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The Professionals Resource Network (PRN)

The Professionals Resource Network (PRN). The Impaired Practitioner’s Program for the State of Florida. The Florida Medical Association, Inc. 1874. Department of Health Board of Chiropractic Medicine Chapter 460. Types of Impairment. Substance Abuse. Substance Dependence. Physical.

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The Professionals Resource Network (PRN)

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  1. The Professionals Resource Network (PRN) The Impaired Practitioner’s Program for the State of Florida

  2. The Florida Medical Association, Inc. 1874

  3. Department of Health Board of Chiropractic Medicine Chapter 460

  4. Types of Impairment Substance Abuse Substance Dependence Physical Infectious Disease Psychiatric Axis I/II Disruptive Psychosexual

  5. Criteria for Substance Abuse A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period: (1) recurrent substance use resulting in a failure to fulfill major role obligations (2) recurrent substance use in situations in which it is physically hazardous (3) recurrent substance-related legal issues (4) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance

  6. Criteria for Substance Dependence A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring within a 12-month period: (1) tolerance (2) withdrawal (3) the substance is often taken in larger amounts or over a longer period than was intended (4) there is a persistent desire or unsuccessful efforts to cut down or control substance use (continued)

  7. (5) a great deal of time is spent in activities necessary to obtain the substance, or recover from its effects (6) important social, occupational, or recreational activities are given up or reduced because of substance use (7) the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

  8. Lying: “Time - Dose - Frequency” A Conscious Process

  9. Lying “Time - Dose - Frequency” Denial Unconscious - is honestly unaware of effects drugs are having

  10. Lying “Time - Dose - Frequency” DenialUnconscious - is honestly unaware of effects drugs are having Anger Specific to General

  11. Lying “Time - Dose - Frequency” Denial Unconscious - is honestly unaware of effects drugs are having Anger Specific to General Bargaining Danger Point

  12. Lying “Time - Dose - Frequency” Denial Unconscious - is honestly unaware of effects drugs are having Anger Specific to General Bargaining Danger Point Depression Tendency to Isolate - Often misdiagnosed by physicians as reason for drug use

  13. Lying “Time - Dose - Frequency” Denial Unconscious - is honestly unaware of effects drugs are having Anger Specific to General Bargaining Danger Point Depression Tendency to Isolate - Often misdiagnosed by physicians as reason for drug use Acceptance Beginning of Recovery Process

  14. Signs Of Personnel Drug Use • Frequent breaks • “Working all the time” • “Hanging around” department • “Balanced Anesthesia” techniques (Anesthesia) • High drug use on cart (or high waste) (Anesthesia) • Long sleeves (Bandages, injuries) • Change in charting • Change in personality • Change in lifestyle/family life • “Tired” alternating ambitious-grandiosity • Reasons for problems

  15. “You’re a doctor 24 hours a day - You can’t escape.” - Debra Paul Orlando Sentinel November 9, 1986

  16. “I don’t want my 13 month old son to grow up to be a doctor.” - Debra Paul Orlando Sentinel November 9, 1986

  17. “It wasn’t like he did it all the time - It wasn’t like every day - It was more for escape - like to sleep you know.” - Debra Paul Orlando Sentinel November 9, 1986

  18. “He could stop at anytime - He wanted to. And he would too.” - Debra Paul Orlando Sentinel November 9,1986

  19. Debra Paul Died at Age 27

  20. AFFECTIVE DISORDERS

  21. Major Depression At least five for a two week period 1. Depressed mood 2. Anhedonia 3. Weight loss/gain (anorexia/hyperphagia) 4. Insomnia/hypersomnia 5. Psychomotor disturbance 6. Diminished energy 7. Diminished self-esteem/guilt 8. Impaired concentration 9. Recurrent thoughts of suicide

  22. DYSTHYMIC DISORDER

  23. BIPOLAR DISORDER

  24. Manic Episode At least three for a one week period 1. Inflated self-esteem 2. Insomnia while feeling rested 3. Talkative/pressure 4. Flight of ideas 5. Distractible 6. Increased goal-directed activity 7. Excessive pleasurable activity

  25. Bipolar I Major depression/manic Bipolar II Major depression/hypomanic Lifelong chronic illness with licensure-long implications

  26. SUICIDE

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