Answer Addiction

Tag: Features

  • We Need Harm Reduction for All Drugs, Not Just Opioids

    We Need Harm Reduction for All Drugs, Not Just Opioids

    While we’ve made great strides with harm reduction for people who use opioids, we’re slow to provide non-abstinence-based treatment for people who use other drugs.

    A quick glance at the news reveals the catastrophic effects of opioids across the nation: around 120 people a day die from opioid-related overdoses. It’s so devastating that the nation is calling it an opioid epidemic. Yet even as we watch this tragedy unfold, we’re missing the point.

    By focusing exclusively on opioids, we’re overlooking the harm caused by other deadly drugs. How can we highlight harm reduction resources if we only focus our efforts on people who use one class of drug?

    The Problem with the Opioid “Epidemic”

    According to the Centers for Disease Control and Prevention, more than 700,000 people died from a drug overdose between 1999 and 2017. Sixty-eight percent of those deaths in 2017 involved an opioid — approximately 70,200. However, that’s not the 100 percent that the “epidemic” coverage would have us believe.

    While I’m not arguing that the opioid-related deaths shouldn’t be covered — they should! — I am saying the problem with zeroing in on the opioid epidemic is that we are focusing too narrowly on the harms caused by one drug and are blinding ourselves to the impact of other deadly drugs. We should be reporting on those, too.

    A more accurate picture of drug-related deaths in 2017, according to the CDC, looks like this:

    • Alcohol was responsible for the deaths of 88,000 people
    • Cocaine misuse killed 13,942 people
    • Benzodiazepine misuse was responsible for 11,537 deaths
    • Psychostimulant misuse, including methamphetamines, was responsible for 10,333 deaths.

    Those aren’t insignificant numbers, so why are they being overlooked? I asked recovery activist Brooke Feldman for her perspective.

    “The sensationalized and narrow focus on opioids fails to account for the fact that people who develop an opioid use disorder typically used other drugs before and alongside opioids,” Feldman said. “So, we really have a polysubstance use situation, not merely an opioid use situation.”

    She continues, “Focusing on opioids only had led to the erection of an opioid-only infrastructure that will be useless for the next great drug binge and is barely relevant to address the deadliest drug used, which is alcohol.”

    The Deadliest Drug: Alcohol

    Alcohol is responsible for more deaths than any other drug. But we overlook it for two reasons: because it’s legal, and because it’s a socially acceptable drug. Not only that, but advertising actively promotes its use — you only have to look on Instagram or Etsy to see how widely excessive use of alcohol is normalized — especially among mothers and millennials. These advertisers have been smart to market alcohol as a means of self-care — encouraging drinking to help unwind from the stresses of the week — and as a means of coping with motherhood. 

    Social media reinforces the message that alcohol is a tool to cope with stress and something that should be paired with our favorite stress-relieving activities, like yoga. Captions on Instagram read like “Vino and vinyasa,” “Mommy’s medicine,” “Mommy juice,” “It’s wine o’clock,” “Surviving motherhood one bottle at a time,” and “When being an adult starts to get you down, just remember that now you can buy wine whenever you want.”

    Perhaps what is most insidious about alcohol is that it heavily impacts marginalized and oppressed communities. For example, Black women over 45 are the fastest-growing population with alcohol use disorder. And the LGBTQ+ community is 18 percent more likely to have alcohol use disorder than the general population.

    Alcohol aside, looking at the harm done by other drugs, we can see that opioids are no longer the leading cause of drug-related death in some states. In Oregon, statistics show, deaths related to meth outnumber those that involve one of the most common opioids, heroin. In fact, there has been a threefold increase in meth-related deaths over the last ten years, despite the restriction on pseudoephedrine products, which now require a prescription. 

    Similarly, in Missouri, which was ground zero for home-based meth labs 20 years ago, the recent spotlight on opioids has overshadowed an influx of a stronger, purer kind of methamphetamine. Deaths related to the new and improved drug are on the rise.

    Oregon’s state medical examiner Karen Gunson speaks to this disparity of focusing on opioids over other deaths and the damage that those other drugs cause. “Opioids are pretty lethal and can cause death by themselves, but meth is insidious. It kills you in stages and it affects the fabric of society more than opioids. It just doesn’t kill people. It is chaos itself.”

    Abstinence Is Not Attainable for Everyone

    Our approach to recovery has been too one-dimensional, stating that complete abstinence is the goal. But this perspective is outdated. Abstinence isn’t attainable for everyone. If it were, then more people would be in recovery. However, harm reduction is attainable. It reduces deaths, treats medical conditions related to drug use, reduces the transmission of diseases, and provides options for treatment services. In fact, people who use safe injection sites are four times more likely to access treatment.

    “Whether it is with problematic use of alcohol, tobacco, cocaine, methamphetamine, etc. use, centering harm-reduction principles and practices would likely engage more people than an abysmal 1 out of 10 people who could use but do not receive SUD (Substance Use Disorder) treatment,” Feldman explains. “Requiring immediate and total abstinence rather than seeking to address overall well-being and quality of life concerns is a barrier to engagement — and sadly, it is placing the focus more on symptom reduction than it is on what is causing the symptom of chaotic drug use in the first place.”

    Harm Reduction for All Drugs Means Fewer Deaths

    Our focus on the opioid crisis has helped improve harm reduction resources — like the increased availability of naloxone to reverse overdoses, and the more accepted use of pharmacotherapy and medication-assisted treatment (which has now been endorsed as a primary treatment by the Substance Abuse and Mental Health Services Administration), and some safe injection sites — but it has also meant we aren’t concentrating as much on research, funding, and education devoted to harm reduction practices for other harmful drugs. The result is that we have fewer resources and less awareness when it comes to keeping people who use non-opioid drugs safe.

    We need to look at reducing harm across the spectrum of drug use to reduce all deaths. More safe usage sites, clean tools, safe disposal bins, medical assistance, education, referral to other support services, and access to pharmacotherapy (including drugs to treat or mitigate harms of alcohol use disorder and the development of new medications for help with other substances). Specialized treatment other than abstinence should be accessible for people who use all drugs — not just opioids. 

    View the original article at thefix.com

  • 8 Super Relatable Songs About Addiction and Recovery from the Last 5 Years

    8 Super Relatable Songs About Addiction and Recovery from the Last 5 Years

    Drug-fueled parties, overdoses, stories of survival and despair. These songs deal with all that and more.

    There are so many songs celebrating the party lifestyle “and we dancing to a song about a face gone numb” (Macklemore – “Drug Dealer” feat. Ariana DeBoo). What about songs that explore recovery from addiction? There are more than you might realize. 

    How long will it take to dispel the stigma around substance use disorders and other mental illnesses? Songs that talk openly about these issues are helping to bring awareness to the public consciousness. In just the last decade, there have been so many incredible songs written about addiction. Here are just a handful of the best songs about addiction and recovery from the last five years:

    1. Shawn Mendes – In My Blood

    Shawn Mendes wrote the 2018 song “In My Blood” as a way to open up about his struggles with anxiety. The lyrics ring true for anyone who knows the excruciating pain of trying to cope with mental illness, including addiction. The song is empowering with the lyrics “sometimes I feel like giving up but I just can’t, it isn’t in my blood.” Survivors can relate to the drive to not give up on yourself, even when it’s something you can’t explain, that it just isn’t in your blood to give up.

    I’m overwhelmed and insecure, give me something
    I could take to ease my mind slowly
    Just have a drink and you’ll feel better
    Just take her home and you’ll feel better
    Keep telling me that it gets better
    Does it ever?
     

    2. Mike Posner – I Took a Pill in Ibiza

    You might know this 2015 song in its hyped up, remixed version. The SeeB remix of this song was played in clubs non-stop and streamed over a billion times on Spotify, and its music video seen over a billion times on YouTube. The original is actually a stripped-down tune about regretful drug use, excessive partying, depression, and loneliness. The backstory of a song doesn’t dictate how it’s consumed by listeners, but this tune was basically borne from a bad trip and written as a way to process “dark and heavy emotion.”

    The song is also poignant for its mention of Avicii, who was open about his own experiences with depression, addiction, and recovery, and who died by suicide last year.

    But you don’t wanna be high like me
    Never really knowing why like me
    You don’t ever wanna step off that roller coaster and be all alone
     

    3. Calvin Harris, Rag’n’Bone Man – Giant

    Scottish DJ Calvin Harris collaborated with Rag’n’Bone Man to create the stirring 2019 song “Giant.” Giant starts off with a common thread in addiction, loneliness, and trying to fill that void with something (in this case, pills). The song itself goes on to feel empowering and hopeful. Rag’n’Bone Man sounds like he’s singing about recovery: “You taught me something, yeah, freedom is ours, it was you who taught me living is.”

    I understood loneliness
    Before I knew what it was
    I saw the pills on the table
     

    4. Demi Lovato – Sober 

    The entirety of Demi Lovato’s single “Sober” is a real-life relapse confession. She wrote this song about her 2018 relapse after six years of sobriety. Part of the message is similar to Macklemore’s “Starting Over” as she sings about letting down her fans and the challenge of being public about sobriety. Loneliness is a central tenet of addiction for many, and this song touches on that with lyrics like “it’s only when I’m lonely…just hold me, I’m lonely.”

    Momma, I’m so sorry, I’m not sober anymore
    And daddy, please forgive me for the drinks spilled on the floor
    To the ones who never left me
    We’ve been down this road before
    I’m so sorry, I’m not sober anymore
     

    5. Ed Sheeran – Save Myself

    Ed Sheeran’s 2017 “Save Myself” is about finally learning to put yourself first. Like a person who became addicted to cope with codependency, the song talks about the problems inherent in giving your everything to save another person. If we don’t take care of ourselves, we can’t ever help anyone else.

    Life can get you down so I just numb the way it feels
    I drown it with a drink and out-of-date prescription pills
    And all the ones that love me they just left me on the shelf
    No farewell
    So before I save someone else, I’ve got to save myself

    And before I blame someone else, I’ve got to save myself
    And before I love someone else, I’ve got to love myself
     

    6. J. Cole – Once an Addict

    Cole’s 2018 album KOD tackles topics like mental health, addictions, trauma, and mental illness stigma in the black community. The song “Once an Addict” explores being an addict who is the child of an addict. Those of us who have experience with a caregiver’s alcoholism can directly relate to the pain of watching someone you love kill themselves slowly; then to numb that pain, becoming addicts themselves.

    Something’s got a hold on me
    I can’t let it go
    Right
    Life can bring much pain
    There are many ways to deal with this pain (right)
    Choose wisely
     

    7. Belly – What Does It Mean?

    Palestinian-Canadian rapper Belly put together the powerful 2018 album “Immigrant.” The album includes a song titled “What Does It Mean?” This track doesn’t hold back in its honest depiction of addiction at a young age. It holds hope by talking about still being alive after having an overdose at only 16 years old.

    On God that’s the moment that they all fear (all fear)
    Look, I was only fourteen (fourteen)
    X addiction got me feeling like a whole fiend
    Sixteen, first time that I OD’d
    And I’m still here
     

    8. NF – How Could You Leave Us

    Nathan Feuerstein, better known as NF, is a rapper who often pens songs about childhood trauma and mental illness. NF’s 2016 song “How Could You Leave Us” is a heartbreaking song about losing his mother to an addiction to pills. He says in the song that he doesn’t know what it’s like to have that addiction, but he does “know what it’s like to be a witness, it kills.”

    I wish you were here mama but every time I picture you
    All I feel is pain, I hate the way I remember you
    They found you on the floor, I could tell that you felt hollow
    Gave everything you had plus your life to them pill bottles
     

    What are some of your faves? Let us know in the comments.

    View the original article at thefix.com

  • Digital Detox: I Gave Up My Smartphone for 22 Days

    Digital Detox: I Gave Up My Smartphone for 22 Days

    I had no idea how much of an Internet world I’d been living in, comparing my own Internet life with other Internet lives. Compulsively engaging with our smartphones distorts our self-image and objectivity.

    The idea to give up my phone came to me one day when I saw Facebook posts about the 10th anniversary of the death of 21-year-old Casey Feldman, who was killed by a distracted driver. I wanted to do something special to commemorate this, and then realized her anniversary was 22 days before my dad’s. He was also killed by a driver using a phone.

    I announced it on Instagram, knowing I wouldn’t open the app for three weeks to see anyone’s reaction to it: 

    “Because I believe distracted driving starts even before we get into a car, I’ve decided to go on a smartphone cleanse for 22 days every year, starting this year. That means the only phone use I will have is what it was built for—phone calls (and of course, not while driving—hands-free is risk-full!). I hope some of you will join me in this phone-free detox. I’m giving up apps, Instagram, music, podcasts, texting, whatever my phone does that puts it between my eyes and the world, for 22 days every year to honor two very special people who died because of it. I imagine my life will be much friendlier and more productive as a result. We’ll see. I’ll report back here on August 8. Good luck to those of you who join me.”

    Nothing could have prepared me for what came next.

    Week One

    It’s only been six days since I decided to go phone-free (except for calls) for a month, and I’m already happier. On Sunday night, I saw this beautiful sunset and was disappointed in myself when my first instinct was “must post photo of gorgeous sunset”…and of course I couldn’t, because I couldn’t use my phone, not even to take photos. Then I got really happy because I realized I was actually LIVING the sunset, something the compulsion to document everything can interfere with. Also, no more comparing my life to other people’s lives on Instagram or Facebook, and that’s bound to raise someone’s happiness level. 

    I’ve cheated a few times when I had no other option, like when my train was coming and I didn’t have time to buy a ticket. But other than these times, I’ve fought every urge to look at it. If someone texts me who doesn’t know about my cleanse, I politely text back but keep it short. No more novel-long texting sessions, which I’m realizing are nowhere near as effective or connective as a simple phone call. 

    I’m also more present and creative. Ideas for my writing have come to me more clearly—I feel less lost in structuring stories because my brain is more present and I’ve got plenty of time to think about it. I’m more present in pretty much everything I do. There is a clear line now between being on a computer and being out in the world, just like there used to be, before smartphones.

    My conversations are better. Because I’m more present when I’m by myself (i.e., not reading my phone), I’m also more present when I’m with others. I’m a better listener and my stories are better (or so I’m told). I’m operating at peak capacity instead of whatever percentage I was at before. And I’m hella more productive! When I’m sitting at a desk, my brain gets it that this is “work time.” There is a balance, a dividing line between work and rest. 

    In short: Life is so much better. Yes, I’m getting pretty bad FOMO. I guess I just have to trust that whatever I’m missing probably isn’t all that important. And there are still analog ways to do things, we can still exist in the world without being connected 24-7. When I see other people on their phones for entire train rides or walking around (or tonight, when I saw a guy straight-up watching a movie on his phone with giant headphones while RIDING A BIKE), I feel bad for them. I think, Man, I’m sorry life is so uninteresting to you that you have to do this. 

    None of this even begins to address people who have to stay on their phones while driving, the catalyst for my doing this. But I’m beginning to see why the addiction is so hard for them to break. If they weren’t addicted, putting a phone aside would feel like nothing. 

    Week Two

    I’ve had moments during the past week where I felt tempted to use my phone. I did have a few exceptions this week, like brief texts with a friend I was meeting for dinner who didn’t know about the cleanse and emailing a work contact when an assignment was suddenly due. And I’ve used my phone for my alarm clock. 

    But other than that, I haven’t used it at all.

    This means no Googling when I want to know about something. I have to actually think things through and surmise an answer. Not feeling like this gadget requires my constant attention is tremendously freeing. I hadn’t realized how much mental energy I’d been needlessly devoting to it all this time.

    Another interesting development: My animosity towards just about anyone has softened. If someone says something I perceive as troubling, I give them the benefit of the doubt. I’m noticing that with the lack of phone interaction (texts, social media, etc.), I’m thinking in a more civilized manner. I greatly prefer this way of relating—one that allows for shades of gray in people’s motivations. 

    On the flipside, I’ve had a few moments of anxiety that surprised me. I found myself crying profusely twice and feeling great panic and overwhelm a few others. I realized that in my regular life, these emotions are being suppressed. The panic is coming from just plain existing without being able to distract myself with my electronic pacifier. And that’s scary—what other emotions has my smartphone been repressing all this time? 

    Cognitively things are better, too. Creative problems are solved faster. I have more faculties available to me and can think more deeply about them. My vocabulary is better and I have better access to my subconscious, so a writing problem I was struggling with for a year has now been solved. 

    I also suddenly have more hours in a day. Not stopping to photograph everything and then sharing it means I get to experience the thing fully, just by myself or with whoever is next to me, and I get to experience twice as many of those things. 

    Don’t get me wrong, I’m not saying that sharing things via your phone is a waste of time. Like everything, it’s meant to be a tool to enhance your life, not escape it.

    I had no idea how much of an Internet world I’d been living in, comparing my own Internet life with other Internet lives. It seriously distorts your self-image and objectivity—and sense of gratitude. I am so grateful now for my wonderful life, one I am living, through my own eyes, and not through a screen any longer.

    I can’t wait to see what the next 11 days bring.

    Week Three

    Of course I would manage to schedule driving somewhere new smack in the middle of my 22-day smartphone cleanse. I was invited to speak on a podcast today an hour and a half away.

    When I set out to make the drive, I figured I wouldn’t need GPS at all. It was a straight shoot down the Garden State Parkway, with only two turns at the end. But then I needed to stop for gas. 

    I’d been rehearsing in my head things I might say during the podcast—like how bad technology is for us. And then technology saved me. I turned too soon, into a car wash instead of the Lukoil, and I couldn’t see any way for me to get over there. I pulled over into a gravelly parking lot, put the car in Park, and opened my GPS. It rerouted me and got me where I needed to be. 

    Using GPS is okay. It’s interacting with GPS while driving that’s not. I emailed my podcast hosts to tell them what happened while I was sitting in my parked car at the gas station, which was safe. Doing that while driving would not have been.

    Week Four: The Aftermath

    I’ve been allowing myself all smartphone privileges again for six days now, and it’s been really weird.

    Thursday, the anniversary of my dad’s death, was the last day of my 22-day smartphone cleanse. I experienced it far differently than I have in years past—mostly because I didn’t wake up thinking, What should I write about this on social media? Instead, I talked with my family about it, on the actual phone. There is something about sharing these things online that isn’t sufficient—it almost dissipates the weight of this very private thing. Plus, the responses you get from strangers can never equal the heartfelt responses you get from people who were actually there. 

    On Saturday, just before my cleanse ended, I was walking around my neighborhood and noticed another development—I was looking around more. I was seeing more of my world because the tunnel vision I’d developed from looking at a small screen all the time had gone away. Even six days back from the cleanse, I haven’t returned to it.

    My first time looking at my phone for longer than five minutes was last night. I could feel the addiction start to take hold again, so I imagined a giant X over the phone when I went to bed. After I set my alarm, I flipped it over so I couldn’t see the screen. When I woke up and checked the time, I saw someone had texted me but decided I wouldn’t respond until I’d gotten to work—in fact I wouldn’t use my phone at all until I got to work, just like I did during the cleanse. I’m going to keep doing this.

    One Month Post-Cleanse

    It’s now been four weeks since the end of my experiment, and I’m still not back to using my phone like I was. I don’t use it until I get to work, and I don’t use it after I get into bed at night. I also haven’t gone back to listening to music on my phone. Early on, I realized I wouldn’t be able to make it through the cleanse without music, so I switched to using my iPod. Turns out the audio quality is much better. Plus just listening to music is more enjoyable when you’re not also checking email and reading texts.

    The hardest part is when I can’t sleep. In the past, I’d scroll with my brightness dimmed, hiding the phone below the mattress so as not to wake my husband (an incredibly light sleeper). But now I picture that giant red X over the flipped-over phone along with a big circle around it, “no smoking”-style. And that seems to help.

    Engaging with our smartphones is a never-ending cycle that starts with good intentions. We check it to be sure family members are okay. Next thing we know, we’re checking for texts from our mothers, then work email, then texts and email from friends, then all our various social media accounts. We have our calendars and exercise and music on our phones. And then we’ve got the devastating 24-hours news cycle and you-know-who’s Twitter account. The result is we’re chronically feeling bad about ourselves. 

    We feel like we’re never enough.

    And then before we know it, we’re compulsively checking while driving—when the most compassionate thing we could do for ourselves, our kids in the backseat, and other people out there on the road is be present.

    When we make the effort to actually see others, with our own eyes, we open the door to be seen ourselves.

    We open the door to see ourselves.

    Five quick-and-dirty tips if you want to modify your phone use:

    1. Give it up cold-turkey for a set amount of time. Knowing I had a 22-day deadline helped me stick to it. It’s a misconception that it takes 21 days to start a new habit. Scientists have found it typically takes more like two months or longer. But if you give yourself three weeks, that feels more doable. Even a few days, as you can see from my accounts, can make a big difference.

    2. Do it for someone you love. I did mine for my dad and for a girl I’d never even met who died the same way my dad did. It never would have been enough for me to do it just for my own well-being or the well-being of others. When we do things for honor, it makes our drive stronger. It’s how marathoners finish races when they’ve raised funds for charity at the same time.

    3. Don’t beat yourself up if you slip. Whatever you slip on will teach you a lot about yourself—though I already knew I ran around like a chicken with her head cut off. The idea is to limit the hold the phone has on you, not prohibit use when you legitimately need it. 

    4. Don’t worry about losing social media. People you’re truly close to will understand and bend to fit your new rules. And the people whose voices you miss hearing will become closer again. A novel-long text exchange does little to convey the emotions a five-minute phone call can.

    5. Don’t be scared if emotions appear that you didn’t know were there. Our phones keep us in a perpetual state of reactivity. It’s better to be available to think and process things fully. We become like superheroes when we have our wits about us—able to be aware and help others, able to talk to strangers and make new friends, able to think an idea all the way through, able to appreciate the beauty of a songbird or a tree or a new house going up. As small as our worlds might feel without constant awareness of all those other worlds online, it’s easier to feel gratitude and that our life is a good life—and we are the ones leading it. 

    View the original article at thefix.com

  • Should I Stop Vaping?

    Should I Stop Vaping?

    Are the alarming headlines justified? And should the risks associated with vaping be a deterrent when the alternative is smoking cigarettes?

    Over the past few weeks we’ve seen a surge of headlines that say vaping may be more harmful than we might have initially thought. Seven deaths have been linked to the use of e-cigarettes. In response, some states have banned vaping products. However, naysayers — including experts — argue that a knee-jerk reaction by health agencies is premature, overlooks the harm reduction that vaping achieves, and could cause a potential public health disaster. 

    If smoking is the de facto predecessor of vaping, then e-cigarettes should be examined within the context of nicotine delivery systems as a whole. Smoking is the leading cause of preventable death in the United States. Should the risk associated with vaping be a deterrent when the alternative is smoking cigarettes?

    Some in the recovery community say that it shouldn’t. Many former cigarette smokers have replaced their “analog” smokes with e-cigarettes, using vaping as a means of harm reduction that swaps out cancer-causing tobacco with a safer means of nicotine delivery. Recovery purists and some clinicians, however, argue that smokers are trading one addiction for another and express concerns that, lower risk or not, most vapers are still ingesting large amounts of highly addictive nicotine. They also point to this recent rash of deaths as evidence against vaping.

    Before we address the question of harm reduction, though, do the alarming headlines have any merit in science? And given that e-cigarettes have been around for 15 years, why are we only seeing deaths now?

    Recent Media Coverage of Vaping

    The American Medical Association (AMA) recently labeled vaping “an urgent public health epidemic,” and physicians have urged the Food and Drug Administration (FDA) to act. The AMA claims that research has shown that the use of e-cigarettes and vaping products is unsafe and causes addiction, however the statement does not provide the supporting research. The AMA also says they “applaud steps to remove flavored e-cigarette products from the market.”

    The Centers for Disease Control and Prevention (CDC) issued a statement that together with the FDA, local health departments, and other clinical and public health partners, they are investigating a multi-state outbreak of lung disease associated with e-cigarette products. The FDA echoed the CDC’s concern, calling the outbreak “a frightening public health phenomenon.”

    Dr. Dana Meaney-Delman, who is leading the CDC’s investigation, said in a statement, “The recent rise of acute lung illnesses linked to vaping has deepened concerns about the safety of the devices.” 

    But why now? People have been vaping for over a decade. The CDC’s Meaney-Delman says, “We’re all wondering if this is new or just newly recognized.”

    The Facts About E-Cigarettes

    Here’s what we know: As of this writing (9/21/19), the CDC states that 530 cases of lung illness have been reported from 38 states, and seven deaths have been attributed to vaping. Most affected patients also reported a history of using vaping products that contain THC. 

    The CDC does not yet know the specific causes of these illnesses: “The investigation has not identified any specific e-cigarette or vaping products (devices, liquids, refill pods, and/or cartridges) or substance that is linked to all cases.” Regardless, for those who are concerned with these issues, the CDC recommends refraining from using all vaping or e-cigarette products until they know more.

    Elsewhere on the website, the CDC still states that e-cigarettes have the potential to benefit adult smokers as a substitute for regular cigarettes.

    Because of the media coverage and caution by public health agencies, we are seeing increasing action across the US: New York’s former mayor, Michael R. Bloomberg, has committed $160 million to ban flavored e-cigarettes, Governor Gretchen Whitmer issued an executive order to ban the sale of flavored vaping products in Michigan, San Francisco has banned the sale of e-cigarettes, and President Donald Trump says the FDA will ban flavored e-cigarettes. 

    For Adolescents, Nicotine (in Any Form) May Harm the Brain

    Is this a knee-jerk reaction? It seems that some of the pressure is a result of parents and politicians who are concerned that flavored vaping products are responsible for the surge in teen use. That’s understandable, given the potential for nicotine to harm the developing brain. According to the CDC, one in five high schoolers and one in 20 middle schoolers vape.

    For adults, however, there appears to be conflicting statements by researchers, doctors, and health officials. 

    In a September 2019 article, Dr. Robert Shmerling at Harvard echoed the CDC’s bottom line: Experts are unsure if vaping is causing these lung problems, and lung disease has not been linked to a specific brand or flavor of e-cigarette. A more likely culprit, they claim, is a chemical contaminant within the inhaled vapors that is causing an allergic reaction or immune system response. 

    This belief is supported by a study that came out last year linking the chemical flavors within e-cigarettes to an adverse effect. Dr. Sven-Eric Jordt, PhD, one of the authors of the study, recently told The Guardian that “the liquids vaporised by e-cigarettes are chemically unstable and form new chemicals that irritate the airways and may have other toxic effects.” These new chemicals are not disclosed by the manufacturers to users. 

    Dr. Michael Siegel, a professor at Boston University, claims that health officials and physicians are not telling the full story: In every case in which a specific e-liquid has been identified, that e-liquid has been found to contain THC — a fact corroborated by the CDC. He states that the e-liquids in some of these cases were oil-based and typically purchased off the street; therefore, their ingredients are not strictly regulated. It is these oil-based THC liquids that are known to cause acute respiratory illness. 

    Similarly, the Washington Post reported that the FDA investigation found the same vitamin E-derived oil in cannabis products that were used by those found to be suffering vaping-related illnesses throughout the country. 

    CDC’s Guidelines: Unnecessarily Broad

    While Siegel acknowledges we aren’t in a position to draw conclusions about THC oils or to say that street products are definitely to blame, he believes the CDC’s recommendations are unnecessarily broad and consequently harmful, since people who vape may think it’s safer to go back to smoking cigarettes. 

    “I cannot overemphasize how insane this policy is,” he says. “From a public health perspective, it makes absolutely no sense to ban these fake cigarettes but to allow the real ones to remain on the shelves.”

    Instead, Siegel suggests, the CDC could offer more specific and useful guidance to the public, specifically: Do not vape THC oils (including butane hash oil), do not use any oil-based vaping e-liquid product, and refrain from buying products off the street or using any e-liquid that doesn’t disclose its ingredients. To reduce risk, people should “stick to products being sold at retail stores, especially closed cartridges where there is no risk of contamination or the presence of unknown drugs.”

    Switching from smoking tobacco to e-cigarettes is a proven harm reduction strategy supported by health officials and used by individuals in recovery. 

    Lara Frazier, a person in long-term recovery, explained, “I am in abstinence-based recovery and quit smoking cigarettes over four years ago, thanks to e-cigarettes.” Regarding the recent deaths associated with vaping, she says: “There is mass hysteria about vaping, with people not being properly educated on what is actually occurring.”

    Frazier is concerned about the consequences of recent official warnings: “Nicotine addiction is like any addiction, and banning flavors will likely not result in less nicotine being smoked. This could cause more harm because the teenagers will have to find black-market cartridges, make their own juice, and/or switch to smoking cigarettes.”

    She continues, “I think it’s ridiculous that they are going to ban all flavored juices that aren’t tobacco-based on five (now seven) deaths and illness without properly looking at the data or researching the cause of the illness.”

    Vaping as Harm Reduction

    There is world-wide support and evidence for vaping as harm reduction. A study conducted by the New England Journal of Medicine found that vaping was nearly twice as effective as conventional nicotine replacement products for smoking cessation.

    In the UK, Public Health England also supports vaping as a harm reduction strategy. Even in light of the recent concerns, their position has stayed the same: “Our advice on e-cigarettes remains unchanged — vaping isn’t completely risk-free but is far less harmful than smoking tobacco. There is no situation where it would be better for your health to continue smoking rather than switching completely to vaping,” they said.

    Yaël Ossowski, deputy director of the Consumer Choice Center, urged President Trump to consider the facts before reacting hastily and pushing for a ban, arguing that vaping is a less harmful alternative for consuming nicotine. Ossowski cites a 2016 report by the UK’s Royal College of Physicians, which reviewed the science, public policy, regulation, and ethics surrounding vaping and concluded that e-cigarettes should be promoted widely as a substitute for smoking. The report also sought to clear up misinformation about vaping and long-term harm, stating that while there is a possibility of harm from e-cigarettes, it is unlikely to exceed five percent of that associated with tobacco products. 

    Smoking Cigarettes Is Still The Leading Cause of Preventable Death

    According to the Centers for Disease Control and Prevention, more than 16 million Americans are living with a disease caused by smoking. We have abundant evidence that smoking leads to disease and disability, harming nearly every organ in the body. It causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease. It also increases the risk for tuberculosis, eye diseases, and autoimmune conditions. 

    Worldwide, the use of tobacco products is responsible for more than seven million deaths each year. In the U.S., 480,000 people die every year from smoking, and 41,000 people die as a result of secondhand smoke. Economically, smoking has a huge impact on the United States: it costs $170 billion a year in direct medical care, and $156 million in lost productivity. 

    Smoking remains the leading cause of preventable death. 

    At this point, the evidence supports vaping as an effective means of harm reduction, thus outweighing the limited risks. Further, public health officials have yet to complete their investigations into these risks so they can conclusively identify the cause of the deaths attributed to vaping. It seems foolish to enforce blanket bans on e-cigarettes, as that may cause further harm by pushing people toward buying black-market vaping products or resuming smoking cigarettes.

    View the original article at thefix.com

  • Let’s Talk About Suicide

    Let’s Talk About Suicide

    Changing misconceptions and long-held stereotypes won’t happen overnight, but making the conscious decision to talk openly and honestly about suicide is a strong start.

    Suicide is everywhere. We hear about it on the news, we see the headlines, we read the sad statistics. But here’s the thing: We don’t talk about suicide. We’re not having the kind of open, honest conversations that will start breaking down harmful prejudice and stigma – about people who die from suicide and also the people left behind.

    We know the facts and figures, but that’s only part of the story. We don’t know how to actually communicate about suicide to learn what’s behind the statistics. We can’t fill in the blanks because we’re afraid: We worry that we’ll say the wrong thing, or unintentionally offend someone. So instead we say nothing at all. But staying silent is far more damaging; it further stigmatizes suicide, which is already misunderstood and has so much judgment attached to it in the first place.

    Start a Conversation

    September is Suicide Prevention Awareness Month – a time the National Alliance on Mental Illness (NAMI) describes as a time to share stories and resources in an effort to start meaningful conversations on the taboo of suicide.

    “We use this month to reach out to those affected by suicide, raise awareness and connect individuals with suicidal ideation to treatment services,” reads NAMI’s website. “It is also important to ensure that individuals, friends and families have access to the resources they need to discuss suicide prevention.”

    Suicide is the 10th leading cause of death in the United States overall, but it’s the second leading cause of death in people ages 10-34. In 2017, there were twice as many suicides (47,173) in the U.S. as there were homicides (19,510).

    How Can We Help Prevent a Leading Cause of Death if We Can’t Talk About It?

    There’s a catch-22 when it comes to suicide: People are reluctant to talk about it because it’s a sensitive and deeply personal topic, but it remains a sensitive topic because people don’t talk about it. So we find ourselves tip-toeing around suicide altogether, which doesn’t help anyone. For years, I’d find myself at a loss for words whenever someone would mention suicide, so I’ve been there.

    And yet, I also found myself desperate to talk about it after my father died from suicide in 2003. In the months and years following his death, I began to see up close just how much people are unwilling to talk about suicide. I never realized just how uncomfortable the topic makes people, whether they’d personally lost someone to suicide or they’d seen one of the many headlines about celebrities who die by suicide. It really is a taboo topic. 

    How can we help prevent a leading cause of death if we can’t even talk about it? And how can we help people who have been left behind if we can’t acknowledge the cause of their pain?

    That’s why I’ve been trying to change suicide’s shameful stigma. For the last 16 years, I’ve been vocal, unafraid to talk about the very things people don’t want to talk about. In the beginning, I talked about my father as a way to process my grief. I saw it as a way to keep my father’s memory alive, but as the years went on, I began to realize that my talking about his suicide wasn’t just for me. Sure, it may have started out that way, but the more statistics I read and the more stories I heard, the more I learned how many people are affected by suicide. I began to feel a responsibility to share my story.

    I Want People to Know They’re Not Alone

    Today, I talk about suicide because I want people to know they’re not alone. I talk about suicide because I want people who have lost a loved one and people who suffer from suicidal ideation to know that they shouldn’t feel ashamed or like there’s something wrong with them. And not talking about it? That silence only reinforces harmful stigmas and can even be a significant barrier to someone seeking help.

    Instead of silence, we need to start regularly engaging in an open and honest dialogue, including debunking common myths associated with suicide. For example, misconceptions like the belief that most suicides happen without warning, and that people who die from suicide are selfish and “taking the easy way out” are false and incredibly damaging.

    So where do we go from here? Perhaps the best place to start is to realize that we all have a responsibility to create a safe space, says Forbes contributor Margie Warrell, who lost her brother to suicide.

    “While we may not all suffer from mental illness, we each have a role to play in ensuring that those who do suffer feel less afraid to reach out and get the support they need in the moments when they need it most,” she wrote in 2018. “If people felt as comfortable talking about their PTSD, bipolar or anxiety as they did talking about their eczema or tennis elbow, it would markedly reduce the suffering of those with mental illness and the ability of those around them to support them.”

    The stigma of suicide is far too strong, and any chance you get to talk about it is another opportunity to break down those walls of stereotypes. Don’t say the word suicide in a hushed tone, as if you’re talking about something you shouldn’t; the statistics show that most people have been impacted by suicide in some way. And try not to lie about how your loved one died because you think it will be easier than dealing with the looks and questions from people. When you lie, you’re sending the message that what your loved one did was shameful, and that further contributes to the misconceptions and prejudice people have about suicide. It might be difficult to be open about this, but it’s also freeing (and it gets easier each time you do it). 

    Mental Illness Is Physical Illness

    I’ll never understand why people don’t treat mental health the same as physical health. Why is someone “heroic” for battling cancer, but “weak” for dying from suicide? At its core, mental illness is a physical illness, so we can’t separate the two. The more we start talking about mental illness in the same way we talk about physical illnesses like cancer or diabetes, the more we lessen the stigma surrounding suicide. Changing misconceptions and long-held stereotypes won’t happen overnight, but making the conscious decision to talk openly and honestly about suicide is a strong starting point. 

    If you are in crisis or are experiencing difficult or suicidal thoughts, call the National Suicide Hotline at 1-800-273 TALK (8255).

    If you’re uncomfortable talking on the phone, you can also text NAMI to 741-741 to be connected to a free, trained crisis counselor on the Crisis Text Line.

    For more information about suicide prevention, or to get involved and learn how to help someone in crisis, visit #BeThe1To.

    View the original article at thefix.com

  • The Million Dollar Smile: My Life with Bipolar Disorder

    The Million Dollar Smile: My Life with Bipolar Disorder

    As many as 60 million people worldwide have bipolar disorder. Many of those people, like me, lead productive, happy lives.

    He said my smile was worth a million bucks, or was it that I had a million-dollar smile? 

    I remember when smiling was foreign to me. I’d wake in the morning feeling great for a few minutes, and then the dark clouds came, weighing in on my body, pressing down on me. Depression overwhelmed me, so much so that my entire body ached. I felt empty, hopeless, sad beyond belief, and exhausted.

    An Emotional Black Hole

    It was another day filled with mental and physical pain…another day spent looking for ways to make the pain stop. I sought help from the big one – God. I was in the early stages of finding Him. I also saw a psychologist for therapy, joined a support group, and listened to Melanie Beattie healing tapes. I read books like Happiness Is a Choice and joined a running club. Nothing worked. I sank deeper and deeper into an emotional black hole.

    I wondered how I could enjoy my new relationship with God, love Him, and still feel this intense pain. It was like nothing I ever experienced. I began to understand why people kill themselves, they want to stop the pain. So did I, and I entertained thoughts of committing suicide. Once when running, I visualized doing the deed. It felt real. I sobbed and limped home.

    Even in my desperate search for help, my suicidal thoughts were a closely-kept secret. I was afraid that if I revealed them to anyone I would be admitted to a hospital – maybe locked up forever.

    My life was spiraling down fast. Scared, I called my therapist. He referred me to a psychiatrist who focuses on chemical imbalances.

    The psychiatrist listened to me and asked me a series of questions. He seemed to know the symptoms I experienced without me telling him. Our session ended when he diagnosed me as bipolar 2. He said after six weeks of taking the medication he prescribed, a lot of those symptoms would disappear. I left his office feeling optimistic. Maybe this was the help I needed.

    A Real Smile

    Six weeks later, something wonderful happened. I was in my car and heard something funny on the radio. I smiled – something I hadn’t done in a long time. It felt so good that I pulled the car over and looked at my smile in the mirror.

    It was as if the sun burst out from behind the dark clouds, gobbling each one up. The cobwebs in my brain cleared, and I was smiling – even laughing. The medication wasn’t a miracle worker, but it squelched my black depression and left me with the ability to deal with my problems. 

    That was nearly 20 years ago. I don’t remember what it felt like to live with intense mental and physical pain for no apparent reason, and I don’t want to go there again. So, I take my medication and see my psychiatrist regularly. The dark clouds came back to haunt me once in the last 20 years, and I immediately saw my psychiatrist for help and got back on track.

    The Big Secret

    For the most part, I prefer to keep my bipolar status under wraps. I guess it’s out of the bag now with this story. There’s stigma and prejudice against people who are bipolar. Most people don’t know much about people with mental illness and expect us behave in negative, sometimes scary ways. Some of the most common beliefs are that we have wide mood swings, engage in manic behavior, and that we’re promiscuous, wild spenders, and we can’t sustain relationships or jobs. Even worse, some people, including the media, promote characteristics that bipolar people have tendencies to be violent.

    Sometimes the media reports a story about a criminal or murderer, adding that the person is bipolar. This makes me cringe. They don’t comment if a person has asthma, hypertension, allergies, or was overlooked for a promotion. Labeling these people as bipolar compounds the negative stereotype of violence. People with bipolar disorders don’t come in one category, and most of us, like the general population, do not have violent tendencies. 

    Should I Tell Him?

    Because of the negative stigma and prejudice, I’m careful about who I share my diagnosis with and when. I decided 10 months into a relationship would be a good time for this revelation. By that time, the person I’m in a relationship with would know what I’m typically like. I’m an okay, normal person who gets sad when the situation merits it – like when my boyfriend died from cancer or my job was eliminated. 

    Things moved fast when I met my husband. We started falling in love on our first date, so I felt he should know that I’m bipolar 2 sooner rather than 10 months later. Three months into the relationship, I told Larry about my diagnosis. I remember that nerve-wracking evening. When I tried to speak, the words stuck in my throat. It seemed to take hours before I had the courage to tell him. During this time, Larry grew nervous and wondered if I was going to break up with him. After I told him about my diagnosis, Larry acted like I told him about the weather – not anything serious like being bipolar 2.

    At my suggestion, Larry came with me to the psychiatrist so that my doctor could tell him about my case and answer his questions. Again, I was nervous. I believe I’m okay, but what will my psychiatrist say? What if I’m a nutcase in denial? My psychiatrist of 17 years told Larry that I have a mild case and will be okay as long as I continue taking my meds regularly and get enough sleep.

    Larry and I have been married for three years. As I expected, there haven’t been any crazy episodes or depressions.

    I feel very lucky that I’m getting the treatment I need. I started seeing my psychiatrist four times a year; now I see him twice a year. When I asked him if I could get off the meds, he said it’s not a good idea. I’m fine because I take the medicine.

    There Are a Lot of Us

    As many as 60 million people worldwide have bipolar disorder. Many of those people, like me, lead productive, happy lives. Some articles state that our 16th U.S. President, Abraham Lincoln, had bipolar disorder. Other people with this diagnosis include Catherine Zeta-Jones, Oscar-winning actress; Mariah Carey, singer; Jean-Claude Van Damme, an actor; Ted Turner, media businessman and founder of CNN; Patricia Cornwell, crime writer; Patrick J. Kennedy, Jesse Jackson, Jr., and Lynn Rivers, former members of the U.S. House of Representatives; Jane Pauley, a television journalist; maybe your colleague, sibling or neighbor…and me, a corporate communications and freelance writer.

    Bipolar disorder is a chronic illness with no cure, but it can be managed with psychiatric medication and psychotherapy. I’ve been doing it for nearly 20 years and plan to do that for the rest of my life. Being free of bipolar symptoms enables me to smile…and mean it. 

    View the original article at thefix.com

  • Traveling with Prescription Medication? Here's What You Need to Know

    Traveling with Prescription Medication? Here's What You Need to Know

    Even non-controlled drugs may be regulated. Make sure to investigate the status of all your medications, prescription or otherwise. Don’t risk your vacation turning into an extended stay at a prison camp.

    The first time I flew to Canada, I was petrified about getting through customs and security. My fear was not from venturing into a new country, but from the controlled prescription drug I had tucked away in my carry-on bag. I had just filled the Adderall prescription at my local pharmacy, and I’d asked the clerk if I needed to carry the whole bottle or if I could just bring my pill carrier with the number of pills I needed for the trip (I was only staying four days). 

    “Oh no, honey,” she said, “this is a controlled substance, you probably have to declare it at the border.” DECLARE it? I was so scared going through security the next day that I’m sure the extra pat-down after the body scan was due to my nervous and probably suspicious behavior. 

    Fast-forward a year later and my daughter, who inherited my ADHD, was set to go on a trip to Japan. She called me in a panic, talking about prohibited psychotropics, documents and signatures, and a 30-day restriction. She was going for six weeks and Ritalin was on a list of flagged drugs for the country. 

    So, what do you do in these situations? Google produces a myriad of results that may or may not offer the correct information. In fact, some of the crowdsourced question-answering sites turned out to have completely inaccurate information. Had we followed the instructions on one site I Googled, my kid’s medication would have been confiscated at customs and my daughter arrested by Japanese police—like Julie Hamp was in 2015.

    Below I’ve compiled some questions that my family and others have asked when preparing to travel with controlled prescription drugs. The answers I’ve provided are based on my experience and research, but no resource can address every possible situation and laws change over time, so no matter what you find here, ALWAYS double-check the information with the TSA website if traveling within the U.S., or the embassy of the country you are flying to outside the U.S. 

    1. What types of prescriptions are controlled? 

    Most medications that you should worry about are categorized as narcotics or psychotropics. Narcotics are drugs that may relieve pain, while also possibly making you sleepy or dulling the senses. The term often refers to opioid and opiate medications but could mean others such as benzodiazepines. Psychotropics “affect the mind, mood, or behavior.” 

    Ask your pharmacist if your medication is controlled. You can also find this information in the paperwork that comes with your prescription or on the prescription bottle. 

    (Note: even non-controlled medications may be subject to regulation. Make sure to investigate the status of all your medication, prescription or otherwise, by following the guidelines below.)

    2. How do I find out if my medication requires special preparation or rules? 

    The International Narcotics Control Board (INCB) tries to keep an updated list of substances and the countries that regulate them. Read their “General Information for Travelers Carrying Medicines Containing Controlled Substances.” At the end, click “Browse Regulations by Country.” You can also click on the sidebar links for “Narcotics” or “Psychotropics.” There, you will find links to the updated lists of medications and the countries that regulate them.

    *Note: You will need to know the chemical name for the medication, not its brand or commercial name. You can find that in your prescription records. 
     


    A list of countries that prohibit Ritalin (methylphenidate).

    3. How do I prepare my medication for my trip? 

    Find out what your destination country requires. For Japan, we learned that my daughter can only bring in a 30-day supply of her medication. Now, a Q&A website suggested shipping the additional week of pills to her in Japan. But we see how that worked out for Julie Hamp. In order to have enough medication for her entire trip, my daughter needed to complete special documents that were downloadable from the website of the Japanese Ministry of Health, Labour, Welfare page under “Pharmaceuticals and Medical Devices”. Some of the INCB links do not have working URLs, so prepare to Google to find the right agency. You can also call the phone numbers listed in the country’s info.

    Start this process early. We started two months before my daughter’s trip to Japan. The process included filling out paperwork (including a statement from her doctor – more on that below) that we had to send to Japan ahead of the trip, and then we had to wait for the approval documents granting permission to carry the Ritalin into the country. It took three weeks to get all of the information we needed. If there was a mistake on any of the documents, we had to start all over. 

    *Note: Never modify documents issued by a government. Doing so invalidates the document and may be a crime in that country. 

    4. Does the 3-1-1 rule apply? 

    No. But it may make things easier if you do put your medication bottles together in a clear bag. The TSA may ask you to remove them from your bags. Depending on the rules of the country, you may need to alert the customs agents at the point of entry that you have controlled medications. Make sure that the meds and necessary documents are easily produced to expedite your time at customs. 

    5. Do I need a prescription or a doctor’s note? 

    Maybe. And look up the requirements for your destination country as you may need an additional document. The information we found for Japan in the INCB database specified that we would need a doctor’s note for her Ritalin. 

    6. Will I get into trouble for carrying pills without the prescription bottles? 

    It’s a risk. You could get the pills confiscated and/or have to undergo additional security checks (like a manual pat-down or search). To avoid problems, keep medication in its original container. Also, if you get stopped by police on the street in your destination city, it’s best not to have an unlabeled bottle of pills in your purse or pocket. 

    7. What if my medication is listed as prohibited? 

    Contact the destination country’s embassy to see if there is a way to get special permission to carry your medication. Some countries may prohibit certain medications entirely. If you’re headed to one of those countries and can’t get official permission, don’t risk it. Don’t assume you’ll be the  exception to the rule because you have a doctor’s note or you look a certain way. You don’t want your vacation to turn into an extended stay at a prison labor camp.

    8. I have a prescription for my marijuana, can I take it on a plane (in the U.S.)? 

    Do not bring marijuana when you travel internationally. Regarding domestic travel, the TSA issued a statement on medical marijuana that is unclear. Despite the fact that marijuana is a controlled substance, the TSA says they will overlook it. But what they “say” is not necessarily what they practice. They are not supposed to search my braids every time I go through, but they do—every single time. 

    9. What if I am on a road trip in another country and I get pulled over. Should I tell the officer about my controlled medications? 

    Officers probably are not concerned about your medications, unless they have reason to search the car. At that point, tell them about your controlled medications and exactly where they are located in the vehicle. 

    Customs checkpoints at the borders of countries follow the same regulations as with airplane arrival. So, have your medication together and your documentation handy just in case your vehicle is pulled aside for a search. 

    10. Do I need to worry about my controlled prescriptions when traveling in another country by bus or train? 

    Probably not on buses. This mode of transportation does not have security checkpoints like the TSA. But if there ever is a reason for a search, just disclose what medications you have and where they are located. 

    However, international travel by train may mean going through a security checkpoint. The train requirements for international travel may be similar to or more relaxed than the airports. Look on the train’s website or ask officials for more information when you book the ticket. 

    Whatever mode of travel you choose, be sure to plan early and do the research on how your prescription medication is treated at your destination. A few minutes at the right websites will yield a wealth of information. At the very least, it will save you some time and relieve anxiety at security checkpoints. On the other hand, it could keep you from spending your holiday in jail.

    View the original article at thefix.com

  • Why Aren't There More People of Color in the Recovery Movement?

    Why Aren't There More People of Color in the Recovery Movement?

    For many white people, recovery is a redemption story, proof that they were good people all along. For people of color, a known history of drug use might be the only excuse a prospective employer needs to shut the door.

    When Art Woodard walked into his first Alcoholics Anonymous meeting in New Haven, Connecticut, a sea of white faces turned to stare at him. Some of the faces showed kindness; others hostility. Most people just watched as he took a seat in the back of the room.

    Woodard’s shoulders slumped. As a black man who had recently graduated Yale, he was used to being the only person of color in a room. Still, he thought, it would have been nice to share the recovery journey with other black folks. 

    “None of these stories are like mine”

    As his fellow AAers stood up to tell their stories, Woodard found he couldn’t concentrate. None of these stories are like mine, he thought. Many of the stories involved childhood abuse or mental health issues. For Woodard, heavy drinking didn’t start until he graduated from Yale, when he finally couldn’t take the weight of living in a white world where he constantly felt the need to prove himself, to justify his presence, to assure others he wasn’t a threat. 

    “I got drunk because I thought I had fooled an institution into giving me a degree I didn’t deserve,” he says in a phone interview. “I never really felt I had a place in the world…I embraced alcohol because I needed a release for that insecurity.”

    Woodard never returned to that AA meeting, during which not a single person approached or welcomed him. Luckily, he found a program specifically for people of color elsewhere in the city. When the program nearly folded for lack of funds, he wrote grants to keep it afloat—he was adamant about continuing his recovery journey alongside his peers.

    Over the years Woodard became more visible within the wider recovery movement. He became a public speaker and trainer, often co-leading health and recovery trainings with his friend Jim, who was white. But the specter of race was never far off.

    “I can honestly say that every position or opportunity that I was able to achieve was achievable through a Caucasian male offering me opportunities,” he says. “I was invisible in those settings if I didn’t have [a white person] to speak for me.” 

    He endured the barbs from the people who ignored Woodard if he asked a question, directing their answer to Jim, and the people who expressed astonishment at his “good English,” as they put it. And always, the experience of his first AA meeting came back; almost every recovery space was a sea of white faces. 

    Racial Bias, Recovery, and Criminal Justice

    Woodard’s experience as a person of color in the recovery movement is not unique. It’s no secret that the movement is largely dominated by Caucasians, whether in staff or leadership positions, on organizational boards, or among membership. Why do so few people of color play visible roles within the recovery community, especially given how much the effects of harsh drug policy and chaotic drug use have devastated many communities of color? To merely blame racism, though it certainly plays a role, is oversimplifying a complex problem. 

    One of the reasons we don’t see many people of color in leadership positions within the recovery movement is that it can be harder for people of color to sustain recovery at all. We all know someone who spent a good chunk of their twenties using drugs or alcohol problematically. Perhaps they went to jail once or twice. Perhaps they were even homeless for a while. But today that person is married with children, thriving at a good job, and talks about recovery to anyone who will listen. That person is also probably white.

    Sustained recovery is not as easy for a person of color. For black men, especially, once the criminal justice system sinks its teeth into you, it doesn’t let go. There is little room for mistakes in a world that expects you to fail, and we all know the statistics: Despite similar rates of drug use, people of color are more likely to be arrested for drug crimes than white people, serve longer sentences for the same crimes, and find it harder to break the cycle once it starts.

    Even for people of color who are able to find and sustain recovery despite the odds against them, they likely won’t be as quick to advertise their new status. For many white people, recovery is a redemption story, proof that they were good people all along. For people of color, a known history of drug use might be the only excuse a prospective employer needs to shut the door.

    For evidence of racial bias in recovery, one need only pick up the nearest newspaper or turn on the TV. When the story is about a white drug user, the addiction or overdose death is reported as a tragic loss of potential. But a person of color can suffer a death completely unrelated to drugs—being shot unarmed by a cop, for example—and the public will dig into his past for any evidence of drug use or criminal behavior, then use this information to justify the murder. Any drug history of any kind is enough to brand a person of color for life.

    The overdose crisis presents a conundrum. On the one hand, it provides an influx of funding and sympathy to a movement in desperate need of both. On the other hand, it exacerbates the racial divide by further entrenching the narrative of white recovery as redemptive and black or brown recovery as something else. 

    Follow the Money

    Donald McDonald, a white man from Raleigh, North Carolina with 15 years in recovery, explains, “The opioid crisis is seen as a white issue not just because of the predominantly white images we see in the news. It’s this message about the ‘worthy afflicted.’ We hear about people with legitimate pain receiving lawfully prescribed pain relief. We can then vilify the pill or the pharmaceutical company – not the person experiencing addiction. Historically this has not been the black experience in America.”

    The people whose faces are presented as sympathetic victims are almost always white. And this is no mere coincidence. The recovery movement is made up of people who have long suffered heavy stigma, but now, for the first time, thanks to the attention that the overdose crisis has sparked, the movement is experiencing more public sympathy and financial support. 

    Laurie Johnson-Wade, an African American woman who leads recovery efforts in Kensington, Pennsylvania, says that money lies at the heart of the exclusion of people of color in recovery spaces. 

    “If you show my face [as a black woman] or if you use me as the leader at a conference then you are not going to get the money that you would have if you had somebody representing a different community,” she says. “I think those in the recovery movement started out with good intentions, but if you want to win, you have to play the game…At the end of the day, it is all about dollars and cents.”

    Organizations are putting forward their most sympathetic faces to potential funders and allies—and the whiter and more connected to prescription pills (as opposed to street drugs), the better. Keeping the conversation revolving around pharmaceutical companies also makes it seem as though problematic drug use is a new phenomenon, which allows us to ignore the last few decades of harsh drug policies that have decimated communities of color. 

    Devin Reaves, Executive Director of the Pennsylvania Harm Reduction Coalition and a black man in recovery, explains, “There is hyper focus on Big Pharma creating the opioid epidemic, but [problematic drug use] has been going on in the black community for a long time.”

    These narratives and “solutions,” in which drug problems among white people are the primary focus, further drive people of color away from recovery. Too often, out of genuine desire to be colorblind and put racial strife behind us, people believe that what works for white people should work for everyone. But that is not true in most spaces, and especially not in the recovery space, where racist drug policies have created a very different environment for people of color.

    “I don’t like it when white folks tell me how black I should be” 

    Reaves, who often finds himself the lone person of color trying to shift recovery conversations towards criminal justice reform and strong economic policies, says it’s more than just uncomfortable. It can challenge a person’s very identity.

    “[The recovery movement] is a pretty white space and when you go into white spaces they want you to talk white, dress white,” says Reaves, who says he has been reprimanded many times by white people for being too outspoken about race. “I don’t like it when white folks tell me how black I should be.” 

    For a person of color, living in a predominantly white world can be exhausting. You have to watch your behavior lest someone consider your very presence a threat. You never know when you might encounter someone who will show open hostility towards you. You have to put up with constant micro-aggressions. And often you are a solitary voice trying to remind everyone not to forget about people of color, not to pursue solutions that only benefit white people, not to pretend that race doesn’t matter. 

    Woodard explains that there is a price to getting ahead. The people who “succeed” in a primarily white environment are the ones who act in a way that white people consider socially acceptable. But when someone else is dictating the terms of your behavior—sometimes literally, sometimes passive aggressively—that experience can change you. Spend enough time straddling two worlds and you may find that you no longer belong in either.

    “People of color [who spend a lot of time in a white world] get locked into these insecurities,” explains Woodard. “There is an environment we want to have success in, but that environment is changing us.”

    For many people, that is too steep a price to pay, which is why historically white spaces often remain that way. It takes a long time for enough trailblazers to change the environment to one that feels safe and welcoming to people of color. 

    How to Be More Inclusive

    So how do we start that process of change so that recovery environments become more inclusive?

    Donald McDonald says that the first step is to acknowledge that race and gender inequality exists in recovery spaces and then to take action to correct it. He admits that although there is awareness within the recovery community about the lack of space for people of color, it hasn’t yet translated into action on a large scale.

    Devin Reaves says that people of color should be represented on organization boards, in community meetings and at conferences…but not in a way that implies mere tokenism. 

    “Every movement should be trying to find the next generation of advocates and pull them up,” he says. “Give people an opportunity to excel, but also try to mitigate the harms of being a black person in an all-white space.”

    Laurie Johnson-Wade says that rather than asking for more inclusion in white spaces, people of color have to organize on their own and become a “constituency of consequence.”

    Some self-organizing is already happening. At the 2018 Harm Reduction Conference in New Orleans, leaders of color came together prior to the main conference to hammer out priority issues for their communities. They are tired of having their identities challenged by a world that continues to put their issues on the back burner, tired of the steep price of participation in a white space. And tired of asking permission to speak.

    “We have to make ourselves visible, almost like a force to be reckoned with,” says Johnson-Wade. “We have to pull our own resources together and say we are going to do this work regardless. We will not sit around and wait.”

    View the original article at thefix.com

  • My Methadone Pregnancy

    My Methadone Pregnancy

    I listened to what my doctor told me. I did my research and I am at peace with my decision: getting off methadone while I was pregnant just wasn’t an option.

    The last time I stuck a needle in my arm was three whole months before I conceived my son, and I’m grateful that he’s never experienced me in active addiction. I say three whole months as if it were a lifetime, but it really is to anyone in early recovery. I was fortunate, I stopped using heroin before I found out that I was pregnant. I had just turned 29 and was in a stable relationship with my now-husband.

    For many women, getting on methadone doesn’t happen until they find out they’re pregnant. Their options are to either keep using or get into treatment. I started taking methadone five months before I stopped using and faced a bit of a learning curve. It was difficult to separate myself from the lifestyle and the people who I interacted with on a daily basis. I also had a needle addiction, and there’s no maintenance medication for that.

    When I decided to stop getting high, I immediately started trying to fix everything that I had destroyed. I was in a new relationship with someone who understood that I was broken and he took me to the methadone clinic every day. We met shortly after I got clean and he never once judged me for my past actions or made me feel bad for taking methadone during my pregnancy. Every expecting mom who takes opioids knows that if you just stop taking them, there is a high risk you will miscarry. Your baby experiences the withdrawal symptoms more strongly than you and in many cases they just aren’t strong enough to withstand it.

    Making The Best Painful Choice

    I was in a heartbreaking situation, but I needed to do what was best for the baby. I can see the comments already: How could you continue to take a medication like that while pregnant?! How could you do that to a tiny human, he’s going to withdraw! I heard this from my mother and a few other opinionated individuals who believed it was appropriate to weigh in on my treatment. I listened to what my doctor told me. I did my research and I am at peace with my decision: getting off methadone while I was pregnant just wasn’t an option.

    The doctor at the treatment facility gave me a ton of information as to what to expect with my continuing treatment. She told me that as the baby grew, I would most likely need to take more methadone to accommodate the increased blood volume. I needed to pay attention to my symptoms and try to tell the difference between normal pregnancy discomfort and methadone withdrawal. I was really grateful for her kindness and advice, especially in the beginning.

    After I had my baby, I found out that there are many online support groups for pregnant women on maintenance medication. These sites provide information on symptoms, what is normal, the rights you have as someone who has struggled with opioid addiction, and more. It’s especially important to know what your hospital’s protocols are for infants going through opioid withdrawal. I know a lot more after giving birth than I ever did in my pregnancy.

    I Would Judge Me, Too

    I was afraid that Child Protective Services would be getting involved during and after my pregnancy, but I was assured by my OB-GYN and the doctor at the methadone clinic that as long as I stayed clean, I would have nothing to worry about. Still, as someone who has worked in the medical field, I knew the stigma attached to my condition. I worried at every appointment that people would look down on me and talk negatively about me after I left. I mean, I was an ex-heroin addict who was pregnant and who was continuing to put something addictive into my body. I would judge me, too.

    My apprehension was unnecessary, my OB-GYN was very supportive. She referred me to a high risk maternal/fetal medicine doctor who I also saw regularly. I went to every appointment, took my methadone as prescribed, and continued to go to therapy.

    When I was about 10 weeks along, I told my parents I was pregnant. I wish I waited a little longer, but I was so excited to be a mom. Their reaction was concern that once my baby was born, he would go through withdrawal from the methadone. I tried not to take it as criticism and judgement, because their concerns were valid. I felt very guilty and scared that this little soul was going to suffer and it was all my fault.

    My stepmother threw me the biggest, most elaborate baby shower that I had ever been to. She invited all of her friends and they brought me nice gifts and things I didn’t know I needed. I remember eating the cherry cake she’d ordered especially for me and starting to cry. This party was thrown for me by a woman who I’d lied to and stolen from during my addiction but none of that seemed to matter to her. She invited her friends because I only had one or two left. I’d cut contact with everyone from my previous life when I stopped using.

    I chose to not go to meetings or participate in any 12-step activities because I did not want to be around other people who were struggling in the same way I was. I know that NA is a great support system and helps many people stay clean, but it wasn’t the right fit for me. Of all the resources available to me, I was the most successful with just the support of my husband, my parents, and our church.

    Induction

    At my 37-week appointment, the doctor found that I was low on amniotic fluid and decided I should be induced that day. I was ready, even though I was afraid of the pain and even more afraid that the painkillers wouldn’t work due to the methadone.

    My husband and I hustled over to the labor and delivery wing of the hospital, excited and nervous. As expected, when I got there, I was drug tested. It was mandatory since I had a recorded history of heroin use but it still made me sad.

    The induction process was incredibly painful. I remember not wanting to ask for anything to help with the pain because I didn’t want to be judged, but as soon as I felt my cervix start to stretch, I stopped caring what anyone thought. It was brutal. After 18 hours of agony, I received an epidural. I was exhausted and excited and running on encouragement from my husband.

    Before I knew it, I was 10 centimeters dilated and surrounded by doctors who were telling me to push with each contraction. A few minutes after they set up their delivery equipment, he was here! I have never cried harder than the moment they handed me this pink, messy, angry little person. He was gooey and gross and perfect. I felt so much at once; it’s hard to explain those first few moments. He was on my chest for about 45 minutes before they cleaned him up and took him to the NICU because his blood sugar was low.

    Because I had methadone in my system during my pregnancy, we had to stay for an extra five days so they could monitor my baby for withdrawal symptoms. I spent that time trying to breastfeed, learning to hold a baby properly, and getting sleep.

    My New Baby, in Opioid Withdrawal

    I would like to end this by saying that we went home after the five days and lived happily ever after, but that’s not the whole story. My husband and I went home but our little boy had to stay for an extra two weeks. He started to show signs of methadone withdrawal around day five.

    There are lots of myths about babies in withdrawal and what they look like. Yes, some are inconsolable and have tremors, but that isn’t always the case. I wasn’t able to recognize the symptoms in my baby because he didn’t match the picture in my head of a baby in withdrawal.

    He had a high-pitched cry; I held him against me and nursed him constantly. Sometimes it calmed him down, sometimes it wouldn’t.

    In the hospital, they use a chart called the Finnegan Scale to assess the severity of withdrawal and determine if the infant needs medication, and my son’s symptoms indicated that he needed to be medicated. The doctor in the NICU told us they were going to start my baby on a small amount of morphine to calm him down and make him more comfortable. I didn’t want them to give him morphine, but I felt more strongly that I didn’t want him to suffer.

    Seeing my baby for the first time after he was medicated gave me some peace. I knew that was best for him, just like taking my methadone was best for him during my pregnancy. It’s hard to convince someone unfamiliar to the world of maintenance medications and opioid addiction that I did what was right for my baby, but I know I did.

    He started getting better immediately and every day he received a little less morphine. My husband and I were lucky enough to have a private room in the NICU and be able to be with him 24-7. The most important things I did for his recovery were keeping him close to me (skin to skin contact), keeping the lights low, and the noises to a minimum. They recommended that I breastfeed as often as possible and my baby had an amazing nurse who taught me how to do this. She constantly encouraged me and kept me informed about his treatment.

    A Healthy, Happy Boy

    Per hospital protocol, my husband and I were interviewed by social services. I had to be completely transparent with them and give my doctor at the methadone clinic permission to speak with them. They even came to look at my home to make sure that it was a safe place for my baby to be. I went through a variety of emotions during this time. I felt violated, angry, insulted, and even confused. I had passed every drug test for the past year and my ability to be a good mom was being questioned. The whole process lasted about a week and then we never heard from them again. I was told that the only reason that social services (CPS or DYFS depending on your state) were contacted was because there were traces of methadone in his meconium.

    Our baby boy has been growing and thriving ever since we brought him home. I still have guilt about his first few weeks in the world, but that’s okay. I try to tell myself that he wouldn’t even be here if I didn’t get on methadone in the first place, but that might just be me justifying it. I now have a smart, healthy, beautiful two-year-old little boy who never stops smiling. When he gets older, I will have to explain to him why he got sick right after he was born. I hope he understands and forgives me.

    View the original article at thefix.com

  • On Ascension: Finding the Courage to Heal and Grow

    On Ascension: Finding the Courage to Heal and Grow

    My optimism was the reason I had stayed in abusive situations as well as my catalyst for leaving.

    The first garden I ever really tended to, I planted with an ex-partner. We’d spent several weekend mornings tilling and nurturing a small plot in my backyard, transforming the soil from arid and unkempt to rich and fecund. Upon harvesting, we filled a large basket with robust vegetables: chards, bright magenta-colored beets, green-leaf lettuce, cherry tomatoes, Anaheim peppers. I was most excited with the constant supply of tomatoes, amazed we’d started the produce from seeds and yielded such healthy plants. 

    Months later it became obvious that the garden was flourishing but the relationship was ending. I realized that after years of single motherhood, I’d allowed myself to attach to an emotionally abusive person out of loneliness.

    When the relationship ended, I was bedridden for three months, falling deep into a clinical depression. Whenever I’d get up, my head felt dizzy, my thinking dulled and lagging. I was unable to keep up with my full-time job and just let it fade away, hoping my savings was enough until I was well again. In the mornings, I would struggle to get my daughter ready for school and I’d return from the bus stop exhausted. 

    The Shame of Mourning

    The garden was forgotten. I couldn’t bear to weed or water, and every plant became shriveled and dry. Winter was approaching and as the cold settled in, I’d look out into the backyard from the window and watch the dead plants swaying with the freezing winds. As painful as it was, I felt stronger letting something we’d tended together die, as if in that letting go I was reminding myself that it had been only temporary, the needing anyone so badly.

    “You need to let go of him and focus on your daughter.” This was the constant advice I received from well-meaning friends. As a single mother, I always found it strange how policed my emotions were by others when it came to any romantic endeavors, how shamed I would be for mourning anyone at all. 

    I’d already known heartbreak, had mothered alone when my baby was only one. I didn’t need the reminder; single moms know well how to mitigate their sadness and still nourish their babies. Although I’d known it before, the depression had never taken hold of me so fiercely. I realized I was mourning more than losing a partner, or the aftermath of emotional abuse; I was also far away from the writing career I’d always imagined I’d have. And I was finally feeling the deep pain I had buried when my relationship with my daughter’s father ended. Even then, I’d been shamed for my sadness and advised to focus on my child. 

    It was a difficult winter, alone in my thoughts. I remember wishing there was a way someone could crawl into my mind and cradle it, almost like holding my hand to lead me out of my sadness. I didn’t even know what clinical depression was, though I realized I had experienced episodes over the years. I remember sitting blankly, staring at the grimy walls of a community mental health clinic where I was finally prescribed antidepressants. 

    Renewal

    A month after that, I was taking regular runs again, a practice I used to love. My stamina returned and the body that had shriveled up all winter grew robust and strong. 

    The following spring, I finally gathered enough intention to walk down the deck and face the garden. Pulling out the shriveled roots, I felt ashamed at my neglect. When I’d finished clearing the space, I watered and turned the soil, taken with how rich it had become. I sat in silence and thought about how that reflected inward, as well. The pain and solitude had alchemized me and what had sat inside that whole winter was now made anew.

    Years later, I’m sitting in my therapist’s office. She’s white, Midwest-born and raised. I hadn’t planned on having a white therapist, but when I’d filled out the preference form I only checked off “woman.” She had an optimism I appreciated, and I didn’t feel especially inclined to inquire whether she was aware just how much of that optimism came from her privilege. I saw parts of myself reflected in her personality. One of the more painful aspects of my internal calcination was accepting how hopeful I’ve always tended to be, even despite the harm I would seek out. My optimism was the reason I had stayed in abusive situations as well as my catalyst for leaving. I’d hope it would get better and once I saw it wouldn’t, I’d hope a doorway would appear. 

    My career was now in motion. I was dumbfounded by the task of negotiating a book contract without an agent and didn’t know how to proceed. I’d written and performed largely for free for my entire career and was realizing that I was afraid to ask for a substantial sum because I still struggled with my own self-worth. 

    A Reluctant Astronaut

    “Did you send the email?” 

    “I didn’t. Not yet, I just, don’t want to seem off-putting, you know? What if I ask for too much and they rescind their offer?” 

    “I don’t think that’s going to happen,” she said. “They approached you.”

    I cradled my head in my hands. “I don’t know how to do this. No one taught me about money. All of this is new. I’m navigating this alone and there’s no map, no manual.”

    “You know what you are?”

    I looked up.

    “You’re a reluctant astronaut. That’s what my mom called me and my sisters when we were afraid. You have the ability to travel through the universe, and you’re afraid to get in the captain’s seat. You’ve trained, you’re ready. You’ve got to get out there for all those who didn’t get the chance, and more so for those who will.”

    I blinked back tears. A reluctant astronaut. In all my life, no one had ever said anything even remotely close to those words, that concept. 

    “You’ve got to send that email.” 

    I realized how much her words had struck me. The queer daughter of first-generation parents, I was told that I would not be allowed to leave home for college. My older brothers were encouraged to exercise their freedom while I stayed in my hometown and worked while I went to school. I could only move out when I found a husband. I wasn’t taught I was a reluctant astronaut. Instead, I was tethered to the ground from birth. 

    I wondered what would have been of me had I been encouraged to fly. 

    ***

    There are times when I have to leave my daughter, now ten years old. Sometimes she’ll watch me pack, her eyes heavy.

    “Mommy, don’t go. I get scared when you’re far away, scared you won’t return.” 

    I don’t tell her I’m afraid, too. I’m not afraid that I won’t return, but that I won’t get to leave at all.

    I need her to be brave for both of us. She’s now old enough to understand she’s a reluctant astronaut, too. I want to make this natural for us, how sometimes I’ll have to go sit in the captain’s chair and close the hatch, home becoming small as a pin before fading out.

    View the original article at thefix.com