Tag Archives: Heroin Epidemic

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It has been quite a journey over the past several years trying to educate many members of the Legislature and the Governor of Maine as it relates to the benefits of Medication Assisted Treatment for Opioid Dependency. I would like to say that they have been as receptive as the Police, the Portland Chamber of Commerce, and many citizens - but unfortunately, I can not say that!

But I must commend Dr. Mary Dowd on a superlative piece, and what makes it so powerful is it could just as easily be titled, "Patients Do Matter"!!!  Listen to the Voices of Addiction.

We might be worn down, but when it comes to advocating for patients, never worn out. Hopefully some of our politicians will want to read my testimony to the Maine Health & Human Services Committee eleven months ago.

Maybe they might consider reading my book because Addiction Is On Trial in Maine.

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For the first time in U.S. history, the Surgeon General has sent letters to each and every physician warning them about the Opioid Epidemic.

Dr. Vivek Murthy is not only asking for changes in prescription practices, but also "asking clinicians to help us change how our country thinks about addiction."

For a more in-depth analysis of the role physicians play in this health crisis, please read my blog post, "Heroin Epidemic Reason #1: Blame the Doctors".

As evidenced by the Surgeon General's warning, we must all take steps to change how the country thinks about the disease of addiction.

To that end, I am donating all my author proceeds from my novel, Addiction on Trial, to addiction treatment centers, homeless shelters and academic endeavors that support the destigmatizing of addiction.

I hope you will consider buying a copy for yourself or to give it as a gift to anyone interested in changing hearts and minds about the disease of addiction.

Please also visit my Facebook page or Twitter account to learn which organizations have been identified as the beneficiaries of this ongoing fundraising campaign.

If you would like to recommend any additional organizations that would benefit from an author-proceeds fundraising campaign, or awareness-building social media posts, please send information to me through my Contact Page.

Below, please read about how Dr. Vivek has taken unprecedented steps by sending an official Surgeon General's warning to all doctors about opioids, which he calls 'the health crisis of our generation'.

Photo Surg GenI have included below a copy of the personal letter I received. I look forward to assisting the Surgeon General in his mission to destigmatize the disease of addiction!  Remember - "It Takes a Village" and "A Thousand Points of Light".

Surgeon General's Warning

I welcome your comments, questions and insights by either clicking "Leave a Reply" below, or by answering any of my Polls about the Heroin Epidemic!

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WLBZ2 Portland Maine from Steven Kassels on Vimeo.

Many thanks to Channel 2 WLBZ Portland for allowing me to explain some of the issues regarding the current Heroin/Opioid Epidemic - and don't think for a minute that it is only affecting Maine. In fact, it has become a worldwide issue, so maybe we should more appropriately be refer to it as a Heroin/Opioid Pandemic.

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Medical Thriller's Educational Value

Since my last blog when I boldly challenged whether a Murder Mystery can be Literary Fiction, I have been humbled by two more speaking invitations. I believe this further reinforces the premise that the term Literary Fiction is more expansive than commonly espoused.  Should a Medical Thriller’s Educational Value be judged solely upon a narrow definition or on the message it imparts?  Let’s remember that the term Literary Fiction is commonly used in the book-selling business to connote “serious fiction” with arbitrarily applied criteria such as having different types of book covers, titles or types of book formatting. Wow! How about determining literary merit based on messages of social commentary, political criticism, or exploring some part of the human condition.  Why can’t a novel entertain and excite while carrying a serious message?

I have been invited to use my book as a foundation to explore the educational value of using Fiction with a Message to expand the views of graduate students studying Communication and students in the School of Public Health.  Over the next several months I will have the honor and privilege to make presentations at the following academic institutions:

  • University of Massachusetts School of Public Health & Health Sciences, Amherst, MA:  “Addiction as a Disease Model” -  Presentation/Discussion,  December 7, 2015 
  • Philadelphia College of Osteopathic Medicine, Georgia Campus, Suwanee, GA: “Destigmatizing Addiction” - Presentation/Discussion; December 10, 2015
  •  University of Amsterdam,  Graduate School of Communication, Amsterdam, NL,   "The Use of Fiction as a Vehicle to Communicate & Educate" - Presentation& Discussion;  March, 2016 (date TBD)

As exciting as all this sounds, it is no more important than continuing to use Addiction on Trial  to emphasize the devastating heroin/opioid epidemic still gripping our country. There need not be limits to a Medical Thriller's Educational Value.  I welcome invitations to participate in book clubs gatherings (large and small) to discuss the characters, the messaging, the struggles of addiction and the duplicitous approach of society’s response.  A recent article is a must read: In Heroin Crisis, White Families Seek Gentler War on Drugs.

Thank you to all my followers who continue to give me inspiration to speak and to write!

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Welcome back to Ten Reasons for the Heroin Epidemic. This is the second and final primer to lay the foundation before launching into the ten reasons we currently have a heroin epidemic raging across our country.  But before I proceed, I hope you all will read the recent article published in the New York Times on April 17, 2015 entitled, Serving All Your Heroin Needs. Here are two quotes that are extremely revealing:

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“… selling heroin across the United States resembles pizza delivery.”

“… a new home for heroin is in rural and suburban Middle America …”

To better understand why pizza delivery of heroin works and how it found its way into suburban and rural America, there are three related terms that are essential to understand:

  • Tolerance
  • Dependency
  • Addiction

Tolerance refers to not getting as much bang for the buck.  In medical terms, it is the body’s adapting to a drug which then necessitates consuming more of the drug to achieve the same effect.

Dependency refers to the state of having symptoms in the absence of the drug. Examples of withdrawal symptoms are the “shakes” after a heavy drinker stops drinking; or the chills, nausea, vomiting, abdominal cramping, etc. when a heroin addict is deprived of his/her next “fix”.

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Addiction is the drug seeking behavior of an individual.  However, a person who is dependent may not necessarily be addicted.  Remembering from the last blog that the disease of addiction has bio-psycho-social aspects, a person may become dependent but not have the components of addiction.

For example, if sweet Aunt Tillie ends up in the hospital with severe intractable pain from a tumor pressing on her spinal column, she may be given an opiate such as morphine to reduce her pain until the tumor size can be minimized by radiation or chemotherapy or surgically removed.  A few weeks of medication may be needed and during that time Aunt Tillie develops tolerance and dependency to morphine.  After the tumor size is reduced and the pressure on the spinal nerves is diminished, the frequency and amount of morphine is gradually decreased to avoid withdrawal symptoms. After a week or so, Aunt Tillie will no longer require an opiate to eliminate her pain and will be showing no signs of withdrawal. After she is discharged home, she is happy taking an occasional non-narcotic pain medication like Tylenol or Ibuprofen. But how about the person who goes home and has some bio, psycho and/or social components of the disease of addiction. He/she may very well start looking for that euphoric “high” and start seeking drugs.  That is the essential difference between dependency and addiction!

We are now ready to delve into the 10 reasons we have a heroin epidemic. Next blog we will focus on the injudicious prescribing of opiates by doctors as reason #1. But first let’s get a look at Jimmy, Annette and Travis – they are dependent and also addicted.

Annette laid out several lines of cocaine, one definitively larger than the other two. Everyone knew the “fat line,” as they jokingly called it, was hers. Travis prepared the portions of heroin, which had already been processed to a fine powder for snorting. They were now ready to snort their speedballs, a combination of heroin and cocaine. Annette much preferred an amphetamine rush, so her drug cocktail was heavily weighted with the cocaine powder and contained only a small amount of heroin. The reverse was true for the boys….

Within an hour after the speedball, Annette craved more cocaine, but she wanted to set an example for Travis, who undoubtedly would soon be itching for more heroin. Her cocaine buzz was starting to dissipate and numbing herself with alcohol served as a distraction to the hollow depressed feeling as a result of the depleted levels of the chemical dopamine in her brain. Dopamine, a neurotransmitter, is an essential naturally occurring compound that is required to stimulate the portion of the brain that elicits the feeling of pleasure. The greater the frequency and amount of cocaine used, the greater the amount of dopamine is depleted. This results in longer lag times for the brain to produce sufficient quantities of dopamine and therefore progressively longer periods of pleasure deprivation and sadness. This vicious cycle encourages more use, which only partially rectifies the effects of the depleted dopamine stores. Annette did not need a course in neurochemistry to understand that doing more and more lines was a never-ending journey.