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Why Are Some People More Vulnerable to Addiction than Others?

Posted on: December 4th, 2017 by sobrietyresources

“I don’t use the heroin to get high; I use it to feel normal.”

We still don’t get it right when it comes to understanding addiction. The most recent example of our failure to appreciate what makes addictive behavior so compelling is the burgeoning widespread addiction to the synthetic opiate oxycodone—with all of its tragic consequences. We keep reacting as if the problem is the potency of the drug itself that leads to the escalation of use and, unfortunately, sometimes progression to the more deadly intravenous use of heroin. The examples that are most frequently encountered are the instances where oxycodone was initially prescribed for some medical or surgical problem, but then the person becomes “hooked.” As the psychoanalyst Sandor Rado instructed at the turn of the 20th century, it is not the drug but the urge to use it that causes addiction. Similarly, Norman Zinberg pointed out that it is the drug interacting with the person and their surroundings—i.e., drug, set, and setting—that leads to addiction. I offer another example that has recently caught my attention as yet another mischaracterization and misunderstanding of what addiction is about. This one has to do with recent clinician warnings that addicted individuals on the street and in correctional settings are seeking out Seroquel, a powerful antipsychotic drug, to “get high.” This is just one more pejorative and stigmatizing misinterpretation of addiction. Addiction Treatment pioneer Edward Khantzian has had a bird’s eye view of every substance use trend and drug epidemic over the past half-century. His Self-Medication Hypothesis, which encourages the view of addiction as an attempt, however unsuccessful or self-defeating, to relieve the user’s internal psychological distress, has demonstrated both empirical and intuitive validity over time. In his second piece for Professional Voices, Dr. Khantzian looks at the Q Ball phenomenon, in which people seek out and “misuse” the powerful antipsychotic Seroquel…Richard Juman

The generic name for Seroquel is quetiapine, thus the use of the street term “Q Ball.” While the street name of the drug draws a parallel to street use of “speedball” injections—an intravenous admixture of opiate and cocaine—the presumed intentions behind the misuse of the two drugs couldn’t be more different. You don’t get “high” on Seroquel—you get tranquilized, you get relief from something so disturbing that it makes you go to great lengths to shut it off.

As my colleagues and I have written in the past, I believe that substance addiction “functions as a compensatory means to modulate distressful affects and self-soothe from unmanageable psychological states” and that substance misusers are unsuccessful in managing negative emotional states on their own, without the use of substances. Instead, “substance abusers use drug actions, both physiological and psychological effects, to regulate distressful emotions and achieve an emotional stability.” I view substance addiction and misuse as an interplay between the properties of the drug of choice and the “inner states of psychological suffering and personality organization” of the user.

For example, opiates (e.g., heroin, codeine, and oxycodone), which are used medically for pain management, may similarly be used by persons who have difficulty managing their rage and aggression, which I posit are “often linked back to earlier traumatic exposure to violence and aggression.” In this manner, “opiate abuse functions as a temporarily adaptive response that mutes and attenuates the rage and aggression.”

As another example, the drug effects of cocaine use may include elevated mood, improved confidence and an enhancement of feelings of self-esteem. There is evidence to suggest that “low-energy individuals use cocaine because they do not possess an adequate degree of psychological capacity to relieve themselves from the feelings of boredom, emptiness, and fatigue state, whereas high-energy individuals use cocaine because of their magnified need for elated sensations. Cocaine users’ need to regulate inner emptiness, boredom, and depressive states or to maintain restlessness draw them to the powerful, energizing effects of cocaine.”

Finally, alcohol misusers frequently present with “rigidly overcontained, constricted emotions. To avoid distressful affects, emotions are isolated and “cut off” from abusers’ awareness through the use of rigid defenses, leaving the feelings of emptiness and isolation.” Alcohol, a depressant with sedating and relaxing qualities, softens these rigid defenses and provides relief from these constricted emotions.

So I argue that simplified explanations for the seductiveness of drugs are insufficient explanations for the development of addiction, whether it is alcohol, cocaine, marijuana, oxycodone or Seroquel. The use, misuse and sometimes dependence on these substances are driven by a meaningful and purposeful connection between the inner state of the individual and the effects of the person’s drug of choice. As psychoanalyst Debra Rothschild has pointed out, in addiction theory and practice “the object of study should be the individual rather than the substance.” Here, in what follows I offer a perspective on some of the psychodynamic determinants that make addiction so compelling.

With respect to Seroquel, it could be argued that since it is sedating, individuals are drawn to it to help them sleep. More often, what is not sufficiently appreciated in these cases is why individuals seek these drugs out so persistently. Indeed, if it is for sleep, we do not often enough ask what keeps people from sleep. And in the case of inmates who seek it out for reasons beyond sleep, what could its appeal be? Is it possible that Seroquel does for them what is does for the more seriously mentally ill?

The term “sedative” does not do justice to the effects of medications like Seroquel. Medications in this category are powerful agents to quell states of agitation, intense fear and uncontrollable rage and violent feelings. Recent reports, for example, indicate that quetiapine is effective in treating patients who suffer with borderline personality, a condition in which the aforementioned intense painful emotions predominate. Opiate pain medications have similar actions. As a returning combat veteran suffering with all the violent feelings of rage and anger associated with his PTSD put it, “I don’t use the heroin to get high; I use it to feel normal.” These feeling states can keep us awake and tossing, or can cause a person such discomfort as to want to “zone out.” Pharmaceuticals such as Seroquel are powerful calming agents, which in good part explains their appeal. Yet unlike addictive drugs, Seroquel does not cause tolerance (the need to use more to get the same effect) or dramatic withdrawal symptoms when the drug is discontinued.

Despite the fact that individuals who experience extreme physical trauma (e.g., painful burn conditions), and are treated with opiate pain killers, in the largest majority of instances do not become addicted. What more likely happens is a vulnerable person discovers that such drugs counter more than the feelings of physical pain. Rather, the drugs grab ahold of susceptible individuals because knowingly or unknowingly they suffer with co-existing psychiatric conditions and painful psychological feelings and states. A recovering alcoholic physician, a reserved and reticent man, described himself as a “born-again” isolationist, and in exquisite and colorful language, described in group therapy the preparation of a gin martini—the scent of the bitters, the crackling of the ice, etc. Then he exuberantly exclaimed, “I could feel free, be one of the guys, I could join the human race!”

Addictive drugs, as powerfully compelling as they can be, are not universally appealing. Whether in non-medical experimentation or legitimate medical use, most individuals exposed to these drugs do not become addicted. We still tend to explain the appeal of addictive drugs on the basis of reward and pleasure (“the high”) that can be obtained from these drugs. Such explanations derive from old and new theories about addiction. Freud and his early followers emphasized pleasure drives (and to some extent destructive drives), and modern neuroscientists, examining where the drugs act in the brain explain that addictive drugs “hijack” the pleasure and reward centers of the brain.

Then if it is not pleasure or physical pain that causes addiction, why are some of us more vulnerable than others to addiction? My colleagues and I at Cambridge Hospital have collectively spent more than six decades trying to explore, understand, and explain the powerfully compelling nature of addiction. Beyond biological addictive mechanisms of tolerance and withdrawal, and genetic predispositions, we have had enough extensive clinical evidence backed by empirical studies to conclude that addictive disorders are related to the powerful effects addictive drugs have on a range of painful feeling states, thus giving them their appeal. For example, there is data indicating that there is a far disproportionately high co-occurrence of addictive disorders in conditions such as post-traumatic stress disorder, bipolar disorder, attention deficit disorder, and schizophrenia, conditions which have unimaginable emotional pain associated with them, which we understand makes such people self-medicate. And one need not suffer with a painful psychiatric condition, however, to find addictive drugs appealing. Those who endure excessive painful or intolerable emotions are also more likely to find inordinate relief and comfort in addictive drugs. If there is “reward” associated with addictions, it is less the reward of pleasure, but more the reward of relief from intense psychological suffering.

Dr. Khantzian is Professor of Psychiatry, part time, Harvard Medical School in Boston, and President and Chairman, Board of Directors, Physician Health Services of the Massachusetts Medical Society in Waltham, Mass. He is in private practice and specializes in addiction psychiatry.

https://www.thefix.com/why-some-people-more-vulnerable-addiction

Heart failure tied to meth use rising among veterans, study finds

Posted on: December 4th, 2017 by sobrietyresources

By Susan Scutti, CNN

Updated 1:33 PM ET, Tue November 14, 2017

Meth is chemically similar to the nervous system stimulant amphetamine. It is typically inhaled or smoked, swallowed, snorted or injected once dissolved in water or alcohol. More than 4.7% of Americans report trying this drug at least once, according to the National Institute of Drug Abuse.(CNN)Heart failure tied to use of methamphetamines is on the rise among US veterans, suggests a preliminary study presented Tuesday at the annual scientific meeting of the American Heart Association.

“Methamphetamine is an addictive drug, which could have a wide range of effects on patients’ physical and mental well-being,” said Dr. Marin Nishimura, the study author and internal medicine resident at the University of California, San Diego. “In addition to the heart, methamphetamine has been shown to have toxic effects on the brain.”

Thousands of veterans studied

Nishimura and her team became interested in meth-associated heart failure “because we noticed that we have been seeing increasing cases of this condition in the hospital where we practice.”

They reviewed the medical records of heart failure patients at San Diego VA Medical Center between 2005 and 2015 to see which had used meth. All told, the team looked at records for 9,588 patients and found 480 with a documented history of meth abuse.

“The proportion of patients that used methamphetamine was increasing from 2005 to 2015,” Nishimura said: from 1.7% of total heart patients at this facility in 2005 to 8% in 2015.

Patients in the two groups — users and non-users of meth — had striking differences, she said.

“Heart failure patients with methamphetamine abuse were younger, more likely to be homeless, unemployed and diagnosed with other substance-abuse and psychiatric conditions,” Nishimura said.

On average, the meth users with heart failure were 61 years old. This is considerably younger than the average age of non-meth-using heart failure patients at the facility: 72 years old. Meth users were also more likely to have post-traumatic stress disorder and depression.

In addition, meth users were less likely to have atrial fibrillation — an irregular heartbeat that can lead to blood clots, stroke and heart failure — than non-meth users.

And, compared with non-using VA heart patients, those who used meth were less likely to have significant coronary artery disease yet tended to visit the ER more frequently.

Nishimura believes she and her colleagues need to address these issues to better take care of VA patients. “Furthermore, these differences may give us a clue as to when we should be screening for methamphetamine use when patients are newly diagnosed with heart failure,” she added.

Still, more research is needed, because the findings are based solely on a small number of veterans at a single medical center in San Diego, which means the study is too limited, she cautioned.

‘Vulnerable population’

Dr. Harshal Kirane, director of addiction services at Staten Island University Hospital in New York, said the new study “is yet another call to address the challenging needs of US veterans.” Kirane was not involved in the research.

“Methamphetamine use is associated with numerous well-established health consequences in essentially all systems of the body,” he said, adding that “methamphetamine-associated cardiomyopathy,” in which the heart muscle deteriorates as a result of meth use, is still only “partially understood.”

Slightly more than 5% of the heart failure hospitalizations in the US are attributable to stimulant use, he said.

Meanwhile, patterns of drug use continuously evolve, he noted, “as well as the potential for medical consequences from drug use.”

“Military veterans are an especially vulnerable population for developing mental health and substance use issues,” Kirane said.

He added that the new research “raises important questions” about why veterans may be using methamphetamine and what challenges they face in “accessing care for substance use disorders and general medical issues.”

“It also raises questions about the underlying biology of the heart that may make some individuals exquisitely vulnerable to developing heart failure from methamphetamine use,” he said.

The fact that potent illicit drugs can be manufactured from over-the-counter medications “has contributed to increased methamphetamine use in regions of the country less accessible to major drug trafficking pathways such as rural communities,” Kirane said.

Though it’s “unclear” why an increase in meth use has occurred among veterans, Nishimura agrees with Kirane’s basic assessment.

“What’s certainly contributing to the current popularity is likely due to the fact that it can be synthesized in small-scale laboratories,” she said. “And sold at relatively low street prices.”

http://www.cnn.com/2017/11/14/health/meth-heart-failure-veterans-study/index.html

Anxiety and pain medication together can kill you, especially with a drink

Posted on: November 27th, 2017 by sobrietyresources

By David Heitz

Especially in light of the nation’s opioid epidemic, this shouldn’t be happening anymore: Opioid painkillers and anxiety medication being taken (and often even prescribed) together. We already know it’s a volatile mix proven to lead to easy overdose, especially when combined with alcohol. Both drugs are highly addictive individually – opioids (painkillers) and benzodiazepines (anxiety medication). But they take hold with a strangling grip when taken together. Especially with alcohol. Take it from the National Institute on Drug Abuse, or NIDA:

“Combining opioids and benzodiazepines can be unsafe because both types of drugs sedate users and suppress breathing—the cause of overdose fatality—in addition to impairing cognitive functions. In 2015, 23 percent of people who died of an opioid overdose also tested positive for benzodiazepines

“In a study of over 300,000 continuously insured patients receiving opioid prescriptions between 2001 and 2013, the percentage of persons also prescribed benzodiazepines rose to 17 percent in 2013 from nine percent in 2001. The study showed that people concurrently using both drugs are at higher risk of visiting the emergency department or being admitted to a hospital for a drug-related emergency.” (1)

What’s even more concerning lately is that high school children in Northern San Diego County now appear to be experimenting with anxiety medication, such as Xanax. The same dealers who brought them opioid painkillers are trying to fill the void of painkiller supply, dwindling due to enforcement. Sobriety Resources recently reported why Xanax is the fifth most commonly overdosed drug in America, coming in just behind heroin, fentanyl, cocaine and oxycodone.

What’s dangerous about high school children throwing Xanax into the mix is that we know they already experiment with painkillers and alcohol together. Adding Xanax, valium, Ativan, Klonopin and the like could prove deadly. These are cocktails to stop the heart.

“Right now, we’re trying to pinpoint the exact source of where it’s coming from,” Yesenia Martinez told the San Diego Union-Tribune. “This doesn’t seem to be coming from a pharmacy.” (2) Martinez is a community organizer for Escondido Drug-Free Community Coalition. The program receives referrals through a court-based juvenile diversion program. Rich Watkins, director of pupil services and intervention for the Escondido Union High School District, told the Union Tribune, “Our concern is that kids are involving themselves in some of these activities, and it’s logical to assume that there is more out there than we’re aware of.” (2)

Depressing breathing to the point of stopping heart

It’s not hard to figure out what happens when you mix these drugs. All are depressants. Eventually, your heart can stop. And “the slope is slippery” is more than a saying if you take a second to look down at the ice. I think anyone who has lived the bar/party lifestyle knows how it goes when it comes to being offered pills. It’s always when you’ve been drinking anyway and are pretty messed up. Then you take the pill. Then you’re even more messed up. “Here, want a blue?” “Didn’t I just take a pill? Or not?” And then you take another pill. This is how people wind up dead. And everybody knows someone these days. It doesn’t have to be a needle in the arm. Usually it isn’t.

FDA issues warning many do not heed

The problem of people overdosing on a deadly mix of opioids and benzodiazepines is so serious that last year the FDA required special labeling of these medications. The labels warn the medications can cause “extreme sleepiness, respiratory depression, coma and death.”

“It is nothing short of a public health crisis when you see a substantial increase of avoidable overdose and death related to two widely used drug classes being taken together,” FDA Commissioner Dr. Robert Califf, said when the requirements were announced. “We implore health care professionals to heed these new warnings and more carefully and thoroughly evaluate, on a patient-by-patient basis, whether the benefits of using opioids and benzodiazepines – or CNS depressants more generally – together outweigh these serious risks.” (3)

The FDA at that time noted that some people in recovery take opioid maintenance therapy as part of their treatment plans. Opioid maintenance therapy weans people addicted to drugs such as heroin and fentanyl off the dependency. Further research is needed to determine how anxiety medications interact with opioid maintenance therapy drugs, the FDA determined.

Spreading the word of the little-known, deadly mix

Read what this shocking study in the British Medical Journal this year warns:

“Providers may co-prescribe (anxiety medication) with opioids for its anxiolytic and skeletal muscle relaxant effects. It is also known to be used for insomnia, mania, depression etc.

“However, (anxiety medication) may increase the euphoric effect of opioids leading to potential misuse and co-abuse with other medications. Also, cytochrome P450 plays a role in the metabolism of opioids and certain BZD (benzodiazepines), inhibitors of which can lead to decreased clearance of these drugs, predisposing patients to overdose.

“Primary care patients receiving opioids who are on concurrent BZD are more likely to refill opioids earlier than those using cocaine. Further, BZD are associated with increased risk of suicidal attempt.” (4)

Still, many Americans and even some doctors appear oblivious to the burgeoning overdose crisis being helped along with anxiety medications. This is why the FDA is requiring special labeling.

International Overdose Awareness Day spreads word

What else is being done to let America know this is yet another ticking time bomb in you or your loved one’s medicine cabinet? Not a whole lot. It’s up to all of us to spread the word about this deadly combination of opioids and benzodiazepines (anxiety medication), especially when mixed with alcohol. The International Overdose Awareness Day website has some interesting information explaining how the drug dual team up to kill:

“Half-life refers to the time it takes for a drug to drop to half the strength of its original dose. Some drugs have a long half-life, for example some benzodiazepines. If a person has used yesterday, they may still have enough in their system today to overdose if they use more.

Diazepam (Valium) has one of about 24 hours, so if you took 20mg yesterday you would still have approximately 10mg of diazepam active in your system today. If you were then to use heroin or morphine, you would have an increased risk of overdose as you would be using the opioids in addition to that 10mg of diazepam.” (5)

We learn more and more every day that some of the most addictive and deadly drugs around are those that are legal and readily available to us. It’s easy to lose sight of this because we still stigmatize drug addiction as criminal activity. It’s absolutely time we wake up and smell the coffee about who is becoming addicted to drugs and how. Only then can we be honest about deadly cocktail combinations thought by many to be harmless.

Bibliography

National Institute on Drug Abuse. (2017, September). Benzodiazepines and Opioids. Retrieved Nov. 8, 2017, from https://www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids

Sullivan Brennan, D. (2017, Nov. 2). Xanax abuse creeps into schools. San Diego Union Tribune. Retrieved Nov. 8, 2017, from http://www.sandiegouniontribune.com/communities/north-county/sd-no-xanax-schools-20171102-story.html

3. U.S. Food and Drug Administration. (2016, Aug. 31). FDA requires strong warnings for opioid analgesics, prescription opioid cough products, and benzodiazepine labeling related to serious risks and death from combined use. Retrieved Nov. 8, 2017, from https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm518697.htm

4. Gandan Venkata, H. et al. (2017, March 14) Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis. British Medical Journal (BMJ). Retrieved Nov. 8, 2017, from http://www.bmj.com/content/356/bmj.j760/rr-5

5. Overdose Basics. International Overdose Awareness Day. Retrieved Nov. 8, 2017, from https://www.overdoseday.com/resources/overdose-basics/

The FDA Approved an Opioid Addiction Treatment Device

Posted on: November 27th, 2017 by sobrietyresources

By BRIEF

A device originally designed for treating chronic and acute pain has received approval from the United States FDA to be used in opioid addiction treatments. The NSS-2 Bridge works by zapping parts of the brain linked to processing pain information.

WRITTEN BY Dom Galeon, November 24, 2017

The U.S. Food and Drug Administration (FDA) announced on November 15 the approval of a device called the Neuro-Stim System Bridge (NSS-2 Bridge), which is meant to help reduce the symptoms of opioid withdrawal. It’s the first medical device of its kind that’s been given the FDA’s blessing.ZAPPING THE BRAIN

The NSS-2 Bridge is a relatively simple device that attaches to the skin behind the ear, where it uses a chip to transmit controlled electrical pulses to stimulate four cranial nerves in the part of the brain that’s associated with processing pain information.

Marketed by Indiana-based Innovative Health Solutions, the Bridge was previously cleared to treat chronic and acute pain in 2014. The new approval “expands the use of the device as an aid to reduce the symptoms of opioid withdrawal,” according to the FDA, though it will only be available by prescription. It is rather pricey though, with previous Bridge treatments costing between $600 and $800.

There’s little to suggest how broadly effective this treatment could be, however. The FDA granted permission for the device after reviewing data from a clinical study that worked with “73 patients undergoing opioid physical withdrawal,” the announcement says. The trials showed that 64 out of these 73 patients, or 88 percent, successfully transitioned away from opioids after five days of using the Bridge. There is clearly efficacy here, although the number of respondents could’ve been higher.

TOWARDS BETTER TREATMENT

An opioid addiction treatment device is still welcome news, particularly since abusive use of opioids has continued to be menace in American society. The National Institutes on Drug Abuse reports that some 90 Americans die every day from opioid overdose, and a lot of this comes from misuse of prescription pain relievers, as well as overdose from heroin and synthetic opioids like fentanyl.

Meanwhile, the Centers for Disease Control and Prevention (CDC) notes that prescription opioid misuse costs the U.S. around $78.5 billion a year, from healthcare expenses, loss productivity, addiction treatment and from criminal justice involvement.

“Given the scope of the epidemic of opioid addiction, we need to find innovative new ways to help those currently addicted live lives of sobriety with the assistance of medically assisted treatment,” FDA Commissioner Scott Gottlieb said in the press announcement. “While we continue to pursue better medicines for the treatment of opioid use disorder, we also need to look to devices that can assist in this therapy.”

Gottlieb noted that there are already three approved drugs for treating opioid addiction, but the FDA remains “committed to supporting the development of novel treatments, both drugs and devices, that can be used to address opioid dependence or addiction, as well as new, non-addictive treatments for pain that can serve as alternatives to opioids.”

Indeed, there are a number of other efforts to combat the opioid epidemic, including an app that tracks opioid overdoses all over the U.S. in real-time. Others are looking to artificial intelligence (AI) to find solutions, while some are testing devices that could replace non-addictive painkillers. In order to put an end to the opioid crisis, it’s also necessary to improve on our knowledge of how drug-seeking behavior works.

https://futurism.com/fda-approved-opioid-addiction-treatment-device/

Emerging Rapper Lil Peep Dies at Age 21

Posted on: November 21st, 2017 by sobrietyresources

ENTERTAINMENT – His emo- and rock-influenced music attracted a large online audience.

11/16/2017 10:01 am ET Updated 4 days ago

By Ron Dicker

Lil Peep, a promising crossover rapper who recently released his first full-length album, died Wednesday night, just hours before he was to perform in Tucson, Arizona, according to reports. He was 21.

“I’ve been expecting this call for a year,” his manager, Chase Ortega, tweeted early Wednesday.

Lil Peep gained popularity through Soundcloud posts and his YouTube channel, which attracted viewers by the millions. He made much of his music in an apartment on Los Angeles’ Skid Row, The New York Times reported.

The Long Beach, New York, native, who was born Gustav Åhr, often sang about depression and drug use. The Guardian, citing his rep, Adam Grandmaison, reported Lil Peep was rushed to a hospital following a suspected overdose.

In a video the alt-rapper made before a scheduled gig Tuesday in El Paso, Texas, Lil Peep said he took six Xanax anti-anxiety pills. “I’m good, I’m not sick,” he added.

Lil Peep’s alternative hip-hop tracks contained emo and hard-rock influences, outlets noted. He once told the Times that his songwriting candor about his struggles connected him to fans. “They tell me that it saved their lives,” he said. “They say that I stopped them from committing suicide, which is a beautiful thing.”

His debut full-length album “Come Over When You’re Sober, Pt. 1” came out a few months ago, around the same time the rapper came out as bisexual. A PitchFork review described the album as “a 24-minute bender informally dedicated to destroying relationships and idling around in what he sees as this vain and absurd existence.”

His passing drew swift reaction.

https://www.huffingtonpost.com/entry/emerging-rapper-lil-peep-dies-at-age-21_us_5a0d8b67e4b0b17e5e1445ed?ncid=engmodushpmg00000003

Grandmother, 69, Dies After Cleaning Up Scene of Son’s Suspected Overdose

Posted on: November 18th, 2017 by sobrietyresources

Inside Edition Staff Inside Edition November 16, 2017

A Pennsylvania family lost two of its members in a matter of days after investigators say a grandmother died after cleaning up the scene of her own son’s suspected fatal overdose.

The Cambria County Coroner believes 69-year-old Theresa Plummer likely absorbed a substance she came into contact with while cleaning the bathroom where her son Ronald Plummer, 45, was found unresponsive Nov. 5.

Watch: ‘We’re Raising a Generation’: Grandparents of Children Orphaned By Opioid Crisis Say They Need Help

When Theresa Plummer left the intensive care unit where her son was fighting for his life following a suspected opioid overdose, she went home and began cleaning the bathroom, according to local reports.

At some point thereafter, she began to experience trouble breathing and was rushed to the hospital.

Theresa Plummer died Nov. 6. Her son gave up his fight a day later.

Toxicology reports on the mother and son will take weeks to come back, so the cause of their deaths has not been officially determined.

However, as deaths from fentanyl continue to rise across the nation, so too have cases of overdoses stemming from accidental contact with the synthetic opioid, which can be easily inhaled or absorbed through the skin.

The DEA has even issued warnings to first responders as accidental overdoses continue to be reported in police officers and paramedics.

Even tiny amounts of the drug and those related to it can be fatal, and anyone at the scene of a suspected overdose is urged to wear protective gloves and a face mask.

Sadly, it’s unlikely Theresa Plummer was aware of such warnings when she returned to clean up her home.

Watch: Amid Scourge of Opioid Epidemic, How Addicted Americans Are Struggling to Get Clean

An obituary said Theresa is survived by three grandchildren and three children. “She enjoyed rescuing animals and spending time with her family,” it read.

A memorial was held for Theresa on Nov. 11.

https://www.yahoo.com/news/grandmother-69-dies-cleaning-scene-161425359.html

FDA chief warns about kratom to treat opioid addiction; will seek more regulatory power

Posted on: November 16th, 2017 by sobrietyresources

Jayne O’Donnell, USA TODAYPublished 9:00 a.m. ET Nov. 14, 2017 | Updated 4:57 p.m. ET Nov. 14, 2017

Citing 36 deaths, the Food and Drug Administration chief warned consumers Tuesday not to use the herbal supplement kratom to ease opioid withdrawal and announce plans to step its regulatory oversight to combat the opioid epidemic. The FDA public health advisory on kratom follows the Drug Enforcement Administration’s reversal or at least delay of plans to classify kratom as a controlled substance on the same level as heroin and LSD. FDA commissioner Scott Gottlieb says the FDA plans to work with the DEA to determine how kratom should be classified. Kratom, a plant grown naturally in countries including Thailand and Malaysia, is widely sold in smoke shops and other locations as a powder that can be used in tea to slow the effects of opioid withdrawal. But it has addictive properties of its own, FDA says. public health advisory related to the FDA’s mounting concerns regarding risks associated with the use of kratom.

The FDA says kratom carries similar risks of abuse, addiction and in some cases, death, as opioids. It is also often used recreationally for its euphoric effects. Along with opioid withdrawal, kratom is also believed to relieve fatigue, pain, cough and diarrhea. Anita Gupta, an osteopathic anesthesiologist and licensed pharmacist, has expressed concern about an increase in the use of kratom among her chronic pain patients. Kratom users and advocates were “dismayed to learn of the DEA’s plan to classify kratom as a Schedule 1 substance – the same classification as LSD and heroin – despite anecdotal and scientific evidence indicating kratom could be an effective opioid alternative,” says Walter Prozialeck, chairman of the pharmacology department at Midwestern University Chicago College of Osteopathic Medicine. As an active “drug”, kratom certainly has potential for causing harmful effects and can, itself be addictive,” Prozialeck, who co-authored a December 2016 study on kratom in the Journal of the American Osteopathic Association. “However, overwhelming evidence indicates kratom is far less dangerous than classic opioids.”

Studies from Asia indicate kratom, in its pure form, has not been linked to any deaths in that part of the world, says Prozialieck. He blames a “lack of quality control in western countries including the U.S., which can lead to dangerous alterations of kratom or the addition of other drugs. “The therapeutic potential of kratom is real, but more research is urgently needed to evaluate its safety and efficacy,” he added. “One of my concerns is that a total ban will likely stifle such research.” Because kratom is unregulated, “you never know the real strength, ingredients, or how it’s prepared,” agrees Chris Barth, who used the medication Suboxone to recover from a pain pill addiction a decade ago.

“Limited access and or lack of knowledge of approved treatments is what’s probably driving this.” says Barth. “It’s probably easier to ‘do it yourself’ with kratom ordered over the internet than find — if it’s available — and pay for FDA approved, doctor supervised treatment.” Gottlieb also told his agency’s criminal investigations staff that he may ask Congress for more authority and resources to fight the opioid epidemic, according to remarks prepared for delivery Tuesday afternoon. Gottlieb also says in the remarks that a new working group with Customs and Border Patrol is working on stepped-up enforcement at entry points for illegal narcotics.

The fact Gottlieb is speaking to the investigations staff is significant because “if they find people here who are opening the gates to these drugs, there may be opportunities for the FDA to investigate at a high level,” says Joshua Sharfstein, former principal deputy FDA commissioner in the Obama administration. Importers, organized crime or others in the supply chain could be part of conspiracies to distribute illegal opioids, Sharfstein says. FDA is already using import alerts and other authority to stop foreign, unapproved and misbranded drugs at the border to keep kratom shipments from entering the United States. Hundreds of shipments have already been detained and many are seized.

Still, more than 340 million packages reach the U.S. every year.

“Given that massive volume, it’s estimated that only a small percentage of the illicit drugs smuggled through the (international mail are being intercepted,” Gottlieb said. While it’s very important to strengthen border enforcement, “the challenge is akin to pushing the tide back into the ocean,” says Sharfstein. Gottlieb, who did two previous stints at the FDA, has publicly expressed misgivings about how long it took the agency to truly address the crisis. “We’ve learned a tragic lesson from the opioid crisis: that we must pay early attention to the potential for new products to cause addiction and we must take strong, decisive measures to intervene,” said Gottlieb. “From the outset, the FDA must use its authority to protect the public from addictive substances like kratom, both as part of our commitment to stemming the opioid epidemic and preventing another from taking hold.

https://www.usatoday.com/story/news/politics/2017/11/14/fda-chief-warns-kratom-treat-opioid-addiction-seek-more-regulatory-power/860825001/

Handcuffed To Opioid Addiction

Posted on: November 13th, 2017 by sobrietyresources

Handcuffed To Opioid Addiction

11/12/2017 03:26 pm ET Updated Nov 13, 2017

Ritchie Farrell, Contributor

I think back on one of the many days I was dope-sick. I was still with my wife and kids. It was near sunrise. I drove from my farmhouse in Pelham, New Hampshire squeezing my sphincter muscles until the urge to fart left me. If I could only hold out until the white liquid hit my heart—I wouldn’t shit myself.

Adams Street, the place I scored heroin, was naked except for a grotesquely thin Puerto Rican kid in his early 20s. He had a teardrop tattoo under his left eye. He was Nieta—an extremely dangerous Puerto Rican jailhouse gang. Of course, I was driving a Mercedes Benz and was built like a jock. He thought I was a cop.

I was “jonesing,” and I couldn’t care less what he thought of me. Only my agenda mattered. First, don’t give him the money and let him out of my sight. Second, bite the bag—make sure it’s heroin. Third, get safely to the Burger King bathroom down the street to cook the heroin and stick the needle into my vein.

I motioned him into the car. He jumped in and directed me to a house a few streets off Adams Street with hand commands. It was a predominantly Cambodian neighborhood. We didn’t speak. I had a 9-inch screwdriver in the driver’s side compartment of the lower door. My left hand never left the yellow handle.

He left the car, expecting me to follow. One knock and it opened. The place was a shooting gallery. Wall to wall junkies sleeping on the floor. I followed him to the bathroom. The mold smell made me gag. He cooked a bag in an aluminum beer-bottle cap, shot it, and handed me a needle and a fresh bag of heroin. His eyes were pitch-black—emotionless. His purple-crimson blood was clearly visible in the bottom of the syringe—maybe a centimeter thick between the end of the needle and the black rubber stop on the stick-push.

I carefully poured the tiny bag of heroin into his cooker. Grabbed a cigarette butt out of the ashtray on the windowsill, bite off a small piece of the filter, and spit it into the cooker. I thought about my little boys and what it must feel like to die of AIDS. I turned the cold water on, gathered 20cc of water into the syringe, shot it into the cooker, fired-up a match, and watched it bubble. The Puerto Rican kid watched. He thought I was hesitating because I was a cop. He had no idea I lived on a half a million-dollar farmhouse with a wife and two children.

That was 30 years ago.

When I look back now, I cannot believe I survived. Nothing mattered to me except heroin. It was my God. Every word that exited my mouth was a lie. Every day I woke up, I wanted to die. Every injection I administered into my veins was my silent attempt to commit suicide.

But I survived, caught some luck and became a writer. It wasn’t easy. I did it the hard way: abstinence.

I am very thankful for the fact I do not have to enter recovery today. I am not sure that I would have made it. Today the major MOT, method of treatment, for opioid addiction is long-term maintenance. What, back in my day, we referred to as “liquid handcuff.”

I kicked methadone once and honestly, I would rather kick heroin cold a dozen times before I went through methadone withdrawal again. I remember praying to God to take my life. It felt like my bones were on fire.

PLEASE understand: suboxone and methadone are much-needed drugs to help the addict through the initial physical withdrawal of opioids affect on the human body. However, in some ways, the physical tolls of substance abuse can be easier to address than the emotional ones. In many cases, people are driven back to heroin by emotional swings, not by irresistible cravings.

But I would be a fool to think that my way, abstinence, is the only way for a fully successful recovery from opioid addiction. However, I firmly believe that we are going to lose the war against opioid addiction if we continue with the MOT presently being used to treat opioid addiction. And we are going to lose badly!

Big Pharma controls the United States Congress. Big Pharma created this opioid epidemic. Why should we be shocked that Big Pharma does not want the deaths of what many estimate as many as 150 Americans per day to end?

It is all about the “Benjamins.” On June 22, 2017, Time Magazine reported the following facts:

In 2016, the pharmaceutical companies that make opioid painkillers raked in $8.6 billion in sales for 336 million opioid prescriptions, according to the data firm QuintilesIMS. That’s enough to give pain pills to 9 out of every 10 American adults.
Analysts estimate that the follow-on opioid market is worth at least $3 billion a year. Given current trends, some project that it will top $6 billion by 2022.
Pharmaceutical companies made billions promoting the aggressive prescribing of opioids. Now they’ll make billions from treating the consequences of overprescription.
Three of the main companies that make naloxone products raised the prices on their drugs as demand increased. From 2005 to 2014, Hospira, which was purchased by Pfizer in 2015, increased the list price of its 10-milliliter injectable naloxone pack by 2,300 percent, from $9 to $220, according to data from Truven Health Analytics. From 2001 to 2014, the list price for Amphastar’s 20-milliliter naloxone pack jumped 175 percent, from $120 to $330. Kaléo raised the price of Evzio, its naloxone auto-injector, by 550 percent. When it was first introduced in 2014, it cost $575. In 2016, it was $3,750.

Did I mention that Big Pharma controls the United States Congress?

On Oct. 26, 2017, President Trump declared the opioid epidemic a national health emergency. Moments before he came on national television, I was on a live MSNBC panel to discuss the epidemic. I mentioned abstinence, and I received an avalanche of nasty tweets and emails.

Regardless, what the doctors tell opioid addicts, Big Pharma knows the truth. Suboxone and Methadone are opioid agonists that create a conscious sedation which separates the addict from their present awareness.

Again, we will not win the war against opioid addiction by treating opioid addicts with opioids. We must at the very least offer abstinence as a method of treatment for heroin addiction.

However, it will not be an easy alternative option, Big Pharma knows that they have created a population handcuffed to addiction.

Ritchie Farrell is the author of I Am A Heroin Addict.

Follow Ritchie Farrell on Twitter: www.twitter.com/ritchiefarrell1

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

https://www.huffingtonpost.com/entry/heroin-treatment-handcuffed-to-addiction_us_5a06fc88e4b0cc46c52e6ac7?utm_hp_ref=drug-abuse

KILLER ADDICTION

Posted on: November 6th, 2017 by sobrietyresources

What is Tramadol, what are the side effects, is it banned anywhere apart from Egypt and how easy is it to become addicted?

The strong painkiller is often prescribed to patients who are suffering extreme discomfort after surgery and injury

By Jennifer Newton

TRAMADOL is the strong painkiller that can only be prescribed by a doctor to people suffering severe pain.

Here’s all you need to know about the drug that TV star Ant McPartlin says he became addicted to after knee surgery.

What is Tramadol?

Tramadol is an extremely strong painkiller given to patients who are in extreme discomfort when other traditional painkillers stop working.

It is available by prescription only and comes in tablet, capsule and liquid drops that you swallow.

It works by stopping pain signals from travelling along the nerves to the brain to ease any discomfort a person might be feeling.

Tramadol is quite often given to patients who might be in pain after major surgery or to people who have long-term conditions such as arthritis.

Is Tramadol banned anywhere?

Tramadol is available on prescription in the UK, but some countries have strict laws regarding the drug.

Customs officials in countries such as Egypt are extremely hot on any drug that has been derived from opium poppies.

Brit holidaymaker Laura Plummer, 33, was this week left fearing the death penalty in Egypt for carrying the painkillers with a “street value” of £23.

The Foreign Office says: “Some prescribed and over-the-counter medicines that are available in the UK are considered controlled substances in Egypt and can’t be brought into the country without prior permission from Egypt’s Ministry of Health.

“If you arrive in Egypt without this permission and the required documentation, the medication will not be allowed into the country and you may be prosecuted.”

Other countries that take a hard line on drugs such as Tramadol and codeine include Dubai, Abu Dhabi and elsewhere in the UAE.

Thailand requires travellers to carry a permit for any of their personal medications and those visiting Canada and Vietnam are also advised to carry a letter from their GP listing any prescribed medicines, as well as their dosage.

What are the side effects of taking Tramadol?

Even though Tramadol is a very effective painkiller, like all drugs, there can be side effects to taking it.

Common side effects that aren’t much of a cause for concern include nausea, vomiting, dizziness, drowsiness, constipation and a dry mouth.

However, some people suffer more serious issues that are linked to taking Tramadol.

These include itching, rashes and a swelling of the face, lips, tongue and throat.

Some people have reported have difficulty breathing and their asthma becoming worse as a result of taking the drug.

Other reported side effects have included a sudden fast heartbeat, heart palpitations, muscles spasms and even feelings of anxiety.

How easy is it to become addicted to Tramadol?

As long as you take Tramadol in the doses your doctor recommends, it is unlikely that you will be become addicted.

However, it can be a highly addictive, as people who are in pain can develop a dependency on the drug to relieve them of their symptoms.

This can be the case if they have been taking Tramadol over a long period of time.

TV presenter Ant McPartlin recently opened up about his Tramadol addiction after a two month stint in rehab.

He was prescribed the drug after having surgery to repair a knee injury he sustained while dancing on TV show Saturday Night Takeaway.

But he soon grew dependent on the painkiller before being given a more extreme drug by doctors.

TV host Richard Madeley has revealed he also took the same painkillers which led to Ant’s rehab stint but ended up flushing them down the toilet when he saw how addictive they were.

Can Tramadol be mixed with alcohol?

Patients who are prescribed Tramadol are advised that they should not drink alcohol while taking the drug.

But some people find that mixing the two increases the effect of Tramadol, which can put them at a greater risk of developing a dependency on it.

Mixing alcohol and Tramadol can also affect the central nervous system meaning that it decreases your motor co-ordination and mental alertness.

Taking both substances in large quantities can cause seizures, slowed heartbeat loss of consciousness and can even prove fatal.

https://www.thesun.co.uk/fabulous/4238419/tramadol-side-effects-addiction-law/

Recovery advocate Anita Devlin says President Trump ‘in denial’

Posted on: October 27th, 2017 by sobrietyresources

By David Heitz

Although First Lady Melania Trump may have stolen the show, President Trump declared the opioid epidemic “a public health emergency” on Thursday.

But will it really be enough to turn the tide and stop overdose deaths?

Here’s an even bigger question.

If resources weren’t an issue, what’s the single biggest thing we could do, as a country, and as individuals, to deal deadly opioids a decisive blow and liberate its victims once and for all?

The answer probably has less to do with financial resources and more to do with intestinal fortitude.

For starters, everyone needs to speak up.

“My son became addicted to opioids when prescribed pain pills for a football injury.”

“My mom overdosed while taking my little sister to soccer practice last week.”

“My uncle went to prison for prescribing pain pills to people who didn’t need them.”

Just ask Anita Devlin, author of S.O.B.E.R., the no-words-minced story of a proud Greek family’s journey from addiction (and stigma) to recovery.

Why the delay, President Trump?

On Thursday, in an exclusive interview with SobrietyResources.org, she stated “people are ignorant” and the president is “in complete denial” over the opioid epidemic.

Devlin echoed the same sentiment as the tens of thousands of others who have lost loved ones to opioids: Why did it take 76 days for President Trump to follow through on a promise to declare an emergency?

In that amount of time, Devlin noted, more than 10,000 people in the U.S. died of opioid overdose. That’s using a widely held statistic of about 175 deaths per day, a statistic President Trump quoted Thursday.

“These are not addicts who are dying,” she said. “These are our sons and daughters who are dying.

“Addiction is an octopus. Anyone who is in denial and ignorant about the situation tearing through our country, killing our children, all they do, with their ignorance and denial, is feed and nurture this ugly octopus.

“Fearing what they don’t understand.

“Denial equals death, and it’s our children who are dying.”

The pillar of that denial for many of us is that we live in a nation where powerful corporations are able to break laws in ways that hurt us.

And just as the Department of Justice boldly moved at long last in 1999 to hold Big Tobacco accountable for the deaths of millions of Americans, as well as staggering healthcare costs, it probably will need to do so again with Big Pharma.

And in his speech on Thursday, President Trump hinted that may be coming.

The DOJ largely failed in its pursuit of the makers of the deadly tobacco plant, but individual states and private attorneys saw great success.

Lawyer who took on Big Tobacco now aiming legal artillery at Big Pharma

Clearly, there is such a thing as divine justice.

The name Mark Moore may sound familiar to you. He scored a credit in the movie “The Insider,” a movie about – you guessed it – whistleblowers in the tobacco insider.

Moore played himself in the movie. Moore is the lawyer, Mississippi’s attorney general at the time, who negotiated “the largest corporate legal settlement in U.S. history: a 50-state, $246 billion agreement that funds smoking cessation and prevention programs to this day,” to quote Bloomberg Businessweek. (1)

Moore is in the news again because now he’s taking on the opioid industry. It sure is bad luck for them that Moore found his nephew overdosed from opioids seven years ago, slouched down from overdose, wet vomit on his shirt.

But it was good luck for the nephew, who was saved by Moore, who is a father figure to the man.

In July, Moore met with a dozen top lawyers from around the country at the same Washington hotel where the quarter-of-a-trillion class-action lawsuit against Big Tobacco was born.

Reported Fortune late last month:

“Aided by the lawyers in the room (and others, including high-profile and high-profiting alumni of the tobacco wars, such as Joe Rice and Steve Berman), 10 states and dozens of cities and counties have sued companies including Purdue Pharma, Endo, and Johnson & Johnson’s Janssen Pharmaceuticals—beginning in 2014 but mostly in the past few months.

(Forty state AGs have launched preliminary investigations as a way to gauge the viability of litigation.) The suits allege that the companies triggered the opioid epidemic by minimizing the addiction and overdose risk of painkillers such as OxyContin, Percocet, and Duragesic. Opioids don’t just cause problems when they’re misused, the suits argue: They do so when used as directed, too.” (2)

Many municipalities already have taken aim at Pharma and its tentacle industries.

In a tiny town in West Virginia in June, mega-healthcare giant Cardinal Health, fingered in the 60 Minutes probe as being one of the most audacious violators of law, flew in top brass to “educate the (Mingo) County Commission.”

Fortune quoted attorney Ken Feinberg, who believes Pharma doesn’t have too much to worry about. Check out this incredibly rich prose:

“Even if the litigation is successful, what will you do with this money?” Feinberg asked.

He says giving it to surviving victims may be problematic, given their addictions.

As for paying for the nation’s crisis, well, the bill is just too big. Says Feinberg:

“I don’t think there’s enough money to cover it.”

How America won the tobacco war

But going back to the tobacco war, it may have taken half a century but it is being won.

Why has the war against cigarettes been successful? Every ugly aspect of smoking has thoroughly been exploited, and the educational campaign was paid for by Big Tobacco.

Along those lines, Devlin has a great idea. She is on the Board of Directors of a Foundation that will educate young people and communities about opioid addiction through music. She said musical artists are lining up to participate in a campaign to host sober concerts all over America.

The Foundation is called, “Above the Noise.”

You can bet that anything Anita Devlin is involved with likely won’t be sterile in its messaging. Her book, S.O.B.E.R., stands for “Son of a Bitch, Everything is Real,” after all.

Meanwhile, even Melania Trump is saying it: Stop the stigma.

“I have learned so much from those brave enough to talk about this epidemic, and I know there are so many more stories to tell,” Melania Trump explained in a lengthy introduction of her husband Thursday, which included a passionate description of her advocacy work for opioid-addicted children.

In the end, Trump’s order was not the “national emergency” type of declaration used for hurricanes and earthquakes, which would have made a lot of money available very quickly. But it will make money more quickly available in some ways, including getting telemedicine treatment to rural areas where clinicians are scarce.

You can check out USA Today’s exclusive report and live footage of the president’s speech by clicking here.

There never will be an “end” to opioid abuse even if overdoses were slashed by 90 percent. Once a genie is out of a bottle, the genie can fool the unsuspecting.

Is this really what an “emergency” designation is for, then? How can we recover from an ongoing crisis?

And is now really any time to be using natural disaster funds for things other than natural disasters?

The declaration may have been moot anyway in the long run. Facing stigma and addiction takes every person in every city in every town. Nobody can be forced to acknowledge this problem until they are dead or at a funeral.

But as the president’s approval ratings sink to a new low (38 percent) per Fox News on Thursday, he must face the people who elected him: The so-called ‘Opioid Belt,’ so desperate for hope that a populist message convinced them to vote for him. (3)

And he has let them down in a very big way, even if only in appearances.

Bibliography

Deprez, E. et al. (2017, Sept. 28). The lawyer who beat Big Tobacco takes on the opioid industry. Bloomberg Business Week. Retrieved Oct. 26, 2017, from https://www.bloomberg.com/news/features/2017-10-05/the-lawyer-who-beat-big-tobacco-takes-on-the-opioid-industry

Fry, E. (20176, Sept. 27). Big Pharma is getting hit with a huge wave of opioid suits. Fortune. Retrieved Oct. 26, 2017, from http://fortune.com/2017/09/27/big-pharma-opioid-lawsuits/

Fox News. (2017, Oct. 26). Storms erode Trump poll numbers. Retrieved Oct. 26, 2017, from http://www.foxnews.com/politics/2017/10/25/fox-news-poll-storms-erode-trumps-ratings.html