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.

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Woefully Unprepared

(Today begins a series of topical blogs based on excerpts from Opiate Nation, chapter by chapter, that will run for 28 weeks. Translation into most languages is available to the right.)

It’s a bit ironic that as I begin blogging through Opiate Nation we are in the midst of a pandemic. Ironic in several significant ways.

Opiate Nation was written because of the opioid epidemic – which, in reality, is a pandemic. Every industrialized nation, and many emerging and third-world nations too, are dealing with the results from the ease of availability of opioids, whether natural and home-grown, or synthetic and imported. Or both, as is the case in America.

And like the Coronavirus pandemic that crept up on us so gradually that it’s deadliness caught us by surprise and mostly unprepared as nations, the opioid epidemic crept up on us too. In both cases, certain international players were unscrupulous for various reasons, causing delays in awareness when there might have been a chance for all of us to not be caught off balance.

The “inoculation” that should have happened, especially in the United States, by way of accurate scientific information disseminated by responsible leaders, didn’t happen. Instead, false information fueled by political agendas and financial motivation created a scenario that so crippled a timely public health response that, for many nations, it became too little too late.

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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.

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A Lament and A Love Song – for Our Son

Lament for a Son is an intensely personal tribute by Nicholas Wolterstorff to his 25-yr-old son who died in a climbing accident. It is eloquent and unforgettable as he gives voice to a grief that is both unique and universal: the tortured pain of losing an individual, a child, your child.

We lost our 25-yr-old son to a heroin overdose six years ago on August 2, 2014. Lament for a Son has been one of our go-to books since that time. Wolterstorff expresses the incomprehension and sense of unfairness that, I believe, parents worldwide feel when they lose a child – someone who is supposed to bury you, not the other way around. It doesn’t fit with the cycle of life we expect – it is jarring, unsettling, bewildering, frustrating, disquieting.

In the Preface he relates:

A friend told me he gave a copy of Lament to all of his children. “Why?” I asked. “Because it’s a love song,” he said. That took me aback. But, Yes, it is a love-song. Every lament is a love song. Will love-songs one day no longer be laments?

Yet, while the book expresses the common feelings brought on by sudden unexpected death, what he doesn’t share with those of us who have lost a child to drug/alcohol addiction are the previous long years, sometimes decades, of turmoil, anxiety, fear, and depression that we experience on top of all the normal grief.

And shame.

There is no glory in being the parent of someone who is an addict or alcoholic.

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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.”

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Choosing to Look Away: Pain avoidance

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?

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CAN MONEY REALLY COMPENSATE ?

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?

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AIRING DIRTY LAUNDRY?

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.

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