No More Shame and Blame

http://www.theguardian.com/society/2016/feb/25/by-understanding-why-people-use-drugs-i-now-know-why-i-dont-use-them

(2/25/2016) Why I don’t use heroin by Chris Arnade

I spent the last five years documenting drug traps in neighborhoods poorer than is decent for such a rich country. I have become close friends with women and men who live under bridges and earn money for heroin by selling themselves for sex. I have bought heroin for them, unable to stand by as their body rejected the lack of drugs. I have provided them with clean needles, water, and a safe space to inject…

I am surrounded by heroin but have never used, because I am not in pain and have it good. I grew up with parents who cared about me and kept me safe, surrounding me with books and toys. I was encouraged, and expected, to finish high school, and to keep learning beyond that. After my education I was lucky to find a job (I was good at thinking in numbers), and was paid well.  The people I met in the drug traps had none of that. Their parents, if around, were too busy with their own problems to keep them safe. Many did far worse, abusing them physically and sexually. If the abuse didn’t come from a parent, it came from an uncle, or the mother’s boyfriend, or a stepbrother, but the abuse almost always came. It was the ultimate betrayal of trust: being raped by men who were supposed to keep them safe.

Their childhoods were spent dealing with problems that would break most adults…

And so drugs are popular, because drugs work. They allow people in pain, whom society has rejected, a way to integrate into a community that does work for them. How much someone uses drugs is often a measure of how much pain they have suffered, how isolated they are…

That in any city or town, across all of America, people live on the streets, shooting up, selling themselves for another bag, should make us all stop and ask ourselves “why does our society create and allow such pain?”.

I never saw Bernice again, she disappeared from the streets, presumably into a rehab, jail, or perhaps she moved to another town. Still, I cannot forget the last thing she said to me, “Why am I using drugs and hustling? Because I am out here trying to kill myself. I want to get a gun and do it faster, but I am too scared to blow my head off.”

Try not to judge people for how they decide to manage their pain. I know that many of these ways are often destructive, like my addiction to cigarettes. I don’t have the looks to be able to sell my body, but I know what desperation and pain can drive a person to do. And if you don’t understand that kind of desperation, then you’re lucky.

According to all of my reading on this subject, most drug addicts are like the ones described in this article. And so I’m wondering about the homes they ran away from, specifically if most drug addicts are from poor neighborhoods. According to the government’s statistics, most heroin addicts are white people from middle-class homes. I’m not sure about the government’s definition of “middle-class,” but I know that most patients who can afford an addiction clinic are usually from the middle-class.

And so I’m wondering, what kind of pain are these middle-class heroin addicts running from? I’ve been comparing the current heroin “epidemic” to the drug epidemics of the past, specifically in the middle-class. It seems like boredom is one of the reasons for drug use in the upper classes, and I suppose we can also blame the immaturity of young brains.

I used to think I was in the middle-class, perhaps lower middle-class. It’s hard to remember every day of my life, but I don’t think I’ve ever been offered heroin. I don’t know what kind of crowd you have to hang out with to be exposed to drugs like that, but I’m guessing it’s people with a lot more money than I’ve ever had. And perhaps, also, people with a lot less than I have.

I can see why a lot of parents blame legal drugs and drug dealers (I mean, doctors). Who else is left to blame? There are many people who believe that parents are to blame when children do things like take drugs. But parents who don’t take drugs also have children who do, and vice versa, so I think the blame falls more on our DNA (along with the types of drugs that one is exposed to). And yet, there’s all this violence, abuse, rape, and bullying, that contributes to drug addiction…

Does the white middle-class really want to stop the heroin “epidemic”? Does it really want to delve into the reasons for addiction? Abuse and violence are already against the law, yet that hasn’t stopped drug use and abuse. The drug war hasn’t stopped it either.

People abuse sex, just like they abuse drugs. In the past, most people felt that unmarried women having babies was shameful (only for the woman, of course). People used to think that women who took the pill were sluts. One day, our society will progress to the point of not shaming those who use drugs, for whatever reason.

Thinking of you, Bernice.

When pain patients attack each other

I suppose it’s not easy to talk “to” people instead of “at” them, especially if you’re on opposite sides of an issue. I realize that my blog allows me to articulate my opinions in ways that I might not be able to if face-to-face with my opponents. However, I put more thought and effort into my writing than I do for verbal communication. In other words, I stand by all of the words and opinions expressed by me on this blog.

I’ve seen the drug war force many changes on the pain patient population in the past 30 years, but I don’t think I’ve ever felt such desperation in my fellow sufferers. Unfortunately, desperation has caused some patients to draw lines, like how many pain patients blame drug addicts for the opioid war. Like how the DEA and grieving family members of overdose victims blame the drugs.

My blog is mostly about my own opinions of living with chronic pain, although I also include the thoughts, feelings, and comments from other pain patients. Which brings me here…

https://painkills2.wordpress.com/2016/02/23/future-visit-to-serenity-mesa-addiction-clinic/

Sun, Mar 6, 2016 1:10 pm
Re: Blog posts about Jennifer Weiss-Burke
From: Jennifer Weiss-Burke (jenweiss24@msn.com)

Dear Johnna,

You are right I am not an expert in chronic pain and I’ve never claimed to be. My husband suffers from chronic pain and, like yourself, was dependent on painkillers for a number of years. They almost killed him and destroyed his life so he now seeks effective alternatives and non-opioid medications. So while I do not have direct experience with being a chronic pain patient, I know what my husband went through and continues to go through each and every day.

When you decide to visit Serenity Mesa, I will be happy to have someone other than myself guide you on a tour. You can call 877-3644 which is our main number. Anyone who answers can help schedule something.

I am a supporter of MAT and do not deny any of our residents access to these medicines that are proven to be effective for opiate addiction. In addition my son was on MAT so no I do not deny people access to effective and evidence based solutions, including medication.

We submitted our Medicaid application back in August and are waiting for it to be approved. We have contacted the state Medicaid office numerous times and have been told that all Medicaid applications are on hold because they are changing the application process. If you have any contacts in this area who can help me push the process through I would greatly appreciate it.

No, these are not paid positions. I am a community member of the prescription drug misuse and overdose prevention committee and there are two other community members who are chronic pain patients so your concerns are represented on this committee. The meetings are open to anyone so you are welcome to attend.

You have made a number of assumptions about me that are not true, posted quotes on your blog that I have not said and continue to try and devalue my advocacy efforts. But, the truth remains that young people are becoming addicted to pain killers at alarming rates throughout this country. Kids are dying. Kids are becoming heroin addicts when their supply of pills runs out. Those are the facts. I wish that was my opinion or my over exaggerated perception but sadly it’s not.

I feel for your pain and pray for your strength and perseverance to get through each and every day. I am sorry you are going through what you are going through and hope you somehow find peace. My heart goes out to you.

Sincerely,

Jennifer Weiss-Burke
Executive Director Healing Addiction in Our Community (HAC) & Serenity Mesa Youth Recovery Center
jenweissburke@serenitymesa.com
(505) 363-9684
http://www.serenitymesa.org
http://www.healingaddictionnm.org

Along with this reply from Mrs. Weiss-Burke, her significant other, David Burke (Dbkono@gmail.com), posted a comment to the above link (twice), which I have copied below in its entirety:

As a fellow chronic pain patient I completely agree that prescription pain medications should not be taken away from us! The last thing those suffering from chronic pain need is to suffer daily without remediation. I have been fighting since 2006 with an intense intestinal disease in which I have lost sections of my small intestine and suffer daily from villitrocious sections of my intestines that will never heal. Currently I am still on a variety of other medicines to take care of my condition but I have to live in constant pain everyday.

I, like you, was addicted to painkillers and they almost destroyed my life. I lost everything before I was finally able to detox off the opiates and am proud to say that I have been clean for over 5 years now. I have learned to live and deal with the pain and now advocate. along with my wife, for laws, funding, facilities and whatever else it takes to help stop this epidemic that results in needless opiate overdose deaths.

I have been reading your blog (more like uneducated personal attacks) and have come to one conclusion. You like me are nothing more than an addict. If you weren’t you wouldn’t be so crazed about losing your “drug” and would be more active in doing something about ensuring the laws being put into place protected your rights in being able to use them safely and ensuring that big pharma wasn’t continuing to get rich off of your addiction. If you were actually educated in the facts instead of spewing lies and mis quoting people you would also know that for the last five years we have been working hard with the department of health and many Senators and Representatives ensuring laws like SB 263 and SB 277 among many others protected the rights of chronic pain patients. If you don’t believe me, Call Senator Richard Martinez from Rio Arriba or Sen. Brandt from Sandavol County who is himself a chronic pain sufferer and advocate. Or how about Senator Cervantes. I can go on and on with all the support we have received from both sides of the aisle to show you that one of the biggest concerns from all involved was to ensure the protection of chronic pain patients. Believe me when I say this that your rights as a chronic pain patient are protected.

Unfortunately, your rights as an addict are much harder to protect. In NM there isn’t enough treatment beds for adults, teens, Men or women. When it’s time for you to get help what are you going to do? Where are you going to go? Who are you going to call? Sadly most people have no where to go or call. For the last five years we have been fighting to change that. HAC has been fighting for the youth of this state. Doing everything we can to ensure our young people have a place to go to get help. Wether they are rich, poor, middle class, coming out of jail, homeless or affluent homes. White, black, Hispanic, Native American, purple, or green. After all drugs or addiction don’t really discriminate do they? Have you ever seen anyone die from an overdose? Have you ever looked into the eyes of a 16 year old who is so gripped by opiates that his whole life is consumed by the drug? Have you ever looked into the eyes of a family that has had their lives turned upside down because they lost their son or daughter because of these drugs? Do you not care? Do you not have a heart? I don’t think you do. I think right now you are like every other addict I have ever met. All you care about at this point in your addiction is making sure you are able to get your next dose or “fix”. You are so blinded by your addiction that your lashing out at people who are actually trying to help you keep your precious drugs while trying to make sure others are protected from those same drugs.

My wife may not be an expert in chronic pain but she has never claimed to be. I, however am an expert in chronic pain. My wife has never claimed to be an expert in addiction but an advocate and one who constantly educates herself on addiction. I am an addict and I do the same. We do both however live it everyday. We live it through the eyes of the boys we care for. Through the death of her son. Through the everyday struggle of addiction in my own disease. Through the pain we see in the hundreds of phone calls and emails we receive from parents, grandparents, brothers, sisters and friends of people who have died or are struggling with this horrible addiction!

Do you even know the statistics? Do you even care about where our state falls nationally? Do you even care how many people die every year because of prescription pain pills?

I know if you truly wanted to you could advocate for your cause. It doesn’t take any thing more than picking up a phone or as you are always on your computer or outside taking pictures of planted trash outside your apartment. Just pick up your computer and write a letter to you legislator stating your concerns! Did you know they are required to respond to you? Did you know your elected officials in reality actually do care? All you have to do is try!

You constantly assume things and you know what they say about people who assume things right? There is absolutely nothing and I mean nothing truthful about one thing in ANY of your blogs about my wife or our facility.. We continue to lobby UNPAID for more funding to complete the entire facility. We travel around the state speaking to everyone possible. Anyone who will listen about this epidemic. We will speak to judges, DRs, lawyers, dentists, students, teachers. ANYONE. Especially addicts like you because I don’t want to see you die of an accidental overdose. As a matter of fact I think you should get a prescription of Nalaxone and keep it on hand for anyone around you to know how to use just In case you overdose. Doctors in NM are now starting to co-prescribe Naloxone with an opiate script because the danger of death is so high. There are lots of good NA meetings located around NM. Remember the first step is admitting you have a problem😀 You may have chronic pain but being an addict and a chronic liar can be a far worse disease than the other disability😢

So there is no chance of you misrepresenting this post or me I will be posting my wife’s letter yours and mine on my Facebook page, Yahoo page and have saved a copy of it in my notes in case you decide to alter it in any way. You know being that your so honest and all.

Dear Mr. Burke:

Sometimes my honesty comes across in a negative way…

Well, if I’m being honest (about my obsession with honesty), perhaps I should say that it’s often seen in a negative light. I suppose that’s because the truth often hurts. But since my pain levels are always higher than the pain from honesty, I find the truth to be quite refreshing.

Obviously, this obsession doesn’t win me any popularity contests. But I think the lies we tell ourselves cause us more pain — like anxiety, depression, and digestive problems — than the truth.

So, I think the very last line of your comment pretty much sums up how much you know about me. Funny, if you really wanted to learn more about me, all you had to do was take the time to read some of my blog posts — not just the very small handful that are about your wife.

There’s an awful lot of information on my blog (over 6,500 posts), so I don’t expect you to be familiar with all the details of my chronic pain survivor story. I find it terribly ironic that you accuse me of making assumptions, when it’s you who has made a great number of assumptions about me. But that’s okay, because I don’t mind correcting you.

I think it’s very, very sad when pain patients attack each other. And one of the poison darts often thrown is to accuse another patient of being a drug addict — as if suffering from this additional medical condition is something to be ashamed of. Anyone who follows and reads my blog knows about the enormous amount of empathy I have for those who suffer from any kind of addiction, as well as the in-depth self-analyzing I’ve done on my own addictions.

Tell me, Mr. Burke, do you recognize your addictions?

https://painkills2.wordpress.com/2015/02/17/do-you-recognize-your-addictions/

For those pain patients who choose stoicism over drugs, I salute you. I can only warn you that untreated pain can very easily turn into chronic and intractable pain, increasing your daily pain levels, sometimes to the point of being unmanageable (even with drugs).

For those who choose to treat their pain with other drugs besides opioids, I wish you luck. But please don’t play the hypocrite, with the belief that some drugs are good, while others are bad. All drugs have side effects, and you can become addicted to antidepressants, anti-anxiety drugs, and stimulants, just like opioids. In fact, some patients have more trouble detoxing from antidepressants than opioids, with longer-lasting effects. Have you read about brain zaps?

https://painkills2.wordpress.com/2015/08/12/lilly-chalks-up-a-win-for-cymbalta-in-first-u-s-trial-over-withdrawal-symptom-claims/

Mr. Burke, you claim to have been “clean” for five years. I suppose that means you haven’t taken any painkillers, as if these are the only drugs that can make one feel dirty while taking, and become clean when they cease taking them. (Heck, some people feel that way about gluten.) If your chosen treatments for pain are working for you, that’s great.

For the past 4 years, I haven’t taken any prescription drugs for chronic pain, even though I’ve had more than one opportunity to purchase them in the underground market. And while you think that I’m addicted to drugs — only interested in getting my next “fix” — the truth is that I was really addicted to doctors and the medical industry. Freeing myself from that addiction was both the hardest and best thing I’ve ever done.

So, there’s no way I can overdose, unless it’s on aspirin. But you’re so very kind to worry about me, Mr. Burke. But dude, there’s no way on Earth that you could ever shame me, although I’m sure you tried your best. Tell me, why did you think it was a good idea to assert that I plant trash outside of my apartment? I think that’s the silliest thing I’ve heard all year.

And no matter how many thinly-veiled innuendos you throw at me, you can’t make me feel bad about my blogging and art therapies — at least they’re free. And I’m sure we can agree that blogging and art therapies are not addicting (unlike the prescription drugs you’re currently taking).

The problem I have with you and your wife’s advocacy work is that it’s not helping pain patients. In fact, it’s harming them. (Isn’t New Mexico at the top of the list for drug abuse and overdoses, including alcohol? And if you check your statistics, you’ll find suicide on that list, too.)

I find it odd that you and your wife don’t understand the results of your actions, but then you both have a rather narrow focus on addiction. And until you read every email (posted on this blog) that I’ve written to government employees (and anyone else I thought might help), you have no business telling me to “try.”

Don’t get me wrong, your comments didn’t offend me. But your attitude — especially as a chronic pain patient — is offensive and harmful to millions of other patients. I think you know that. And I hope you also know how foolish you look, trying to judge me, based on your own misconceptions and the lies you tell yourself.

Dude, you’re not an “expert” on chronic pain. You’re only an expert on your version of adequate treatment options. You discriminate against certain drugs, just like your opinions about me discriminate against other pain patients. I’m not trying to change or open up your mind — no, I’m trying to inform millions of other pain patients what they’re up against in the opioid war.

It’s unfortunate that we’re on opposite sides of this war, Mr. Burke, but I prefer to be on the right side of history. The drug war is, and has been, a total failure (just like prohibition). The war against cannabis has been a disaster, too. The opioid war will also be a failure, but it could take decades — decades of increased suffering, depression, disability, alcoholism, homelessness, and suicides. Yes, and overdoses, too. All because of people like you and your wife. (And a shout out to Unum and the CDC.)

If I believed in shame, I would call that shameful. Hopefully, the patients treated at your addiction clinic are not shamed, as you have tried to shame me here.

https://painkills2.wordpress.com/2015/04/14/what-is-the-purpose-of-shame/

Future Visit to Serenity Mesa Addiction Clinic

https://painkills2.wordpress.com/2016/01/22/dear-new-york-times/

Fri, Jan 29, 2016 12:17 am

Johnna,

I have “enjoyed” reading your continual posts about me and my advocacy work and your “opinions” about me give me a good laugh now and then. You question my ability to fact check and to be labeled as an “expert” in addiction but maybe you should do your own fact checking. Numerous entries in your blog are incorrect. Your most recent blog post listed several quotes that you said I made (see below). I never made these quotes and have no idea who did. Maybe there is another Jennifer Weiss in Albuquerque or someone made those comments in my name but I absolutely did NOT make those comments.

You can talk about me, my deceased son, my advocacy work all you want but please do not start posting false information about me and making up things that I did not say. I also do not receive endless amounts of funding from the state as we are up in Santa Fe right now fighting for the little funding we do get. Maybe you should do your own fact checking before you publish inaccurate information with my name attached to it.

And, as it appears that you have an excessive amount of time on your hands, maybe you should come visit Serenity Mesa and I will give you a personalized tour showing you all of the evidence-based therapy we provide our young residents who suffer from heroin and meth addiction. Maybe if you saw the services we provide and the work we are doing you wouldn’t be so quick to judge. It’s obvious you have never been an addict, loved and addict or lost an addict so maybe you should try a little more empathy and a little less judgement for something you know nothing about.

Once again, the comments below were not made by me:

Jennifer Weiss · Top Commenter · Albuquerque, New Mexico

And one more thing. Since it looks like you hate cops, how many times has APD arrested your dumb butt for just being a jackass or slapping around your p*nis because no hooker in their right mind would ever touch you. So how many times have you been locked up?

Jennifer Weiss · Top Commenter · Albuquerque, New Mexico

Loretta Baca obviously you think your s*it doesn’t stink because you think violence begets violence. Wow, you’re more into death and destruction for your own gratification because your life is so boring and lacking of what is truly important. And you know what, I actually feel sorry for you. You are a pitiful excuse for a human.

Jennifer Weiss-Burke
Executive Director
Healing Addiction in Our Community &
Serenity Mesa Youth Recovery Center
jenweiss24@msn.com
(505) 363-9684

—————–

Tue, Feb 23, 2016 4:36 am

Dear Jennifer:

I’m sorry it took me so long to respond to your email, but if you follow my blog, then maybe you can understand the lateness of my reply. (Being disabled, poor, and powerless is no fun, believe me.) And if you’ve read my blog, then no doubt you are prepared for the type of response you would receive. (At least, I hope so.)

You may not believe this, but it was nice to hear from you. And it’s nice to know that I could give you a good laugh, even if it was at my expense. After all, I’ve heard that laughter is the best medicine. 🙂

We’ll have to disagree about the Facebook comments you’re now disclaiming, because I think they were, in fact, made by you. However, there have been plenty of times when I’ve responded in anger and said things I didn’t mean, so let’s just forget about those comments for now.

It’s funny what some people use to claim the title of “expert” these days, especially in the addiction industry. Considering your background, you can’t be surprised that anyone would question your credentials. Maybe that doesn’t happen in the addiction and political industries? Or is this the very first time? Being rich and white is something I’ve never experienced, but I’m guessing the combination has been really helpful for you.

Maybe you can tell me why you think your experience — specifically in pain management — qualifies you for things like this:

https://painkills2.wordpress.com/2014/12/25/prescription-drug-misuse-and-overdose-prevention-advisory-council/

“The council shall meet at least quarterly to review the current status of prescription drug misuse and overdose prevention and current pain management practices in New Mexico and national prescription drug misuse and overdose prevention and pain management standards and educational efforts for both consumers and professionals. The council shall also recommend pain management and clinical guidelines.”

https://painkills2.wordpress.com/2015/02/02/because-grieving-parents-make-great-medical-experts/

“We will have a discussion on how opiates affect the brain, their addictive qualities and how prevention is a far better option than treatment. We will also offer ideas on how the dental community can help be part of the solution to an epidemic affecting so many people in NM.”

I can’t help but wonder if these are paid positions, and if so, which part of your work experience has qualified you for these positions? Maybe all you need is a college degree, like doctors who become addiction “specialists”?

You say you’re now fighting for more government funding (an endless task, right?), but you didn’t mention the funds you’ve already received:

https://painkills2.wordpress.com/2014/12/25/1172014-healing-addiction-in-our-community/

https://painkills2.wordpress.com/2015/02/02/nonprofit-501c-organizations-albuquerque-nm-87187/

And remember when you advocated to deny the approval of Zohydro?

https://painkills2.wordpress.com/2014/12/31/reconsider-approval-of-dangerous-new-opioid-zohydro/

I also have to wonder, what is your experience with Zohydro? Do you think that treating pain and drug addiction are the same thing? Do you also advocate to deny patients access to opioids like Suboxone, Methadone, and bupe?

And why doesn’t your addiction clinic accept Medicare/Medicaid?

With all your advocacy work on pain management and addiction, you must be aware of the crisis that millions of pain patients are experiencing. You must also be aware that even if your work helps thousands of drug addicts, at the same time, it is also part of terrorizing tens of millions of pain patients. So, with this knowledge, I assume that you also understand why I have felt compelled to publicly point out all the hypocrisy.

We might be fighting on opposite sides of the opioid war, Jennifer, but as a 30-year intractable pain survivor, at least I can say that I’ve tried very hard to understand your side. Can you say the same? Not in my opinion.

For all these reasons, I would be happy to accept your offer for a visit to Serenity Mesa. However, I don’t think it should be a scheduled visit, or include a tour given by the owner of the facility. And because of my current financial difficulties, as well as my disabilities, I don’t know when I’ll be able to plan this visit.

But rest assured, I plan on visiting Serenity Mesa in the future. And just like any stranger off the street who may have questions about your facility (and the treatments offered therein), I hope my visit will help me better understand addiction. After all, I advocate for access to all treatment options for all patients, not just for those suffering from chronic pain.

Now, Jennifer, what are you going to do to learn more about chronic pain?

Johnna Stahl
Executive Director of My Own Blog
The Disabled Community
painkills2@aol.com
No phone

Dear New York Times

Re: How the Epidemic of Drug Overdose Deaths Ripples Across America (1/19/2016)
From: painkills2@aol.com
To: letters@nytimes.com, public@nytimes.com, publisher@nytimes.com
Cc: jmonahan@ix.netcom.com

Your publication is just one of many that has helped to create the opioid “epidemic.” (And don’t think that 100 million pain patients will ever forget that.)

I don’t know how you choose which “experts” to quote in your drug-war articles — or how you even determine who is actually an expert — but in the case of Jennifer Weiss-Burke from New Mexico, you’ve made a terrible mistake. Is there anything in this woman’s background, besides the tragedy of her son’s death, that would suggest she’s an expert in addiction and its treatment? Are you basing her expertise on the fact that the state has showered her with funds to open up her own addiction clinics (where they use reiki as a treatment option)?

Let’s look at a few of her online comments, shall we?

Jennifer Weiss · Top Commenter · Albuquerque, New Mexico

And one more thing. Since it looks like you hate cops, how many times has APD arrested your dumb butt for just being a jackass or slapping around your p*nis because no hooker in their right mind would ever touch you. So how many times have you been locked up?

Jennifer Weiss · Top Commenter · Albuquerque, New Mexico

Loretta Baca obviously you think your s*it doesn’t stink because you think violence begets violence. Wow, you’re more into death and destruction for your own gratification because your life is so boring and lacking of what is truly important. And you know what, I actually feel sorry for you. You are a pitiful excuse for a human.

“When you go right back to the same environment, it’s hard to stay clean,” [Weiss-Burke] said.

Actually, it doesn’t matter what kind of environment you return to, those who suffer from drug addiction will always have a hard time staying clean, especially if you believe that being drug-free is the only way to conquer addiction. There are plenty of parents who have sent their kids to different environments, only to result in the exact same problems.

The reputation of the NYT is not as good as it used to be, and issues like this are part of the reason why. I know the newspaper industry is going through a lot of changes, but there’s no excuse for crap like this. Are you a respected newspaper or a tabloid rag?

Johnna Stahl
Albuquerque, New Mexico 87114
(I’m too poor to have a phone)
painkills2@aol.com
https://painkills2.wordpress.com/

Tale of Two Suicides; Lessons for Opioid Public Policy

http://www.pharmaciststeve.com/?p=12691

http://nationalpainreport.com/tale-of-two-suicides-lessons-for-opioid-public-policy-8828356.html

For one it was the best of times, for the other, the worst. At no time did the paths of their lives cross, but they shared the same fate, one most would consider a tragedy. Their legacies, for pain and public policy, could not have been more different…

 I knew one, only heard of the other; both dramatically affected my life.

Bob was a marine. He had valiantly served his country, and he was proud of it. His identity was so tied to his service that he could not handle the thought of being any less of a marine, a warrior… a man, whatever that means. His back injury robbed him of that identity, and he struggled in a futile attempt to regain that which he no longer was, or, at least thought he was. Perception is reality, and his perception was that he was no longer what he wanted to be, needed to be.

Surgeries and elixers, therapies traditional and non-traditional. All tried in a vain attempt to rid himself his pain. All failed. Some made his pain worse.

He used pain meds to numb the pain, but they couldn’t restore his manhood. In desperation, he kept taking more and more. After a while, he gave up the hope for a cure. He was a broken man, not just physically, but also mentally and spiritually. The meds gradually became a temporary reprieve from his painful reality.

I was his doctor. I never really saw that brave marine. Rather, I saw a broken, staggering man, subservient to the world his pain had created for him. Our goal for any treatment is to improve one’s function. For many, opioids accomplish that. Not for Bob…

I told him that I could no longer prescribe the medication for him as I saw it harming more than helping…

There were no candle-light vigils for Fred [Bob]. He was gone, and quickly forgotten…

Billy’s parents took to the legislature to exact vengeance. While few would ever be driven to action to help Bob, there were many who sought to vindicate Billy. There are few things more motivating than a grieving mother’s wailing, and the legislators were not immune. Soon, laws were being enacted in a vain attempt to “stop the carnage.” In a world fueled more by emotion than reason, the land of “feel-good law,” the law of un-intended consequences reigns supreme. Soon, laws were passed. Addicts still died. Those in pain struggled to find someone with the courage to defy those laws and care…and they died too, but their cries went unheard…

The battle has only started, and it is not just in the legislatures, and not just in my state of New Hampshire. It is also in courtroom. In the chilling wake of a second degree murder conviction for Dr. Hsiu-Ying “Lisa” Tseng, accused of prescribing opioids in the course of her practice that led to the deaths of three patients, I, like many others feel lost and vulnerable…

Under comments:

Jackie
November 23, 2015 at 5:49 pm
Have you wondered if telling Fred you were taking away his medication (his main means of controlling his unrelenting pain) may have in fact been the catalyst for his suicide? As a chronic pain sufferer I know a few sufferers who have done so when no longer able to get the medication they need. It is a very frightening thing to face the kind of pain you know is going to come. My pain is managed by opiates, but my strength fortunately comes from somewhere else.. So it’s never an option I would take, but I certainly understand why others may not want to have to deal with unremitting pain for the rest of their lives.

Shari
November 23, 2015 at 4:34 pm
I have Chiari Malformation and EDS and several other chronic debilitating conditions. I am to the point that I have PTSD because of the treatment I have received due to patient profiling and being labeled a drug seeker. Because of this I am unable to go to any dr. and would rather die in my home than go to the ER because of severe anxiety just thinking about calling to make an appointment let alone actually go to it. I don’t drive and have been house bound since August ’14 and spend most of my days in bed or on the couch. That wasn’t the case when I was going to pain management. I actually engaged in life rather than waiting to die like I do now. I’m 43 I do not receive ssdi and live with family because I have a 9 year old daughter and I am unable to properly care for her! Physically or financially. The thought of living another 5 or 10 or 20 years like this is daunting to say the least! But as I hear far too often “it could be worse, at least you’re alive!”
REALLY??? I fail to see how that would be worse!

In my search terms:

“can a politician in my community help me fight unum for my ltd benefits”

Wow, this is a really hard question to answer…  (Please note sarcasm.) I guess that depends on how much money and influence you have. I mean, anti-drug advocates spend a lot of time and money on politicians, and it obviously works.

Unfortunately, the problem with Unum and LTD benefits exists in the federal government, not state or local governments. It’s all about the ERISA law, which no one really understands. Basically, ERISA should be renamed to something like URFUCKED.

In Heroin Crisis, White Families Seek Gentler War on Drugs

When you think about the New York Times, you usually think about some kind of quality reporting. Maybe even some fact-checking. I think of the NYT’s coverage of the drug war to be more of a mouthpiece for corporate and political America than real investigative reporting. But it’s always nice to know what the rich and influential are thinking:

http://www.nytimes.com/2015/10/31/us/heroin-war-on-drugs-parents.html

While heroin use has climbed among all demographic groups, it has skyrocketed among whites; nearly 90 percent of those who tried heroin for the first time in the last decade were white…

The Times states this as if it were fact, when it’s only based on “self-administered surveys to gather retrospective data on past drug use patterns among patients entering substance abuse treatment programs.”  I can’t imagine that too many people are honest about their past drug use, let alone those who suffer from addiction. And I imagine that the racial make-up of addiction treatment programs is unlike the racial make-up of America’s prison system. Like a lot of (psychiatric) research studies, this one doesn’t prove anything.

I don’t know what percentage of first-time heroin users have been white in the last decade, but heroin has always been a drug used more by white people than blacks (even if the media in the past portrayed it differently). It’s usually not good to generalize, but people use certain drugs because they have access to them — a $400/day heroin habit is not something most black people would have access to. (Another reason why pain patients, usually poor and disabled, aren’t really a part of this heroin “epidemic.” Even though the DEA says heroin is cheaper than pills, if you need to spend $400/day for the drug to be effective, that’s a choice most pain patients don’t have.)

And the growing army of families of those lost to heroin — many of them in the suburbs and small towns — are now using their influence, anger and grief to cushion the country’s approach to drugs, from altering the language around addiction to prodding government to treat it not as a crime, but as a disease.

“Because the demographic of people affected are more white, more middle class, these are parents who are empowered,” said Michael Botticelli, director of the White House Office of National Drug Control Policy, better known as the nation’s drug czar. “They know how to call a legislator, they know how to get angry with their insurance company, they know how to advocate. They have been so instrumental in changing the conversation.”

Mr. Botticelli, a recovering alcoholic who has been sober for 26 years, speaks to some of these parents regularly.

Their efforts also include lobbying statehouses, holding rallies and starting nonprofit organizations, making these mothers and fathers part of a growing backlash against the harsh tactics of traditional drug enforcement…

These mothers and fathers are also part of the backlash against opioids. So, even though they’ve changed their thinking on how to treat addiction (no jail time for their families), that doesn’t mean they want to end the drug war. Far from it.

Heroin’s spread into the suburbs and small towns grew out of an earlier wave of addiction to prescription painkillers; together the two trends are ravaging the country…

I’d say the suicide epidemic is the trend ravaging our country, but then maybe my opinion differs from those over at the Times. But I get very tired of the media saying that prescription painkillers started this whole heroin epidemic, because that’s not true. Maybe in the media’s little white bubble, painkillers are to blame because that’s all they see — because white people are the ones with the most access to painkillers (and heroin).

This is what pain patients are up against — grieving, middle-class white people, with the time and money to make our lives miserable. Grieving parents writing anti-drug curriculum for schools, opening addiction “clinics,” and yelling in the ears of politicians and those with influence (like Michael Botticelli, director of the White House Office of National Drug Control Policy). Do you think Mr. Botticelli would make time to talk to pain patients (who are disabled and poor)? Do you think an ex-alcoholic could even understand our position?

While it’s great that more (white) people are finally recognizing addiction as a disease, the problem remains:  What’s the best way to treat it? Obviously, what we’re doing isn’t working, and these parents know it because their family members usually spent time in rehab. So, we’re gonna send millions of new patients into treatment and treat them with… what? Bupe and Suboxone? Antidepressants? AA? Talk therapy? An addiction clinic on every corner?

It’s like creating a war against opioids, but not being prepared for the consequences. The plan to substitute alternative therapies for opioids isn’t working — as if there was even a small chance that it would. Now everyone wants to treat addiction with treatments that only work for a small number of people.

We know the results of the failed (white people’s) drug war.  What will be the consequences of the white people’s war against addiction and opioids?

The epidemic of grief-stricken parents

http://www.startribune.com/rosenblum-parents-pain-helps-shift-prescription-drug-awareness/189749261/

Steve Rummler died in 2011 of an accidental drug overdose, after a long, frantic battle to manage chronic pain from a back injury. His death at age 43 ended the life of a popular Edina athlete and musician who was planning to marry his high school sweetheart.

Life is a whirlwind for [Steve’s mother] Judy, with luncheon speaking engagements at Rotary clubs, visits to local churches and colleges and, on Thursday and Friday, a presentation at a Food and Drug Administration public hearing in Bethesda, Md., regarding drug labeling…

Judy is not opposed to opioids used appropriately and responsibly. For end-of-life issues, palliative care and, even in some acute situations, they can be a godsend. But she refers to a note Steve left, which has become the tragic sound-bite for their foundation: A lifeline, he wrote, became “a noose around my neck.” …

In 1996, Steve suffered a severe back injury, “and life was never the same again for him,” Bill, 72, said. “I don’t know if he ever had a good night’s sleep after that.”

Steve sought help immediately but never got a treatable diagnosis. Depressed, he started taking antidepressants. “He reached the critical fork in the road,” Bill said. “The antidepressants gave him a little relief, so, gee, let’s keep going down this road.”

In 2005, Steve was prescribed narcotic painkillers and the anti-anxiety drug clonazepam. His family watched their gregarious son and brother start slipping away. In 2010, he checked into the Pain Rehabilitation Center at the Mayo Clinic in Rochester for three weeks, where he was weaned off his medications…

Knowing that he might lose Holtum, Steve completed 28 days of treatment at Hazelden in May of 2011. He relapsed shortly afterward. In unbearable pain one desperate night, he sought out illegal drugs. He died on July 1, 2011.

The Rummlers, who split their time between Edina and Bonita Springs, Fla., began sharing their story soon after, winning respect from many physicians. “They’re really helping with awareness,” said New York-based psychiatrist Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing (PROP)…

Click to access Spoke2015_05_13Int.pdf

Bill and Judy Rummler spoke to us about this growing problem…. Their son Steve died in 2011 from an overdose. Steve had become addicted to opioid painkillers as the result of a chronic back pain problem that could not be solved by doctors. The Rummlers were determined that Steve’s death would not be in vain. They formed a foundation with the mission “to heighten awareness of the dilemma of chronic pain and the disease of addiction and to improve the associated care process”. The motto is, “Providing HOPE for those with Chronic Pain and Addiction.” 

Rotary clubs in Minnesota have provided support for the organization…

http://creatingnewnormal.com/2011/12/01/the-myth-of-the-five-stages-of-grief/

Judy Rummler
December 4, 2011 at 5:48 pm
Hi Emily,
I sponke with your Dad again today at church… We lost our 43-year old son Steve in July to a drug overdose. He had suffered with chronic pain for 15 years and had been prescribed narcotic pain killers to which he became addicted. Our ministry is to make a difference for others with these same struggles…

http://blog.illumen.org/healthways/?p=77038

The FDA’s decision to more tightly control prescription pain medications surely will save lives… “Wow!” said Judy Rummler who, with husband, Bill, was back east visiting family when she learned of the FDA’s long-awaited decision. “This is the most exciting news we’ve had since we started this effort.”

The Rummlers, of Edina, can be credited with influencing the dramatic policy shift. Judy and Bill are founders of the Steve Rummler Hope Foundation, named for their son, a gifted musician and financial adviser…

She also had no idea how reluctant the FDA would be to recommend stricter controls on popular pain medicines, despite support for tighter oversight from the Drug Enforcement Administration and Centers for Disease Control and Prevention…

So Rummler, joining leaders of other similarly focused organizations, has been pushing back, testifying before congressional committees, speaking to Rotary clubs and attending drug summits. Earlier this year, she met with FDA Commissioner Margaret Hamburg…

The turning point, Rummler believes, occurred on Oct. 1, when 600 people from several states protested on Capitol Hill during their “Fed-Up Rally.” The rally, chaired by Rummler, demanded a federal response to the opioid epidemic…

Steve’s parents are very selective in how they choose to remember their son and what details about his story they choose to tell. But even with the small amount of information available on this 43-year old pain patient — who had been suffering from chronic pain for 15 years — it doesn’t sound like he died from an “unintentional” overdose. Was it suicide?

I’d say the first thing that led to his death was unmanageable and under-treated chronic pain. It was the unrelenting pain that killed him, not the drugs. Unfortunately, even though the antidepressants appeared to help him initially, they didn’t work for long. And in the end, he was only being treated for addiction, not depression or chronic pain.

The other thing that contributed to Steve’s death were his efforts at abstinence. These kinds of abstinence-related deaths — closely following a stint in rehab (or a visit to the doctor) — are seen in both chronic pain patients and those suffering from drug addiction. You can’t stop treating either pain or addiction with drugs and replace that treatment with essentially nothing, which is how I describe all these “alternative” treatments that everyone is forcing on pain patients (especially veterans). As we have seen with injections, the available non-opioid treatments are doing more harm than good, creating even more pain. And all the other alternative treatments only help a small percentage of patients.

As a chronic pain patient, I can understand Steve’s feeling of the drugs being a noose around his neck, especially considering all the expense, regulation, and shame involved in being treated with opioids. But he was wrong — the drugs are not the noose. It’s the unmanageable pain that strangles the life out of you. I’d say it’s possible that the drugs kept him alive longer than if he didn’t have access to them, which is what his parents now want for all pain patients.

I don’t know how Steve’s parents expected him to treat his chronic pain — with religion? His parents have no comprehension of what their son’s life in pain was like, so their advocacy efforts in his name are very misguided (a familiar story). They have based their opinions on feelings of grief, not facts or science. And these grieving parents have a lot of money to support themselves while they travel and talk to universities, rotary clubs, and agencies like PFROP and the FDA.

As every American knows, money equals speech in this country. The voices of pain patients are not being heard, but the voices of well-to-do and middle-class grieving parents have been heard loud and clear. The voices of the drug war have always been those of the privileged and powerful, and I don’t know any pain patients who are a part of that exclusive group.

Steve didn’t start taking painkillers until 9 years after his pain started, so it’s not like he didn’t try to do it mostly on his own. Unable to manage the pain, he slid into a depression, although I can’t say he was adequately treated for either. Seems like he tried to get help, but eventually the only advice he got was to stop the treatment for pain, only focusing on treating his addiction with abstinence.

I think Steve gave up on the hope of achieving any real pain relief. He knew his pain would just continue to get worse, but with abstinence, he had no way to manage it. I know exactly how he felt. After my last pain doctor abandoned me, I couldn’t come up with any way to manage my pain except suicide. Steve had the courage to do it, but I didn’t. Now he’s at peace — and I’m envious of a dead man.

The foundation’s motto is:  “Providing HOPE for those with Chronic Pain and Addiction.”

Hey Judy, you and your anti-drug advocacy groups are actually doing the very opposite of what your motto claims to be. You and yours are causing pain patients to lose hope that their voices will ever be heard. In fact, I hold you and your groups partially responsible for the death of every pain patient who overdoses — including your adult son.

Political strategies in the war against pain patients

In trying to help pain patients understand that the war against them is not because of drug addicts, doctor-shoppers, or any other group of patients, I’ve used the drug war so we can see the bigger picture.

Just like you can compare the issues in our history of alcohol prohibition to the federal government’s refusal to legalize cannabis, it is interesting to see how the political strategies for the overall drug war have been adapted to the war against pain patients.

http://www.cannalawblog.com/they-said-it-on-marijuana-quotable-saturday-part-lxx/

In the book, Smoke and Mirrors: The War on Drugs and the Politics of Failure (we urge you to read it if you have not already done so), author Dan Baum explains:

The [Nixon] White House lived by the principles of the southern strategy, and Dent’s office had its own lingo. There were issues that mattered to “our” people, and those that mattered to “their” people. “Their” people were what the White House called “the young, the poor, and the black.” The phrase rolled off the tongue like one word: theyoungthepoorandtheblack. The young were the longhaired student antiwar types for whom the president had open and legendary contempt; the poor and the black were leftover concerns from the Great Society.

Brownell daily read a dozen newspapers from around the country and clipped stories that played on those themes. He looked for stories about badly managed social programs, watched for currents of localized resentment, combed the columns for colorful quotes and juicy anecdotes the presidential speechwriters might use. He particularly kept an eye out for drug stories. Drugs were one thing the young, the poor, and the black all seemed to have in common.

In the old days, marijuana was cheap and used by poor people because of that, but you can’t say that today.  Of course, the amount of disposable income available for luxuries like health care have decreased a lot since the old days.  And if you think that illegal drugs are not part of health care, then you must also think that legal drugs aren’t part of health care.

And I’m not only talking about legal drugs that require a prescription, but also legal drugs like caffeine, sugar, and nicotine.  What, did you think you weren’t self-medicating with every cup of coffee or energy drink?  Do you think you should have to pay a doctor for access to that drug? Should that drug be illegal?  Should caffeine and nicotine be included in the DEA’s drug scheduling list?

Despite Nixon’s assertion to the Disneyland crowd that drugs were “decimating a generation of Americans,” drugs were so tiny a public health problem that they were statistically insignificant: far more Americans choked to death on food or died falling down stairs as died from illegal drugs.

So Brownell was delighted that the media were inflating the story by melding the tiny “hard drug” heroin threat with the widespread “soft drug” marijuana craze. Marijuana, Brownell knew, was a perfect focus for the anger against the antiwar counterculture that Nixon shared with “his people.” Brownell dug out a-recent clip from Newsweek: “Whether picketing on campus or parading barefoot in hippie regalia, the younger generation seems to be telling [the middle-class American] that his way of life is corrupt, his goals worthless and his treasured institutions doomed. Logically enough, a good many middle-class citizens tend to resent the message.” In an article Brownell might have penned himself, Newsweek identified the targets of that middle-class resentment this way: “The incendiary black militant and the welfare mother, the hedonistic hippie and the campus revolutionary.” The young, the poor, and the black. Nixon couldn’t make it illegal to be young, poor, or black, but he could crack down hard on the illegal drug identified with the counterculture.

The federal government cannot make it illegal to suffer from chronic pain, but it can crack down hard on the drug treatments identified with chronic pain.  Working- and Middle-class resentment against those on welfare or disability is nothing new, but now a lot more middle-class people have moved into the working-class and are part of the poor.  So don’t be fooled that these loud voices of resentment contain as large of a group as they did in the old days.

Just like in the overall drug war, the war against pain patients is also about the grief of parents who have lost children to drug addiction and their resentment against the drugs involved, which they blame.  And now those drugs include opioids, many times being blamed as a “gateway” drug to heroin.  Some people still think cannabis is a “gateway” drug to stronger drugs like heroin, but I think the research says differently.  (Besides which, the gateway drug theory isn’t even a theory anymore — it’s more like a joke.)

John Erlichman (of Watergate fame) eventually admitted that the drug war had been dreamed up by Nixon and his team because it was too good not to do so:

Anybody who thinks this is the wrong fight for the NAACP should take a peek at this note from the diary of H.R. Haldeman, President Nixon’s chief of staff, referring to the launch of the war on drugs 40 years ago.

“[President Nixon] emphasized that you have to face the fact that the whole problem is really the blacks,” Haldeman wrote. “The key is to devise a system that recognizes this while not appearing to.”

For the war against pain patients, the system includes the PDMPs, patient contracts, drug testing, pill counts, and the blurring of definitions for dependency, abuse and addiction.  When you criminalize a drug, you criminalize the people who use it.  When you criminalize a medical condition like addiction, you also criminalize the people who might potentially suffer from it. And then a pain patient is automatically guilty (of abuse or addiction) and has to continually prove their innocence (through drug tests, pill counts, checking the blacklist, etc.).

That system turned out to be the War on Drugs, with marijuana being put in the same category as such drugs as heroin and morphine. Nixon’s White House counsel, John Ehrlichman, verified the intention of the War on Drugs in a 1995 interview with author Dan Baum, author of Smoke and Mirrors: The war on drugs and the politics of failure.

For the war against pain patients, illegal heroin is put in the same category as prescription medications.  Meaning, people who use opioids are as “bad” as the people who use heroin.

“Look, we understood we couldn’t make it illegal to be young or poor or black in the United States, but we could criminalize their common pleasure,” Ehrlichman confessed. “We understood that drugs were not the health problem we were making them out to be, but it was such a perfect issue for the Nixon White House that we couldn’t resist it.”
(From, Joining the fight: Not your grandfather’s NAACP, by Larry Gabriel.)

The war on drugs has been a sham since day one. That alone is reason to end it.

Because the war on drugs is a sham (and a failure), then the war against pain patients is also a sham (and will also be a failure).  But it’s taken over 40 years for the drug war to start winding down. How long do you think it will take for the war against pain patients to turn around?

Back in the old days, when the drug war first started, there were a lot of political motivations behind it.  It’s not hard to see the political motivations behind the war against pain patients, but it is hard to count them all.  Since the Great Recession (I don’t know what else to call it), there are now less rich people at the top pulling the political strings. Unfortunately, the amount of money involved only increases as time goes by, even though it’s held by fewer people. Regardless, one of the “people” with the most money will always be the federal government. And the federal government spends a significant portion of its money on the drug war — really, on any and all wars.

Hey, don’t we fund the federal government?  Aren’t we some of the investors in this corporation? Trouble is, we’re only small investors — corporations are really the “people” with all the money. How do pain patients fight corporations?

A strategy for pain patients would be to connect with advocacy groups that have more political clout, like the environmental or gay rights movements.  (I’ve personally tried to find interest in the issues of pain patients from marijuana advocacy groups, but received no response.)  But first, we would have to make up a big enough group for other groups to take us seriously. And I guess we would also need funding — good luck with that.

How painkillers are turning young athletes into heroin addicts

http://www.si.com/more-sports/2015/06/18/special-report-painkillers-young-athletes-heroin-addicts?xid=si_topstories

A foot injury his junior year didn’t derail Roman. He needed minor surgery on a small bone, but he popped some OxyContin and after a few weeks was back on the mound.

Oxy for minor surgery?  Since this was legally prescribed to him, I would want to know his doctor’s reasons for doing so.  Seems like there’s a lot of doctors who cater to athletes, giving them whatever they want so they can keep playing, especially on professional teams.

His senior year Roman planned to lead Eldorado to a state title and then declare for the 2008 major league draft (the Braves had expressed the most interest in him), spurning about 20 Division I scholarship offers. Before the season, though, Roman committed one of those judgment-deprived acts for which teenagers are known. He and some friends used a stolen credit card at a mall. They got caught. The school found out. Though it was Roman’s first offense, he was kicked off the team.

There are plenty of teenagers who don’t steal or try to use a stolen credit card at the mall. And I think his parents are just guessing that it was the first time he exhibited this type of behavior; that this was his first offense. Yes, it might have been the first time he had been caught, but I really doubt it was his first criminal act. I would say Roman was one of those people who liked risk and was comfortable with it — maybe taking risks even gave him a thrill and adrenaline rush, just like athletics. I would also say that these kinds of people are at a high risk for drug addiction.

Humiliated, angry and depressed, Roman thought back to the numbing effect of the OxyContin. His prescription had run out, but that wasn’t much of an impediment. In the upscale Northeast Heights—more High School Musical Albuquerque than Breaking Bad Albuquerque—painkillers were competing with marijuana and alcohol as the party drug of choice. “There are pill parties,” says Roman’s younger brother, Beau. “[Pills are] so easy to get. They’re everywhere.”

Roman was soon in the grip of Oxy. He lost interest in baseball.

Lost interest?  He was kicked off the team.  If he had other interests as strong as his interest in athletics, maybe he wouldn’t have been seduced by the drugs.  But keep in mind we’re talking about teenagers and young adults here, whose brains don’t yet have the ability to see the consequences of their actions.  They are not able to picture themselves in the future — they are only interested in the here and now.

He showed up high for graduation. JoAnn Montano and her husband, Bo, who owns a wheel-alignment and body-shop business, figured their son was just floundering—until JoAnn caught him using. She took him to an addiction center, and he was prescribed Suboxone to treat his opioid dependency.

Roman, though, couldn’t fully kick his habit. Before graduation he had switched to a cheaper substance that offered the same high at a lower price: heroin…

They said that Roman had been found slumped in the driver’s seat of his car behind a FedEx store, a syringe in his arm, the motor running. He was 22 and dead from a heroin overdose…

You can see by the title of this article that they’re blaming Oxy for Roman’s heroin addiction, even though he took it because he was “humiliated, angry and depressed.”  Maybe it would be a good idea to teach kids about how to handle these kinds of negative emotions instead of trying to teach them abstinence from drugs.

If, at this point, Roman had chosen cannabis instead, perhaps he wouldn’t have moved on to heroin. And maybe if his self-esteem wasn’t so irrevocably tied to athletics, he would have been able to move in a different direction.

While hard data for heroin use among young athletes are difficult to come by, the anecdotal evidence is abundant and alarming. A seven-month SI investigation found overdose victims in baseball, basketball, football, golf, gymnastics, hockey, lacrosse, soccer, softball, swimming, tennis, volleyball and wrestling—from coast to coast…

As the sports industry expands each year—and the stakes on rinks, fields and courts grow higher—young athletes face enormous pressure to manage their pain and play through injuries…

And if they didn’t have this pressure, would they still be at risk for drug addiction? Blame the pressure and the lack of other options for these athletes, not the pain medications. After all, how many high school and college athletes end up going professional? Isn’t it something like 1%?  In my opinion, basing a child’s future on athletics is never a good idea. Making a living by abusing your body is not a career that will last very long.

Moreover, “sports that involve high levels of contact (e.g., football) tend to socialize youth to view pain, violence and risk as normative features,” Veliz said, and these “may influence risky behavior both on and off the playing field. In other words, participants in contact sports learn to view their body as an instrument that can be easily gambled with, even if it would involve permanent damage.” …

In the beginning, many athletes are involved in their sport because they love it. But if they’ve got any talent, that love of the sport quickly turns into a question of how much money they can make. Can the sport provide a good living? Just like young people who join the military to make a living, there are few career options for kids today.

And let’s not forget how much sports is celebrated in this country, from high schools and universities to professional teams and the Olympics. There’s a reason that cities spend so much money on sports stadiums. In other words, we are part of the problem. We pay lots and lots of money to see athletes abuse their bodies. We are the consumers of the products that perpetuate and fund sports. We are the spectators in this Roman coliseum of abuse, and often violence.

There are many reasons why kids try drugs, including alcohol.  Blaming the drug alone just isn’t logical.  We’ve done that throughout the decades-long, failed drug war and look where we are today.

Another pain doctor bites the dust

http://www.pharmaciststeve.com/?p=10722

Pawan Kumar Jain, 62, of Las Cruces, N.M., was arraigned this morning in Las Cruces federal court on a 114-count superseding indictment which alleges that, among other crimes, Jain’s over-prescribing of opioid pain medication resulted in the deaths of four patients…

According to the superseding indictment, Jain allegedly committed the offenses charged between April 2009 and June 2010, in Doña Ana County, N.M. During that period, Jain was a licensed physician with a neurology subspecialty who operated a pain management medical practice in Las Cruces. Jain’s medical license was suspended in June 2012 and subsequently revoked in Dec. 2012 by the New Mexico Medical Board.

Each of the 63 dispensing charges in the superseding indictment alleges that Jain unlawfully dispensed prescription painkillers, primarily Oxycodone and methadone, to patients outside the usual course of medical practice and without a legitimate medical purpose. The maximum statutory penalty for a conviction on each of the 63 dispensing charges is 20 years in prison and a $1,000,000.00 fine…

It’s just great that law enforcement and government agencies now decide what is a legitimate medical purpose for prescribing medications.  Everyone wants to play doctor.

The 51 healthcare fraud charges allege that Jain engaged in a scheme to defraud two health care benefit programs, Medicare and Medicaid, by causing claims to be submitted for payment for prescription medications he dispensed to patients outside the usual course of medical practice and without legitimate medical purpose. The maximum statutory penalty for a conviction on each of the health care fraud charges is ten years in prison and a $250,000.00 fine…

This case was investigated by the DEA’s Tactical Diversion Team in El Paso, Texas and the FBI’s Healthcare Fraud Unit with assistance from the New Mexico Medical Board and the New Mexico Board of Pharmacy. The case is being prosecuted by Assistant U.S. Attorneys Sarah M. Davenport and Richard C. Williams of the U.S. Attorney’s Las Cruces Branch Office…

This case is being prosecuted pursuant to the New Mexico Heroin and Opioid Prevention and Education (HOPE) Initiative. The HOPE Initiative is a collaborative effort between the U.S. Attorney’s Office and the University of New Mexico Health Sciences Center that is partnering with the Bernalillo County Opioid Accountability Initiative with the overriding goal of reducing the number of opioid-related deaths in the District of New Mexico… The law enforcement component of the HOPE Initiative is led by the Organized Crime Section of the U.S. Attorney’s Office and the DEA in conjunction with their federal, state, local and tribal law enforcement partners. Targeting members of major heroin and opioid trafficking organizations for investigation and prosecution is a priority of the HOPE Initiative…

The medical industry is now forever in bed with law enforcement.  When you see a pain doctor, you’re basically talking to a DEA agent.  Think of the money involved in paying all these people to make the treatment of pain and/or addiction a criminal offense.  If there were as many “initiatives” and funding to treat chronic pain and mental illness, all the rest of this stuff wouldn’t even be needed.

The NMPHA is the New Mexico Pharmacists Association, part of the Bernalillo County Opioid Accountability Initiative.  (Who can keep track of all these anti-drug agencies?) Here’s a presentation from their 2014 summit:

http://www.nmpha.org/Resources/Documents/Opioid%20Initiative%20

Presentation%20to%20NMPHA%202014.pdf

This group includes the Heroin Awareness Committee (Healing Addiction in Our Community), an advocacy group started by Jennifer Weiss, who’s son died from a heroin overdose and now runs addiction “treatment” centers.  An interesting conflict of interest, as it means more money for her business.

Part of this group’s recommendations for action:

-Support policies to expand evidence-based early childhood support programs, including home visiting focusing first on low-income families  [emphasis theirs]

-For pain control, promote evidence-based alternatives for Rx opioids [Good luck finding any.]

-Reduce supply of Rx opioid pain medication by increasing access to and usage of Prescription Monitoring Program database AND prescribing guidelines to limit over-prescription of opioids

It’s very sad that the University of New Mexico, along with Molina Health Care, are involved in the drug war.  Are there any pain patients in these agencies and anti-drug groups?  What do you think?

Once and for all, it’s not an “epidemic”

http://www.huffingtonpost.com/gary-mendell/through-smart-drug-policies-we-can-change-our-communities-for-the-better_b_6928176.html

Addiction to opioids including heroin and prescription pills like Vicodin and OxyContin is an epidemic sweeping our nation…

This epidemic is hurting millions of Americans who are struggling with or have lost a loved one to the disease of addiction. I share this pain. I felt it personally when I lost my son, who was just 25 years old at the time, to the crippling disease of addiction. I feel this pain every day.

After my son’s passing, I refocused my life to lessening the pain and stigma associated with this disease in our communities. I founded Shatterproof in the hopes of turning a story of tragedy into one of hope. There’s a lack of resources for Americans struggling with addiction, and that’s what I set out to change. Along the way I found that sound public policy is critical to providing a support system that can protect our children and save lives within our communities…

There are five critical protections that are vital to encourage bystanders to make that 911 call and, in turn, save lives the most lives possible:
1. No arrest, charge or prosecution for possession of a controlled substance.
2. No arrest, charge or prosecution for possession of paraphernalia.
3. No arrest, charge or prosecution for alcohol consumption by minors.
4. No arrest, charge or prosecution for providing or enabling alcohol consumption by minors.
5. No charge or prosecution for those who are on probation, pretrial release, parole, furlough or in the violation of restraining orders.

So, a person’s life has to be at stake before we stop arresting people for drugs?  Instead of making all these new laws, wouldn’t it be easier just to end the drug war?

And to the states now adopting these new laws:  Many states have already passed these laws, and I’m sorry to say that it hasn’t made that big of a dent in the overdose problem.

As long as the media and “experts” keep focusing on inaccurate portrayals of addiction, like blaming Vicodin and Oxy, I can’t see how progress can be made.  Addiction is not about one drug over another, and advocates working on the side of patients should know that.

It always makes me uncomfortable when I come across another advocacy group started by a parent who’s child has died of a drug overdose (or suicide).  I’m sure a lot of these people mean well, but as it turns out, many of these advocates do more harm than good.

New rules on narcotic painkillers cause grief for veterans and VA

http://www.pharmaciststeve.com/?p=9279

But after the DEA regulations were put in place, he was unable to get an appointment to see his doctor for nearly five months, [Craig] Schroeder said. He stayed in bed at his home in North Carolina much of that time…

His wife, Stephanie Schroeder, said getting him a VA appointment turned into a part-time job and her “main mission in life.” While part of the problem was a shortage of doctors, she said she also noticed that VA had become hostile toward patients who asked for painkillers.

“Suddenly, the VA treats people on pain meds like the new lepers,” she said. “It feels like they told us for years to take these drugs, didn’t offer us any other ideas and now we’re suddenly demonized, second-class citizens.”

The agency recently set up a Choice Card program for veterans, which would allow those facing long wait lists or who live more than 40 miles away from a VA hospital to use private clinic visits. Veterans say the initiative is complicated and confusing. VA officials acknowledged this month that veterans have been using this program at a lower rate than anticipated…

As part of a $21.7 million initiative with the National Institutes of Health, VA is looking for therapies that could substitute for opioids…

Yeah, perhaps the NIH and the VA should have started this initiative BEFORE the DEA began its war on pain patients.

But Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing, called the new DEA rules “the single most important change that could happen. The best way to treat any disease, whether it’s Ebola or opioid addiction, is to stop creating more people with the disease.”

This is “the single most important change that could happen” — for doctors who treat addiction ($$$$$). And the best way to stop chronic pain is to aggressively treat acute and severe pain before it becomes chronic and intractable.  It’s called prevention, although Kolodny appears unfamiliar with that term.  Perhaps because he knows nothing about pain management. After all, if you successfully prevent addiction, Kolodny (and Jennifer Weiss) would be out of work.

But no, the DEA, PFROP, and the medical industry would prefer to see people suffer.  When in fact, they’re just creating more pain patients, drug addicts, and patients on disability. And when all this untreated pain turns into chronic pain, what then?  Massages and acupuncture for everyone?

The disease is the drug war.  Let’s stop creating more people who suffer from this disease.

No, bupe is not a wonder drug, sorry

2/9/2015, The Wonder Drug

http://www.slate.com/articles/news_and_politics/politics/2015/02/suboxone

_could_help_heroin_addicts.html

I hate to be the bearer of bad news, but there’s a lot more to addiction than just an addict’s drug of choice, whether it’s heroin or opiates.  Most stories I read about addiction are about the use of two or three drugs (sometimes more), all of which have addicting qualities (including alcohol). Buprenorphine may help with an opiate or heroin addiction, but it may not help with an addiction to, say, Xanax or Valium.

I’ve read claims that bupe stops the craving for opiates, but to me, this sounds a little too good to be true.  More like it moderates the cravings, making them easier to manage.  There are also claims that bupe can’t get you high, but that’s not true either.  The fact is that the underlying reasons for addiction aren’t addressed with bupe — medication is just one tool in the tool box. And you can’t repair something with just one tool.  (Well, maybe you can, I’m no handywoman.)

Sure, it’s great that the government wants general practitioners to dispense Suboxone, but what do GPs know about addiction?  Heck, what do specialists in the addiction and rehabilitation industry really know about addiction?  (Like the new drug czar being a former alcoholic means he knows about heroin or opioid addiction.)

It brings to mind a pain doctor I saw at one time, when during our first appointment, I asked her what she knew about TMJ.  She told me she didn’t know anything about TMJ.  So then I asked her, “How can you treat my pain if you know nothing about TMJ?”  Her response was, “Because no one else will.”  That was back in the 90s, when most doctors gave anti-depressants to any woman complaining of pain.

Yes, Suboxone and Narcan will bring down the rates of drug overdoses, but only slightly.  If you look at states (like New Mexico) that have better access than states like Kentucky, you’ll see that these addiction drugs can in no way be defined as “wonder” drugs.  They are only a small piece of the puzzle, although “experts” like Kolodny of PFROP and the media tout these drugs as the thing that will save us all.  It’s not only short-sighted, it’s a lie.

And while addiction treatment centers and clinics are springing up like Walmarts, most of them are based on old theories and practices that don’t work.  I’ve only read about a very few that treat the whole person, not just the drug addiction.  The fact that a lot of these clinics are staffed by doctors who claim to be specialists makes the problem even worse.

Without access to affordable treatment, no matter what that might include, drug poisonings and suicides will continue to escalate.  Those who suffer from addiction know more about drugs than the “experts,” and will find others to abuse.  And they’ll probably be just as dangerous as heroin or meth.

There may even come a time when bupe is blamed for not doing enough (because it’s just a drug, after all, not a miracle cure). Blamed for additional underground market activity, because… the drug war.  At some point, politicians will come to the realization that, no, bupe isn’t a wonder drug — it’s just another methadone.  Big Pharma (and its minions) lied again, so the DEA will happily have to start restricting access again.  Now, methadone has a bad reputation, and one day in the future, bupe will too.  It’s inevitable.

And the drug war continues…

$$$$$$$$$$$

I was just thinking about how easy it was for Jennifer Weiss of the Heroin Awareness Committee — I mean, the renamed “Healing Addiction in our Community” — to get the ear of politicians, including the Governor and the Mayor of Albuquerque. I guess my voice isn’t… green enough.