You have been thinking about jelly beans since Easter Sunday. You retrace your childhood steps downstairs to find a chocolate bunny sitting upright in a sea of cellophane grass. You admire the marshmallow peeps, aware that many jelly beans are hiding beneath the glossy, green, waves. It never crosses your mind what those colorful pellets might represent.

Finally, you give in. You pull into the drug store parking lot and score a bag of half-priced jelly beans. And now you are feeling sick on your way to pick up a pizza, a special treat for a difficult week. You try not to heap stress on top of your general unease. You turn on the radio, searching for the perfect song. Stay between the lines. You are probably just thirsty. Sugar does that.

You do not know why you like Longmire so much. Soap operas are not your style. You think of what Bob told you about his grandparents, about how their soap operas took priority over their grandkids, and how you used to think they were using TV to escape reality.

The show is set in a fictional county in Wyoming. Walt Longmire, the local Sherriff, is nothing to write home about. The plot elements are predictable and full of holes. There is always a body, multiple suspects, a splash of sexual tension, a measure of distrust, somebody spends time in the jail cell that sits in the middle of the sheriff’s office, and someone always ends up confessing everything to Walt.

No one warned you that Walt, Vic, Ruby, Ferg, Branch, Cady, Henry Standing Bear, Matthias, Travis, and even Jacob Nighthorse, grow on you. No matter how bad the dialogue, or how deep the plot holes, you want to know what the characters will do next. You had no idea it would be so addictive, as irresistible as the sugar in those jelly beans.

You realize that you are using the show as mental floss. Washing away the cares of the day by immersing yourself in a story that does not even faintly resemble your own reality. It would be counter-productive if you were able to place yourself in their shoes. The more improbable, the better. You are self-medicating with sugar and TV.

Finally, you make it home with the pizza. Bob has pulled down the movie screen and hooked the laptop to the projector. Your heart has calmed down. “What will it be tonight?” Bob asks as you carry your plates to the living room. “Oh, I don’t know. A bear mauling? Maybe a drug overdose? Arrows?” You cannot wait to find out.

Our generation doesn’t think to send their kids off to college with, “And stay away from heroin, it’s a killer!” But we need to because heroin is ubiquitous, cheap, easy, and deadly.

Last month I was blindsided by Zafer’s death. After recovering my balance, I started reading. I needed to know how a well-adjusted, talented college freshman had overdosed on heroin. What I learned was shocking.

The United States is experiencing an epidemic.

“Accidental drug overdose is currently the leading cause of injury-related death in the United States for people between the ages of 35-54 and the second leading cause of injury-related death for young people. Drug overdose deaths now exceed those attributable to firearms, homicides or HIV/AIDS.” – DrugPolicy.org

“Heroin-related deaths more than tripled between 2010 and 2014, with 10,574 heroin deaths in 2014.” – CDC.gov

“Use of the drug in the United States increased 79 percent between 2007 and 2012, according to federal data, triggering a wave of overdose deaths and an “urgent and growing public health crisis,” Attorney General Eric H. Holder Jr.” – Washington Post

“Use it twice and you’re addicted” someone told me. Z died on his third try. But he wasn’t addicted, I protest. Zafer does not fit my image of a heroin addict. Times have changed.

Today’s heroin user is more likely to smoke it than inject it. It comes in pill form, is much cheaper than it was forty years ago, and you can even buy it online. “In the ’70s, a bag of heroin — enough to get a user high once — cost $30 and was about 28-percent pure. Today, it’s 80 percent to 90 percent pure, which makes it powerfully addictive, and it sells for $4 a bag.” from NPR’s Heroin in America series.

Riding the white horse has never been easier.

I try to put myself in his shoes. Like Zafer, I felt invincible at nineteen. My parents cautioned me against sex, drugs, and rock and roll to no avail. My life was mine to live and I wanted to taste everything it had to offer. Except heroin, of course.

I hung out with friends who were users. They called it horse, but as much as I love to ride I never rode this one because we all knew it rode you. No one wanted a monkey on their back nor wished that horror on others. I’d seen the writhing pain of withdrawal and wanted none of it. My friends never offered to share the drug and I never asked. It was different back then.

Heroin is now accepted as a recreational drug without regard for the risks and we have widespread pharmaceutical use and legalized marijuana to blame.

Blaming meds is easy. I disdain the pervasive fear of pain or discomfort that drives the pill culture and loathe the predatory pharmaceutical companies. A little pain never hurt anyone! My country has become a nation of addicted weenies.

I am less inclined to implicate marijuana. Facts are facts, though and when you take Mexico’s economy into consideration, the correlation makes perfect sense. The legalization of marijuana reduced the profitability of cannabis at the same time widespread use of pain meds opened up a lucrative market for heroin. Farmers began planting poppies in their pot fields and pain medication addicts soon had a cheaper alternative.

Utah, of all places, demonstrated the path forward with an aggressive education program. “The state’s overdose death rate climbed steadily during the early 2000s, driven by growing prescription opioid dependence. But Utah lawmakers took action early. In 2007, they established a two-year public health-based program to combat painkiller misuse.

Over the next three years, prescription opioid-related overdose deaths dropped more than 25%, but the success was short lived. After funding ran out in 2010, deaths began to climb again.

“We saw that when we weren’t educating the public and providers, awareness decreased and deaths increased,” said Angela Stander, prescription drug overdose prevention coordinator at the Utah department of public health.” [CDC.gov]

Bottom line, education will stop the spread of the overdose epidemic. Support legislation. Throw in with the folks at Shatterproof. Spread the word.

Additional sources:

Overdose Death Rates

A deadly crisis: mapping the spread of America’s drug overdose epidemic

Office of National Drug Control Policy: The International Heroin Market

How Much Does Heroin Cost?

Why a bag of heroin costs less than a pack of cigarettes

How Your Teenage Son or Daughter May Be Buying Heroin Online

Colorado Opioid Symposium: Reducing the Impacts of Opioids in Colorado

Opioid-Antidote Drug Will Now Be Available to US High Schools for Free

Prescription drugs have long been a cleverly disguised problem, endorsed by the feds, enthusiastically promoted by their manufacturers and embraced by the public. Modern humans trust their doctors and pharmacists with childlike innocence. However, there is mounting evidence that “asking your doctor” may not be the safest path. In fact, your helpful little pain meds may lead you straight into heroin addiction.

Here’s the scene: you have experienced a painful recovery from an ugly mishap or life-saving surgery. Your prescription for Oxycontin is a god-send but sadly, you are left with persistent residual pain. Or, more likely, you are now chemically addicted and your doctor has moved on, denying you further refills. At this point, you will do anything to get another script.

As I dug around, I found one story about a woman who went so far as to have some of her teeth pulled to get more painkillers. Another documents the 5% decrease in emergency room traffic after they began flagging repeat offenders and denying them new prescriptions. Apparently, desperate addicts were showing up with fake symptoms, seeking medication.

But for all these med-dependant folks there is another route, one that is increasingly being explored by oxycontin/oxycodone addicts – heroin. No longer able to afford your med of choice or maybe unable to convince your doctor to continue scrawling their name on that coveted piece of paper, you look for an alternative. At 1/10th the price and readily available without the hassle of faking a migraine in the emergency room or having a molar pulled, heroin is an easy choice.

Alarmingly, heroin deaths are on the rise, tripling in just three years. With the increase is a shift in user profile from fringe to mainstream, young to older. These days police officers, teachers and nurses are showing up at the detox centers. Or on stretchers in the autopsy queue.

How tempting it must be to blame the increase in heroin addiction on the legalization of marijuana. And predictable. Oh, that evil cannabis… On the other side of the fence, studies prove that marijuana “can be effective as a substitute for treating opioid addicts and preventing overdoses.”

After looking at all these stories, one statistic unites them all – both opioid and heroin addiction are on the rise.  You get to decide if there’s a connection. As for me, I’m letting pot off the hook.

Sources:
NPR: Emergency Rooms Crack Down On Abusers Of Pain Pills
NPR: How Heroin Made Its Way From Rural Mexico To Small-Town America
CNN: Heroin deaths up for 3rd year in a row
Washington Post: The rate of heroin overdose deaths has nearly tripled in just three years
Newsweek: Prescription Drugs Have Pushed Heroin Into the Suburbs
The Independent: Marijuana, heroin and meth spreading into Colorado’s neighboring states after legalisation of cannabis
The Week: Can medical marijuana curb the heroin epidemic?

It’s nice to see the AMA getting savvy. Now if the general public would only follow suit.

I expect it’s the same with most people. We generally make our way through life on an even keel. And then there are days when we go from bliss to abyss in moments. From feeling loved to feeling rebuffed in a few words. From being at peace to wanting to say, “Do you want a piece of this?”

The drug industry’s image problems are beginning to hurt pharmaceutical companies where it matters most – at the bottom line.
>snip<
“A lot of the demand that the industry has created over the years has been through promotion, and for that promotion to be effective, there has to be trust,” said Richard Evans, an analyst covering drug stocks at Sanford C. Bernstein and Company. “That trust has been lost.”
>snip<
In the third quarter, United States sales of prescription drugs fell 3 percent at Bristol-Myers Squibb, 4.5 percent at Johnson & Johnson, and 15 percent at Pfizer. Merck said its overall revenues fell 2 percent despite favorable foreign exchange trends.
>snip<
“Is the public more cynical? Yes,” said Dr. John LaMattina, Pfizer’s president of global research. “There’s a perception that we don’t bring much to the party.”

And One Step Back:

Enrollment in the new Medicare drug benefit begins in three days, but even with President Bush hailing the plan on Saturday as “the greatest advance in health care for seniors” in 40 years, large numbers of older Americans appear to be overwhelmed and confused by the choices they will have to make.

“I have a Ph.D., and it’s too complicated to suit me,” said William Q. Beard, 73, a retired chemist in Wichita, Kan., who takes eight prescription drugs, including several heart medicines. “I wonder how the vast majority of beneficiaries will handle this. I fervently wish that members of Congress had to deal with the same health care program we do.”
>snip<
In Kansas, Medicare beneficiaries have a choice of 40 prescription drug plans charging premiums from $9.48 a month to $67.88 a month.
>snip<
Asked about beneficiaries’ confusion, Michael O. Leavitt, the secretary of health and human services, said: “Health care is complicated. We acknowledge that. Lots of things in life are complicated: filling out a tax return, registering your car, getting cable television. It is going to take time for seniors to become comfortable with the drug benefit.”

Need I say more?

Okay, here’s more. The entire article, as published on Orion online:

Having just returned from a week in England where, among other things, walking more than ten yards a day is quite normal, I was once again startled by the crypto-human land whales waddling down the aisles of my local supermarket in search of Nabisco Snack-Wells, Wow chips, and other fraudulent inducements to “diet” by overindulgence in “low-fat” carbohydrate-laden treats. And they did not look happy.

To say that Americans are shockingly obese is hardly a novel observation, yet it is discouraging to see so many of your fellow citizens in such a desperate and unhealthy condition, and I’m sure it is even more discouraging to be in such a state. Related to this is the recent disclosure that one-third of all Americans are taking prescribed antidepressant medications, specifically the SSRIs of the Prozac family (Selective Serotonin Re-uptake Inhibitors, including Zoloft, Paxil, and Celexa). That’s one out of every three men, women, and children! The American media routinely regard the scandalous levels of both obesity and emotional distress here with befuddlement and even indignation, as though it were inexplicable and even unfair that such a friendly, generous, valiant, humorous, and enterprising folk as we should be so mysteriously afflicted with The Blues.

Have any reporters noticed how we actually live here in America? With very few exceptions, our cities are hollowed out ruins. Our towns have committed ritualized suicide in thrall to the WalMart God. Most Americans live in suburban habitats that are isolating, disaggregated, and neurologically punishing, and from which every last human quality unrelated to shopping convenience and personal hygiene has been expunged. We live in places where virtually no activity or service can be accessed without driving a car, and the (usually solo) journey past horrifying vistas of on-ramps and off-ramps offers no chance of a social encounter along the way. Our suburban environments have by definition destroyed the transition between the urban habitat and the rural hinterlands. In other words, we can’t walk out of town into the countryside anywhere. Our “homes,” as we have taken to calling mere mass-produced vinyl boxes at the prompting of the realtors, exist in settings leached of meaningful public space or connection to civic amenity, with all activity focused inward to the canned entertainments piped into giant receivers–where the children in particular sprawl in masturbatory trances, fondling joysticks and keyboards, engorged on Cheez Doodles and taco chips.

Placed in such an environment, even a theoretically healthy individual would sooner or later succumb to the kind of despair and anomie that we have labeled “depression,” in our less than honest attempt to shift the blame for these predictable responses from our own behavioral choices and national philosophy to some more random “disease” process. But the misery is multiplied when these very behavioral choices–inactivity, isolation, and overeating sugary foods–lead to disfiguring obesity on top of despair. And it must be obvious that I am describing a self-reinforcing feedback loop that generates ever more personal misery and self-destruction.

Another way of looking at our predicament is as the result of a high entropy economy–entropy being provoked by huge “free” energy “inputs” in the form of a hundred years of cheap oil, and entropy being expressed in forms as varied as toxic waste, ruined soils, and buildings so remorselessly ugly that the pain of living with them corrodes our souls. Depression (despair and anomie) and obesity are as much expressions of high entropy as the commercial highway strips, the Big Box stores, the housing subdivisions, the hamburger chains, and all the other accessories of the wished-for drive-in Utopia.

It doesn’t help, of course, that this entropic fiasco of self-reinforcing feedback loops and diminishing returns has been labeled the American Dream–because neither patriotism nor all the Prozac in the world will immunize us from the consequences of our own behavior, our foolish choices, and our self-destructive beliefs. This particular American Dream more and more looks suspiciously like a previous investment trap–we’ve sunk so much of our national wealth into a particular way of doing things that we’re psychologically compelled to defend it even if it drives us crazy and kills us.

It was interesting to note over in England how many people were out enjoying themselves in the public realm, with other people. By public realm I mean in the streets, the cafes, the pubs, the parks, the riverside promenades, and other places explicitly designed for humans to enact their hard-wired social proclivities. Everywhere I went in Oxford, Cambridge, and London I was amazed at the hordes of young people so obviously enjoying the company of groups of their friends, and what a contrast this was to the current culture back home where you hardly ever see anything but a couple, or perhaps two couples, out in a bar or restaurant, and where the Starbucks cafes are filled with solitary individuals, and the streets are for cars only, usually with lone occupants. It was also startling in England to see groups of old people walking together in the streets or sitting on a blanket in the park, because in America old people have been conditioned to go about outside of home only in cars. Today’s older Americans have spent their entire lives in a car-obsessed culture in which walking is seen as uncomfortable at least and at worst socially stigmatizing, something only winos do.

In Europe, people make 33% of their trips by foot or bicycle, compared with 9.4% for Americans. American suburbanites weigh on average 6 pounds more than their counterparts in walkable cities. They have higher blood pressure, are more susceptible to diabetes, and live two years fewer on average than Europeans. Pedestrians in the US are three times more likely to be killed in traffic than in Germany, six times more likely than in Holland. Bicyclists here are twice as likely to be killed in traffic than Germans, three times as likely as Dutch.

Statistics hardly tell the whole story, though. The emotional toll of the American Dream is steep. What we see all over our nation is a situational loneliness of the most extreme kind; and it is sometimes only recognizable in contrast to the ways that people behave in other countries. Any culture, after all, is an immersive environment, and I suspect that most Americans are unaware of how socially isolated they are among the strip malls and the gated apartment complexes. Or, to put it another way, of what an effort it takes to put themselves in the company of other people.

This pervasive situational loneliness, of being stuck alone in your car, alone in your work cubicle, alone in your apartment, alone at the supermarket, alone at the video rental shop–because that’s how American daily life has come to be organized–is the injury to which the insult of living in degrading, ugly, frightening, and monotonous surroundings is added. Is it any wonder that Americans resort to the few things available that afford even a semblance of contentment: eating easily obtainable and cheap junk food and popping a daily dose of Paxil or Prozac to stave off feelings of despair that might actually be a predictable response to settings and circumstances of our lives? (I’d add pornography to the list also, a substitute for sex with other real people who cannot be accessed in the condition of pervasive situational loneliness). How depressing.

If it’s any consolation, I repeat what I have said in previous rants: that we are headed into a social and economic maelstrom so severe, as the people on this earth contest over the remaining oil and gas supplies, that everything about contemporary life in America will have to be rearranged, reorganized, reformed, and re-scaled. The infrastructure of suburbia just won’t work without utterly dependable supplies of reliably cheap oil and natural gas. No combination of alternative fuels or energy systems will permit us to run what we are currently running, or even close to it. The vaunted hydrogen economy is, at this stage, a complete fantasy, and at the very least there is going to be an interlude of severe disorder and economic discontinuity between the unwinding of the Cheap Oil Age and anything that might plausibly follow it.

We will be driving a lot less than we do now, and cars will generally be a diminished presence in our lives. The automakers and the oil companies can lobby all they like, but history has a velocity of its own, and it is taking us into uncharted territory where the GM Yukons and Ford Excursions will be useless. When the suburbs tank, they will go down hard and fast. The loss of hallucinated wealth is going to shock us to our socks, and the fight over the table scraps of the 20th century is liable to entail a lot of political mischief here in the USA.

The physical arrangements for daily living will have to be revised and re-ordered accordingly. We’re going to have to return to traditional human habitats: towns, villages, cities, and agricultural landscapes. We will have to walk out of necessity, or at least ride some places with other people. We may be too busy to indulge in the blandishments of television and the other entertainment narcotics we’ve become addicted to, and even the Internet may be made irrelevant in a world of regular brownouts. We may have to grow more of our food closer to home and do some of the physical work ourselves. As far as I know, there is no such thing as a Cheez Doodle bush. We are going to be living a lot more locally and thrown on our own resources.

We’re going to have to do this whether we like it or not, because circumstances will compel us to. There may be a lot of hardship and difficulty, but in the process we are going to get some things back that we threw away in our foolish attempt to become a drive-in civilization. And most of these things we get back will have to do with living on more intimate terms with other people, getting more regular exercise, eating better food, leading more purposeful lives, and rediscovering the public realm that is the dwelling place of our collective spirit. Paradoxically, when that happens fewer of us will need Prozac or the Atkins diet.

I laughed, thinking about all the parents and children who cross this zone with their meds tucked in their purses, briefcases and book bags. There should be a sign below this one that reads:

EXCLUDES: Adderall, Arcalion, Concerta, Desyrel, Hydrocodone, Lamictal, Paxil, Prozac, Ritalin, Vicodin, Welbutrin, Xanax, Zoloft, etc.
AND OTHER DRUGS MANUFACTURED BY: 3M, Abbott Laboratories, Aventis, GlaxoSmithKline, Lily, Merke & Co, Novartis, Pfizer, Roche, Shein, Swartz Pharma, etc.
AS ADVERTIZED: in magazines, on TV and the Internet
AND DISTRIBUTED BY: your Pediatritian, Physician, Psychiatrist or Surgeon

My brother, who works in the childcare industry, feels that the children he works with are being used as guinea pigs by the pharmecuetical companies, as they are often prescribed drugs that have not been tested on humans. Another concern is the allure of advertizing. Dr. Stephen Borowitz, in this article speaks about the dangers of giving Prilosec, that “purple pill” to children.

“I tell them about nondrug tactics that often help the symptoms,” says Borowitz, a professor of pediatric gastroenterology at the University of Virginia. “But they want their kids to have the pills they’ve seen on TV.”

The purple pill is just one of hundreds of powerful adult drugs — many of them not tested for pediatric use — that are increasingly being given to children.

The drink, called Spark, contains several stimulants and is sold in two formulations: one for children 4 to 11 years old that includes roughly the amount of caffeine found in a cup and a half of coffee, and one containing twice that amount for teenagers and adults.
>snip<

Many of AdvoCare’s customers say they love the products, but pediatricians, medical experts and others involved in youth sports express strong concern about the levels of caffeine and the idea of encouraging children to use performance-enhancing products, especially at a time when professional athletes are under scrutiny for using stimulants and muscle builders.

I just want to know one thing. Why would a parent serve this to their child?