public health – Opiate Nation

The Least of Us, Part One: Julian

(Translation into most languages at tab to right)

As I was driving home in 105-degree heat last week, I noticed a young man carrying a plastic bag stumble to a bus stop bench and sit down. It was clear he was homeless and it was equally clear that he was on drugs. I felt compelled to pull over. I rolled down the window and asked, “Are you ok?” He said, “No.” I asked if he needed help, and he wept and said “Yes.” When he came over to the truck, I asked if he was on drugs, and he said “No.” I said “I think you are on drugs and you don’t need to be ashamed.” He said he was, so I asked if I could sit with him and talk.

As we sat on the bench in the heat I asked what drug Julian (not his real name) was using. Fentanyl in the form of street Oxy’s that sell for $2 and come from Mexico. He is homeless, has never known his father, his mother is out of state and done with him. He is 23 years old and has been struggling with alcohol and addiction for 5 years – fentanyl for the past 1½ years. I told him about my son and said Julian was on the same path to the morgue unless he could get clean. He had gone to rehab in March with a predictably miserable 5-day detox and then was supposed to go to a sober home, but said they never got him there – probably not true. I offered to take Julian for something to eat and to try to connect him with a program to help him. While I drove and he nodded off, I called a few of the directors I knew from programs our son went to, but had to leave messages. I decided to take him home for a shower and a rest as we tried to find him a place.

My husband John prayed with this sweet and troubled young man and encouraged him to know there was hope and that he wasn’t a bad person, or less-than, but had a powerful war waging in his brain that needed medical help and emotional support. We drove him to the public behavioral health service, where he had gone in March, and got him signed in. It was an hour wait for him to go through intake again, so we left him with our names and phone numbers to give as his contacts for help so that we could follow up on how he was doing.

When we tried to follow up the next day, we found he had done a runner and never went through the intake. I would guess the fear of excruciating withdrawal was stronger than the fear of a potential or eventual death. This is so common, especially for those who have tried many times to get clean. Addiction specialist, Dr. Richard Whitney said, “Once people get addicted, they really lose the power of choice.” (1) Even with medication, the drugs need to be out of your system first. On average, it takes 4-5 recovery attempts and 8 years to achieve one year of sobriety. After another 5 years in recovery, the relapse rate drops to 15%.(2)That is 13 years to try to undo what most commonly started as trying something fun as a young person. The chemistry in our brains needs more time to recover than a few weeks or months from the damage done by opiates.

In 2015, Sam Quinones released his award-winning book Dreamland: The True Tale of America’s Opiate Epidemic documenting how Purdue Pharma – with a monopoly on the market on pain in the 1990’s with its new highly addictive drug, Oxycontin – deceptively promoted it as a non-addictive solution for every ache and pain. Then, with the lure of easy money, young men in Mexico, independent of the drug cartels, trafficked black-tar heroin to neighborhoods in America as a cheap alternative to Oxy’s. Its powerful long-lasting high then became the go-to drug for millions of young people who could heat and smoke it – our son included. Quinones states that the perfect storm was created when the pursuit of prosperity, pain avoidance, and the breakdown of close-knit family and community life, beginning in the 1960’s, created the void that those easily available opiates filled.

Quinones has recently released The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. It is the second most important book written on addiction and American society. In my next blog, I will delve into this new book and discuss where we are in the drug epidemic and where we can go from here. I personally need some hope as I see the thousands of homeless young people on the streets of my city and struggle with the tension of wanting to help prevent one more life from a literal “dead end” and feeling frustrated with the lack of effective programs to help these addicted individuals get the long-term recovery care they need. This – in a country where the majority of people seem to think that health care is a privilege for those who can afford it instead of a basic service for all Americans, including the least of us.

Dreamland, pg 328
John Kelly, PhD – https://www.recoveryanswers.org/

What Would They Say?

(Short topical blog based on Opiate Nation – translation into most languages in tab on right.)

August 2^nd is the seventh anniversary of our son’s death. JL died of a heroin overdose in the early morning hours of that Saturday in 2014. He was 25 years old.

In 2020 alone, 93,000 people died of drug overdoses in the USA – hundreds of thousands more worldwide. Millions in the past few decades. These were beloved daughters, sons, partners, parents, friends, relatives. I think I can confidently say they did not want to be addicted and if they could have turned back the clock to the time before they began using drugs, they would have.

Regrets: Endless Stairways

(Twenty-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.)

Our family loves the art of Dutch mathematician and artist M. C. Escher: the buildings that open into themselves, the school of fish that become a flock of birds, the circuitous stairways that go up and down throughout multiple buildings without an end point. Yes, stairways that never get you where you want to go, but keep you endlessly retracing your steps. They are no longer interesting art to wonder at. They now mirror how John and I have felt many times since August 2nd—regrets—retracing the steps of our entire lives.

Celebrating Freedom and New Life

April 4, 2021

(I am taking a break from the chapter by chapter topics from Opiate Nation to focus on the significance of this holy week. Translations into most languages available at tab to the right.)

Spring is the season of regeneration, freedom, new life. The time of year when the whole earth seems excited to be alive after being dormant all winter. For the northern hemisphere, March and April are Spring – for our friends and family in Australia, right now it is Autumn. Regardless of what season it is where you live on this planet, it is Easter Sunday and the end of Passover week. Both the Christian and Jewish traditions celebrate the freedom from bondage and the beginning of a new life, although from differing perspectives and beliefs. Both begin the time with reflection and prayer. (I don’t understand Islamic tradition well enough to comment on it except to say that Ramadan is observed around this same time of year with introspection and fasting in remembrance of Muhammad receiving the Quran.)

For Christians, the freedom is from the bondage to sin in one’s life; for Jews, it is the freedom from bondage that the Israelites suffered under in Egypt. Both faiths look to an historical event in the past. They also remind us that while bondage was dealt with symbolically once – whether personally or communally – it is an ongoing problem in this imperfect world.

Who Is My Neighbor?

(Sixteenth 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 am re-posting this blog due to a glitch on some platforms in January)

In 2020, overdose deaths have increased worldwide, and by as much as 25% in the US. Deaths from acute intoxication have also increased dramatically. People are isolated and anxious, their treatment and recovery programs have been disrupted, and the illicit drug supply has become dangerous. Health officials believe that the majority of these deaths have occurred because hospitals are full and emergency services are overwhelmed with Covid-19 patients, thus removing the urgent, lifesaving care of overdose reversal that has been established in the past few years. Funding for all mental health services has also been diverted to pandemic care, which has complicated access to basic resources. Suicides are rising at an alarming rate.

A conversation that I believe is relevant to the current times came to mind this week. A lawyer asked Jesus “Who is my neighbor?” as he was trying to wriggle out of the command to “Love your neighbor as yourself.” Jesus told him about a man beaten and robbed while on a journey. As the man lay almost dead on the road, he was passed by several religious leaders who refused to help him. Then a man, who was not the same nationality or religion, came and bandaged and rescued him and paid for his care until he was well. Jesus asked the lawyer, “Which of these men proved to be a neighbor?” The lawyer replied, “The one who showed compassion.” Jesus responded, “Go and do the same.” *

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.

Death in the time of Covid-19: The Body Bags

During the first few years of writing Opiate Nation, the working title was Saying Goodbye Through a Body Bag. As I got closer to publication, friends suggested I look for another title, saying it was off-putting and gave a depressing visual image. It took me a while to adjust to the idea of another title because it was the experience of doing just that – saying goodbye to my son through a thick black body bag in the hot August sun – that pushed me through my grief and on to writing about what my husband and I had experienced and what we hoped could be a warning for others.

Choosing to Look Away: Pain avoidance

In these weeks of living life in a new way with the Coronavirus pandemic, I have found myself doing something I am not normally inclined to do: choosing to look away from the ongoing Opioid Epidemic. Sadly, it has been easy to do. John and I arrived in Melbourne in March on the last flight from LAX allowing non-residents into Australia. When we planned our trip in January to be here for the completion and delivery of our new Tiny Home, Covid-19 was barely in the news.

After our 14-day quarantine, and during our first few weeks here, we were supposed to speak at two events which were cancelled. When the meetings switched over to Zoom, we were then able to share the story of Opiate Nation. It was well received and appreciated, as it brought to light pitfalls and vulnerabilities that parents and their children face in the 21st century. Since then, we have been busy setting up our new home, arranging installations, and finding furniture and appliances. We are thankful and feel blessed to be able to be here with our daughter and family – and to be in a country where the leaders have been honest and proactive, where the government has a wide social safety net and comprehensive health care for everyone, and where the public is almost uniformly willing to trust and follow their stipulations.

Meanwhile, in the back of my mind, I have continued to think about people struggling with addiction and wondering what their lives are like during these times that are challenging – even for the rest of us. With the restrictions to help slow the spread of the virus, many rehab and recovery programs are now not an option. For those who have had jobs, many of which are hourly-wage or temporary positions, they may now be unemployed. If they are taking medication as part of their harm reduction/medication assisted treatment, how will they pay for it?

OPIUM: UBIQUITOUS THEN AND NOW

When I was in Melbourne, Australia recently with our family, I was starkly reminded of the ubiquitous presence of opium in the past as well as the present. Not that I can ever really forget it’s demon-like presence. But when I am asked what I do and I respond that I am a new author, the next question is what my book is about. After I give a short description, I am always surprised at how many people have stories of their own involving this ancient plant – a plant that truly offers humankind a double-edged sword. It can so wondrously relieve pain when our bodies have been injured or undergone surgery. Yet it has a mysterious way of latching on to a large percentage of we mortals who, having once legitimately used this soothing balm, then find the memory of that bliss like an oasis in the desert that we chase after at all cost.

Within a week, I heard three stories. One seems like something out of another era. A 60-yr old man, after hearing about our son and Opiate Nation, began to tell me about his years growing up in Singapore. He explained that both his mother and his father were addicted to opium and would regularly go to the opium dens to smoke. He remembers the intoxicating smell when he would go to find them to use the opportunity of their being in a blissful state to get money from them. He never wanted to use that drug or any other. Melbourne, Australia

Continue reading “OPIUM: UBIQUITOUS THEN AND NOW”

GLOBAL DRUG SURVEY 2020

The Global Drug Survey (GDS) runs the largest drug – which includes alcohol – survey in the world. The GDS is now it is ninth year and is translated into 16 languages and partners with over 30 countries. Their international team is committed to helping make drug use safer regardless of the legal status of the drug and promoting honest conversations about drug use across the world.

How we wish we had been able to have more open conversations with our son while he was struggling during a relapse or actively using. Had he not feared some punitive measure we could impose on him in an attempt to force him to be squeaky clean, he would have felt less shame and the feeling of being a failure. He could have felt that we were partners with him in his battle against the overwhelming enemy that was within. Continue reading “GLOBAL DRUG SURVEY 2020”