Tag Archives: opioids

Living in the Aftershock of Someone Else’s Earthquake

Illustration by Zoe van Dijk

Ashley Abramson | Longreads | November 2017 | 16 minutes (3,939 words)

 

Springtime, just after my parents’ divorce: My dad had moved into a musty one-bedroom set in the corner of a cluster of white, rundown apartment buildings, the exact inverse of the impractical three-story he’d bought us just two years earlier after his promotion to district manager. My mom, who shuffled between jobs frequently, had been front desking at a doctor’s office in the next town over, down the street from the Tastee Freez. Que sera, sera, we would croon, our lips painted white with soft serve, whatever will be, will be. The two of us, singing, on either side of innocence.

The day my mom got busted at a pharmacy called Drug Town, I was 9, almost 10, the same age she was when the river swallowed her twin brother. I, too, would be devoured, inhaled by a force beyond my control. But that day, I was careless, browsing the drugstore’s collection of Easter candy while my mom picked up a prescription, one of the dozens of pills she took for reasons which, to that point, had remained just outside the confines of my life. She wasn’t yet sick enough for me to notice, or maybe she was, and I just hadn’t had a reason to peer beyond my love for her into her world, a place where she could do wrong. Not until that day.

First, two police officers, then me in the drug store’s break room, surrounded by teenage employees just old enough to understand what my mom had done and distract me with knick-knacks from the toy aisle. Still, I heard it from behind the closed door: My mom’s frantic bail phone call to my dad, his irate footsteps minutes later, her excuses in shards, the word “felony.” Que sera, sera. Her life and mine, slowly and suddenly eclipsed by her pills and whatever it took to get them. Whatever will be, will be.

And what, exactly was that day, but a mirror doing its job, reflecting back what had been true all along? On the surface, my mom, being accused again by my dad or someone more powerful than him. Below that, someone who had clearly done something wrong — broken the law — to get the thing she wanted. Another layer beneath that one: A woman who had been betrayed by her body. And at the core, the pain, always radiating, penetrating through, convincing us all that whatever she did wrong was just a glitch, as if her suffering had taken the wrong shape.

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The Sacred Right of Universal Narcotic Entitlement

Julie Rinaldi, left, and Lynn Locascio, right, both of Tampa, Fla., react as names are read of people who have died from OxyContin abuse. Rinaldi's daughter, Sarah, died at 17 from taking OxyContin. (AP Photo//Bristol Herald Courier, David Crigger)

The Sackler family funds top-tier museums (the Met, the Tate, the Smithsonian), universities (Princeton, Cambridge), and scientific research institutes (the Mayo Clinic, the National Academy of Sciences). Where does their cash come from? Writing in Esquire, Christopher Glazek tells us: pharmaceuticals — these days, largely OxyContin, which generates over a billion dollars in sales each year on the back of a campaign built on misleading both doctors and the public about its addictive potential. Over 200,000 people have now died of OxyContin overdoses, and many more from heroin after first becoming addicted to opioids via Oxy.

The Sacklers have experience turning an addictive drug into a household name. In the 1960s, family patriarch Arthur Sackler did it with benzodiazepene:

In the 1960s, Arthur was contracted by Roche to develop an advertising strategy for a new antianxiety medication called Valium. This posed a challenge, because the effects of the medication were nearly indistinguishable from those of Librium, another Roche tranquilizer that was already on the market. Arthur differentiated Valium by audaciously inflating its range of indications. Whereas Librium was sold as a treatment for garden- variety anxiety, Valium was positioned as an elixir for a problem Arthur christened “psychic tension.” According to his ads, psychic tension, the forebear of today’s “stress,” was the secret culprit behind a host of somatic conditions, including heartburn, gastrointestinal issues, insomnia, and restless-leg syndrome. The campaign was such a success that for a time Valium became America’s most widely prescribed medication—the first to reach more than $100 million in sales. Arthur, whose compensation depended on the volume of pills sold, was richly rewarded, and he later became one of the first inductees into the Medical Advertising Hall of Fame.

Later, the company would do the something similar with OxyContin and pain, when it “rebranded pain relief as a sacred right: a universal narcotic entitlement available not only to the terminally ill but to every American.”

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The Kids Are Not Alright: How Opioids are Destroying American Families

(AP Photo/David Dermer)

The first casualty of America’s opioid epidemic beyond the users themselves? The American family. As Julia Lurie reports at Mother Jones, while mom and dad are nodding out and overdosing in record numbers, the kids are going into an under-funded foster care system struggling to handle the sheer volume of children who need food, shelter, clothing, and above all, stability.

Long before the social workers showed up in his living room this March, Matt McLaughlin, a 16-year-old with diabetes, had taken to a wearying evening routine: trying to scrounge up enough spare change for food while his mom, Kelly, went to a neighbor’s house to use heroin. On a good night, the bookish high school junior would walk through his neighborhood in Andover, Ohio, a Rust Belt town surrounded by fields and trailer parks, to pick up frozen pizza from the Family Dollar. On a bad night, he’d play video games to distract himself from his grumbling stomach and dipping blood sugar, and wait for Kelly to return with glazed eyes.

It wasn’t always this way. When Matt was little, Kelly was a Head Start caseworker who patiently taught parents how to manage their autistic children. She loved hosting potlucks with friends and playing Barbie with Matt’s sister, Brianna. There was always music: Tchaikovsky when Kelly was at the piano, or Jimmy Buffett blasting through the speakers while she cooked. “Growing up, we were the house that everyone wanted to come to,” remembered Brianna, now 20. “I loved every minute of it.”

It’s hard to overstate just how pervasive the epidemic feels here. Detective Taylor Cleveland, who investigates drug cases in Ashtabula, told me, “I’m dealing with some ruined home two and three times a day.” Cleveland, who coaches youth soccer and recently adopted a 17-year-old player whose mom overdosed, leads a task force that responds to every overdose in the county. Once, he arrived at an overdose scene only to realize that the victim slouched over in the motel room was his cousin, whose young daughter had called 911. “Every OD that happens, I get a text. I’ve gotten two texts while we’ve been talking.” We’d been talking for less than an hour.

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West Virginia: Still High on Hope

Dr. John Aldis holds a naloxone nasal spray kit with the instruction sheet in Martinsburg, W.Va. Aldis trains people so that they can administer naloxone to an individual in the midst of a heroin overdose. (Jenni Vincent/The Journal via AP)

At The New Yorker, Margaret Talbot reports on the opioid epidemic in West Virginia. There, the overdose rate is the highest in the United States and many are fighting to help loved ones, friends, neighbors, and sometimes complete strangers get healthy: An emergency paramedic who routinely sees multiple overdoses a day, sometimes the same people on repeat. A team of moms called “The Hope Dealers” who drive addicts hours away to get the treatment they need. A 71-year-old doctor offering free public classes on how to administer Narcan, a drug that reverses the effects of these now-commonplace overdose. All this in an opioid epidemic fueled by cheap highs and small-town despair over limited prospects.

We were driving away from Hedgesville when the third overdose call of the day came, for a twenty-nine-year-old male. Inside a nicely kept house in a modern subdivision, the man was lying unconscious on the bathroom floor, taking intermittent gasps. He was pale, though not yet the blue-tinged gray that people turn when they’ve been breathing poorly for a while. Opioid overdoses usually kill people by inhibiting respiration: breathing slows and starts to sound labored, then stops altogether.

As we drove away, Barrett predicted that the man would check himself out of the hospital as soon as he could; most O.D. patients refused further treatment. Even a brush with death was rarely a turning point for an addict. “It’s kind of hard to feel good about it,” Barrett said of the intervention. “Though he did say, ‘Thanks for waking me up.’ Well, that’s our job. But do you feel like you’re really making a difference? Ninety-nine per cent of the time, no.” The next week, Barrett’s crew was called back to the same house repeatedly. The man overdosed three times; his girlfriend, once.

But a larger factor, it seems, was the despair of white people in struggling small towns. Judith Feinberg, a professor at West Virginia University who studies drug addiction, described opioids as “the ultimate escape drugs.” She told me, “Boredom and a sense of uselessness and inadequacy—these are human failings that lead you to just want to withdraw. On heroin, you curl up in a corner and blank out the world. It’s an extremely seductive drug for dead-end towns, because it makes the world’s problems go away. Much more so than coke or meth, where you want to run around and do things—you get aggressive, razzed and jazzed.”

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Nyet to Harm Reduction: Russia’s HIV Epidemic

Julien Behal/PA Wire URN:6698749

At Gizmodo, Josephine Hüetlin (writing under the pseudonym Emma Lantreev) reports on how Russia’s aversion to harm reduction as a strategy to combat drug addiction has led to an HIV epidemic. In Yekaterinburg — the fourth largest city in Russia, with a population of 1.5 million people — one in 50 are HIV positive. In Russia, addiction is considered a “moral sickness” and methadone is illegal, “a despised ‘narcoliberal’ idea.” The country has gone so far as to assert that drug addiction and homosexuality are notions imported from the West in a bid to corrupt ‘Russia’s “conservative ideology and traditional values.”’ For those who are suffering, the prospects are grim.

The government’s primary strategy for dealing with people struggling with addiction is “making them feel miserable,” Sarang says. “As if the social pressure will make them stop using drugs.”

In a country with the largest population of injection drug users, methadone therapy is illegal. Methadone distribution is punishable with up to 20 years in prison. Heroin addicts— “anti-social elements,” as they’re called—are expected to quit cold-turkey, perhaps in one of the jail-like “treatment” centers.

Those suffering from both addiction and HIV complications face a torturous dead end. According to several reports by the Rylkov Foundation, doctors have often refused to treat HIV patients who use heroin, on the grounds that they won’t be able to follow their treatment regime.

The City Without Drugs organization is still active, as is their YouTube channel. It features hundreds of videos of drug addicts being dragged half-conscious through the street, their faces not blurred, or confessing their alleged worthlessness, their hopelessness, their shame.

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Opioid Addicts Are Losing Their Memories and Doctors Don’t Know Why

Image courtesy of Pixabay

After two years of almost daily drug use, Max had the amnesia spell, and his life began to spiral out of control. Unable to remember what year it was or how to get around Boston, he dropped out of school. He had to quit the restaurant job after two dizzying shifts losing people’s orders and forgetting where his tables were.

“I remember feeling, just like, intense dread, because I didn’t know what was happening,” he said. “Because I thought I was going to be like that for the rest of my life. It made me act like a crazy person.”

The cluster of new cases in eastern Massachusetts, which began with Max’s case in 2012, appears to be growing in step with the nationwide opioid epidemic. Opioid overdoses have quadrupled in the last 15 years, driven largely by a rise in heroin use and, more recently, by fentanyl, an opioid 50 times more powerful than heroin. In Massachusetts, where overdose rates have doubled since 2012, 75% of people who died of an unintentional overdose last year had fentanyl in their system.

After overdosing, some opioid addicts are losing their memory and nobody really knows why. All doctors know is that each patient’s hippocampus — the area of the brain responsible for memory — becomes severely damaged. Are the opioids laced with an unknown toxin that targets the hippocampus? Does reduced respiration caused by opioid overdose damage the hippocampus? Azeen Ghorayshi reports at BuzzFeed.

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Winnipeg’s Indigenous Bear Clan Patrol Protects the Vulnerable

drug parephenalia scattered on a sidewalk, black and white photo with splashes of red
Photo by Mr. Theklan (CC BY-SA 2.0)

After the body of 14-year-old Tina Fontaine was found in Winnipeg’s Red River in 2014, members of the community took action. At Vice, Geraldine Malone reports on the Bear Clan Patrol, a grassroots group that formed in Winnipeg’s North End neighborhood to walk the streets at night. Nearly three years later, over 530 volunteers act as “boots on the ground,” focusing on harm reduction by handing out condoms, offering rides, diffusing violent confrontations, preventing opioid overdoses by administering naloxone, and protecting the vulnerable to “get that village feel back,” as co-founder James Favel says. They’re “Trying to inspire people to care more about one another.”

Gathering in the small centre before patrol all of the volunteers grab their necessary gear: the bright yellow vests, plastic gloves and containers to store used needles they find on the street. There’s also bags of apples this night. A volunteer named Bob bought them and everyone fills their pockets with the fruit, a hot commodity on the streets, especially with kids. Sometimes they also have candy to hand out, the volunteers laugh that it’s a favorite of the kids.

One kid runs up with an envelope and whispers to a volunteer, “there are needles inside.” It’s taken some time for the Bear Clan to build this kind of trust. Favel says at first when they started people assumed it would be like most social efforts in this neighborhood—here one day and then gone the next. Good intentions with little follow through is something they know all too well.

Last fall they were in this same housing complex when a woman came outside screaming, Favel says. Two people had been drinking and got into a fight that escalated quickly when one of them brought out a machete. A guy had his fingers almost completely chopped off.

The Bear Clan Patrol have first-aid training and responded quickly, treating the severed fingers and calling for paramedics. It was because of that response the guy ended up keeping mobile fingers, Favel says.

Last November, many of the Bear Clan Patrol members were trained to administer naloxone, an overdose-reversing drug. Members carry the naloxone kits on patrol but they also work with paramedics if they come across someone who may be overdosing.

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