Who is to Blame for the Drug Crisis?

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If there’s one thing Americans of all backgrounds, religions and political affiliations agree on, it’s that the United States is in the midst of a drug overdose epidemic, one that is fueled, largely by opioids. While virtually everyone agrees that losing over 70,000 lives a year to the drug epidemic is a travesty, many people are looking to place blame where blame is due. Complicating things further it is no one person, place or thing that created the opioid epidemic. Many historical, socioeconomic and individual factors play a role in the crisis.

One reason people look to assign blame is they believe (sometimes rightfully so), that finding the one thing to blame is the first step to solving the problem. This may be partially true, but for an honest, successful solution to the drug overdose crisis, we need to look at every possible factor that plays a role in the growing problem. Being honest with the findings is the best way to address the multitude of issues that contributed to the crisis.

Illicit drug dealers and pharmaceutical companies are who most people automatically blame for the drug crisis.

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“Big Pharma” drug manufacturers most certainly played a role in the drug crisis, by overselling the benefits of opioids and downplaying the risks. Yet there are various other factors that contributed to the opioid epidemic in the United States.

Of course the first place people look to when placing blame for the opioid epidemic is the drug dealers and manufacturers. Since President Nixon declared the “War on Drugs” in 1971, our strategy for dealing with the problems drugs cause in society was to go after the supply chain. In the nearly 50 years since this war on drugs was declared, we are nowhere close to solving the problems drugs have created in our society.

Certainly, drug dealers and big pharma have played a major role in creating the drug crisis in the United States. Many companies (including, most notably Purdue Pharma), have been found in court to have lied about the safety and efficacy of their prescription drug products. In the late 1990’s, Purdue aggressively marketed Oxycontin to doctors, claiming the extended-release of opioids would prevent misuse of the drug. This formula allowed the giant pharmaceutical company to receive FDA approval to put more opioids in each pill and we all know how that turned out.

The reality of Oxycontin was that it is much more prone to be abused or misused. People who developed a dependency to opiates found that the extended release formula could be bypassed by crushing up the pills and either snorting the powder or injecting the drug directly into their veins with intravenous needles. Because the oxycodone pills are so powerful, an addiction to opioids could develop very fast. Once the prescription ran-out, the addicted patients were forced to move on to street drugs like heroin, just to avoid the excruciatingly painful opiate withdrawal symptoms.

Even when someone successfully quit using opioids, they are highly prone to experience a relapse. A 2016 study found that people who are in recovery from opioid addiction experienced at least a 30% to 70% relapse rate within the first 6 months of their recovery. Fortunately, as a response to this contributing factor, the same pharmaceutical companies developed medications to help treat opioid addiction. Medication assisted treatment (MAT) can greatly help ease painful withdrawal symptoms from opioid addiction and they can greatly lower the rate of further relapses into substance use.

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Are doctors, physicians and other medical professionals to blame for the drug crisis? While some doctors ignored the warnings others may have been intentionally misled.

Doctors who overprescribed opioids and other painkillers are also rightfully to blame for the drug crisis in the United States.

While it is certainly easy to blame drug dealers and multi-billion dollar corporations for the opioid epidemic, the problem equally rests in the interpersonal and professional relationships of patients and doctors in their local communities. A 2016 survey found that about as many Americans blame doctors for overprescribing opioids (34%) as they do the patients who abuse prescription painkillers themselves (37%).

Illicit drug dealers market street drugs like heroin, counterfeit versions of prescription opioids and various forms of fentanyl. However, according to SAMHSA data, fewer than 10% of prescription opioids are obtained from drug dealers or other strangers. Over 50% of the misused or abused pills come from family members or close friends, while only 25% are obtained with a prescription from a doctor or physician. While the problem of patients receiving multiple prescriptions from different doctors, this only represents 3.1% of the opioids obtained for non-medical use, whereas over 22% receive prescription opioids from only one doctor.

Our overall approach to pain management drastically changed in the 1970’s when pain became the “fifth vital sign”.

Before the 1970’s, the medical profession virtually ignored the importance of pain management in a patient’s medical care. The inclusion of the question: “was your pain adequately treated” on patient surveys brought about a sort of preoccupation within the medical community on how to provide adequate pain management. Pain became the “fifth vital sign” along with body temperature, blood pressure, pulse and respiratory rate.

As a doctor, you certainly don’t want to see your patients suffer with pain symptoms. With a newfound focus on pain management, physicians and hospital administrators began aggressively treating pain symptoms, which led to a massive increase in opioid prescriptions.

We have to admit that opioids do serve as effective pain relievers and, when used appropriately, they can benefit the overall quality of health care services available in our society. Opioids do serve to benefit people who have recently undergone surgery, experienced a major bone fracture, cancer patients and other severely painful medical events. We cannot simply prohibit doctors from prescribing them appropriately.

Various forms of alternative pain management techniques are available, yet many doctors aren’t taught them in medical schools. The pharmaceutical industry provides massive funding to most of the medical schools in the US. This problem is compounded by the health insurance companies’ reimbursement policies. These policies make prescription opioids a much cheaper option for patients than other, alternative approaches to pain management, such as acupuncture, physical therapy or chiropractic techniques.

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Opioid manufactures, over-prescribing doctors, insurance policies and patients themselves have all played major roles in the drug overdose epidemic. Now that we know, it’s time to start fixing the problem.

While it is easy for people to simply blame “big pharma” as the culprits of the drug overdose crisis in America, we think that is simply just the tip of the iceberg. Of course the Sackler family from Purdue Pharma, along with other pharmaceutical giants like Johnson & Johnson seriously downplayed the risks associated with their products.

Currently, over 2,000 court cases against opioid manufactures are pending in the US. These cases rightfully assert that “big pharma” may have intentionally misled doctors into prescribing more opioids, which most certainly played a role in the creation of the opioid epidemic. Yet opioid misuse is a much more complicated issue than that.

Drug abuse typically coincides with strong feelings of hopelessness, depression and despair. The states that are the worst-hit by the opioid epidemic also suffer from the highest rates of joblessness and economic turmoil. Until we address all of the underlying causes of the current drug crisis in America, we are going to be fighting an uphill battle.

Overcoming an addiction is never easy, yet there are people who do it every day. 10 Acre Ranch offers a full medical detox and recovery program that can help you, every step of the way.

Please call us today to speak with one of our addiction specialists and we can get you, your family member or loved one the help they need right away. We are available 24/7, 365 days a year. Call now:

 

877-228-4679

 

 

Can I Tell if Someone is on Benzos or Xanax?

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Just like many other types of addictions, an addiction to Xanax will affect nearly every aspect of the person’s life. A typical addict will let their personal relationships deteriorate, while often isolating themselves socially. Job loss, financial hardship and legal troubles are common with those who are addicted to benzos. Developing a chemical dependence on Xanax can lead to many dangerous situations. Since benzodiazepines are sedatives, it is generally unsafe to operate an automobile, even when on a prescribed dose from a doctor.

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A Brief History of Mental Health & Substance Abuse Treatment

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Throughout history, the use of illicit substances is documented as far back as the earliest of recorded human civilization. 5,000 year-old Egyptian hieroglyphs show us that people who suffered from alcohol addiction were cared for in the homes of other people. Both the ancient Greek and Roman empires carry records of not only people suffering from alcoholism, but also for those people receiving treatment in “public, or private asylums.”(1) The ancient Chinese civilizations also had problems with their citizens abusing opium, which was first imported from Great Britain. Opium abuse also gave westerners a sense of moral obligation to colonize the greater part of Asia and help them wean off of their addiction to opium. As such, the British government began compelling the Chinese to cut poppy production after the second Opium War.

In America the first instances of any substance abuse treatment were in the Native Americans’ ‘sobriety circles’. The European settlers of the 1600’s had brought alcoholic beverages to the Americas and soon they began trading alcohol to native tribes, sometimes for nefarious reasons. It is known that the European settlers would give chiefs gifts of alcohol before they negotiated settlement and trade deals, to loosen them up. It has been argued that the European settlers of the 1600 and beyond would often give alcohol to native populations to decimate them and make them conquered more easily. Members of many tribes attributed the alcoholic liquids to ‘bad spirits’. They would gather those affected in a circle formation to give them a sense of tribe and to try to repel those bad spirits. The 12-step program model is loosely based on the natives’ sobriety circles.

In colonial America, Benjamin Rush, the father of modern psychiatry was the first to attribute addiction as a type of mental illness and therefore one that could be treated. This was the first time addiction was seen as anything different than the stigma of a moral failing. In Rush’s mind, alcoholism was a chronic disease that could be treated with various techniques. Those techniques became very hot properties, as every form of experimenter and entrepreneur wanted to try to profit off of the treatment of this disease. This led to some practices that we now know today to be very harmful such as electro shock therapy and injecting the body with various substances like gold, silver, mercury and arsenic. This injection therapy was the brain-child of Dr. Leslie Keely and while that method was unorthodox, and just plain wrong, one of his ideas, a 31-day stay at a treatment facility is the foundational drug and alcohol abuse treatment models primarily used today.

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History of mental health treatment techniques and substance abuse therapy.

These substance abuse treatment centers were a huge step in understanding addiction and the ability to treat it as a disease.

Along came the era of prohibition and the temperance movement thought they had a major victory in reducing alcoholism in the United States. Prohibition however, was a colossal failure. Alcohol use continued to rise and after thirteen years, the 21st amendment was ratified to help fight organized crime and allow citizens to continue to consume alcohol legally. After just 2 short years, Bill Wilson and Dr. Bob Smith founded Alcoholics Anonymous. In the formation, they channeled the concept of the sobriety circles from the Native Americans and also were the first to use the 12 steps in recovery. These steps were a pathway of different techniques, geared towards living a life free from alcohol or drugs. AA remains today as the most commonly used resource for someone looking to steer away from substance abuse.

Many people have found the help they need in AA or their offshoot, Narcotics Anonymous (NA). Still, others criticized the use of the ‘higher power’ and surrendering to being powerless against their addictions. As this was the classic AA model, today there are alternative versions of the program for agnostics and secular considerations of the twelve-step program.

The Minnesota model really cemented the version of the substance abuse treatment facility that we know and understand today. In 1948, this model incorporated the principles of the 12-step program, but added family involvement within a 28-day inpatient stay. AA was attended both during and after the inpatient stay. They also believed that addicts could help each other through their recovery so the hospital was staffed with both medical professionals and trained resource personnel that were usually recovering addicts themselves. This treatment model was instrumental in suggesting that alcoholics and other addicts were not morally inept and instead had a physical disease that was treatable. The stigma of substance abuse continues to this day, but more and more are becoming increasingly understanding of the concept of addiction as a disease, instead of a moral failing.

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During the early years of substance abuse treatment, many experimental methods were adopted and tested.

One example was the United States Narcotics Farm in Lexington, Kentucky. This farm legitimately had good intentions in helping addicts recover from their disease. They were among the first to use methadone to help heroin addicts, a practice that continues with success to this day. The Central Intelligence Agency however found an unnoticed resource with the farm, using it to conduct early experiments with LSD on their patients. The Federal Government decided to turn its work with substance abuse to the states in 1975.

Substance abuse and mental health treatment has come a long way since then, and science is still progressing to more effectively treat those in need.

Medications have been developed to help fight substance abuse and are showing great promise. Medically assisted treatment (MAT) programs are being used today to fight the current opioid epidemic. These medications help the patient control and manage their withdrawal symptoms, which is a reason many don’t want to quit their addictions. A recent move towards an evidence-based approach to recovery has advanced rehabilitation facilities in a positive way. This approach uses scientific verification to prove the success of their treatment or rehabilitation programs. However, there are still a lot of recovery centers that try to take advantage of addicts, as they are seen as a vulnerable and marginalized group.

Progress in psychology and psychotherapy have shown addiction specialists a deep connection between mental health and substance abuse. Today virtually all alcohol and drug abuse treatment programs use a combination of social, psychological and medical treatments.

As we continue to learn from our history, there is continual pressure for the substance abuse treatment industry to innovate and evolve with the trends and new discoveries science has offered. This pressure is guiding the treatment industry in the right direction, but there are still many who need help. If you or your family member or loved ones are seeking treatment, give us a call right away. We are open 24/7 and we can help you get the help you need.

(877) 228-4679

(1) White WL (1998) Slaying the Dragon. Chestnut Health Systems, Bloomington

The 2018 Opioid Bill

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The United States Congress reconciled both House and Senate opioid bills aimed at reducing the deadly toll of the nation’s top health care crisis: the opioid epidemic.

In the SUPPORT For Patients and Communities Act, Republican and Democrat lawmakers came to a rare agreement between both parties. The drug overdose epidemic claimed 72,000 lives in 2017 alone and roughly two thirds of those deaths were from prescription and non-prescription opioids. The bill will now head to the Senate as the House of Representatives almost unanimously passed the bill in a rare, 393-8 vote. President Trump is expected to sign this legislation into law before the midterm elections.  This is a fairly large bill, that will cost the US billions of dollars but many argue that the bill doesn’t do enough to address the nation’s greatest public health issue. Senator Elizabeth Warren has proposed a bill that would cost the US tax payer $100 billion over the next 10 years, as she argues this is what is really necessary to fully address the opioid crisis.

The SUPPORT for Patients and Communities Act takes a wide approach to the opioid epidemic from law enforcement, treatment and public health care measures.

We will talk about some of the major policy changes in the bill and the full-text of the bill is available here.

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The 2018 SUPPORT for Patients and Communities Act was passed by United States Congress and signed into law by President Trump.

One of the greatest achievements of the new bill is a provision to allow Medicaid recipients to seek care at addiction treatment centers. The restrictions on Medicaid funding for substance abuse treatment had been long outdated and congress finally addressed this problem. Allowing Medicaid to help fund up to 30 days of inpatient rehab stays, including medication-assisted treatment (MAT) is going to help a lot of people get the help they desperately need. The bill authorizes a grant program through the Substance Abuse and Mental Health Services Administration (SAMHSA) to help communities develop opioid recovery centers. While the bill does address the lack of funding for increased access to treatment programs, many addiction specialists argue the bill does not do enough in this regard. While noting that the bill is not itself bad as it does a lot to address a multitude of issues, it is severely lacking on access to treatment, which many believe is the most important technique that could help solve the opioid crisis.

Another provision in the bill lifts restrictions on medications used to treat opioid use disorder and other types of addiction. This measure simply allows more medical practitioners to prescribe medications such as buprenorphine, used to help ease withdrawal symptoms in addiction recovery. As it stands today only 5 percent of doctors are licensed to prescribe this life-saving drug. Another medication, naloxone was addressed in this bill. One provision allows first responders greater access to the life-saving opioid antagonist which can reverse the effects of an opioid overdose.

The major law enforcement provision of the SUPPORT Act is aimed at the trafficking of drugs through the postal system. Fentanyl that is illegally imported from Mexico and China has been blamed for many of the opioid-related deaths in recent years. One package seized in Philadelphia last June contained 110 pounds of fentanyl, valued at $1.7 billion dollars. This was estimated to be enough of the dangerous substance to kill the entire population of the state of Pennsylvania two times over. Fentanyl is 50 times more potent than heroin, so it is easy to smuggle large amounts of the substance through the mail system. This bill makes it harder for people to sneak illicit substances into the US from abroad. The bill will require packages coming in from foreign countries to reveal their contents and where and who they’re coming from. While the bill is broadly aimed at targeting illicit drug suppliers, it includes protection for individuals looking to import cheaper prescriptions from overseas. This was in direct opposition to pharmaceutical companies’ requests to include enforcement against importing cheaper prescriptions from other countries.

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The opioid epidemic kills nearly 200 Americans every single day.

While the SUPPORT for Patients and Communities Act does a lot to fight the opioid epidemic, there is still a lot of work to be done in the near future. The bill even authorizes research into opioid alternatives to pain management and penalizes drug manufacturers and distributors for overprescribing. A lot more could have been done to address the root causes of addiction and it should have offered greater access to outpatient treatment programs. However, while a lot of divisive partisan issues like funding were ignored in the bill, the Democrats and Republicans agreed on a lot of ‘second-tier’ issues that will definitely help save lives. Given the extreme divisiveness in American politics in the Trump era, this is a small political victory.  Thankfully, everyone finally seems to want to work together in fighting this urgent national health crisis.

Why Do I Keep Relapsing? 5 Ways To Become Stronger

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If you find yourself asking this question, either for yourself, a family member, loved one, neighbor or coworker just understand that a relapse is a very normal part of recovery. If you have been through a successful addiction treatment program, experienced a period of sobriety and fell into a relapse, please know you are not alone. Relapses are not uncommon and it does not mean you are a failure. Hope is always an option and there are many resources that can help you. How you react to your situation after experiencing a relapse is critical in your overall road to recovery. In this crucial time, forgiveness is an important factor to express to yourself or your loved one. Learn to forgive yourself or your family member for the recent relapse into substance use.  This is a better, more productive attitude to have that in the long run will help you or your loved one keep striving to maintain their sobriety.

 

“Treatment of chronic diseases involves changing deeply rooted behaviors, and relapse doesn’t mean treatment has failed.”–National Institute on Drug Abuse (NIDA)

 

It is estimated that 40-60 percent of people who maintain sobriety through rehab, treatment and recovery will relapse into heavy use, while 70-90 percent will relapse and use again at least once. In the medical field, a relapse used to be treated as an uncommon thing but that has largely changed due to the advances in behavioral science and addiction therapy. Sadly, many addicts are stigmatized by society as hopeless drug fiends or treated with the perception that they are a bad person for their substance use. Many of us here in the addiction treatment industry are advocating a different perspective. With addiction being a curable disease, you could compare it to the relapse rates of people with other medical problems such as diabetes, high blood pressure or asthma. The rate of relapse into these common medical diseases is close to the same as for people with a substance abuse disorder. Treating this as a medical condition will help ease the stigma associated with drug and alcohol abuse.

 

As we have seen the overdose epidemic explode in the United States, it is important for us to begin treating this as a serious medical condition, not a criminal activity reserved only for the ‘bad people’ in society. As you are reading this now, most of us know someone dearly who has struggled with some form of substance abuse. While we look to help those closest to us, deep down inside we know there is still a good person underneath the surface of their drug or alcohol addiction.

 

It is estimated that nearly 72,000 people in the United States died from a drug overdose in 2017. That’s close to 200 people each and every day. – Centers for Disease Control (CDC)

 

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Finding the right coping mechanisms and staying the course in recovery is the key to overcoming an addiction.

Warning: Your Drug Tolerance Levels Will Change

It is extremely important to note here that many who relapse will overdose their first time because they think they can do as much of the drug as they had been doing before they went through detox and a period of sobriety. Simply put, your body cannot handle as large an amount of the drug, even though they had built up a tolerance over their period of substance abuse. Your tolerance has changed through recovery and you might not be able to handle the “usual dose” as you have in the past and immediately die. We cannot stress this enough, so please keep this in mind throughout your post-recovery stage as most people do not plan to have a relapse.

Ultimately, it is up to the individual in recovery to actively want to change things in their life to help them maintain their newfound sobriety. This is a difficult path to navigate and there are many things you can do to help you avoid the temptation to relapse into substance use.

 

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Tips on how to overcome a relapse and not give up on your addiction recovery

Specific Risks to Avoid During Your Process of Recovery:

 

  1. Avoid drug-related ‘triggers’: Many in recovery can be tempted to relapse if they are around old hangouts where they used to purchase or consume drugs or alcohol. Even the sight of drug paraphernalia or a drink can be too much to handle for some. Also known as drug-related cues, these thoughts can come from a variety of places, depending on your individual situation. Most treatment programs will help you identify your potential triggers and help you formulate a plan to avoid them.
  2. Be extra cautious during the first 90 days: Most relapses occur during this crucial period of recovery. Your addiction doesn’t simply stop once your detox is completed. For many, addiction can shape your thoughts and behaviors for the rest of your life. The good news is the longer you stay sober, the easier it will be for you to avoid a return to your past substance abuse.
  3. Find help in a structured environment: Rates of relapse are much lower for people who participate in some sort of organized support group after their drug or alcohol detox. Relapse prevention or twelve-step programs like Alcoholic’s Anonymous (AA) or Narcotics Anonymous (NA) are great at helping people maintain their sobriety and offer personal help when you feel the urge to use again.
  4. Start creating healthy lifestyle habits: Studies have shown that even a mild amount of exercise can help reduce cravings and withdrawal symptoms for recovering addicts. Eating healthy foods and thinking healthy thoughts are important to developing and rebuilding the self-confidence necessary to maintain your sobriety. Controlling your emotions and developing healthy coping mechanisms to deal with difficult situations can greatly increase your success in recovery and sober living.
  5. If you do relapse, don’t be afraid to ask for help (again): When a relapse occurs, know that there are a multitude of resources willing and able to help you break the cycle of your addiction. Sometimes treatment needs to be tried several times before the patient is fully recovered. Remember, relapse is completely normal and nothing to be ashamed about. Your family and loved ones will be happy you were honest and asked for help. Repeated attempts will work eventually and it will help you develop the desire for a healthy, sober lifestyle.

Addiction Stigma In The Language

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Alcohol use disorder and opioid use disorder. Addict, alcoholic, alcohol and/or substance abuser. Junkie, crackhead, dope fiend, pill head, et al. If you are in recovery, you’re acutely familiar with all of these terms. Many of you have even referred to yourself using such pejorative names. The language we use to describe people who have been touched by the insidious disease of addiction can, and does, have an effect on the afflicted. Even if those suffering from such conditions don’t know it.

Addiction is a complex disease that is centered in the brain. The causes are debatable, but the treatment is not—generally speaking. Despite the fact that use disorders are accepted mental health conditions, the general public remains skeptical about how much choice is involved. To be sure, people suffering from addiction made an initial choice to try a substance. But what followed for those predisposed to the disease had little to do with choice.

When we refer to people as abusers, a word still used among people even in the field of addiction, the condition becomes stigmatized. The word abuse is hardly ever accompanied by something good. Yet, even in modern times when addiction is understood better than ever, it is hard to change the language of addiction. Rest assured, however, that by altering how we talk about the disease, more people can be encouraged to seek help.

Addiction Stigma In The Language

Changing how we label substance use disorders is difficult. Even experts struggle to agree on the correct way to go about the renaming. Even when a label sounds scientific “use disorder,” dis-order still carries a negative connotation. The word “abuse” needs no explanation. Some people have even raised concerns about the word alcoholic, after all, there are centuries of negative undertones associated with the word.

What’s more, there is likely a huge contingent of people in recovery who would not be receptive to identifying as, “My name is John D., and I have an alcohol use disorder.” But changing how people in recovery refer to themselves is not as important, at the end of the day. Changing how society refers to people in the grips of addiction, could have a profitable effect. People who are described as having a form of chronic disease, are far more likely to seek help. Compared to people who are labeled as “X” abusers. And researchers tend to agree on this.

In fact, recent studies have shown that the language we use actually matters. Dr. John F. Kelly, director of the Recovery Research Institute at Massachusetts General Hospital in Boston and associate professor of psychiatry and addiction medicine at Harvard Medical School, conducted a study which supports this idea. His findings showed that medical professionals are more likely to treat people with substance use disorders differently if they are described as “abusers,” according to U.S. News & World Report.

“Dropping the use of stigmatizing language “can save lives,” says Dr. John F. Kelly. Certain language “could suggest willful misconduct, which some people believe should be punished, not treated.”

From Stigma to Treatment

Dr. Kelly’s sentiments are shared by the former Director of the Office of National Drug Control Policy (ONDCP), the article reports. Michael Botticelli, the executive director at the Grayken Center for Addiction Medicine at Boston Medical Center, says:

“Changing the Language of Addiction,” a 2016 paper he co-wrote for JAMA. “Stigma isolates people, discourages people from coming forward for treatment and leads some clinicians, knowingly or unknowingly, to resist delivering evidence-based treatment services.”

Botticelli co-authored a paper on this very subject that was published in JAMA.

Changing the language of addiction in America could help some of the millions of people who are resistant to seeking help. Fear of reprisals for seeking help is deeply rooted, due to the government’s response to addiction in the past. The stakes are extremely high, people are dying from the disease every day. If you or a loved one is struggling with addiction, please contact 10 Acre Ranch, today.