Monday, April 24, 2017

Insight into America's Opiate Addiction

My Special Forces brother Ed is a medical professional in New York state. I have known Ed since we were young Green Berets together at Fort Bragg and Fort Sam Houston in the 1980's. 

I wrote a rant on Facebook a few days ago about America's opiate addiction, and Ed shared the following comment with me, which needs to be memorialized on the net. 

"Steve, let me let you in on this opiate shit. 
For YEARS, prescriptions pads in NY were simply ordered from a printer. Everyone's name in the practice was on the thing, and we used to get boxes of them at a time delivered to us.
New York State DOH has a unit called the Office of Diversion Control. They are responsible for keeping prescription drugs from being "diverted" from the use for which they were intended, that is, medical versus abuse. 
So how are prescription drugs diverted? Easy. 
You take your new prescription and copy it on any one of the fancy new printers out there that produce a copy of such quality that it cannot be told from the original. 
Maybe you make 40 copies. Then, armed with your handy NY State Medicaid "gold card", you take those copies to 40 pharmacies and turn your 40 hydrocodone tablets into 1600 tablets. 
Then you sell them for $10 each. You just made a nice profit of $16000 bucks. And the good taxpayers of NY paid for it. And this was happening all over New York. 
So the New York State Department of Health decides they have to do something about this. Now we have printed prescriptions that can ONLY be ordered from the State of New York. They have a bar code and a serial number. They cannot be copied or forged. 
Hmmm. This is a problem for all those people out there who have been getting prescription narcotics on a regular basis. They are habituated. "Hooked" in other words. And the gravy train is dry. 
Fortunately the US Government has guaranteed the health of the opium trade in the 'Stan. How convenient. 
That's were the heroin problem in NY got started. Blaming prescribers is bullshit."

My problem is that I learned about narcotics many years ago when my pancreas was trying to kill me. As anyone who has experienced a pancreatic attack can attest, the pain is excruciating. 

So the nice doctors at Bangkok General Hospital gave me some IV Demerol.

Oh, my. Oh, my Sweet Jesus. All my pain magically vanished. I literally felt like I was 19 again. Nothing hurt. 

My wife was laughing at me because I was a little bit wasted, they gave me just a taste too much. I have not been high since. But I understand now why junkies need their medicine. 

So the VA prescribed Tylenol #3 with Codeine for me, and I took that, in gradually increasing doses, until my cardiologist in Bangkok and I called a time-out. I was taking too much, and I was freaked out by the amount of Tylenol that I was taking. Tylenol can kill your liver. 

So I went to a Pain Clinic at that hospital, and based on the availability of opiates at that facility in that country and the expertise of a pain specialist, I transitioned over to Methadone and to straight Codeine. 

I dramatically reduced my consumption of opiates, and I still achieved pain relief. I no longer take Methadone. I do not need it. 

I am careful with my opiates. I limit myself now to two 15mg tablets of Codeine at night, simply so I can sleep. 

I have substantial orthopedic injuries from military service so if I do not have narcotics I simply cannot sleep. I keep waking up due to break-through pain. 

Now that I am back in the states, getting treatment at the VAMC in Orlando, they transitioned me over to Oxycodone. Whatever. 

Since the American government decided to turn off the prescription opiate spigot in America, I experience increasing hassles getting my prescriptions filled at the VA. 

I am pleased to submit to blood tests and to urine tests to confirm my compliance with my prescription. I do not abuse my narcotics, I never have, simply because I fear becoming a junky. I have gone cold turkey when I could not get them, and I will not ever put a needle in my arm, or purchase street drugs. 

But it is supremely unpleasant when I run out of opiates. 

So I am not technically a junky. I am not addicted. I am, however, without dispute, dependent. 

I judge addiction like this: if you can physically die without narcotics, you are addicted. If you merely endure supremely uncomfortable days without them, you are dependent. 

Some folks freak out about my subscription opiates and they tell me to reject them and to use ganja. I never liked marijuana, not since high school, because it makes me stupid. I am already stupid enough. I need to protect the brain cells that I still have, because as a writer I need my brain to function as well as it can. 

I am on a mission to complete some books that I have been writing for decades now. This is all that I care about completing in this life before I die, which a fortuneteller told my wife will happen in my 62d year. I am now 56. So I have a few years, if you believe this fortuneteller, which I do. 

Plus, ganja remains illegal in Bangkok. Medicinal marijuana is not an option open to me, even if I could find a sweet spot and drill in on a dosage and a strain of the plant that does not impair my thinking. 

So I take prescribed Oxycodone from the VA, and when I am in Bangkok, I take Codeine: two 15mg tablets spaced over twelve hours. 

I am dependent upon opiates. I am not happy about it, but I literally cannot function with any quality of life without them. 

I requested an appointment to the Pain Clinic at the Orlando VAMC two months ago. I am still waiting for an appointment. This is just yet one more indignity inflicted on me by the Orlando VAMC, and it is yet one more reason why I am on a warpath to expose their incompetence and their dysfunctional scheduling system. 

I have a close friend whose sister lost her daughter to opiates. She lost control of herself after she was prescribed pills to manage pain after a traffic accident. This is a common tale in America now, and this is why the number one threat facing New Englanders is opiate addiction. 

She is now a junky. She has been in and out of rehab, and she cost her family hundreds of thousands of dollars in thefts, all to feed this addiction. She injects the drug, and she lives on the street in Los Angeles, prostituting herself to feed this demon. 

So, I get it. Narcotics are supremely dangerous. 

I use acupuncture and massage to manage pain. I meditate. My biggest defense against narcotic addiction is my fear of it, and my focus on finishing my books. I do not actually enjoy intoxication. I cherish my mind too much. 

Right now, two 15mg tablets of Codeine are the best that I can do. If I can ever get an appointment at the Pain Clinic at the Orlando VAMC, I will try to put the miracle drug Lyrica into the mix, as I took Lyrica years ago when I had shingles, and my God, it completely eliminated Restless Leg Syndrome, which is another ailment that makes it impossible for me to sleep without medicines. 

When I asked the VA for Lyrica years ago they literally laughed at me, as Lyrica at that time was a new miracle drug, it was supremely expensive, and it was not in the VA formulary. 

I share this very personal history with you because you need to know more about opiates and why they are demolishing Americans. This is just my story. There are many such stories in America, and I will tell you more in coming days. 

We desperately need better mechanisms than simply denying junkies access to their medicine. We now know, beyond doubt, we have 50 years of data confirming it, that prohibition does not work, and it will never work. 

I have long advocated government provision of narcotics directly to junkies through government health clinics based on urine and blood tests and ongoing management by addiction professionals. 

This is a much bigger part of this story, and I will write a longer reasoned explanation why I believe that de facto legalization of most illegal substances is the only rational path forward. 

This is a radical stance for somebody like me to adopt, and remember, I worked for DEA. 

But it is based on personal experience, and research, and much thought. 

I will write more about this shortly. 


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