The Politics of Drugs: Purdue & the DOJ

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

When public health is at risk, one can only wonder about the motives behind politicians’ decisions – our “public servants” as they used to be referred to – regardless of what they may say. But we don’t have to guess their motives because actions speak louder than words and the actions of the US Department of Justice (DOJ) this week regarding Purdue Pharma and the Sackler family are unconscionable. This deal is not justice for the victims and their families for this pervasive and criminal corporate greed.

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Separation Anxiety

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

After many years of not having a dog, we decided to adopt one from our local shelter. We found a beautiful German-shepherd/wolf mix who was 18 months old. Bella was docile, sweet and quiet. The next day, as I headed out to the grocery store, I gave her a hug and saw her watch me through the window as I got into the car.

            When I returned an hour later, I was met with a shock. I found her, panting rapidly and pacing nervously in our bedroom where our wooden shutters were open and had bite marks. She had tried to escape while I was gone. I had no idea why. I immediately called the shelter. “She is having separation anxiety: she needed to escape being left alone.” We found out that she had been with two families previously when she was dumped at the shelter because she continued to try to escape when she was left alone for hours on end. They gave us the name of a dog behaviorist and we started down the long road of helping Bella manage her fear when we had to leave her at home.

            Children and adults can experience separation anxiety when someone they are attached to leaves them. They can have recurrent and excessive distress just anticipating being separated from loved ones and the anxiety can be so intense that it is hard to function in everyday life. Panic attacks and physical symptoms such as nausea and headaches can occur. For me and my husband, on the morning of our son’s death from overdose, standing over our son in that body bag we experienced the ultimate separation anxiety. The overriding emotion we felt was fear: fear of the unknown future we were facing. We couldn’t visualize how we would survive without our son as part of our lives and the future we thought we all had together. He had not only been an integral part of our lives for 25 years but he was literally a part of us–the combination of our DNA that formed him as a particular and unique human being. To say that it was like having part of you taken away doesn’t describe it. This was having our hearts torn out.

            We would never embrace or kiss or stroke the cheek of our son again. We were facing an existential crisis, shaken to the core, questioning our reason for living. Regardless of our strong faith that had seen us through many other deaths in our families, this separation seemed incomprehensible and cruel. It was only by falling down on our faces and waiting for Mercy to gradually pick us up that we were able to survive this traumatic separation from our son and move forward again in life.

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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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).

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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

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A Different Death

Yesterday, my husband John, and I, along with family and friends, celebrated my father’s life of 92 years with a beautiful memorial service. He was buried with military honors for his service during WWII. In the week since his death, friends have asked me how I was feeling about his death – knowing that this death is the now the fifth death in my immediate family since 2001. First my younger brother at 40 from AIDS, then my sister at 56 from breast/brain cancer, then my son at 25 from a heroin overdose, then my other brother at 51 by suicide – and now my father.

This death, of a great-grandfather, is different than the previous four in so many ways. Not only do we expect grand-parents to pass away before their children, grandchildren, great-grandchildren, but we know by the 10th decade of life, the day to meet our maker is fast approaching. For my father, he was doing quite well mentally, but his health was declining rapidly this year. By August, we knew his days were numbered – and so did he. The dying know they are dying, and for my father, it made him sad. He loved life and he loved his family. And even though he had a strong Christian faith and confidence in waking up in a new and unimaginable existence with his loved ones who went before him, he still had a very natural trepidation of the process of dying.

His last two weeks were marked by no appetite and finally no ability to even drink – his body was done with this life. With John holding his hand, he took his last breath and his spirit left the room – and left this earth. How did I feel? Sad because we will no longer enjoy his presence, and his death marks the end of an era of the large Italian family dinners and parties. But I was also relieved that he was no longer suffering in a body that was giving out.

The unexpected death of our son from a heroin overdose was different in every way imaginable. I look back now and wonder how John and I made it – how we didn’t end up institutionalized under heavy medication. I remember in the first few months feeling that my mind was on the verge of splitting in two – my heart was already broken – but it is our minds that hold us together. The love and support from our close friends and family surely were part of that glue. But the real potion that caused us to not tip over the edge was the mercy and grace of God. Without Him, we wouldn’t have had the courage to go on or the strength to look ahead with hope of an eternity with our son and with our other family members.

For those of you with friends who have lost a child to a drug overdose, please remember that a sudden, unexpected, preventable death is different from all other losses. These deaths are not natural, the lives were not completed, the parents and family can not just move on. They need your love and support – and prayers.