2015-03-25

According to the CDC, an estimated nine percent of adult Americans use some sort of addictive drugs on a regular basis. That’s 24 million people. Approximately 16,000 Americans die every year of opioid overdose, up from 6,000 in 2001. Prescription drug overdose is now the leading cause of death among young people in the United States. Americans consume 80 percent of the opiates produced in the world. This constitutes a modern-day plague.

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Fighting drug abuse in America is like fighting the Hydra of Greek mythology. Just as soon as we seem to make a little progress in one area, something new and unexpected arises to take its place. Some drugs like heroin, which you might think would have killed off all their serious users a generation ago, are now making a strong comeback. The innate power of these substances to drive human behavior can be awe inspiring.

Desperate Behavior

Addictive drugs have the potential to utterly deactivate a person’s moral compass. I have seen otherwise intelligent, well-educated, morally upright people offer their bodies, their livelihoods and their families up in exchange for their particular substance of choice. People who are seriously addicted will lie, cheat, steal and even kill with little thought to subsequent consequences. It is this particularly sordid aspect of drug addiction that makes the widespread use of drugs such a significant issue for the typical prepared American.

The numbers are startling. Approximately 66 percent of regular drug abusers began their addictions with marijuana. In 2012, 29 million people had driven under the influence of a mind-altering substance at least once in the previous year. During that same year there were 18 million Americans who met the criteria for alcohol dependence and just over 4 million who met the clinical criteria for abuse of marijuana. Whether the area is urban, suburban or rural, there is always a ready market for illicit drugs both from commercial and unregulated sources. When I lived in the Alaskan interior back in the 1990s, law enforcement officers frequently grappled with marijuana and cocaine problems even in the frigid, dark winter months. If drug abusers can get cocaine in Fairbanks, Alaska, in February, it is available everywhere.

Desperate drug addicts can be unbelievably dangerous. Some drugs induce a sense of invincibility and the innate craving that drives serious addicts can compel them to do literally anything to maintain an uninterrupted supply of their drug. If you want a glimpse of this phenomenon, simply deprive any serious smoker of their cigarettes for a couple of days. Nicotine is as addictive as many of the most serious illicit drugs available to American users today.

Everyday Poisons

In recent times there has been a classic paradigm shift in the genesis of drug abuse in America. Where once drug abuse was almost uniformly of the illicit variety, today most drug addicts begin their addiction at a doctor’s office. Interestingly, our nation’s exploding enthusiasm for prescription drugs seemed to coincide with an institutional push to treat pain more aggressively in medical settings. We were taught as physicians to treat pain aggressively to facilitate better outcomes for organic painful disease states. While this is an honorable goal in managing physical problems that are inevitably painful, there were some unintended consequences.

While the number of deaths from cocaine overdoses has been declining steadily since 2006, deaths from prescription opiate overdoses have increased threefold since 2001. Deaths from overdoses of prescriptions like Xanax, Valium, Klonopin and Ativan have gone up sixfold during the same period.

The lengths to which addicts will go for a buzz simply defy imagination. Sniffing glue and huffing spray paint are old standbys that wreak incalculable damage on sensitive lung and sinus tissues. Whipped cream canisters provide a source of nitrous oxide gas, the same stuff that dentists use to calm you down for a tooth filling. “Sizzurp” is the street name for the particular combination of prescription hydrocodone cough syrup and a flavored drink. Crystal meth is cooked up at home using nasal decongestants, battery acid and drain cleaner, among other vile ingredients. My local Wal-Mart will not sell duct tape to anyone under 18 because teenagers are rolling it up and smoking it. Beyond the immediate deleterious effects, the long-term ramifications of such practices on the brain and nervous system are literally beyond comprehension.

Destructive Drinking

Someone dies in America every 51 minutes on average from a motor vehicle accident involving an alcohol-impaired driver, and one-third of the deadly motor vehicle accidents in the U.S. involve alcohol. Statistically, more than half of Americans drink at least monthly, and roughly one quarter binge drink at least once a month. Just over five percent of American adults meet the clinical criteria for an alcohol use disorder.

Alcoholics are frequently jovial and fun. They are the life of the party. Therein lies the problem. Severe alcoholism seems to follow a predictable path. It starts in the late teens or early 20s. It becomes a problem in the 30s and wrecks marriages by 40. If sufficiently severe, it can be lethal by 50. In my experience, when a committed alcoholic dies from cirrhosis or chronic pancreatitis, they are typically attended solely by their mothers. By this point in their lives they have alienated everyone else they know.

Breaking free from alcohol can be extraordinarily difficult, and the process is initiated by a realization that drinking has become a problem. Alcoholics Anonymous (aa.org) began as a book originally published in 1939. The 12 steps that are intrinsic to the AA recovery process are spiritually centered and proven effective. AA is apolitical, self-supporting and multiracial. It operates independently of any outside professional affiliations. However, AA doesn’t actively recruit. When someone with a drinking problem is ready, they will seek out help. Google or the Yellow Pages can put you in touch with Alcoholics Anonymous. There is a chapter in most every community in America.

For my patients who drink regularly, I inevitably have a challenge: Stop drinking for at least two weeks. If it is an easy thing to eschew alcohol entirely for two weeks, then the patient is likely in control. If they cannot do this simple thing, then it is a problem and they need to seek help. Stopping a heavy and long-standing alcohol habit suddenly can be very dangerous, however, and must be undertaken carefully and with medical supervision.

For heavy drinkers who stop drinking suddenly there are potentially some frightening and potentially catastrophic problems. Around half of the alcoholics who stop drinking will have significant withdrawal symptoms. About five percent will suffer delirium tremens.

Delirium tremens is Latin for “shaking frenzy,” and it can be difficult to watch. Even in modern times, delirium tremens carry a mortality rate of 5 to 15 percent. Without treatment, that number rises to approximately 35 percent.

Alcohol is a pervasive component of modern life in America. It is readily available and socially accepted. In excess, however, it can be extraordinarily destructive. Most serious alcohol problems are insidious—they creep up over time. If you, a family member or a friend have a problem with alcohol, help is available that is effective and non-threatening. The first step is recognizing the problem.

Out Of Breath

Among the addictive drugs in America, one in particular stands out above all the others as the “alpha killer.” It is responsible for the demise of 478,000 Americans per year. This drug kills more people than murder, suicide, HIV, alcohol, firearms accidents and car wrecks combined. A typical American male lives to be 78. A typical American male user of this substance has a life expectancy of 62. This deadly addictive drug is nicotine.

It is the fact that tobacco predates the FDA and has been in such widespread use from the very beginning that it was not banned from the outset. The capacity of nicotine to bring calm and “settle one’s nerves” is well established. It is simply that every single cigarette subtracts an average of 12 minutes from a normal lifespan. A pack-a-day smoker spends roughly $1,700 or more per year on his or her habit. By the time the typical male smoker dies from lung cancer or heart disease at age 62, he has smoked around 321,000 cigarettes on average.

The only thing worse than trying to get your family through some horrible catastrophe is trying to get your family through some horrible catastrophe while gasping for breath and withdrawing from nicotine. If you smoke, then quit smoking. If you can’t quit on your own, then find a doctor and let them help you. The money you save will fully fund your prepper plans, and the act of quitting will allow you to watch your grandchildren grow up. It is the best piece of survival advice you will ever hear.

Addiction is a horrible problem, and no stratum of American society is immune. Crystal methamphetamine, cocaine in its various forms, illicitly used prescription drugs, extasy, PCP, LSD and others provide a backdrop against which lives are inevitably ruined and families destroyed. The direct and indirect costs of combating and treating drug abuse in this country are quite literally staggering. Current estimates are that we spend $600 billion annually on this problem when the costs of drug-related crime, health care and lost productivity are taken in total. The effectiveness of fighting drugs at their source or in transit, juxtaposed against the legalization of mood-altering drugs like marijuana, can and has been debated ad nauseam. However, the reality remains that drug abuse and addiction represent grave threats to public health and safety.

Now well into the 21st century, thorny problems regarding addiction treatment facilities and modalities rage while we still spend billions of dollars on interdiction and enforcement of counter-drug laws. On a personal level, lives are lost or saved based upon societal and family support as well as an engaged and effective health-care system. Regardless of politics, the war against drug abuse and addiction will inevitably be long and brutal. If you know someone with an addiction, seek help.

ADDICTION SOLUTIONS

Drug addiction affects nine percent of the adults in America. No one is immune. Addiction afflicts Americans across all socioeconomic strata. If statistics are any indication, a fair number of the folks reading these words either have a problem with addictive drugs or have a family member who is struggling.

Drug abuse and addiction can be isolating. Drugs can tear families to pieces. One of the first things to know if you or someone in your family is struggling with addiction is that you have lots of company. There are roughly 24 million Americans so afflicted.

Warning Signs

The signs of drug abuse are predictable. They include ignoring responsibilities in school, at work or at home, taking drugs in dangerous situations such as driving, stealing to support a drug habit or allowing drug use to cause issues in personal relationships with family members, friends or coworkers.

By contrast, clinical addiction has a different flavor. Drug addicts show an increased tolerance, which leads to increased use to attain the same effects. They use drugs to avoid the physical symptoms of withdrawal. Addicts typically exhibit uncontrolled use of drugs despite an intention and plan to quit. An addict’s life will seem too focused on finding drugs, using them and recovering from them.

Finding Treatment

Treatment for drug and alcohol problems can be either inpatient or outpatient. The medical support structure for this problem in America is, while at times inadequate, still quite extensive. If you or someone you love is struggling with alcohol or drug abuse or addiction, visit the website recovery.org. This website is full of reliable, sound information, and it can initiate the connection to the professional support system required to allow a person to free themselves from the burden of deadly addictions.

EMERGENCY OVERDOSE KITS

It is frighteningly easy to overdose on narcotic pain medicines. Narcotic drugs in excessive amounts simply disengage a person’s will to breathe. When police and first responders happen upon overdose victims, the first few minutes can be critical. Fortunately, there is a new application of an old drug that can literally save lives when used quickly.

The side effects of narcotic medicines differ according to the chronicity of use as well as the dose and individual physiology. In overdose situations, these drugs can cause sleepiness, dizziness, excessive sweating, slowed heart rate, low blood pressure and, in severe cases, seizures, respiratory arrest and death.

Instant Response

Naloxone is an opioid antagonist. This means that for drugs like morphine and heroin, Naloxone binds to the opioid receptors on the brain to block the effects of these drugs very quickly. In the past, Naloxone was only delivered intravenously in a hospital. In early 2014, the FDA authorized the use of Naloxone intranasally for use in instances of acute overdose. As a result, this drug is now packaged as an Overdose Rescue Kit designed for use by first responders such as firefighters, police officers and paramedics. Each kit costs $40 or less and can be safely employed with minimal training. In practical application this kit saves lives.

Intranasal Naloxone is easily administered via a small spray bottle equipped with a Mucosal Atomizer Device (MAD). In patients with opiate overdose, Naloxone typically takes effect within three to four minutes. As overdose patients are frequently found unconscious and may have poor veins due to past drug abuse, the intranasal route provides ready access in a timely fashion. This also minimizes the exposure of first responders to bodily fluids potentially contaminated with hepatitis, HIV or other virus as a result of trying to establish IV

access in the field.

Saving Lives

While the legal considerations surrounding the use of a prescription medication by non-medical providers in an emergency setting are labyrinthine to say the least, there are ongoing programs across the country to expand access to these kits particularly among first responders. Naloxone is itself a non-scheduled prescription drug with no addiction potential. There are also initiatives ongoing around the country to equip caregivers and narcotic drug abusers themselves with Naloxone so they can be better prepared to address an overdose situation. The CDC estimates that around 10,000 overdose-related deaths have already been prevented around the U.S. through the use of Naloxone.

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