Social Safety Nets – Opiate Nation

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

About

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

https://www.theage.com.au/national/australia-s-opioid-crisis-how-pain-management-got-out-of-control-20200204-p53xrn.html?login_token=6k67UOPLwp5Xl2j0rc4YRnMBCQfFMYmi_oQ7Wy-FhUoshvJtqTVUQRQtnZMeXk9e6ZvG2rO1y9HCtcf1QfpRxw&expiry=1659821531

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.

Who Is My Neighbor?

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

(I am re-posting this blog due to a glitch on some platforms in January)

In 2020, overdose deaths have increased worldwide, and by as much as 25% in the US. Deaths from acute intoxication have also increased dramatically. People are isolated and anxious, their treatment and recovery programs have been disrupted, and the illicit drug supply has become dangerous. Health officials believe that the majority of these deaths have occurred because hospitals are full and emergency services are overwhelmed with Covid-19 patients, thus removing the urgent, lifesaving care of overdose reversal that has been established in the past few years. Funding for all mental health services has also been diverted to pandemic care, which has complicated access to basic resources. Suicides are rising at an alarming rate.

A conversation that I believe is relevant to the current times came to mind this week. A lawyer asked Jesus “Who is my neighbor?” as he was trying to wriggle out of the command to “Love your neighbor as yourself.” Jesus told him about a man beaten and robbed while on a journey. As the man lay almost dead on the road, he was passed by several religious leaders who refused to help him. Then a man, who was not the same nationality or religion, came and bandaged and rescued him and paid for his care until he was well. Jesus asked the lawyer, “Which of these men proved to be a neighbor?” The lawyer replied, “The one who showed compassion.” Jesus responded, “Go and do the same.” *

Loneliness Pt. 2: Unemployment Anxiety & Isolation

We are a global community – like it or not. We are connected down to the minutia of life, from what we breathe, to what we eat, to what we think, to what infects us. And right now, the world, our world is in a life-or-death struggle with a microscopic enemy that seems to keep gaining the upper hand. The result in just one area is massive unemployment and the subsequent loss of access and funding for public and private support services.

I don’t want to get in to the politics of whether economies should be opened up regardless of Covid-19 and suffer the consequences in lives lost, verses lives ruined by no work and massive personal and societal debt. What I am concerned about are the consequences of what so many millions of people are facing from having lost their means of livelihood, and in particular, those whose lives were already balanced on a knife edge on a daily basis.

Loneliness in a Lonely Time

It has been said that the 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…and 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.

OPIATE NATION WINS NATIONAL INDIE EXCELLENCE® AWARD

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.

If my son were alive today during the Covid-19 pandemic…..

I would fear for his life more than ever.

“Drug Overdoses Soaring: Suspected overdoses nationally jumped 18% in March, 29% in April, 42% in May, data from ambulance teams, hospitals, and police shows.”

As a young man in America who wanted more than anything to be free of his deadly heroin addiction, how would he be weathering the Covid-19 pandemic?

“The drug-overdose-and-death epidemic already was hurting communities before COVID-19, but during the pandemic there have been reports from every region of the country on spikes in opioid-related calls to first responders, visits to emergency rooms, fentanyl and tainted-drug-related overdoses. There also have been challenges to accessing sterile needle and syringe and exchange services.”