By Lauren Brande | Published 12/18/17
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You’re listening to Let’s Talk Drugs, a podcast produced by ProjectKnow.com (that’s project k-n-o-w dot com), a website that is dedicated to providing real-world drug information in simple language, because everyone should have access to the truth. If substance abuse or addiction has taken hold of your life or the life of someone you love, please reach out for help at so that you can get the help that you deserve.
My name is Lollie and in this series we’ve been talking with three different people who have very different perspectives on the current overdose crisis. Detective Nicole Lucas described the influence that this epidemic has had on law enforcement officers and first responders, as well as the work that law enforcement has been taking on to clean up the treatment industry and prevent abuse of patients. Dr. Stephen Grinstead discussed the impact that this crisis has had on U.S. healthcare, from rising insurance costs to prescribing practices, highlighting the benefits and risks of opioids’ medical origins.
In our last episode, we talked with Stephanie Muzzy, who has endured opioid addiction firsthand. She described her experiences with addiction, and shed light on the epidemic from the perspective of someone who has actually suffered under its weight, including the enormous emotional impact it can have, even on those who are not personally addicted.
For the final part of this series, I want to look at the many different ways that we can help. We all play a role in the reduction of this crisis, and there are simple actions that we can take every day to alleviate this epidemic. Detective Lucas, Dr. Grinstead, and Stephanie all had excellent advice for anyone who wants to help end this crisis, and there’s no better time to get started.
How Can I Help?
The struggle with addiction is complicated, but never hopeless. Recovery is a process, and many different people can play a role in that process. Stephanie struggled with addiction for years, doing things she never thought she would do because the disease of addiction is a disease of the body and brain. But, that’s not who she is. She is not her addiction. The help that Stephanie got during her darkest times saved her life.
Stephanie Muzzy: My life is so different today than it was 5 months ago. I’m able to view things with a different mind. I’ve had a lot of friends relapse since I’ve been out in Vegas and seeing them messed up on the drug, sometimes it’s a little triggering, it’s like, “Ooh I want to feel what they’re feeling,” but then I have the clarity in my mind to think it through and be like, “Do I really want to feel that?” Because I know that if I sniff that pill or shoot that heroin that 2 days from now everything in my apartment will be sold, I will be homeless, I will not have a job, I will not have my family, everything that I’ve worked so hard for will be gone.
They say it’s “play the tapes through,” which I never really understood what that meant but basically if you just, if you take a moment to think before you act and you think of all the terrible things you’ve been through, I know for me I don’t want to feel that stuff again. I don’t want to ever feel those feelings again and I don’t have to as long as I think before I do. If I could jump and say, “Yup, let’s go get some heroin,” then I’m giving up everything and I don’t want to give anything up. I still love the idea of the feeling of getting high and I will never be rid of that, but I do know the consequences outweigh the good feelings and I don’t want to have to deal with those consequences.
Thousands of other people deserve another chance at life, which is why everyone must pitch in to alleviate this epidemic. Lasting abstinence takes a community of support where everyone is involved.
One of the most important starting points is drug education. Past attempts at drug education, such as D.A.R.E., haven’t shown much effectiveness when it comes to reducing the rate of substance abuse.
Stephanie Muzzy: Health class when you’re a kid in 7th grade, they teach you about, I guess they mention drugs, maybe? I don’t even remember to be honest. I was part of the D.A.R.E. program as a kid, again I don’t remember actually talking about the drugs, I just remember the red t-shirts and going to the movies with my classmates being on the front page of the newspaper. I don’t remember ever being talked to about drugs.
I think that if I had, maybe health classes in school could have had someone come in who was a recovering drug addict like me and tell their story and let kids know how bad it gets and warn them ahead of time. So that they don’t have to go through it and experience it firsthand. I know that if someone maybe had come into my school when I was younger and told me all the horrible things that I would experience as a drug addict, I might have thought twice about taking that first Percocet.
I don’t think that people realize how bad it gets and I think that being able to spread the word and tell people, you’re looking forward to a life of misery if you do this, I think just the awareness would absolutely, at least make people think twice about it. I’m not saying we can cure addiction and make everyone be so scared they’ll never do anything ever, but, I do think that awareness and letting people know exactly how bad it gets would absolutely help people to consider maybe not taking that first pill or not smoking this or shooting that. I think that it’s just knowledge is power.
Dr. Grinstead echoed Stephanie’s point about knowledge and education, emphasizing that people who are taking prescription opioid painkillers take some time to read up on the associated risks.
Dr. Grinstead: I honestly believe knowledge is power but, like John Quincy Adams said a couple hundred years ago, “A little knowledge that acts is worth more than all the knowledge in the world that’s idle.” So, one of the things they can do is to start educating themselves. Consult with the professionals, consult with the experts, get an appointment, go online, connect with some of these organizations that are advocates that want to help people.
Educate, educate, educate. I’ve personally written a number of books on chronic pain and addiction, I’ve written hundreds of peer review articles on this. Some of them are up on your Recovery Brands site by the way. And the other thing is, if the person’s in dire need, places like ours, A Healing Place, call us, we do free consultations with people and a lot of programs do. A lot of providers will offer free consultations to see what are the next steps that are necessary.
Drug education must focus on the real risks of substance abuse, not the scare tactics. If you’d like to learn more about what was lacking in programs like D.A.R.E., or about creating an effective drug education program, check out our previous series, Alcohol and Pop Culture, specifically episode 4. Adequate drug education may help prevent this crisis from expanding into future generations.
Community and Family Involvement
Recovery doesn’t just take education, however. It takes a community. Opioid drugs like prescription painkillers and heroin not only affect pleasure and reward areas of the brain, they also have a significant impact on a brain chemical associated with social bonding: oxytocin.1 Oxytocin is often called “the love hormone” because it gets released when you hug, kiss, and have sex. It is a major part of developing trust, and it can combat depressive thoughts and feelings.
Opioids stimulate an increased release of oxytocin in the brain, tricking the brain into seeing heroin as a trusted loved one. People who are addicted to opioids may feel a deep emotional connection with the drugs, in a way using them as a substitute for human connection (or as a way to cope with a sense of being alone). Stephanie described this emotional connection with heroin.
Stephanie Muzzy: It’s like the heroin becomes a significant other. I got a Vivitrol shot before I came to treatment this time and Vivitrol basically blocks your body from being able to get high from opiates. And I was on the way to the doctor’s office and I was crying my eyes out because I knew I was about to go get this shot that would stop me from being able to do heroin. I felt like I was driving to a funeral. I felt like I had just lost the love of my life and I was never going to be able to feel that again. And I have not done heroin since then.
And I don’t want to say I mourned it, because that makes me sound like I’m glorifying it, but it is a part of your life at that point and when you can’t use it anymore, when you can’t feel it, the whole process, the whole lifestyle, it’s sick how much it takes over you and you literally feel like you just lost a family member or significant other or something. It’s kind of embarrassing to say that. I felt like I lost a boyfriend because I was going to get a shot that would stop me from being able to do heroin. It sounds sick but it’s reality.
Heroin is like the most abusive partner a person could ask for. Breaking the emotional bond with opioids requires a new sense of belonging in society. Building up social connections may help encourage an addicted person to turn away from substance abuse in favor of healthier relationships. Detective Nicole Lucas has been working with the addiction recovery community for years to build better relationships with law enforcement so that addicted individuals can actually be protected. She also had some excellent advice for community members to get involved in the fight to end this epidemic.
Nicole Lucas: People are afraid of what they don’t understand. We have a lot of barriers to break down. It has been the most incredible year, I don’t know if you’ve been on my Facebook page, but it shows these people, everybody, that law enforcement and a community that I think most people would have thought, “Oh, they’re never going to come to the police,” we’ve really bonded and I’ve been welcome with open arms, and it made so many things possible. Law enforcement cannot do their job as well without community involvement, and that’s the biggest thing. That is what my police department really embodies.
I also encourage, if there’s a sober home on your street, a lot of people get really scared and really upset and people want to move, or they want to avoid those people. If you have a nice neighborhood, people need to take ownership of that community. If you don’t help those residents feel like part of your community, then they’re not going to and they’re not going to take ownership of it. But, if like back in the day when a new family moved in on the street, people would take over cake or cookies, or welcome them to the neighborhood.
So, as scary as it is, I think that’s the way to go. Sober homes and halfway houses are not going anywhere. We need to welcome those people and let them know that, “as long as you’re doing the right thing, you’re okay with me.” We can’t choose our neighbors, and so I just think we really need to build those relationships to not be afraid of what we don’t understand or what we’re not familiar with.
There’s a street in Delray that has 4 sober homes on it, and the residents were obviously pretty nervous at first when that first started happening, and they were not sure really what to do. But, they accepted them, and they welcomed them, and it turned out wonderfully. They do block barbeques and all types of events. One gentleman that lived there prior to the start of that was a veteran, and there was a veteran that had moved into one of the sober homes. They could share experiences and feelings that other people don’t understand. So, you don’t even know, you could be helping somebody immensely by just making a relationship, saying hi and making them feel welcome in their community.
Having a sense of community is important to everyone. Humans are social creatures- yes, even the introverts. This means that we enjoy feeling like part of a group, whether that group is based around hobbies, political leaning, mutual interests, neighborhoods, or even something as straightforward as family. These groups encompass a sense of community engagement, and this can be an extremely powerful protective factor when it comes to addiction and relapse, even for family and loved ones.
Stephanie Muzzy: Ok, so, my mom, she came to a family program at one of the treatment centers that I went to and she met a bunch of other families—there were 10 families. 2 of those patients whose families came are now dead. They’ve overdosed and died. And the rest of them, most of us are still, we’re all alive but some of us are barely. I have 5 months sober, one of the other women, she’s struggling right now, she’s got warrants for her in two different states and I think that the families of the addict can help support one another.
Because I know for my mom, she thought she was the only one basically who was feeling this way and it may not stop people from doing drugs, it may not stop the addict, but the support for the family is just as important as it is for the addict because, like I said, addiction is a family disease and you can’t just expect it to go away. It doesn’t just affect one person, so I feel that if families were able to support one another, I think that that would spread more awareness and help people not give up on their family members.
I’m not saying enabling is good, but I think that being supportive and letting the addict know that you understand what they’re going through and not blaming them and not demeaning them, I think that that’s very, very important. Because I’ve had my mother’s support this whole time and I’m much more respective when she is supportive in a positive way. Just by being there. When I get, I don’t want to say, what’s the word I’m looking for?
When my mother comes at me and says, “Stop doing drugs, just stop doing it,” that’s not going to do anything for me. But if families can support each other and help spread the knowledge of what exactly addiction is and how their addict have affected their family I think that would help the addict feel more inclined to want to get sober because they’re not being looked at as an addict, they’re being looked at as a family member who needs help. And I think that that is a super important part, because you want to be able to feel like you can go to your family for help and I know my mom has always been there for me. When I’m struggling I know that I can go to my mother and she will help.
Not look down on me, not view me as a disgusting drug addict but as her daughter who needs help. That’s what I mean by families supporting one another. Just spreading the knowledge and their experience with each other. Just the same way that we spread our knowledge and experience with each other as addicts.
Being a part of a community also involves looking out for one another.
Nicole Lucas: Then, as far as the community, what the community could do, is: if you see something that you don’t think is right if there’s a sober home on your street, call local law enforcement. Kenny Chatman, the gentleman that the FBI arrested, was forcing female patients into prostitution. That happened for a long time, and sadly in our society a lot of people want to turn a blind eye or say, “Oh, someone else will call.” They don’t want to get involved. We need people to get involved. If you think something is wrong, call the police and let them check it out. We’d rather it be nothing, than something and nobody does anything.
Call the police if something is wrong, and don’t judge these people until they give you a reason to shut the door.
One of the most challenging things that a community, particularly friends and families, may face is walking the fine line between supporting a recovering person’s sobriety and enabling their addiction. Because addiction often starts with a repeating cycle of relapse and recovery, it can be difficult to balance the love felt for the individual with the distrust that accompanies the disease. Stephanie explained some of the ways that her own family worked through this mess, which helped her find her way into self-motivated abstinence.
Stephanie Muzzy: I was told that enabling is when you are helping an addict while they are using by either giving them money or allowing them to stay in your house and take advantage of you. But helping—my mom likes to call it facilitating—is when the addict is actually trying to get and stay sober and you help them with that.
You, for example, my mom, I needed stuff for work or an apartment. My mom wouldn’t just go out and buy it for me, she would send me stuff that I already have. That’s the difference between enabling and helping. You’re not going to go out of your way to make this drug addict feel comfortable, but you want to help them feel comfortable enough that they can succeed in staying sober.
I think that I’ve had a lot of friends who, while they’re using, their family just, they don’t care. They act as if it’s not going on and I don’t think that that’s going to help at all. I think that a family being aware and acknowledging the issues that the drug addict is going through, I think that is helpful. But I don’t think that a family pretending that it’s not going on and just allowing this to happen in their house is helpful at all.
There is a fine line between helping and enabling and it’s a personal thing but it’s pretty much it comes down to, if a person is doing the wrong thing and you are facilitating that, that’s enabling. And if the person is doing the right thing and trying to get help and trying to get better, that’s helping.
Supporting sobriety is an active practice for everyone involved. Trying to work through recovery alone can feel alienating, not to mention discouraging. Community and family support can make a huge difference when it comes to recovery and the risk of relapse, but ultimately recovery has to come from within the struggling person themselves. Recognizing when to get help can be a confusing process filled with feelings of defensiveness, loneliness, depression, and despair. It can also be a process of healing, learning, and growing.
Stephanie Muzzy: I always say better safe than sorry. I think that if you’re young and you’re partying you think it’s normal. I know when I was 22, drinking all day, every day, that was normal to me because that’s what all of the 22 year olds did. But, when you seek it out on your own or when you start to think about it all day every day, or you just don’t want to spend one sober moment, you may not even realize it but that’s when it starts to creep up on you. And if you have any feelings of, “Maybe I can’t stop,” or “Maybe I don’t want to stop,” I think that possibly, even listening to a podcast of someone who’s struggled, or looking up an AA meeting online, or going and seeking out a support group, or even just talking to your family physician—there’s so many things that you can do and if you question, “Am I a drug addict?”, “Am I an alcoholic?”, look into it. Do research, because if you’re questioning it, odds are it might be the issue and you might be able to stop it ahead of time.
The fact is that acknowledging an opioid addiction could save a life. Being a treatment professional, Dr. Grinstead has seen suffering individuals transform from feeling lost and hopeless in the throes of opioid dependence to finding safe, opioid-free pain management solutions. He wants people who are suffering under the weight of opioid addiction, especially those who are also coping with other disorders, to see that there is hope.
Dr. Grinstead: I really hate it when people get into that hopeless helpless state of mind, especially people with chronic pain. They can move into what I call the chronic pain trance. They feel hopeless, helpless, there’s no way out, they get depressed, and they may even feel suicidal. What I want to offer to people is there is hope. And I believe that freedom from suffering is every person’s right, but, it’s also their responsibility.
I have my own personal website—everything, all the information on it’s free—it’s freedomfromsufferingnow.com that has a lot of information. And it’s just amazing what’s out there if we just are open to looking and seeking and finding the right people. If you have chronic pain you want to not only meet with a pain specialist, but make sure that pain specialist has expertise or has a team mate who has expertise in substance use disorders and mental health disorders. Because they go very commonly together.
A lot of chronic pain patients we work with have a major unresolved trauma history, they have depression, they have anxiety, they have sleep disorders. Some of the even have eating disorders. They have a lot of other secondary problems that sabotage their substance use recovery, but they also sabotage their pain management. So, we need to reach out to the experts, the people that do this well, that do this effectively and get help. The biggest thing is you don’t have to do it alone. You have to do it yourself, but you never have to do it alone.
What I tell all my patients is I want you to move past surviving and back into thriving. And a lot of times that means you’ve got to resolve your grief and loss issues, you’ve got to have hope that recovery is possible and preferable, and you’ve got to be willing to do the footwork biologically, psychologically, socially, and spiritually to get there.
I really love that phrase: moving past surviving and into thriving. That progression can change lives. Unfortunately, there are many people looking to take advantage of vulnerable people. Detective Lucas has seen all kinds of terrible addiction treatment centers, from ones that abuse and feed their patients’ addictions, to people like Kenny Chatman (mentioned earlier by Detective Lucas), who was selling his patients as prostitutes, essentially holding them hostage by withholding food or medications.2 She gave cautionary advice to anyone looking into getting help for themselves or someone else.
Nicole Lucas: If there’s a family that has a loved one that has a substance abuse issue, they should really investigate where they’re sending that person for treatment. So, if you’re going to send somebody to a different town in another state that you’re not familiar with, I would insist on knowing the address of the place. Because a lot of time the only thing that you’re getting is the treatment center address, not the housing address.
You want to check with the local law enforcement agency–I don’t know about small towns, but I can talk about Delray. We have a portal on our website where people can go and check the crime stats and things like that in the area. So, what I would do is check the treatment center for calls for service: what kind of problems have they had there? Have they had overdoses there? Have they had disturbances there? Have they had reports of theft there? Check the home where you’re going to be living, look it up on the map–does it look like what their website says it’s going to look like? Probably doesn’t. What’s the call for service at that house? Has that house had 5 overdoses in it in the last month? [Then it’s] probably not the place for your family member.
Just go deeper, don’t just take what this beautiful façade is that they’re showing you on their website because every treatment center looks amazing online. Find out what it’s really like. So, that would be one thing. Also, not to take anything for free. That saying, “If it’s free, it’s for me,” NO. If it’s free, it’s not for you. That’s an indication, it’s a red flag that that’s a bad place. You should be buying your own airplane ticket to the treatment center, you should have your own insurance, they should not be buying you insurance. If you think something’s not right, something is not right. So that’s what I would say as far as looking in to a center.
Also, have that open dialogue with a loved one, even though it may be difficult to trust that person. If they get down there and they tell you something’s wrong, don’t just brush that off. Look into that: what is wrong, what can we do? Don’t just leave them down there. People, family members, say, “Well, I don’t have any money to come get them.” Then maybe you shouldn’t have sent them so far away, so think about that too. Do you have an exit strategy? Don’t let your family member come down here to south Florida if you have no way to get them back if something goes wrong.
Along the same lines of preparing for treatment by investigating any centers being considered, Dr. Grinstead had some great advice from the medical side of this epidemic, for both doctors and patients.
Dr. Grinstead: There needs to be some real good monitoring protocols set in place. A lot of these DEA and law enforcement war on drugs went to war on pain management and you would think a lot of the problem came from people scamming their doctors or stuff like that. But the majority of the problem comes from people diverting from warehouses, from pharmacies, not from the end line user. So they’re putting the target on the wrong end of it.
Although the end line users need to be monitored too, like my partner Dr. Cabaret, in his practice, he really goes through a strict monitoring process with people. Then he does baseline labs, does a urine drug analysis to see if they’re really taking what they say they’re taking, because a lot of people that go in are selling the medications because there’s a high street value for a lot of these medications—especially super opiates.
And, if the prescribers are not testing these people randomly and consistently to make sure that they’re actually using the product they’re supposed to. That’s another piece that gets overlooked. I mean, there’s a lot of moving pieces here. Document, document, document. Patient education though, is I think the most left out piece. Having a discussion and following it up with written highlights for the patients about the risks and benefits of these types of medications is absolutely crucial. And a lot of the better prescribers are absolutely doing that. There’s still some that are not.
But we have to have that open communication between the provider and the patient. And they need to know what they’re signing up for—we call it informed consent. And we need to give them handouts so to speak, because a lot of times when people are in a doctor’s visit, their stress levels are up, they’re upset, they’re anxious, and they don’t remember a lot of what the doctor’s telling them. So a lot of the good ones back it up in writing and hit the highlights for them. Or have an advice nurse that meets with them, or a tech that meets with them, a medical assistant. And education is the key I believe for most everything. Knowledge is power.
Above all, the most important thing is to stay informed and keep fighting. Addiction doesn’t have to be the end of someone’s life, it may be the door to appreciating everyday successes. Stephanie has been in out of treatment many times, but she always found her way back. Her life has changed in so many ways, and she has seen herself grow an incredible life for herself- one that she never could have imaged while she was in the throes of heroin addiction.
Stephanie Muzzy: Like I said, I’ve been in treatment 7 times. One time was only for a day so I don’t know if that counts, but it was still a treatment center that I went to and I had found Solutions Recovery, I went to because my insurance wouldn’t pay for in-network treatment anymore because I abused it, I had gone way too many times. So, Solutions was the only place and it was in Las Vegas and I was living in Florida at the time, and my mom was like, “You can not go to Las Vegas to get sober.” But I did, 3 times. And this last time, I came and showing your face in a treatment center for the third time after you’ve relapsed again and again, it’s kind of humbling.
Nobody judges you at all, but the feeling of coming back, it’s like you walk in with your tail between your legs, and this time I didn’t even know if I really planned on staying sober. I don’t want to say that I came in and said, “I’m never going to do drugs again,” because the reality is I still think about drugs sometimes. It’s never going to go away. But, the thing that’s kept me sober this time is I’ve gotten a life back.
A year ago I was living with an abusive boyfriend, getting drunk every single day, partying, no job, just being a bum. And now, I’m living in Las Vegas, I can see the Stratosphere out my bedroom window, which is amazing, I have an apartment, I have a great job at a bank, I have friends who care about me. My family is in my life, my mother and I talk, we Facetime every single day. I have money in the bank—I have money from last week’s paycheck in the bank, which is great.
I don’t wake up feeling like I need to, alright who has drugs today? How can I get money for drugs today? Is this going to be enough? What am I going to do tomorrow? I mean, that’s a full time job in itself and not having to do that is one of the perks of staying sober. I just wake up and I think of, ok I have to actually go to work and I have to earn a paycheck so I can pay my bills. And, I’m a dork, the feeling of paying my bills is the best feeling ever. I have struggled with my bills my whole life and luckily my mother has always been there to help me, but being able to pay all of the bills for the whole month by the 1st week of the month is awesome and it’s an awesome feeling. I have a calendar on my wall, I check it off every time I pay a bill and that check mark is a great feeling because I’ve never been able to do that before.
It’s just being able to live, I’m 31 years old, it’s about time I lived like this. Living like an adult at the age of 31 is a huge accomplishment for me, because just last year I was the complete opposite. And, having responsibilities is not always fun, but to me it is. I get to work for what I have and I have stuff to be proud of and I don’t have to lie to people, I don’t have to hide who I am or what I’m doing.
And, it’s an accomplishing feeling and I love this feeling and I don’t want to do anything to mess it up. I’ve had some opportunities in the past 5 months where I could have lost everything all at once and I’ve made the decision not to do that. And that alone is, the fact that I’ve pushed for 5 months again, that’s big for me, because I’ve actually done it on my own, and I feel great about it and I don’t want to give this up.
If society had given up on Stephanie, she might not be here today, living a fulfilling life without drugs. Solving this overdose epidemic isn’t going to be easy, but it is extremely important, and we all have a part to play. As a country, we need to work together to save thousands upon thousands of lives.
Whether you know someone caught in the addiction trap or not, this epidemic has affected you. We’ve explored how this crisis has affected law enforcement, medical practitioners, and people just like you who developed this disease due to numerous factors, many of which are well beyond their control. We cannot dismiss these overdose deaths as simply a product of poor choices. This epidemic is a product of our society, and we all must fight to end it.
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- Zanos, P., Georgiou, P., Weber, C., Robinson, F., Kouimtsidis, C., Niforooshan, R., & Bailey, A. (2017). Oxytocin and opioid addiction revisited: old drug, new applications. British Journal of Pharmacology.
- Mower, L. (2017). Notorious treatment center operator Chatman gets 27 years in prison.
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