Tag Archives: addiction

Hillary Clinton, Heroin, and the Time to be Heard

Three weeks ago, Hillary Clinton’s health-policy advisor called me to discuss the opiate epidemic, its causes and what could be done about it.feed-image-1

The advisor said she was reading my book, Dreamland, and that Mrs. Clinton had read my NY Times op-ed column of April 19 about the issue.

The advisor told me Mrs. Clinton had been hearing a lot of very passionate comments from parents with addicted children as she campaigned in Iowa and New Hampshire.

We spent an hour on the phone, talking about policy, about pain pills, pill mills, Mexican heroin trafficking, and about the quiet surrounding this epidemic that had allowed it to spread.

So I’m glad to see that Mrs. Clinton is now coming up with policy proposals to address it, one of which is to begin talking about it and end the stigma and silence surrounding addiction.

This epidemic is neither a red nor a blue issue. Thus I hope candidates from both parties will respond as well. I’ll be happy to chat with them, if they want to call.

I’d hope, moreover, they would focus not only on heroin, but on the broader problem of overprescribing of opiate painkillers, which so often provide the gateway to heroin. (Pain pills have their legitimate role in medicine, but too often are massively and unnecessarily prescribed.)

But there’s another important point in this. I believe parents of addicted children need to use this approaching presidential campaign as a way of magnifying their voices.

As a longtime journalist, I know that the most poignant stories are the ones that can have the most impact. Sadly, many parents up to now have kept silent, ashamed or simply worn out by their children’s addiction.

That is changing. More are stepping forward, as Mrs. Clinton was hearing on the campaign. Some are mentioning heroin overdose as a cause of death in their children’s obituaries – an act of enormous, and necessary, courage.

But these stories are still not being heard the way they need to be.

During past drug scourges, public violence aroused public ire. The crack years, for example, saw drive-by shootings and carjackings. I was a crime reporter during those years and saw this first hand.

None of that public violence has happened during this epidemic. So the job of arousing public attention falls almost entirely to parents.

I believe this presidential campaign offers an opportunity to be heard, to magnify voices. Make opiate abuse (pain pills and heroin) and overprescribing a point of presidential debate.

To do that, parents in particular need to step forward and tell their stories the way no one else can.

Photo: Hillary For President website

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Remembering Dreamland: One woman’s story

 Some people think that my use of Dreamland as the title to my book refers to the euphoria addicts are seeking.Dreamland-HCBig
    In reality, the title refers to an enormous pool that existed years ago in Portsmouth, Ohio, a town mightily afflicted by opiate addiction. Dreamland was the town square, in a sense. Life revolved around it. Kids grew up in public, under the watchful eye of hundreds of parents. It was a place where everyone was equal in bathing suits. The pool embodied the feel of community.
    I’m still awed by the letters I continue to get in response to the book. Here’s another …

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    I grew up in Portsmouth, born in 1952.  It was a safe blessed time in post war America.  I had 6 cousins in my Catholic school class, picnics with the families on weekends, a perfect childhood of Dreamland every summer day, walking home from school with friends each fall, enduring the brief winter to count the days until Dreamland reopened.
     I left after high school and did college at Ohio Wesleyan where my husband and I met. We moved to PA and I did law school as my husband served the United Methodist churches of Central PA.  We made semi-annual trips to Portsmouth with our three children to see family.  Each time we went, the town was more depressing.  Family members became drug addicts.  We were stolen from at my mothers funeral.  I rescued my dad from a nursing home where the facility clearly had users on staff.  This was in 2013.  He was not safe in his own home due to a family member selling drugs right under my IMG_4147dad’s nose.
     He died in 2014, in PA, after having lived 92 years in Portsmouth.  He knew Branch Rickey, Rocky Nelson, and the great years of Portsmouth.  4 of his six brothers served our country; my dad was deferred due to problems after having polio and rheumatic fever.  I have Ohio River blood in my veins.
    Thank you for making me understand a bit more that the addictions which decimated my family were not totally their fault.  I worked 35 years as an attorney in health care law and  I knew the power of the pharmaceutical companies and the collision of profit in healthcare.
    If you would like to take on another pharmaceutical issue in the future, let me suggest Lyrica. It was presented as the holy grail for nerve pain.  I am no longer practicing law as I had to quit due to seizures after using Lyrica.    Facebook even has a Lyrica survivors page of which I am a member.  It is another sad tail of “big pharma” all over again.
    Thank you again for your wonderful work of Dreamland.
Barbara G. Graybill

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Dreamland: A Mother’s Story

I’ve been getting amazing, intense email letters in the two weeks since Dreamland was released. I hope to be adding some of them to my blog. Here’s one.

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I almost lost my beloved 23-year-old son (he is now 26) to heroin addiction, which had progressed from OxyContin to black tar heroin.  We are a family of hard working professionals in a university town.

Like most families, we cherish our kids and do everything we can to help then live an honest successful life. When this happened, my son was a pre-med college student. I was and am very close to him, and he had always been a very good Dreamland-HCBigstudent and loving son and brother. He was kind, funny, highly gifted, devoted to music and passionate about becoming a doctor.   He was also prone to depression at times.

When I found out, he was in his 4th year of college, and getting As and Bs in hard science courses such as organic chemistry, but could not seem to manage on his college budget. He kept running out of money.  He started having vague physical symptoms, like constipation, malaise and abdominal discomfort. His grades in his last year of college started to slip.  At Christmas, we visited my sister’s family in Midwestern farm country. Later, my sister, bless her heart, confided in me that her Oxy pills that had been prescribed for shingles had disappeared from her medicine cabinet when we were staying with her. She was reluctant to tell me as she did not want to make anyone uncomfortable or blame anyone. I am so very grateful that she told me this.

I immediately put together that my son had stolen the pills and had a life-threatening problem. I knew it in my gut to be true beyond any doubt. Perhaps because I am a child of the 60s and knew too many friends who were lost to drug addiction: classmates who were drafted and came back from Vietnam addicted to heroin, and 2 college roommates who went to federal prison for smuggling cocaine as an airline stewardesses.  We also have a family history of alcohol abuse and addiction, which my mom told me way too many times.

I freaked out! I knew that he had to be addicted to do something so desperate as steal my sister’s pills. This explained everything – his money problems, dropping grades, and vague feelings of being sick.  I could not sleep for fear he would soon be dead. I confronted him in tears and said I knew he had stolen the Oxy. He of course denied it, but finally admitted he had stolen the pills. He admitted he was addicted to Oxy pills, which he had started using after being given a script for narcotic pills after a foot laceration.

I immediately called an addiction doctor I know and, in tears and panicking, offered to pay her anything if she could please help save my son.  She drove in from out of town and (at a high hourly rate) met with him and helped him realize he was an addict. She personally went with him to an NA meeting (she is a former cocaine addict and involved in NA). I would have paid anything for any chance to save him.

He went to the NA meeting and started to see addiction therapists, which we paid for, but he remained in denial. He kept saying it wasn’t a big deal and he could kick the habit. He went to some NA sessions, but over the course of 18 months he relapsed 3 times, each time worse than the last. During one of the relapses, he called his father to say goodbye after injecting what he thought was a fatal suicidal dose of black tar heroin in his arm. He had started getting the heroin from a “friend” – a former college football player who had been selling him Oxy and was now selling him heroin once he could no longer afford the street price of Oxy.

His father found him in his apartment unresponsive, but he survived.  He was so ashamed that he could not defeat the problem that he said he couldn’t live with the shame and did not find life worth living. We did family interventions and told him we would not give up on him and brought him to more therapists.

He almost died three more times. After the first relapse, I demanded to know his dealer’s name as I wanted to kill him.  I traced his phone calls (I was paying for his cell phone) and had repetitive thoughts about killing the demon who sold him the drugs and taught him to inject heroin.  I wasn’t sure how I could go on living if I lost him.

When using, he would not see me as he knew that I would know if he was using. So he moved to LA and declined rapidly.  His father went to see him and told me that I should go visit him, as he would not be alive long.  I did. He looked like a skeleton. He was taking Suboxone, as well as additional narcotics and probably other drugs.   I kept saying that I would pay for any addiction therapy he could find, but would never give up on him and not give a penny to his habit. My life was hell.

Thank God, he found an addiction therapist in LA (a former Vietnam vet heroin addict) who he really connected with. He started seeing this therapist while still using.  I got a “call” (God how we fear those calls!), but it was not that he had died. It was that he had voluntarily decided to go into “long term” drug rehab.  We found an inpatient facility in Utah that the addiction specialist recommended. I knew the enslaving power of heroin addiction and how statistically unlikely it was that he would voluntarily say goodbye to heroin.

I don’t know how he had the strength, but he got on the plane, flew to the University of Utah hospital where he admitted himself into the psych unit for several days of detox. He then voluntarily admitted himself into a Utah inpatient facility for 30 days, then into 90 days sober living, and then underwent 18 more months of therapy and voluntary monitored UAs.

My son is now 35 months completely clean, and is in medical school. He keeps track of every single day he is sober. He says that every day remains hard work. BUT, he has done the work and gotten his life back. He started exercising, working and studying steadily. He took premed courses and passed grueling medical school exams.

My son is now successfully finishing his first year of medical school.  He wants to be an addiction doctor and find a way to help others survive this hell.

I still worry about him every day.  But we cannot talk about this, as most people do not feel comfortable with the topic. I also need to not jeopardize my son’s career. He tells some people and is doing an internship this summer at rehabilitation clinic. He was open with them when he applied for the position.  He answers all questions honestly, but does not bring the topic up with others unless they are very close friends.

I have read every book about addiction that I can get my hands on, and some are excellent, such as “Beautiful Boy.”  But no other book so skillfully and adeptly addresses this huge crisis like yours, nor does any other book touch me in terms of what I have lived with like your book.

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Xalisco Boys – now in northern Ohio

In case anyone thought the Xalisco Boys – the heroin traffickers from Xalisco, Nayarit, which I write about in Dreamland — were an old Screen Shot 2015-05-03 at 3.33.02 PMstory, there’s this recent bust from the Cleveland and northern Ohio areas.

The interesting part of this story is that they have apparently moved into the Cleveland market. I know they’re in Columbus, Nashville and Memphis, Indianapolis and elsewhere.

Until recently, apparently, they hadn’t made a move into northern Ohio, which seemed too close to Detroit, another heroin hotspot.

But things change in the underworld, particularly as the Xalisco Boys (delivering black-tar heroin like pizza with drivers and operators standing by) work like a lot of corporations in that they’re always competing with each other and seeking new sales territories.

Never ceases to amaze me how this system evolved and spread like a fast-food franchise – gaining special momentum after it arrived in 1998 in midwestern and Appalachian areas where pain pills were just then being massively over-prescribed.

That was the first example of a heroin distribution system discovering the market inherent in pain-pill overprescribing.

Here goes some of the above cited newspaper story:

“This group utilized numerous men to act as couriers to deliver the heroin to customers. Many of these couriers were brought illegally to the United States from the Nayarit/Tepic area of Mexico to the Painesville area with the promise of working on a farm or in an automobile garage. Once in Ohio, these individuals became couriers for the drug trafficking group, according to court documents and the FBI.”

Tepic is the capital of the state of Nayarit, which is on Mexico’s Pacific Coast. Tepic is a few miles from Xalisco, where this system started and where the guys who started the system are from.

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Another Family Steps Up – D.J. Wolanski RIP

Another family has stepped up to acknowledge in an obituary that a child has died of a heroin overdose.4318752_300x300_1

Daniel Joseph “DJ” Wolanski, of Mahoning County in Ohio, died April 20. Read his obituary.

It must be so difficult for this family to come forward and say this publicly. But this scourge has spread because so many people before them have kept quiet, allowing the rest of us to imagine that the problem really isn’t as bad as it has become.

So it’s important to acknowledge the courage of those who do step up, speak publicly.

The obituary reads….

“Over the course of DJ’s life, he made many bad decisions including experimenting with drugs. Unfortunately, his five year addiction and battle with heroin took over. His family and friends truly loved him and tried everything from being supportive to tough love as he struggled with his own inner demons and heroin. …

“DJ often talked about the growing number of friends that he had lost to this destructive drug and how it destroyed families. They used to say it takes a community to raise a child. Today, we need to say that it takes a community to battle addiction. Someone you know is battling addiction; if your “gut instinct” says something is wrong, it most likely is. Get involved. Do everything within your power to provide help. Don’t believe the logical sounding reasons of where their money is going or why they act so different. Don’t believe them when they say they’re clean.”

Profound words – the way to attack a drug that turns every addict into a silo, a loner wrapped in a cocoon – is through community.

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Why Pain Pill Addiction? One Nurse’s View

I’m on tour to promote Dreamland, and along the way I’ve have had conversations with parents of addicts, doctors, public health employees, and the public in general.

Often the conversation revolves around why this is a problem, and why it continues to be — if we see that massive Dreamland-HCBigprescribing of pain medication has clearly led to heroin addiction.

This letter from a nurse practitioner at a chronic-pain clinic in a  mid-sized town in the western United States helps explain.

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The clinic I work at has a reputation for liberal opioid/opiate prescribing and there is a culture of  dependency and codependency that has been instilled by the owner. Prior to coming to this clinic I worked in a psych and drug rehab hospital in a rural part of the United States for five years. I saw all the patients that became addicted first by pain medication or other means. It is a struggle for me everyday to know that I now contribute to this problem.

Every day I try to have the conversation with patients on what it would be like to get off the medication. Most patients tell me no one has ever had that conversation with them. It makes it that more difficult because then I look like the jerk that wants them off their meds when every provider before me told them they would be on pain medication their entire life.

I have developed a reputation as being a terrible provider by many of the clinic’s patients. The front desk asks my medical assistants what it is like working with me since all they hear is terrible things about me.

Many people talk about going after to the doctors to stop this opioid epidemic. The problems I see are patients with terrible insurance that doesn’t cover comprehensive pain management. What I am stuck with is a person with limited resources and a 20-minute appointment and sometimes all I have left is medication. Most of my patients get upset with me, and laugh when I give them breathing exercises to perform.

I don’t start many people on pain medication but I have kept many people on medications that I sometimes don’t feel comfortable prescribing. I go out of my way to try to find alternatives to pain medication for my patients. My hope is that one day pain management is taken out of primary care completely. Pain is too complex to dealt with in a 20-minute appointment.

The other issue is patient satisfaction. That is a huge issue in emergency departments. I have spoken with many ER docs and it seems a lot of the care is driven by customer satisfaction. Doctors fear bad reviews from patients. I think this drives a lot of the pain medication prescriptions in EDs. Because of this, I have seen some of my patients get opioid/opiate prescriptions for relatively minor medical issues.

I have found some positives. Most patients I discharge for multiple violations of their medication agreements never come back. The ones that do often turn out to be my favorite patients. When I don’t worry about prescribing controlled substances with patients then we often get to work on lifestyle changes like better management of their chronic conditions or quitting smoking.

Anyways… I probably have a lot more to say but that seems like enough. Thank you for your time.

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The Normalcy of Addiction

I’m in Little Rock for the Arkansas Literary Festival, a very nice book festival held downtown.Dreamland-HCBig

So here’s what happened yesterday. Flew in, met my fellow panelists, learned that Southwest lost my bag, went to the hotel, took a quick nap, went to a festival reception, met someone with an opiate addict in the family (the family member is a woman in her 60s or so).

Little Rock is no different from every other part of the country I’ve visited recently.

Researching our national addiction to pain pills and heroin to write my book, Dreamland, I’ve been struck by the normalcy of addiction nowadays. Everywhere, strike up a conversation, you find someone with a family member or friend or co-worker addicted to opiates.

It’s far more prevalent than crack use was, I believe, and certainly infinitely more deadly.

I remember starting the research, flying to Dallas a couple years ago. On the plane was an elderly couple from rural Oklahoma. We got to talking and before long, they were telling me of their oldest son, addicted to OxyContin.

Not long after that, in a tavern on New Year’s Day in Covington, KY, I met a family, celebrating a young girl’s birthday. Before long, we’re talking about two people in that extended family dead from heroin overdoses.

There are many reasons why this is so.

First: the massive over-prescribing of pain pills nationwide. We often debate whether supply or demand drives drug plagues. This one is supply driven. Pain pills eventually lead to heroin addiction – as the pills are molecularly similar to heroin and much cheaper; in some areas, like those serviced by the Xalisco Boys I write about in Dreamland, heroin is easier and more convenient to obtain the pills.

But this is also driven by silence. There’s no violence to fuel public ire. Meanwhile, though, parents are loathe to talk about their children’s addiction. When they die, they camouflage it in some palatable cause of death. Some parents are going public. But far too few given the huge numbers.

The result is silence, and stories you never hear until you’re sitting next to someone on a plane, or chatting with them at a cocktail party.

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DONE!!!!!

After many many months of traveling the country, reporting, interviewing, of writing and rewriting and more rewriting, I just turned in the manuscript to my book about the country’s epidemic of pill and heroin abuse.

YAAAAAHHHH!

It’s called DREAMLAND: The True Tale of America’s IMG_0638Opiate Epidemic.

120,000 words.

Comes out in April, Bloomsbury Press.

I’m still walking around in a daze.

Writing a book is a process of discovery, I found again to my delight.

This is my third book. It started out very differently than it ended up.

Quite unexpectedly, it became a tale about the country, where we are as America and Americans, about rural America, the Rust Belt and the country’s nicest suburbs, about what excess will do, and the value of community. About what we lose when we undermine that which gives us community.

None of that should have surprised me, because unlike previous drug scourges this one has permeated virtually the entire country – or at least all of white America.

The story’s about drug marketing, and about our belief that we are entitled to feel no pain.

It’s also about Mexico, and the Mexican town that has devised a system for selling heroin like pizza. Making heroin convenient, and cheap and potent, as well.

On one level, the story’s about Mexican drug trafficking, but it’s probably as much about the impulse behind immigration, andIMG_0546 the Mexican village, and envy and desire.

I didn’t start out thinking that parents of addicted kids would be  part of the mix. But if you keep your mind open, new directions present themselves. So they are now. I love this about journalism.

I belong now to a Facebook site called The Addict’s Mom, where parents write in daily about their addicted kids. So many have died recently. So many people are wrapped up in addiction or the addiction of their children.

It’s amazing that it’s so quiet, because this is happening everywhere.

Given how hard this dope is to kick, it’s going to be with us for a long long time.

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Dispatches from the frontlines of America’s addiction

The Addict's MomAs I’ve spent the last year-plus writing a book about the opiate abuse epidemic in America, I’ve come across some remarkable people in times of frightening stress.

Along the way I encountered one of the most poignant pages on FB. It’s called The Addict’s Mom, run by Barbara Theodosiou, a Florida PR consultant and mother of two addicts, one in recovery and one in jail. She set up the site a few years ago feeling that no one could understand her but another mother of an addict.

The site now has 12,000 members. They are American mothers who write in the rawest, most honest terms about the arguments, jail, kids who lie and steal from grandparents, prison, their children homeless, raising their children’s children, mortgaging all they own to send their kids to $40,000 rehabs, the joy of seeing a child 200 days clean, and the terror of the late-night phone call, or policeman’s knock on the door.

I hope to be quoting some of these posts, without names, simply because they, like poetry, evoke stories you can imagine in full. (Note: AS=Addicted Son.) Here’s one that I’ve broken out from the original prose into verse:

I have found myself planning my AS’s funeral in my mind.

Recently I have even found myself praying for God to at least take one of us because the pain is just too much.

And then I step back and ask myself what kind of mother could pray for death for one of her own children !?!

I feel horrible even putting these words on paper but i just need to let it out.

I am tired of fighting this fight.

I am tired of seeing my only son destroy himself.

I am tired of all the arguments with him.

I am tired of living with fear of getting that ‘phone call’.

I just don’t know how much longer he can survive at the rate he is using .

 

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Candace Pert dies; discovered opiate receptor

 

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I did not know about Candace Pert until I read that she had died in this great obituary by Tom Maugh in the LA Times.

Pert explained why humans get addicted to opiates.

She discovered the receptor in the human body to which opiates attach, fitting like a hand in a glove and allowing both for the calming of pain and the addiction to the substance produced by the opium poppy.

Her research and discoveries have never been more timely than they are today, amid a nationwide opiate epidemic.

Great quote from the story: “God presumably did not put an opiate receptor in our brains so that we could ultimately discover how to get high with opium,” Pert told Smithsonian magazine.

Still it was others who discovered the reason for the receptors: substances produced naturally by the human body — endorphins — that reduce pain and produce euphoria when they attach to the receptors.

Utterly fascinating, I think, that one plant, alone in all that we know of nature, produces a molecule that fits so perfectly onto this receptor in humans.

For this reason, one unseen particle, the morphine molecule, produces both heaven and hell — the most merciful pain relief and most harrowing enslavement — in the planet’s dominant mammal.

We are seeing the effects of this all across the United States, from rural America to the wealthiest suburbs.

It appears from Maugh’s obituary that Pert was largely blunted in her research by male researchers above her, then had most of the recognition usurped by those same men.

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Heroin is Marion’s Economy

IMG_4034 Well, I’m not gonna lie — I like this guy’s style.

Brad Belcher was upset that people in his hometown of Marion, Ohio (north of Columbus) weren’t talking about the rampant heroin/opiate addiction in their midst.

Home to President Warren G. Harding, the rural town of Marion, like much of Ohio, has been hammered by departing jobs and a general malaise of defeatism and inertia, Belcher told me.

Heroin (in the form of courts, jail, the underground economy, etc) has taken the place in the economy of a lot of manufacturing and other businesses that for decades kept the town tight and townspeople concerned for each other. (Marion was once home to Marion Power Shovel, which once employed 3200 people making earth moving and mining equipment. It closed in the late 1990s.)

Now people were dying. Dope was everywhere.

IMG_4060 (1)So to ignite discussion about all this, Belcher printed 800 signs and late one night put them up all over town: in front of Walgreens, outside cornfields, in the wealthy neighborhoods, along the retails strips.

He was caught in the act by three officers of the law just as he was about to put them around city hall and downtown.

They took down most of the signs, but his little bit of guerrilla political theater — a la Abbie Hoffman — was taken up online and in social media.

Belcher, a former addict himself, became a cause celebre.

The signs made the topic okay to talk about, he says. Before people were mortified to admit they had addicts in their families.

The town, he says, is now at least attending to the problem it avoided. Churches are involved. Local folks recently organized a heroin march. The cops arrest more heroin dealers than ever before. People talk openly about what they once kept silent. But the town doesn’t have any drug treatment facilities — besides its jail, that is, which serves as de facto center for detoxifying from heroin.

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