(Translation into most languages at tab to the right.)
Eleven years ago today my husband John and I woke up thinking it would be just another normal, hot August Saturday morning. But when the sheriff knocked on the door, the day – and our lives – were no longer normal. It is surprising how quickly our lives can go from normal to abnormal.
I was sorting through some files and found a drawing that our son, John Leif (JL) had done when he was around nine. It was obviously of Van Gogh’s “Starry Night” but it was also obviously done by a normal nine-year-old – not an artistic prodigy. And it made me think about how JL was just like any other normal kid growing up in middle-class America in the 1990’s-2000’s. He learned to ride a 2-wheel bike at around five, he played with Lego’s, he took swimming lessons, he loved monster trucks and lasagna and macaroni & cheese with ketchup. But something so abnormal for normal young teenagers ended up ruining some of what should have been the best years of his life and ultimately taking his life – and the lives of many of his friends and hundreds of thousand other normal kids.
What was abnormal was the criminal promotion and availability of highly addictive medicine to young kids by Purdue Pharmaceuticals and the Sackler family. Never before had American kids been exposed to legal drugs (that were promoted as “non-addictive”) that they experimented with as if they were simply trying a joint. And the results were the devastation of the Opioid Epidemic. Which is not over, especially for the once normal kids who are still alive and living with the cancer of addictions. We see many of them on the street corners and under bridges, living from hand to mouth, barely surviving, living anything but a normal life.
Sadly, seeing these shells of once normal kids has become a “new normal” as our society doesn’t seem to agree on how to best provide lasting recovery options with a continuum of care – or whether we even should. In my last Substack podcast and article with special guest Sam Quinones we discuss some ideas from his book “The Least of Us” for how to help get these once normal kids from normal families the help they need to try to return to something like a normal life. (1) Let’s not forget that those addicted people were once normal kids.
Just when we thought everyone was aware of the fatal danger of fentanyl and it being mixed into every drug of abuse available on the street, a new threat arises. Nitazene or Isotonitazene (ISO) or Protonitazene, new lab-made opioids, are showing up at hospitals and morgues around the world in the bodies of people thinking they were taking their drug-of-choice only to find it was laced with one more deadly drug. It is being mixed in with cocaine, or formulated into fake Oxy’s and other pills. In the US, it first showed up in 2019 in the Midwest and spread rapidly.
Nitazenes were developed in the 1950’s by pharmaceutical companies as an alternative to morphine but shelved due to the risks of overdose. There is still no approved medical use for nitazenes today. Another ‘Designer Drug’ being made in illicit labs around the world, Nitazenes are up to 40 times stronger than fentanyl. Fentanyl is already 50 times more powerful than heroin and up to 800 times more powerful than morphine.
No wonder these drugs are referred to as ‘Frankenstein Opioids’ – only an insane, evil intentioned scientist would work to create such a drug. But in reality, the motivation is greed more than insanity because synthetic drugs are cheap to make and easy to ship and deliver – and highly profitable. But evil is the correct description for the immoral heads of the drug syndicates and cartels around the world whose entire life and business is dealing death.
What can be done?
For parents with children still at home, community connection and education are the best preventative measures. As I have said before, my husband and I were totally unaware of what substances were readily available to our middle school son in the early 2000’s. Our concern was smoking and marijuana. Little did we know. General discussions about drug abuse were the extent of our educational conversations. But we would have been much better prepared and had much more information if we had been involved with our kids’ school community. Instead, we were insulated from vital resources because we spent so much time with our church community. But make no mistake. Many of the families at church with kids in youth group were just like us – unaware and ill prepared and sadly many of them suffered the same loss as we did.
There are other important aspects in raising self-reliant kids who are not subject to the lures of the “cool” kids or “in” crowd. Below is a link to a previous blog dedicated to the perils modern teens and their parents face with important resources. I hope it will be helpful to you and those you love.
(Translation into most languages at tab to the right)
We recently spent some time with a young man who was a close friend and fellow opioid user with our son. While he has survived dying from an overdose and has been clean on and off for almost 20 years, he has been on Suboxone for the past nine months, trying once again to be clean after one more cycle of opioid addiction. He has tried many ways to get free of the stranglehold that opioids have on his brain, to no avail. How did this happen?
Our son, like millions of other adolescents, were prescribed opioids for some type of pain: oral surgeries, sports injuries, accidents, etc. John Leif (JL) had his first experience with opioids at 12 when he had teeth extracted before wearing braces. What we didn’t know then (2001) were the facts about opioids and addiction. Why we didn’t know – and most doctors and dentists didn’t either – was due to Purdue Pharma and other drug companies’ propaganda on the safety of oral opioids: “Opioids are not addictive if a person is in pain.” That, of course, is a lie and one they knew perfectly well. The opioid epidemic is the result of their lies.
The more recent information from multiple drug studies is what we wish we would have known 20 years ago: Legitimate use of prescribed opioids before the 12th grade is independently associated with a 33% increase in the risk of future opioid misuse after high school by age 23 compared to those with no history of an opioid prescription. This wasamong patients with little drug experience and who disapprove of illegal drug use. (1)
Why does an opioid prescription predict future opioid misuse most strongly among individuals with little to no experience with use of illegal drugs – i.e., adolescents? For drug-naïve individuals, an opioid prescription is likely to be their first experience with an addictive substance. Most likely the pain relief is pleasurable, and a safe initial experience with opioids may reduce perceived risk. A pleasurable and safe initial experience with a psychotropic drug is a central factor in theories of who goes on to misuse drugs. (2)
As I was driving home in 105-degree heat last week, I noticed a young man carrying a plastic bag stumble to a bus stop bench and sit down. It was clear he was homeless and it was equally clear that he was on drugs. I felt compelled to pull over. I rolled down the window and asked, “Are you ok?” He said, “No.” I asked if he needed help, and he wept and said “Yes.” When he came over to the truck, I asked if he was on drugs, and he said “No.” I said “I think you are on drugs and you don’t need to be ashamed.” He said he was, so I asked if I could sit with him and talk.
As we sat on the bench in the heat I asked what drug Julian (not his real name) was using. Fentanyl in the form of street Oxy’s that sell for $2 and come from Mexico. He is homeless, has never known his father, his mother is out of state and done with him. He is 23 years old and has been struggling with alcohol and addiction for 5 years – fentanyl for the past 1½ years. I told him about my son and said Julian was on the same path to the morgue unless he could get clean. He had gone to rehab in March with a predictably miserable 5-day detox and then was supposed to go to a sober home, but said they never got him there – probably not true. I offered to take Julian for something to eat and to try to connect him with a program to help him. While I drove and he nodded off, I called a few of the directors I knew from programs our son went to, but had to leave messages. I decided to take him home for a shower and a rest as we tried to find him a place.
My husband John prayed with this sweet and troubled young man and encouraged him to know there was hope and that he wasn’t a bad person, or less-than, but had a powerful war waging in his brain that needed medical help and emotional support. We drove him to the public behavioral health service, where he had gone in March, and got him signed in. It was an hour wait for him to go through intake again, so we left him with our names and phone numbers to give as his contacts for help so that we could follow up on how he was doing.
When we tried to follow up the next day, we found he had done a runner and never went through the intake. I would guess the fear of excruciating withdrawal was stronger than the fear of a potential or eventual death. This is so common, especially for those who have tried many times to get clean. Addiction specialist, Dr. Richard Whitney said, “Once people get addicted, they really lose the power of choice.” (1) Even with medication, the drugs need to be out of your system first. On average, it takes 4-5 recovery attempts and 8 years to achieve one year of sobriety. After another 5 years in recovery, the relapse rate drops to 15%.(2)That is 13 years to try to undo what most commonly started as trying something fun as a young person. The chemistry in our brains needs more time to recover than a few weeks or months from the damage done by opiates.
In 2015, Sam Quinones released his award-winning book Dreamland: The True Tale of America’s Opiate Epidemic documenting how Purdue Pharma – with a monopoly on the market on pain in the 1990’s with its new highly addictive drug, Oxycontin – deceptively promoted it as a non-addictive solution for every ache and pain. Then, with the lure of easy money, young men in Mexico, independent of the drug cartels, trafficked black-tar heroin to neighborhoods in America as a cheap alternative to Oxy’s. Its powerful long-lasting high then became the go-to drug for millions of young people who could heat and smoke it – our son included. Quinones states that the perfect storm was created when the pursuit of prosperity, pain avoidance, and the breakdown of close-knit family and community life, beginning in the 1960’s, created the void that those easily available opiates filled.
Quinones has recently released The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. It is the second most important book written on addiction and American society. In my next blog, I will delve into this new book and discuss where we are in the drug epidemic and where we can go from here. I personally need some hope as I see the thousands of homeless young people on the streets of my city and struggle with the tension of wanting to help prevent one more life from a literal “dead end” and feeling frustrated with the lack of effective programs to help these addicted individuals get the long-term recovery care they need. This – in a country where the majority of people seem to think that health care is a privilege for those who can afford it instead of a basic service for all Americans, including the least of us.
(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.
(Fifth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
After many years of not having a dog, we decided to adopt one from our local shelter. We found a beautiful German-shepherd/wolf mix who was 18 months old. Bella was docile, sweet and quiet. The next day, as I headed out to the grocery store, I gave her a hug and saw her watch me through the window as I got into the car.
When I returned an hour later, I was met with a shock. I found her, panting rapidly and pacing nervously in our bedroom where our wooden shutters were open and had bite marks. She had tried to escape while I was gone. I had no idea why. I immediately called the shelter. “She is having separation anxiety: she needed to escape being left alone.” We found out that she had been with two families previously when she was dumped at the shelter because she continued to try to escape when she was left alone for hours on end. They gave us the name of a dog behaviorist and we started down the long road of helping Bella manage her fear when we had to leave her at home.
Children and adults can experience separation anxiety when someone they are attached to leaves them. They can have recurrent and excessive distress just anticipating being separated from loved ones and the anxiety can be so intense that it is hard to function in everyday life. Panic attacks and physical symptoms such as nausea and headaches can occur. For me and my husband, on the morning of our son’s death from overdose, standing over our son in that body bag we experienced the ultimate separation anxiety. The overriding emotion we felt was fear: fear of the unknown future we were facing. We couldn’t visualize how we would survive without our son as part of our lives and the future we thought we all had together. He had not only been an integral part of our lives for 25 years but he was literally a part of us–the combination of our DNA that formed him as a particular and unique human being. To say that it was like having part of you taken away doesn’t describe it. This was having our hearts torn out.
We would never embrace or kiss or stroke the cheek of our son again. We were facing an existential crisis, shaken to the core, questioning our reason for living. Regardless of our strong faith that had seen us through many other deaths in our families, this separation seemed incomprehensible and cruel. It was only by falling down on our faces and waiting for Mercy to gradually pick us up that we were able to survive this traumatic separation from our son and move forward again in life.
(Third in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Chapter 1: The Letter
Most of us have felt like we were “in over our head” at some point in our lives. Maybe it was in a job, or a class, or a relationship. Perhaps in the ocean, or on a steep mountain trail or having made a commitment to an event or project that turns out to be more involved and time consuming than we thought. When we finally realize there are more problems than we can handle or a difficulty that we just can’t surmount, what do we do?
I remember one time when John and I were in Morocco and the friends we were traveling with were gone for the day. We decided to explore a lighthouse we saw ahead. As we walked through an opening in a wall that surrounded it, we started to feel we might not be in a safe place. We felt fearful as we saw trashed looking apartments and expensive cars with black tinted windows. What made us turn and literally run was the sound of mean dogs barking. As we ran back through the opening, several came in view with their spiked collars and bared teeth. Thankfully, as we hit the main street, their owners called them off.
(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. If you feel this blog is important, please repost to your social media using the buttons below. Thank You!)
When our 25 yr old son died of a heroin overdose in 2014, the statistics for the average life-span of a heroin addict was 5 years. Five years. Not very long if you are 15 or 20 or even 30, the age when most young adults’ nowadays are just getting in gear with their career, a long-term relationship, and planning a family. To have your life swept away before you have a chance to experience some of the most wonderful years of living on this earth is painful to consider.
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 