drugs – Freud & Fashion

A Psychiatrist’s Tips To Survive Summer Music Festivals

{Coachella in Indio, California}

I’ve been to my fair share of music festivals and several of my patients feel comfortable enough to tell me when they’re attending festivals as well. As fun as music festivals can be, they can also be exhausting, so some may return home feeling physically ill (I admit that I caught the flu after Coachella this year). And though strict policies exist regarding illicit drugs, they still make their way on to festival grounds, and some may experience longer lasting neuropsychiatric symptoms as a result of substance use during these events.

Since we’re in the midst of summer music festival season, the following are my tips on surviving music festivals with your health (and mind) as intact as possible:

Prioritize Sleep & Rest. Music festivals are like a marathon (the typical music festival occurs over one weekend, from Friday to Sunday), so conserve your energy and plan for breaks and naps when needed. You’ll likely return to your accommodations (camp, hotel, house, etc) pretty late (or super early in the morning), so make sure you get enough rest before heading back to the festival grounds. More power to you if your goal is to party all day & night, but chances are you won’t have the energy to make it through the entire festival.

Stay Connected. Most people travel in groups, so minimize the stress of losing track of each other by doing the following:

Set up a group chat (use apps, such as WhatsApp or Facebook Messenger, since cell phone reception might be spotty).
Time stamp your text messages — there’s nothing worse than receiving a delayed text (and not knowing it was delayed because there was no time stamp!).
Set a meeting place as a designated spot if you and your crew can’t find each other.

Know where the medical tent is. I know several colleagues who have worked at medical tents for Coachella and they’ve seen it all — from dehydration to intoxication. Each music festival should have a medical staff stationed there, so even if you don’t know where they’re located, at least know that medical services are available if needed.

Stay hydrated. With high temps during the summer combined with a lot of dancing, walking, and possible use of alcohol or drugs that may exacerbate dehydration, it’s important to make sure that you have plenty of water on hand.

Use your best judgment when it comes to drugs and alcohol. Medically, I’d like to say “don’t drink or use drugs,” but the advice of “just say no” has long been proven to be ineffective. And also, I don’t live under a rock — I know that illicit drugs get used at these festivals. So, what I will offer here is my hope that you will use your best judgment, in addition to considering the risk of long-term neuropsychiatric effects that may occur from use of certain substances, especially the commonly used MDMA (ecstasy, Molly, etc). Due to the massive serotonin release of this drug, tolerance develops quickly, and prolonged use can lead to permanent damage to serotonergic mechanisms in the brain. I’ve treated patients with panic attacks, generalized anxiety, depression, memory impairment, insomnia, and other sequelae that have persisted even after stopping use of this drug.

What to pack. Don’t be fooled by social media and assume that everyone dresses in picture perfect outfits and walks around in heels during these festivals (I made this mistake and wore heels to my first festival — worst mistake ever). Comfort should be a priority when it comes to deciding what to wear and what to bring. Aside from clothing, here’s a list of other important items to consider packing:

Comfy shoes
Hat
Sunblock
Portal phone charger
Bandana (to cover face in dusty environments since most festivals are in fields)
Long sleeve or light sweater/jacket when it gets colder at night

And last, but not least — my last tip is to let go of any pressures you have to undergo the ‘perfect’ experience because that mentality just adds unnecessary stress. In my experience, once I let go of trying to look ‘picture perfect’ (not every outfit has to be Instagram-worthy) and do ‘everything’ during the festival, I was able to focus on being present, enjoying the music, and having a fun & memorable time.

June 14, 2017 6 comments

Medicine Psychiatry

The Drug Rep Dilemma

written by freudandfashion

I attend pharmaceutical dinners every once in awhile because: 1) I like to stay up to date with all the new drugs (or just a slightly modified version of the generic, but with a much fancier name and packaging); 2) Though I’m several years out of med school/residency, one thing I have maintained from those formative years is the mentality where I’d never pass up a free meal. I know that pharmaceutical sales representatives (also known as drug reps) have been banned and limited in several institutions, and I completely understand the reasoning (it has been shown that drug reps’ marketing tactics influence physicians to write prescriptions they typically would not write, thus boosting pharmaceutical sales). However, I also think it’s important for physicians to be self-aware of their existence and influence in order to make conscious decisions on their own.

A few months ago, I attended a pharmaceutical dinner sponsored by the manufacturer of one of the newest psychiatric medications. These dinners always feature a physician, who describes the medication (the pharmacology, indications, side effects, etc), explains the existing research in support of the medication, and leads a discussion and answers clinical questions. My initial impression of the night’s presenting physician: charming, and since his introduction boasts the research he conducts at a prestigious university, he must be highly reputable and intelligent. But, as his talk progressed, I realized how narcissistic and full of sh** he was. I sat in the very front, yet chuckled to myself and assumed every other clinician in this room picked up on his suave, yet unconvincing tactics. I mean, who was this guy trying to fool by flaunting his European accent and stories of trips around the world??

However, I looked around the room and the entire audience of doctors and other clinicians were laughing and smiling in awe. I tried to hide my disdain and cringing facial expressions, but I sat at the very front of the room, so I’m sure others noticed. Or maybe not…I mean, everyone in the room was mesmerized by this guy! I figured that I should refocus my thoughts and give him another chance and caught up just in time to hear about his trip to Europe. I shook my head and thought to myself, “wow, can you believe this guy? And he gets paid tons of money to attend this dinner and talk about himself?” I smirked and assumed his current, pointless story-telling (aren’t we supposed to be discussing the medication?) would be convincing enough to prove his bullsh**, fake persona, so I turned to look at the audience assuming others would catch on. Still, all smiles.

At the end of the dinner, I found myself in a dilemma as I had to pass this man on my way out as I left the dining room. I contemplated whether I should act just as fake as his schmoozing and say something along the lines of “hey, great presentation” or should I challenge some of the comments he made? I settled for a more neutral comment and told him “thanks, you are very entertaining” as I shook his hand and smiled.

Then, I realized at that very moment I became just like everyone else in the audience who commended and complimented him. For a temporary, quick second I even contemplated prescribing the medication. The thought of prescribing the medication was short-lived, for, after I left the restaurant, I snapped out of it and wished I gave him a piece of my mind.

I thought, “oh well, instead I’ll just stick with my guns and won’t be overly influenced to prescribe the med, unless clinically indicated.” (I’d never deprive my patients of a medication that might possibly help). I now realize even more why pharmaceutical companies used to frequently provide fancy trips, extravagant dinners, and expensive novelties before policies/rules became more stringent. The speakers and drug reps can be quite hypnotic and mesmerizing, but it’s our duty not to be fooled by any marketing tactics.

Or have I already been swayed?

July 2, 2015 11 comments