Malibu Beach Recovery Center

When I first saw the headline, “Overdose Rescue Kits”, I thought it was a joke, a takeoff on articles about hangover remedies. But it wasn’t a joke. (FYI, since that day, the “New York Times” has changed the headline to “Kits Using Naloxone Revive Addicts After Opiate Overdose”. They make those changes occasionally.) I knew about oral activated charcoal used for drug overdoses, but this was different.

Last October I posted about states passing legislation to help those who overdose by removing the fear of being arrested if someone calls 911 to get the person help. This article is about helping people in other countries who overdose on drugs like heroin and Oxycontin.

In Europe, someone dies from a drug overdose every hour, the article says. (I wonder what the figure is in this country.) With naloxone (or Narcan, the brand name), which blocks opiate receptors, the person may be revived. I don’t know if it’s possible in every case, but it’s been “shown to work” and “has been used for decades by surgeons and paramedics.” Naloxone is “a secondary chemical in the drug Suboxone”, according to Wikipedia.

The article mentioned there’s a question about how legal it is to distribute these kits the way other countries do it, but there are groups in Central Asia and in Europe hard at work. In China, if you call a hotline, someone on a motorcycle will deliver the kit to you. In Afghanistan, however, the person who gave you a heroin injection may also provide the Naloxone shot. L

Now the cost. Roughly between  25 cents and $2.00 in other countries, in contrast to about $6 or $9 in the U.S, depending on what article you read.

Be sure and check out the photo of the kit in the article. It looks very professional, like a first aid kit you might buy for your house. A nasal spray is available as well. I wonder why I never heard of these kits before.

In a 2009 article in Time magazine, addiction writer Maia Szalavitz wrote about programs in Chicago and North Carolina in this country.  I also found mention of the kits by a Canadian blogger. Here’s an article from the Harm Reduction Journal on a government site about a study of a program in New York City. The conclusions seemed pretty positive. Finally, NPR has had a story on the kits, too.

As the New York Times writer mentions, if someone is revived with this kit, it may send him or her back to rehab. On the other hand, Szalavitz notes a problem with these programs: could drug users also think that if this is something that can resuscitate them they can continue using drugs with impunity? Which, as we know, is playing Russian roulette with your life.

About hangover remedies…there’s news on that front as well. Just before New Year’s, several new products hit the news. Enterprising entrepreneurs have been busy.

One product, a patch, goes on an area like a forearm 45 minutes before drinking and should be worn for eight hours after the last drink. It contains B and other vitamins, Acai berry, and folic and pantothenic acid. But even the doctor that helped produce the patch said that nothing will help those who drink a lot, so doesn’t this appear senseless?

Another supposed remedy is a pill that is a blend of aspirin, an antacid, and caffeine, and yet another is a mix of vitamin B and C, magnesium and cysteine. It seems to me there are so many more productive things to be doing with one’s time, and so many better things to invent for mankind.

Update from Joan Borsten:

Fifteen minutes after we published Pat's article, the phone rang.  A woman had already read it and wanted to know where to get a Naloxone kit.  She said she wanted to have one on hand in case her brother, a heroin addict, overdosed.   While researching this article, Pat had looked without luck for a manufacturer of these kits.  She tried again and discovered that kits require a prescription and the local pharmacy may or may not have a kit on hand, but there are apparently 200 naloxone distribution programs around the country.  There is a large program in New York directed by Sharon Stancliff with the Harm Reduction Coalition.  To find one in your area, type http://hopeandrecovery.org/overdose into your search engine and enter a zip code into the program locator.

When I saw the headline, I had a feeling I knew what the article would say. The Medpage Today article was titled: “Relatives, Alcohol, Knives, and Other ED [Emergency Department] Thanksgiving Tales.” I was right; it warned readers about holiday merriment when drinking is involved. "People need to minimize their alcohol consumption. But if they don't, stay away from relatives and carving knives," if offered.

Articles like this start appearing around Thanksgiving each year. At a minimum, it certainly doesn’t hurt to remind people of the dangers of drinking and driving at a time when people may imbibe more (especially people with a problem). Besides parties with family and friends, there are those holiday office parties, too.

 Also, college students returning home for the break and congregating in bars can be a real concern. Here’s an article (“Home for the Holiday, Time to Party”) on this yearly ritual from the Wall Street Journal. The paper referred to these events as “the alcohol-fueled get-together[s] of the old high-school crowd.” Of course you think about the drive home and hope the young drivers don’t get behind the wheel.

On the other end of the scale, inebriated family members have caused heartaches, arguments, and worse during holiday get-togethers. Every family in this situation knows what I’m talking about, and families are at different places as to how they handle a family member who drinks. Some try to overlook the drinking and enjoy the holiday despite it. A number of people roll their eyes about their “Uncle Harry” whose drinking is quite obvious during the holiday celebration. Some families insist the the family member who drinks refrain from drinking, or some family members stay away if that family member is allowed to attend. Each family – and family member – has to handle it their own way.

 Then there are the questions regarding family members in recovery. Do you drink around them? Do you only have non-alcoholic drinks? Do you ask them their preferences? It’s not always easy to know what to do.

I suppose you can characterize attitudes toward certain drugs as either liberal or conservative. But there’s a movement regarding drinking that is so liberal as to redefine the word.

Proponents of this theory hold that it’s OK to allow alcoholics to drink rather than try to move them to treatment and save their lives. In some places across the country, alcoholics are allowed to live in houses where no treatment is provided and people are allowed to drink themselves to death. A piece on Minnesota Public Radio ("MPR") dubbed the St. Anthony Residence in St. Paul, where 60 men were living in December 2010, a "hospice".  At the time that article appeared on the MPR website, Minnesota had four “wet houses” in the state.

The arguments for and against wet houses are fairly obvious. Those in favor say treatment doesn’t work for some people and the more humane act is to give these people a home and allow them to live out their days as comfortably as possible. Some alcoholics are simply hopeless, advocates say. Why make them continue the cycle of DUIs, incarcerations, and relying on emergency rooms for emergency care? (They’re provided with medical care if they get sick in these Minnesota homes.) They also cost the government (and taxpayers) a ton of money living this way.

Critics, however, including William Moyers, author of "Broken: My Story of Addiction and Redemption," say this thinking makes no sense. Just as you don’t give up on people with cancer, you just don’t give up on people with an addiction.

A more recent article about wet houses appeared in The New York Times Magazine in April. In this article, an employee at one of the houses said people who live there actually moderate their drinking, and the houses save taxpayers money since they’re funded by non-profits and others.

These houses have to be one of the most controversial topics ever.

I’ve run into several people whose alcoholic family member gets up each morning and goes to a job, so the sober person says their loved one doesn’t have a problem. For people who don’t understand substance abuse and addiction, the high-functioning alcoholic can be difficult for some people to wrap their brain around.

Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights, by Sarah Allen Benton, explains that some of us are influenced by the stereotype of the jobless and homeless substance abuser who’s all tapped out. That’s what an alcoholic is to them. Benton calls people who represent this stereotype “low-bottom drunks.” and I take that to mean drinking takes over these peoples’ lives to the point where they lose everything and can barely function.

Roughly 18 million people suffer from alcohol abuse or dependence in this country, and about 9% of those fit the stereotype just mentioned, according to the book. However, 20% of people who abuse alcohol may be high-functioning, Benton tells us. They work, often in prestigious careers, and they can maintain a life outside work. They often hide their disease well. Plus, their success makes it even easier for them to deny they have a problem.

But this group exhibits the same warning signs as anyone with a drinking problem: They experience blackouts, they feel shame about their drinking, they obsess about it, and they can’t stop. There are several other signs as well. Plus, they’re on the road that leads to one place only: death.

Benton speculates that there’s not a lot of research on this segment of drinkers simply because they’re higher functioning. They don’t pose as severe a problem for society and government systems as their severely addicted counterparts. Her discussion of famous “HFAs”, as she calls them, reminds us that no one is immune. The list goes on and on: Buzz Aldrin, Elizabeth Taylor, celebrity host Pat O’Brien, Representative Patrick Kennedy, Grammy winner Keith Urban, Eric Clapton, and more recently, Charlie Sheehan, to name a few. There but for the Grace of God go you and I.

The book is divided into two sections: Active Alcoholism and Recovery, which I found to be an interesting approach.  It stands to reason that the author discusses the controversial topic of cutting down, or drinking in moderation, since it’s an option most HFAs probably consider. She presents a ton of research, both pro and con, and you can guess, on reading her background, which side she’s on.

A high-functioning alcoholic herself, Benton is a mental health counselor in Boston entering her 7^th year of sobriety. Her story of alcoholism and recovery, woven throughout the book in actual entries from a journal she kept, seem especially poignant, probably because as a professional she has great insight into her experiences. “The longer I have been in recovery, the more I change my perspective on my past,” she writes.

Here’s a blog post Benson wrote for Psychology Today: http://www.psychologytoday.com/blog/the-high-functioning-alcoholic/200903/high-functioning-alcoholics-are-everywhere-are-not-gettin

There’s a lot of information in this book, but if it’s the personal story that always gets you, Benton certainly has one.

We hear over and over again that alcoholism wreaks havoc on the human body, but I’ll never forget the first time I learned how pervasive the damage can be.  Hearing about it is one thing, however, but seeing it in print really brought it home to me. It’s not pretty, and that’s a good place to start this cautionary post.

People who drink to excess suffer from poor nutrition because they can’t absorb vitamins properly, so aside from the physical complications, their appearance suffers. Overall poor health from alcoholism can make someone’s skin appear pasty and their hair look dull. If you’ve seen broken capillaries on someone’s face, you’ll probably agree they’re unsightly, too.

But that’s not the half of it. Let’s start at the top. Brain degeneration is a big problem, along with the possibility of severe memory loss and Wernicke-Korsakoff (“wet brain”) syndrome. Symptoms of the latter disorder include unsteady walking, hallucinating, confabulation (making up stories), and vision changes.

Experts say alcoholism can also lead to cancer of the colon, liver, larynx, and esophagus. Not only that, liver disease (alcoholic hepatitis), followed by cirrhosis of the liver, and esophageal bleeding are not uncommon, nor is pancreatitis.

The list goes on. Alcoholics can experience depression, insomnia, high blood pressure, and nerve and heart muscle damage. In women, alcoholism can lead to the cessation of menstruation, and in men, to an inability to get an erection.

On one hand, many of these are clinical-sounding unemotional medical terms that read like a Scared Straight script, the talk prison inmates give to young people to try and keep them on the straight and narrow. On the other hand, if you or a loved one has experienced some of these complications, you know how serious they can be, and how heart-breaking.

Whether or not an addict enters recovery as a result of an intervention, a court mandate, or a personal choice, the important thing is that they get there, right? Actress Elizabeth M., one of the success stories on this website, is interesting for many reasons, but one is that she knew it was time. Granted, her talent agent had recently fired her, but her story is uplifting because of how she so willingly gave herself over to the program from the start. She drank on the ride there, but there was no denial. She had told herself, ‘This is it. I have to do it.”

You might argue that she had hit bottom when she found herself without a career, and because her marriage was on shaky ground because of her drinking. She’s quick to point out that she was afraid of what her drinking was doing to her son, too. He was 9 when she entered Malibu Beach Recovery Center.

But the self-realization she owns up to is inspiring. It’s common to find people in deep denial after years of hurting themselves and others. Recently I interviewed a man who said that even weeks into his stay at a Pennsylvania program he was still lying to everyone—and himself. It’s the nature of the disease.  Elizabeth is also looking back from the perspective of a year’s sobriety, but if she’s to be believed (and there’s no reason not to) she desperately wanted her life back. Her mother had been an alcoholic and started drinking when Elizabeth was 9, the age her son was when she decided to get sober. The irony is striking. Or, as Elizabeth says about the coincidence, “the planets were aligned.”

When I asked Elizabeth to describe a little of what rehab was like, she said she doesn’t remember the first two days because she was detoxing. She remembers how frail she was when she started, and that the food was “the best she had ever eaten 28 days in a row.” She also recalls that she was determined to succeed, because she didn’t want to have to return.

Like most people I’ve talked to who are in recovery, Elizabeth has gained a truckload of wisdom about herself and about life since achieving sobriety at 46. She attends daily self-help meetings, and she still talks to her sponsor. Perhaps most important, she’s confident she’ll be around to see her son graduate from high school now, which a doctor had told her, before rehab, might not happen.

An addiction specialist I interviewed once told me that the hardest people to treat are those who are down and out financially and those who are successful. The first group figures they have nothing more to lose if they don’t stop drinking, and the second group figures they have enough financial resources that they can continue drinking for quite some time with few consequences.

Both groups are mistaken.  Just ask Elizabeth.