The Tattoo – Stigma

(Translation into most languages at tab to right.)

In the Greek and Roman worlds, a stigma was a tattoo or brand, especially for a slave, identifying the person as “inferior.” As stigma moved into English, it referred to a mark you couldn’t actually see but which was nonetheless powerful. Social stigmas are based on perceivable characteristics, associated with certain behaviors that distinguish a person from other members of society. They convey disapproval and disgrace. Dis-approval. Non-approval. Dis-grace. Non-grace.

In an article on The Stigma of Addiction from Hazelden Recovery we learn: “The stigma of addiction stems from behavioral symptoms of substance use disorder…which can result in negative consequences including legal, occupational and relationship problems. Understandably, these consequences cause embarrassment and shame among those affected. They also create stigmatized attitudes and perceptions among the wider public, a response that perpetuates and exacerbates the private shame associated with drug addiction. For generations, this combination of personal shame and public stigma has produced tremendous obstacles to addressing the problem of alcoholism and addiction. Today, the stigma of addiction is seen as a primary barrier to effective addiction prevention, treatment and recovery efforts at the individual, family, societal levels. Addiction stigma prevents too many people from getting the help they need.” Yes, only one in 10 people struggling with addiction receive treatment. The article goes on to discuss the irony that many of these stigmatizing behaviors diminish and/or disappear when a person is appropriately treated in recovery.

When talking recently with some of our son’s friends, they have been unwilling to let their past drug use become public knowledge because of the potential negative repercussions they justifiably fear in their careers and relationships. How much worse would it be if they were still living with addiction? What does this say about us as individuals, communities, employers, and society in general? When an individual is seen as having a moral failure instead of a chronic health condition, stigma is the logical result. But no one makes the decision about how their brain will react to a substance and whether they will become addicted after minimal use or hate how it makes them feel and never use it again.

Negative labels stick like glue to our hearts and soul and, for those struggling with addiction and alcoholism, the personal shame becomes how they define themselves. The public stigma that follows is the tattoo they never asked to have. If we can reject stigmatizing and instead provide a safe and listening ear to those struggling with addiction, inviting them to share their stories and encourage them to consider recovery options, they may be willing to join the many people who do learn to manage their disease and successfully recover. Let’s remember that they are just as valuable and able and worthy of love – and as human – as you and me.

https://www.hazeldenbettyford.org/recovery-advocacy/stigma-of-addiction

Australian Real Drug Talk

Translation into most languages at tab to the right.

One of the things I have come to appreciate about the Australian way is their straightforward approach to life. They are easy-going yet they say what they mean and you know where you stand. A lack of pretense – with a large dose of slightly off-color humor added in.

I think that is why they are more advanced in their drug policies and treatments than America – they are more honest and have less taboos. They benefit from having had comprehensive public health for decades which has facilitated progressive drug policies such as clean needle exchanges, safe-injecting sites, and medication assisted treatment.

John and I had an interesting conversation a few weeks ago here in Australia with Jack Nagel. Jack does the “Real Drug Talk” podcast from Melbourne and also runs the Connection Based Living Recovery Programs. We were preparing to record a podcast with Jack – see links below – and were asking about his experiences and what the current trends are here with drugs of abuse.

https://podcasts.apple.com/us/podcast/saying-goodbye-to-my-son-in-a-body-bag/id1507177011?i=1000533422150

In discussing opioids, I wondered why methamphetamines seems to be the main drug of choice and why heroin is not as common here as it is in the States. Jack said that in the 1990’s there was a big problem with heroin coming in from the Golden Triangle of SE Asia and lots of overdose deaths. And the heroin use was IV, not smoking. So, there is a collective memory of street people using heroin and dying which created a lot of stigma and fear associated with IV use.

After that trend slowed, people began using meth – young people like Jack –because smoking or snorting meth seems more innocuous and a less intrusive way to take a powerful drug than IV. Jack said that there is a huge cohort of people who don’t live on the streets and who smoke meth for years. Sadly, they don’t seek help because the public messaging that portrays meth addicts as homeless people with sores and missing teeth doesn’t apply to them. But meth addiction will eventually burst that bubble and ruin their lives too.

There is also a growing problem with cocaine. While once considered the drug of the wealthy city dweller with some high-flying users in Australia spending $10-$20K per week, statistics reveal cocaine usage has now spread much further. Consumption has grown in other areas and demographics where prosperity has increased such as middle-class teachers, tradesmen, etc. Australia is now the highest per capita user of the drug in the world. And the rise in use is being driven by men aged in their 20’s, with Sydney leading the country in use. The most recent stats reveal that there are nearly 1 million weekly cocaine users in Australia out of a population of 26 million. (1,2,3)

We also talked with Jack about what the entry drugs are for kids here in Australia. After alcohol and pot, they usually begin with hard “party” drugs used at house parties and concerts like ecstasy/MDMA, benzodiazepines, GHB/GBL. All mood-altering drugs that create different types of euphoria, but which are dangerous because many times they are mixed with alcohol and other drugs, sometimes without the user’s knowledge.

Even though heroin is in the background in Australia, it is still available and becoming more dangerous due to fentanyl being mixed in to the supply of much of the heroin, and all opioids, along with other drugs of abuse. (4)

When our son, JL, began using Oxy’s he never thought he would even try heroin. Then, as Oxy’s became more expensive and heroin was cheaper, he started smoking heroin. He then swore he would never stick a needle in his vein – the danger and stigma to him was clear. Eventually, just like 95% of heroin users, he did just that. He was living under the delusion that smoking opioids – or any drug – would never lead him to become a “junkie”, an IV drug user.

My concern for the young people and families of Australia is that, as The Age reported in 2020, pain management with opioids has increased here too, although not to the degree it had in the States. Opioid-related deaths have increased in the past decade and today at least three people die from opioid harm each day and 150 are hospitalized. (5) Fentanyl is showing up in wastewater testing and drug overdoses of cocaine and meth, drugs where the users are not expecting a potent narcotic. Because it is synthetic and cheaper to produce in China and India, it brings its criminal networks a greater profit margin.

As I’ve said before and will continue to say: We will not treat our way out of the opioid/drug epidemic. Prevention is key. Let’s continue to stay aware and educated about what we all can do to keep our children and their future safe and healthy.

http://www.RealDrugTalk.com.au

1. Why cocaine is most used drug in Australia behind cannabis

https://www.heraldsun.com.au/news/national/why-cocaine-is-most-used-drug-in-australia-behind-cannabis/news-story/0fa9bbcec60dfe0ecfb52a5cb58a38f5

2. Australia the highest per capita cocaine user in the world

https://www.news.com.au/national/australia-the-highest-per-capita-cocaine-user-in-the-world/news-story/c91869d4e2b2adeef266917d82f705e0

3. Sydney and cocaine: an illicit love affair for the ages

https://www.smh.com.au/national/nsw/sydney-and-cocaine-an-illicit-love-affair-for-the-ages-20210225-p575uz.html

4. Fentanyl in the Australian illicit drug market

https://adf.org.au/insights/fentanyl-australian-illicit-drug/

5. Australia’s opioid crisis: How pain management got out of control

2021 International Overdose Awareness Day August 31

Translation into most languages at tab to the right.

The need has never been more urgent to alert us all to the risk of overdose facing millions of people worldwide. During the 18 months of the Covid-19 pandemic, overdose deaths have risen approximately 30% in many parts of the world due to isolation, unstable drug sources, and lack of reliable medical and recovery help. Even the normal inadequate support services have been seriously disrupted and diverted. And the hope of C19 disappearing sometime soon is now seen as wishful thinking – it is a new deadly virus we will have to learn how to live with.

So, what can we do to help prevent further loss of lives for those already struggling with addiction?

Continue reading “2021 International Overdose Awareness Day August 31”

Teenage Perils

(Translation in most languages available at tab on right)

Int’l Overdose Awareness Day Sale on eBook & Paperback through Sept 1st

Most of us have heard that the category of “teenager” came about after WWII. Before that, in a mostly agrarian society, you were either a child or an adult and the demarcation was when you went from being directed and cared for by your parents to being responsible for yourself and caring for others.

The word “teen” was introduced as early as 1818 referring to a person who was 13-19, “teener” from 1894, and “teen-ager” from 1922 (1). But the terms didn’t stick and didn’t carry a sociological group identity until after WWII. Being a teenager became its own sub-culture that revolved around like-ness, popularity and a fear of being on the outside.

Increasingly, the modern teenager relies more on peer-pressure than family relationships and values. And, peer pressure and group dynamics is known to be one of the highest risks for adolescent drug and alcohol experimentation and use. In one chapter of Hit Makers: The Science of Popularity in an Age of Distraction, Derek Thompson discusses teenagers at length (2). He writes, “Psychologist Laurence Steinberg, put people of various ages in a simulated driving game. Adults drove the same, whether or not they had an audience. But teenagers took twice as many “chances” when their friends were watching. Teenagers are exquisitely sensitive to the influence of their peers.”

Continue reading “Teenage Perils”

Looking Back to See the Future

(Translation into most languages is available to the right.)

When I am doing research for an upcoming blog post, I can get lost. There is so much information now on drug addiction and the opioid epidemic that I suddenly look at the clock and realize I’ve been wandering virtually around the world and becoming more discouraged with each new article or report: Scotland has more drug overdose deaths per capita than any European country (1); Fentanyl is  flooding California with overdose deaths skyrocketing (2); the use of over-the-counter codeine (an opiate) cough medicine among eighth graders in the US has increased (3); and, Australia now has the eighth-highest per-capita opioid consumption in the world (4).

Continue reading “Looking Back to See the Future”

What Would They Say?

(Short topical blog based on Opiate Nation – translation into most languages in tab on right.)

August 2nd is the seventh anniversary of our son’s death. JL died of a heroin overdose in the early morning hours of that Saturday in 2014. He was 25 years old.

In 2020 alone, 93,000 people died of drug overdoses in the USA – hundreds of thousands more worldwide. Millions in the past few decades. These were beloved daughters, sons, partners, parents, friends, relatives. I think I can confidently say they did not want to be addicted and if they could have turned back the clock to the time before they began using drugs, they would have.

Continue reading “What Would They Say?”

Stories: Common Threads

(Thirty-second in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

During the years since our son died, we have been encouraged and supported by his friends –many of whom have awe-inspiring recovery stories. We asked several of them to share their stories in Opiate Nation with the hope that they will give insights for parents and encourage other young adults to know they can be sober and have a meaningful life full of joy, love, and hope.

What we learned from these stories – and from the many stories we have heard in recovery meetings, in the news, and in books – is that there are some common threads that run through the lives of people struggling with addictions. And although there are no formulas for raising kids who will not use drugs or abuse alcohol, becoming aware of the common threads and risk factors in families with addiction and alcoholism is a good place for parents to start. If these commonalities are understood and taken into consideration, they might help avert tragedies such as the one we experienced.

I have written about each of these threads in separate chapters of Opiate Nation, but I will summarize them here:

Continue reading “Stories: Common Threads”

Celebrating Freedom and New Life

April 4, 2021

 (I am taking a break from the chapter by chapter topics from Opiate Nation to focus on the significance of this holy week. Translations into most languages available at tab to the right.)

Spring is the season of regeneration, freedom, new life. The time of year when the whole earth seems excited to be alive after being dormant all winter. For the northern hemisphere, March and April are Spring – for our friends and family in Australia, right now it is Autumn. Regardless of what season it is where you live on this planet, it is Easter Sunday and the end of Passover week. Both the Christian and Jewish traditions celebrate the freedom from bondage and the beginning of a new life, although from differing perspectives and beliefs. Both begin the time with reflection and prayer. (I don’t understand Islamic tradition well enough to comment on it except to say that Ramadan is observed around this same time of year with introspection and fasting in remembrance of Muhammad receiving the Quran.)

For Christians, the freedom is from the bondage to sin in one’s life; for Jews, it is the freedom from bondage that the Israelites suffered under in Egypt. Both faiths look to an historical event in the past. They also remind us that while bondage was dealt with symbolically once – whether personally or communally – it is an ongoing problem in this imperfect world.

Continue reading “Celebrating Freedom and New Life”

The Important 0.1 Percent

(Nineteenth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

DNA sequences for any human is approximately 99.9 percent identical to every other human. That means that only 0.1 percent of our genetic makeup is unique to us. Genes are functional units of DNA that make up the human genome. But don’t be fooled into thinking that 0.1 percent variation is insignificant. It is nearly 3 billion base pairs of DNA which boils down to 3 million differences that determine our physical features like hair and eye color and health risks or protection from diseases such as heart disease, diabetes – and addiction. Genes influence the numbers and types of receptors in peoples’ brains, how quickly their bodies metabolize drugs, and how well they respond to different medications.

The National Institute of Drug Abuse (NIDA) reports that family studies that include identical twins, fraternal twins, adoptees, and siblings suggest that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup. Scientists estimate that genes – including the effects environmental factors have on a person’s gene expression, called epigenetics – account for between 40 and 60 percent of a person’s risk of addiction.

Epigenetics – epi meaning “above” – is the study of functional, and sometimes inherited, changes in the regulation of gene activity and expression that are not dependent on gene sequence. This means exposures or choices people make can actually “mark” (remodel) the structure of DNA at the cell level. So epigenetic regulatory systems enable the development of different cell types (e.g., skin, liver, or nerve cells) in response to the environment. These epigenetic marks can affect health and even the expression of the traits passed to children. For example, when a person uses cocaine, it can “mark” the DNA, increasing the production of proteins common in addiction which is believed to correspond with drug-seeking behaviors.

Continue reading “The Important 0.1 Percent”

An Ounce of Prevention

(Eighteenth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

In 1735, Benjamin Franklin wrote a letter to his own newspaper, The Pennsylvania Gazette, where he used this now-famous phrase: An ounce of prevention is worth a pound of cure. He wasn’t referring to a pandemic or keeping your roof in good condition so it won’t leak or changing the oil in your car so you won’t ruin your engine or, my personal example, brushing your teeth to avoid tooth decay and gum disease.

When I was growing up in the 1960’s, brushing our teeth every day was a new habit for most Americans. Even though the toothbrush was invented in 1857, it wasn’t until after WWII that we got in the habit of regularly brushing our teeth. When I was young, I didn’t give much thought to personal care and it seems I didn’t brush my teeth often – I was too busy living life – which is why my two older sisters gave me the endearing nick-name “moss-mouth”.  (FYI, I must have good teeth genetics because I didn’t have my first cavity until I was 30.)

Continue reading “An Ounce of Prevention”