(Ninth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Shells are beautiful and fascinating to me. Each and every one is unique, differing from others just like our fingerprints. John and I just spent time at the central eastern coast of Australia and on our daily walks on the beach I just couldn’t stop picking up shells – especially the Nautilus shells with their logarithmic spirals of every size, shape, and color. These are empty shells that were once the home of a sea creature.
The exoskeleton of mollusks is the hard, outer layer that protects the tender creature inside. As the creature grows, layers are added to accommodate it. One day, as I was picking up shells in the surf, the inhabitant was still inside. It immediately retreated as far back into its shell as possible.
(Seventh in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
When public health is at risk, one can only wonder about the motives behind politicians’ decisions – our “public servants” as they used to be referred to – regardless of what they may say. But we don’t have to guess their motives because actions speak louder than words and the actions of the US Department of Justice (DOJ) this week regarding Purdue Pharma and the Sackler family are unconscionable. This deal is not justice for the victims and their families for this pervasive and criminal corporate greed.
With so much distress in the world with the Covid-19 Pandemic, especially the effects it is having on the weakest and vulnerable members of our societies, I have hesitated to announce a personal accomplishment. Yet, my hope is that as Opiate Nation gains more visibility, it will get into the hands of people who could be most encouraged and benefit from our story.
I am a member of a group of 35,000 women called “The Addict’s Mom” on Facebook. I confess, I rarely read the posts because it is so depressing: Story after story of mom’s who have been holding out for years to see their daughter or son released from the hell-hold of addiction to drugs, only to then post that “…today I lost my daughter/son…can someone tell me how I will survive this?” It is for these mom’s and dad’s and siblings and friends that we wrote Opiate Nation, but one of the stipulations of being a member of the group is no self-promotion. So I hope that, with more visibility and more reviews and re-posts on social media, our book will get to these most desperate of people.
In these weeks of living life in a new way with the Coronavirus pandemic, I have found myself doing something I am not normally inclined to do: choosing to look away from the ongoing Opioid Epidemic. Sadly, it has been easy to do. John and I arrived in Melbourne in March on the last flight from LAX allowing non-residents into Australia. When we planned our trip in January to be here for the completion and delivery of our new Tiny Home, Covid-19 was barely in the news.
After our 14-day quarantine, and during our first few weeks here, we were supposed to speak at two events which were cancelled. When the meetings switched over to Zoom, we were then able to share the story of Opiate Nation. It was well received and appreciated, as it brought to light pitfalls and vulnerabilities that parents and their children face in the 21st century. Since then, we have been busy setting up our new home, arranging installations, and finding furniture and appliances. We are thankful and feel blessed to be able to be here with our daughter and family – and to be in a country where the leaders have been honest and proactive, where the government has a wide social safety net and comprehensive health care for everyone, and where the public is almost uniformly willing to trust and follow their stipulations.
Meanwhile, in the back of my mind, I have continued to think about people struggling with addiction and wondering what their lives are like during these times that are challenging – even for the rest of us. With the restrictions to help slow the spread of the virus, many rehab and recovery programs are now not an option. For those who have had jobs, many of which are hourly-wage or temporary positions, they may now be unemployed. If they are taking medication as part of their harm reduction/medication assisted treatment, how will they pay for it?
CNN reported this week that Mallinckrodt, a large opioid manufacturer, has reached a settlement agreement in principle worth $1.6 billion with attorneys general for 47 states and US territories. Mallinckrodt announced that the proposed deal will resolve all opioid-related claims against the company and its subsidiaries if it moves forward. Plaintiffs (states) would receive payments over an eight-year period to cover the costs of opioid-addiction treatments and other needs.
Compensation: recompense given for loss injury, or harm suffered. Are the settlements that are being levied against Purdue Pharma, Johnson & Johnson, TEVA, Mallinckrodt, McKesson Corp., Cardinal Health Inc., AmerisourceBergen Corp. really compensation for the millions of lives ruined by opioid addiction? Or for all the lives lost in the past 20 years?
When I was growing up, this metaphor was commonly espoused: “Don’t air your dirty laundry in public.” That is, you shouldn’t reveal things from your private life that people usually don’t want others to know and they don’t want to hear anyway. Things like inappropriate confessions and unpleasant family secrets. Everyone will be embarrassed and people will feel ashamed.
Now we are more likely to hear someone respond with “TMI – Too much information” when someone goes beyond the bounds of information that no one wants to hear – either too creepy or medical or personal. Totally understandable.
But is it airing dirty laundry for us to speak openly about conditions or situations that are of a communal nature? Topics such as physical or sexual abuse, or complicity and criminal behavior by politicians or leaders, or suicide, or addiction? Of course, there are some details about issues that plague us as a community that do not need to be part of the public discussion in certain situations. But that is different than bringing an issue into the light of day so that it can be discussed in order to work towards a solution.
The other day I was thinking about our son and his struggles with drugs and alcohol and all that we know and understand now compared to what we knew and understood in the early 2000’s right up until his death in 2014. I saw myself, as if I were standing out in an open field, turning, looking back over my shoulder. That’s what I do when something unexpected or disturbing happens. I look back and try to figure out what I missed, what I could have done differently.
My next thought was: Why couldn’t my husband and I see the handwriting on the wall? Why didn’t we realize how dire the situation was at every new juncture with our son as the years went by? But, I realized that it wasn’t that we couldn’t see the handwriting on the wall. It was that we didn’t understand what it meant.
Arizona brought a case to the Supreme Court that sought to stop the Sackler family, who own Purdue Pharma, from transferring billions of dollars from the company in an attempt to avoid paying the claims made against them concerning flooding communities with the prescription opioid painkiller Oxycontin. The Court said they would not hear the case – the justices like to hear rulings from lower courts first.
One of the places the Sackler’s have hidden their money is in an estate in England. A recent article* states: “A complex web of companies and trusts are controlled by the family, and an examination reveals links between far-flung holdings…The estate is proof of the great wealth belonging to the family accused of playing a key role in triggering the US opioid epidemic. But there’s little evidence of that connection. On paper, the land is owned by a handful of companies, most based in Bermuda, all controlled by an offshore trust.” Read the rest of the article which cites the Associated Press’ findings of the deceptive and convoluted practices of a family dynasty that has lived like kings and queens off the misery and deaths of millions of people world-wide. Our son was one of them.
An estimated 10.3 million Americans aged 12 and older misused opioids in 2018. These estimates are likely too low. How many people who are taking opioid Rx’s for pain that could be relieved by physical therapy or a change in lifestyle actually report they are “mis-using” them? My next blog will delve further into this aspect of a country that has become averse to pain…
John and I live in Melbourne, Australia with our daughter and her family several months of the year. Since our son’s death by overdose from heroin 5 years ago, we have become interested in and involved with some of the Alcohol and Other Drug (AOD) programs there. We also receive news reports on current trends etc.
What is interesting to me is the contrast between the Australian approach to AOD use and the American approach. Australians accept that there will be drug and alcohol abuse in their society and therefore speak openly and candidly about it. A recent newsletter (Dec. 13, 2019) from VAADA (Victorian Alcohol and Drug Association) is a perfect example of their approach. It was an alert about “ increasing numbers of reports about very strong heroin in Melbourne, which has resulted in an increase in accidental overdoses.”
The alert asks providers in the AOD sector to alert their clients (heroin users) to this problem and to be careful and look out for their fellow users. They also urge providers to share specific harm reduction information to help reduce the risk of overdose, such as: get naloxone and keep it handy; try not to mix drugs (there is a lot of methamphetamine use mixed with heroin/opioid use); be smart about your tolerance, knowing it can change if you haven’t used for even a few days; and try not to use alone or in an unfamiliar place where you wouldn’t get help if you do overdose (which was the case for our son).
When I was in Melbourne, Australia recently with our family, I was starkly reminded of the ubiquitous presence of opium in the past as well as the present. Not that I can ever really forget it’s demon-like presence. But when I am asked what I do and I respond that I am a new author, the next question is what my book is about. After I give a short description, I am always surprised at how many people have stories of their own involving this ancient plant – a plant that truly offers humankind a double-edged sword. It can so wondrously relieve pain when our bodies have been injured or undergone surgery. Yet it has a mysterious way of latching on to a large percentage of we mortals who, having once legitimately used this soothing balm, then find the memory of that bliss like an oasis in the desert that we chase after at all cost.
Within a week, I heard three stories. One seems like something out of another era. A 60-yr old man, after hearing about our son and Opiate Nation, began to tell me about his years growing up in Singapore. He explained that both his mother and his father were addicted to opium and would regularly go to the opium dens to smoke. He remembers the intoxicating smell when he would go to find them to use the opportunity of their being in a blissful state to get money from them. He never wanted to use that drug or any other.
The Ohio Society of Addiction Medicine is a chapter of ASAM - A professional society actively seeking to define and expand the field of addiction medicine.
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