by Justin Mckibben | Jun 11, 2018 | Anthony Bourdain, Celebrity, Death, Depression, Dual Diagnosis, Heroin, Mental Health, Mood Disorders, News, Suicide
Anthony Michael Bourdain, born June 25, 1956, was a man with a rich and vibrant legacy. He took us on exotic adventures to explore the world and tried to expand the view of the audience on culinary arts and culture. He was much more to so many than a celebrity chef.
Anthony Bourdain was an author, travel documentarian, and television personality. He used programs like A Cooks Tour and No Reservations to travel across the globe, focusing on the international culture, cuisine, and the human condition. He has sat down for humble lunches with President Obama, and his explosive personality has even been featured in cartoons like The Simpsons and popular FX series Archer. Bourdain has taken us to some of the most secluded corners of faraway places to chat with the locals and enjoy a simple dessert. Anthony Bourdain was widely regarded as one of the most influential chefs in the world.
On June 8th, 2018 the world was shocked to hear that Anthony Bourdain had died at 61 years old. Even more heartbreaking was to learn his death was a suicide. Over the last several days, his passing has sparked a continuous stream of dialog about mental health and the need for treatment resources. Over the years the famous traveling chef fought against drugs like heroin, as well as depression. As we remember who Anthony Bourdain was, and as we call for letting go of stigma and pushing forward with helping those in need, it is important to look at the whole story.
Kitchen Confidential
Anthony Bourdain first fought his way up the kitchen ladder in New York to become a long-time chef at Brasserie Les Hallas. Around this time, he wrote his breakthrough memoirs titled Kitchen Confidential: Adventures in the Culinary Underbelly, which took him beyond the cutting boards to carving his way through the literary map.
Part of this first memoir describes the long journey that brought him to become a chef, and a notable element of his story is extreme excursions into drugs, strung out over years. In the book Kitchen Confidential he wrote about his experiences back in 1981 working at a restaurant:
“We were high all the time, sneaking off to the walk-in refrigerator at every opportunity to ‘conceptualize.’ Hardly a decision was made without drugs. Cannabis, methaqualone, cocaine, LSD, psilocybin mushrooms soaked in honey and used to sweeten tea, secobarbital, tuinal, amphetamine, codeine and, increasingly, heroin, which we’d send a Spanish-speaking busboy over to Alphabet City to get.”
Later, Bourdain became more open about discussing his drug use. He’d even said some of these problems should have killed him in his 20s. In 2014, he did an episode of his show Parts Unknown that highlighted the ongoing opioid epidemic in Massachusetts. During the episode he says,
“Somebody who wakes up in the morning and their first order of business is (to) get heroin — I know what that’s like,”
Parts Unknown went on to be honored with five Emmy awards.
Eventually, Anthony Bourdain found himself kicking heroin in the 80s in drug rehab. When talking about finally getting clean he said,
“And we’re the lucky ones. We made it out alive. There are a lot of guys that didn’t get that far. But you know, I also don’t have that many regrets either.”
However, he admits to still worked long hours in New York kitchens interspersed with binges that consisted of cocaine and alcohol. Following rehab that Bourdain had cleaned up his act, although he continued drinking alcohol. He later wrote,
“Most people who kick heroin and cocaine have to give up on everything. Maybe because my experiences were so awful in the end, I’ve never been tempted to relapse,”
On June 8, 2018, Bourdain was found dead of an apparent suicide by hanging in his room at the Le Chambard hotel in Kaysersberg, France. At the time he had been traveling with friend Éric Ripert. Ripert reported that he became worried when Bourdain missed dinner and breakfast. According to the public prosecutor Christian de Rocquigny du Fayel, Bourdain’s body showed no signs of violence. At this point there has been no official word on toxicology tests to determine whether drugs or medications were involved in his tragic death.
Legacy
It is hard to put into words the life and legacy of a man as dynamic as Anthony Bourdain. He wasn’t just a face on TV, he was a voice trying to tell us to embrace more of the delicious variety in life. It is easier to just look at some of his many accomplishments. Bourdain wrote multiple bestselling nonfiction books over the years, including:
- Kitchen Confidential: Adventures in the Culinary Underbelly
- Medium Raw: A Bloody Valentine to the World of Food and the People Who Cook
- A Cook’s Tour: In Search of the Perfect Meal
- The Nasty Bits
His articles and essays appeared in many publications, including:
- The New Yorker
- The New York Times
- The Times
- Los Angeles Times
- The Observer
- Gourmet
- Maxim
- Esquire
He even co-wrote an original graphic novel titled Get Jiro! For DC Comics/Vertigo.
Between 2002-2018 he hosted a number of shows, including:
- A Cook’s Tour
- No Reservations
- The Layover
- Parts Unknown
He worked on various other television shows, doing everything from judging to producing.
With the sudden news of Bourdain’s death, people from all across the world have paid homage to the man who did so much to try and share the beauty of diversity with us all. In the days following Bourdain’s death fans paid tribute to him outside his now-closed former place of employment, Brasserie Les Halles on New York City’s Park Avenue.
Fellow celebrity chefs and other public figures expressed sentiments of condolence, including Gordon Ramsay and Andrew Zimmern.
Beyond his amazing adventures of cooking in different countries, Bourdain also believed in making a difference for those less fortunate. He championed industrious immigrants from places like Mexico, Ecuador, and other countries in Central and South America.
He became a big advocate in the fight against sexual harassment in the restaurant industry in 2017, calling out other celebrity chefs and people in Hollywood.
Depression and Suicide
Anthony Bourdain had also been open about his struggles with depression. In 2016 he did an episode of Parts Unknown where he traveled to Argentina for psychotherapy. At one point he tells the camera,
“I will find myself in an airport, for instance, and I’ll order an airport hamburger. It’s an insignificant thing, it’s a small thing, it’s a hamburger, but it’s not a good one. Suddenly I look at the hamburger and I find myself in a spiral of depression that can last for days.”
While the passion he had for his work is quite obvious, traveling around 250 days of the year can take a toll. More than once he described his life as lonely. During an interview with People magazine, he said he was living the dream, but admitted that it did come at a cost. That cost may have had something to do with the ups and downs of marriage and divorce he experienced over the years.
Only a few months ago, when discussing his 11-year-old daughter Ariane, Bourdain had said he felt he had to “at least try to live” for her. Although he explained he also felt he did have things to live for. Sadly, it seems that over time, the iconic chef started losing his battle with the feelings he wrestled with on the road.
Anthony Bourdain’s death is another tragic loss in a trend we have seen a spike over the years, including among celebrities. Only three days before Bourdain’s own death, fashion designer Kate Spade took her own life. Suicide is a growing problem in the United States. According to a survey published by the US Centers for Disease Control and Prevention:
- Suicide rates increased by 25% across the country over nearly two decades ending in 2016.
- 25 states have experienced a rise in suicides by more than 30%
While Anthony Bourdain may have been clean for decades, there was still pain there. While overcoming drugs may have been a huge victory in his inspiring legacy, other fights can still wear us down.
There is Help
As we remember the incredible impact that Anthony Bourdain had as an adventurer and advocate, we emphasize the importance of supporting those who need it the most. Sadly, we don’t always know when people need help. But we should always work to make sure people know that there is help, no matter what they are struggling with.
“As you move through this life and this world you change things slightly, you leave marks behind, however small. And in return, life — and travel — leaves marks on you. Most of the time, those marks — on your body or on your heart — are beautiful. Often, though, they hurt.”
–Anthony Bourdain
June 25, 1956 – June 8, 2018
Mental health is an important part of recovery for people who struggle with drugs or alcohol. Fighting depression and suicide prevention means supporting well-being and fighting for mental health support. For those struggling, treatment for mental health disorders and addiction is not always the easiest thing to seek out, but as we as a nation continue to evolve the conversation and raise awareness more people are finding out about the amazing pathways to a life in recovery that are out there. We urge you to seek yours. If you or someone you love is struggling with substance abuse, please call toll-free now. You are not alone.
CALL NOW 1-888-922-5398
by Justin Mckibben | Mar 20, 2018 | Donald Trump, Drug Dealers, Drug Policy, Drug Trafficking, Fentanyl, Heroin, News, Opioids, Prescription Drugs, Synthetic Drugs, War on Drugs
The fight against prescription opioid abuse, heroin, and fentanyl in America continues to intensify. Our political landscape may soon see even more drastic shifts because of it. Controversy and conjecture have surrounded many ideas brought to the table on both sides. Even the President himself has been behind some pretty divisive propositions. Then Monday, President Trump unveiled his plan for combatting the ongoing opioid crisis in America while in New Hampshire.
During his speech, the President talked up a few key elements of his plan; some we have heard of before, and others have only recently become a serious topic of conversation. As the administration puts the final touches on their proposals, we thought should take a look at some of the highlights and see which of his plans could actually work, and why experts and advocates believe others probably won’t.
Arguably, there are some pretty good ideas here… and some pretty bad ones, depending on who you ask.
An Opioid Vaccine
Let’s kick this off on a high note.
The Trump opioid plan includes supporting the search for a vaccine. This honestly seems like a good ambition to get behind, but will it work? Researchers at the Walter Reed Army Institute of Research and the National Institute on Drug Abuse developed an experimental heroin vaccine back in December. So far the compound has been tested with rats and mice. Their latest breakthrough found that antibodies in the vaccine bound to the heroin before crossing the blood-brain barrier. This reaction effectively prevents the euphoric effects of the drug.
While this is an exciting development, it is still a vast leap to go from treating mice to treating humans. We still have a long road ahead before this possible vaccine could be approved. However, more funding and resources from the federal government could make a big difference.
Even so, it is important to note that this vaccine will not be a cure-all answer that fixes everything. After all, we have seen opioid blocking methods before. Drugs like Vivitrol and other implants were also developed to hamper the effects of opioids, and they still haven’t stopped the crisis from growing. Experts are already saying this vaccine will only work in the short term and require repeated doses. It is expected to be an incredibly expensive treatment, and it may only be another variation of the Vivitrol shot. Still, some believe this vaccine, used alongside other treatment methods, could be a crucial tool in fighting opioids.
Big Pharma and Prescription Drugs
The Trump opioid plan also takes a look at prescription opioids. The President acknowledged the contribution of pharmaceutical companies and prescription drugs to the opioid crisis. In his statement, he indicated that this administration support research for opioid alternatives.
“That includes federal funding for the development of non-addictive painkillers.”
In talking about prescription drugs, President Trump said the administration also planned on addressing the issue of overprescribing addictive medications. He even touted the Justice Department’s new task force that may soon be fighting Big Pharma companies in court.
“Our Department of Justice is looking very seriously into bringing major litigation against some of these drug companies. We will bring it at a federal level.”
He acknowledges the recent work at the state level to hold Big Pharma accountable. President Trump said his administration will be working to reduce opioid prescriptions by 1/3 over the next three years. Hopefully, as time goes on there will not only be more accountability to those manufacturing these potent medications, but also more options for the thousands of people suffering from chronic pain who do need pain management.
Commercial Campaign
This show we have seen (fail) before. The crisis probably isn’t going to get fixed with re-runs and reboots.
For a long time, Trump has been talking about creating a media campaign to try and combat the opioid crisis. In his remarks on Monday, the president said,
“We are thinking about doing a really large-scale rollout of commercials that show how bad it is for the kids… Scare them from ending up like the people in the commercials.”
Trump said he would spend a lot of money and direct people to make the commercials depict “pretty unsavory situations” claiming that this strategy has worked before with cigarette smoking.
Sadly, the reality is that we have tried this before. Using anti-drug messaging that specifically targets kids and young adults is exactly what was done with the “Just Say No” ad campaign of the 1980s and early 1990s, and the DARE program of the same period. Neither program was proven to be particularly effective in reducing drug use. Some have even argued it did the opposite and actually intrigued young people into drug use.
This is just one part of the Trump opioid plan that reminds people of the ideas pushed in the failed War on Drugs that already destroyed countless lives and only ended up making the problem worse.
So how will this new campaign be different?
The Border
The President also mentioned the importance of combatting the flow of illicit drugs like fentanyl and heroin into the country. He became particularly energized of course when talking about his proposed border wall with Mexico, saying,
“90% of the heroin in America comes from the southern border, where eventually the Democrats will agree with us and we will build a wall to keep the damn drugs out.”
However, many are not so convinced that the wall will be especially effective in stopping drug traffickers. Support for the wall experiences ups and downs as negotiations over immigration continue. Then the President took the opportunity to scrutinize sanctuary cities, calling out California and claiming these places were harboring the most terrible kinds of criminals, including drug dealers.
If part of the Trump opioid plan is to apply even more pressure to sanctuary cities, we may see more back-and-forth when it comes to compromises on immigration policy reform. Recently the Republicans were using DACA as a bargaining chip with Democrats to get the infamous border wall built, but now Trump says Democrats are holding onto it so they can use the issue during the election cycle.
Death Penalty for Drug Dealers
Now, THIS proposal is the one part of the Trump opioid plan that is causing the most controversy, and understandably so.
UPDATE: Attorney General Jeff Sessions sent out a memo Wednesday officially asking federal prosecutors to pursue the death penalty in drug trafficking cases “dealing in extremely large quantities of drugs”. So the administration is now implementing President Donald Trump’s plan to ramp up “tough on crime” punishments in response to the opioid crisis.
In his speech, the President brought having the death penalty for drug traffickers to the forefront. This is an extreme even some of his supporters believed was more tongue-in-cheek than actual proposed policy. The details on this proposal were still pretty scarce at the time. Some support Trump pushing for the death penalty, saying this punishment would only apply to high volume, kingpin-level dealers. But what we should consider is this:
- The federal death penalty is available for a few drug offenses. This includes violations of the “drug kingpin” provisions in federal law.
- Reports indicate that Trump wants Congress to pass legislation that will reduce the amount of drugs needed to trigger mandatory minimum sentences for traffickers.
So should we assume that the President intends to expand what qualifies as “drug kingpin” activity to make the death penalty easier to enforce? If so, what does that mean exactly? And what does it mean for further enforcing other mandatory minimums?
The Justice Department has said it would seek the death penalty “when appropriate under current law.” While drug-related murder is already a capital offense, no one has ever been executed by those rules. However, President Trump says that he and the Justice Department are working very hard to change the laws. To do so would require an act of Congress, and many believe Congress is highly unlikely to expand the federal death penalty. So will any of this be changing soon?
In his comments, President Trump stated,
“If we don’t get tough on the drug dealers, we are wasting our time. And that toughness includes the death penalty.”
President Trump’s call for the death penalty is being strongly met with condemnation. The proposal’s critics range from treatment advocates to law enforcement officials and civil liberty organizations.
Maria McFarland Sánchez-Moreno, executive director of Drug Policy Alliance, said in a statement,
“If this administration wants to save lives, it needs to drop its obsession with killing and locking people up, and instead focus resources on what works: harm reduction strategies and access to evidence-based treatment and prevention.”
Jesselyn McCurdy, deputy director of the American Civil Liberties Union’s Washington office, said,
“Drug trafficking is not an offense for which someone can receive the death penalty,”
McCurdy is referring to a Supreme Court precedent that puts constraints on using the death penalty for a convicted person who did not commit murder.
Furthermore, there are plenty of arguments that this kind of policy is not practical. Some say it would either be so broad it became unconstitutional, or so specific that it would be obsolete. This aspect of the plan has sparked nationwide debate. Americans everywhere are arguing whether or not a drug dealer should be responsible for the deaths of customers.
Sadly, this is so frustrating because past data does not hold with the idea that getting ‘tough’ on drugs is more effective than offering treatment opportunities. One of the best studies backing this is a 2014 study from Peter Reuter at the University of Maryland and Harold Pollack at the University of Chicago. Researchers determined that while simply prohibiting drugs to some extent does raise their prices, there’s no good evidence that tougher punishments or harsher supply elimination efforts do a better job of driving down access to drugs and substance misuse than lighter penalties.
In fact, many addiction advocates argue that harsher punishments can actually be counter-productive because they end up punishing people who need treatment, not incarceration. So the need for a more comprehensive approach to opioid addiction treatment is paramount. Hopefully, this administration will see the need to focus on support for treatment, instead of a primarily punitive focus.
Trump Opioid Plan on Treatment
This is a critical and commendable element of the Trump opioid plan, and I applaud some of its intentions. However, I wish we could talk a lot more about this and a lot less about captial punishment.
Still, I give them credit for saying they want to increase access to addiction treatment and adopting harm reduction. There isn’t much detail to go on though, as far as how this will happen. One aspect is to increase the use of medications such as methadone and buprenorphine.
As another highlight, Trump also asks Congress to repeal a rule blocking Medicaid payments to larger treatment facilities, which could provide a boost in the billions to inpatient clinics. Hopefully, this is one factor of the Trump opioid plan that will pan out, because one of the biggest issues the US faces with the opioid crisis is a limited access to adequate treatment options. If the White House allows Medicaid to reimburse larger treatment facilities, more people will be able to get effective care. Still, it is unclear how many resources the administration is willing to commit to treatment resources.
Hopefully, the Trump opioid plan will evolve and we will see a resurgence of resources going toward helping get people suffer the help they need. It is understandable to want to curb the rise of addiction through anti-trafficking measures and raising awareness, but we already have thousands and thousands of people struggling every day all over America who need help. Preventive steps are crucial, and the President is trying to push for them. But it is vital that we also give everyone already struggling more of a fighting chance. The possibility of more people having greater access could help create a huge shift.
Palm Healthcare Company believes in providing innovative and effective holistic treatment options for those who are battling with addiction. Our facilities believe in comprehensive and compassionate care, and our mission every day is to transform as many lives as possible. Together, we can make a difference. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help.
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by Justin Mckibben | Mar 6, 2018 | Drug Dealers, Drug Policy, Drug Trafficking, Law Enforcement, News, Stigma, Violence, War on Drugs
One of the consistent topics in politics now is how the current administration plans to tackle issues concerning drug policy. There’s plenty of recent news, such as the Attorney General announcing a plan for the Justice Department to support states suing Big Pharma opioid makers, while also claiming that marijuana is partly responsible for the opioid crisis. Reports have indicated China is willing to work with the US to fight fentanyl trafficking, but critics are still worried about the massive cuts President Trump proposed for the Office of National Drug Control Policy.
But that isn’t the only proposal made by President Trump that has inspired debates about drug policy.
This past Thursday, while speaking at the White House event on opioid issues, many believe that a few of Trump’s comments endorse the idea of executing people who sell illegal drugs. Shocking as it may seem to some people, the concept isn’t all that new. In fact, we see people all the time in the comment section of many articles on opioids who seem to think this is an acceptable idea.
We have asked the question before if drug dealing should be considered homicide, with mixed responses. However, now it seems we should be asking- is drug dealing punishable by death?
President Trump Admiring the Philippines
If we take a look back, President Trump has supported this strategy before. Just last year the leaked transcript of a phone call with President Rodrigo Duterte of the Philippines quoted Trump praising the nation’s bloody and brutal War on Drugs. In recent years, thousands of extrajudicial killings have taken place in a country fully immersed in a violent vendetta against drugs. The president was quoted saying:
“I just wanted to congratulate you because I am hearing of the unbelievable job on the drug problem. Many countries have the problem, we have a problem, but what a great job you are doing and I just wanted to call and tell you that.”
However, not everyone shares the president’s admiration. An inquiry by the International Criminal Court is actually investigating the killings of the Philippines drug war. Not to mention, others would argue that the brutal crackdowns in the Philippines haven’t exactly worked out either. In December, the head of the country’s drug enforcement agency publicly stated that they have been unable to stop dealing at the street level.
President Trump on Drug Dealers
This isn’t the only reported instance of the president supporting this extreme tactic. Just days before his Thursday remarks there was a story that Trump had privately told a number of people, including leaders in Congress, that he supports executing drug dealers.
So what did President Trump say at the White House Thursday? In general, he thinks sellers of illegal drugs don’t get punished severely enough in the US, stating:
“We have pushers and we have drug dealers that kill hundreds and hundreds of people and most of them don’t even go to jail,”
“If you shoot one person, they give you life, they give you the death penalty. These people [who sell drugs] can kill 2,000, 3,000 people and nothing happens to them.”
Even back in January, President Trump made comments that some think was a precursor to this conversation. In another report, the president suggested he had an idea for a change in drug policy that might be too dramatic for the country.
“No matter what you do, this is something that keeps pouring in. And we’re going to find the answer. There is an answer. I think I actually know the answer, but I’m not sure the country’s ready for it yet. Does anybody know what I mean? I think so.”
There is not yet any indication the president has committed to go this far. And yet, he has repeatedly vowed to be “much tougher on drug dealers and pushers.”
President Trump also said that his administration will be rolling out policy over the next three weeks, promising it will be “very, very strong.” This administration is definitely consistent with its focus on stricter enforcement and tough-on-crime tactics for the drug problem. So is this recent stir surrounding the president’s comments well-founded? Or is the president’s support for dealing with drug dealers with the death penalty just an opinion of his that won’t go into any actual policy plans?
Should Drug Dealers be Executed?
Surely, we will see plenty of arguments in the comments here. There are bound to be some very strong opinions. Some people do believe that drug dealers are the cause of countless deaths and that they should face the harshest punishments possible.
One person might say ‘an eye for an eye… trade one lethal injection for another.’ But we still need to ask ourselves if this is actually effective.
Many would argue that a lot of street-level dealers are addicts themselves, who peddle their own prescription medications or other illegal substances out of desperation. They might still be people suffering from an illness that leads them to do things they might not otherwise do.
You might say- well, then we should only execute people who provide drugs that lead to a death. But there are plenty of cases where this strict of a penalty seems extremely cruel and unusual. And there are already instances where the individual providing drugs to someone who overdosed has been charged with manslaughter. Some were even charged with second-degree murder. For example, there was the case of Joshua Lore. Lore had gotten himself high on heroin and then prepared and administered a dose for his friend, 23-year-old Kody Woods. After Woods died from the overdose, Lore was charged with second-degree murder. The coroner ruled the death accidental. However, the law still allowed for him to be charged as if he had intentionally shot his friend down in the street.
Would anyone argue that maybe he should face the death penalty because maybe his friend paid him for the drugs? What if?
Criminal Charges for Overdoses
In 1986, Boston Celtics draft pick Len Bias’s death was deemed cocaine-relate. The federal government then implemented stiff penalties on drug dealers whose sales can be directly tied to overdoses. This includes a minimum of 20 years, and up to life in prison. But there is the still scrutiny to prove the allegations against dealers. Back in 2014, the U.S. Supreme Court ruled that a drug can’t just have contributed to death. It needs to actually be proven as the cause of death.
So where do we draw the line there? Because in some cases an individual may not die directly due to an overdose, but because the drug causes a reaction in the body with a pre-existing condition or counteracts other drugs it turns deadly. What if someone buys drugs from multiple dealers in one day, then dies? Does each dealer get put to death just in case?
Let us say we are only going to consider the death penalty with king-pins and large-scale traffickers. Kellyanne Conway, who is the head of the White House’s anti-drug effort, supposedly told Axios the proposal from President Trump is more nuanced and would only apply to “high-volume dealers who are killing thousands of people.” Fair enough. But how do we measure that exactly? Will it depend on the drug? Are we going to have someone with marijuana farms being executed next to fentanyl traffickers, even though the substance they sell is considered legal in several states?
It all becomes a much deeper conversation about where the mindset of our world is right now. These days it seems our society has continued to embrace the idea of choosing the lesser evil. And we can argue all day about whether or not people think this is ‘right’… but would it even work?
Lesser Evil
Sadly, even if President Trump were to make the necessary distinctions, there are still going to be people who think all drug dealers should face death. But is trying to fight drugs by making an example out of dealers a practical solution? If people say drug use is still a voluntary act, should selling drugs constitute the death penalty if drugs aren’t forced into the victim’s body? And if we say yes, many also want to know if the president will support holding Big Pharma executives who engaged in corruption and shady marketing to the same standard.
Sure, maybe killing some drug dealers might scare a few others, but it won’t scare them all. If a dealer is taken off the streets, odds are another will take their place. Experts are sometimes split on whether attacking addiction at the supply-side has not been an effective strategy. Some say it makes drugs harder to get and more expensive. However, others say the open market inspires more dealers to take advantage of scarcity with higher prices. Studies even suggest there is no hard evidence that harsher penalties or supply elimination reduces drug use.
The tragic truth is there are already people who think we shouldn’t even be doing so much to save the lives of addicts. They say those who overdose should be left to die.
Is that who we are now? We see the people in our communities in pain and we leave them to die?
President Trump seems to believe a less punitive approach won’t work. So do the people agree? Should we have more compassion or convictions? If we stopped trying to arrest and punish our way out of the opioid crisis, could we be making more lives better?
Should we really be relying on the lesser evil?
The pain of losing a loved one to addiction is undeniable, and the desire for justice is understandable and natural. Even though we see addiction as a disease, we have to know we take our lives into our own hands every time. Sadly, sometimes we don’t make it back. But if you do, take it as an opportunity to make a change. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-888-922-5398
by Justin Mckibben | Feb 20, 2018 | Drug Abuse, Drug Policy, Harm Reduction, Needle Exchange Programs, News, Safe Injection Sites
Right now a few American cities are aiming to establish active safe injection sites, with most recent reports indicating the first will probably be San Francisco. Currently, the Golden Gate City is on track to open two of these facilities in July. Meanwhile, Philadelphia is not far behind as city officials are pushing forward with a proposition from January. Other areas fighting for the controversial programs include Seattle and Baltimore.
Now it seems this fight for safe injection sites may soon pit state governments against the federal government, as the DEA under the Trump administration vows to take action against these facilities.
Safe Injection Sites for San Francisco
The city of San Francisco has an estimated 22,000 intravenous drug users. As of now, it has become the norm to see people injecting drugs in broad daylight on a park bench, public transit, or any sidewalk. As a consequence, dirty needles get left out in the open. So the decision by San Francisco officials to establish safe injection sites isn’t all that alarming.
Safe injection sites mean fewer needles on the streets. Reports from public health officials expect that 85% of the intravenous drug users in the city would use these sites, and the city could potentially save $3.5 million a year in medical costs. According to the director of San Francisco’s Department of Public Health, Barbara Garcia, officials are already working out the details. Garcia is currently working with six to eight nonprofits that already provide needle exchange programs and other addiction services. Two of them will soon be operating as safe injection sites.
Garcia says that because the cities fiscal year will begin on July 1, the process of opening these safe injection sites should begin close to that date. She also adds that once officials are able to examine how the first two sites are working, they can decide if and when to open the third and fourth sites.
Because intravenous drug use is still against state and federal law, the city will be avoiding liability by funding these sites through private investments. Garcia did not include where the money would be coming from. Garcia also does not appear to be too concerned about whether opening safe injection sites will draw the ire of the Trump administration, saying,
“That’s to be seen. I’m more worried about people dying in our streets.”
Given the rates of intravenous drug use and overdose death in the area, that sounds like a reasonable reason to worry. Part of operating safe injection sites also means providing a supervising medical staff equipped with overdose antidotes, and offering addiction treatment resources to those willing to seek help.
Hope for Harm Reduction
State Senator Scott Wiener is also working to get state law changed to ensure that anybody associated with safe injection sites won’t face arrest or punishment, including:
- Property owners
- Employees
- Drug users themselves
The bill Wiener is pushing was last year passed in the Assembly, but remains two votes short of confirmation in the Senate.
Part of the reason for so many officials pushing to protect and advance this project seems to come from a fair amount of public support. For the first time, the Chamber of Commerce’s Dignity Health CityBeat Poll included a question about safe injection sites this year. It asked respondents whether they support or oppose-
“drop-in facilities called safe injection sites where intravenous drug users could use their drugs, off the street, and in a place where medical and social services are available.”
Out of all those who answered the survey:
- 67% of respondents said they support the idea
- 45% of those were ‘strongly’ supportive
- 22% of those were ‘somewhat’ supportive
- Only 27% percent opposed it
- 6% didn’t know
The poll found support for the sites regardless of:
The demographics also includes support from:
- Progressives
- Liberals
- Moderates
- Even 42% of self-described Conservatives
Mayor Mark Farrell is another supporter who said,
“I understand the misgivings around it and some of the rhetoric from people who don’t support it, but we absolutely need to give it a try.”
While issues like homelessness, crime and gang violence were all concerns consistent with opening of injection sites, city officials seem to believe the old way isn’t working. The hope is that by providing social services and treatment options, these safe injection sites will not only save lives but help more people get off drugs that otherwise might not have access to these resources.
Trump Says Sites Will Face Legal Action
It still seems these efforts will be met with resistence from the federal government. Last week the Trump administration made it clear they reject any facilities where heroin users can inject drugs under supervision. The president and his Attorney General Jeff Sessions seem to be committed to their ‘law and order’ approach to the drug problem, despite any lessons learned by the failed War on Drugs.
One might note that in general, the U.S. Drug Enforcement Agency views safe-injection sites as facilitation of criminal behavior. Therefore, it’s an absolute possibility the DEA will take some kind of enforcement action against any safe injection sites that pop up in the states. Katherine Pfaff, a DEA spokesperson, argued that these programs remain federally prohibited. She states,
“Supervised injection facilities, or so-called safe injection sites, violate federal law. Any facilitation of illicit drug use is considered in violation of the Controlled Substances Act and, therefore, subject to legal action.”
However, it appears some of the states that have approved safe injection sites are already preparing to do legal battle with Attorney General Jeff Sessions and his Justice Department to convince the courts that this public health emergency is far too critical to pass up any opportunity at harm reduction.
So, what is going to become of this new controversy? More people, including law enforcement officials and conservatives, could be warming up to the idea of cleaning up the streets with safe injection sites in some states. If the DEA make moves to shut them down, what will happen next? Are safe injection sites an acceptable form of harm reduction? If not, what else could help address the opioid crisis?
Let us know in the comments what you think about these programs.
Palm Healthcare Company believes in providing an effective, holistic treatment program to help those suffering who need help. Providing safe and comprehensive care should always be a focus in the effort to overcome the drug problem, and preservation of life should always be a priority. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-888-922-5398
by staff | Nov 24, 2017 | Addiction Medicine, Addiction Treatment, Maintenance Drugs, Medication-Assisted Treatment, Methadone, Prescription Drugs, Recovery, Suboxone, Vivitrol
Support for Medication-Assisted Treatment (MAT) has continued to grow in recent years as the opioid epidemic in America has put a mounting strain on the country. While the numbers of overdoses and opioid-related deaths have steadily climbed to devastating heights there has been more effort to explore treatment options. A better understanding of the medical and mental health aspects of addiction has become a priority. Stigma has slowly begun to carry less weight while advocates push for more effective and supportive routes to care for recovering addicts. One thing people have turned to heavily is medications like Suboxone of Methadone in attempts to steer away from more illicit and dangerous substances like heroin or fentanyl.
The application of medication in treatment can be very useful. It is a strategy that can help with the preservation of life by helping people stay off more unpredictable and life-threatening substances. However, some would say that if used for long-term this form of treatment is still relying on the idea of substitution. Often times these drugs have their own very harsh withdrawal symptoms, especially with extended use.
Taking a look at the more popular drugs used for medication-assisted treatment, one may ask- can you quit medication-assisted treatment with no withdrawals?
Understanding Medication-Assisted Treatment
Medication Assisted Treatment is the use of anti-craving medications to try and help address issues related to drug dependence, withdrawal, and relapse. The more common medications used in MAT include:
But MAT is also utilized alongside comprehensive therapy and other forms of support. Experts and advocates for addiction recovery, including the Substance Abuse and Mental Health Services Administration (SAMHSA), insist that maintenance medications alone are not sufficient enough treatment.
Advocates for medication-assisted treatment will compare MAT to someone taking medication for diabetes or asthma, with the belief that maintenance drugs are an essential part of staying healthy. However, others in the world of addiction recovery still believe it is possible to be healthy in recovery without the prolonged use of powerful medications.
The truth is the answer may not be the same for everybody. Different treatments may be more useful for different people. No one should be ashamed of the method they use to get help. But we also want to look at how some drugs used in medication-assisted treatment might make things more complicated for certain people.
Suboxone
Looking at the most popular maintenance drugs for opioid addiction, of course, we find Suboxone. To better understand Suboxone withdrawals, we first have to know what it is. This popular brand name is used to identify a prescription medication that contains active ingredients:
- Buprenorphine- a narcotic opioid medication
- Naloxone– an opioid blocker that impedes the effect of opioid medications
This medication functions as a partial opioid agonist and diminishes cravings as well as prevents other opioids from reacting to the brain’s opioid receptors. Taken in low doses for short periods of time, the drug can be helpful in curbing opioid withdrawal symptoms while tapering off without too many residual effects.
The tricky part comes when someone uses Suboxone for an extended amount of time as a replacement for heroin or other opioids.
Sometimes this can lead to its own form of recreational use and physical dependence. Even the U.S. Drug Enforcement Administration reports that Suboxone is commonly susceptible to abuse. It is still a powerful drug.
Suboxone Withdrawal Symptoms
While Suboxone and other maintenance drugs may be a preferred tactic for going ‘cold turkey’ off of heroin or other opioids, the drug itself still has the power to cause its own set of withdrawal symptoms. These symptoms can include:
- Irritability or agitation
- Anxiety
- Difficulty sleeping
- Profuse sweating
- Tearing
- Runny nose
- Frequent yawning
- Stomach pain or cramping
- Diarrhea
- Dilated pupils
- Nausea and vomiting
- Confusion
- Changes in mood
Not to mention precipitated withdrawal, when the ingredients in this medication can actually induce the onset of unpleasant symptoms rapidly, if not immediately, for someone actively engaged in opioid use.
Methadone
Methadone is a long-acting opioid medication utilized since the 1970s to try and help people get off of heroin. It is typically used today under strict medical supervision because the drug is very potent and has a high risk of addiction. In fact, a 2012 National Survey on Drug Use and Health found that approximately 2.46 million people reported to using methadone for a non-prescribed purpose at least once.
According to another study, in 2009 methadone was responsible for 1 out of every 3 opioid overdose deaths.
Because of the risks, a gradual taper should be utilized to wean someone off of methadone. Often times doctors will prescribe another detox medication to help with this process, with the tapering to be done under medical supervision.
Methadone Withdrawal
But as with trying to quit heroin or other powerful opioids ‘cold turkey’, trying to abruptly discontinue methadone can bring on intense withdrawal. This includes physical and psychological symptoms such as:
- Agitation
- Anxiety
- Depression
- Insomnia
- Runny nose
- Tearing or watery eyes
- Muscle aches
- Joint pain
- Sweating
- Nausea
- Abdominal cramps
- Diarrhea
- Vomiting
- Shivering
- Trembling
Many of these symptoms are similar to the symptoms of withdrawing from heroin or other opioids. So in a sense, this drug can create similar withdrawal symptoms as the drugs it is supposed to be used to treat.
Quitting Medication Assisted Treatment
Is it possible to quit medication-assisted treatment- yes, there are always other options for getting comprehensive care and lasting recovery without the prolonged use of these medications. Even relapse prevention is possible without relying on medications to fight cravings.
Can you quit medication-assisted treatment with no withdrawals? Well, that may be a process. It depends on a number of factors, such as the specific maintenance medication and the length of time using it. For example, someone who has been using methadone for years could probably have a much harder time getting off methadone than someone who used another medication for a month or so to help get off opioids.
Safety is crucial when deciding to quit MAT. Quitting medication-assisted treatment without a taper or other forms of medication can cause intense withdrawals. It is not suggested that someone try to quit MAT ‘cold turkey’ or without consulting a doctor for help with changing the dosage and slowly tapering off the drugs.
Again, just because it isn’t heroin or fentanyl doesn’t make it harmless.
MAT or Detox?
Medication-assisted treatment holds a lot of value, but the question becomes whether or not it is the kind of sustainable solution you want. Recovery isn’t one-size-fits-all. Medication-assisted treatment can be helpful in saving someone’s life who cannot stop using drugs. But is it something that will completely eliminate cravings and withdrawals, or will it just postpone these symptoms?
Remember, these are still powerful narcotic drugs that have a high risk for abuse. Some people end up using medication maintenance for life. Others will use it for a short period of time, with a detox period afterward. Either way, it is your choice; how long do you want to rely on substances, and to what extent?
Other models believe in providing holistic treatment and personalized therapy after a detox period, helping to reduce and remove chemical dependence and build a foundation for personal recovery.
Using medication to help with the painful and often overwhelming symptoms of withdrawal from opioids and other drugs can be essential to a smooth and healthy transition. In fact, with a safe medical detox, each individual is given an initial assessment to see what medications will be helpful in making this phase of treatment comfortable and safe. This can include medications for anxiety, mood disorders, physical pains and various other side-effects of substance abuse.
And when it comes to some of these medications, it can sometimes be necessary to continue using them.
The biggest difference is whether narcotic maintenance medications like Suboxone or methadone become a long-term prerequisite to recovery, or if they are used to help someone who is sick get better so that the real healing can happen.
Palm Healthcare Company believes in providing a safe medical detox to allow for a comfortable and healthy transition from active drug or alcohol use. Our facilities utilize an experienced and professional medical staff who help to monitor each individual’s progress and provide effective medical support for lasting recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help.
CALL NOW 1-888-922-5398
