Tuesday, October 23, 2012
I am not a big supporter of capital punishment. While I would not argue that if one takes another's life, his own life could also be taken in return, as I do see that punishment fitting the crime. But, still, it does not sit well with me. Maybe because one of my closest friends was once involved in a gang, and I am pretty sure he killed a few people before he found recovery, although he has never really said it. I met him many years after he moved away from that scene, in hopes to save himself and his children. He got clean, and he went back to school, and today he is one of the most productive, best guys I know. Maybe it is because I love Norman Mailer's input in works on prisoners, and murderers, including "The Executioner's Song" and "Belly of the Beast." Maybe it is just because I think that redemption is possible, even when chained inside a locked room. And maybe I am just an idealist, that thinks everyone deserves the chance for their own redemption.
This first lines of one of my favorite books, "Shantarum," by Gregory David Roberts, he says, "It took me a long time and most of the world to learn what I know about love and fate and the choices we make, but the heart of it came to me in an instant, while was chained to the wall and being tortured. I realized, somehow, through the screaming in my mind, that even in that shackled, bloody helpless, I was still free: free to hate the men who were torturing me, or to forgive them. It doesn't sound like much, I know. But in the flinch and bite of the chain, when it's all you've got, that freedom is a universe of possibility. And the choice you make, between hating and forgiving, can become the story of your life." Such a powerful sentiment. Shantarum is an excellent book about a heroin addict, who was jailed for robberies in New Zealand, where he escapes and winds up a wanted man, living in Bombay, India. The story is about redemption, and finding your lost soul, in so many ways. I highly recommend this book, by the way. But, that brings me back to the point, I think anyone deserves redemption, and that chance to forgive, as I hope that when the moment ends, we can be at peace.
While I can understand why one would support capital punishment for murderers, and I would never argue that. It is not my place to, really. But, I cannot support taking someone's life for a non-violent crime, or even a crime that is not taking another's life. Maybe it is just that I believe in an eye for an eye, or maybe it is my belief in redemption. And I am thankful that I live in a country that does not kill people for a number of offenses, including drug offenses. So, something inside my gut rumbled a little when I came across an article, descrying the execution of ten drug traffickers in Iran. Maybe I am too sympathetic, but it just not seem like a punishment that fits the crime. But, what do I know?
Monday, ten drug traffickers were hanged in Tehran. After the men's death verdicts had been confirmed by Iran's Supreme Court, the men were hanged in a prison in the capital, according to iolNews.com. I think back to hangings in our own history, as people gathered around the Cathedral in Jackson Square, New Orleans, to watch a public hanging, in the times of Marie Laveau, the Voodoo Queen who often ministered these prisoners in their last days and months. I think about today's executions, and I still see the public spectacle. Think of the hanging of Sadaam Hussien. Somehow, we are drawn to the gore in these things. I wonder how many people witnessed the hanging of these ten men. I wonder, did they all go at once, or did they do them one by one? Were there spectators watching, as if it were a sport? Or was the hanging reserved for family, officials, and the press?
Seven of the ten men belonged to a gang involved in trading one ton of methamphetamine. The remaining three men were from a separate gang, and had smuggled opium from south-east Iran to Tehran. And I wonder once more if the punishment really fits the crime. Maybe I am just too sensitive, I think. But, it just seems like a really harsh punishment, even for drug traffickers.
Amnesty International condemned these deaths, too. They said, "The vast majority of executions in the country in recent years have been for drug-related offenses, despite there being no clear evidence that the death penalty serves as an effective deterrent- the country has one of the highest rates of drug addiction in the world." Murder, rape, armed robbery and trafficking more than five kilograms of drugs are among crimes punishable by death in Iran.
Yes, I also wonder what the intention of the death penalty is…is it to serve as a deterrent to other offenders? Or is it merely and eye for an eye? Either way, I do not see the death penalty matching up to these traffickers in Iran. Of course the death penalty is not a deterrent to traffickers, as money is more alluring. The money that can be made from trafficking drugs is far greater than the fear of the death penalty…if they get caught. I know back in the day, when I sold dope, I did not think about the time I could spend in jail for each bag I had, much less the other paraphernalia I may have been carrying. The desperation for the cash, to serve my fix, drove me harder than any punishment could have deterred me, very possible even a death sentence. We just do not think about it like that when we are caught up in our addictions. And if it is an eye for an eye, well, I just do not see how that fits here, either.
Personally, I am thankful that my country does impose the death sentence in such cases, and I think it would not set well with me if this was commonplace in my world. At the same time, I can see the argument that these men took lives, by supplying drugs to people. I can see it, but I do not agree with that. I personally do not think a dealer should be charged when someone overdoses on the drugs supplied. There is more than one person at the heart of the blame there, as I do not know of any dealer who would force the drugs into one's arms, nose, or mouth. I also think that a doctor should not be arrested for responsibly prescribing medication to someone who overdoses, but I do think that a pill mill doctor who irresponsibly doles out too much medication should be punished. But, not by the death penalty. It just seems that executing drug traffickers is not the way to handle this situation, and in my mind, the punishment does not fit the crime. What do you think?
Wednesday, October 10, 2012
Tuesday, October 9, 2012
She woke that day,
Like so many days before,
Seemed to me that this day,
Wasn’t that different than those before.
But, I was not inside of her head,
I was not there,
As she awoke,
Probably awaken and stirred
By the little voice
That woke her most mornings,
That little voice wakes me now, too…
And it often seems
That little voice is the only one I have in my world
We lamented over the loneliness
Of being a single mother, so many times.
But, we agreed,
It is what kept us both,
Pushing on through.
But, she awoke one day,
Not so different than those before
Dropping her baby off at school
As she drove away,
Dressed in black.
She drove away that morning,
And I wonder of she looked back.
When she drove away that day…
I don’t think she thought-
For a second
That she’d never return.
Wednesday, October 3, 2012
6 Things You Should Know About Rapid Opiate Detoxification
Rapid opiate detoxification clinics speckle the Internet, selling the buyer a “painless detox from opiates,” making wild claims that the addict will “be back to normal in a matter of days!” This ever-popular treatment for opiate dependence claims to have the “magic pill” that can end your nightmare of addiction virtually overnight. As a recovering opiate addict, I am well aware of the work that goes into recovery long after the detoxification process has finished. And as a wary consumer, I am always leery of the “magic pill” that seems too good to be true. In my experience, when something is too good to be true, it usually is not. Long-term recovery from opiate addiction takes a lot of effort and hard work, and there is no “magic pill,” to date, anyway.
Rapid opiate detoxification has steadily grown in popularity, as more and more people search for this quick fix. As an addict, we become accustomed to the quick fix, hardly realizing there really is no quick fix for addiction. Rapid opiate detoxification shows no concrete evidence to be any more effective at treating opiate addiction than other methods, and some would even argue it is less effective. To further complicate matters, this method can be dangerous to certain patients, not to mention that it is incredibly hard on the addict’s already worn body.
Like many of us, I Googled rapid opiate detoxification when I first raised questions about this method. Interestingly enough, the first twenty sources of information on Google came directly from these opiate detoxification providers, which led me to dig a little further. Thankfully, my journalism training has taught me to always look at your source to determine how reliable the information is. The clinics that provide rapid detox are going to be supportive of this treatment, and they will be willing to leave out some important details in order to gain your business. Rapid opiate detoxification is a business, and a big business at that! The primary goal of these clinics’ web presence is to attract customers.
These rapid opiate detoxification centers rave about the success of this method, and their “success” is backed up with a number of personal testaments. But, alas, there really are no statistics, or facts used to back up any of these wild claims. Upon digging a little deeper, I found that most of the studies related to rapid opiate detoxification only tracked these patients for 6 months following the procedure to determine the success of their program. If you ask me, the first two years of my recovery were the hardest, the period where I was most vulnerable, and I would argue that following these patients for a mere six months is not a very good indication of long-term success.
Rapid opiate detoxification is a medically supervised detox, where they accelerate the detoxification process by intravenously pumping the body with naltrexone, which is an opiate agonist. This drug works to rapidly dispel all the opiates from their receptors in your brain, thus cramming the detoxification period into a matter of hours. The quicker that the opiates are removed from one’s brain, the more intense the withdrawal symptoms will be. As a result, rapid detoxification is done while the patient is asleep, under heavy anesthesia.
These rapid opiate detoxification websites offer a quick and painless withdrawal, a sort of “magic pill,” if you may. Having been opiate-free for five years, I do not believe there is any “magic pill” to deal with addiction. Recovering from an addiction takes a lot more personal soul-searching than simply undergoing a 2-day detoxification period. Most addiction experts will agree that detoxification is just the beginning. I am weary of anyone who is trying to sell a quick fix for any illness, especially when that illness is such a complex issue, like addiction.
After scrolling though five pages on Google, I was inundated with personal stories about the rapid detoxification process. Unlike the testimonies on the rapid detox providers’ websites, these stories were speckled with pain and frustration. Overwhelmingly, these patients described the process as painful and tough. Not one account described their experience with rapid opiate detoxification to be the painless process that these clinics advertise. One patient said that when he awoke from the procedure, he felt the worst withdrawal he had ever experienced. Another patient described waking up from the procedure, vomiting all over. Even another patient described an awful bought of diarrhea, where he actually messed his bed up every hour or so. He describes a sense of utter embarrassment to have a nurse changing his diarrhea stained sheets every hour. Contrary to what these rapid opiate detoxification providers promote, this procedure is not an entirely painless and dignified process.
So, what does one need to know about rapid opiate detoxification before considering undergoing this process? Look past the vast majority of raving product promotions, and consider some of the lesser-known facts about this procedure.
6 Things You Should Know About Rapid Opiate Detoxification
1) Detoxification is only the beginning. Most addiction experts will agree that detoxification is only the beginning of the process of recovery. Although traditional abstinence based recovery is not the only method we have for treating addiction today, it is still the leading method. A traditional treatment center provides much more to the addicted than simply getting them off drugs physically. The treatment process involves counseling, education about addiction and recovery, and often even includes numerous 12-step meetings. During treatment, addicts will learn about the disease of addiction, while being armed with the tools they need to fight this battle.
Furthermore, many treatment centers recommend a longer stay for opiate addicts. A 30-day stay in a treatment facility will often not be enough time for these addicts to gain the tools they need to stay clean. Often times, these clients will just be starting to feel good enough to engage in activities when their time has ended. Possibly, a rapid detoxification before a 30-day inpatient stay at a treatment facility could help these addicts on a short stay. Most addiction professionals will advise opiate addicts to remain in treatment for at least 90 days, and often a year is the recommended length of stay.
2) Dependence vs. Addiction. Dependence and addiction may seem like the same thing to some, but they are actually very different. Dependence is characterized by the user’s physical dependence on the drug. The dependent individual will experience withdrawal symptoms when they are deprived of their drug of choice, or drug of dependence. Addiction, however, is characterized with negative consequences. A person crosses over from dependence to addiction when the drug use is causing negative consequences in his or her life. The addicted will keep using despite these negative consequences.
Addiction is a complex disease that is compounded with a variety of factors. Addiction is different for everyone who experiences it, as factors such as environment, genetics, and mental health can play big roles in the addiction process. To maintain long-term sobriety, addiction professionals agree that some form of psychotherapy gives the best defense against relapse. Addicts must figure out the reasons they use, in order to combat the use. Often times, addicts have other underlying issues that need to be dealt with. These issues can be medical, personal, or spiritual issues. By dealing with the mind, body, and soul, and addict stand a better chance of long-term sobriety. Rapid opiate detoxification only deals with the physical aspect of addiction, thus leaving the addict vulnerable to relapse.
A number of the publications I read about rapid opiate detoxification mentioned that this was a treatment for opiate dependence, but made no mention of opiate addiction. To be fair, rapid opiate detoxification would be a great way to deal with dependence, but not addiction. The dependent person will not experience cravings, and does not feel the desire to go back to using. The dependent person is generally thought to be able to go right back to their life once detoxified, with little or no extra support needed.
But, this treatment is not aimed at just the dependent person. These rapid opiate detoxification providers claim that this process can nearly cure one’s addiction, while making very little mention of aftercare, or other treatment elements, such as therapy. Most of these websites do mention that they “strongly encourage” patients to seek out some kind of therapy, but this therapy is rarely provided by the rapid detox clinic. I did find one rapid opiate detoxification center that offered a short stay at their “sober house,” following the procedure. Of course, the longer the stay, the more the price goes up. Additionally, this “aftercare” is only available for 4 weeks following the rapid opiate detoxification procedure, and a number of addiction professionals would argue that this is just not enough time for an opiate addict to gain all the tools needed for long-term sobriety.
3) Post Acute Withdrawal Syndrome, PAWS. Opiate addiction alters the brain’s chemistry dramatically, and it may take quite some time for the addict’s brain to return to its normal functioning. When opiates are used for a significant period of time, the brain stops making its own natural opiates. Opiates control our motivation, our feeling of well-being, and our tolerance to pain. When the drugs are taken out of the equation, the user will experience an intense withdrawal that lasts about a week. Although rapid opiate detoxification aims to lessen that withdrawal, in both time and severity, it does not manage anything beyond the mere withdrawal.
It can take an addict’s brain much longer than a few hours, or even a few days to return to normal. For some, the process could take weeks or months, while others may even find they are stuck with PAWS for a year or more. It is during this time period that I always ended up relapsing. The addict will feel totally devoid of his energy, as if he is merely dragging his feet along the ground to even walk. The addict will have little to no motivation, and experience a heightened sensitivity to pain. Basically, the opiate addict may feel like complete crap for months following detoxification.
Rapid opiate detoxification makes no mention of Post Acute Withdrawal Syndrome, and it does not attempt to manage these symptoms. While flooding the brain with naltrexone during the detoxification process will help to eliminate the opiates from your system, it does nothing to help the addict’s brain to replenish these natural opiates. Even with rapid opiate detoxification, the symptoms of PAWS will persist, and the addict is left incredibly vulnerable during this crucial period of recovery.
Rapid opiate detoxification clinics do provide their patients with naltrexone to take in the weeks and months following their procedure. While this does not help to eliminate the symptoms of PAWS, it can eliminate cravings and many argue that this ensures that the addict will not use other opiate in this crucial time. Naltrexone works to block the effects of opiates on the brain.
This actually poses a dangerous position for the addict to be in, without the proper therapy and education needed to remain drug free. The naltrexone is given in two forms, pills and a sub dermal patch. A number of the rapid opiate detoxification clinics prefer to use the patch, as it seems to keep these patients on their naltrexone regimen. With the pills, an addict can easily decide to skip his daily naltrexone dose in order to use. This alone poses a serious risk, as the naloxone will make the opiate addict much more sensitive to opiates than before the rapid opiate detoxification procedure. Too often, addicts will use what would have been considered a small amount of opiates before the procedure, but with the naloxone treatment, this “small amount” can cause an overdose. Furthermore, some patients have reported trying to actually cut these patches out of their skin, so they can use again. Others just use right along with the patch. This, too, is dangerous. The naltrexone blocks the effects of the opiates, but it does not stop them from working. An addict who attempts to use while on naltrexone can easily consume lethal doses, without feeling high before they overdose. Simply using naltrexone after the rapid opiate detoxification procedure does not help to prevent PAWS, and could be more dangerous than not using it.
4) A large number of opiate addicts are not good candidates for rapid opiate detoxification. There are several contradictions to rapid opiate detoxification, in which these people will not be allowed to participate. Rapid opiate detoxification is incredibly rough on the body. Just imagine compacting all the pain for a weeklong kick into a matter of hours. The pain is not lessened, and instead is intensified, over a shorter period of time. It is so painful that the patient is put to sleep, but your body still goes through an incredibly traumatic event.
Some health conditions make it impossible to withstand rapid opiate detoxification without serious complications. If the candidate is pregnant, she will have to wait until after having the baby to consider this treatment. Although, I must admit that I called a number of these rapid detox clinics, asking questions about these health issues, and one clinic even said they would perform the procedure on a pregnant woman. The others stated, “Definitely not.” Patients who have had heart problems are also not candidates for the procedure, as the procedure is likely to cause hypertension and irregular heart rhythms. To complicate this matter further, some intravenous addicts have significant damage to their heart that they may not even know about. Renal issues and liver issues can also exclude someone from this procedure. Finally, a patient with a history of mental illness is not eligible for rapid opiate detoxification. With the number of dual diagnosis patients admitted to treatment, I think this would rule out a significant portion of the opiate addicted population. To make this criteria even more difficult, a number of opiate addicts are simply self-medicating and do not even realize they have these underlying mental issues. Some addicts discover their mental illness while in treatment, which could cause some issues with rapid opiate detoxification. Furthermore, a number of addicts are in poor health due to their addiction and they may not even be aware of some of these problems. Unreported or unknown medical issues can cause some serious complications with rapid opiate detoxification, some of which have led to death.
There are a number of other factors that will not exclude the patient from rapid opiate detoxification, but these issues make these patients “unsuitable” candidates. Some of these clinics will still take these patients, depending on the situation, but it just seems risky to me, especially considering that these issues are ones that are often shared among the addict population. Additionally, rapid opiate detoxification is done intravenously, and some opiate addicts hardly have any good veins left, especially not solid enough to be pumping in a massive amount of drugs while the ill-veined patient undergoes a withdrawal experience that is traumatic and difficult on the body.
Chronic pain patients are generally not good candidates for rapid opiate detoxification. These patients often need these opiates to function, so kicking them out of their system could cause more pain. Chronic pain patients are generally advised to attend treatment centers that specialize in these patients. Dealing with addiction and chronic pain becomes a balance of managing their medications. Patients with dependence on alcohol, benzodiazepines, or stimulants are also not recommended for rapid opiate detox. These substances not only create medical complications, but these patients obviously need more intense treatment. More importantly, to rule out any addicts who are poly-substance users makes the qualified candidate pool rather small. Patients with a history of depression are also not suitable candidates. From my experience, there are a large number of opiate addicts who have some history with depression. Finally, those clients who have unstable social circumstances are not advised to use rapid opiate detoxification before they have stabilized their home life. An unstable social circumstance? Isn’t that where all of our lives end up when we are immersed in active addiction?
5) Poses more serious dangers compared to any other detoxification method. There have been more deaths associated with rapid opiate detoxification than any other method of detoxification. Heavy anesthesia alone can cause problems, even death, not to mention the toll that the procedure takes on the addict’s body. One thing that these rapid detoxification providers fail to mention before the procedure is that diarrhea is a very common side effect. Some patients claim to have messed up their bed every hour from this uncontrollable diarrhea. A gastric ulcer, caused from extreme stress, can result from this procedure. Psychiatric complications are not uncommon, and reactions to the variety of drugs pumped intravenously are just as common. Cardiovascular complications have taken more than one life following this procedure. Rapid opiate detoxification can cause high blood pressure and irregular heartbeat. Many candidates may not realize they have heart issues, until they are exacerbated by the procedure. Finally, rapid opiate detoxification can also cause kidney failure and sepsis, both of which can be fatal conditions.
The most common reasons for patient death following rapid opiate detoxification are pulmonary edema, brain hemorrhaging from extremely elevated blood pressure, and choking on their own vomit. The procedure does make the patient vomit, as it is often a symptom of withdrawal. Rapid opiate detoxification is done while you are “asleep” under sedation, making the chance of aspiration very high.
6) Very expensive. This procedure is not covered by health insurance, mostly because it is not a proven therapy. Health insurance companies are leery of the controversial rapid opiate detoxification, stating it is not usually covered because it is not proven to be safe. Prices may range anywhere from $4,000 to $40,000, depending on the services rendered. The most expensive rapid opiate detoxification prices reflect a 4-week stay at an adjoined sober-living facility. Furthermore, a number of patients who opted for the cheaper treatments claim that the rapid detox clinic added a number of charges during the procedure, such as doctor checks at a nurse’s request. To make financial matters even more strenuous, higher risk patients are generally charged more. The cost of methadone is close to the lowest price of rapid opiate detox, for the entire year! The cost of a 90-day treatment center can even be cheaper than a two-week stay at one of the top rapid detoxification clinics! And both of these methods have more proven success.
On another note, I called a number of these rapid detoxification clinics, pretending to be a patient with some of these health risks, to see what the response was. Most of the people I spoke with dismissed health problems like extremely high blood pressure, or even history of a stroke, claiming that they could still work with these risky issues…just for a much higher fee.
Personally, I do not like to put my life in the hands of one who is out for financial gain, first and foremost. When it comes to healthcare, the patient should come first. The patient’s well-being should come before the dollar. I feel like a rapid opiate detoxification clinic that would take these high-risk patients, weighing profit before potential death, simply do not have the patient’s best interest at hand. Secondly, any clinic that offers the “magic pill,” or “miracle cure” is most likely offering up a pipedream. Recovery from addiction begins with detox, and for these rapid detoxification clinics to only suggest counseling or other aspects of treatment, without providing many viable resources for it, is by no means putting their patient’s well being first.