Prescription Pain Meds – Opiate Nation

All Souls, All Saints, All of Us

(Translation into most languages at tab to the right.)

This year, the All-Souls’ Procession in Tucson, where I live, is today. The traditional date for celebrating All Souls’ Day (the Day of the Dead) is November 2nd. It was delayed this year because Halloween was on the same weekend. Tucson has one of the largest processions in the country with several hundred thousand people participating. Preceding this is All Saints Day on November 1^st.

All Saints Day had its beginnings in Roman Church tradition dating back to the early centuries when Christians were martyred for their faith or who had publicly confessed and somehow survived the Roman persecution. The belief was that they were saints and immediately taken up into heaven. By the mid 800’s, Pope Gregory IV assigned Nov. 1^st as the holy feast of All Saints.

All Souls’ Day evolved sometime around 1000 as a time to pray for the souls of all who had died. This is tied in directly with the Catholic Church belief in purgatory and those who are awaiting the joys of heaven. In pleading for them, we are reminded of our own offenses and so inspired to lead purer lives.

My husband, John, and I have walked many times in the procession here in Tucson although we are not Catholics and we believe that all those who have faith in and follow Jesus are saints, as the New Testament teaches.(1) Many Evangelical Christians think it is wrong to participate in All Souls’ events because it is not biblical to pray for the dead and they reject the concept of purgatory because nothing we do can alter ones destination in the afterlife. (2)

While we hold to basic New Testament beliefs, we do not find it contradictory to be part of the All-Souls’ procession in remembrance of our son, John Leif. The procession is a public ceremony to honor the dead and celebrate their lives, allowing participants to release and integrate their grief. Our son’s death from a heroin overdose – a reason many others are there – continues to be a source of sadness and regret. To remember and celebrate him as a person worthy of love is important for us. We do not want to shame him and do not want him to be forgotten.

What is sad to us is the way in which this holiday is treated with similar vitriol that partisan politics infiltrates so many areas of American life these days. There are “Christians” who stand along the procession route shouting out ugly and sinful – yes, sinful – rebukes to those walking in remembrance of their loved ones. Sadly, many people feel it necessary to take a side on almost every issue – and supposed Christians are some of the leading voices. The unholy mixture of politics and “faith” in our country is deeply disturbing to us and absolutely un-Biblical.

While we hold that our beliefs are true and worthy of sharing with others, we also feel it imperative that we respect others’ beliefs and faith traditions without mocking or denigrating them as all New Testament writing demonstrates. This is especially important when it comes to how people choose to remember and honor their loved ones who have died.

In the past several decades, opioid addiction has taken the lives of hundreds of thousands of beautiful young people. We believe they are worthy of being remembered without shame and with love in whatever way their loved ones choose. And in so doing, we hope their lives stand as a warning for other young people tempted into experimenting with increasingly deadly drugs.

I Corinthians 1:2, Romans 1:7, Philippians 1:1, Ephesians 2:19
Hebrews 9:27
History behind All Saints and All Souls:

https://www.osvnews.com/the-history-behind-all-saints-and-all-souls-days/#:~:text=Remembering%20and%20praying%20for%20the%20faithful%20departed&text=He%20instituted%20this%20commemoration%20on,All%20Saints%20DayAll%20Souls

Just Normal

(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.

JudeDiMeglioTrang1.substack.com

Prescriptions in Adolescence and Future Opioid Misuse

(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 was among 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)

Unwelcome Reminders & Another Anniversary

(Translation into most languages at tab to the right)

“We were trying, all of us, so hard, and he just wanted to live.” (1)

Ursula Rauh said this about her brother, Tommy, after his death from a fentanyl overdose and a dozen stints in rehab in ten years. He became addicted to Oxy’s at 23 after being prescribed an unlimited amount for tendinitis and a year later, another prescription for wisdom teeth extraction. Sam Quinones retells the family story in The Least of Us: True Tales of America and Hope in the Times of Fentanyl and Meth. “The tragedy wasn’t just the death of her brother; it was all the time, effort, love, and pain that the family traversed, the hoping and living for the smallest encouragement.” (1)

When my husband, John, and I returned from Australia in May, we decided that we needed to address the decades of files we had saved and ‘stuff’ we had accumulated and ‘stuffed’ away in closets. We have shredded and recycled dozens of boxes of documents, cleared out half the books in our library, and now I have moved on to scanning and sorting thousands of photos. While I was pulling bins of photos and albums out of closets, I came upon a few more file bins. I sighed out loud to John, “Oh boy…more of JL’s file’s I’d forgotten about.”

The Least of Us, Part Two: Big Dope, Consumerism, Supply & Demand

(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.

The Least of Us, pg. 362
Ibid
Where the Buck Stops and Where It Is Hiding – BLOG January 26, 2020 https://opiatenation.com/2020/01/26/where-the-buck-stops-and-where-its-hiding/
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.
The Least of Us, pg. 81
https://samquinones.com/

The Least of Us, Part One: Julian

(Translation into most languages at tab to right)

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.

Dreamland, pg 328
John Kelly, PhD – https://www.recoveryanswers.org/

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).

Peter’s Story: Alcohol The Gateway Drug

(Thirty-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.)

This week’s Story of Hope is from a friend of JL’s, Peter (not his real name). Here are some excerpts from his story in Opiate Nation (5 min read):

My name is Peter and I’m an alcoholic and addict. This is how I introduce myself at the AA meetings I attend several times every week, as I have done for over 10 years. I am from a fairly affluent family, raised with high moral standards, and attended the best schools. So how is it that I became an alcoholic by the time I was a senior in high school and an opioid addict and dealer by the time I was 20?

The first time I used alcohol was in my junior year in high school. I was new to the school and I felt like I didn’t get the playbook for how to be a part of the group. I had been raised with strong values against using drugs and alcohol – but I wanted to fit in with the popular kids.

I tried a capful of vodka—that was it. I hated the way it tasted. The next day I was sick—not so much from the alcohol, but with guilt. This would be a consistent theme in my drinking and using: I always felt guilt and the consequences of doing something soul-crushing and bending the moral line I had deep within me. Once that barrier had been crossed, then anything was permissible. Initially I only drank on weekends at parties so that I wouldn’t be the outsider.

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.)

What’s Inside the Shell?

(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.