(Translation into most languages at tab to the right)
I wish everyone could read the penultimate chapter of The Least of Us by Sam Quinones. Its title is the same as that of the book. I have almost every line underlined and starred. In it, he describes the dire state we in Western society are in with addiction, the well-thought out reasons many of our public policies are still getting it wrong, and the slivers of hope that encourage us that the world could look differently for the next generation of young people. Some poignant quotes:
“Underground chemists seem to be searching the chemistry literature for drugs that might be molecularly modified to be more potent…The world Gary Henderson predicted when he coined the term ‘designer drugs’ in 1988 is now with us. Counterfeit pills laced with fentanyl (and new synthetics every day) and made in Mexico now dominate the market…There seems now no way to stop all the bizarre drugs devised by those whose own brain chemistry has been twisted by the profits of the underworld’s free market…recovering addicts face scary odds as long as the drugs that torment them are widely available, potent, and almost free. The now-cliché is ‘We can’t arrest our way out of this.’ We can’t treat our way out of it either, as long as supply is so potent and cheap.”
(Translation into most languages at tab to the right)
It’s hard to know where to start in delving in to Sam Quinones new book, The Least of Us. The more I read, the more I want to say in the hope of convincing everyone to read this insightful and comprehensive treatise on how we ended up where we are today in American society and why he finds reasons for hope even amid such despair.
When Sam wrote Dreamland in 2015, he was truly an anthropologist documenting the origins, development and cultural characteristics of the Opioid Epidemic. But Quinones saw beyond the opioid epidemic and warned us of the dangers of synthetic designer drugs and the kingpins who made their products in Magic Bullet blenders and illicit labs. With cheap fentanyl, 100 times more powerful than morphine, traffickers laced it into every other street drug causing tens of thousands of deaths in America. At the same time, they made Meth more potent and cheaper, causing its own epidemic of mental illness, violence, and homelessness. It presents “the rawest face of living addiction. Meth users dragged themselves through the nighttime streets, howling, hysterical, starving.”
When he continued his investigations in The Least of Us, he came to realize that, “In a time when drug traffickers act like corporations and corporations like drug traffickers, the forces looking to manipulate our brains for profit are frightening to behold. So many more synthetic blasts compete for our brain receptors–from chicken nuggets and soda to cell phones and social media apps, methamphetamine and fentanyl.” (1) This is not news to any of us and yet we seem strangely mesmerized to our own state – and that of our children – as we continue to acquiesce to the lure of pervasive consumerism.
Big Dope – like Big Tech, Big Pharma and Big Finance – is Big Business aimed at the voracious consumer market in Western society where traffickers are producing illegal synthetic drugs of abuse year-round. No more having to wait for two or three poppy crops every year. They have easy access to world chemical markets, global banks to wash their money, and weapons to enforce their will. Blood Gun Money: How America Arms Gangs and Cartels written by journalist Ioan Grillo in Mexico, documents the ways guns are easily bought in the US and smuggled south to arm drug gangs in Latin America. Seventy percent of firearms the Mexican military seized in 2018 were made or bought in the US. But Quinones is clear that Mexico, China, and the US all share responsibility for the worldwide addiction crises.
Although the Law of Supply and Demand is commonly associated with economics, it is also part of our daily lives. When the supply of something decreases (making it rarer) or when the demand for that good increases (making it more sought after) the price goes up. Conversely, goods will decline in price when they become more widely available (less rare). This is never truer than in the world of illicit drugs.
Sam Quinones lived and worked in Mexico for 10 years and he believes “solutions will come only when Mexico and the US work together. This is crucial because walls don’t stop dope. Not in an era of free trade.” (2) He stresses that drug demand is important, but the drug epidemic begins with supply. Remember how the opioid epidemic started? Purdue Pharma – Big Pharma – and their relentless marketing (pushing, trafficking, peddling) and unlimited supply of prescription opioids? (3) They were the initial ‘dope dealers’ of the opioid epidemic. Or go back in time to the Opium Wars and British trade merchants. (4) And how about sugar-laced breakfast foods, snacks, drinks? (5) Did we demand them for our children or were they supplied and pushed via relentless advertising by multi-national corporations? And the motivation for all these actions? Money, and lots of it.
Next time, I will share the hope Quinones gained as he traveled the country and listened to stories from those affected by the addiction crisis. I hope that I have piqued your interest sufficiently so you will buy a copy of The Least of Us (6), read it, and pass it on to friends and family.
Laudanum––an opium tincture that contains almost all of the opium alkaloids, including morphine and codeine––was developed in the 16th century. Many Puritan wives of the whaling merchants used it daily. By the 18th century, the medicinal properties of opium and laudanum were well known. The Chinese knew it was addictive when the idle rich used it “recreationally”, and so they banned it in the 1720’s. But the British trade merchants (some of the early ‘corporations’) saw it as a source for additional income from their colonies. In 1839 the first wars were fought––The Opium Wars––that succeeded in opening up trade with opium from India. Those increased supplies created what we’ve all heard about – Opium Dens – that plagued China for a century.
(Translation into most languages available at tab on the right.)
My husband and I learned years ago that in many areas, we see and experience the world in very opposite ways. I live in the future, he enjoys the present. I am content with less, he needs more. I want to get to the destination, he enjoys the ride. Our theme song is The Beatles Hello Goodbye: ‘You say Goodbye, and I say Hello’. After living together so many years, some of our ingrained predispositions have begun to change as we have rubbed off on each other – and this is a good thing as I believe it makes us each a more balanced human.
This thought came to mind this week as I began to work on this blog post. Sometimes I am so focused on my destination or goal and being faithful to stick with it that it takes a while for me to realize I am not enjoying the ride. As I wondered why, I realized that it’s not that I don’t feel passionately about advocating for those struggling with addiction and mental health issues. Rather, it’s that I have begun to feel stretched too thin – which is not comfortable or healthy. With the holidays approaching, there are increasing family commitments and events that I want to enjoy and not just endure until they are over. The path to this goal is to be more realistic about what I can and cannot do within my finite energy and allotted time.
This contrast in ideologies applies to recovery strategies as well. When our son was trying to recover from opioid addiction 10-15 years ago, the goal was to complete a recovery program and once and for all become clean and sober – get to the destination. As unrealistic as this seems to us now, it is still a prevailing goal for many recovery programs. Sadly, what it did for our son – and for us – was to set us up for discouragement and shame with every inevitable relapse. Failure.
What I hear from current recovery advocates is that recovery is a goal and a process. If your desire and goal is to become clean and sober, you will embark on a plan of some sort. It is absolutely essential that you get to your destination because with many drugs, continued addiction often leads to death. But it’s also absolutely essential that you understand that it will be a journey with many ups and downs – and that you need to be able to enjoy the ride, the process, as much as possible so that you will have the continued desire to make it to the goal. And that those who are advocating for you, riding with you, will understand and assist you on your journey.
So, in attempting to take my own advice, I am going to discontinue weekly blog posts for a while. Instead, I will write blogs as often as I can and I look forward to your comments and ‘likes’ – every ‘like’ helps with visibility and brings new readers. After almost four years of posts on all aspects of addiction & substances, grief & loss, and mental health, if you search the site, you should find something to bring insight and encouragement for the issues that you are facing today. Let’s enjoy the ride as much as possible as we head toward our destinations.
It has been said thatthe opposite of addiction is not sobriety, it is connection – to others, to a community.The Coronavirus pandemic has brought disconnection and magnified loneliness and stress for people the world over due to social isolation, economic instability, reduced access to spiritual communities, and overall national anxiety and fear of the future. “We certainly have data from years of multiple studies showing that social isolation and social stress plays a significant role in relapse…relapsing to drug use can play a role in overdose.” Dr. Wilson Compton, deputy director NIDA.
The acronym HALT: Hungry, Angry, Lonely, Tired, is used in Alcoholics Anonymous and most recovery programs. It is a simple reminder that when our basic human needs are not met, one is susceptible to toxic thoughts and self-destructive behaviors including relapse and suicide.
Regardless of where you live, there have likely been restrictions imposed to limit the number of people who can gather together – from dozens in some countries to only the members of your immediate household in others – in order to slow down the high-speed train that is Covid-19. For many of us, we have been able to maintain our emotional equilibrium because we know this is for a limited time and we can look forward with hope to the future.
But what about those vulnerable members of society who already struggle on a daily basis with insecure housing and food supplies and to maintain their mental health, sobriety, or recovery? In the midst of one of the most isolating crises the modern world has known, it is no surprise then that cities across America, and around the world, are reporting dramatic increases in drug overdoses, alcohol relapses, and suicides.
In-person community meetings are at the foundation of recovery programs. And no wonder. It is in community where individuals become part of something greater than themselves. And I believe it is in the breakdown of communal life in individualistic American ideology that has, to a great degree, contributed to the anxiety, insecurity, and depression that so characterizes our national psyche and has led to the pursuit of finding relief in so many unhealthy ways.
A friend of our son who is an alcoholic who has been working his recovery for the past 8 years, put it this way:
“Self-isolation breeds relapse for people in recovery. With quarantine, people are losing the accountability they have relied on from in-person meetings and it’s a lot easier for people to further isolate and close off their emotions. Attending virtual meetings keeps me grounded and gets the message across as much as regular in-person meetings but lacks the fellowship aspect. This will no doubt expose many in recovery to loneliness.”
Even though increasing numbers of people around the world are vaccinated, it will not stop some of the isolation and loneliness. Is there anything those of us who are not isolated emotionally can do to help? The one thing my husband and I have made as a priority in our weekly schedule is to check in with friends around the world via texts, emails, letters, phone or video calls – including our young friends who are in recovery and elderly friends who just need to know they are not forgotten. With our social networks and finances, we can support organizations that are working the front lines to serve the addiction/mental health population. We can make or purchase masks, buy food and basic supplies, to give to those in need and support recovery programs in our area.
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What is a recovery community and what should it look like?
The answer to these questions is not simple – real solutions to real problems rarely are.
To recover means to return to a normal state of health or strength. When someone is injured in an accident or undergone surgery, they usually recover in hospital for a period of time where they can receive the special medical care that is required to keep them alive. If the injury or illness was severe or life-threatening, after hospitalization they would be moved to a rehabilitation facility where they receive appropriate and specialized care and therapy as they convalesce – they wouldn’t just go home. Convalescing is the recovery process of returning to health.
Recovery can also refer to the process of regaining possession or control of something lost or stolen. In a real sense, those who have become addicted to a substance or damaging behavior have had something stolen. That’s not a cop-out if we consider what happens to a person’s brain when addiction takes over. The chemical changes that take place in the brain steadily decrease the individual’s original ability to think clearly and make logical choices. Especially with substances, I consider that capacity to have been stolen.
Translation into most languages at tab to the right.
A few weeks ago, John and I were interviewed by Jeff Simone for his Surviving the OpioidEpidemic podcast (see YouTube link). We had a really great conversation about our family living with a teenage son with opioid addiction and how his death from overdose affected us and changed our lives. Jeff serves the addiction community with a coaching service called Reaction Recovery.
Here are some insights into his recovery approach.
Reaction Recovery is a private coaching service designed to help individuals thrive in their life of recovery from substance use disorders. It is a one to one, intensive behavioral approach to help individuals identify areas to make focused and intentional lifestyle modifications. Dr. Simone has been formally trained in clinical pharmaceutical and dietary supplementation advisory and management. He has earned degrees in nutrition, physiology, is a certified life coach, and has personally worked with over 200 people recovering from substance addictions.
Why ‘Reaction’ Recovery? Who is reacting and to what?
Reaction Recovery was started as a “reaction” to the current treatment approach to addiction. The medical community is doing a good job offering short-term acute care crisis management for addictive disorders, but are doing poorly offering long-term treatment for those who have become abstinent but not yet stabilized. This describes our son’s – and most others we know – situation perfectly. Addiction needs long-term care and support.
The basic coaching approach addresses the physiology of the addiction, post-acute withdrawal syndromes, nutritional interventions, dietary supplementation, and how this all can safely integrate with other pharmaceutical treatment strategies that might already be on board.
Based on what Dr. Simone has called the ’12 Daily Rules for Recovery,’ their coaching techniques will systematically and methodically help the individual identify specific areas to be adjusted and then develop individually tailored strategies to affect real change.
The 12 Rules focus on building up a support community – first and foremost – then developing a healthy and consistent morning routine, understanding the importance of full-day nutrition, ensuring the body is receiving all nutrients necessary to support a strong and optimal brain and body, establishing a safe and appropriate dietary supplement regimen, expanding the mind with helpful books and information, developing a realistic exercise routine, carefully auditing the external distractions in our lives, constructing a regular nighttime routine, and more.
When these considerations get repeated across thousands of iterations, and with a little guidance and accountability, they become a foundation upon which the rest of the individual’s recovery will be built. Eventually – through ruthless repetition – new neural pathways begin to form until eventually this life of abstinence doesn’t feel so difficult and a sustainable, meaningful recovery is able to take shape.
Jeff’s approach of community as essential and creating new, healthy habits to replace old, destructive ones has been the topic of several of my blogs (see below). Whatever habits we create will become automatic and will serve us and our life-goals well as we go through each day.
(Translation into most languages is available to the right.)
During a recent podcast on Straight from the Source (1), David Higham (founder of The Well, a peer-run alcohol and other drug service in the northwest of England) spoke about his life.
For more than 20 years, David was a habitual heroin user more accustomed to life in prison than the outside world. He joined a 12-step program during his final stint. Upon release, he found that sustained well-being and recovery was rare and he knew he had to help change that. What interested me most from his story was this insight:
“Drug treatment is trying to find a solution for my solution…But what’s the solution for my problem?”
(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).
(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.
(Short topical blogs based on Opiate Nation – translation into most languages in tab on right.)
When we hear the phrase “ghost stories” most of us think of scary and spooky stories shared around a campfire with the intended, and predicable, consequence of keeping us awake at night.
But when H Lee (aka Harris Insler) decided to call his new podcast series “These Ghosts Must Be Heard”, it wasn’t because he would be interviewing people with paranormal experiences. And although the stories his guests share aren’t scary in the ghoulish sense, they have kept their narrators awake at night for days, weeks, and months on end. John and I included. (To hear our interview with Harris, see links below for Podbean, Amazon, Spotify.)
These are real-life experiences and these “ghosts” are the spirits of our deceased loved ones: children, friends, partners who have succumbed to premature and preventable deaths from opioid overdoses.
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.
Opiate Nation 