As another holiday season is upon us, I am touched by the stories that highlight the fact that together we are making a difference and that our message is becoming mainstream. While we should celebrate the progress made, we must remain relentless in our commitment to convert the naysayers. But let us all remember, that progress is made by educating and not by demeaning or ridiculing those who have a different opinion about Substance Use Disorders.
And an especially big thank you to patients afflicted with the disease of addiction for having the courage to speak out. I hope you enjoy the reflective article about Rediscovering Christmas and the heart felt story of how the Opioid Epidemic Grips a Community; but there is hope!
And let's not forget to thank the many Law Enforcement Leaders who understand the need to destigmatize the disease of addiction. Here are two examples of Police Chiefs who are helping to save lives through unique programs. Thank you to Chief Leonard Campanello of Gloucester, MA for establishing the The Angel Program and Chief Robbie Moulton of Scarborough, ME for developing the program called Operation Hope.
We are truly making progress and please feel free to contact me to assist in any way.
To all those afflicted with the disease of addiction and to friends and family members, please do know that you are not alone and there is progress being made. Most importantly, please do reach out. Many of us are waiting to help.
I am honored to have Geoff Kane, MD, MPH as a guest blogger this week.
I have known Geoff for many years and he is not only an extremely competent physician, but also possesses the highest degree of compassion for patients and the utmost commitment to assisting those afflicted with the disease of addiction. Dr. Kane is the Chief of Addiction Services at the Brattleboro Retreat in Brattleboro, VT. He is board Certified in Addiction Medicine and Internal Medicine, a Fellow of the American Society of Addiction Medicine, and Chairs the Medical-Scientific Committee of the National Council on Alcoholism and Drug Dependence.
If you want to learn more about Dr. Kane, please visit: geoffkane.com
Addiction statistics are scary. For example, excessive alcohol causes an estimated 88,000 deaths per year in the United States. Deaths from cigarette smoke exceed 480,000 per year. In 2013, about 100 Americans per day died from drug overdoses. The annual cost to this country of addiction and other substance abuse—including healthcare, crime, and lost productivity—is over $600 billion.
Such damage ought to prompt interventions that are swift and sure, but that is not the case. Not only have severe social and economic consequences of addiction been with us for a long time; some measures are getting worse.
Conflicts of interest impede the prevention and treatment of addiction by inhibiting individuals throughout society from adopting alternative actions that would reduce the toll of addiction. If we attribute all responsibility for addiction to addicted persons themselves, we are like a naïve family member who says, “It’s your problem. Take care of it.”
People in all walks of life contribute to the proliferation of addiction—whether they realize it or not. The clearest conflict of interest, however, may indeed lie within the individual with addiction. More addictive substance will surely forestall withdrawal and ease emotional and physical distress, and perhaps cause pleasure as well. In the “logic” of addiction, competing priorities such as family, career, and citizenship are eclipsed by the drive to obtain more substance.
Yet others’ conflicts are also part of the problem. Such as well-intentioned family members who long for loved ones to get sober but later undermine their loved ones’ sobriety when abstinence reconfigures the distribution of power in the household. Or well-intentioned addiction treatment professionals and mutual-help members who are so attached to specific treatment approaches that they fail to engage newcomers who don’t align with them. Or well-intentioned community members who only support addiction treatment centers located someplace else, making treatment less accessible in their own neighborhoods.
Conflicts of interest often involve money. Do some doctors prescribe controlled substances too freely? Could some addiction treatment facilities provide less than rigorous care so that patients will return? Are some health insurance companies more invested in restricting access to care than providing it? Are some managed care reviewers rewarded when they deny coverage instead of certify it?
In order to be used, addictive substances must first be available. Use increases when these substances are easily obtained, which promotes new addiction along with recidivism among the abstinent. The business interests of large segments of the pharmaceutical, alcoholic beverage, tobacco, and legal marijuana industries are in conflict with the health interests of the public. Might the business interests that boost substance availability also influence decisions of government and other policymakers?
Besides availability, belief that the risk of harm is low or otherwise acceptable is a second condition to be met before many individuals will initiate use of addictive substances. Numerous people who subsequently developed addiction were given a false sense of security from well-intentioned peers, family members, healthcare providers, and the media including advertisers, reporters, and editors.
Respectful, nurturing interpersonal relationships in families and throughout society reduce the vulnerability of young people to addiction and make recovery more attainable for those seeking a way out. Yet people continue to depersonalize one another, reacting to stereotypes rather than appreciating individual human beings.
Addiction statistics are not likely to improve until we all identify and accept our own unavoidable share of responsibility for curbing the problem. Individuals seeking recovery are responsible for accepting support and changing elements of their lifestyle. Communities—meaning everyone, including law enforcement, business, government, healthcare providers, third party payers, and the media—are responsible for reducing the availability of addictive substances and permissive attitudes toward their use; making individualized addiction treatment accessible; reducing barriers to transportation, employment, and housing; and replacing stigma with respect.
A collective desire to be part of the solution may not be sufficient to make a difference. Healthy change proceeds more reliably when individuals are held accountable. For example, recovery from addiction often requires that family, professionals, and recovering peers keep tabs on those entering and maintaining recovery and impose consequences if they get off track. Likewise, we may all better meet our responsibilities if we gently but firmly hold one another accountable to act on addiction in ways that address the overall picture rather than just our own narrow point of view.
To think about: Will manufacturers and distributors of illegal addictive substances ever support the common good? Is accountability under the law the only possible incentive for them to change?
I recently had the honor of receiving the 100th review for Addiction on Trial on Amazon. I am truly honored and appreciative to all who have left such remarkable and heartfelt reviews of my book.
I wrote Addiction on Trial with the goal to entertain as well as educate, and I immensely enjoy hearing feedback about the impact the book is having. This blog is simply a special thanks to all the reviewers and to take the opportunity to share a few reviews that represent a theme. These types of comments have further inspired me to finish the sequel to Addiction On Trial and I will continue to work diligently tomakeLost To Addiction as enjoyable and as educational as it's predecessor.
Most importantly, I am pleased that Addiction On Trial is appealing to such a diverse group: lovers of mysteries and legal thrillers; followers of Crighton, Cook and Grisham; addiction professionals; folks concerned about how to educate high school students or personally touched by addiction; and page turning fanatics 🙂 A SPECIAL THANKS TO ALL !!!
This Book Reads Like a Screenplay..and I Can't Wait to See the Movie!
The timing of the publication of Dr. Kassel's book could not have happened at a better time. Since Philip Seymour Hoffman death, there's been a lot of long over due attention to the topic of addiction. Dr. Kassels' book is a gripping tale that graphically illustrates what the disease of addiction brings to a family, and how from there it trickles throughout the community at large. It is in all of our lives, on one level or another. His book reads like a screen play and it wouldn't surprise me if it is made into a movie one day. Plus, there's bound to be a sequel which I can't wait to read it as well.
Riveting Stuff
Once you pick up this book, you find yourself moving faster and faster to the dramatic conclusion. Its an absolute page turner and the courtroom drama was smart and believable! A story that keeps you guessing to the end but more importantly a raw and compelling insight into the complexity and desperation of addiction. I confess to a slight addiction to John Grisham. This was every bit as good. And the fact that Kassels is a guru on addiction gave the book a feel of substance and gave me a base of knowledge that I did not have before. It truly was interesting and enlightening. Cant wait for the next one!
Nuanced Medical Thriller
"Addiction on Trial" is a serious medico-legal mystery and page-turner. If you're a fan of the big names in this field like Crighton, Cook, Grisham, etc, then give Kassels a try as well. My usual complaint with the genre of "medical thrillers" is that the "medical" side of the story is usually grandiose and non-believable. Not so with "Addiction on Trial". Dr. Kassels has weaved a medical storyline that is nuanced, entertaining, factually accurate, and keeps you guessing until the very end. Well done! I'm looking forward to the sequel already!
Don't Miss Out On This Book
WOW, I could not put this book down. Every chapter got better and better. It was loaded with suspenseful moments just when I least expected it. I felt myself getting wrapped up in all of the characters lives and gaining a greater understanding around the challenges of addiction. Kassels is a master of valuable information and experience along with a creative powerful writing talent. Absolutely a dynamite combination. I look forward to the sequel with great anticipation. I wonder what Shawn Marks will get into next?
Page Turner Extraordinaire
I could not put it down, and stayed up till 3AM to finish it. Besides being very entertained, I learned much about an unfamiliar realm.
The book casts a new and sympathetic light on a problem we tend to relegate to unfair stereotypes.
So Insightful!
Dr. Kassels weaves a captivating mystery thriller that takes the reader into the entangled world of drug addicts. He not only skillfully shows the emotional havoc drug addiction creates for the individual, his or her family, and the community at large, but also explains the medical and legal implications of the disease. I think young people would greatly benefit from reading this book and suggest that it be required reading for high school health classes.
Dr. Kassels hits a first serve ace...
Addiction on Trial was a great read and I breezed right through the book. The story line, the characters, their interactions and the author's descriptions throughout kept me engaged. I came away with a better understanding of what doctors and nurses go through in emergency room settings, and the helpless feeling many families have when dealing with addiction issues. The timing of the release comes when coverage of heroin overdoses has taken off. Over prescribed, expensive pain killers morphing into heroin have become a challenge to treatment and rehabilitation. This book gives an accurate account of the perils of addiction and how it affects many lives. By bringing awareness to addiction, Dr. Kassels is shedding light on the problem without being preachy or judgmental. His book is a great vehicle for opening discussions about a topic that is obviously wreaking havoc on all walks of life.
Fantastic, smart, captivating, frustrating and so satisfying!
Fantastic read! Where do I begin? A close loved one was/is affected by addiction, so years ago I started reading blogs by opiate addicts--both active in their addictions and in recovery. I was trying to understand more about the experience of addiction itself and the recovery insights that survivors could share. I learned that addiction IS a disease, harm reduction helps keep more people alive to have a chance at recovery, and maintenance treatment is an important, valid, effective and "respectable" path to being a functional, happy, healthy person. I eventually stopped reading the blogs, but I am still fascinated by the topic.
Imagine my excitement when I found that an expert in addiction treatment wrote a novel about this! Addiction on Trial gives a deeper look into the larger world around an addict: family, relationships, medical treatment and the legal system. It's a fascinating thriller--and so frustrating (and real!) to see how addicts can be their own worst enemies, by trying to do what's "right" for themselves and other addicts. It's heartbreaking to see how a community will judge addicts, when it's a harder experience than any of us can imagine.
The characters are also so fascinating! Each one has their own motive, and they work perfectly together to form one cohesive mission. More like two sides at war, actually. If you have any interest in addiction, or you just enjoy legal or medical thrillers, this is a great read.
Riveting and Educational! Fantastic Read!
As a licensed addiction treatment professional I am always looking for information that can help educate the public about the issues of addiction and recovery. This book is the ideal balance of providing basic education on addiction side by side with understanding the human side. Dr. Kassels does this exceptionally well by blending them in a way that keeps the reader engaged and informed at the same time. This is a must read that should be in the arsenal of all treatment professionals!
I loved every aspect of this book and really it should …
Rarely would I give a book five stars and I have been meaning to review this book for months, I loved every aspect of this book and really it should be characterized as Literary Fiction because not only was I engaged and entertained, I was thoroughly educated as well. I heard the author today on NPR and his passion and his dedication reminded me that I needed to write this review. Without question it is a five star winner.
I am overwhelmed and appreciative of the many inquiries I have been receiving, so much so, I am compelled to give answers to the questions, “What is taking you so long and when will the next Shawn Marks Thriller be finished?” I am humbled by the interest in the sequel to Addiction on Trial, which is entitled, Lost to Addiction. But as we all know, once editors and publishers get hold of the manuscript, who knows what the title will be☺.
But that won’t affect the story line and for those of you who want a taste of the coming action, and without giving away anything to the readers who have not yet finished the first adventure of Shawn Marks, that egotistical but likable big shot Boston attorney, let me give you a peek through the window. The opening chapter of Lost to Addiction has Shawn Marks sitting at dinner with District Attorney Venla Hujanen at the French restaurant overlooking Somes Sound. Just as the conversation is about to fall into the crevasse of legal entanglements, with each struggling to ignore personal attraction and maintain appropriate professional etiquette between two adversarial attorneys, Marks get a phone call from shipping magnate George Kreening. You remember Mr. Kreening – he’s the one who allowed Marks to stay on his yacht in West Haven Harbor while defending Jimmy, the heroin addict from away, who was accused of murdering Annette. Apparently, Kreening’s son has found himself in a bit of trouble, to say the least – a dead roommate is never a good thing.
Okay, sorry I got sidetracked, but I am as anxious to get the sequel finished as you are to read it. And yes, that bombshell reporter Sally Jenkin may even return, along with the likes of Hanny! But I have some good reasons for the delay. As you know, I wrote Addiction on Trial to entertain while also educating about what addiction really is; to enthrall while sending a message of societal discrimination toward drug addicts; and to weave intrigue and suspense culminating in a riveting murder trial while relying on medical and legal truths. I am pleased to say, that I have accomplished my goals, and more so than I ever imagined. As a result I am being pulled me away from finishing the sequel. But if I sound like I am complaining, au contraire.
And if you think that the relentless New England blizzards this winter would allow me to nestle up next to a fire, while writing voraciously, I think these photos show a different perspective ☺
But on a more serious note, my worlds of doctor and author have both collided and merged. As you may know, there is an opiate (Heroin, OxyContin, etc.) epidemic raging across our country, most notably along the east coast. Our politicians are not responding in concert, as you may have read in my previous Blogs & Op-eds. My medical administrative responsibilities have increased significantly with the surge in demand for treatment, and the requests for my participation in educational and legislative matters have grown as well. This week, I will be in on the road for three days. First, I will have a meeting at a medical school to discuss how to incorporate Addiction on Trial into the general education of students; to help them understand at their embryonic stages of becoming doctors that addiction is the precursor to many diseases and societal ills. The following day I will be on the MBPN/NPR Radio Call-In Show along with a patient to discuss my book and more importantly the legislative budget proposals to cut certain funding for addiction treatment in Maine. From there I will travel to meet with students in Psychology courses at a local college to review the characters of my book and to discuss potential treatment strategies, as if the characters were real, which they are, at least in my mind, and based on thirty years of Addiction Medicine experiences. In May, I have been invited to speak to medical school deans and curriculum advisors at a meeting of the Coalition of Physician Education in Substance Use Disorders – “COPE”. I also appreciate the interest by book clubs and groups to meet with me in person and by Skype, and these interactions are always engaging and fun; so please let me know if you want to schedule an event.
But none of this would be possible without the tremendous support I have received from all of you who have read, enjoyed and embraced the messages of Addiction on Trial. It may take me a little longer than we all want to get the sequel on to bookshelves, but in the interim, I hope that I do not lose your passion for more of Shawn Marks, as he takes us on another adventure of murder and intrigue, passion and denial, and the “what-ifs” of life. A special thanks to all the readers who have written Amazon Reviews and my utmost appreciation for your spreading the word.
Please feel free to post comments and let me know what characters you definitely want back in the sequel, as it is not too late! And be sure to let me know what actor should play Shawn Marks in the movie ☺
