The “Highly Sensitive Person” is Code for Autistic

By Jillian Enright: For Complete Post, Click Here…

Some accommodations are normalized while others are pathologized.

Everyone needs accommodations to thrive

I just read an article arguing that highly sensitive people (HSP) and autistic people are not the same. The article then went on to describe all the ways in which they are, in fact, The. Same. Thing.

The screen shot below was from the section detailing all of the “differences”, under the subheading impact of environment:

If I’m reading this correctly, HSPs require environmental accommodations in order to flourish, whereas autistic people require accommodations to thrive…

Can somebody please explain to me where the difference is?

For example, the article states:

“Research has shown that highly sensitive individuals have poorer developmental outcomes and an increased likelihood of behavioural and psychological difficulties in stressful and unsupportive early environments.”

Research has shown the exact same thing for autistics.

One study showed that the two greatest predictors of poor physical health in autistics were anxiety and sensation sensitivity behaviours — in other words, sensory processing differences, also known as being “highly sensitive”.

Another study listed the three most important predictors of quality of life for autistic adults, which were: employment, relationships, and social supports. In other words, a supportive employer, supportive partner, and a supportive environment.

I’m still not clear on where the differences are.

Car Rentals for People with Dwarfism

From Ability-Tools Staff: For Complete Post, Click Here…

Dan Okenfuss – Public Policy Manager, California Foundation for Independent Living Centers

It’s summer! Time for vacations to faraway places! Whenever I fly on a pleasure trip, I am usually renting a car at my destination, especially when visiting friends who live far from reliable public transportation. That way, I can comfortably drive with my family of four and carry our luggage.

Picking out a rental car for most travelers is fairly simple: just pick the appropriate size and capacity of car at your particular price points. However, it’s a lot more challenging for a family of four individuals with dwarfism (skeletal dysplasia) who are less than 4 feet 6 inches tall.

To accommodate this accessibility challenge, I usually rent a car with hand controls because I’m usually the driver and I can’t reach the brake or accelerator due to my short legs. I used to bring my own pedal extensions, but I found it difficult to connect them to the rental car pedals as I got older and less flexible.

The hand controls look like a motorcycle or bicycle hand grip that sticks out of the left or right side of the steering column. Usually, you turn the handle down for the accelerator and push the handle in for the brake.

Most major rental car companies have cars with hand controls available upon request, as long as you notify them in advance. I try to give rental car companies at least a month’s notice that I need a car with hand controls ready at my destination.

Sometimes, you can’t select this option on the rental car reservations website. You need to search more creatively. Therefore, I try to avoid any online hassles and call the rental car agent directly and ask for its “accessibility” or “ADA customer” desk. That way, you get in touch with the right expert who can best take your request and ensure you have an accessible car waiting for you at your destination. Remember to always get names, phone numbers and emails from the contacts you work with. That way, you are more prepared to book for future travel.

Blind and Visually Impaired Pedestrians: What Are Their Difficulties When Crossing the Street?

By Carole Martinez: For Complete Post, Click Here…

Blind and visually impaired pedestrians can face many obstacles and challenges when they navigate the streets, especially for crossing them.

Abled pedestrians cross the street in an automatic way without even thinking about it. They simply check out the color of the traffic lights and start walking as soon as the green man appears.

They “just” have to be careful when crossing the street by checking if a car is coming. For blind and visually impaired pedestrians, being careful is a state of mind. It never leaves them.

Because as soon as they step foot outside, the world can easily become inhospitable. But if you become aware of their struggles and issues, you’ll be able to make sure they can safely cross the streets of your city.

There are solutions that enable blind and visually impaired pedestrians to feel less anxious when crossing the street. First, let’s see what actions they need to take to safely cross the street.

  1. Locate the beginning of the crossing
    This actually represents the most challenging action for blind and visually impaired pedestrians.

They more or less know where they stand on the intersection. Other pedestrians rely on visual cues to spot the desired crossing and go towards it. But how can they know where the crossing begins?

They can rely on a locator tone that constantly emits sound.

The locator tone is used as an audio signage: it helps blind and visually impaired pedestrians find the beginning of the crossing.

Unfortunately, not all intersections are equipped with one. So what can they do when there’s no locator tone?

Either people with visual impairments are already familiar with the intersection and they know where the crossing begins. They may have tips like counting steps.

Or they can focus on the ambient sound: traffic with cars coming and going, people talking while waiting their turn to cross…

They can also ask another pedestrian to tell them where the crossing is.

  1. Press the pushbutton

Can Low-Dose Naltrexone Offer Pain Relief?

by Heath McAnally: For Complete Post, Click Here…

Recent study highlights benefits and builds on previous research.

Most of the long-term pharmacotherapeutic options for treating chronic pain have failed us over the years in one way or another. The tragic results of opioid overprescribing need no further review. Adverse effects from nonsteroidal anti-inflammatory (NSAID) overuse are more insidious but may in fact confer (or at least contribute to) even greater morbidity and mortality given their far greater prevalence. (While gastric and renal toxicity get the most airplay, vascular injury including coronary and cerebrovascular issues may comprise the most serious harms from these ubiquitous medications.) Many of the potential long-term individual and community implications of marijuana use for pain remain unknown, but some evidence suggests potential harms involved with chronic use.

When confronted with serious chronic pain, then, what’s a caring physician to do?

This month I’d like to highlight a (non-funded) study carried out by our practice over the past few years on low-dose naltrexone (LDN), which builds on previous research in this area. For those in a hurry, I’ll start with the highlights and circle back to basic science a little later, but for starters, I want to point out that our most intriguing and encouraging finding is that so-called neuropathic pain may benefit even more from LDN than the so-called nociceptive or inflammatory pain states that it has been directed at over the past 20 years.

The Main Points

First off, we saw no harms from LDN over the 6-year study, which relied on a retrospective cohort design using data from 2014 to 2020. In fact, no one has really ever seen (nor would we expect, based on the drug’s known safety profile especially at very low doses) any adverse effects with LDN treatment.

We saw a statistically significant (P<0.001) 38% pain reduction reported by people who consistently used LDN for at least 2 months, with a number needed to treat (NNT) of 3.2 to achieve an outcome of at least 50% pain reduction. Age, gender, and disease-matched controls reported 4% improvement in pain over the study period, without significant differences in interventional procedures performed.

One statistically significant confounder was chronic opioid use; LDN patients discontinued the use of chronic opioids, or simply were not on them to begin with, whereas controls had a 65.3% prevalence of use during the study.

The 5 Stages of Chronic Illness No One Tells You About

By Erika Bohling: For Complete Post, Click Here…

When I was 13 years old I had just re-learned how to walk. I lost the use of my limbs when I was 12; having finally regained their use I thought my life had finally gotten back on track. Then I fell ill again. Shortly after, my beloved Nan passed away.

Seven years on, my life is finally starting to make sense. Something became very clear to me: dealing with being incurably sick was hard. There are many things that doctors do not tell you when you get diagnosed. If I could go back to my 13-year-old self and tell her everything is going to be OK, I would. But I can’t. So this is a letter written through the naive eyes of a chronically ill 13-year-old with the hindsight of a 20-year-old who’s on her way to figuring this all out.

1. Denial

An Alternative to Psychiatric Hospitals

By John Read Ph.D.: For Complete Post, Click Here…

  • Traditional, ‘medical model’ approaches to treating psychosis are often ineffective and involve the risk of serious adverse effects.
  • An effective alternative to psychiatric hopitalisation, initiated in California in the 1970s, has been resurrected in Israel.
  • A recent article reports on the successes and challenges of three new Soteria-style houses in Jerusalem and Tel Aviv.

California’s Fight Against Homelessness Has Turned Desperate and Dangerous

By Jay Caspian Kang: For Complete Post, Click Here…

If the homelessness crisis in California can offer any lessons to the rest of the country, it’s what politics looks like when a restless and beleaguered public places pressure on politicians to do something — anything — about a complex and seemingly intractable problem. The state has spent billions of dollars a year and tried a variety of solutions; none has put much of a dent in the public face of homelessness — the tent encampments of unhoused people that have sprung up throughout every major city in the state.

In an earlier newsletter, outlined what I think is the emerging ideological battle line in the homelessness crisis, not only in California, but also throughout the country. There are housing-first advocates who believe that a greater supply of subsidized, supportive and affordable housing is necessary to end homelessness not only for the people on the streets but, perhaps more important, also for the people who are about to be short on a rent payment and will soon be living in their cars, in motels or in shelters. The other side, which I’ll call “mental health and addiction first,” believe that a liberal and permissive culture around homelessness in California’s cities has opened the floodgates for mentally ill and drug addicted people from around the country to set up camp in San Francisco and Los Angeles.

Until now, the housing-first people have largely won the significant battles in both the federal government and the state of California, which both adopted their policies in the mid-2010s. But there are signs that some of this might be changing, in large part because of people’s frustrations with the lack of visible change.

Last week, the California State Assembly passed a bill proposing the creation of the Community Assistance, Recovery and Empowerment Court program, or CARE Court, with a 9-to-1 vote. In the State Senate, the vote was 38 to 0 in favor. The bill, which must still make it through a few more political hurdles to become law, establishes a “framework to deliver mental health and substance use disorder services to the most severely impaired Californians who too often languish — suffering in homelessness or incarceration — without the treatment they desperately need.”

What this means on a practical level is that if a police officer, behavioral health provider or family member observes someone acting erratically and suspects the person is suffering from a mental health breakdown, the observer can submit a petition for referral to a CARE Court, even if that person has not committed a crime. The person will then receive a “clinical evaluation” to diagnose “schizophrenia spectrum or other psychotic disorders.” If any is found, the person will be appointed counsel and be entered into a CARE plan, receiving treatment in the form of counseling and court-ordered “stabilization” medications. State Senator Tom Umberg, an author of the bill, told me that it is aimed at somewhere around “7,000 to 12,000 individuals in California” with “schizophrenia or schizophrenia-like conditions” who he says are “very difficult to reach, very difficult to stabilize and very difficult to bring back into society.”

A Young Person’s Guide to Navigating Chronic Pain

By Kylee Grace Schmuck: For Complete Post, Click Here…

So you’re in your late teens or 20s and have been diagnosed with chronic pain. Now what? I sense some of the overwhelming and intrusive thoughts in your brain. “I can’t even drink, but I have to live in pain,” “How could this happen? I’m only 20” and other variations of these types of questions race in your head. You start calculating how many years you’ll be living in pain. Half your life? Three-fourths? Two-thirds? Anything more than half is likely, and you’re terrified.

You start drowning. Drowning without any hope or possibilities in sight. You sit in waiting rooms for specialists and doctors, most often surrounded by those much older than you. You’re given strange looks. Maybe someone will ask why “someone like you” is in a place like this. You won’t know how to respond. You’ll look down and mumble something about having an appointment.

Navigating a diagnosis of chronic pain is never easy, no matter your age, race or gender. However, since being diagnosed with chronic pain and femoral acetabular impingement (FAI) at a relatively young age, I’ve learned that age can present a number of interesting and unique challenges.

You’ll need to cultivate skills, similar to those that anyone diagnosed with chronic pain needs to develop. You need to learn how to properly research various treatment options that may be suggested, how to effectively deal with insurance company and how to advocate for yourself and what you feel is best with anyone who may be on your treatment team.

The Opioids Crisis: Don’t Punish Pain Patients To Treat Opioid Addiction

by Kate M. Nicholson and Sally Satel: For Complete Post, Click Here…

The U.S. is suffering not one epidemic, but two: The opioid crisis continues to rage through the Covid-19 pandemic. In 2020, opioid deaths surged 30 percent to 93,000, the Centers for Disease Control (CDC) just announced, due largely to fentanyl, a potent synthetic opioid trafficked from Mexico and China. Federal action to help Americans combat substance abuse is urgently needed.

But a sin tax imposed in a new bipartisan Senate bill, The Life Budgeting for Opioid Addiction Treatment (LifeBOAT) Act, is sorely misguided, robbing pain patient Peter to treat addiction patient Paul.

Introduced by Senator Joe Manchin (D-West Virginia), along with ten co-sponsors including Senators Mitt Romney (R-Utah), Elizabeth Warren (D-Mass.), and Amy Klobuchar (D-Minn.), the bill would establish a tax on sales of opioids (“stewardship fee”) of one cent per milligram. The revenue would be earmarked to fund drug treatment.

New York State tried an opioid sin tax; the results were not encouraging. In 2019, it imposed taxes and fees on opioid manufacturers and pharmaceutical distributors that deliver opioids to pharmacies and hospitals.  According to Kaiser Health News, “scores of manufacturers and wholesalers stopped selling opioids in New York,” among them Epic Pharma, a manufacturer, and Independent Pharmacy Cooperative, a wholesaler. AvKARE and Lupin Pharmaceuticals no longer ship to New York.

DOJ: Maine violating ADA, over-institutionalizing children with disabilities

BY BRAD DRESS: For Complete Post, Click Here…

Maine has violated the Americans with Disabilities Act (ADA) by sending children with disabilities to mental health facilities as it fails to meet their needs in the community, the Department of Justice (DOJ) said on Wednesday.

In a press release, the DOJ said it concluded an investigation that found the state system “unnecessarily” segregated children with mental or physical disabilities from their communities by sending them to psychiatric hospitals, residential treatment facilities and a juvenile detention center called Long Creek Youth Development Center in Portland.

The DOJ said children with disabilities are more likely to be institutionalized in Maine because of difficulties in accessing behavioral health and other basic needs in the community.