# 32

Irony in terms; 2nd take

The Federally funded National Institute on Drug Abuse functions under the National Institute of Health.  Its website makes no apologies for the use of the term Drug Abuse in the naming of the organization.

Yet, in its article, Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide, the title and the entire article frequently uses the term drug use while never opting for the term used in the organization's very name: Drug Abuse.

Excerpt below:

• school failure
• problems with family and other relationships
• loss of interest in normal healthy activities
• impaired memory
• increased risk of contracting an infectious disease (like HIV or hepatitis C) via risky sexual behavior or sharing contaminated injection equipment
• mental health problems—including substance use disorders of varying severity
• the very real risk of overdose death

How drug use can progress to addiction.
Different drugs affect the brain differently, but a common factor is that they all raise the level of the chemical dopamine in brain circuits that control reward and pleasure.

The article does a fine job of illustrating the "adolescent brain" (which they carry into adulthood/age 22) and it does note, in the final bullet above "the very real risk of overdose death."

As long as the Federal Agency uses the term Drug Abuse in its name, critics of the term abuse will be minimized as they strive to steer people into using the more forgiving term- use.


https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/introduction

# 31

DoubleSpeak/DoubleThink is alive and well in addiction circles.

Understanding the Legislature's English in Substance Abuse Matters and how efforts are underway by persons who do not like the legal terms to subtly change the terms/meaning.

The term "doublespeak" probably has its roots in George Orwell's book Nineteen Eighty-Four. Although the term is not used in the book, it is a close relative of one of the book's central concepts, "doublethink". Another variant, "doubletalk", also referring to deliberately ambiguous speech, did exist at the time Orwell wrote his book, but the usage of "doublespeak" as well as of "doubletalk" in the sense emphasizing ambiguity clearly postdates the publication of Nineteen Eighty-Four.^[5][6] Parallels have also been drawn between doublespeak and Orwell's classic essay Politics and the English Language, which discusses the distortion of language for political purposes.^[7]
Edward S. Herman, political economist and media analyst, has highlighted some examples of doublespeak and doublethink in modern society.^[8] Herman describes in his book, Beyond Hypocrisy the principal characteristics of doublespeak:

What is really important in the world of doublespeak is the ability to lie, whether knowingly or unconsciously, and to get away with it; and the ability to use lies and choose and shape facts selectively, blocking out those that don’t fit an agenda or program.^[9]

In his essay "Politics and the English Language", George Orwell observes that political language serves to distort and obfuscate reality. Orwell’s description of political speech is extremely similar to the contemporary definition of doublespeak;

https://en.wikipedia.org/wiki/Doublespeak

I recently visited some Substance Addiction websites and performed content analysis on the language used to describe things.  For example, as one sentence described a fatal OD substance, the writer did not use the term: abuse.

In the politically-charged world of addiction/recovery, a new language is presenting which is inconsistent with State Law Maker's terms and language.  In the passage I read, the writer who did not use the term abuse, instead wrote the word use.  Their dropping of the prefix ab, before the word use, may be interpreted by some as being less judgmental or pre-determinant.  Surely, it was not a typographical error.

Meanwhile, below, the Code of Virginia features 188 instances reflecting the use of the legal term: substance abuse.

Certainly, ever since the AMA described alcohol and substance abuse as disease, Society should be trying to remove the stigma which has attached to the self-administering adults.  In a perfect world, that may someday occur and every patient having these diseases will be treated by Physicians...because Physicians have accorded the term disease to the condition and only Physicians treat disease.  However, some of the very persons who are concerned about the placement of the prefix ab in front of the word use have absolutely no problem that non-Physician former alcohol/substance addicts are providing the majority of treatment for the diseases by way of counseling.

Parallel Universes

Legal Terms, published in Codified Laws, are the precise descriptors used by Judges, Lawyers, Court Clerks, Police and Detectives, Probation Officers, Medical Examiners, Toxicology/Forensic Science Labs and the Legislators which craft the wording of their laws.

Contrary to the Law's accurate expressions are two subsets of persons directly affected by Addiction.  One group, as reported earlier in this blog, accepts the legal terms and tells the painful truth as they craft the obituaries of their addicted loved-ones - frequently pegging the outcomes to choices made by the addicts.  The other group is not about to be so forthcoming (yes, of course they have that right) and, without attempting to have their Legislature remove the term Substance Abuse from the law books, they operate on a separate path and use a language which can be as crafty as Orwell described.

The Bible says that we should test/prove everything.

1 Thessalonians 5:20-22King James Version (KJV)

²⁰ Despise not prophesyings.
²¹ Prove all things; hold fast that which is good.
²² Abstain from all appearance of evil.

The same level of testing/proving should be applied to anything involving substances and addiction as readers seek the truth...even the testing/proving of this blog. 

§ 37.2-100. Definitions.

As used in this title, unless the context requires a different meaning:
"Abuse" means any act or failure to act by an employee or other person responsible for the care of an individual in a facility or program operated, licensed, or funded by the Department, excluding those operated by the Department of Corrections, that was performed or was failed to be performed knowingly, recklessly, or intentionally, and that caused or might have caused physical or psychological harm, injury, or death to an individual receiving care or treatment for mental illness, intellectual disability, or substance abuse. Examples of abuse include acts such as:

"Administrative policy community services board" or "administrative policy board" means the public body organized in accordance with the provisions of Chapter 5 (§ 37.2-500 et seq.) that is appointed by and accountable to the governing body of each city and county that established it to set policy for and administer the provision of mental health, developmental, and substance abuse services. The "administrative policy community services board" or "administrative policy board" denotes the board, the members of which are appointed pursuant to § 37.2-501 with the powers and duties enumerated in subsection A of § 37.2-504 and § 37.2-505. Mental health, developmental, and substance abuse services are provided through local government staff or through contracts with other organizations and providers.
"Behavioral health authority" or "authority" means a public body and a body corporate and politic organized in accordance with the provisions of Chapter 6 (§ 37.2-600 et seq.) that is appointed by and accountable to the governing body of the city or county that established it for the provision of mental health, developmental, and substance abuse services. "Behavioral health authority" or "authority" also includes the organization that provides these services through its own staff or through contracts with other organizations and providers.
"Behavioral health services" means the full range of mental health and substance abuse services.
"Board" means the State Board of Behavioral Health and Developmental Services.
"Commissioner" means the Commissioner of Behavioral Health and Developmental Services.
"Community services board" means the public body established pursuant to § 37.2-501 that provides mental health, developmental, and substance abuse services within each city and county that established it; the term "community services board" shall include administrative policy community services boards, operating community services boards, and local government departments with policy-advisory community services boards.

http://law.lis.virginia.gov/vacode/title37.2/chapter1/section37.2-100/

# 30

Online Drug Treatment Resource takes realistic view of the consequences in our society for possessing and selling illegal substances....even if you are an addict; recommend treatment before your next arrest.  Site does not even try lobbing up the false claim that people are jailed for "usage" of drugs.

What Are the Penalties for Drug Abuse and Possession in the United States?

If an individual is caught with possession of illegal drugs, they can face potential fines as well as jail time.   The length of jail time differs according to the state in which the offense occurs and the previous criminal record of the individual.     Most states in the U.S. now have a mandatory minimum sentence for drug possession that cannot be plea bargained away.   The average amount of jail time awarded in a drug possession case in the United States is between 30 and 40 months.

In addition, individuals in the U.S. could face steep fines for possession of drugs. Some judges may require that the individual commit a large number of hours to community service as a type of penance for their crime.

The Penalties for Selling Drugs

Selling drugs carry much harsher penalties than those received for simple drug possession, with strict minimum sentences in all 50 states of the country.   An individual who has repeatedly been caught selling drugs can face three, six or nine years in prison, depending upon the situation.   Those who are found guilty of selling drugs to a minor face an even bleaker future – with sentences of 10 years or more not uncommon at the state law level.

In some instances, it doesn’t take much of a substance to be deemed that one has the intent to sell. Law enforcement officers will look for other signs that you intended to sell the drug as well, such as large amounts of cash, scales or small plastic bags. A conviction of intent to sell relies heavily on the testimony of arresting officers. If they feel that you intended to sell the drugs you were carrying, this will go a long way in court. It’s just not worth the risk.

http://www.drugabuse.net/drug-policy/penalties-for-drug-abuse/

# 29

Narcan antidote works with two doses after mother ODs in store; State takes tot for obvious reasons.

A self-administering, adult, mother was recently revived in Massachusetts after her toddler daughter was found attempting to wake her up.  She was not charged as she was not found to be in possession of anything, however, her choices and priorities resulted in the removal of her daughter.

http://www.foxnews.com/health/2016/09/23/video-shows-mom-overdosing-in-toy-aisle-at-store.html

# 28

Heroin accounted for the most deaths. But fatalities related to the powerful synthetic painkiller fentanyl, which is often mixed in heroin, unbeknownst to users, saw the biggest spike.

Heroin deaths rose 68 percent to 566 in the first half of the year, and fentanyl deaths rose 268 percent to 446. Deaths from prescription opioid-based painkillers rose 10 percent to 210. Users who have overdosed and died are often found to have more than one drug in their system.  (taken from the below article)

Every death reported in the below article represents a solitary life.  Each of those souls had a point in their life which could be referred to as "the day before addiction" when they were clean....with one exception; some could have been born to mothers who were also addicts and, as babies, these souls may have never seen a day before addiction.

http://www.baltimoresun.com/health/blog/bs-hs-maryland-overdose-deaths-20160922-story.html

# 27

No one should be surprised that people pursuing the dollar will hold a different set of priorities.

In the below article, we can read how Pharmaceutical companies will fund just about anything to attain their objectives for increased lawful sale of their synthetic opioid substances.  The article suggests that the State of Washington's legislature held the line against the effort and findings indicate that lost lives data has been reduced when compared to most other states.

http://wtop.com/government/2016/09/drugmakers-fought-domino-effect-of-washington-opioid-limits/slide/1/

# 26

Opioid Antidote needs an App, according to the FDA, so that anyone can go to their smart phone and locate the nearest Naloxone - even in a neighbor's medicine cabinet - and obtain, possibly, a fatal overdose-reversing drug.  (article below)

Imagine, one responsibility of government is to schedule harmful/lethal substances and use every lawful means to investigate the manufacture and sale of such substances.  In instances where government emergency medical responders attend to near-death, criminal, substance abuse matters...this truthful information can be shared with those sworn to uphold the law.

Now imagine that another responsibility of government is to provide emergency medical care to avert overdose deaths.

Blend into these two complimentary aspects of the government's responsibilities and process the ramifications described in this article.  Let's say that Angel Purity overdosed on opioids three times in 2016 and each time EMTs responded and administered the antidote.  The three responses are documented in EMT records as are the use/cost of the antidote and the address and name of the victim to which they responded.  This data is useful across many disciplines...all, hopefully, designed to make society a better place in which to live and also, hopefully, while attempting to reduce Angel's substance addiction.

If Angel Purity's relative is able to go to an App and obtain the antidote more quickly, how will society capture the data for all of the positive reasons the data is important?  Any street narcotics detective will immediately see this as an end-run which hides the events from EMTs as well as police, courts, probation officers, drug counselors, etc.  The data is never captured.

At a time in our society when we are supposed to be contemplating every facet of an issue and taking all things into consideration, this FDA approach does not appear to have considered the data collection and law enforcement positions which are just as vital in improving our society.

Using the hypothetical adult, self-administering substance abuser Angel Purity as an example; isn't there a higher objective for our society to get Angel off the revolving cycle of overdose-antidote-back to overdose?

How many times does society need to save Angel's life before it asks itself: "When are we going to stem/curtail Angel's self-placement of her life into jeopardy?"

https://www.washingtonpost.com/news/morning-mix/wp/2016/09/20/overdosing-on-heroin-and-searching-for-naloxone-the-fda-wants-an-app-for-that/?hpid=hp_rhp-morning-mix_mm-fda%3Ahomepage%2Fstory

# 25

Mother who lost son, at age 18, heads non-profit in New Mexico which emphasizes four things:

• Not Another Life Lost

• Awareness and Decisions

• Target age group 14-21

• Long-term residential care for twelve months

Jennifer Weiss-Burke finds that her lobbying her legislature for a seven-day limit on pain killer prescriptions - to stem addiction - is being countered by high-paid pharmaceutical lobbyists who are chasing profit.

http://healingaddictionnm.org/

http://wtop.com/health/2016/09/drugmakers-fought-state-opioid-limits-amid-crisis-2/

# 24

Two adults who self-administered Heroin and had a child in the car are photographed by Ohio Police in an effort to illustrate what they term "an epidemic."

This post will serve as a basic reminder of drug abuse terminology.

High....a Central Nervous System Stimulant produces increased respiration and heart rate (examples: Cocaine, Caffeine, Nicotine, Methamphetamine, Hallucinogens)

Low.....a Central Nervous System Depressant produces slowed respiration and heart rate (examples: Heroin, Morphine, Opium, synthetic opioids like Fentanyl and Carfentanil) which can take the self-administering abuser from a state of awake alertness to sleep, coma and death as it depresses the brain's respiration control center.

CNS stimulants and depressants may also produce analgesic, or pain blocking effects, but the ones that take their abusers up can blow out their hearts and the ones which take the abusers down can act like elevators which descend to the lowest floor which is death.


http://www.cnn.com/2016/09/12/health/heroin-effects-police-photo/index.html

# 23

In conflict with her own message, a former heroin abuser reports that she emphasizes "choices" with the abusers she counsels, however, she blames the choice her adult daughter made - which led to her death - on "drug policy."

"Drug policy is the reason people are dying."

Not the choices to self-administer made by adults...even for their very first instance itself.

Not the substance, which many parents elect to cast the blame...in this story, we read of mom's prior heroin abuse, then we read that she blames policy while extolling the antidote drug.  Clearly, she has moved along the continuum of substance abuse and is using the starting point which is far down the line from "the-day-before-addiction."

http://www.cnn.com/2016/08/27/health/mom-heroin-overdose/index.html

# 22

Southeast Asian botanical substance known as Kratom banned by DEA without public comment; active ingredient deadens pain at Opioid receptor sites while not slowing respiration but has produced hospital admissions at ERs.

A September 30, 2016 ban, administratively imposed by the DEA, on the substance Kratom has added another example to the debate regarding real and perceived pain, profiteer's pursuit of cash and government agency's efforts to protect the public.

In a perfect world in the USA, the FDA and DEA would be our guardians and they would ensure that a minimum amount of sudden and unexpected deaths occurred by performing qualitative and quantitative analysis of all marketed substances - especially in behalf of persons in pain who are desperate.  In this same perfect world, persons around the globe who seek profit in the USA while circumventing the regulatory agencies as they sell proscribed/regulated substances would rightly be seen as the enemy of all potential users/abusers.  Finally, the perfect world in the USA would have physicians prescribing regulated substances and Americans only using such substances in dosages their doctors prescribed.  Under this schema, fewer overdose deaths would occur and life would rightly be preserved; pain addressed.

There will always be people who seeks cash by selling substances which permit adults to self-administer substances which can kill them.  While it may not always be suicide, when such adult users/self-administrators skirt the regulators, they have to know that they are circumventing the very guardians the taxpayers established to protect them.

http://www.forbes.com/sites/davidkroll/2016/08/31/dea-argues-that-public-comment-is-unnecessary-before-kratom-ban/#69d6c11b388b