drug and alcohol abuse – Opiate Nation

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.)

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.”

Choices While in the Dark

When life on this earth results in tragedy and loss – personal, communal, international – we are immediately faced with choices we did not anticipate nor plan for. An untimely death, an assault or abuse, financial ruin, a health crisis, relational trauma, anxiety: the list is endless. What do we do? Most of us want to just turn and run while we also know there is no place to run to or to hide from the turmoil within. So how do we take the next step forward when everything in us doesn’t want to and we are facing a challenge we have never faced before?

We remember that we all have choices even when it seems there are none. It is what makes humans unique. Referring back to my blog “Darkness & Light” and the thoughts from Jerry Sittser in his book A Grace Disguised, when we choose to move towards the darkness knowing we will eventually see the sun rise, we find gifts along the way that we could have never imagined. But we also find more choices. Sittser cites Viktor Frankl’s Man’s Search for Meaning, reflecting on his time in a Nazi death camp and how “the prisoners who exercised the power to choose how they would respond to the terrible loss and darkness of their circumstances displayed dignity, courage and inner vitality. They found a way to transcend their suffering…and so grew spiritually beyond themselves…they learned that tragedy can increase the soul’s capacity for darkness and light, for pleasure as well as for pain.”

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.

Who Is Dying Today?

In 2017, 16,000 people were killed by gun violence in America: some of them innocent children and young people while they were in school; some while they were just growing up in poor neighborhoods. Our first-world allies are stupefied that we can continue to allow such preventable deaths.
According to the US Centers for Disease Control (CDC) there were 63,632 drug overdose deaths in the US in 2016 – preventable deaths: 172 deaths per day; 42,249 (66.4%) of those deaths were due to opioids. More deaths in one year than those as a result of firearms, homicide, suicide, or motor vehicle crashes. And more deaths in one year than all the deaths from the Korean or Vietnam Wars.
Why are opioids so addictive – and deadly? One area in the brain that opioids directly affect is the amygdala – the pleasure center. For a large percentage of people, once those receptors that regulate emotions have sampled opioid joy, no other experience compares: not sex, food, sights, sounds. And, as Thomas Aquinas said in the 13th century:

“No man can live without joy.”
I watched the truth of Aquinas’ insight in increasing measure with our son over the years as he fought his addiction to heroin. Heroin, the goddess of fleeting joy, always requiring more of her while she offers less pleasure. It was not just the misery of the horrendous withdrawal symptoms every time John Leif would try to get clean again. After they subsided, it was the flatness in his emotions and the dullness of living life without joy. What could replace the euphoria of a heroin high? How long would it take for that pleasure center to normalize – would it ever return to its pre-opioid state?

Eventually we would see the light return to his eyes … this was especially true during the last 8 months of his life. Clean, sober, awake, in touch with life and with those around him. Enjoying the opportunity to see life “through a child’s eyes” as he played Legos with his 3 and 5 year old nieces: the real John Leif, alive and participating in the joy that life without addiction can offer. But, even this period of recovery ended – as did his life.

There is another part of the brain that opioids directly affect: the nucleus accumbens, which is the addiction center. Opioids change the neuroplasticity in this region so the brain physically craves them. Scientists are not sure how long it takes to rewire the addiction center because even after periods of sobriety, it does not return to normal, and thus the cravings continue. For most people, the cravings are irresistible and the easy solution is to return to using. For some, a strong impetus for freedom along with a spiritual renewal that gives them the strength to do the hard work of recovery with adherence to a 12-step program, is a life-saver.

For a recovery program to actually bring long-term changes to the brain, anything less than 6 months will not work. And the current thought by many professionals now is that recovery programs for opioid addiction should be 6 mo-1year and include a strict sober living program for a year following. Don’t let costs deter you. The Salvation Army has very solid alcohol and drug rehab/recovery programs in many cities and they are free:
https://www.salvationarmyusa.org/usn/combat-addiction/

If you are struggling with addiction and feel trapped – or if you know someone who is – please do not let another day pass without seeking help. It is urgent – it is more than important – it is essential – it is life and death – your’s or someone you love.