmit” button, I couldn’t call for another unit. I was unable to speak.  The phones didn’t work.  I was completely helpless.  I woke up sweating and terrified.  I wasn’t even a cop yet, and I’d just had my first “cop dream.”  

There is no exact science when it comes to the study of dreams. We dream between 90 and 120 minutes per night, depending on how long we sleep.  We tend to only remember the last dream we had, unless you have reoccurring dreams, which are pretty common in both humans and in animals.  Sometimes I watch my dog Marley twitch, whine, and pant while he naps.  I often wonder if he’s reliving some of the terrible abuse he suffered before we rescued him.  Humans obviously suffer similar emotionally difficult dreams.  The top five most common dreams for humans are:

• I’m Being Chased
• I’m Falling
• I’m Lost or Unprepared
• I’m Naked in Public
• My Teeth Are Falling Out (how weird is that?!)

Law enforcement personnel also tend to have similar, reoccurring dreams.  We once took a totally unscientific and unofficial Facebook poll on the “JD Buck Savage” fan page and we found that the top five “cop dreams” are some variation of:

• No Matter How Hard I Try, I Can’t Pull the Trigger
• I Fire My Gun, and the Round “Dribbles” Out of the Barrel
• I Need to Run Somewhere but I Can’t Move
• I Can’t Get to My Gun, My Ammo, or My Holster is Empty
• I Fire and Fire and Fire and the Rounds do Nothing