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

 

The Unwritten Rule Book

Once again I am making an attempt to 'blog'.  After all, it's only been a couple of years or so since the last post.  Since that time, many of my friends have encouraged me to do the thing which has served me well in some situations and maybe not so much in others.  Casey said I did too much of it and that's 'talk'.

So, to my followers, my apology for not 'talking to you' for quite some time.  It may be more than presumptuous of me to think that you are interested in what I may have to say.  However, for those who are, this is something that I have been mulling over for quite some time - the Unwritten Rule Book.

For a book of rules that is so illusive, it wields a tremendous amount of power and influence.  I've never seen this 'book' but have certainly been made aware of the 'rules' for families of addicted loved ones.  Here are some of which I have become painfully aware (not ranked according to importance, just as they come to mind):

1- If  the parent of a child is under the age of 18 who is sick makes sure they get the proper medical attention, he or she is a 'good and loving parent'.  Once they become "an adult", albeit one who has a brain disease called addiction, efforts to access the best care possible are 'co-dependent' and 'enabling' behaviors.

2 - If your loved one has the disease of addiction and they overdose, it's acceptable to reverse that overdose one time.  If they overdose after that, using Narcan (Naloxone), that is encouraging their drug use. 

3 - If the person who is addicted behaves in a manner that is dictated by their disease, discharging them from treatment is the remedy. 

4 - Since treatment for addiction is not always successful, it's a waste of time and money to provide access to it.

5 - Not everyone will survive the disease of addiction and we need to practice acceptance.

6 - It's acceptable for physicians to choose not to treat the disease of addiction. 

7 - What's the big deal?  Just arrest them! Punishment by incarceration is what's needed for this disease.  Once they have suffered enough consequences, they will "get it".

8 - The person must 'want' treatment.  Otherwise, it won't be successful.

9 - Loved ones try to intervene so 'they' will feel better.  It is of little or no benefit to the person who is addicted.

10 - Addiction is a choice.  If they "want" it bad enough, they will recover.

I never thought that Casey would die from a 'socially unacceptable' disease, a disease that is shrouded in myths/unwritten rules that continue to dictate the treatment available to a person who is addicted.  All other chronic illnesses have an established standard of care that promotes health and healing.  Addiction on the other hand is defined as a disease and treated as a crime. Where does our hope lie for a paradigm shift?  I believe it will come from families like ours, families like the ones who changed the attitudes and perceptions about AIDS or like the efforts of MADD.  

I hope that one day we will look back with wonder and amazement at how far we have come in advancing the science of addiction and erasing the stigma, the stigma that must have been a contributor to The Unwritten Rule Book. 

Until next time. . .

Peace,
Charlotte
Casey's mom