Sunday, July 20, 2008

Plentiful Pills

What I would like to know is where are all these prescription drugs coming from that our kids are popping, sniffing and injecting? Upon learning my son had an addiction to pain pills this was a question that haunted me. According to him, every kid he was hanging out with was sniffing pills and they were buying pills from dealers "right down the street". As luck would have it, we had settled into a very quiet, very nice middle class neighborhood, so it was beyond my comprehension that there were 'dealers down the street'. Oh, how wrong I was. So where were the dealers getting them? Pharmacy break-ins? I was pissed. My son is addicted to prescription pain pills and I wanted to know where these damn pills were coming from.

First there is the obvious....illegal smuggling and drug trafficking.......United States Border Patrol are seizing massive amounts of illegal drugs all the time? Our borders are being patrolled, even random traffic stops produce large amounts of illegal drugs on occasion. But what about Internet prescription drug sales? This article was a jaw dropper...

Recently I discovered a couple of other ways that prescription drugs may be getting into the hands of our children... these situations were actually experienced first hand.

The scenario:
Grandma has a prescription of morphine and other pain meds due to a number of ailments and old age to boot. My grandmother has a stash of morphine that would kill 20 elephants........ These pills have been flowing freely to her residence via FedEx. She does not even take half of what is prescribed but still they come like clockwork. When we informed the doctors and hospice nurses that she was not taking them all we assumed they would take them back and dispose of them right?.....Wrong!....Their 'policy' would not allow them to take these meds back so they told us to 'just dispose of them ourselves'. Being that I am going through what I am going through, I felt like punching this nurse in the face... You MUST be kidding me!

Another true story:
Robby had his wisdom teeth pulled on a a prescription of 15 percocets to fill. By Monday morning he was out.... unbeknownst to me he called the doc and easily had it re-filled .... no questions asked. It was that Thursday night when I had him in the ER with severe withdrawal. I did not turn in the doctor, but I should have. How many doc's do this?

And then there is the good old Doctor/Pharmacutical relationship. Pushing meds is a win/win situation for both parties.....It is disgusting! It makes me want to vomit. Are their kids addicted yet? Another article that pisses me off.

In 2007 doctors filled more than 45 million prescriptions for an antipsychotic, according to IMS Health. Yet there are only 2.4 million schizophrenic patients (for whom the drugs were originally intended), according to the National Institute of Mental Health.

And that’s just the overprescription of one pill!

Thursday, July 17, 2008

Is Addiction Genetic?

There is much to be said about whether or not addiction is genetic, hereditary, a lack of will power or all of the above....

So much in fact that it is hard to know where to start. The scientific research behind the study of addiction is overwhelming. Some studies show that it is very much a genetic trait. Others state that environment plays a large role in addiction. Still others say that carrying your addictive fathers gene does not shape your destiny and that it is a choice.

Since this subject is so controversial, I'd rather not even attempt to relay to anyone ALL the clinically studies that I have read, re-read and absorbed into my wee 3 lb brain. From one to the next, the conclusions contradict one another... There is research that shows YES.. that it is in fact hereditary... then there is more research challenging those findings. Why does one child have it when another does not...? Why does it skip generations and move on to the next?

I myself will always believe that is an overall a combination of many things....these are my feelings. I am not a scientist. I am still unsure, so why give my opinion.... I will leave that up to science.

So to wrap up this short post, lets just think of addiction in a new light... lets call it "dependency"
because whether or not your father or mother, grandmother or grandfather, aunt or uncle, is or is not...was or was not.... addicted to something.....someone we love is.... somehow they have become dependant on a drug. It has now wrapped itself around there brain and the battle has begun.

In the end does it really matter how you got there? You are there now. I am there now. I would rather spend my time working on a solution rather then to try and generate sympathy.

Monday, July 14, 2008

Life is Beautiful Sixx A.M.

You can’t quit until you try
You can’t live until you die
You can’t learn to tell the truth
Until you learn to lie

You can’t breathe until you choke
You gotta laugh when you’re the joke
There’s nothing like a funeral to make you feel alive

Just open your eyes
Just open your eyes
And see that life is beautiful.
Will you swear on your life,
That no one will cry at my funeral?

I know some things that you don’t
I’ve done things that you won’t
There’s nothing like a trail of blood to find your way back home

I was waiting for my hearse
What came next was so much worse
It took a funeral to make me feel alive

Just open your eyes
Just open your eyes
And see that life is beautiful.
Will you swear on your life,
That no one will cry at my funeral?

Just open your eyes
Just open your eyes
And see that life is beautiful.
Will you swear on your life,
That no one will cry at my funeral?

Just open your eyes
Just open your eyes
And see that life is beautiful.
Will you swear on your life,
That no one will cry at my funeral?

Just open your eyes
Just open your eyes
And see that life is beautiful.
Will you swear on your life,
That no one will cry at my funeral?

Nikki Sixx "The Heroin Diaries"

Helping at-risk kids. "Saving the life of even one kid".

Nikki has established “Running Wild in the Night,” to raise funds to support Covenant House’s work in providing services to nearly 78,000 youth last year.

Every time Robby and I were in the car together, this song would come on the radio. Yes it is a popular song, but it became almost eerie. I almost would change the station because I did not like the 'crying at my funeral' part. My son seemed vulnerable... almost depressed at times. I finally said something to him one day about the song always being on the radio when we were together. He shrugged. I started to really listen to all the words and decided to look into it....what this song was about?

Science and Anatomy are not my Specialty!

Explaining the brain and the effects that opiates have on it has been a difficult task. It is easier to read and understand then it is to explain through writing.
I am certainly not the most intellectual person (not even close) I hope that I have given a fair and accurate explaination of what I have learned. As I posted before, there are many, many websites regarding addiction.

Saturday, July 12, 2008

Opiod .v. Opiate

Brain Opioid: ( Endorphins; end-ogenous + m-orphin-e Enkephalin, Dynorphins) these are known as Neuropeptides. (Peptide molecules produced and released in the nervous system that act like transmitters)

Exercise, ("runners high") chocolate, laughing, hot peppers.... stress and pain. All of these things release endorphins (dopamine etc.).......attach to receptors, and determine our mood, pain threshold, and stress level. It is a natural brain function and biological process that brings a result. Again, each transmitter bonding only to certain receptors like "a specific key fitting a certain lock". Endorphins are also involved in respiration, nausea, vomiting, pain modulation, and hormonal regulation.

One of the most interesting facts I learned, is that this bond is always temporary. After the receptors receives the signal the chemical is recycled or destroyed.

The process of inactivation of the transmitter happens in one of three ways:
Reuptake: Reabsorbtion and recycling. This is a common way the action of norepinephrine, dopamine and serotonin is stopped...these neurotransmitters are removed from the synaptic cleft so they cannot bind to receptors.
Chemical Enzymes: Destruction of the neurotransmitter known as enzymatic degradation. A specific enzyme changes the structure of the neurotransmitter so that it is not recognized by the receptor
Diffusion: the neurotransmitter becoming detached from the receptor and drifts out of the synaptic cleft.

This is our bodies and our brains way of regulating these chemicals so they are never in contact with receptors long enough to form tolerance or dependency.

Opiate #2 Opium, Morphine etc

If we live on this planet, whether we ever did drugs or not, we already had an understanding that within seconds of sniffing, inhaling or injecting opiates (specifically) that this chemical travels directly to the brain through the bloodstream activating the brains 'reward circuits', immediately arousing intense pleasure, well being and euphoria.

I still can't be sure how many times someone has to repeat this activity to become addicted. I don't know if there are any sound statistics. Some say they were immediately addicted. Others I talked to said it took some time. Depending on the risk involved may be part of the answer. Say someone is taking pain pills for pain. Orally that is. It may take quite a long time for dependency to occur. With recreational use, you are going after the high. You seek it out and then go back for more of the same. I believe (and this is only my opinion) that there is a definite difference between a hereditary addiction and one that develops into a 'dependency'. Some may argue that but I have found that although the battle to 'quit' is just intense for both, the person who is not genetically predisposed to addiction may be more determined to quit and may not find themselves lying in a alleyway somewhere. Whatever the case, all addicts refer to themselves as addicts and do not believe it matters how they got there. Whether it is sooner or later, the outcome is always the same.

Opiate drugs work by mimicking natural opiate-like molecules made and used in the brain.

Once in the brain, the heroin is rapidly converted to morphine, which then activates and overstimulates opiate receptors causing greater amounts of dopamine to be released. Over time, addictive drugs alter the way in which the pleasure center, as well as other parts of the brain, functions. The way the cells communicate is changing. Changes to the synapse and shape of brain cells is inevitable. The brain will try to adapt, reducing the amount of dopamine released into the synapse. Over time a tolerance builds and cells grow so used to having abnormal amounts of the synthetic opiates around that they actually need these amounts to feel normal. Normal amounts are no longer adequate. Brain regions are now becoming 'hardwired". The drugs have taken over. If opiates are taken away from dependent nerve cells, these cells become overactive.

To decide to 'quit' is a very intense and lengthy battle. It will be impossible to stop now without going through severe withdrawal. It is a painfully long battle to fight. It will take time for the brain to go back to its original state. For most, it will be the battle of their lives. It will not go away easily. They are not only faced with the physical aspects of overcoming addiction, but also (and even more intense) is the mental and emotional fight. Of the three, the physical addiction is the easiest to overcome.

Tuesday, July 8, 2008

Just Scratching the Surface

Is there any reason to learn the intricate design and function of our brains? If your studying to be a brain surgeon...yes. The rest of us?...... Well, we know we have a brain, we hope it is healthy and working properly. Unless faced with tragedy, like a brain injury (or addiction) most of us unknowingly take the human brain for granted. Sure, we all know how amazing and complex the brain is. We know our brains think and learn, they tell us to feel happy or sad. We also understand that when we touch something hot it is our brain that tells us to remove our finger quickly. It also tells us not to do it again.

I am no more the expert in brain function today than I was 2 years ago although I do have a much better understanding. Our brains are so complex and so completely awesome, it would be wrong of me to even try to explain in any great lengths. To be honest, I don't think I could without sounding like a complete idiot. So I decided that it was best to keep it as simple as I could, and even that was not easy.

Some day when you have a 'few weeks' with nothing to do, you may find it interesting to look into any of the many informative websites educating us on how our brains work. It is staggering information. I could not help but feel like part of my brain was bruised as I read and struggled through the intense information and details of the human brain.

Here is my humble attempt to relay to you only a fraction of what I read about basic brain anatomy and function.

This awesome organ, weighing in at a whopping three pounds, is likened to not just one, but 'millions of little computers' that come together as a whole, in perfect unison. It controls every single thing about us including, but not limited to, intelligence, memory, personality, emotion, speech, and ability to feel and move. Motor control, visual and auditory processing, voluntary and involuntary functions, thirst, appetite, sleep patterns, breathing, heart rate, blood pressure, swallowing, digestion, and blinking. It enables us to interpret and respond to every single thing we experience.

The brain is divided into three basic units:
The forebrain is the largest and most developed part of the human brain. It consists primarily of the cerebrum, the source of intellectual activities. It holds your memories, allows you to think and plan, imagine, recognize people, read and play games. The cerebrum is split into two halves. The two cerebral hemispheres communicate with each other through a tract of nerve fibers. Each hemisphere has specific functions. The surface of each hemisphere is made up of grey matter known as the cerebral cortex and is responsible for thinking, perceiving, and producing and understanding language.
The midbrain controls some reflex actions and is part of the circuit involved in the control of eye movements and other voluntary movements
The hindbrain includes the upper part of the spinal cord, the brain stem and the cerebellum. It controls vital functions such as respiration and heart rate. The cerebellum coordinates movement and is involved in learned movements like playing a piano.

The inner brain, lies deep within the brain controlling your emotions and memories. This is known as the limbic system.The limbic system uses current situations and memories to generate your emotional responses particularly those associated with our survival. It is involved in many of our emotions and motivations, such as fear and anger. The limbic system also regulates feelings of pleasure. If something is pleasurable or rewarding, you want to do it again. This is also referred to as the Reward System. Limbic system structures called the amygdala and hippocampus are also involved in memory. One of the reasons that drugs of abuse can exert such powerful control over our behavior is that they act directly on the brainstem and limbic structures, which can override the cortex in controlling our behavior and eliminate the most human part of our brain from its role in controlling our behavior.

The central nervous system is divided into two parts: the brain and the spinal cord
The peripheral nervous system is divided into two major parts: the somatic nervous system and the autonomic nervous system. It allows our brains to communicate with the rest of our bodies by way of a very complicated highway system. Using the example of the hot stove, when our finger touches the heat, this sensation (or message) travels to our brain at a speeds up to 268 mph and tells us to pull our finger away.

The brain consists of about 100 billion cells called neurons. Each of the billions of neurons produce chemicals that trigger or "talk" to other neurons. These chemicals are called neurotransmitters that send messages from one nerve cell to another binding to receptors on the neuron receiving the message. The place where a signal passes from one neuron to another is called synapse.(Meaning to fasten together)When the transmitter hits the receptor, the receptor will change shape causing changes inside the nerve ending. This then sets off an electrical message onto the next brain cell. This sequence continues until the effect occurs.

The three major categories of substances that act as neurotransmitters are:
Amino Acids (primarily glutamic acid, GABA, aspartic acid and glycine) Amino Acids are the building blocks of proteins, the precursor to neurotransmitters and balance brain chemistry.
Peptides (vasopressin, somatostatin, neurotensin, and many more) Peptides are short polymers formed from the linking of amino acids in a defined order. The link between one amino acid residue and the next is known as an amide bond or a peptide bond.
Monoamines (norepinephrine, dopamine and serotonin, acetylcholine and others)
Serotonin is known as the "feel good" neurotransmitter. It plays an important role in the regulation of mood. Low levels of serotonin can cause excessive feelings of sadness and anxiety.
Dopamine and norepinephrine affects brain processes that control movement, emotional response, and ability to experience pleasure and pain. Controls heart and blood pressure, sleep, arousal and drive. When the brain does not produce enough dopamine or norepinephrine, you feel tired, unmotivated and foggy.

There are two kinds of neurotransmitters –
Excitatory transmitters stimulate the brain.
Inhibitory transmitters calm the brain and balance mood. They are easily depleted when the excitatory neurotransmitters are overactive.

Endorphins. A group of ten neurotransmitters that activate opiate receptors. Endorphins are composed of chains of amino acids. Since the discovery of the endorphins in 1975, scientists have theorized that these neurotransmitters are released when the body encounters stress. After a physical injury, endorphins activate opiate receptors and produce an analgesic effect, alleviating severe pain. During times of emotional stress, endorphins are released in the limbic system of the brain and produce a euphoria that lessens anxiety and melancholy The word endorphin comes from a combination of the word Endogenous, meaning 'growing within' and morphine.

In 1973, scientists discovered that the brain had receptors for opiates. (Places on neurons that recognize opiates). Two years later, scientists discovered the brain produced its own opiates known as "endorphins." Endorphins are always in the brain, but they are released in larger amounts when people are in pain or under stress. Each receptor recognized and only allow specific transmitters to bind to them similar to the way only 'one' key works in a specific lock.

Last but not least in this section, I found this next bit of information completely amazing:

By a process known as 're-uptake' (and others) our brains recycle and regulate normal levels of neurotransmitters by reabsorbing them once they have performed their function of transmitting the neural impulse.

Incredible stuff for something that only weighs 3 pounds..... and that my friends, is only scratching the surface.

Monday, July 7, 2008

Through the words of an Addict

The "tough love" forums that had been there for me in the beginning were not going to help me now. I had a bigger challenge, a life threatening challenge. My son was an addict, not an unruly teenager.

I turned to addiction sites and found myself begging for help from active addicts, struggling addicts and recovering addicts. These people I had once despised, I now turned to for help. Lack of knowledge had always led me to think that their actions were selfish ones, that they did not care about the pain and misery that they caused the people that loved them. But I was now ready to open my mind and understand addiction. I needed to know what motivated them to turn to drugs.

They asked me many questions about Robby, and one question in particular... "Is your son ready to quit?" They asked why he was not there talking to them. I told myself.....He was overwhelmed with his addiction, he did not know where to start, I had to help him. He wanted it, he really did. My answer to them.... he WAS ready to quit. He will be here soon, online, ready to get help.They warned me that this had to be Robby's choice..... not mine.

Pushing through their doubt ....I logged on every day. I needed to learn and understand everything. In the end the answer was always the same, (but not what I wanted to hear).. "You cant help him if he doesn't want the help."

Of course he wanted help....but then I would ask myself, did he even understand fully what he had done to himself? Did he believe he even had a problem? Was he ready to fight this battle? How could he believe it when I could barely except it?

I kept asking questions, refusing to believe their warnings. I was obsessed with finding answers that I wanted to hear. I lurked on many addiction forums reading tragic stories and joined others to tell my story. As the days and weeks passed, I found friends among these addicts. Doctors, nurses, lawyers, housewives and even a Congressman. Blue collar workers and white collar alike. Twenty year olds and fifty year olds. Some came from households with addictive parents and some did not. Others had started taking prescription pain killers due to an accident or illness. And still others turned to opiates as a recreational drug not knowing that it would eventually eat them alive. Each story was unique but eerily similar. Most had never thought for a moment that this would become a life long battle. They were people just like me who had jobs, families and very full lives. By the time they realized their lives were becoming unmanagable due to their addiction it was almost impossible to stop. They could not function without these pills now. Coddling their addictions, they continued to do whatever they could to get pills, convincing themselves they had legitimate pain or suffering. Some were filled with shame or embarrassment that kept them from seeking help from their family. Addiction kept them from thinking rationally always finding a reason why they still needed to take pills. Chasing pills was part of their lives until the inevitable day came when they were losing or had already lost everything...... their health, their families, their jobs, their lives were gone or hanging on by a thread before they knew it. These are some of the nicer stories.

All of these people had started using painkillers for one reason or another years ago. In some instances it had been half their lives and even after being ravaged by addiction were still fighting to stay sober. My fears grew as I listened to them. All of my previous thoughts and feelings started to dissolve away. There was 'no truth in labeling'. These were people who had wrestled with addiction.... got chewed up and spit out, defeated by drugs..... now they were haunted by years and years of drug abuse. They had been humbled along the way and now selflessly helping others get through it. It did not take me long to gain a new found respect for all of them. I will never know a stronger group of people than the recovering addict. There 'will to survive' is in a class of its own.

I 'watched' as literal strangers met and bonded in a matter of minutes. Rallying support from other members... staying close to one another, pulling each another through the weeks of retched physical and mental pain associated with withdrawal, all the while cheering each another on. Sometimes they would relapse, only to be encouraged to keep moving forward, pick themselves up and not look back. It was incredibly heart wrenching. I longed for my son to be there with me watching what he could do if he only wanted it bad enough. It was nauseating to think that this is what he had to look forward to. As painful as the reality of it was I was seeing these people were beating it..... and I knew he had a chance. It was a moving experience. One I will never let go of. One that opened my eyes yet again.

Still......they were ruthless in their belief that my son had to want to change and that I could not do it for him. I could not do anything for him but love him. Their words were painfully harsh. At times I was far from comforted.

I continued to challenged their 'expertise'.........and pressed on, learning as much as I could from them and any other source available to me. I was consumed. I was on a mission to save my son. I had always been there for him, and was not going to stop now. I would never give up.

But the questions would drive me insane.
"Why could he not just stop?"
"How could he not see how much he was hurting himself and JUST STOP!"
"Didn't he want a 'normal' life?

Their answers were always the same. "He was an addict, he cant stop unless he truly wants to." They kindly tried to reassure me that "it was not my fault". I had to let him take full responsiblity for his decisions now and back away from the situation. Their questions to me where always the same. "Where is Robby?" ...and "Why is he not here talking to us?"
Although some were more compassionate then others (or maybe they just started to feel sorry for me) it was as they had warned .....always the same dead end. "I could not force him to stop, I could not help him if he did not want the help". He not only had to want it, but want it bad enough to endure the unavoidable and painful struggle that was to come.

Through the words of the addict I had acquired knowledge that I never thought I would crave. I hung onto the belief that the more I could educate myself the more I could do to help Robby. Funny, but at this 'late date' I was listening to their words but still not hearing everything they said. Somehow I had contributed to this mess and it was now my 'job' to fix it.

When I was not talking with recovering addicts, I was scouring the Internet trying to understand addiction through science and medicine. What affect were opiates having on him mentally, physically and emotionally? What I was about to learn was both mind blowing and frightening.