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“The first draft of anything is shit.”

-Ernest Hemingway

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30 THOUGHT-PROVOKING QUESTIONS TO HELP YOU BECOME MORE SELF-AWARE

❦ how much self-control do i have with things that i know are bad for me, but tend to indulge in?

❦ how do i respond to someone who is different from me or whose ideals and beliefs i don't agree with or understand?

❦ how do i deal with being misperceived or misunderstood?

❦ how do i respond when someone judges me, makes fun of me, or calls me names?

❦ how do i deal with other people's mistakes and unpleasant behavior?

❦ how do i deal with people who have hurt me in the past?

❦ how do i spend my free time?

❦ how do i deal with negative people?

❦ how do i deal with stressful situations? do i tend to worry a lot? what else do i do?

❦ how do i deal with inconvenient life situations?

❦ how do i respond to situations that i have no control over?

❦ how do i deal with negativity in my environment?

❦ how do i deal with challenges in my life?

❦ how do i respond to situations that force me to get out of my comfort zone?

❦ how motivated am i to change my life for the better?

❦ how much do i follow through on what i preach and talk about?

❦ how do i deal with uncertainty, the unknown or a future event that i have no control over?

❦ how do i respond to obstacles, hardships, and "bad" things that happen in my life?

❦ how do i respond when i don't get what i want?

❦ how fulfilling is my everyday life?

❦ how do i respond to new ideas and new ways of thinking?

❦ how do i respond to bad or inconvenient news?

❦ how do i deal with the violence, hate, and suffering in the world?

❦ how do i recharge, rejuvenate, and replenish my energy?

❦ how much do i prioritize spending time and energy on myself and on my passions?

❦ how do i deal with change? new job, new house, new lifestyle, new people, new rules, new technology...do i tend to avoid it, welcome it, fear it, like it, complain about it, stress out about it, worry about it?

❦ how do i deal with emotional pain?

❦ how do i respond when plans change or plans get cancelled without my say so?

❦ how do i respond when i make a mistake or when i fail at something?

❦  how do i deal with rejection?

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Harm Reduction Ideas for Substance Use Disorder

Recently I have been listening to a podcast called The Curbsiders Addiction Medicine. If you are a clinician that works even sometimes with people who use substances (every clinician ever), it is a fantastic look at all the harm reduction practices you can use to make these individuals safer. Plus, you get free CME.

I’m hardly going to do the podcast itself justice with this post, but I wanted to share some things I learned from it:

If the dangers of using substances (social and legal consequences, time commitment, health problems, money problems, etc…) was a deterrent, people wouldn’t be doing it. But it’s not. Because uncontrolled substance use is a chronic disease that generally does not get better without treatment. When people are treated, not only do they generally use less, but they have a much lower chance of death and a much higher chance of a happy, productive life- whatever that means for the patient.

Previously (even a few years ago) we hung such treatment on the requirement that people be abstinent from substances in order to receive help. This works for some people, but far from everyone.

The evidence shows that best thing we can do for many individuals is to make their use safer and less of a burden on their life and health. This is called harm reduction, and it WORKS.

Here are some evidence-based ideas for how to help your patients:

Create a space where you are working together with your patient and following your patient’s lead. Do they want to become abstinent? Great! Do they want to use less or use in a more controlled way? Also great! Do they want to continue use in a safer way? You guessed it, also great! Support them in whatever their goal is

Provide or prescribe safe, clean tools of use. Things like clean needles, Pyrex pipes, and straws. This decreases rates of infection and abscesses

Prescribe medications that reduce cravings or reduce/eliminate withdrawal (methadone, buprenorphine, topiramate, bupropion, naltrexone) without requiring abstinence

Teach people safer use practices and safer routes, such as rectal (booty bumping) or oral (parachuting) instead of injection drug use

Prescribe PrEP if people are at risk of HIV without requiring abstinence

Test for and treat the consequences of substance use (such as HIV and Hep C) without requiring abstinence

Provide fentanyl and xylazine test strips so people know what is in the substances they are using and can adjust doses/use pattern accordingly

Recommend Never Use Alone hotlines to prevent overdose death or better yet, take turns using with a buddy

Prescribe naloxone to anyone who uses any substance- nearly all street drugs are contaminated with synthetic opioids and naloxone is an effective way to prevent deaths

People use substances for a reason, especially early in their journey- pain, coping with depression/other mental illness, ADHD, and social issues like being unhoused. Treat the problem if you can find it, and you can help people significantly decrease use or use in a more controlled way

Be aware that return to use (or return to uncontrolled use) is a thing you can plan for with the patient and manage before it even happens

It’s hard sometimes to change the idea of addiction/substance use disorder as something that can only be treated as a reward for staying sober. But thats why so few people seek treatment for it. The evidence does not equivocate. Harm reduction WORKS.

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The 40 hour work week isn't good for anyone. We know this, both on a gut level and from empirical research.

However

There are people, the majority of people in fact, who go through their 40 hour jobs and then come home, make dinner, and do something with their evening that is enjoyable and not just a dead-eyed zone out. They spend time with family or friends, play with pets or kids, engage in hobbies, or even just sit and enjoy media actively.

When they talk about how much it sucks to go to work, it's a kind of general grumbling (because again, nobody likes the current system).

If you approach going to work and feel like you might just die if you have to go in again. If you come home after work and can't do anything except stare blankly at the TV or your phone. If you can barely make dinner or keep your house clean. If you feel like you're actually drowning all the time and have no ability to actively engage in any enriching activities outside of work.

That's not just the general shittiness of the system. That's a sign that you have a mental or physical health issue that's being compounded by the system. It's a sign of disability.

The medical system where you are may suck donkey balls, but there's a lot you can do just by tracking your symptoms and trying to figure out what's going on. And if you can get medical help, you can vastly improve the quality of your life, even if you can't get out of the system.

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my goal for 2025 is small simple and clear: change my whole entire life

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2024 gonna be my year fr

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𝔱𝔥𝔢 𝔣𝔦𝔫𝔞𝔩 𝔰𝔱𝔯𝔢𝔱𝔠𝔥

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I study using the reverse Pomodoro method where I focus for 5 minutes and fool around for the rest 25 minutes.

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reading non-fiction will have you standing up and giving ted talks to your furniture

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i've been sending my supervisor (very nice 60 something year old white man, very grandfatherly vibes) my thesis proposal document under the filename "bad draft" and he just sent me my final revisions under the file name "rad draft"

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Why is studying suddenly so hard when I'm in college? I could spend 6 hours without a break on studying while in highschool and now sitting down and actually focusing for 30 minutes is such a challenge every time (I fear that my "logically" passed exams are going to end really soon). Does anyone have a similar experience?

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I want to be an arthropod. University is too hard.

Forget return to monke. I want to become isopod

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✂ dollars notion template.

Links: install (free) | more notion templates

Dollars is a free Notion template for tracking your daily expenses and income. Take full advantage of the new charts update to visualise your spending over the months, and easily add recurring payments like bills and salaries.

Features: charts (breakdown of monthly expenses, track expenses & income over the months), buttons for adding recurring payments, money overview page to view all transactions

Note: You will need a Notion Plus plan (or above) in order to save more than one chart in your workspace.

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idk who needs to hear this but if you have been putting something off bc it doesn't need to be done until the end of the month. we are almost done with the teens we are approaching the big numbers (the twenties). that date shall dawn upon you swiftly and without mercy before you know it. psa for everyone except me i got plany off time

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