JUST SAY “NO” TO FAILED DRUG POLICIES

I recently returned from Australia and began to connect with the addiction community there via several agencies and their newsletters and articles. One very thoughtful article published by Family Drug Support Australia (FDS) is excerpted here. Written by an emergency room physician who is on the front line with overdose victims, he is also a parent who is concerned for his children’s future unless drug policies in Australia change sooner rather than later. There, as in the US, bureaucrats spend years discussing options for change while people die in the tens of thousands. However, from people I’ve spoken with there and from all I’ve read, they are ahead of us in some significant areas. May we all learn from each other.

Stop sacrificing young lives at an altar of drug dogma
By David Caldicott
December 11, 2018

I am the very proud father of some very naughty children, and I would happily walk through fire for them. I am also an emergency consultant with an interest in illicit drug overdoses and, by obvious extension, how to reduce them.

Since the death of yet another young man at a music festival this weekend, from a presumed overdose, it is in this latter capacity that I have been asked, on several occasions now, “How do you feel about another festival death in New South Wales?”…

Put aside the politics & policy debates. A young man is dead before his time…Allow yourself, for one terrible moment, to let that wash over you, as if it were happening to your loved ones. And now tell me what you wouldn’t do, how far you wouldn’t go, to stop that happening to your family.

This is the perimeter around which I perpetually hover. I am the man who rings you to tell you that your child or partner is in our department, and that you need to come into hospital — right now. I am the man who will hold your hand if you need me to, and tell you that I am sorry…I am the man who will agree with you that you never suspected that your loved one, my patient, was in the slightest bit interested in using drugs. Every time I do this, part of me breaks, and I rush home to hold my own a little tighter.

Australia’s National Drug Strategy supposedly is based on the three pillars of demand reduction, supply reduction and harm reduction, but it is effectively a one-legged milking stool. Research conducted by the agents tasked with implementing drugs policy shows that the lion’s share of the money we spend on drugs policy goes into prohibition.

We are not without evidence to guide us from around the world. In the early 2000s, Portugal was in a worse place than where Australia is now. By flipping expenditure on drugs policy to shift the focus to health outcomes, Portugal now has a drug-related death rate 10 times lower than Australia’s.

…my heart breaks for the parents and loved ones of yet another curious, bright, naughty kid who was unlucky enough to eat the wrong thing at the wrong time…How would I cope with the loss of one of my own, in the knowledge that society has not implemented everything that it could to ensure the tragedy could be avoided? That some in society might think that it “serves them right”, dabbling with infractions of the law. Really? Death as a “learning outcome”? 

In the end, this issue is not going to be resolved… by opponents inspired by the un-attainable ideology of a “drug-free Australia”… This is an issue that will be bled out of Australia, life by life, until such time as parents decide: “No more.” I have yet to meet a parent who is prepared to sacrifice their child on this altar of ideology and I abhor those who embrace the rhetoric that suggests this is reasonable.

It’s not reasonable that young people should die before the generation that preceded them. It’s not reasonable to accept that as a norm. What is reasonable is for any civilized society to leave “nothing in the locker room” when it comes to keeping people alive.

Leadership requires bravery and wit, and whatever it is we’re seeing from politicians on drugs policy, it’s neither courageous nor clever. And if politicians of any shade can’t look down the barrel of a camera and say that they will commit to that, they don’t deserve the job with which they’ve been entrusted and for which we pay them.

David Caldicott is a consultant emergency physician at Canberra’s Calvary Hospital in Australia.
Original article can be found at:
https://www.fds.org.au/messageboard/opinion-piece-by-david-caldicott-from-canberra-s-calvary-hospital

 
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Grief – It’s Just Like That

I am sitting in our Arizona room looking out past our front garden, up to the soaring Rocky Mountains and the crystal clear cerulean blue sky. It is a view I love more than any other in the world. But my heart is heavy and I can’t seem to cheer it up.

And I realized, after a few days feeling like this, that grief is just like that. We can’t force the feelings to go away when they show up. We just have to ride them out. Like being on a river in a raft, floating along enjoying the peace and quiet and beautiful scenery when you come to a section of rapids. Hopefully you have your equipment in place: helmet, life vest, paddle. You know you need to hold on, gather up your energy and fortitude, and ride it out until you are through the rough water.

Where do we find the fortitude to be able to ride out the turmoil that this life can bring our way? This world offers many kinds of coping mechanisms, most of which offer only temporary relief – diversions – like watching a movie, going on a trip, shopping, eating, using alcohol, or a substance, etc. These may work for a small dip in the waves. But what if you are thrown out of the raft during a violent upheaval from the current? How will temporary diversions and coping mechanisms fare? As we all know from experience, not too well.

The equipment we need for a healthy and stable life on this planet should be in place so that when difficult times come, we can at least fall back on it: daily habits that promote well-being; a solid community support system like AA or 12-step groups or a small accountability group; a foundation of spiritual beliefs and practices.

My husband and I rely on that equipment – the only real stability we have known in the wake of our son’s death from a heroin overdose. We keep up our daily exercise and healthy diet and sleep; we call on our close community of friends who know us well and support us through thick and thin; and lean on our faith in a God who loves us, trusting His promises. We aren’t instantly removed from the tumultuous currents, but we know we will get through. I need to remember this today.

Memories

I am surprised when, although it has been over four years since our son died of a heroin overdose, memories surface and grief follows. The surprise comes because the memories seem to come ‘out of the blue’, from no particular trigger and for no particular reason.

My husband just had a memory that was triggered when he heard our seven year old granddaughter express trepidation over seeing a bird that had died and fallen into the back yard. It was as if our son was seven again, full of wonder and normal childhood fears. His voice, his emotions, him.

I have had memories of our son as I’ve been working in our daughter’s garden or driving to the grocery store. JL as a young adult, just his face in some everyday interaction, triggering the sadness that he is no longer on this earth, part of our life, living the life that most 29 year olds are living.

It seems that memories don’t need a reason to rise to the surface from out of our hearts. Our son has been in our hearts since the day he was born and he continues to live there. It is the strongest ‘evidence’ we have that life does not stop after we die and physically leave the land of the living. We are eternal beings and I am very thankful for that.

WITH or WITHOUT HOPE?

There is something unique about the Christmas season, even if you do not buy into the Biblical story that lies at its core, even if you hold some other faith, even with no faith at all. For some reason, and not coincidentally, this time of year usually brings a sense of hope to most of us: hope in a better future for us and our loved ones, for society, for the world.

I think it is also tied in with the advent of a New Year, a new beginning, a chance to make changes that need a special impetus. “Hope smiles from the threshold of the year to come, whispering, ‘It will be happier’.” (Tennyson). It seems “Hope springs eternal in the human breast” (Pope) and as we stand at the starting line on the path of a new year, we are forward-focused with possibilities, even unlikely ones.

Hope is optimistic. Hope creates courage. Hope fosters healing. Hope dispels fear. Hope supplies fortitude and persistence. Blind Helen Keller said, “Optimism is the faith that leads to achievement. Nothing can be done without hope and confidence.”

But what about those among us – our family, our friends, even our selves – who see no hope for the future, feel no sense of expectation but instead see only more of the drudgery they have lived with in life, the continual uphill climb with no rest along the way, no way out of an unbearable situation? A relationship, prison, an addiction, an illness, poverty, a loss. I think we all know that for these discouraged and depressed ones this week, among all weeks of the year, is the final straw. Everyone seems happy and contented, planning new goals, possible changes, new adventures – everyone except them, except “me”.

Eight months before our son’s death, he saw a friend overdose and die during the holidays. It was the impetus for him to seek help and go through withdrawals from heroin one more time with the hope that he would be free forever from his addiction. It was a realistic hope – if we had understood what he knew: he needed medication to help him achieve that long-term goal. We had hopes but they were based on mis-information and faulty assumptions. Eight months later we realized our mistake.

If you are among those who feel no hope, who are facing unbearable situations, seemingly unbeatable odds, please remember that we all – ALL – need help at times with feeling hope-full. Take the one step that can help you find the hope you need to envision a different, better future for yourself: call someone or go somewhere. A friend, a help-line, a hospital, a 12-Step meeting, a church service. Reject feelings of shame at admitting you need help by remember that we ALL need help to make it through this life. We were never meant to live life alone. We ALL need the support of a community of some sort. Advocate for yourself – you are worth it – until you find someone who will help. And don’t forget God. His children throughout the millennia have felt despair and depression. But we can remind ourselves of what King David said: “Why are you in despair, my soul? Hope in God, my help, my God.” (Psalm 43:5)

And for those of us who are feeling the anticipation of a new year with new hopes and realistic expectations, let’s be intentionally on the look out for those whose hope is lost and who need a listening ear and a helping hand. Let’s use our blessed life to help someone else.

Woman of Substances

In 1979, the novel A Woman of Substance was published. It was the first in a series of seven portraying the substances and schemes, the means and maneuvers of three generations of a retail empire. Being “a woman of substance” is considered a great compliment for a woman who aspires to be influential, a woman of power, a positive influence. 

In a clever spin on this phrase, journalist and author Jenny Valentish has written Woman of Substances. I picked it up last year while in Melbourne, Australia and I couldn’t put it down. Her narrative flair for relaying her personal experiences while presenting scientific findings on addictions of all  sorts is extremely engaging for women – and men.

Jenny’s nutshell:

A girl falls down a rabbit hole. She obeys every ‘drink me’, ‘eat me’ prompt and meets all sorts of freaky characters. Chaos ensues. Then she wakes up and exploits her position as a journalist to ask experts what that was all about.

Although it is not a memoir per se, her blatant honesty and self-deprecation about her past and her choices is revealing, while not glamorizing the depths to which her addictions took her. She interviewed 35 clinicians, counsellors, doctors and academics about their fields of expertise and shares her personal experiences of her up and down road to recovery and sobriety.

The chapters cover: The roles of temperament and impulsivity in addiction. Hitching adolescent identity to substances. Internalized misogyny as a contributing factor. The relationship between substance use, eating disorders and self-harm. Sexual assault and spiking. The impact of childhood trauma on the brain and behavior. Related foibles, such as gambling, theft, compulsive buying and compulsive sexual behavior. Self-medicating mental illness and PTSD. AA and other forms of treatment. The ways in which research and treatment is geared towards the male experience.

My husband, daughter, and I had the privilege of meeting with Jenny for lunch in Melbourne last week. She is as real in person as she is in print. We discussed current trends of drug addiction in Australia along with recovery and family help groups she is connected with.

What reviewers are saying:

“Raw, revealing, at times heartbreaking, but searingly honest and aimed to support anyone who is wondering if they will ever recover from addiction.”

“This book taught me things I wasn’t expecting about the landscape of substance use. You don’t have to be a spectacular comet of crazy like the young Valentish to find something of yourself in these pages. I can’t imagine there isn’t a young person, friend or parent who won’t get something important from reading this book.”

“Like a tour guide in a foreign land, Valentish waves a flag and provides a path back from the abyss. This is an enormously compelling, confronting and informative piece on addiction and recovery from a female perspective.”

Ultimately, Jenny show us that being a Woman of Substances keeps you from being influential, powerful, and a positive influence. As we told her, we are proud of her determination to truthfully relay her failures and her persistence in walking the uphill road to wellness and freedom. They will assure her place as a powerful and positive influence on this generation.

www.womanofsubstances.com

You can purchase Woman of Substances on Amazon or at your local bookseller.

Change Our Way of Thinking

In the 1970’s, Bob Dylan sang: “We’ve got to change our way of thinking, make ourselves a different set of rules…”

I thought about this song recently as I remember how differently we, as parents of an opiate/heroin user, thought a decade ago. We thought, and were taught, that if our son just worked the 12-Steps hard enough he could gain lasting sobriety.

We had an abrupt and jolting wake up call on August 2nd, 2014. And what we have learned since our son’s death is that it’s just not that simple. Yes, there are opiate addicts – better, those with Substance Use Disorder – who have survived this deadly addiction without Medication Assisted Treatment (MAT), but they are few and far between. And they did not achieve sobriety with one attempt.

Last week,I heard an update on the current Ebola outbreak in the Congo. Two hundred people have died already and those fighting the battle are using every resource possible to contain it. It is terrible.

What if we treated the opioid epidemic with the same urgency and resources?

A sheriff in a county near Seattle had a similar epiphany last year after he was elected sheriff. He toured the jail and and saw it had become a de facto detox center full of very, very sick people. TY Trenary said: “Detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out, just suffering.”

Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.

The county’s program includes small steps, like making transportation easier for people in drug treatment. They train family members and others in the community on steps to reverse overdoses with medicine, and they send teams of police officers and social workers to help addicted homeless people.

The new approach is paying off. The teams have helped hundreds of people find housing and drug treatment.

I have changed my way of thinking – how about you?

https://www.npr.org/sections/health-shots/2018/10/28/658476111/a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster%20?utm_source=npr_newsletter&utm_medium=email&utm_content=20181104&utm_campaign=&utm_term=

No Magic Bullets

Last week here in Tucson, Arizona, some young people were together at a house using heroin. They were unaware it was laced with fentanyl. Friends ran to a nearby restaurant and flagged down police to help one person who was unresponsive from an overdose. He was revived with Narcan (naloxone). The officers were then taken to the house where six others had overdosed. One 19-yr old did not make it. Tucson Police all carry naloxone because they are usually the “first responders” to victims of overdose. Sadly, our Pima County Sheriff officers do not carry it – with the line of reasoning being that it is too costly for the training and they are not usually the first responders.

Naloxone (Narcan, Evzio, injectable or intranasal spray) was patented in 1961, and is an opioid antagonist—meaning that it binds to opioid receptors and can reverse and block the effects of other opioids by displacing them from the opioid receptor sites in the brain. Whereas an agonist causes an action, an antagonist blocks the action of the agonist. It has been used in hospital “code arrest” emergency situations for decades. It is being carried by emergency personnel and families of addicts because it can very quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain medications.

But it is not a magic bullet. Statistically, most opioid overdoses happen when the user is alone. By the time they are found, usually many hours later, it is too late for resuscitation. Another reason is that public safety experts are concerned, and rightly so, because addicts may be less motivated to find a way to quit using opioids since they can be revived. Their family and friends will also feel less anxiety and less concerned about urging their addict to get long term help. A recent news special interviewed several opiate addicts who had been revived multiple times with naloxone. One was an older man who is a “career addict”. He has no real desire to get clean and carries naloxone in case any of his friends need it. The other was a young woman who had overdosed and been revived several times and had finally gone through a recovery program and is clean and sober. She is very thankful for the times she did not die because finally, finally she was able to get to the point where she wanted to leave her miserable life of addiction and be free. But let’s remember: she needed a recovery program option. We cannot just turn those addicted to opioids back onto the streets after reviving them.

She is an example of the recent statistics that it takes on average 10-12 recovery attempts before an opiate addict can stay clean and sober long-term. Ten to twelve. It is a fact that relates to the addictive quality of opioids. For many of those addicted to opiates, those 10-12 attempts will never happen without overdoses and then being revived with naloxone. We, as a society, must be willing to offer this chance to those who are trapped by addiction to substances that have poured onto our streets and into our schools at an unprecedented rate. Our son went through several recovery programs and was at the point of really wanting to be free of his addiction. But without the needed medication, such as Suboxone, his last relapse proved fatal. He died of a heroin overdose at 25 yrs old – alone. There was no magic bullet for him.