Benefits of Public Dialogue

John and I live in Melbourne, Australia with our daughter and her family several months of the year. Since our son’s death by overdose from heroin 5 years ago, we have become interested in and involved with some of the Alcohol and Other Drug (AOD) programs there. We also receive news reports on current trends etc.

What is interesting to me is the contrast between the Australian approach to AOD use and the American approach. Australians accept that there will be drug and alcohol abuse in their society and therefore speak openly and candidly about it. A recent newsletter (Dec. 13, 2019) from VAADA (Victorian Alcohol and Drug Association) is a perfect example of their approach. It was an alert about “ increasing numbers of reports about very strong heroin in Melbourne, which has resulted in an increase in accidental overdoses.”

The alert asks providers in the AOD sector to alert their clients (heroin users) to this problem and to be careful and look out for their fellow users. They also urge providers to share specific harm reduction information to help reduce the risk of overdose, such as: get naloxone and keep it handy; try not to mix drugs (there is a lot of methamphetamine use mixed with heroin/opioid use); be smart about your tolerance, knowing it can change if you haven’t used for even a few days; and try not to use alone or in an unfamiliar place where you wouldn’t get help if you do overdose (which was the case for our son).

Continue reading “Benefits of Public Dialogue”

Holidays While In Recovery

I want to pass along a blog from Shatterproof.org that says pretty much everything I try to remember – especially during the holidays – even though I’m not in recovery. The only thing I would add is while starting a new tradition, consider a way to volunteer. If you want to experience joy that no substance can come close to matching, give sacrificially for just a little bit of time. I guarantee you, you will be anxiously awaiting the next opportunity. I am an ambassador with Shatterproof, an amazing non-profit that works tirelessly in the battle to help reduce the addiction rate by means of education, information, and legislation. Check out their website – link below.

9 Tips for Enjoying the Holidays While Maintaining Recovery

By Holly Jespersen, Shatterproof’s Senior Communications Manager

https://www.shatterproof.org/blog/9-tips-enjoying-holidays-while-maintaining-recovery

This is my eighth holiday season in recovery. At this point in my sobriety, I am very comfortable with my new life. I have learned to live without substances, and have a life that is full of loving, supportive relationships. In the beginning, I had assumed that recovery would be boring. I couldn’t have been more wrong. My life these days includes a job that I love and a very packed social calendar full of fun things with people who bring joy to my soul. But it’s not always easy. The holiday season, especially, can be a stressful time for people in recovery like me. Luckily, there are ways to get through it. Here are a few of my top tips for enjoying the holiday season without jeopardizing your health. Continue reading “Holidays While In Recovery”

Fentanyl & Breathing Under Water

BREATHING UNDER WATER

I built my house by the sea.
Not on the sands, mind you;
not on the shifting sand.
I built it of rock.

A strong house
by a strong sea.
And we got well acquainted, the sea and I.
Good neighbors.
Not that we spoke much.
We met in silences.
Respectful, keeping our distance,
but looking our thoughts across the fence of sand.
Always, the fence of sand our barrier, always, the sand between.

And then one day,
-and I still don’t know how it happened –
the sea came.
Without warning.

Without welcome, even
Not sudden and swift, but a shifting across the sand like wine,
less like the flow of water than the flow of blood.
Slow, but coming.
Slow, but flowing like an open wound.
And I thought of flight and I thought of drowning and I thought of death.
And while I thought the sea crept higher, till it reached my door.

And I knew, then, there was neither flight, nor death, nor drowning.
That when the sea comes calling, you stop being neighbors,
Well acquainted, friendly-at-a-distance neighbors,
And you give your house for a coral castle,
And you learn to breathe underwater.

(Sr. Carol Bieleck, RSCJ, from an unpublished work)

I first heard this poem as it was read at our son’s memorial by the director of a recovery program we had attended with JL in Tucson. It is full of spiritual metaphors and allusions to addictive behaviors. It came back to me this week as I received the latest information on fentanyl deaths in a report from the Centers for Disease Control (CDC), summarized by CNN:
Fentanyl deaths skyrocketed more than 1,000% over six years in the US.
By Nadia Kounang, CNN, 03/21/2019
https://www.cnn.com/2019/03/21/health/fentanyl-deaths-increase-study/index.html

Continue reading “Fentanyl & Breathing Under Water”

Memories

I am surprised when, although it has been over four years since our son died of a heroin overdose, memories surface and grief follows. The surprise comes because the memories seem to come ‘out of the blue’, from no particular trigger and for no particular reason.

My husband just had a memory that was triggered when he heard our seven year old granddaughter express trepidation over seeing a bird that had died and fallen into the back yard. It was as if our son was seven again, full of wonder and normal childhood fears. His voice, his emotions, him.

I have had memories of our son as I’ve been working in our daughter’s garden or driving to the grocery store. JL as a young adult, just his face in some everyday interaction, triggering the sadness that he is no longer on this earth, part of our life, living the life that most 29 year olds are living.

It seems that memories don’t need a reason to rise to the surface from out of our hearts. Our son has been in our hearts since the day he was born and he continues to live there. It is the strongest ‘evidence’ we have that life does not stop after we die and physically leave the land of the living. We are eternal beings and I am very thankful for that.

Change Our Way of Thinking

In the 1970’s, Bob Dylan sang: “We’ve got to change our way of thinking, make ourselves a different set of rules…”

I thought about this song recently as I remember how differently we, as parents of an opiate/heroin user, thought a decade ago. We thought, and were taught, that if our son just worked the 12-Steps hard enough he could gain lasting sobriety.

We had an abrupt and jolting wake up call on August 2nd, 2014. And what we have learned since our son’s death is that it’s just not that simple. Yes, there are opiate addicts – better, those with Substance Use Disorder – who have survived this deadly addiction without Medication Assisted Treatment (MAT), but they are few and far between. And they did not achieve sobriety with one attempt.

Last week,I heard an update on the current Ebola outbreak in the Congo. Two hundred people have died already and those fighting the battle are using every resource possible to contain it. It is terrible.

What if we treated the opioid epidemic with the same urgency and resources?

A sheriff in a county near Seattle had a similar epiphany last year after he was elected sheriff. He toured the jail and and saw it had become a de facto detox center full of very, very sick people. TY Trenary said: “Detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out, just suffering.”

Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.

The county’s program includes small steps, like making transportation easier for people in drug treatment. They train family members and others in the community on steps to reverse overdoses with medicine, and they send teams of police officers and social workers to help addicted homeless people.

The new approach is paying off. The teams have helped hundreds of people find housing and drug treatment.

I have changed my way of thinking – how about you?

https://www.npr.org/sections/health-shots/2018/10/28/658476111/a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster%20?utm_source=npr_newsletter&utm_medium=email&utm_content=20181104&utm_campaign=&utm_term=

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

SAFETY NETS

On August 7, 2018, Rolling Stone reported that Demi Lovato was given Narcan (naloxone) by paramedics in response to a drug overdose after 6 years of sobriety.“I want to thank God for keeping me alive and well,” she said. Yes, God – He works through people and available medications. After 2 weeks in the hospital, she entered rehab. I imagine she has health insurance for hospital expenses and the rehab costs should be no question considering her career.

But how many other Americans battling addiction are not insured – or under-insured – or insured without mental health or rehab coverage, as our son was? And how many can afford the costs of detox, rehab, medications, and long-term recovery programs? Here are some average costs:
Outpatient detox: $1500
Inpatient rehab: 30 days, up to $30,000 / 60-90 days, up to $90,000 or more
Medication: Methadone $5,000 yr / Suboxone $200-600 mo
Sober Living Homes: $500-$2000 mo

Opioid addiction needs detox, rehab, medication, and then – as has been proven time and time again – at least a year of sober living and perhaps a lifetime of medication – along with a 12-step community. Where is a student or an unemployed or under-insured addict supposed to go when there are no safety nets in our society?

The New York Times August 8, 2018 article “Too Little Too Late: Bankruptcy Booms Among Older Americans” – another group for whom safety nets have disappeared. In a study from the Consumer Bankruptcy Project, “A three-decade shift of financial risk has occurred from government and employers to individuals – who are bearing an ever-greater responsibility for their own financial well-being as the social safety net shrinks…older Americans turn to what little is left – bankruptcy court.”

We, as a society, should be ashamed of this. Are we so independently minded and lacking in empathy that we cannot accept the need to collectively care for the weak among us – those in need – with social safety nets? In previous generations, families took care of their own – from birth until death. But as modern society has shifted from rural and communal to urban and individualistic, there is a need for we as a society to have safety nets in place.

Our daughter and family live in Australia. They are the beneficiaries of one of the best single-pay health systems in the world. When we tell friends about it, the response is, “They have socialized medicine, right? They can’t get medical care when they need it and people die on the streets.” As the conversation continues, we hear they are a socialist country and lack freedoms we enjoy. None of this is true. They enjoy a very good standard of living and pay higher taxes – taxes that provide a safety net for each and every citizen.

As the opioid epidemic continues to take the lives of so many, leaving families destroyed, we need to not only acknowledge that addiction is a disease that can be treated with medication, rehab, and community, but also fight for a health insurance system – a social safety net – that cares for Americans from birth through death.