The Stigma of Drug Overdose from North Carolina Harm Reduction Coalition

I am in agreement with this article and the need of the Substance Use Treatment  community need to speak loud about Drug Over Dose and many other issues such as racism of Drug Laws misinformation and treatment.   Blogger from The Worse Treatment I ever had; Solrac           North Carolina Harm Reduction Coalition (NCHRC) Home | About Us | Harm Reduction | Law Enforcement | Advocacy | Contact

The Stigma of Drug Overdose: A Mother’s Story Article by Tessie Castillo Denise Cullen has lived through one of the worst tragedies a mother can experience – losing a child. But if there is anything worse than losing a child, it is losing a child to a drug overdose, because grief is accompanied by stigma and blame. Denise lost her only son, Jeff, when he was 27 years old to a fatal combination of morphine and Xanax. She remembers him as “warm, open, loving, bright and stubborn. He had a huge laugh and a fabulous smile,” she says. He was also impulsive and suffered from ADD. “We were very, very close,” Denise recalls. “Even during those horrible years [of drug use], he and I never became distant from each other. It was torturous at times but the one thing that was always, always apparent was that he loved his family and his family loved him. No matter what.” Jeff began using drugs in the 9th grade, possibly to self-medicate his ADD. Over the next 12 years he experimented with a variety of drugs, including his final drug of choice, opiates. During those years, “Jeff tried so, so hard to stop,” says Denise. “He felt ‘broken’ and guilty for the hurt he inflicted on his parents. He once wrote about his ‘fairytale life’ that he had screwed up so badly, and his self-esteem was gone toward the end. But he always took total responsibility for what he did.” For Denise, the pressure and fear of watching her only child battle addiction was “like a roller coaster with good periods and crashes. You learn to be hyper-vigilant, living always with fear. You have hope as well – as long as they are alive you have hope, but the sound of the phone ringing at night, or not hearing from them in a normal way is very difficult. It’s always in the back of your mind that your child could die in some way as a result of their addiction. You may think you can imagine it, that you are in a way prepared…but you are not.” The fateful day arrived on August 5, 2008. Jeff was at the beach with a friend waiting for a bed to open up in a long-term rehab facility. Denise remembers that he was happy and hopeful about the treatment center. “I called him in the afternoon to ask when he would be home,” says Denise. “He said he’d call, but hadn’t done so by 6:30 or 8:30pm. Finally at 10pm I called and left a very angry message. I was upset that he was acting like ‘the old days’ and making [his parents] worry. He never got those last messages. He was lying on the grass in a nice neighborhood…dying.” According to eyewitnesses – and shockingly, there were many – Jeff was lying on the grass starting around 4:30pm. He lay very near a curb where cars parked on an active street, yet no one stopped to ask what a clean, good-looking kid was doing motionless on the grass. At 11pm a woman finally called police, saying that Jeff hadn’t moved an inch in two hours. The time of death was around 10pm. He could have been saved. “At around 3:00am a very kind man, a Sheriff from the Orange County Coroner’s Office, rang our doorbell,” says Denise. “He had Jeff’s wallet, keys, phone, and beach gear…I am not a dramatic person but I fell to the floor and screamed until I couldn’t scream anymore and simply made sounds like a wounded animal.” Losing her only son was the worst kind of pain Denise could imagine, and she began visiting grief groups for parents. To her shock and chagrin, parents whose children had died of non drug-related means were judgmental about Jeff’s overdose. “I could actually feel people move their chairs away from me [when they heard Jeff had died of an overdose],” says Denise. “They had an attitude like ‘your child chose what killed him. Mine didn’t.” But judgment and accusation didn’t stop Denise. She left the traditional grief groups to found her own chapter of GRASP (Grief Recovery After a Substance Passing), for parents who also bear the unique stigma attached to drug overdose. GRASP was originally founded by Pat and Russ Wittberger of San Diego, but after they stepped down, Denise and her husband volunteered to take over. Today GRASP has 43 chapters in 24 states and offers healing and advice to parents in mourning. “My advice to parents is to learn as much as they possibly can about addictive illness and drug use from responsible sources early on,” says Denise. “Talk honestly about the risk factors of becoming addicted by ‘experimenting,’ talk about family history of alcohol or substance abuse.” Denise and her husband Gary also founded Broken No More, a nonprofit that works to change how substance abuse is viewed by the public and to fight failed drug policies. Run by people dealing with substance abuse issues in their families, the organization advocates for sterile syringe availability, 911 Good Samaritan laws that encourage witnesses to an overdose to call for help, and greater access to naloxone, an antidote to opiate overdose. Most importantly, Denise believes that to resolve the overdose crisis, people whose lives have been touched by this issue need to speak up. “We must get loud about overdose,” she says. “During the AIDS crisis, nothing was done until the gay community spoke up, then help came by the bucketfuls. Now, not only has the disease become more manageable, but the stigma has been reduced as well. With overdose, we must address both these elements. We must research addiction and find better treatments and a cure. It can be done. We just have to care enough to do it.” Death is not a time for blame. It is a time for reflection. And then, it is a time to speak. ----------------- This article was written by Tessie Castillo, NCHRC Program Coordinator

Update on: White House Announces Brain Mapping Initiative

This article comes from Dr. Mark Willenbrigh Substance Matter: Science and addictions.

Whew! Long drought! I was caught a bit off guard by the response to Jane Brody's column about Inside Rehab, which generated a lot of inquiries and new patients for Alltyr! All good things, plus opening the new office in downtown St. Paul and many other activities have left me a bit overwhelmed. Today's blog is written by Ian McLoone, a graduate student at the University of Minnesota Master of Professional Studies in Integrated Behavioral Health. Ian has been working with me learning about clinical work, as well as helping with Alltyr Clinic and other activities. He's going to be a regular contributor to Substance Matters.

MW

White House Announces Brain Mapping Initiative

President Obama announced on Tuesday plans to invest more than $100 million to develop and fund technology to map the human brain. The project, titled “Brain Research through Advancing Innovative Neurotechnologies”, or BRAIN Initiative, aims to improve our understanding of the human brain and, according to the White House, “uncover new ways to treat, prevent, and cure brain disorders like Alzheimer’s, schizophrenia, autism, epilepsy, and traumatic brain injury.”

Being hailed as the next Human Genome Project, the ambitious initiative will direct $50 million to the Defense Advanced Research Projects Agency (DARPA), $40 million to the National Institutes of Health (NIH), and another $20 million to the National Science Foundation (NSF). In addition, several private sector foundations and institutes have pledged significant contributions, each with specific goals in mind.

Cori Bargmann of Rockefeller University and William Newsome of Stanford University will lead the NIH working group. They will be tasked with creating specific plans, goals, a time frame, and cost estimates for the project moving forward. Of course this begs the question: what goals or plans would blog readers like to see addressed in this process? Is this initiative too ambitious, or not ambitious enough, given its size and scope? Leave your comments after the jump.

Welcome to Drinkers Check-up

This belongs to Dr. Reid Hester programs and I copy and pasted here as I think it is a good assessment tool for persons with alcohol problem to check.

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Get started to Find out what this program is all about take a confidential screening and get objective feedback about whether the program might be useful for you. After getting feedback from the screening you can decide whether or not to register. Once you've registered, you can get A comprehensive evaluation detailed feedback help with making a decision about whether or not to change your drinking. This program will not, however, pressure you to change in any way. The Check-up is free to use. At the end though we will ask for your support. It's entirely voluntary. Users of the program are its sole source of support. If you decide to cut back your drinking, our Moderate Drinking app can help you be successful. Its effectiveness is supported by scientific research. And Moderation Management is a mutual-help group that supports people in cutting back on their drinking. If you decide to stop drinking, consider SMART Recovery® to help you be successful. We are also studying the effectiveness of a new web app for them, Overcoming Addictions and that app will become available this summer. Privacy & Confidentiality Copyright/Patent Info About us/Contact us Limitations Ad Policy Site last updated May 21, 2013. © 2013 All rights reserved. Drinker's Check-up ™

Junkies Unite For YOUR Civil Rights.

"Unai Unai" says some "graffitists’ in the streets of Miami, Florida. Is a Latin way of saying Unite Unite, as we begin to see graffiti saying "Junkies Unite 4 ur civil, constitutional and patients' rights". There was a song in Spanish that went Unai Unai, meaning the United States, but I do not remember how the rest of it goes. Moms United to End the War on Drugs - A New PATH

What is it about governments who without evidence of harm or victims decide to take on a population of their own citizens and establish that they are criminals? One of the most damaging aspects of the war on drugs is the spread of governments endorsed misinformation about drugs.

The government has taken the position of misinformation so far and their political repression and oppression keeps many from speaking favorably about what they think should be done. This
repression reminds me of dictatorial relationship between the government and oppositions in Latin American Countries where the left (as well as the right did decades ago) suppressed free thinking and democratic ideas.

The War on Drugs has amongst many of its historic events, many issues of racism. These articles
sponsor by Florida International University " The War On Drugs Is Nothing But Institutionalized Racism" by a Dylan Ratigan http://articles.businessinsider.com/2012-01-16/home/30631016_1_drug-arrests-drug-money-drug-trade#ixzz2SYEat026

http://articles.businessinsider.com/2012-01-16/home/30631016_1_drug-arrests-drug-money-drug-trade

discusses some of the current statistics. But its history goes back to the 1st Anti-Drug laws in the
United States.

Hidden between the pages of history of the anti-drug laws, is the fact that the early anti-drug laws where based on racism and they were not concern about anyone’s wellbeing or health. You would think that legislators might have learned this by now. Here is the beginning of another article written by a Federal Judge:

The first anti-drug law in our country was a local law in San Francisco passed in 1875. It outlawed the smoking of opium and was directed at the Chinese because opium smoking was a peculiarly Chinese habit. It was believed that Chinese men were luring white women to have sex in opium dens. In 1909 Congress made opium smoking a federal offense by enacting the Anti-Opium Act. It reinforced Chinese racism by carving out an exception for drinking and injecting tinctures of opiates that were popular among whites.

http://www.huffingtonpost.com/judge-frederic-block/war-on-drugs_b_2384624.html

The Drug Policy Foundation has also noted the inequality as to the Race and the War on Drugs.

http://www.drugpolicy.org/race-and-drug-war

When we base our models and ideas for policies, legislation, regulations and laws on misinformation propaganda and prejudices the outcomes are a similar product. Most of us have heard the long-standing notion "Garbage In, Garbage Out".  Meaning if you input bad data into a computer nothing else can come out but a bad product or outcome. It is logical. 

I assert that we are making extremely bad policy decisions because they are based on bad information.  Most European countries (even our enemies like Iran) have decided to go their own way and treat their persons with substance use problems with much more humanity than we do. Their results, and more in Hollan than any other country in the world, are convivial to the persons with the problem and applaudable to the government for being more tolerant than in the United States.  Hollan seems to have learned from their experience with the most intolerating government of Nazi facism back in the 1940s.

The reason we continuo to have a major drug problem in the United States is because we have not come up with good solutions. Ours are stubbernly narrowminded. Susan Sarandon says in her writings. “The war on drugs is ridiculous, because you’re only getting—you’re spending a huge amount of money. It’s completely racist. You’re picking up everybody at the lower level because mandatory minimum drug laws let you trade in to get off, so if you don’t have anyone to trade in, if you’re at the bottom, you’re going to jail,” read the whole piece.
Susan Sarandon Says War on Drugs is RACIST http://theblacksphere.net/2013/04/sarandon-says-war-on-drugs-racist/

I heard that Obama has promised or spoke about declaring the War on Drugs over. I have not found any information on this except people wanting it to happen. I have yet to see an article confirming Barak Obamas commitment to end the War on Drugs.

http://newsone.com/2412446/obama-war-on-drugs/

http://justsaynow.firedoglake.com/2013/04/24/no-obama-didnt-end-the-war-on-drugs/


We need to say it loud.

OBAMA PLEASE STOP THIS DAMN WAR ON DRUGS, it is hurting most people including our communities and innocent persons.  And persons that are in the "grip of addiction" all it does is provide irreversable harm in terms of felony convictions that can never be errase from the record and contnues to hunt them when they try to recover.  Most people under these conditions do nothing other than resign themselves to this bad policies and laws and make their lives bad.

http://en.wikipedia.org/wiki/Race_and_the_War_on_Drugs

If their is a poduct that is well documented is the racism behind this war on drugs, but legislators continuo to turn a deaf ear and blind eyes to these facts. They think that by being hard on addicts and on everyone involve eventually this war will be won. Yet the evidence is that it is getting worse not better.  The evidence of the last 30 decades at least tell us so.

We can not get worse by being more humani to persons with substance use disorder. Treatment effective treatment is no doubt a much better alternative than prisons.

From Facebook On Stigma of Methadone Recovery by patients.

Whether the public or other people in recovery like it or not methadone treatment is not only the preferred methodology of choice of persons with Opiate Dependent Disorder, but it has been substantially better scientifically research than any other treatment available. Abstinence based treatment of 12 Step Programs have avoided been studied for a substantial amount of time. Not until third party payers including the federal government began to demand Evidence Based Treatment (which they started back in 197X with the Chief of Substance Abuse Mental Health Service Administration). Nevertheless Methadone patients have suffered more Stigma, Discrimination, Prejudice, Bigotry, Inequity, Injustice and Intolerance than any of the groups in recovery, and harm reduction approach.

 
These exist even though the research data is on Methadone for its safety and effectiveness if anyone cares to read at least the review of the scientific literature. You will find perhaps no scientifically based practitioner that would go against methadone as an effective and safe treatment approach. But when it comes to clinicians who perhaps have not read a scientific journal since they left college or know little about the science they assert they believe in, you will find few if any who would agree that methadone is the most effective methodology against illicit opiates.

Stigma Essay

by Tamara Meyer (Notes) on Monday, May 13, 2013 at 9:08pm

Facing Stigma in the MMT Community


There is a tremendous weight put on recovering addicts who choose to use Methadone as a means of sobriety and it is suffocating. The media, society, friends and even sometimes our own families buy into the misinformation and make it harder on those of us fighting the demon that is addiction. They believe what the media is telling them. They believe we are just trading one drug for another. We are still getting high. We are not truly in recovery. We are labeled and our integrity is questioned. Utilizing Methadone as a means to recover from debilitating addiction is looked upon with scorn from the outside world.

The stigma surrounding our treatment is a huge obstacle getting in the way of our recovery. It’s a roadblock for those who would be utilizing Methadone Maintenance Treatment but don’t because all they get from conventional news sources is the stigma that is force fed in abundance. Imagine how many addicts would be that much closer to ending the cycle of addiction if they had both sides of the story? How many people in MMT would be that much more successful in their recovery if they had the support of their community? A lot of addicts in recovery leave MMT prematurely and end up relapsing because they too believe that Methadone is not recovery.

Despite the overwhelming amount of scientific evidence that supports the fact that Methadone works successfully in the treatment of opiate addiction, many still don’t believe in its legitimacy. Nobody, not even most health care professionals themselves, believe that Methadone can be used as a tool to help heal an addict in recovery. There are MANY Methadone patients who will attest to the healing they gain from MMT, but nobody ever takes us seriously. That in of itself hinders us in our quest in gaining full acceptance on our road to full recovery. We need the help and acceptance of our community if we are to be totally successful in recovery.

What needs to be reversed is the moralization of addiction. There is a hardcore belief out there that addiction is a behavior problem, and not a legitimate disease. The belief that addiction is a “choice” is almost a national anthem. “Methadone is a crutch, and you’re just trading one drug for another” is another one we in treatment hear A LOT. “Methadone just prolongs addiction, and patients need to stop as soon as possible.” That’s another social stigma that is the total opposite of the truth. Many patients do better thelonger they remain in treatment. MMT is about much more than the medication. We are offered tons of support in the form of counseling and group therapy. In treatment we get help from our peers, nurses, and constant reassurance on our journey through recovery. The rule of thumb with MMT is you get out of it what you put into it. Like the old Al Anon adage: “It works if you work it, you’re worth it!”

The stigmas surrounding MMT is doing much more than make it hard on us patients and potential patients. It stops treatment from being offered outside of clinic settings, such as in jails, where it would probably do a lot of good. It would help curb a lot of inter jail drug dealing and use. It stops doctors from being able to prescribe Methadone in an office based setting like Suboxone is. Stigma has lead to children being taken from the family home of parents in MMT. Stigma is responsible for the way the clinic itself operates. By the laws enforcing dose restrictions, the supervised urine screens, restricting the amount of time patients stay in treatment and the moratorium on the formation of new clinics.

We as patients need to help reverse the stigma. To do that, we need to speak out and need not to be secretive and embarrassed about our success with MMT. Stop reinforcing the stigma by being bad patients and taking advantage of this life saving treatment modality, which just reinforces misinformation. Those who use MMT for other things besides recovery are just feeding the stigma surrounding us. We need to be mindful and realize that words do matter, and how we present ourselves to the world does reflect back on our treatment. We as patients can help put a new face on addiction treatment, and who is affected. We are your Brother, Sister, Mother, Father, Daughter, Son, Best Friend and maybe even your Accountant…

From Substance Matter: Oxytocin Shown to Block Alcohol Withdrawal

Oxytocin Shown to Block Alcohol Withdrawal

In a small, randomized, double-blind clinical trial, intranasal oxytocin blocked the effects of alcohol withdrawal on a population presenting to a hospital-based detoxification unit. Results from the study were published in the March edition of Alcoholism: Clinical and Experimental Research and are the first to confirm results obtained in other studies using non-human subjects.

In the study, participants (n=11) were given either lorazepam and oxytocin (n=7), or lorazepam and placebo (n=4), over three days of inpatient detox. They were then administered several standardized alcohol withdrawal measurements (CIWA, AWSC, ACVAS, POMS) and compared the two groups. Across the board, patients who were administered intranasal oxytocin scored significantly lower on withdrawal measures, while reporting significantly less craving and significantly better mood.
While the limitations of the study (small size) are clear, these findings are impressive and will lead to further research. In recent years, oxytocin has shown promise in the treatment of multiple disorders. Certainly, this research will add another voice to the chorus of oxytocin advocates.



I hope that one day that the blogger of Substance Matter spend a little time on Ibogain and the fact that this West African hallucigenic also blocks withdrawl from alcohol and opiates.

When Treatment is done right!!!!

This is an article promoted by a NAMA member and Methadone Advocate who has been working his tail off to assure the existance of treatment in Johnson City, Tennessee.

http://www.johnsoncitypress.com/Opinion/article.php?id=105510#axzz2PxuPsb4q

The case for a clinic

Published March 18, 2013

I am the manager and co-owner of Tri-Cities Holdings LLC, the business applying to open an opiate addiction treatment and counseling clinic in Johnson City. I would like to respond to the March 8 editorial opposing the location of a methadone clinic in your city.
First, I completely understand that community members may feel apprehension at the idea of having an opiate addiction treatment in your community. I’m hopeful, however, that as Johnson City citizens study this issue, they might come to understand that this treatment option is necessary and would be beneficial to Johnson City and the greater Tri-Cities area.
Opiate addiction is an epidemic in the United States, is higher in Tennessee and even higher in the Tri-Cities area.
Let me start with some quick facts about opiate treatment clinics. First, one of the clinic treatment options — methadone — is not “meth.” Meth is slang for methamphetamines — an illegal stimulant that is widely abused and has caused widespread social problems throughout our country. Our proposed clinic has nothing to do with this scourge.
Second, our clinic is not a “pill mill.” Pill mill is slang for doctors who overprescribe large quantities of painkillers that can cause addiction and abuse. Our clinic is the opposite of a pill mill. We seek to get people off pills.
Third, opiate treatment clinics provide substantial social benefits. Around 80 percent or more of opiate treatment clinic patients are employed, maintain a household and support a family. Illegal drug use or criminal activity will get a patient discharged from treatment. In contrast, 80 percent of untreated opiate-addicted people support their addiction through crime. Addicts also are more likely to leave their families, have higher rates of HIV and tuberculosis, engage in criminal activity and have higher unemployment.
This fact is commonly known as the “80-80 rule” that concisely summarizes the social decision that a community makes in deciding whether to offer a legal opiate- treatment option.
We can all agree that untreated addicts create multiple problems for cities and communities like Johnson City. Our goal is to provide the treatment that alleviates the problems associated with this epidemic.
Fourth, our clinic intends to be entirely private pay and will not take a dime from public health coffers. Allegations of a drain on public funds are simply not true. Patients pay for their own treatment, which is much cheaper than an illegal drug habit running hundreds of dollars per day.
There was a past effort to open a clinic that failed. In 2003, the Tennessee Health Facilities Commission granted a permit to open a drug treatment clinic in Johnson City.
That permit decision was reversed by an administrative law judge, who ruled that the commission did not have a quorum when it voted 8-0 to approve the certificate of need. There was a unanimous decision by the Health Facilities Commission then that there was a need for an opiate treatment clinic in Johnson City. There is an even greater need now than in 2003.
You should know that some of the patients in these clinics are injured veterans from Iraq and Afghanistan who have become addicted to opiates. Currently, they must drive between 100 to 200 miles a day to a clinic if they want opiate-addiction treatment. In fact, the nearest in-state clinic is in Knoxville, which is 106 miles from Johnson City. Current rules prohibit a patient from bringing home even one extra day’s dosage during the first 45 days of treatment — so a new patient must drive between 4,500 miles (out of state and back) and 9,000 miles (to Knoxville and back) during the first 45 days of treatment.
Multiple studies show distance is a primary obstacle to treatment, so requiring Johnson City residents to drive such enormous distances to seek treatment results in many just giving up and going back to pill mills, illegal pill dealers and heroin.
Right now, at least 1,000 citizens of Johnson City and the Tri-Cities area are addicted to opiates and are being treated at clinics in Knoxville and outside of Tennessee.
From an economic perspective, our clinic will be a big positive for Johnson City. Our clinic will offer more than 20 good-paying counseling, nursing and administrative positions. Our proposed location is located in the already medical-zoned part of Johnson City, like many other medical services businesses.
When we first began looking for a location, we were committed to finding an appropriate and accessible location some distance away from residential neighborhoods and schools. We determined that this is an ideal location.
Study after study shows that opiate treatment clinics raise employment rates, improve family lives and lower crime rates. A 2012 University of Maryland Medical School study found no geographic correlation between opiate treatment clinics and criminal activity.
It is important to note that people who are addicted to opiates and are seeking treatment are sick and are protected under the Americans with Disabilities Act and the Rehabilitation Act of 1973. Denying disabled people convenient access to treatment, and forcing them to drive hundreds (in this case thousands) of miles for treatment is a violation of federal law.
The prescription drug epidemic is an enormous problem in Johnson City and the Tri-Cities area that must be addressed like the rest of the United States. We have devoted a substantial amount of time finding a location that is not near a church, school or park.
We believe that the proposed clinic can be a part of that solution but we also know of the need of prevention, particularly as it pertains to our youth. For that reason we are prepared to fund a local program to help local at-risk youth. In this regard our goal would be to start that program soon after the clinic opens.
If you are ready to reduce crime, increase employment, reduce drug usage, reduce transmission of HIV and TB and increase family stability, I encourage you to write a letter of support:
Health Services and Development Agency
The Frost Building Third Floor
161 Rosa L. Parks Blvd.
Nashville, TN 37243

Steve Kester is manager and co-owner of Tri-Cities Holdings LLC, the business applying to open an opiate addiction treatment and counseling clinic at 4 Wesley Court. He is a part owner of nine other methadone clinics in four states.

Read more: http://www.johnsoncitypress.com/Opinion/article.php?id=105510#ixzz2TC71KaA5