Like it or not, this “mess” is a continuing saga. In the US. Around the world. This may be the fourth and “final” post in this Demon series, but the opioid and addiction menace continues. I’m sure there will be various follow up posts dealing with this dilemma.
Some of us don’t like to read about it, while others suffer from it. Those supposedly not afflicted in some way, probably think the subject matter is boring. Illness and dependency of any kind are serious, sad, oft-times deadly, but never boring.
Still I find I must press myself to write on about these matters because I want to share my personal thoughts, trials, tribulations and fears, as well as that info gleaned from pertinent sources. In one way or another, all of us can relate.
These demons are persistent and sneaky. Depression can attack anyone. I know. Opioids prescribed by a physician can help. Again, I know. Addiction can easily take place in any of us. Fortunately, I don’t know first hand about this aspect, but I’ve walked that thin line. I do know how easy it is to become addicted to . . . whatever.
The AARP Bulletin ran a feature story by John Rosengren on the opioid mess and some of the startling highlights begin with:
- Almost one-third of all Medicare patients — nearly 12 million people — were prescribed opioid painkillers by their physicians in 2015.
- That same year, 2.7 million Americans over age 50 abused painkillers, meaning they took them for reasons or in amounts beyond what their doctors prescribed.
- The hospitalization rate due to opioid abuse has quintupled for those 65 and older in the past two decades.
Illustration by Gregory Reid
I don’t think I’ve taken as many pills in my life as I have these past four to five years. Even before my cancer treatment of specialized chemotherapy (not the old fashioned kind) – pills and IV – I took medicine to treat a weird outbreak of lymphoma on both legs. About the same time I had surgery for skin cancer on most of my nose.
In my mid-sixties, I was eventually diagnosed with Leukemia (CLL) and, via a three year clinical trial, took various treatments of experimental chemo medicine. That med saved my life: Venetoclax, which I still take.
I’m not trying to discuss my past medical history since nobody really cares about that, but I am admitting that I’ve been through a lot that I hadn’t previously experienced. Throw in my wife’s stroke and damaging my back when I tried to help her as she was having her stroke (I attempted to pick her up from the floor after she slipped from my grip, thus resulting in me fracturing a few vertebrae in my lower spine — oooooh, that really hurt, damn!), eventually led to me being on painkillers and subsequently a very good opioid.
Aside from the physical pain, there’s the mental aspect of dealing with cancer, being caregiver to my wife, living a lifestyle neither one of us wants and trying to still earn some kind of living when no one wants to hire someone over 50, let alone past 60.
You guessed it; that’s where depression, anger, frustration, anxiety and who-knows-what-else factors in. It would be too easy to say I’m going crazy. I’m not even sure how that would feel. Hey, as a writer, maybe I could sit down and interview my crazy self and compare how these two people coexist. That might be interesting; it may also be a potential script for a new Twilight Zone episode – for those of you of a certain age.
But with so many different things happening just involving Pam, my wife, that are bureaucratically stupid, my anger lashes out at Pam (not good or advisable) since I can’t fight what I can’t see. I’ve learned you can’t fight bureaucracy; you learn to deal with it. However, that doesn’t mean you accept it. I don’t.
In large part, this is where my opioid comes in. As I’ve mentioned before, I take Narco (Acetaminophen Hydrocodone 10-325) to help with the pain in my lower back but it also helps calm me. I’m also getting back on Duloxetine (Cymbalta) or Fluoxetine since these meds help keep a good balance in my brain to help keep me on a more even keel and less temperamental. I am not one for shouting matches but my circumstances these past few years have warranted medical help.
I sound like a potential addict, don’t I? I’m not, don’t worry, but it scares me as to how close one can come to becoming a statistic. According to the AARP report, nearly 14,000 people age 45-plus died from an opioid overdose in 2015 — 42 percent of all such deaths in the U.S., according to the Centers for Disease Control and Prevention (CDC). The actual number is likely much higher. Overdoses in older people are often mislabeled as heart failure or falls.
Drug overdoses killed about 72,000 Americans last year, a record number that reflects a rise of around 10 percent, according to new preliminary estimates from the Centers for Disease Control. The death toll is higher than the peak yearly death totals from H.I.V., car crashes or gun deaths.
Analysts pointed to two major reasons for the increase: A growing number of Americans are using opioids, and drugs are becoming more deadly. It’s the second factor that probably explains most of the increased number of overdoses last year.
Credit: NICOLAS RAPP, AARP BULLETIN
Synthetic opioids are driving up overdose deaths. Strong synthetic opioids like fentanyl and its analogues have become mixed into black-market supplies of heroin, cocaine, methamphetamine and the class of anti-anxiety medicines known as benzodiazepines. Unlike heroin, which is derived from poppy plants, fentanyl can be manufactured in a laboratory, and it is often easier to transport because it is more concentrated.
According to the C.D.C. estimates, overdose deaths involving synthetic opioids rose sharply, while deaths from heroin, prescription opioid pills and methadone fell.
Where is treatment in all this? It has become increasingly difficult to quit “cold turkey” as in a smoking addiction. Talk therapy alone is not the answer. Medication and therapy? Could make for some odd bedfellows. But, hey, if it works . . .
In Oakland, CA, the Highland Hospital E.R. offers patients suffering from opioid addiction a dose of buprenorphine, a weak opioid that activates the same receptors in the brain that other opioids do, but doesn’t cause a high if taken as prescribed. It’s one of three medications approved in the United States to treat opioid addiction and works by easing withdrawal symptoms and cravings.
Dr. Andrew Herring of Highland Hospital in Oakland, Calif., left, gave a dose of buprenorphine – it eases the symptoms of opioid withdrawal – to a homeless man who collected cans to pay for bus fare to get to the hospital. Credit Brian L. Frank for The New York Times and reporter Abby Goodnough
Highland, a clattering big-city hospital where security wands constantly beep as new patients get scanned for weapons, is among a small group of institutions that have started initiating opioid addiction treatment in the E.R. Their aim is to plug a gaping hole in a medical system that consistently fails to provide treatment on demand, or any evidence-based treatment at all, even as more than two million Americans suffer from opioid addiction.
Highland has provided buprenorphine to roughly equal numbers of blacks and whites, with Latinos, Asians and other ethnic groups filling out the rest. Many of those patients are homeless and most are on Medicaid, the government health insurance program for the poor that, crucially for Dr. Herring’s program, California expanded under the Affordable Care Act. Buprenorphine can cost more than $500 a month, putting it out of reach for many of the uninsured.
Since February 2017, Highland’s E.R. has offered buprenorphine to more than 375 emergency room patients. Two-thirds of them accepted it, along with an initial appointment for ongoing treatment at the hospital’s addiction clinic.
The demons within are relentless. They never give up in their zealous attempts to get us hooked. What’s more, we can become hooked without even being fully aware of it. Let’s face it, we humans are great at denial.
I hope this series of posts, or at least one of them, has gotten your attention and made you aware that these demons are everywhere. Depression, opioids and addiction of any sort are not to be messed with. Each one on its own can be deadly if not treated. More often than not, we usually experience more than one of them at a time. This makes it even more serious and mandatory to get help before someone plans a funeral.
The Substance Abuse and Mental Health Services Administration offers a confidential help line that can connect you with treatment services in your state. Call 800-662-HELP (800-662-4357).