Translation to most languages available at tab to the right.
The human brain is a miracle – there is nothing on earth that comes close to its capabilities. Although the brain and the heart are the only two organs that can’t regenerate, our brain can form new connections and pathways. Neuroplasticity is this amazing ability of our neural networks to grow and reorganize – to change and adapt as a result of experiences.
Until recently, it was thought that neuroplasticity stops after about 25, but with new research, we now know that it isn’t all downhill from there. Neuroplasticity can be facilitated by physical exercise, paying attention, and learning new things.
Physical exercise that increases blood flow to the brain is now a no-brainer. Paying attention is when we are doing something that is not out of habit – when we switch off autopilot and pay attention to what is happening. This is called mindfulness. Learning new things and being open to change becomes harder the older we get – and it will become increasingly more difficult if we don’t intentionally challenge ourselves mentally.
But what happens when drugs – any drug really, but drugs/substances of abuse are my topic here – enter the scene? Neuroplasticity then becomes the facilitator of addiction as our brain learns to adapt to the new stimulus, increasingly over time.
Translation into most languages at tab to the right.
One of the things I have come to appreciate about the Australian way is their straightforward approach to life. They are easy-going yet they say what they mean and you know where you stand. A lack of pretense – with a large dose of slightly off-color humor added in.
I think that is why they are more advanced in their drug policies and treatments than America – they are more honest and have less taboos. They benefit from having had comprehensive public health for decades which has facilitated progressive drug policies such as clean needle exchanges, safe-injecting sites, and medication assisted treatment.
John and I had an interesting conversation a few weeks ago here in Australia with Jack Nagel. Jack does the “Real Drug Talk” podcast from Melbourne and also runs the Connection Based Living Recovery Programs. We were preparing to record a podcast with Jack – see links below – and were asking about his experiences and what the current trends are here with drugs of abuse.
In discussing opioids, I wondered why methamphetamines seems to be the main drug of choice and why heroin is not as common here as it is in the States. Jack said that in the 1990’s there was a big problem with heroin coming in from the Golden Triangle of SE Asia and lots of overdose deaths. And the heroin use was IV, not smoking. So, there is a collective memory of street people using heroin and dying which created a lot of stigma and fear associated with IV use.
After that trend slowed, people began using meth – young people like Jack –because smoking or snorting meth seems more innocuous and a less intrusive way to take a powerful drug than IV. Jack said that there is a huge cohort of people who don’t live on the streets and who smoke meth for years. Sadly, they don’t seek help because the public messaging that portrays meth addicts as homeless people with sores and missing teeth doesn’t apply to them. But meth addiction will eventually burst that bubble and ruin their lives too.
There is also a growing problem with cocaine. While once considered the drug of the wealthy city dweller with some high-flying users in Australia spending $10-$20K per week, statistics reveal cocaine usage has now spread much further. Consumption has grown in other areas and demographics where prosperity has increased such as middle-class teachers, tradesmen, etc. Australia is now the highest per capita user of the drug in the world. And the rise in use is being driven by men aged in their 20’s, with Sydney leading the country in use. The most recent stats reveal that there are nearly 1 million weekly cocaine users in Australia out of a population of 26 million. (1,2,3)
We also talked with Jack about what the entry drugs are for kids here in Australia. After alcohol and pot, they usually begin with hard “party” drugs used at house parties and concerts like ecstasy/MDMA, benzodiazepines, GHB/GBL. All mood-altering drugs that create different types of euphoria, but which are dangerous because many times they are mixed with alcohol and other drugs, sometimes without the user’s knowledge.
Even though heroin is in the background in Australia, it is still available and becoming more dangerous due to fentanyl being mixed in to the supply of much of the heroin, and all opioids, along with other drugs of abuse. (4)
When our son, JL, began using Oxy’s he never thought he would even try heroin. Then, as Oxy’s became more expensive and heroin was cheaper, he started smoking heroin. He then swore he would never stick a needle in his vein – the danger and stigma to him was clear. Eventually, just like 95% of heroin users, he did just that. He was living under the delusion that smoking opioids – or any drug – would never lead him to become a “junkie”, an IV drug user.
My concern for the young people and families of Australia is that, as The Age reported in 2020, pain management with opioids has increased here too, although not to the degree it had in the States. Opioid-related deaths have increased in the past decade and today at least three people die from opioid harm each day and 150 are hospitalized. (5) Fentanyl is showing up in wastewater testing and drug overdoses of cocaine and meth, drugs where the users are not expecting a potent narcotic. Because it is synthetic and cheaper to produce in China and India, it brings its criminal networks a greater profit margin.
As I’ve said before and will continue to say: We will not treat our way out of the opioid/drug epidemic. Prevention is key. Let’s continue to stay aware and educated about what we all can do to keep our children and their future safe and healthy.
(I am re-posting this from July 4th for those who were on holiday and missed it.)
Topical blogs taken from OPIATE NATION. Translation into most languages at tab on right.
I was listening to a young man who had been heavily addicted to crystal meth. As he told his story, one of his “ah-ha” moments was walking into a bathroom in his parents’ home and seeing himself in the mirror. As he looked at the vestige of his former self – an emaciated, festered, hollow-eyed man – he remembered who he once was: a happy and carefree young person with good friends, a star athlete, a kind and honest person, a loving son. That moment of realization caused him to reach out and ask for help which eventually led to the beginning of his recovery journey.
As I heard his story, a photo flashed before my eyes of my son, JL – one we found on his phone after he died from a heroin overdose. It was a selfie he had taken after he had relapsed, just days before he died, standing in front of a full-length mirror in a public bathroom. He was dressed for work in slacks and a dress shirt. No smile. I have always wondered why he took that photo. Was it to remind himself of who he really was? To be able to be honest with himself when he might look at it later when he was high? Was he attempting to make himself stop using? To ask someone for help?
Topical blogs taken from OPIATE NATION. Translation into most languages at tab on right.
I was listening to a young man who had been heavily addicted to crystal meth. As he told his story, one of his “ah-ha” moments was walking into a bathroom in his parents’ home and seeing himself in the mirror. As he looked at the vestige of his former self – an emaciated, festered, hollow-eyed man – he remembered who he once was: a happy and carefree young person with good friends, a star athlete, a kind and honest person, a loving son. That moment of realization caused him to reach out and ask for help which eventually led to the beginning of his recovery journey.
As I heard his story, a photo flashed before my eyes of my son, JL – one we found on his phone after he died from a heroin overdose. It was a selfie he had taken after he had relapsed, just days before he died, standing in front of a full-length mirror in a public bathroom. He was dressed for work in slacks and a dress shirt. No smile. I have always wondered why he took that photo. Was it to remind himself of who he really was? To be able to be honest with himself when he might look at it later when he was high? Was he attempting to make himself stop using? To ask someone for help?
I’ll never know.
But after listening to this other young man, I’m guessing my son had similar thoughts going through his mind. Yet, what seems to have happened is that his addicted mind told himself that he could handle it on his own – that he could just cut down his use and not have to go through withdrawal one more time, not have to be embarrassed by telling us he had relapsed after 6 months of sobriety, not have to start all over again.
Perception refers to how we interpret things and it is the motivation behind our actions and reactions. His perception of his ability to use his willpower was skewed, because our self-perception is influenced by many factors including our perceived needs, our experiences, and our expectations.
Beneath self-perception is our self-concept, our view of our self, which influences our decisions, our feelings, and our judgement. It may include genuine self-knowledge or varying degrees of distortion.
Many times, we choose – albeit unconsciously – to be self-deceived because it is too painful to be honest with ourselves, to interpret what we see in the mirror with unbiased and accurate judgement. There is a saying written in the first century AD that sums this up:
“Those who hear (a clear direction) and don’t act are like those who glance in the mirror, walk away, and two minutes later have no idea who they are or what they look like.”
Because of this very human tendency, we all need a few close friends and a safe community who love us enough to honestly reflect back what we saw in the mirror – which we can so conveniently forget.
(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.
(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 Nationwas 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.
A few months ago, John was on a phone call with a physician who was asking his input about a new drug to help with opioid addiction. At the end of the call, as I walked into the room, John told him about our son’s addiction and death and how we hoped that by speaking openly about him and through our book and blog we could help in some small way. His response was something I will never forget. He said “Don’t underestimate advocacy because it is the surest way to change things. Science and medicine take a long time and have limited effectiveness.”
His comment came to mind in the recent weeks as I watched millions of people around the world protesting against racial prejudice that lay at the heart of police brutality to People of Color (POC). They are advocates of racial equality as a basic human right. I thought: how I wish I could be helpful in a practical way to a problem I have watched change very little over the decades of my life. I felt anger and also frustration, wondering if all the sacrifice and effort would actually bring about real, lasting change.
It is the same feeling I have when I see a young person on the streets, homeless and struggling, enslaved to a substance that is stealing their life. Or anyone living with addiction of any sort. And if I feel discouraged and hopeless, how must they feel? What will help bring real, substantive change and hope in all these circumstances?
As the months have passed since Opiate Nation was released last October, we have received many very encouraging reviews and comments. I have gathered some of them together and created a new page entitled “Recommendations & Reviews.” (see Menu) If you have wondered whether our story is worth the read, especially if you have no personal experience with addiction or heartbreaking loss, then perhaps these reviews will have some insight that will inspire you to order a copy for yourself or a loved one. If you have already read it, we would love to hear from you and know how you have been supported and reassured through our book. It is the reason we have written and published it.
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?
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.
The Ohio Society of Addiction Medicine is a chapter of ASAM - A professional society actively seeking to define and expand the field of addiction medicine.
Opiate Nation 