A Sobering Thought

It is so easy to fall prey to thinking that everyone understands addiction, at least to the extent that it can be understood.  There is so much yet to be learned about this complicated brain disease.  

Thirteen years ago when I went to Frankfort, I assumed that the Legislators would be on the same page with me.  They were not even in the book much less on the page.  However, remarkably, a bill that presented a concept that had at one time been widely used was introduced in a different light and it passed!  Casey's Law became effective on July 13, 2004. 

On March 30, 2017, Senators unaware of Casey's Law refused to vote on House Bill 305 in part, thinking it was new legislation. Hard to believe?  Not really.  There are a lot of people in Kentucky who do not know of the existence of this law. 

Another problem with HB 305 was the issue of taking away a person's rights when they have not committed a crime because failure to comply with the court orders can result in some time in jail, not as punishment but only as a means of keeping the person safe until the process can move forward.   

The reality is that everyone using an illegal substance has committed a crime.  People driving drugged have committed a crime. Many, like Casey, are never incarcerated and ordered to treatment, dying before their arrest. Casey's Law is the intervention that can come before the crime and an untimely death.  It is a law that uses incarceration as 'the hammer' that can keep a person in treatment long enough for the brain to begin healing and recovery to begin.  Jail is only a stop gap, a safety net, NOT a punishment accompanied by criminal charges.  A big difference from the involuntary commitment laws of the past.

So, here we are thirteen years later and the issue of rights still overrides the fact that a person who suffers from this brain disease has lost the ability to make good choices. Without an intervention, the options will be jail or death. It is shocking and scary to think that in the epidemic we are trying to survive, the issue of rights still reigns, and the scientific facts about this brain disease called addiction are frightfully lacking. 

What is really scary is that IF this bill had been new legislation, it would not have passed.  Think about that for a minute.  So, IF there were not already a Casey's Law and this had been new legislation, there would not be a Casey's Law today.

Now that's a sobering thought!

Until next time. . .

Peace,

Charlotte

Casey's mom and Recovery Advocate

Wake Up Call - It's not over!

I woke up this morning thinking about yesterday and the incredible response from supporters of the bill containing amendments to Casey's Law.  I will forever be grateful for all of the calls and emails in support of HB 305 and for the words of encouragement after it was killed in the Senate.   

At the same time, there was another thought that crossed my mind. Today, is the perfect opportunity to express disappointment about the lack of action on HB 305 and ask the hard questions about why it was set aside.

The issue of taking away a person's rights seems to have been one of the issues that was a problem for the Senate Leadership responsible for deciding what bills are reported for a vote.  So, this morning let's think about rights, your rights.

You have the right to talk to your legislators about what is important to you.  Otherwise, you cannot expect them to know, especially not to know about the disease of addiction and how it effects your family.  Make no mistake!  As much reporting as there has been about the drug epidemic, understanding of addiction is found lacking.  If this is important to you, let  your legislators know it.  All of the contact information that you need can be found at www.lrc.ky.gov

You have the right to advocate for your loved ones as you would if they had any other chronic, progressive, potentially fatal illness. That means on every level not just in state government.  Do not give that right away to others who would have you believe that your relationship is altered or worse, obliterated when a person becomes a certain age.  When does your son stop being your son, your daughter stop being your daughter, your mother stop being your mother, your father stop being your father, and so on.  You get the picture.  

AND you have the right to cast your vote for legislators who act on your behalf, who are educated about addiction and make their decisions based on that knowledge rather than on personal opinions about people who have this disease.

Recovery advocacy happens all year long, not just in the 30 or 60 days that the Legislature is in session.  You have the opportunity today and every day to get in touch with your State Representative and Senator.  Get to know your legislators and let them get to know you.  It's by your vote that they have the right to serve in this critically important decision-making position for YOU and the people you love and care about.  This is not only regret about HB 305. Regardless of what the bill related to addiction, legislators will be more likely to vote your voice if they have heard your voice.  

Until next time. . . .

Peace,

Charlotte

Casey's mom and Recovery Advocate

What's the connection between tainted cucumbers and heroin addiction you may ask - Read on for my take on it. . .


"Salmonella outbreak linked to cucumbers from Mexico sickens hundreds" this was the headline on September 4th.  That is when Fox 31 in Denver also reported a statement from Cara Christ, director of the Arizona Department of Health Services saying “State and local health departments have been working around the clock with federal partners to rapidly identify the source of this outbreak so we can inform the public.” 


Last week while watching the national news, there was an update reporting that 3 had died and over 300 in 30 states had become ill from this "salmonella outbreak".   That's when I knew this had to be my next blog.  Here's how I see it:


For years, another product of Mexico has been poisoning people in our country, namely heroin. 


Nationally, fatal overdoses are occurring at the rate of 1 every 4 minutes.  That translates into more than 350 people a day.  Do we ever hear that statistic?


If there have been "federal partners working around the clock with our state and local health departments to "rapidly identify the source of the heroin into this country so the public can be informed", I must have missed that announcement!


How is it possible that salmonella linked to cucumbers from Mexico gets national attention when people are dying at an alarming rate from the heroin that's coming from the same state!!  How does that happen? 


Are the deaths and illness from the salmonella worth reporting?  Absolutely.  More than heroin addiction?  I think not!  This public health issue demands at the very least equal media exposure and the same kind of "rapid" response on the federal, state and local levels.


That's why the rally in DC on October 4th is vitally important.  The Unite to Face Addiction Rally on that day is to bring attention to the need for immediate attention to this disease and make it "The Day the Silence Ends".  The silence that surrounds this disease is deafening and deadly.  Let's stand up and speak out and "unite to face addiction".  For more information on the rally, visit: https://www.facingaddiction.org


In case you are interested in learning more about how heroin has gotten into this country, go to Dreamland  by Sam Quinones.


This has been some 'food' for thought, pun intended!


Until next time. . .


Peace,
Charlotte


  

The Beginning of the End

Thirteen years ago today, Casey overdosed for the third and final time.  It would be the beginning of the end, the first of ten days that he lay in a coma before we had to let him go.   This time would be different from the others, he wouldn't walk out this time.  There would be no more chances for recovery. 


It has only been in the last couple of years, while listening to a presentation for nurses and other health professionals, that I heard of just how many Kentuckians overdosed that same year and at the same hospital as Casey.   The presentation included a slide of data from University Hospital of patients with Kentucky zip codes presenting with an overdose from 2000 to 2011 or 12.  While the audience was focusing on the top of the chart, my eyes zeroed in on 2002, the year that Casey was one of those statistics.   It was surprising to most that the number of overdoses in 2002 exceeded the number at the top by approximately 1,000. 


I thought that one of those more than 5,000 overdoses in 2002 was enough, enough because that one was my son, Casey. 


Since Casey's death, my thoughts have often been a series of "what ifs".  Today, I can't help but think   "what if",  wondering whether or not we would be living the nightmare of this heroin epidemic, if people had paid attention 13 years ago!  We'll never know.  Tragically, most were in denial, believing that heroin would never touch their loved ones and fearing that if it were acknowledged that it would.  Even without the acknowledgement and  in fact, because of it, more families are in the club that no one wants to join.


Those who have the ability to be optimistic in the face of such devastation would say that we are at the 'tipping point'.  On my best days, I would agree.  On days when one call after another is one of desperation and hopelessness, I have my doubts.


What I do know is that while resources are still limited and a standard of care is in the early stages of development, the disease of addiction in general and heroin in particular demands attention. 


It's also blatantly obvious that we are not where we were and closer to where we hope to be.  Hopefully,  progress will continue so that 13 years from now we will not be looking back wistfully at what might have been but rather celebrating what is. 


In the meantime, perhaps, just perhaps, through our collective efforts, this will again be the beginning of the end, the end of the tragic results of this devastating epidemic and the beginning of affordable, accessible and available evidence-based care for the treatment and recovery of our loved ones.


Until next time. . .


Peace,
Charlotte
Casey's mom

Who Failed Richard Bragg II?

That’s the question being asked by the people who knew him and perhaps even more by those who didn’t, people like my friend and fellow advocate who has taken it upon herself to make sure that his body does not remain unclaimed.   Kim, a total stranger who cared simply because he was another human being who deserved to “be claimed”, reminds us that, as in the Legend of the Starfish, “each one matters”.   Her compassionate response to the death of this young man demonstrates how everyone has someone who cares about them.  However, an opinion still held by some is that people who die from addiction are “those people” who have no one who loves and cares about them and that society will just be that much better off if they die.  Not so.  Thank you, Kim, for contradicting this stereotypical view and reminding us of our humanity.

In the process of making arrangements for a memorial, some tragic information has been revealed.  Richard had a heroin addiction that, according to a friend, he longed to recover from so that he could be a father to his children.  Like so many others, his disease resulted in multiple arrests and incarcerations.  There were 15 that were found.  That means there were at least 15 opportunities for him to get treatment for the disease that was killing him.  Fifteen times there could have been an intervention to redirect the life of Richard Bragg, 15 times that he could have been offered hope for recovery and instead was given another opportunity to continue in his disease.  Fifteen missed opportunities!   If there remains any doubt about incarceration not being treatment and that we cannot incarcerate ourselves out of the problem, Richard Bragg is the tragic proof!

So, who failed Richard Bragg?  Could it be a system that was never created or designed to treat a chronic, progressive, potentially fatal illness?   Why was this system ever expected to treat addiction?  Could it be because there has never been a standard of care for this chronic illness?  Could the reason for that be our archenemy, 'Stigma' and the accomplice 'Discrimination'?   Who can help rid society of these devastating and deadly detriments to recovery?  All of us! 

What have we learned from Richard’s death?  I hope that his death sounds the alarm yet again of the importance of intervention on this disease for whomever, wherever and whenever possible.  Why?  Because each one does matter and it truly is a matter of life and death.  

Thank you, Richard, for reminding us of the work that still needs to be done and for giving us the inspiration to continue doing it.

 

National Rx Drug Abuse Summit

Four years ago, I attended the first National Rx Drug Abuse Summit in Florida.  It was an exceptional opportunity to connect with others who are dedicated to prevention, treatment and recovery for the disease of addiction.  I met some incredible individuals at that conference and got reconnected with others.  This year I was again able to participate in the Summit, this time, as a presenter in the Education and Advocacy Track.  What an honor and privilege!  Once again, there was an invaluable networking opportunity and so much more. 


The Summit is more than the networking, gathering of information and caliber of speakers who present in the General and Breakout Sessions, it's the overall climate of the Summit.   For me, it's a time of renewal and rejuvenation being surrounded by like-minded people.  It's encouraging and hopeful to hear comments like this one, reportedly from former U.S. Representative Patrick Kennedy, "We know what to do.  We need the political will to do it".   Another striking quote was, "The death rate is a fact.  Everything else is an inference", attributed to William Farr.  And then there is always the amazing Dr. Nora Volkow who spoke in the General Session on Wednesday.  I heard her speak of the issue at hand as not being a "novel problem" and therefore there was a "recipe for forgetting".  She said that what is needed are "sustaining efforts".  In my estimation this speaks to the need for advocacy.  There is no doubt in my mind that it will be  advocates who have the passion, purpose and persistence who will be able to maintain the power and strength to "sustain" the efforts.  


This is a mere sampling of the content that was presented at the Summit.  While there will be something lost in translation by reading power points and possibly viewing a video, the website, www.nationalrxdrugabusesummit.org does allow for both.  If you have never had the opportunity of being at a conference where the disease of addiction is discussed in a spirit of hope for the future of prevention, treatment and recovery, I sincerely hope that it will soon be one of your memorable life experiences.


I will leave you with an incident that happened on my way from Atlanta to the next destination on our trip.  We had stopped for dinner and as I was cruising along the buffet line, I was touched on the shoulder by one of the servers who said, "I like your shirt".  This simple, yet greatly appreciated, compliment made what had been a very long day.  You see she was complimenting me on my Grateful Life Alumni Picnic t-shirt because of what was on the back of it, which reads: The mission of Transitions is to help individuals, families, and communities to break the cycles of substance abuse, family abuse, violence, crime and poverty. . .


This was yet another hopeful sign that society will one day value recovery, recovery from all kinds of ills.  I hope that I live to see that day. 


Until next time. . .


Peace,
Charlotte

Shame, Injustice Separate Addiction, Other Diseases

This was the title given to the Opinion article that was printed in The Enquirer on February 21st.  Due to space constraints my article was edited for the paper.  Below is the unedited  version that, while lengthy, echoes much of what was heard at the 2015 Regional Opiate Summit that was held yesterday and today.   Please consider responding to the 'Call to action' that is found at the end of the article.

Amidst the conversations about the heroin epidemic, there have been more than a few varying viewpoints.  Some have chosen to lay blame at the feet of our legislators for their inability to pass legislation in 2014.  Others have commented that this is a public health issue and belongs outside the realm of our legislative body.  How did it happen that the treatment of a chronic, relapsing brain disease was ever placed in the hands of lawmakers?  In order to have a comprehensive understanding of, among other related topics, the evolution of addiction treatment to criminalization of the disease, William L. White’s 390 full-page book might be a good place to start.  Slaying the Dragon, The History of Addiction Treatment and Recovery in America is the culmination of 10 years of extensive research conducted by this nationally recognized author and recovery advocate.   To sum up in this article his work on how the transition between these two paradigms occurred would not only be impossible, but presumptuous to even attempt such a feat.   So, let’s leave it to William L. White in some of his closing remarks,  “The meager results of our best efforts — along with our history of doing harm in the name of good — calls for us to approach each client, family and community with respect, humility, and a devotion to the ultimate principle of ethical practice, ‘First, do no harm’.”

Has the intention ever been to do harm?   No, it has been a matter of lack of education about the disease of addiction.  Why has there been such depravity?  That can be summed up in 3 words – shame, stigma and discrimination.  Those three words have deprived people who have this disease from accessing medical treatment for decades, or more accurately centuries.  The treatment that has been meted out is not based on research or best practices but rather on philosophical beliefs or prejudices about what is or is not appropriate for a person who is addicted, regardless of other mitigating factors.   No other disease, except perhaps mental illness, has endured such injustice.  Any other disease is treated according to what has been established as the best standard of care, care that is individualized.  People who have the disease of addiction have been mandated to the same treatment regardless of whether or not it is appropriate.   Then, if the treatment proves unsuccessful, somehow it becomes the failure of the person who received the treatment rather than those who failed to correctly assess that person’s needs and treat accordingly. 

What if other chronic illnesses were treated in such a system as we have created for addiction?  Dr. Tom McLellan poses a similar question, “Imagine if we began to treat diabetes in a system such as we have designed for addiction.”  (Dr. Tom McLellan: Addiction and Segregation)  

Conversely, imagine if we treated addiction in the same system of care as we have created for diabetes, or hypertension, or COPD, or cancer?  There would specialists knowledgeable about the disease and the treatment that would be most likely to restore health.   There would be not one specialist but several to choose from so that access would be more readily available.  Treatment would be individualized.  The patient would be deemed worthy of an appointment in a primary care setting prior to a crisis situation.  There would be follow up appointments and periodic assessments about whether or not the course of treatment was effective.   If in fact the treatment was not working, there would be adjustments made, not dismissal from treatment.  How long the treatment lasted would be determined by the physician and the patient rather than a third party who decides that time is up on a treatment even though the patient is recovering and could benefit from continued care.  Incarceration would not be a prerequisite for treatment because in this system the ambulance would be ‘parked at the top rather than the bottom of the cliff’. 

If there were new proven methods of treatment for any of these and other chronic diseases, would there be a moment’s hesitation in utilizing them?  However,   skepticism abounds when it comes to the treatment of addiction often veiled in an unwarranted reticence of acceptance based on opinion and not fact.  There have been many years of not knowing what best practices are for treating this disease.  We know more now.  When we know better, we can do better.    To do anything less is unethical.

What we know is that there are methods of treatment that work for many chronic illnesses, such as the disease of addiction.    To stop treating any illness, including addiction, because there is a casualty would be criminal.  For all other chronic illnesses, casualties serve to inform medical professionals about the efficacy of medications and the critical need for research and the possibility of improved treatment options.   The response would be life saving and life restoring rather than a moratorium on the value of treatment and the people who need it. 

Right now the Kentucky Legislature is in the midst of deliberations on the best way to address the heroin epidemic.   Now is the time to let your voice be heard.   Now is the time to advocate for your loved ones. Now is the time to let your legislators know that addiction needs and deserves to be treated as any other chronic, progressive potentially fatal illness. 

Your advocacy efforts can take many forms.    It can be done through the Kentucky Legislative website, www.lrc.ky.gov where legislators are listed according to counties and emails and addresses are available for letters.  A quick call can be made to the Legislative Toll-Free Message Line at 1-800-372-7181 where a courteous person will take your message and send it directly to the appropriate person or legislative body.   Put simply, advocacy is about talking – talking about this public health issue at every opportunity and making those opportunities often. 

Now is the time to break the silence, to stare down the shame, stigma and discrimination. 

Now is the time because by our silence, we will be defined and the epidemic will remain undefeated. 

Thank you for your advocacy,

Charlotte