Tag Archives: addiction

prescription addiction: small towns not immune to rising opioid epidemic, Part 4

By Jacki Wood, written for the Nodaway News Leader, March 2016

Editor’s note: this is the last part in the series; the names have been changed to protect their privacy.

Nine days after law enforcement officers and Family Services visited Bethany’s home and issued a stern warning to her step-father about getting help, her family moved halfway across the country.

A new state, larger city and several hospitals to frequent, her step-father’s drug abuse only worsened.

Soon thereafter, Bethany was sent to live with her grandparents where it would be “safer for her to stay.”
“That was the healthiest and best thing that ever happened in my childhood,” she said.

***

For the 2016 legislative session, Missouri State Senator Holly Rehder proposed HB 1892, a prescription drug monitoring program, after similar bills she had proposed the last couple of years failed.

During a Senate Special Committee Meeting to highlight the opioid epidemic in January, Rehder told the personal story of her daughter’s drug addiction which began with prescription painkillers.

“I tell you this story to show that drug addiction is no respecter of persons,” she said. “It crosses all socioeconomic statuses. When you go into a high school and ask the kids, ‘what do you want to be when you grow up?’ The answers are ‘a doctor,’ ‘a lawyer,’ ‘a business owner.’ None say, ‘I want to be an addict.’

“Yet addiction is the growing epidemic of our time.”

***

After Adrianna’s mom moved out and she cut ties with her, the effects of her mom’s prescription drug abuse continued to plague her.

“I struggled with depression,” she said. “My attitude toward everything became negative. And I still have trust and confidence issues.”

The one person that was supposed to teach her how to love and be loved was gone, she said.

***

In 2014, Missouri State Representative Steve Lynch helped pass legislation that allowed qualified first responders to use Naloxone, an antidote for heroin overdoses.

Lynch has filed three bills this legislative session to continue to fight opioid overdoses.

HB 1568 would allow pharmacists to dispense Naloxone to individuals.

“Massachusetts passed a similar law and saw opiate-related deaths cut nearly in half as a result,” Lynch said. “We have the opportunity to put a safe, non-addictive drug in the hands of folks who can use it to save lives.”

HB 1569 would provide immunity to those who seek medical attention for someone suffering from an overdose and HB 1570 would authorize a $5 fee for drug-related court cases to fund rehabilitation programs.

***

Emergency Department Nurse Manager Pat Giffin, RN, said SSM Health St. Francis uses Naloxone when an opioid overdose case comes to the hospital.

“The problem is getting so severe that another one of the Suggested Emergency Department Prescribing Practice Recommendations is that healthcare providers should encourage policies that allow providers to prescribe and dispense Naloxone to public health, law enforcement and families as an antidote for opioid overdoses,” she said. “We have the advantage of also having a physician who is specially trained so he can prescribe Suboxone to help those with addictions get off the opioids.”

Suboxone contains Naloxone as well as buprenorphine, a controlled substance to treat pain and addiction to narcotic pain relievers.

Another option for those dealing with opioid addiction is Methadone, a pain reliever used as part of drug addiction detox and maintenance. It is only available from certified pharmacies and there are several Methadone clinics across the state.

***

It’s been a year now since Adrianna’s mom moved out.

“I have been growing up on my own, teaching myself how to be an adult and I have missed out on so many things that I would have done with her,” she said. “She will never get this time back with me.”

Looking back, Adrianna is still struggling with how to deal with it all.

“My mom became a prescription drug abuser,” she said. “And it tore my family and my life apart.”

***

But there is hope.

Bethany has been there. She understands, at least to some extent, what Adrianna is going through.

“In all the books I have read over the years, for my own healing or to make sure my children never experience anything like I did, one thing stood out to me,” she said.

“A child who has at least one adult in their life – it only has to be one – who they have bonded with and who believes in them and adores them, they absolutely can heal and have a ‘normal’ life with healthy relationships.

“My advice would be to embrace that adult – that aunt, grandmother, teacher, coach or pastor who embraces them for who they are – and try to make a strong connection with them.”


prescription addiction: small towns not immune to rising opioid epidemic, Part 3

By Jacki Wood, written for the Nodaway News Leader, March 2016

Editor’s note: this is the third part in the series; the names have been changed to protect their privacy.

An estimated 1.9 million people abused or were addicted to prescription opioid pain medication in 2014.

Those findings from SAMHSA were highlighted March 15 when the CDC released new guidelines aimed to reduce the risk of opioid addiction.

The voluntary guidelines are based on emerging evidence for patients with chronic pain not related to cancer treatment, palliative or end-of-life care.

Among the recommendations are that doctors try pain relievers like ibuprofen before prescribing highly addictive painkillers such as hydrocodone and oxycodone.

Other recommendations include non-prescription treatments such as exercise therapy, tai chi, yoga, weight loss, psychological therapies, interventions to improve sleep and certain procedures.

“It has become increasingly clear that opioids carry substantial risk but only uncertain benefits,” Dr. Thomas R. Frieden, CDC director, said, “especially compared with other treatments for chronic pain.”

***

As Adrianna’s mom became more addicted to the pain meds prescribed by her doctors for her chronic illness, the worse things got at home.

She began seeing problems in her parents’ marriage and her mom finally moved out which surprisingly was a relief for Adrianna.

Her mom had been texting hateful, degrading messages and posting belittling statuses on social media about her. She eventually had to block her phone number and report and block her on social media sites.

“I wanted her out of my life,” she said. “It wasn’t my mom; it was a monster in my mom’s body.”

***

Pat Giffin, RN and emergency department nurse manager at SSM Health St. Francis Hospital, said people don’t intend to become addicted to opioids, they just want something to take away their pain.

“Opioid addiction can make people do things they never would have thought of doing before the addiction, just to get more of the drug,” she said.

The hospital is currently working with SSM Health’s legal department to develop a notice for the emergency department stating that the hospital will not prescribe narcotics unless there is an acute reason.

“Prescribing opioids to patients who do not need them for acute pain only results in addiction and more problems for the patient,” Giffin said. “Chronic pain issues need to be handled by one physician so that the usage can be monitored and controlled.”

***

That was the issue with Bethany’s step-father. His opioid use was not being carefully monitored or controlled by his doctors and the hospital.

And even though everyone around her seemed to know about it, she said, no one would talk.

Until someone finally did.

“Looking back now, as a mother of three, I am in shock that it took someone as long as it did to make the call,” she said.

After hearing that Bethany’s dad was slurring his words and saying really hateful things to her, a friend’s mom spoke up.

“It was humiliating, and at the same time, I felt like I was going to be in trouble for exposing our family secret,” she said.

***

Six organizations representing Missouri healthcare providers issued recommendations in December to reduce opioid painkiller misuse and abuse.

The Missouri Academy of Family Physicians, Missouri Association of Osteopathic Physicians and Surgeons, Missouri College of Emergency Physicians, Missouri Dental Association, Missouri Hospital Association and Missouri State Medical Association jointly recommended that healthcare providers adopt the recommendations.

Many of the state’s emergency departments have existing systems, however, there has not been a consistent set of guidelines statewide for providers throughout the state.

Dr. Evan Schwarz, Fellow of the American College of Emergency Physicians and MD at Barnes-Jewish Hospital in St. Louis, said emergency physicians deal with opioid misuse and abuse on a daily basis.

“This is an important initial effort to address the problem of prescription drug abuse,” he said. “However, in the long run, it will require a multi-disciplinary, public-private approach to provide treatment, reduce abuse and its costs.”

***

Shortly after the call about her step-father’s behavior, law enforcement officers and a Family Services representative visited Bethany’s home.

They discussed what had been reported and her mom reassured them they were fine and that Bethany had exaggerated the situation.

“A pot of coffee later, they were driving away,” she said, feeling even more hopeless about the situation.

However, a follow-up visit came shortly thereafter, and with it, a stern warning that her step-father needed to get help.

Nine days later, they moved halfway across the country.


prescription addiction: small towns not immune to rising opioid epidemic, Part 2

By Jacki Wood, written for the Nodaway News Leader, March 2016

Editor’s note: this is the second part in the series; the names have been changed to protect their privacy.

“The opioid epidemic has been called the worst drug crisis in American history,” wrote Dan Nolan and Chris Amico in their Frontline special, “Chasing Heroin,” on February 23.

“Death rates now rival those of AIDS during the 1990s, and with overdoses from heroin and other opioids now killing more than 27,000 people a year, the crisis has led to urgent calls for action.”

***

Adrianna
After being diagnosed with the chronic illness, Adrianna’s mom received a prescription to deal with the pain and their way of life changed very quickly.

Gone were the days of shopping and getting their nails done together, doing makeovers, talking until two in the morning.

“I started noticing a real difference in her,” Adrianna said. “She would come home (from work) and go straight to bed.”

Barely 16, Adrianna wasn’t really sure what was happening.

“My mom was either yelling at me or ignoring me,” she said. “She would tell me she didn’t love me. And never did. She would tell me she never wanted to see me again.

“Then a couple of hours later, she would say she was sorry.”

And that was just the beginning.

***

Over the last 15 years, opioid deaths have jumped 369 percent while heroin deaths have risen 439 percent, the CDC reports.

Heroin use is growing in popularity as a direct result of prescription painkillers.

Ninety-four percent of people in treatment for opioid addiction said they started using heroin because it was far cheaper and easier to get than prescriptions painkillers.

Nolan and Amico wrote: “Over the course of more than a decade, it has grown into a problem destroying lives across the nation, regardless of age, race, wealth or location.

“Nearly 90 percent of the people who tried heroin for the first time in the past decade were white. And a growing number are middle-class or wealthy.”

The opioid epidemic is erasing the stereotypes of drug abuse. It’s soccer moms and CEOs and even grandmothers.

Last July, the CDC found “significant increases in heroin use were found in groups with historically low rates, including women and people with private insurance and higher incomes. The gaps between men and women, low and higher incomes and people with Medicaid and private insurance have narrowed.”

***

Emergency departments across the country are also feeling the effects of the growing problem.

Between 2005 and 2014, the rate of hospitalizations and emergency department visits from opioid overuse in Missouri has more than doubled, according to the Missouri Hospital Association.

Pat Giffin, RN and emergency department nurse manager at SSM Health St. Francis, said the hospital in Maryville is dealing with similar trends.

“We are seeing a lot of Norco (hydrocodone) use and abuse,” Giffin said. “It has substantially increased in the past couple of years.”

***

Bethany
More than 20 years after her step-father’s car accident, where he was initially prescribed opioids for the pain, Bethany’s younger brother finally learned the truth about those emergency room visits from his childhood.

The 30-year-old youth pastor and father of four was astounded by the revelation.

“Do you realize I spent most of my childhood in an emergency room?” he said to her. “Mom had to drag me along to the ER when he had to get a shot for the ‘pain.’ All the soccer and baseball and basketball games missed…

“All because he was a drug seeker? It was preventable? It was all a lie?”

While Bethany was saddened by his disappointment, she was not surprised.

“Those physician-prescribed drugs ruled our life, and sadly, destroyed relationships and severed family ties,” she said.

***

Missouri is the only state in the nation, Giffin said, without a prescription drug monitoring program.

She said MHA issued a policy in November stating: “The absence of a prescription drug monitoring program through a registry system impedes the ability of physicians, pharmacists and hospitals to evaluate patients’ complete prescription and utilization profile.

“The use of a prescription drug monitoring program may be one effective strategy to help identify patients who may be seeking multiple providers and would benefit from opioid diversion.”

***

The chronic illness became too much for Adrianna’s mom to handle.

“It felt like she gave up on everything,” she said.

And that’s when she started abusing the medicine prescribed by her doctors.

“She held herself differently and sometimes I could barely understand what she was saying,” Adrianna said. “I tried to talk to her about it but she didn’t care about me or my opinion.”

With her dad working long hours – and not feeling like she could share her situation with her friends – Adrianna began to feel very alone.

“My life wasn’t supposed to end up like this,” she said.


prescription addiction: small towns not immune to rising opioid epidemic, Part 1

Drug Overdose Deaths

By Jacki Wood, written for the Nodaway News Leader, March 2016

Editor’s note: the names in this story have been changed to protect their privacy.

Adrianna

The grass had just started to turn green that March and Adrianna could hear a tractor in the pasture, preparing for spring planting, as she pulled into her driveway after track practice.

It was, by most accounts, a beautiful spring day in Northwest Missouri.

For Adrianna, though, that brightness and hope of spring quickly turned dark as she found her mom lying on the lawn.

“I remember shaking her to wake her up,” she said. “I wanted to scream for help, but I didn’t want to cause attention to the situation.”

Her pupils were dilated and she reeked of smoke as she laid there limp.

After months of prescription drug abuse, her mom barely weighed 90 pounds. Sixteen-year-old Adrianna managed to get her into the car and drive her to the hospital.

“I had been waiting for something big to happen for awhile,” Adrianna said, “so I wasn’t surprised.”

Still, it wasn’t how the small-town teenager perceived life a few months before.

She and her mom loved shopping and getting their nails done together, trying new recipes, doing makeovers, talking until two in the morning, laughing, watching movies.

“My mom was my best friend,” she said. “She was the person who I told everything to and did everything with.”

***

Forty-four people die from prescription drug overdoses every day in the United States, largely due to prescription painkillers called opioids, the US Department of Health and Human Services reports.

Hydrocodone (Vicodin) and oxycodone (OxyContin) are the most common ones involved.

Since 2000, the death rate from opioid drug overdoses has increased 200 percent.

Senator Claire McCaskill has been bringing the issue to the forefront in recent months.

“This has reached epidemic proportions in our state,” she said at a hearing held February 8 in Jefferson City.

Missouri ranks number one in the rate of prescription opioids sold among Midwestern states and is the only state in the country without a prescription drug monitoring program.

***

Bethany

Bethany’s family went to church. Her mother was a teacher and she and her brother were on the honor roll. They said please and thank you, took their hats off when they entered buildings and wrote thank you notes.

On the outside, everything seemed normal. Charming, even.

But on the inside, there was a hidden addiction devastating their lives.

“Once in the privacy of our home, my step-father would be nothing short of cruel,” Bethany said, a Nodaway County resident who also grew up in the area during her teenage years.

Her step-father’s addiction to prescription pain medicine began in the late 1980s after he was in a car accident and was initially put on Demerol for pain.

“He kept returning for more, and when he couldn’t get his prescription filled, he’d go to the emergency room,” she said. “Since pain can’t be proven, the ER staff pretty much had their hands tied and he would leave with, at minimum, a shot of pain meds and usually a week’s supply of pills.”

Demerol, Morphine, Oxycodone, Percocet. Anything he could get a physician to prescribe for him.

“Unfortunately in a small town, where there were only a couple of doctors, it was easier to give him a prescription and send him on his way,” she said.

***

Opioids also include the illegal drug heroin.

Four in five new heroin users started out misusing prescription painkillers, according to the Drug Enforcement Agency.

From 2000 to 2013, the rate of heroin overdose deaths nearly quadrupled in the US.

And in a 2014 survey by JAMA, 94 percent of people in treatment for opioid addiction said they went from prescription painkillers to heroin because the prescriptions were “far more expensive and harder to obtain.”

***

Just a few months before, Adrianna would have described her family as normal. Her parents had good jobs and they were well-known and well-liked in the community.

And then her mom was diagnosed with a chronic illness and prescribed painkillers to help deal with the disease.

“She saw more than one doctor and was prescribed more than one pain medication,” Adrianna said.

It didn’t take long before she began to see changes in her mom.

“The disease, combined with the drug use, was taking control of her life at home as well as at work,” she said.

***

At a roundtable discussion on February 16 in St. Louis, McCaskill said: “We are drunk on pain medication in this country.

“There’s a reason that 49 states have implemented a prescription drug monitoring database — because the positives far outweigh the negatives.”

Last week, the Missouri House sent a prescription drug monitoring program bill to the Senate, where similar proposals have stalled in the past.

***

Bethany’s step-father’s addiction tragically led to verbal and sexual abuse in their home.

“Those physician-prescribed drugs ruled our life,” she said. “Everyone seemed to know — aunts, cousins, teachers, community members …

“But no one would talk.”


An honest conversation about obesity

“That they might have joy” column by Jacki Wood

I have fibromyalgia. It’s a big word for a syndrome that basically means I’ve been in pain every day since 1996.

Some days have been tolerable, some rough and some downright unbearable.

It’s also basically how I became obese. Well, sort of.

But I’m getting ahead of myself…

I was very active growing up. I loved playing everything from soccer and softball to basketball and football. It’s also how I dealt with life’s stresses. This continued when I went to college. If I had a problem, I went out and played ball until I felt better.

During my junior year at BYU, I was probably the most active and fit I’d ever been in my life. And then one day, I woke up and I hurt everywhere. That was 1996.

Time passed. I was diagnosed. I dealt with it. Sometimes with success. Sometimes not so much.

It was several years later and dealing with a family member’s health issue that finally sent me over the edge… to self-medication. Not with alcohol or drugs. But with food.

I no longer could deal with stress by playing basketball. And so I turned to food.

I’m not going to go into all of the details, but my lifestyle had become mainly sedentary due to the pain of fibromyalgia. And that collided with my newfound solace in bad food – and a lot of it.

That was around 2001. The self-medicating continued for several years while I started packing on the pounds.

I tried a couple of times to lose weight, and had some success, but it wasn’t sustainable and I fell back into old habits.

Then in December of 2011, a friend of mine asked if I was interested in participating with her in the New Year’s Challenge at the Maryville Community Center. At first, I really only agreed so I’d be able to see her more often on my weekly trips to Maryville for work.

Then that Christmas, we traveled to Florida to see family and take our kids to The Wizarding World of Harry Potter. It was a great trip. But it was also life-changing for me.

The day we went to the park, we headed straight for the Harry Potter and the Forbidden Journey ride. Everyone was excited. But as we approached the castle, my excitement turned into terror. I noticed one of those seats at the beginning of the line; you know, the ones to see if you’re too fat to fit on the ride.

I was horrified. I hadn’t been on a roller coaster in several years and wondered if I was now too fat to ride one. Well, I wasn’t, but it was a very uncomfortable situation, both literally and figuratively.

That experience probably could’ve been enough for me to want to change. But there was more.

The following day, my husband took a picture of me sitting next to his nephew’s wife. When he showed it to me, I was clearly more than twice her size. Now, in my defense, she maybe weighs a hundred pounds soaking wet. But the photo spoke volumes to me.

I was obese, plain and simple.

It was a fact I already knew. But seeing it in the photo – combined with the amusement park ride the day before – struck something new deep down inside of me.

I had to make some real changes.

And so I did. Since I had already signed up for the New Year’s Challenge, I now had the commitment and accountability to help.

Image

So why am I talking about this now, a year and a half later? Well, there are a lot of reasons.

First of all, I think it’s a conversation that needs to take place. It’s a serious health concern that many of us would rather just avoid talking about, one I avoided for many years.

Secondly, I think we all need to do a lot less judging and have more understanding for others. It’s not like one day I woke up and said I think I want to eat unhealthy amounts of bad food and become obese. Did I make mistakes? Yes. A lot of them. But there were also underlying issues that led me down that path.

Lastly, it’s hard to lose weight, especially when you’re also battling another illness. Indescribably hard. But it is possible. And we need to help encourage others.

Since January of 2012, I’ve lost 80 pounds with another 20 to go to reach my goal. It’s a constant battle. Sometimes two steps forward and one back. Sometimes two or three back.

People ask me how I’ve done it but I’ve found there’s not an easy answer for that. Each journey is different because each person and circumstance is different. Because of my fibromyalgia pain, I did it mainly through changing the way I eat.

I’m not telling you my story for recognition. I’m sharing it to hopefully offer a little encouragement. It’s a story I was scared to tell but one I think is more important than my pride or my embarrassment.

Brené Brown said: “Owning our story and loving ourselves through that process is the bravest thing that we’ll ever do.”

It has been for me. And I believe it can be for you, too.