Monday, June 29, 2009

Hopeless teens, self-fulfilling prophesy

Talk about an OMG moment. I first heard about this on the radio this morning, and then I came across this article:

A surprising number of teenagers -- nearly 15 percent -- think they're going to die young, leading many to drug use, suicide attempts and other unsafe behavior, new research suggests.

…a sizable number of teens may take chances "because they feel hopeless and figure that not much is at stake,"…

I still need to track down the study, but I would rate this as one of the most upsetting study findings I have come across in some time.

Where do these teens get this message? What can we do to give them the information/knowledge that that is in fact not the truth? If this is a prime motivator behind substance abuse, violent behavior and risk taking in this number of teens, we need to have a new focus in dealing with these kids. How do we affect behavior that has this type of an underpinning?

Friday, June 26, 2009

Married to dope

My wife got a book recently that she said I should take a look at. It is “Esquire Presents: What It Feels Like:…” by AJ Jacobs. It is an interesting, quick read with short essays on things like what it is like to be gored by a bull or survive a hurricane. I wanted to share one bit from “What It Feels Like To Do Heroin”. I share this so that it can inspire parents, schools, and other groups to push primary prevention; to work hard to prevent that first use. So that people ensure access to secondary prevention (treatment) and, maybe, reduce a bit of the stigma of seeking help and the stigma attached to those people who become users:

Everybody looks at you with reproach…you are married to dope. It’s more than half your life. It is your life. All you want is to be high. And if you are sick, all you want is to get right. It all comes down to one thing: The first time you did heroin you felt better than you’d ever felt in your entire life.” (David “Wilson”, 41, former addict)

This essay is about heroin, but it equally applies to prescription pain meds and any number of other addictive drugs.

I am reading a report on the growing crisis with prescription drug overdoses, more on that later.

Wednesday, June 24, 2009

Healthier Community

I went to a presentation by Dr. James Galloway the other day. It was in support of a pilot program in Chicago to “Build a Healthier Chicago”. Their website is worth a visit.

They are working to develop plans to improve the “pre-medical” parts of our healthcare crisis, as well as working with the more traditional outlets of medical care. They feel that our current situation can be summed up:
Physical activity (lack of), nutrition (unhealthy), and smoking are the three most important areas to target to improve the health of our nation.

I applaud their efforts and it would be great to bring a similar effort here and across the country.
The idea that individual health choices and personal behaviors are the most important determinants of chronic disease is an idea whose time has come…(George Menasah, MD)

But while individual choices are important:
…it is unlikely that individually attempted changes in lifestyles and behaviors alone can avert the growing epidemic of chronic disease that we are witnessing.

As long as a burger and fries are cheaper and more accessible than fruits and vegetables, as long as kids’ brains are bathed with seductive media blitzing in support of unhealthy diet and activity choices, as long as the community does not value and encourage healthier lifestyles, they will not happen. We need a community effort for a healthier community. We need to change our social norms to support/encourage a healthier (and safer) community.

"No one deserves to die by overdose"

…deaths from drug overdoses have been rising and have reached crisis levels in our country. A newly-released report by the Drug Policy Alliance documents the extent of the problem: drug overdose is now the second-leading cause of accidental death in America, surpassing firearms-related deaths. And it's not just young people who are dying of overdoses: overdose is the number-one injury-related killer among adults aged 35-54.

This is true not only with illicit drugs but also with the misuse, overuse and abuse of prescription drugs.

But efforts to implement … solutions are hamstrung by a drug-war mentality in which there are "good" drugs and "bad" drugs and, by extension, good drug users and bad drug users, the latter seen as somehow deserving of death when they overdose. No one deserves to die by overdose. Everyone deserves a second chance at life, and to be treated compassionately …
We need to accept the reality that people will always use drugs, whether legal or illegal, prescribed or sold on the street, mood or performance enhancers, pain killers or stress reducers or sleep-enablers. We are a nation of drug users. We must learn how to reduce the harms associated with our drug use, including reducing the unconscionable and unnecessary number of deaths from overdose.

We must address this problem in new ways. Not just law enforcement, although that is critical, but with well thought out plans and programs. We must use every piece of information that we can access to tackle this crisis. Education, primary prevention before folks use, secondary prevention to prevent relapse and reuse, making a wide variety of treatment available because there is no a one size fits all solution. We must work together, because this is not their problem, it is not my problem, it is our problem. People shouldn't feel as if their toes are getting stepped on or they are being upstaged by someone "out of the box" before they are. There is plenty of work to go around and we all have to work together to get this work done.

Thursday, June 18, 2009

Where death delights to help the living

I like this line (it came to me on a listserv; sorry, I wrote it down without the name of person who contributed it and I don’t believe they cited the author), unfortunately the Latin line looks to be a bit long to put over the door to our office building (would be cool though):

Hic locus est ubi mors gaudet succurrere vitae

This is the place where death delights to help the living

Thursday, June 11, 2009

Healing Community Problems

I was listening to a radio program a few weeks ago (At Issue on WBBM, no link). The folks being interviewed represented a few anti-violence programs in Chicago and had several interesting points. One of the things someone brought up was a list of 3 things that interfere with finding and applying solutions to problems, community problems in particular. I think the list is applicable to a number of problems, not just violence, so I thought I’d put them in here:

First, people won’t work to solve a problem that they don’t think affects them, that they don’t think is theirs. If you see a problem as someone else’s or can convince yourself that it is the other guy’s problem, you think they should work on the solution. I don’t have to; it is your problem you fix it.

Second, people don’t care about the problem. Granted a number of folks just don’t care about much of anything, but his doesn’t mean they are all uncaring people. Many have enough other problems that they don’t have room on their plate for something else to “care about”. When you are scrambling to get food on the table and a roof over your head, you may not “care” about violence outside your house.

Third, if people do not know what works they get overwhelmed thinking of or trying a solution and may quit. We need to put proof that there are solutions that work in the hands of the folks who can and will work toward a solution. The proof must be real and fact-based, not anecdotal. In the case of community violence, there is very good evidence that CeaseFire and it violence interrupters and other interventions work and should be in widespread usage.

To get the community together on working to address/solve community problems we must show them that it affects them, tell them why they should care, and show them what works for a solution. We can work together for community solutions and community healing of a wide range of problems. Community problems can only be solved on a community basis.

Not that it has a much to do with the forgoing, but I have been wanting to share a quote I caught from Bill Murray on TV a while back:

It is not about doing the right thing; it is about doing the next thing right.

Substance Abuse Treament Clinic

I sent this out as a media release, from me personally, yesterday and I thought I'd also share it here:

I am the Lake County Coroner. I am also a husband and a parent. I spend some of my free time as the Medical Director of a new substance abuse treatment clinic in Waukegan, by the name of Green Dragonfly.

I agreed to serve as the Medical Director for a number of reasons. Drug overdose is the number one cause of "unnatural" deaths in Lake County. Something needed to be done. The aunt (Mary) of a 25 year old who died of an overdose while on the waiting list for a local treatment program demanded it. The son of an elderly woman who had become dependent (doctor talk for addicted) on pain medications because of inappropriate over-prescribing by her doctor sent me an email in July 2007 asking me where he could take her for treatment. I didn't know. Opiate-related (heroin and prescription drugs) deaths more than tripled 2007 to 2008 and continue high in 2009.

Green Dragonfly opened in October 2008, currently has 92 patients and continues to grow. Mary (mentioned above) put the clinic together and continues as its Office Manager. She asked for my help and I agreed. More than one third of the patients are being treated for addiction to prescription pain medicines or their addiction started with prescription meds. 60% are employed in a variety of jobs while in treatment. The patients live though out Lake County, in McHenry and Kenosha Counties.

Being in treatment helps these people stabilize their lives. People are less likely to break the law. People can be more productive, contributing members of society. Treatment restores them, improves their lives and improves our community.

This substance abuse epidemic must be attacked with prevention, education, and increasing the likelihood that someone who abuses drugs gets treatment by increasing the availability of treatment and eliminating the stigma of seeking help and getting treatment. I want to be able to tell the 6 mothers of children who have had recent overdose deaths that we are doing everything we can to try and prevent a 7th from joining their group.

Tuesday, June 09, 2009

Drug Info for Parents

A freind of mine sent me a link to this and now i share it with you (I haven't read the whole thing, so I do not vouch for the information, but it seems helpful through the part I have read):

A Guide for Parents to Educate Themselves About Drugs Before Educating Their Kids

...if you are a parent, sometimes saying “stay away from drugs, they are bad for you”, isn’t good enough...

How do you explain to them all of the drugs that are out there and why they are dangerous and what they could do to you if you take them? Here is a list of drugs that every child should be aware of. It may be lengthy, and going over all this information with your children could take a while, but you have to remember that it is for their benefit as well as you, the worried parent.

Friday, June 05, 2009

They are us

I participated in a town hall meeting last evening about an apparent increase in drug use and drug-related deaths locally. One thing (among many) got me thinking afterwards. A couple of the presenters pushed the point that the young people who have died or otherwise used and abused drugs (heroin being a primary focus of the event) bought the drugs outside the area they lived in. This is not really true according to our investigations and other information sources, but that is the story they pushed. I made the point that these young people (the audience being primarily parents) are, quite often, getting their drugs in their own neighborhoods. Sure, before they are resold here someone gets them in Chicago or Milwaukee, but the end users can and do get the drugs close to home.

One speaker described how dangerous and scary the places where drugs are sold are. How his agents, when they do drug buys, have 4 back-ups watching over them to help if the need arises. How violence can erupt at any time. (Although it seems to me that they are the police and their buying introduces variables that do not exist in the more typical drug buy.) I know some of these places are rough and potentially dangerous, like places on the west side of Chicago. But to painting them so ominously, so evil, particularly areas near where I live (North Chicago and Waukegan were specifically mentioned) does seem a bit melodramatic (for crying out loud, I live in Waukegan with my family). Realize that nearly all drug buys go off without a hitch or we would have dead addicts littering our streets.

My thought here is that this smacks of feeling the need to paint these folks as the other, the evil other. Demonize them and we don’t really have to deal with them. They are outside our communities. They live and do evil things elsewhere. Our community is safe. It (the bad stuff) is only outside our community. Sure sometimes it creeps in and affects one of our own. But it is not us, it is them. It is evil contagion from outside. We don’t have to deal with the ickiness, just continue to buff up our stuff.

One of the points I hope I made was that young people are getting the drugs, quite often, near home. The drug sellers are often “us”. The drug users and abusers are “us”. They are among us. Very often you can’t tell by looking at them. They work in our stores and restaurants. They walk by us on the streets and go to school with our kids. They aren’t fiends. They don’t look like the alleged meth user pictures on the Internet that one of the presenters showed.

We as a community need to respond to saves others in our community. Our focus must be more than arrest and imprison. We must make sure help and treatment is available. We must get rid of the stigma and shame that often accompanies seeking and getting help for drug use or mental health issues. “They” are not “others”, they are “us”.