Monday, December 02, 2013

No Spike of Suicides With the Holidays

I was listening to a speaker yesterday and she brought up the old saw that there is a peak of suicides between Thanksgiving and New Year’s Day. It is one of those statements that seems to make sense logically, but is nonetheless not true. 

Suicide is amongst the leading causes of death in our country and every one is a tragedy (although I am not sure that the latter is always true and I will come back to that shortly). While we may be more acutely aware of the tragedy of suicide during this holiday stretch, the incidence of suicide actually peaks in the spring.

I thought I’d take this opportunity to mention just a few other facts about suicide. First, we do not die by suicide at the depths of our personal darkness, but as the energy returns to us we can then act on the thoughts that we had at our darkest. That explains why people “seem better, seem OK” just before they take their own life. It may also explain why suicide peaks in the spring, the renewal of our world returns the energy to act. It also explains why someone who has started on medication for their depression is at increased risk of death by suicide. It is not the medication itself, but the fact that it has lifted them out of the “goo” of depression to the point that they can now act.

I’d also like to mention that there are considered to be 3 categories of suicide. The first accompanies the deep, existential pain of depression. That feeling that the world would be better off with out us or that we would be better off without the world, the only resolution for our pain. The first category of death by suicide accompanies that severe, clinical depression. The heavy blanket sensation that life can get no better. The second category is situational, e.g. accompanying a loss of job and that blow to our identity or a broken relationship. The third category is the rational choice, this usually accompanies the knowledge that you are terminally ill and that your death is imminent or the process will be unbearable for you. The last is the category in which I am not certain that the death is totally a tragedy, although it will always be for the survivors. also, I would note as well that the first 2 categories are at times mixed and synergistic in being a driver toward suicide.

What to do at this time of year, or at any time, when encountering someone with thoughts of suicide. Push them to get help, at the very least to talk to 1-800-suicide or visit their website ( Get them to pause and think as well. There are often options that they do not see at first. Help them expand their thoughts, of possibilities and consequences, but, foremost, get them to professional help.

Thursday, October 17, 2013

Fear the Heroin, not the Krokodil

I know it is jazzier, “sexier” to put Krokodil front and center in the news these days. However, for a news outlet (CBS2) to step on a report about a community forum discussing the scourge of heroin sweeping the suburbs, seemingly to grab attention and not give useful information, is reprehensible in my way of thinking. 

Yes, talking about a drug whose name translates to crocodile as “flesh-eating” (all news outlets) and/or as a drug that turns people “into zombie-like creatures” (CNN) gets folks to tune in and buy your newspaper. But how about a little truth in reporting. Krokodil is a drug made from codeine and various “household” chemicals, including gasoline. When injected it has a high potential of destroying blood vessels in various parts of the users body, dead blood vessels equal dead skin/tissue. It does not “eat” flesh. It no more makes the user “zombie-like” than any number of other illicit and licit drugs. Krokodil use has grown in some countries where codeine is cheap and readily available, while heroin is expensive and difficult to come by. That is not the case in the US and especially not true in the Chicago area.

Krokodil may or may not be in our area. Keep in mind that having “dirty” works for injection preparation or poor injection technique can lead to blood vessel “death” just as certainly as Krokodil.

In our area heroin is cheap ($5-10 a dose), potent, and readily available. I have spoken of that many times in this blog over the years, e.g. 2008 Illicit Drug Prices and 2009 Coroner riffs on heroin deaths. Heroin deaths have shown no signs of abating and they are definitely increasing in many areas around Chicago. The heroin, available in most any neighborhood any more, is so pure you don’t have to inject it, making it oh so much easier to use. It’s purity makes it profoundly addicting as well. It is so cheap that it crowds out competing drugs.

Heroin use and abuse must be our focus, as it was yesterday, is today, and needs to be in the forseeable future. Heroin is the drug scourge locally, not some drug that makes it easier to write catchy headlines and subject teasers. Heroin is what we must fear (and work to get control of), not Krokodil.