Tag: addiction

All my friends are junkies… (that’s not really true…)

Thank God for the Government. The solution for the scourge of opioid addiction in my particular state-of-residence should allow us all to sleep easier. There is a proposal up for consideration that will levy a one-cent-per-milligram tax on opioids produced by Big Pharma and prescribed within the state. That’s hittin’ ‘em where it hurts. That’s boxcar loads of cash. This money is ostensibly earmarked as funding for law enforcement, education, intervention and treatment. My bet is Big Pharma will at first throw a tantrum, bring it to the cusp of a court battle, then humbly capitulate. They may even offer a show of contrition… and six months later start jacking the price of every other pill in the state to the tune of about a penny an mg. This’ll surely cover the tax, and easily recoup the cost of all that discount naxalone/Narcan they will selflessly offer to cops and medics to administer to OD victims.

The promise on tighter monitoring of prescriptions has gotten louder and louder as well, so now the friendly family doc is on alert and had better tighten up. Threats of suspended privileges and censure are no longer idle.

Glad we’re finally getting a handle on this thing. Not.

***

Human history has had its share of cataclysmic disaster. To believe this crisis is an anomaly or aberration is blissful ignorance and modern-day arrogance. I’m not specifying drug abuse/addiction in particular. Since the dawn of recorded history there have been epochs and eras where sudden spikes in wholesale death came to pass. And I’m taking warfare out of this equation. Pandemics and drought, plague and pestilence! Sure, there were a few folks who picked up the flails or rough timbered crosses and slogged around the countryside, making appeals to God’s mercy and demonstrating penitence, but most people reacted to widespread catastrophe by hunkering down and waiting for things to blow over. “Cryin’ won’t help ya, prayin’ won’t do ya no good…” Losing a few family members was a grim expectation in the best of times. When it didn’t rain for five years or a plague swept over civilization, the best one could do was hope—or pray—that whatever cosmic deity they believed to be in charge was more pissed off at the neighbors.

Ah, times were simpler then. The local liege-lord didn’t step out onto the balcony and assure the serfs and peons of his understanding of how serious this situation was. He didn’t inform them he and his staff were hard at work in finding solutions. He didn’t offer pep talks centered on courage and unity. He sure as hell didn’t make promises about “programs” or “special committees” being put into place to alleviate the suffering or finding a means to combat it. In those dark days before mass media, the town crier didn’t march up and down the square barking statistics and bemoaning the fate of “the children.” Nobody expected as much, either. Everybody knew they were in the same boat and equally fucked, whether they lived in a castle or a mud-walled hovel.

Ah, how times have changed. We no longer lack for information. Panic can now be spread and fed in nanoseconds. The upside of this we have instant access to statistics and whatever agenda they’re put forth to prove, and we now enjoy regular updates on the welfare of “the children.” We’ve progressed beyond primitive belief and simple mindedness We’ve outgrown and “out-sophisticated” a thing so silly as accepting the Will of God, and supplanted it with the more enlightened and humanistic approach of assigning blame. Who needs a cleric when we’ve got lawyers and politicians? No better place to seek counsel when it comes to determining where fault should lie. We’re so advanced that we don’t even blame Mother Nature when it doesn’t rain or the tsunami hits. It’s no longer a natural occurrence, but the result of greedy and selfish fuckers who are destroying the Earth Our Mother from both within and without.

Now is when you should ask: “What the hell does this have to do with opioid addiction?”

And now is when I answer: “Everything.”

Despite our modern knowledge and sophistication, we are just as stupid and oblivious as we were in the Middle Ages. We have convinced ourselves that this knowledge and sophistication imbues us with control. We are convinced we have power over conditions that were once universally accepted as forces humankind was powerless against. We can well delude ourselves that we’ve come to the point where Mother Nature is a force we can play with—for good or ill—but won’t accept there is another nature we can’t do shit about: Human Nature.

People like to get fucked up.

Now that we’ve all outgrown the notion that God runs the Show, we’ve chosen to elect (for those who enjoy democracy) people who’ve determined themselves capable in doing His work. Those not living in a democracy are stuck with people who’ve decided to play God. Either way, the people affected by pandemic addiction and death ultimately aren’t going to fare any better. In many ways, we’ve worked very hard and very long to go nowhere.

Since my middle school days, I’ve been told by the powers that be that education was our greatest weapon in the battle against addiction. That’s been the line adopted by those in our nation we’ve put in charge of determining what’s good for us. Folks, we’re educated. If there’s one person in this country that hasn’t had the dangers of opiates and opioids pounded into their heads since elementary school, then that person lives in a cave or a culvert—well “off the grid” in any case. We have all been schooled on the dangers of tobacco, drugs and alcohol . . . and sugar, caffeine, genetically modified chickens and anything “supersized.” Put ten schoolkids in front of a steel post in sub-freezing weather. Tell them not to put their tongue on it. Tell them why it’s a bad thing to do. Stress and re-stress what consequences they could face in performing such an act. Provide evidence, show them pictures, recite testimonials, get an expert opinion. Repeat it over and over until you get every kid in the group to assert licking a frozen pole is a dreadful thing to do. Repeat, repeat, repeat… I’ve not a doubt whatsoever that, despite all this good intent and information, at least one of those little shits will find himself glued to a stop sign within the week.

More by Friday, the end of all this, in fact, guaranteeeeeeed. I’m getting back on track, but it’s taking longer than I’d thought it would. Why is this so? Here’s why: https://www.amazon.com/Lunacy-Death-perspective-developed-investigation-ebook/dp/B079DWFH9T/ref=sr_1_1?ie=UTF8&qid=1519665668&sr=8-1&keywords=lunacy+and+death+book

Whose junk is this, anyway?

Addiction is an awful game of diminishing returns. The longer you live within it, the more it demands. There is no breaking even. There is no “levelling off.” “Jim’s” fiscal relief by switching from pharmaceuticals to street candy will be short-lived. The money he saved by opting for heroin will be recouped by his supplier in a very short time, and then some. He may be spending the cash, but his dealer is the true investor. Such is the economy of addiction. It’s ass-backwards

“Junk is the ideal product… the ultimate merchandise. No sales talk necessary. The client will crawl through a sewer and beg to buy.”—William S. Burroughs.

Before you know it, Jim will soon be spending as much for smack as he was trying to avoid spending for quality-controlled and consistent dosages of Oxycodone. Move down the road a wee bit, he’ll be spending more. If Jim should enjoy a long life as a junky, he’ll let that life rob him of every asset he has, every one. His material possessions, like the house, car, electronics; the emotional, family, wife, friends, kids. Gone, too, will be even his ethereal credit, job, self-esteem, reputation. Not enough? Should his drug of choice-but-no-choice finally deprive him of life itself, his dealer still benefits. Overdoses are good for business. Having a client knock himself off on a product is great advertising. It’s proof of high quality. Lose one customer, gain three. Outrageous as it seems this is not baloney. Find anybody you can who works on either side of the drug trade, and they’ll confirm it. Ass-backwards.

Big Pharma didn’t throw in the towel after OxyContin generated some bad press. Fentanyl came right behind it. The exposure I’ve had to Fentanyl is in its “Duragesic” form; transdermal, time release patches. I’ve seen this in both ODs and suicides.

Fentanyl isn’t new. It’s been around for a long time, and in manifestations other than the patches. A powder/pill form has been around since the 60s and started showing up on the street in the 70s—“China White,” then subsequently “Apache,” “China Girl,” “ Dancing Girl,” “ White China,” “ Jackpot” and whatever name change suits the current market. The street name was co-opted from a sixties term for pure, white heroin, turning up as one of the first bigtime “designer drugs.” This form is almost universally manufactured in guerilla laboratories. It is a wonderful chemical that can be produced in over a dozen analogues, making it handy in evading FDA bans with a simple, chemical tweak. Ban analogue one, adjust the formula and analogue two is technically legal until the law figures it out. The big reason my Office hasn’t seen a lot is that high demand means it get gobbled up on the coasts. The supply gets sold out “right off the boat.” The patches are unique in that the dosage is spread out over three days with a single application. The really cool thing about the patches is that, while the prescribed therapeutic level is cited as three days, there’s still plenty buzz left in a patch after those three days, if you’re willing to work for it. You can wring ‘em dry by chewing them. I’ve seen more than a few corpses with a “dead” patch tucked between the cheek and gum. Yum. I’ve also heard you can jack up its effect by putting what should be a spent patch up your butt. Haven’t seen it, myself, but it wouldn’t surprise me. The problem—again—is this: Sticking something like that between your teeth or up your ass negates the dose/delivery system equation, just like snorting or shooting.

If OxyContin is to Oxycodone like whiskey is to beer, then Fentanyl is what pure grain alcohol with a couple of horse tranquilizers dropped in is to a near-beer. Therapeutic Fentanyl dosages are measured in micrograms—one-thousandth of a milligram, the amount anything with Oxy or Hydro is measured in. So, you may ask: “Are you saying Fentanyl is a thousand times stronger than Oxycodone?” Yes. “Really?” You heard me the first time.

Here’s the fun part: Those who’ve made the switch from pharmaceuticals to street products have essentially put a blindfold on and thrown all their trust—as well as their cash—into the hands of a scumbag. That heroin they think they’re buying might not contain one smidgen of heroin. Throw a “mic” or two of Fentanyl into anything and you can deliver a narcotic effect that’ll pass for heroin. “Is it really that close?” Junkies aren’t known to be picky.

Heroin/Fentanyl combos have been cut with anything from confectioner’s sugar to powdered baby formula to—get this—powdered feces. Whether this final by-product is simply used in whimsy— “I got some really good shit here, man,” or for some other esoteric purpose, I cannot say. Nevertheless, it’s “here we go again.” Whether the supplier is mixing heroin with doughnut sugar or Fentanyl with shit, the user is the one vulnerable to the consequences.

***

Somebody needs to do something. Yep. Really needs to do something. Anything. Sure. Uh-huh.

Big Pharma can sit back and hold the same line: We produce this shit, but don’t prescribe it. We market the fuck out of it, but don’t put it in people’s hands. We offer bonuses, incentives and even kickbacks to prescribers, but we can’t control how those prescriptions are used or abused. They, too, have no problem pointing the finger at cartels and renegades co-opting their work and keeping all that cash for themselves. (I’ve always wanted to see Big Pharma try to sue the “criminals” for patent/trademark/and copyright theft. This could be the answer, you know…)

For now, doctors are taking most of the beatings. Monitoring systems are popping up all over the place, analyzing duration of prescriptions and the amounts prescribed. A lot of wrist slaps and “time-outs” are being levied. Lawyers are doing their bit, throwing lawsuits in all directions. Law enforcement—BIG picture Law Enforcement—are making the usual speeches and declarations. (Mo’ money, mo’ money.) Street level law enforcement, the types I’m familiar with, are essentially asked to piss in the face of a tornado and told to leave a puddle. They do what they can, knowing it’s not much. This brings us to Big Brother, the Babysitter and Caretaker of the Nation. I offer this, an arguably different subject altogether, but one that certainly is consistent in theme and attitude:

“Good people don’t smoke marijuana.” Thus spake our Attorney General, Jefferson Sessions. Wonder how he feels about opioid addicts and junkies? No better way to express how the current administration intends to address addiction. I know I take comfort in seeing those in charge are bold enough to assert this is a character issue after all.

I’ll leave you with that. I shall return with one last rant, and promise I’ll have insights, answers and solutions just as effective when addressing this problem as those history has provided already.

***

Lunacy and Death Ebook available at Amazon, Barnes and Noble and Apple Ibooks.