From vice to substance abuse disorder in 100 years

JAMA (Oct. 24/31, 2017) had an interesting opinion piece, "A death in the family" about a doctor who overdosed on fentanyl. It was a tragedy for his colleagues, family, friends, and thousands of future patients who will never benefit from his skill. But it was also a tragedy for the English language and our search for someone to blame. "Overdose on fentanyl?" "substance abuse disorder?" "stress and burnout?"

Remember when poverty was blamed for drug use--it was a ghetto problem? Remember when it was the pathology of the black family and its roots in slavery? Remember when it was poor parenting and kids hadn't been raised right? Or, they just need Jesus? Or going way back, remember when opium was blamed on "vice" (i.e. Asians)? Or today's news--the drug lords (Mexican gangs)?

30 years ago when I was employed at the vet college I learned that veterinarians had a higher suicide rate than physicians, and women higher (in attempts) than men, but the reasons given were different; the grief and sadness the same.

I certainly don't have the answers, but then, neither has anyone else the last 50-60 years, and that's small comfort.

This article contains a good list. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266064/

Partial view of the JAMA article. https://jamanetwork.com/journals/jama/article-abstract/2658326

Addicted to sugar?

I've never thought of myself as addicted to sugar, but I wouldn't want to go cold turkey deprivation, either. Yet I know I have more than the recommended amount for women (6 teaspoons of added sugar a day). One or two sodas a year works for me, and maybe 3 snickerdoodles warm from the cookie sheet if I made them.

"If you have a history of binge eating, failure at setting rules about your consumption (like cheat meals / days) and repeated failures with the “everything in moderation” approach – then perhaps you are addicted (like I was).

The same way that a smoker needs to avoid cigarettes completely, a sugar addict needs to avoid sugar completely.

Complete abstinence is the only reliable way for true addicts to overcome their addiction.

I have personally made the choice to never eat added sugar again. I now haven’t touched it in over 7 months. I’ve lost a lot of weight and I feel awesome. Kris Gunnars"

I have a friend who says she's stopped eating "white." White sugar, white rice, white flour products like pasta and bread, white beans, white potatoes.  She had lost some weight doing this, in 2015, I think.  Don't know if she was able to continue down that road. The No White Foods diet. But more whole grains can't hurt.

Journalists for Hillary to gather and grieve

Heard on the news that "Journalists for Hillary" are having a conference on how to lick wounds and eat their own vomit. They need a 12 step program for their addiction. Their pro-Obama hyperbole shows no abatement even though his administration set the record for hostility toward media--and not just Fox. They will probably have workshops on new ways to blame Trump for Ferguson, Baltimore and Oakland burning. Poverty, welfare and unemployment stats will be more of a challenge ...as good jobs replace part time retail and restaurant careers; they'll find those trends in pre-Trump administration. They'll scour the tips for people dying because their insurance lapsed for their untreatable, fatal illness. Journalists ridiculed, lied, made up fake news and, by golly Miss Molly, they are not going to back down now and start being the free press the Constitution guarantees us.

Addiction to pain killers

Overdoses from prescription pain killers result in 40+ deaths a day and 1.2 million emergency room visits a year, a 98.4% increase since 2004. Sales of opiods in 2010 were 4X more than 1999. Unlike users of illegal drugs, these addicted people usually aren't injecting, they are employed, and they have family support. But as with users of illegal drugs, short term treatment isn't very successful. JAMA, Jan. 4, 2012.

Just a wild guess here--I'm not a researcher or doctor--but it would seem that addiction can happen without poverty and societal breakdown (numbers are higher than for cocaine and heroin). It happens even with excellent health insurance. So when creating new government programs to help the addicted- low income, I hope someone looks at this report. Addiction to prescribed drugs according to this report also varies by state--so look for older people with a lot of surgical procedures for knees, hips, back, cancer, etc., to account for an increase as the population ages. States like Florida and New Mexico have a greater problem with this than Illinois and Nebraska. Also, what year was it the drug plan for Medicare kicked in?

Democrats Anonymous

The first step is admitting you have a problem. . .

The Addiction Report

Here's an odd site to stumble into--The Addiction Report, with Tiger getting almost a perfect score. I was following a different lead--why 40 years after the current women's movement began major news stories are all about men especially athletes (9 headlines) when I came across this one on addiction, featuring Tiger Woods. Pretty interesting. If you've known any addicts or attended any 12 step programs, you've heard about the cross addictions, risk taking behavior and rage incidents.

"Read and learn through real life Runners Up for Stories of the Month from Doug Thorburn's January-February 2010 Thorburn Addiction Report, which can also be accessed at http://www.preventragedy.com

Eldrick Tont "Tiger" Woods, involved in a 2 a.m. accident that seemed inexplicable, until the world learned of:

(1) his serial adultery with more than a dozen women (sexually compulsive; borrowing the methodology from Drunks, Drugs & Debits, 50% odds of alcoholism),

(2) the fact that he seems to have met most of these women in nightclubs and that most if not all of the women appear to be "party" girls (addicts often hang out with addicts; by itself probably 20%, but add 20% of the remaining 50%, or 10%; see "enablers of the month" below for the luscious details),

(3) that with at least two of the women he not only didn't use condoms, but didn't even ask if the women were using birth control (signs of a sense of invincibility and unnecessarily reckless behaviors; 50% by itself, but, sticking to the methodology, add 50% of the remaining 40%, or 20%),

(4) reported tantrums on the golf course (rage; by itself, 50%, but we can't go over 80% without proof of addictive use; so this simply provides more evidence that the odds of addiction are at least 80%),

(5) a report that he "had been drinking alcohol" before the incident (evidence of addictive use when combined with a misbehavior such as possible DUI; we've now exceeded 80% odds), and

(6) prescriptions to Ambien and Vicodin (which puts the odds of addiction at well over 90%). The fact that one of his mistresses reported he likes to have "Ambien sex" suggests he combines drugs, which with serial unethical behaviors ups the odds of psychotropic drug addiction and, therefore, an explanation (but emphatically not an excuse) for his extra-marital misbehaviors, to nearly 100%--or close enough to make runner-up for top story rather than merely "under watch" (whose denizens display behaviors suggesting 80% odds of addiction, but no greater due to the absence of proof of addictive use)."

But like the aide who covered for John Edwards' spooky behavior and make-believe liberalism, you do have to wonder about what was wrong with all the other golfers and hangers-on, friends, trainers and coaches, sports writers, doctors and club owners who watched all this and kept quiet. But having enablers around them, is also part of the scenario, and if you throw in a huge pot of money and a sense of power, you've got a very toxic mix more addictive and explosive than any drink ever could be.

And by the way, one of those nine stories actually was a woman--the death of Casey Johnson, daughter of Jets owner and heiress of the Johnson and Johnson fortune--a sad conclusion that the news is still all about men and sports.

Art's back!

I didn't even know he was out of jail, and here he was on 610 WTVN talking to John Corby! I about dropped my Swiss Chard. Checking local news sources I found

Art Schlichter, the one-time OSU All-American quarterback whose promising career in the NFL was derailed by his felonious gambling addiction, is back in Columbus—on the airwaves, anyway. Schlichter’s spots as a guest analyst on 610 have been met, so far, with a positive response by most listeners. Most listeners. Schlichter still has a few detractors in Columbus, despite having served some 10 years for his criminal offenses and spending time as a peer counselor in addiction recovery programs.

“He’s really good, he just happens to be an ex-con,” said Mike Elliott, WTVN program director. Elliott said public feedback was split 80/20 in Schlichter’s favor. Most listeners whole-heartedly approve of giving the reformed Buckeye a “second chance,” while others still bear a grudge. Responses run the gamut from “he’s sleazy, he’s awful to ‘good for you, this gives the guy a second chance,’” said Elliott. The Other Paper

He's had more do-overs and screw-overs than the coach's son in a second grade t-ball game.

He talks openingly of his addiction and prison time. We used to work with convicts and know a lot of addicts of various substances and things. You're never cured. It never ends--for the addict and for the family. And Art has had more than a second chance--he's had many. He says he placed his last bet in prison in 2005. He lives with his mother (or did in 2007). His father committed suicide some years ago when he was in prison.

One of my favorite reference questions back in the 70s was when Art was every college kid's idol--he could do no wrong. A freshman came up to my desk and asked, "Who is Art Nouveau?"

Casino gambling keeps reappearing on Ohio's ballot. Remember Art and the family and friends he scammed and destroyed and the promising career he ruined to keep his addiction going. It started really small and finally ruined him.

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Cite your sources!

There's a full page ad in the paper today from the State of New York Commissioner of Health addressed to Disney, GE, News Corp., Sony, Time Warner and Viacom.

"The science is clear: exposure to smoking in movies is the single most powerful pro-tobacco influence on children today, accounting for the recruitment of half of all new adolescent smokers."

No one is more anti-tobacco than I am, but for statements like that, I'd like to see some sources. It sounds like big government trying to push aside the influence of parenting, church, school, social network, and the non-Hollywood arts industry. I went on-line and looked at various studies (CDC, BMJ) read through the summaries, then the corrections, then the citations where authors were often citing themselves (bad form), and I even came across one that said that although incidence of smoking in movies was going down, smoking was going up! And yet the letter claims,

"Tobacco imagery delivers nearly 200,000 U.S. adolescents into tobacco addition each year."

I think, if I read correctly, that for a certain percentage of young teens who try smoking, many have seen a movie in the past year where actors were smoking. I don't know how many who try smoking after seeing an R movie (and where are their parents?) have also been taken to concerts, art museums, plays, library story hours, school lyceums, sporting events and school parties. Do they want to buy a hockey stick or a box of watercolors? I hope they've adjusted for other influences. I suspect that the first cigarette needs to be reinforced by some other type of influence--either genetic predisposition, family members who smoke, or peer acceptance or all three. My son, who is trying to stop his 20+ year addiction, says he was hooked after the first cigarette because he liked how it made him feel. Then smoking behavior was reinforced at school, which at that time allowed it on campus. I tried smoking in junior high, and again in college. It didn't do a thing for me, tasted awful and made my clothes and hair stink, plus I had disapproval from friends, so what would be the point? Smoking was probably in every movie I'd ever seen in the 1950s and 60s and when I was in high school, I saw several movies a week. And they really made it look glamorous and fun in those days. Obesity is passing tobacco as a health problem. Especially in childhood. Next: no movies showing restaurants, eating or snacking. No previews announcing food in the lobby. No popcorn allowed.

So guys, if the science is clear, make your citations clear also.

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Addiction in 6th graders

My son began smoking in adolescence, so a recent article in Archives of Pediatrics and Adolescent Medicine, 2007;161:704-710 didn't surprise me.

10% of children had cravings for nicotine within 2 days of the first inhalation of cigarette smoke

More than 70% of the inhalers had cravings before they were smoking every day



"Results: Among the 217 inhalers, 127 lost autonomy over their tobacco use, 10% having done so within 2 days and 25% having done so within 30 days of first inhaling from a cigarette; half had lost autonomy by the time they were smoking 7 cigarettes per month. Among the 83 inhalers who developed ICD-10–defined dependence, half had done so by the time they were smoking 46 cigarettes per month. At the interview following the onset of ICD-10–defined dependence, the median salivary cotinine concentration of current smokers was 5.35 ng/mL, a level that falls well below the cutoff used to distinguish active from passive smokers."

"Lost autonomy"--interesting phrase, isn't it? He told me one time that he believes he was "hooked" after the first cigarette--sometime around 13 or 14. If you are a smoker, chances are your kids will be too, but it doesn't always work that way. My husband's parents were both chain smokers. Neither he nor his sister liked it and didn't smoke; another brother did. This means he had inhaled the equivalent of 102 packs of cigarettes by the time he was 5 years old. My father smoked until I was about 9, but my sisters and I didn't. Neither my husband nor I smoke, but our son can't break the habit.

I really shudder when I see teens smoking; we were walking behind a group the other night along the lakefront--the oldest being about 16. They just have no idea of the cost and health problems heading their way. They might as well be setting dollar bills on fire and tossing them into Lake Erie.