Malibu Beach Recovery Center

An interesting test of whether a policeman’s rights were violated when he was fired for driving drunk in an unmarked police car while off-duty is currently taking place in Oregon. As the San Francisco Chronicle explains, Jason Servo is suing well, a bunch of people, saying that his rights were violated because he suffers from alcoholism. He has also been stripped of his police certification and says he was denied due process as well.

I’m not sure how many people know that alcoholism is considered a disability under the Americans with Disabilities Act. I sure didn’t before I started researching this case. (It took me awhile in 2008 to let it sink in that thanks to the Mental Health Parity and Addiction Equity Act, treatment for substance abuse must now be covered in group healthcare plans at a level equal to medical and surgical benefits.)

But back to the case. Servo pleaded guilty and entered a treatment program after the January accident. (He and his car ended up in a ditch.) One of his lawyers said the police department should have worked with Servo because he has a disease and should not have fired him, and the lawsuit alleges that the firing was due to budget cuts. The Chronicle article notes that “The U.S. Equal Employment Opportunity Commission … provides an example of how an alcoholic can justly be fired, and it's similar to the Servo case.

In its example, a federal police officer is involved in an accident for which he is charged with drunken driving. About a month later, he gets a termination notice stating that his conduct makes it inappropriate for him to continue. The officer says the arrest made him realize he is an alcoholic and that he is obtaining treatment. According to the EEOC, the employer may proceed with the firing.”

There’s a difference, however. The police officer in the example was on duty and Servo wasn’t.

This reminds me of the time a colleague I was working with at a high-tech company told me that another worker actually kept a bottle of vodka in a drawer and was constantly taking sips. I believe he was given the option of attending a program. I think the woman who told me was the man’s officemate, but after so many years it’s hard to remember. If it was true, that was a pretty progressive company, because there was no legislation like we have today to support that worker. 

The Christian Science Monitor, in printing the same Associated Press article, asks, in the headline about the case: Can he win? I’d love to hear from some legal analysts what his chances are, and I’d like to read what addiction specialists think. And then you wonder: Are police officers held to a higher standard in some cases because they’re charged with protecting the public?

One thing is for sure—this is another story that highlights alcoholism and the workplace and gets people talking about it. That’s one way to make progress.

I don’t know if you remember one of your parents telling you incessantly “Eat your vegetables” when you were struggling with your dinner at the family table. Or my favorite: “French fries is not a breakfast food!”.

Even better, now, it is not just “Eat your vegetables!” that is making a comeback, but like the almighty peacock, it’s a multicolored array of rainbow-hewed vegetables, all more enticing than the next.  Nowadays, going to the farmer’s market is all about reproducing the color palette of the early impressionists.  But, unlike the peacock, this display of colors also reveals a whole pharmacology that puts our modern medicine to shame.

Just like it is, in my opinion, ridiculous to strip wheat from the germ and all the vitamins, minerals and fiber it contains, to mill it, bleach it, refine it, then ooops…. enrich it, add vitamins D and E and calcium and sell it as  a better product than the original, just because a few people have built their business on these intermediary steps, just like this, was I saying, I sincerely believe that nature has intended its pharmacology to be ingested as is, and not pulverized, edulcorated, freeze dried, compacted and spit back in the form of a capsule to take morning, noon and night.  

In addition to the huge health effects of eating brightly colored vegetables and fruits, I think that the first appetite-inducing contact we have with our food is through our sense of vision which is strongly titillated by color.  Just like kids, we love visual stimulation, bright overly contrasted spills of colors and it brings joy to our hearts before we even make sense of what the drawing represents.  As adults, we must bring this childlike joy back into our plates and challenge Mother Nature into feeding us the most beautiful symphony for the eyes.  

But let us not forget the healing powers of consuming these heavily colored gems. For the sake of simplicity, here are the rough drafts of these benefits:

 

Blue and Purple Foods – Rich in antioxidants that protect from cell damage. They may help reduce risk of cancer, stroke, and heart disease. 

blueberries

blackberries 

eggplant 

plums 

figs

Red Foods - contain lycopene, which may help reduce the risk of cancer. 

apples 

beets 

cranberries 

red cabbage 

pomegranates 

strawberries 

tomatoes

Orange and Yellow Foods - help maintain healthy mucous membranes and eyes. They also can lower the risk of heart attack. 

yellow apples

cantaloupe 

yellow squash 

tangerines 

sweet potatoes 

pumpkin 

peaches 

pineapple

mangos

Green Foods - contain lutein and indoles that protect eyes and also protect against cancer. 

asparagus 

avocado 

lettuce 

broccoli 

zucchini 

cucumbers 

green peppers 

limes

White Foods - protect against stomach cancer and heart disease and can help to lower cholesterol and high blood pressure. 

cauliflower 

ginger 

jicama 

onions 

mushrooms

garlic 

turnips

 

Click on "Continue Reading" for the Recipes

Bon Appétit

Licia 

 

Photo: Claude Monet.   Irises in Monet's garden, Giverny (1900)

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Perusing information on the relationship between drinking and gun deaths on the Internet is enough to make a person crazy, especially when so many Americans are inflamed about a gunman killing schoolchildren in Connecticut last December and the victims of the Boston Marathon/MIT killings.  These latest tragedies seem to have rallied the group that wants an end to these tragedies, which in many people’s minds means stricter gun controls.  But the people against gun control are vocal as well and present their own statistics. So researching this is crazy-making.

The most recent mass shootings in the U.S. were by young men who were mentally ill. But for anyone touched by or concerned about alcohol abuse, it isn’t a stretch to also start ruminating about the link between drinking and gun deaths when these tragedies occur.

Two years ago the L.A. Times had an article about a study in the British Medical Journal which found that people who own guns are twice as likely to binge drink (“have five drinks in a single sitting”) and are more than twice as likely to drive when drunk. 

What was really scary is the number of deaths cited that were directly related to drinking alcohol:

“Of the 395,366 firearms-related deaths reported in the United States between 1997 -- when this data were actually collected -- and 2009 -- the latest date for which the tally of firearms-related deaths is available -- about one-third are thought to have involved alcohol. In 2007, 34.5% of suicide and homicide victims in the United States had alcohol in their systems at the time of death, and 60% of those were considered acutely intoxicated.”

Granted, many of the latest group homicides in the U.S. have been perpetrated by males who are severely mentally ill. But anyone who grew up with a violent drinker can relate and shudder. Perhaps we saw the person take a knife, or throw a lamp across a room. We know their potential for violence. And to think what might have happened if they’d had a gun—and in some cases, what did happen….Numerous domestic violence episodes occurred when a person was buoyed by alcohol or another drug. Unfortunately, some family members can only imagine what might have happened if a violent family member had a loaded gun while inebriated.

The New York Times had a more recent article on this subject last February: “Violent, Drunk, and Holding a Gun.” It was an editorial about the “multiple mass shootings by deranged young men” that I just mentioned, but said that to focus solely on this group overlooks others “at demonstrably increased risk of committing violent crimes but … not barred by federal law from buying and having guns.” Specifically, people known for violent misdemeanors, and alcohol abusers.

Did you know that it’s illegal for someone who uses a controlled substance to buy or have a gun, but not someone who has been found to abuse alcohol? The Times cited a study that found people who have been hospitalized for drinking or gotten in trouble at work for the same thing were in more danger of committing suicide and homicide. 

The article says that the problem is the lack of a useful definition of a pattern of alcohol abuse. That’s hard to believe when the writer goes on to show how Pennsylvania has done it: in that state, anyone who has been found guilty of at least three drunk driving offenses can’t buy a gun. That’s at least a start.

 

 

When was the last time you had two pieces of good news in one day? Well, count yourself lucky because this is one of those days, and in the recovery field, that’s cause for celebration. A few weeks ago, Dr. Nick Techentin, PhD,  a therapist who works for Joan at the Malibu Beach Recovery Center's Brentwood House, sent her a link to an L.A. Times article to let her know that her “hard work is starting to catch on.” He was referring to the fact that lawmakers in Washington DC have introduced a bill that should make it harder for people to abuse hydrocodone (for example, Vicodin). The law would place it “in same category as OxyContin, another opiate-based painkiller so potent and addictive that it's sometimes referred to as synthetic heroin,” the article said. This is in accordance with the FDA recommendations from January.

Nick was also referring to Joan’s regular efforts to help those in recovery by bringing awareness to the prescription drug epidemic.  You may recall how politically active she has been, or then again you may not be aware. In 2010, Joan brought two MBRC alumni to Sacramento to lobby in favor of a bill sponsored by Senator Mark DeSaulnier to fund CURES, California's online real time prescription drug data base.  After the bill failed by a single vote, she invited him visit MBRC to speak with addiction industry professionals about resurrecting the CURES database project.  This year after the Los Angeles Times took Attorney General Kamala Harris to task for letting CURES all but die, he reintroduced the bill (with some changes), this time co-sponsored by some political heavyweights like State Senate Speaker Pro Tem Darrell Steinberg, State Senators Fran Pavley and Ted Lieu, and Assembly Budget Committee Chairman Bob Blumenfield.  

So the news about hydrocodone was very welcome. The law, if it passes, will be called the Safe Prescribing Act of 2013. There’s no reason to believe it won’t pass, since four lawmakers introduced it, and “more than 40 additional members of Congress from both parties signed on as co-sponsors.”

The second piece of good news concerns the bills passed in VT last month. In an article published in a CT paper, one of the lawmakers involved said the bills were a response to the opiate addiction and methamphetamine abuse in the state. First, the legislation gave good Samaritans, or people who call about overdoses, immunity from prosecution. (Police will not have access to the database without a warrant.) Importantly, it required doctors who prescribe narcotics to register with the state’s CURES-like database and to use it. Pharmacists are required to ask for ID of those picking up prescriptions for certain drugs, and hospitals have to abide by standards set for referring people to drug treatment programs when needed.

Joan added:  Just as we were about to publish the above report by Pat, yet another piece of good news arrived.  In a surprise showing of bipartisan support, the California State Assembly Health Committee voted in favor of Assemblyman Richard Bloom's AB 831, a bill that would require a temporary state task force of experts to develop a comprehensive plan to address the state's overdose crisis, as well as to establish a modest funding source for groups working to reduce overdose deaths. Assemblyman Bloom represents Malibu, which is home to two dozen alcohol and drug treatment centers, as well as West Los Angeles and Beverly Hills, home to at least another six treatment centers. The bill now moves to the Assembly Appropriations Committee.

 

Photos (above) Senate Speaker Pro Tem Darrell Steinberg.  (Right) Assembyman Richard Bloom.

Buprenorphine has been in the news lately.  A pharmaceutical company is seeking FDA approval for implants that release the drug, and it’s not without controversy.

If you need a refresher on this drug, it’s used to treat opioid addiction (addiction to painkillers like OxyContin andVicodin, for example). When used in Subutex and Suboxone, it “enable[s] opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms,” according to SAMHSA. It carries a lower risk of abuse than heroin and methadone, which is designed to perform the same function, although the potential is there, experts say.

And that was one of the concerns the FDA voiced when the drug came up for review this month. All you had to do wass follow the press to learn the progress of the FDA’s actions. On 3/19, preliminary to an FDA Drug Advisory meeting, the organization released a document containing its thoughts. Shortly afterward, a MedPage article headline proclaimed: “FDA Staff Not Thrilled About Opioid Implant.” 

It seems that during clinical trials, some people still needed oral Suboxone to ward off withdrawal symptoms, which in turn, meant that the company’s claims that implants would reduce pediatric exposure to the medication were not reliable. (The company said that with five rods, patients would receive a steady dose of medication for up to 4 to 6 months.)

Or, as Treatment Magazine’s editor succinctly put it, after reading the document: 

“Long-acting buprenorphine implants, already brand named Probuphine by Titan Pharmaceuticals as the tiny specialty pharma moves through trials and FDA approvals for the implantable opioid replacement therapy, got a decidedly negative review by FDA staffers in what is the key aspect of the implants - their ability to completely replace daily dosing and thus solve a range of thorny bup issues ranging from diversion to proper dosing and even the possibility of cutting back on the highway robbery $150 to $300 monthly doctor's visits.”

However, two days later, a Medscape article stated “FDA Panel Says a Cautious ‘Yes’ to Buprenorphine Implant.” The writer summarized the panel’s findings as follows:

“The vote was 10 to 4 (with 1 abstaining) that the efficacy, safety, and risk-benefit data supplied by the company supports approval.

The panel ‘seemed to agree that this is a product with great potential utility, but there is some deficiencies in terms of dosing and REMS (Risk Evaluation and Mitigation Strategies) but that overall need for a product such as this on the market exceeded those deficiencies,’ said panel chair Edward Covington, MD, from the Cleveland Clinic Foundation.”

(You might need to register on Medscape to read the article.) 

I know implants have been used for birth control for quite some time; it’s interesting to consider them for addiction treatment. You’d think that the convenience would be a big selling point for addicts, but the potential for abuse never occurred to me. And the safety question is troublesome, too. The FDA may have its critics, but it’s a good thing we have them to monitor new therapies

 

Joan added:  Detoxing clients from suboxone or subutex presribed for "long term" pain management is for the most part a long and agonizing ordeal.  The last 2 mg are especially difficult. I wrote about Krissie Bergo's detox from the suboxone here.  I wonder if the FDA took the end game into consideration.  Just what is it like to detox from a buprenorphine implant?  Or is the FDA expecting people to have the implant for life?