substance use disorder – Opiate Nation

Woefully Unprepared

(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 Nation was 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.

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.”

Advocacy Makes a Difference

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?

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.”

Coming Out of the Black Hole

In doing further research in support of the upcoming publication of our memoir, I have found many new groups, websites, and blogs about the opioid epidemic. It is very encouraging. And I was thinking back to 2005 when we first discovered that our son was using Black Tar Heroin. We were in an absolute black hole of information––there was nothing to be found on the internet or in our community, even though it had been a decade since this new way of producing and marketing heroin had hit the streets of the west coast. Eventually we discovered Black Tar Heroin: The Dark End of the Street, a1999 documentary directed by Steven Okazaki. Filmed from 1995-98 in San Francisco. Continue reading “Coming Out of the Black Hole”

Woman of Substances

In 1979, the novel A Woman of Substance was published. It was the first in a series of seven portraying the substances and schemes, the means and maneuvers of three generations of a retail empire. Being “a woman of substance” is considered a great compliment for a woman who aspires to be influential, a woman of power, a positive influence.

In a clever spin on this phrase, journalist and author Jenny Valentish has written Woman of Substances. I picked it up last year while in Melbourne, Australia and I couldn’t put it down. Her narrative flair for relaying her personal experiences while presenting scientific findings on addictions of all sorts is extremely engaging for women – and men.

Jenny’s nutshell:

A girl falls down a rabbit hole. She obeys every ‘drink me’, ‘eat me’ prompt and meets all sorts of freaky characters. Chaos ensues. Then she wakes up and exploits her position as a journalist to ask experts what that was all about.

Although it is not a memoir per se, her blatant honesty and self-deprecation about her past and her choices is revealing, while not glamorizing the depths to which her addictions took her. She interviewed 35 clinicians, counsellors, doctors and academics about their fields of expertise and shares her personal experiences of her up and down road to recovery and sobriety.

The chapters cover: The roles of temperament and impulsivity in addiction. Hitching adolescent identity to substances. Internalized misogyny as a contributing factor. The relationship between substance use, eating disorders and self-harm. Sexual assault and spiking. The impact of childhood trauma on the brain and behavior. Related foibles, such as gambling, theft, compulsive buying and compulsive sexual behavior. Self-medicating mental illness and PTSD. AA and other forms of treatment. The ways in which research and treatment is geared towards the male experience.

My husband, daughter, and I had the privilege of meeting with Jenny for lunch in Melbourne last week. She is as real in person as she is in print. We discussed current trends of drug addiction in Australia along with recovery and family help groups she is connected with.

What reviewers are saying:

“Raw, revealing, at times heartbreaking, but searingly honest and aimed to support anyone who is wondering if they will ever recover from addiction.”

“This book taught me things I wasn’t expecting about the landscape of substance use. You don’t have to be a spectacular comet of crazy like the young Valentish to find something of yourself in these pages. I can’t imagine there isn’t a young person, friend or parent who won’t get something important from reading this book.”

“Like a tour guide in a foreign land, Valentish waves a flag and provides a path back from the abyss. This is an enormously compelling, confronting and informative piece on addiction and recovery from a female perspective.”

Ultimately, Jenny show us that being a Woman of Substances keeps you from being influential, powerful, and a positive influence. As we told her, we are proud of her determination to truthfully relay her failures and her persistence in walking the uphill road to wellness and freedom. They will assure her place as a powerful and positive influence on this generation.

www.womanofsubstances.com

You can purchase Woman of Substances on Amazon or at your local bookseller.

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