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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Science Fiction and Self-Protection

(Sixth 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 have always loved Star Trek. From the early 1960’s shows with the corny scripts and goofy hairdos to the 21st century high-tech and high-stakes extravaganzas. Science fiction envisions the future for us and pushes inventions and technology from getting “beamed-up” in a flash to having a force field to deflect foreign objects.

The concept of a force field would be an incredible tool to have at our disposal – to be able to switch it on and off at will. And I can think of no better time to employ an emotional force field than during the early days and weeks after a sudden death. When it takes all your energy just to exist, to wake up and to face the next moment. An invisible barrier for self-protection.

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Lifespan of Heroin & Opioid Addicts

(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.

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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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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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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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Handwriting on the Wall

The other day I was thinking about our son and his struggles with drugs and alcohol and all that we know and understand now compared to what we knew and understood in the early 2000’s right up until his death in 2014. I saw myself, as if I were standing out in an open field, turning, looking back over my shoulder. That’s what I do when something unexpected or disturbing happens. I look back and try to figure out what I missed, what I could have done differently.

My next thought was: Why couldn’t my husband and I see the handwriting on the wall? Why didn’t we realize how dire the situation was at every new juncture with our son as the years went by? But, I realized that it wasn’t that we couldn’t see the handwriting on the wall. It was that we didn’t understand what it meant.

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KNOW YOUR ENEMY

“Know your enemy” is a phrase that repeatedly returns to my mind when I am looking back on the years of our children’s adolescence. Regrettably, what we have learned is too late for our son, but not for millions of other sons and daughters. I believe that we are at war with an enemy that, as it is taking the lives of our children, it is also taking the future of our nation and our world.

If you know the enemy and know yourself,

         you need not fear the result of a hundred battles.

If you know yourself but not the enemy,

         for every victory gained you will also suffer a defeat.

If you know neither the enemy nor yourself,

          you will succumb in every battle.

The Art of War by Sun Tzu (Chinese military strategist, 5th century BC) Continue reading “KNOW YOUR ENEMY”

STIGMA, Part 2: How to Remove Stigma

Although name-calling is childish and something most parents teach our kids to not do––even when provoked––it’s surprising how many families use it as a weapon and carry its poison into adulthood. The name-calling and negative labeling we have been subjected to from prominent political leaders in the past few years must have been learned at home and seems effective with others who are similarly immature. I was raised with the saying, “Sticks and stones may break my bones, but words will never hurt me” as a way to deflect hurtful, shaming words. As I came to realize when I grew up, it is the farthest thing from true. Negative labels stick like glue to our hearts and souls, and for those struggling with addiction and alcoholism, come to define them––especially to themselves.

When words are dismissive and disdainful they telegraph judgment of addiction as a moral failure, chosen and desired, for which a person deserves to be shamed. Let’s change our vocabulary with true words that describe addiction for what it is: a chronic disease of the brain. Change the inaccurate and stigmatized word “abuse” to “substance-use disorder”: a health issue that can be treated successfully with medication, group involvement and support, and therapy.

Hazelden says their “fundamental addiction stigma-smashing strategy is to shine a light on people who are in recovery and expose the reality that people actually do recover from addiction; that it’s a chronic disease that can be successfully managed for life; and that it affects individuals who are every bit as moral, productive, intelligent, talented—and humanly flawed—as the next person.” That means you and me.

Also, educating health care professionals is very important as they work on the front lines in many areas: in prescribing medications and monitoring patients more closely in order to get them the right help as early as possible. They need the basic knowledge to recognize substance use disorders, understanding the complexity of the disease and the recovery process. Statistics show that physicians are still over-prescribing opiate pain medications, especially after accidents and surgeries, and not making use of physical therapy for pain management. In Dr. Jana Burson’s blog about stigma she cites one doctor who is pro-stigma, saying is “a good thing because stigma discourages deviant behavior and has a civilizing effect on society… and people with substance use disorders are irresponsible.” This doctor said of people who relapse back to drug use repeatedly “it is a behavior almost always under one’s control…” Dr. Burson says, “Loss of control over substance use is one of the hallmark criteria for the diagnosis of substance use disorder.” See her blog for the remainder of this important discussion.

https://janaburson.wordpress.com/2018/07/16/stigma-and-substance-use-disorders/

And prevention. This is the best weapon we have to fight against the epidemic that is taking the lives of over 70,000 mostly young people every year in our country. Trying to stop the immoral manufacturers of addictive drugs in illicit labs in China and Mexico––and by big Pharma in US––is a lofty goal and worth continued effort. But those drugs would have limited consumers if we focus our attention on clearly and openly teaching our children about drug and alcohol addiction from an early age and continuing the dialogue as they mature and experiment. And yes, even as some of our own children become the the 20% who find that, among all of their friends that try the same drugs at a party, they are the ones who can’t just walk away, they would know they can come to us without shame and stigma and ask for help.
The AMA and Am. Society of Addiction Medicine (ASAM) have a good article on stigma:
https://www.asam.org/resources/publications/magazine/read/article/2015/12/15/patients-with-a-substance-use-disorder-need-treatment—not-stigma