The War on Drugs… Wage It on Your Medicine Cabinet, Not Afghani Poppy Growers

Today is Bloggers Unite Against Abuse Day. And to celebrate, I get to soap-box about one of my favorite topics – Prescription Drug Abuse.

Perfect. Because abuse of little white pills and purple capsules is what I spend a good chunk of my time researching in my day job. And at night, when I should be cleaning the toilets or the fridge, instead I’m trying to get the characters in my novel BRIGHTER THAN BRIGHT from not indulging in tiny orange orbs. Yeppers, I’ll admit prescription drug abuse is a passion of mine, right up there with psychosis, depression, and mania.

So here’s the facts, ma’am, followed by some fiction…

When most people think of drug abuse, they think -- Smack. Crank. Blow. Red Mercedes. Ice. Of belts wrapped tight around upper arms, of sucking lines off a foil-lined tray. Considerably more dangerous than what’s hanging out in those amber-colored plastic vials in your bathroom cabinet. Right?

Not so. Although the use of most drugs, including marijuana, heroin, and cocaine, have stabilized or even fallen in recent years, the abuse of drugs available by prescription has increased. Especially in young people, even though growth is substantial among boomers and seniors. Indeed, more kids aged 12 to 17 abuse prescription drugs than all the ‘hard’ street drugs (cocaine/crack, heroin, inhalants, hallucinogens) combined. It’s mostly white kids, although Hispanic youth are increasingly turning to medications to get high, and those who indulge in other substances, especially alcohol and tobacco. What do kids use? Mostly opioid analgesics (e.g., OxyContin, Vicodin), tranquilizers (e.g., Ativan, Halcion, valium), and stimulants (e.g., Ritalin, Strattera).

But prescription drug abuse is not just a problem of youth. More and more older adults – especially women – are falling victim to the ravages of little white pills prescribed by their doctors. Misuse is often unintentional, occurring after excessive medical exposure. And pills are easy to get: docs are willing prescribers, we tend to hoard unused meds (‘fess up – bet you have some leftover Demerol in your medicine chest), friends and family are willing to share, and on college campuses and high schools (and even middle and elementary schools), there is a tremendous grey market for prescription medications.

And why not? Unlike cocaine, heroin, and crystal meth, you KNOW what’s in your OxyContin tablet. You get the same, dependable high with no fear of contaminants screwing up your lungs, your bloodstream, or your brain. After all, the Food and Drug Administration has approved these medications as ‘safe and effective’.

What can you do to stop prescription drug abuse?

1/ Get informed. Go to the experts: National Institute on Drug Abuse, The Substance Abuse and Mental Health Services Administration, and Join Together. Or contact Me - I research this stuff for a living.

2/ Ask your docs to give you the smallest amount of pain medications or other potentially addicting medications. This keeps excess medication off the street.

3/ Talk to your kids. If you’re a kid, talk to your friends. Tell them just because the FDA approves them, they’re dangerous.

4/ Most important - Talk to your pharmacist when you receive prescriptions for analgesics, tranquilizers, stimulants for ADHD or narcolepsy, sedatives for sleep. Ask her how to SAFELY use your medication.

5/ Lock up your medications. You’d be amazed what your housekeeper, realtor, friends, and children will steal.

6/ And DON'T SHARE!

Here’s the fiction… Ben at a pharming party...

I push myself back up the wall, wait my turn. The door opens, the hip-hoppers high-five their way down the hall and I stumble in. The small room reeks, yellow urine puddles by the john. Streamers of toilet paper and clods of crap circle slowly in the bowl. I do my thing, then cling to the sink as white and grey dots skitter across my closed eyelids. A hot, heavy fullness bubbles up my throat; I swallow it down, blast the faucet and splash myself with water. There’s no towel, water streams down my neck. Bloodshot eyes stare back from the glittering glass, the green of iris obscured by vacant, opaque cisterns. An urge to vomit up all the chemicals I’ve ingested strikes me, then passes. What the fuck am I doing? I shake my head, but nothing changes; the stranger gazes back at me. Someone bangs on the door, so I turn from the sink, stagger to the ballroom.

Be safe. Use your meds as prescribed. Peace, Linda

Virtual Pain

And literal pain, too. The last twenty pages of BRIGHTER THAN BRIGHT frizzled my neuronal circuitry to smoky cinders.

Since the beginning of the year, I’ve revised and written 10,000 words every three weeks. No exceptions. I churned through this seventh revision in record pace. But for some reason, the last 5,000 words took me nearly two months to complete. I guess I needed to give the ending it’s due attention, because in some ways, the ending is more important than the beginning. After all, there are so many loose ends to resolve. And, as a critical reader, I am so often unsatisfied with most story endings. So I struggled - and endured much pain as I slashed and modified and rewrote to get it just right.

The struggle of slouching towards THE END vaporized early Sunday morning when I typed those two magic words out for the seventh time, saved the file, and zipped it over to my writing group for their reading and critiquing pleasure. I am two weeks behind my self-declared deadline of 9/15; Chrys and I are now targeting the first week of October to exchange manuscripts.

Speaking of pain, you, dear reader and writing procrastinator, haven’t yet met PHOEBE, the female protagonist of my story and BEN’S love interest. Phoebe is a medical student who escapes from her loneliness in her books and pottery. When Phoebe lost her mother to cancer a decade earlier, she fixated on a medical career like her internist father, but as a pain management specialist. Phoebe’s tenacious – a quality responsible for her academic and sculpture successes - but her stubbornness extends to her difficulty in clinging too tight to the past. She begins to break her own psychic pain by honoring her mother's memory through song at her Unitarian Universalist church:

Ben’s eyes open wide as I go front and center before the other dozen choir members on the two steps leading to the pulpit. The director catches our attention with her eye, then signals with her right hand to begin.

Sometimes I feel like a motherless child,
Sometimes I feel like a motherless child,
Sometimes I feel like a motherless child,
A long way from home,
A long, long way from home.

My voice quavers, then steadies and strengthens, resonating with my mourning. Ben watches me, his intent eyes glisten in the stippled light. I look away; I can’t break down, not now. The choir joins in on the second verse and the momentary urge to weep passes.

My life has accelerated towards this moment for months, maybe even years, but a surprising calm fills me. A hidden strength returns. I raise my voice in tribute to my mother. And for the first time in what seems an eternity, I don’t feel alone.

May your days be free of physical and psychic pain, virtual and real. Peace, Linda

Asian Pears, 9/11, and Rilke: Ponderings in September

There’s a poignancy about September, something that makes me begin to slowly turn inward. Perhaps it’s the abrupt desiccation of the air that turns the sky into a slate of cerulean. Or the slipping into routines of packed lunches, morning busyness, and crushing commutes. The evening you notice, for the first time, the absence of fireflies dancing in garden shadows. The lonely chirrup of crickets as dusk falls earlier than the day before. Perhaps it’s the way the Asian pears take on a golden glow, the way raspberries turn redder, smaller, sweeter. Maybe it’s the four jet liners that inalterably redefined summer’s slow, inexorable slide into Fall when they slammed into towers and fields six years ago.
(Asian Pear, Henry Simoni-Wastila)

All I know is that this week, many things gave me pause. My daughter’s short, stubby legs carrying her down a soccer field. The toothless, stooped man selling papers outside the metro station. Spent syringes lying in the gutter. The flock of grackles, a school of hundreds, weaving patterns above the horizon of trees.

Words moved me, too. Phrases, a collection of sentences, would leap from pages, force me to retrace their origins and read again. Sometimes it was the sheer lyricism of the writing that struck me, other times it was the meaning contained within the words...

In That Certain September, Joseph Grant elicits in two sentences the frustrating experience of emergency room workers on September 11, 2001…

People from all walks of life and from seemingly every ethnic background, all working together, were hammering planks together for makeshift stretchers for the injured that would surely flood our doors any given moment now. In one of the cruelest ironies of that dreadful day the stretchers were abandoned, never to be used.

Fading Away, a haunting short by Joseph Bathanti in the latest The Sun, also brought me to tears…

As Fritz holds Claire in the flickering candlelight, she tells him that Compton once threatened to kill her. She laughs when she tells him, insisting that Compton is nothing but swagger, but Fritz has come to recognize her laugh as an acknowledgement of powerlessness, something people of epic endurance share. They know only how to suffer, not how to hit back. Then he hears himself laugh too. It finally occurs to him that he has been training not to fight, but to flee.

I revisited Allen Ginsburg's The Howl, a testament to an era and its losses (thank you, Sarah)...

I saw the best minds of my generation destroyed by
madness, starving hysterical naked,
dragging themselves through the negro streets at dawn
looking for an angry fix…

And from Robert Graves, noted historian and author of I, Claudius and Claudius the God, in a four-word preface to the fabulous and fabulistThe Cleft by Doris Lessing…

“Man does, woman is.”

(So perfect. So succinct.)

Finally, I spent time meditating on a ceramic vessel I built many years ago. My funerary urn. Carved in the slipped and burnished earthenware, an epitaph extracted from the words of Ranier Maria Rilke…

Explore transformation throughout.
What is your most suffering experience?
Is drinking bitter to you, turn to wine.
…
And if the earthly forgot you,
To the still earth say: I run.
To the swift water speak: I am.

What made you think and wonder this week? Peace, Linda

Bipolar Brains: Different From All the Rest

NIMH: Bipolar Youth Show Distinct Pattern of Brain Development

A fascinating new study shows how cycles of depression and mania change the actual structure of the brain in youth. Go to the link, click on the flicks - and see the dramatic gains in the growth of working tissue in the left hemisphere, the cingulate, and other areas regulating mood function. Meanwhile, grey matter loses ground in the right hemisphere. Spoken and written word functions reside in the left side of the brain, as does as the memory of words.

Neuroscience is proving what social scientists and psychologists have theorized for years - creativity, at least that related to the literary arts, does have some basis in mood. As a study of one (also known as an anecdote), I can attest: I write best when a bit of hypomania fuels my brain.

IN MEMORIUM... Please remember those whose lives were lost in planes, too-high towers, and the Pentagon six years ago today. Peace and prayers to the survivors. And a special tribute and thanks to those who perished trying to save their fellow humans. Peace, Linda

Diagnosis du jour

Like changing hemlines, there are fashions in mental health. In the 1980s, taking Prozac was hip and, on the cocktail circuit, you were embarrassed if you weren’t taking the little blue and white capsule. A decade later, attention deficit hyperactivity disorder (ADHD) was the ‘in’ condition, not just among children and adolescents, but also among driven adults. And now, in the new millennium, the diagnosis of the moment is bipolar disorder.

A new study conducted by researchers at Columbia University http://www.nimh.nih.gov/press/rates_bipolar_diagnosis.cfm?OututPrint) finds that 1 in every 100 youth aged 19 or younger has bipolar disorder (and 2 in every 100 adults). That may not sound so bad – just 1 percent – but taken in the context of trends, it is disturbing: the rate of bipolar diagnosis has increased forty-fold in ten years among adolescents.

Forty-fold.

What the hell’s in the water?

Probably nothing. Historically, bipolar disorder has been under-recognized, under-diagnosed, and under-treated, especially in pediatric populations. The mood swings, excess energy, and restlessness associated with bipolar parallel the signs and symptoms seen in other conditions, including ADHD, oppositional defiant disorder, psychotic disorders, and garden-variety depression. Not to mention the normal angst and sturm of adolescence.

But now it appears we may be swinging to the other side of the pendulum: over-diagnosis. And a consequence of any diagnosis is usually a treatment. The medications used to treat bipolar disorder – lithium and other mood stabilizers, anxiolytics, antidepressants, and antipsychotics – are not innocuous. They are powerful, mind-altering drugs which, when used appropriately, confer tremendous medical benefit. But they also have potent and dangerous side effects, ranging from the inconvenient and uncomfortable (loss of libido, dry mouth, shaking) to the downright dangerous (blood dyscrasias, weight gain, diabetes).

In BRIGHTER THAN BRIGHT, Ben is bipolar. Diagnosed at age 16, he’s a model patient, compliant with his lithium and psychotherapy for the past four years. But a series of events cascade and lead him to ‘forget’ his happy pills and he starts the upward spiral into mania…

My very atoms vibrate: from caffeine, from sleep deprivation, from the constant moving forward. From erratic consumption of my mood regulators. But my mind is sharp, focused; my dreams, Technicolor wonders. Everything I touch explodes from this magical, sub-cellular energy surging within me. When I press the closed hollow-wood door to Bruce’s office, it flies open with a bang. The knob gouges the plaster wall. He sits at his desk, the room dim but for the green glow of a single lamp, head down, not noticing my tumult.