Constant vigilance is part of caring for someone with Opioid Use Disorder. Death can steal a loved one away without argument, like a force of nature, in the same manner a frost settles and kills off susceptible plantings. Also like frost in winter, relapse and death is a possibility in certain ‘Seasons’ or the emotional ups and downs of life.
Stress is like Winter to an addict. I know of three high functioning adults in the past two years, who were special to me for different reasons, who relapsed and died from substance use disorder. One use. One time.
“L’ange de la mort est venu les geler”:
The Angel of Death came to Freeze them.
Opioid Use Disorder or OUD is eventually incompatible with life because the drug is both so compelling as a binder to the receptors in the central nervous system, and the ‘signal’ is so strong it overrides the autonomic nervous system. This is how fentanyl and other opioids kill:
“When a person dies from heroin or OxyContin, there’s not a direct line from the drug to a stopped heart. An opioid overdose is sneakier and slower-moving. It begins by lulling the lungs into cozy submission-the hijacked opioid receptors cause a rush of pleasure that turns into respiratory distress. The lungs sleep so hard that, as the airways constrict, the person literally forgets to breathe.
Death lingers first over the fingers and lips; they turn limp and blue. Gurgling noises dangerously sound like snoring but are actually death rattles. Once the oxygen starvation moves inward to vital organs like the heart and brain, a loved one or rescue worker has three to five precious minutes to jolt the receptors awake and reverse the over dose before brain damage occurs and then death.”
-Raising Lazarus by Beth Macy, 2022.
Reflecting:
I got cut a break from caring from my oved one with OUD after I dropped my son off at the Residential Treatment center Phoenix Rising in Palm Desert. Leaving him safely nestled into the Coachella Valley in the Sonoran Desert. I drove back up the State of California reflecting on the deadly drug Fentanyl.
How did our son start using a drug that can kill?
In short: He was not armed with enough knowledge of either the beneficial or detrimental effects of drugs. After his initial use and any adverse effects; his encounters with the medical profession entrenched his dependence on illegal drugs and heightened the feelings of shame and desperation.
Our son will have tried the controlled drug Oxycontin (Another opioid) sometime in his Junior or Senior Year at High School. He was always curious. I am well aware of when he started experimenting with pot. I would tease him and tell him not to be a doofhead and toke in his bathroom as it vented to the corridor.
It was not good that my son tried marijuana, as it led to a scary episode of poor mental health. Yet at the same time it may be the only drug that has an extract or controlled derivative that calms his racing thoughts and allows him to sleep. I remark in this fashion as all drugs have effects both positive and negative:
A Brief history of Good Vs Bad Drugs
All the cannabis species with psychoactive properties have the potential to be as useful to mankind as any drug produced artificially by any pharmaceutical company.
Indeed it is due to the Harrison Narcotics Act of 1914 that we discern between ‘good’ pharmaceutical grade drugs and bad drugs in the first place. Any drug the taxman couldn’t tax henceforth became immoral. “The Harrison Act was a United States federal law that regulated and taxed the production, importation, and distribution of opiates and coca products.”
Before the Act, communities were using opium and coca products with impunity along with alcohol and tobacco and:
After That:
After that, drugs were split into two camps: Those that were Good and Taxed and those that were Amoral and Underground. Eventually along came the War on Drugs. Nixon and Reagan pumped up their support base by casting drug users as America’s Number One Public Offenders. The moral tone was set by the (hilarious in hindsight) 1936 Movie Reefer Madness. Nixon and Reagan portrayed recreational drug users as being akin to abortionists and Communists. I think we can all agree on the Communism element, if you can tolerate this blog.
The War on Drugs also became a de-facto war on Black People and Young People and punitive sentences were set for drug crimes.
Bill Clinton was the worst offender in perpetrating this for political gain, in my view. The War on Drugs is used across the spectrum to buy votes.
THIS HERE is what is killing 100,000 Americans a year. Oh and did I mention in my last post? No-one cares;
Votes have been worth more than lives for the past century. Politics is killing our young. It doesn’t have to be that way. We, parents, aunts and uncles, Grandparents and veterans who have lost young ones just have to be more savvy about who and why we elect people to change the Drug and Medical Care Laws.
I mentioned in my last post some remedies to prevent more deaths. What do I mean? These are politically unpalatable remedies generally recommended by those working in the Harm Minimization field or those other exhausted parents like myself.
I will come back to other tools to defeat drug harm, but we must:
#1 Make legal small amounts of the illegal drug ( a very small percentage ) of the titrated up dose that the user was taking freely available as an alternative to illegal lethal street narcotics. When alcohol dependence is being addressed at home this is called tapering. Humans have been doing this for centuries. AA talks about doing this with “green”, recruits. I did it myself successfully when I ditched alcohol for a decade in my twenties. Individuals must be provided with the dignity to leave behind the drug of their choice and seek out community care and support free of institutionalized stigma and pressure. It is already done by professionals as psychiatrists take patients off high toxicity fentanyl onto Methadone or Suboxone via Oxycodone.
Drug replacement therapy (buprenorphine) or Suboxone must be made available freely to addicts at clinics. Drug and alcohol craving can be so strong. It can ONLY be defeated with drug replacement therapy. Buprenorphine is a partial opioid agonist, meaning that it binds to those same opioid receptors but activates them less strongly than full agonists do. People on Bupe or the long lasting version Sublocade don’t crave and they withstand life’s stressors better than with community support alone. There is still pushback in the Treatment industry against drug replacement therapy. It is seen as a moral failing to be an addict even by those treating us. We’re told to pray to the great cookie dispenser in the sky and try harder next time. Morals Assisted Treatment MUST change for US to STOP dying!
Remembering back to when this all got real as per my previous post: Driving down to Palm Desert my son started to get dope sick. We discussed how to manage this. When I say discussed, I mean there was a back and forth between an exhausted hypervigilant Mom and her dope sick, paranoid son. There was some fear about presenting to Accident And Emergency in San Jose.
So we tried an after hours clinic near Santa Cruz. It was a waste of FUCKING time doing the obligatory Covid test, as when I explained our situation to the intake person, they looked down their FUCKING noses at us and said. “Oh we don’t carry those drugs (buprenorphine and comfort meds that accompany the detox process) here.”
WHY THE EVERLOVING FUCK NOT?
in every American suburb, Kids are dying. Stressed parents are dying. Veterans are dying. This is a fucking war, morons.
Your doctors are morons, for not advocating for a clientele in need. Your politicians are morons and your police and firemen are overworked and frightened. Traumatized and frightened. For us.
I was so tired. I had already been driving for six hours so tried to find a hotel. It was the next day I had had it confirmed that my son would have a bed in residential treatment for the first time.
I say, ‘the first time’. Because although Phoenix Rising Treatment Center in Palm Desert was a wonderful respite for my son and us as parents and our son’s primary caregivers , we have to be ever watchful. And we have had a time so far. as I will detail.
I mentioned the veterans affairs. I got distracted momentarily and took a trip to D.C. to witness the passing of the Pact ACT. And get a few good night’s sleep.
