addiction

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Wither Mental Health in the United States


We are by far the richest nation in the world. But we are 20th in the world in dealing with mental health issues. What countries do we trail? Pick pretty much any country in western Europe plus Japan and you start to get the idea. According to the Well Being Port, which is based on the well-being of any one country versus its mental health care. We are number 3 in well-being worldwide. That means that we rank 20th in mental health paints an even gloomier picture of our approach.

What is mental health? According to the report cited above, 1 in 5 Americans will encounter and mental health crisis at some time during their life. But among those figures, and one least written about is addiction which includes alcoholism. According to the World Population Review, the rate of alcoholism and addiction in the U.S. is among the highest in the world. I think this speaks loudly to our desire to take on these health issues directly. Again, countries such as Sweden, Austria and others have a much lower rate of these diseases. This is not a statistic anomaly, but a reality.

It is strange that anytime a Republican speak of mental health, it is only when there has been some sort of mass shooting. They are most certainly only trying to curry favor with the NRA and have no real empathy for those who suffer a mental illness.

The streets of the cities of the U.S. are littered with the mentally ill. There was a time when such people could be institutionalized until they were stabilized and of no danger to themselves or others. But in the 1970s Democrats in particular, viewed this as involuntary incarceration. If you care to wax philosophically about the, yes, that state is true. But is that good policy for those who suffer? It definitely is not. But also in the 1970s, there was a lack of psychiatric facilities for pure mental illness and a lack of facilities to treat those with drug and alcohol addiction. That has changed somewhat, although medical hospitals are want to treat the mentally ill past 2 weeks and almost uniformly refuse to provide in-patient care for drug and alcohol abuse.

This year, as our debt limit crisis is apparently avoided, Democrats refused to cut back on funding for mental health. But that is like saying, I will pay you 25 cents for your $1 product. Republicans on the other side, tried to reduce funding for those on public assistance. Well, news flash to the Republicans in denial, many of those on such assistance get government aid in the form of public assistance. The answer here is, if you want to reduce how much you pay into public assistance, put more into programs that directly assist those with mental health issues.

In a chapter of the Big Book of Alcoholics Anonymous, written over 80 years ago, Dr. Silkwood, at that time, described alcoholism as a health issue and not one of moral character. And yet still today we treat these individuals as pariahs of the general public. Many employers upon discovering an employee with drinking problems that lead to substandard work, fire such individuals rather than help them find assistance. They simply cite the lack of quality work as the reason for the firing. In truth, it is the combination of these factors. If a person get cancer, they cannot be summarily discharged because they miss so much work. There is a little known law by the public which is a portion of the American with Disabilities Act call the Reasonable Accommodation portion of the law which requires companies to work with people who present every sort of disability. Alcoholism and addiction are most definitely disabilities.

In short, we are failing all around to treat the most treatable illnesses today. Some mental illnesses, such as schizophrenia and psychosis, defy physicians best efforts to contain them. But for the most part, people with mental illnesses can be fully productive provided they receive proper mental health care. Personally, I have what is called, Post Traumatic Stress Disorder (PTSD). I have been on medications for over 40 years and there is little likelihood that I will ever fully recover. And yet, I lead a quiet but happy life. That is because via good health insurance and the Veterans Administration, I am fully cared for. But I believe I am in the minority who receives such care.

It is long overdue that our politicians, of any stripe, step up to the plate and put forth a rigorous plan that attacks the root forms of mental health in our country. We would do well to publicly fund treatment facilities for anyone who suffers any sort of mental illness. The result of this would be two-fold, they would get well and they would become healthy supporters of our economy. This might sound like a huge influx of cash by our federal government, which it would be, but it will reduce the costs of funding other portions of our public sector.

We each have a duty to help those in need. We cannot turn a blind eye to such problems and call ourselves good people. It is good to practice the help as you would wish to be helped thinking we must embrace.

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The True Opioid and Alcohol Crisis


Our country has taken to heart the “opioid crisis” as it should. But there is nothing new about this crisis as it has been around for at least 100 years. What they are really saying, but won’t, is that the prescription opioid has gotten out of control. People are prescribed an opioid based medication for pain relief and soon find themselves addicted. According to the U.S. Center for Disease Control there are approximately 11,000 opioid deaths per year. The notion here is that either doctors are over-prescribing opioid-based medications or that the addict is easily finding the same medications on the street.
But the real addiction crisis in America is alcoholism. According to the CDC approximately 88,000 people die annually from alcoholism. That’s an 8:1 ratio making alcoholism something greater than a crisis if we are going to apply that apelet to opioids. But I have heard nothing on the news or elsewhere that this crisis is getting much attention.

 
The problems with treating either addiction starts with the insurance companies. Most, if not all, insurance carriers provide very little assistance in this area. What they are willing to give is a 2-week in-patient treatment followed by out-patient treatment. There is one very simple problem to this approach. The alcoholic and the addict each need at least a 90-day in-patient program to stabilize them. And even that may not be enough as relapse among even those who have been in a 90-day program is high. Both the alcoholic and the addict tend to need long-term treatment, the length dependent entirely upon the individual.

 
The underlying issue for most, if not all, alcoholics and addicts, is unresolved serious issues earlier in their lives which leave them feeling “less than,” suffering from depression and/or a myriad of other psychiatric issues. But the way the insurance industry followed by the medical community, is to treat the symptom without even evaluating the patient for the real underlying issues.
I was recently hospitalized for a possible heart issue. I had a heart attack 20-years ago and am always considered an at-risk person. While in one of great Boston’s excellent hospitals, I struck up a conversation with the man in the other bed in my room. As it turned out he was an alcoholic. One of the consequences of untreated alcoholism is liver failure. As the liver fails fluid collects in the abdomen causing it to bulge. I found out that this man had had 3.5 liters of fluid removed but still had at least another 10 liters needing removal. He was given the medication Ativan because he was detoxing and without that medication he was likely to experience the delirium tremens, DTs, of withdrawal.

 
For reasons I could not be privy to, the hospital was only treating his liver issue, the fluid. Although he had a good insurance plan, the hospital, a fairly large one, did not have a detox facility and no program to treat an alcoholic on an in-patient basis. This brings us back to the money issue, insurance. Hospitals cannot survive giving the addict and alcoholic the treatment they desperately need and not get paid for it by the insurance companies.

 
The National Institute of Health estimates that there are more than 15 million alcoholics in the U.S. today. That comes to about 5% of the entire U.S. population. Other studies have suggested that upwards to 10% of the population suffers from alcoholism. Most, unfortunately, are untreated. And there is the crisis. What I said about alcoholism equally applies to addiction, be it medical based opioids or street drugs.
Right now the number of facilities that are prepared to properly treat the alcoholic or addict is low. The alcoholic or addict who applies to get into one of these facilities is usually greeted by the statement that there is no bed available. At that point the alcoholic gives up and goes back to drinking.

 
I suspect that in the era of modern medicine, there has never been a concerted effort to treat alcoholics and addicts. These people who suffer from an identified medical, and frequently a psychiatric, illness fall victim to the insurance industry which simply is not interested in dealing with alcoholics and addicts. The irony in all this is that the insurance companies end up paying for alcohol and drug induced ailments over long periods of time which is always very costly. These costs are easily reduced by proper treatment of alcoholics and addicts. The question is: when are the insurance companies going to come to this realization and when is the medical community going to start pushing back at the insurance companies to compel them to act in a more responsible manner?

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Florida’s New Welfare Law Disregards Simple Human Decency


For probably four thousand years, people have had to deal with addiction. Drug addiction and alcoholism are two of the most misunderstood issues in today’s society. And until the late 1930s people probably had good reason to believe those issues were of a moral nature. Then a man named William Wilson and his friend, Dr. Robert Silkworth, took a different view of the issue. Dr. Bob, as he was known, defined alcoholism, and by default addiction, as a medical issue and not a moral issue.

The start of both alcoholism and addiction is a matter of choice. But there is a marked difference between the alcoholic to be and others in taking their first drink. The alcoholic to be uses a drink as one would take aspirin for a headache, to him it is medication. The same is true for the addict to be. And this means that there is far more to this disease than meets the eye. It means that absent an historical view of the individual, it is easy to lay blame at the feet of the alcoholic or addict. But that is simply not the case.

Alcoholics and addicts share common traits: past traumas, untreated psychological issues, and sometimes other medical issues. Taking the last first, it is not uncommon for a person who is prescribed one of the opioid medications to become addicted through long-term use. This means that once the physical necessity has passed a psychological necessity kicks in. Where a well-grounded person will overcome this short-term addiction, the psychologically damaged person will not even try. Or if he does try, will give into temptation.

One of the most common expressions in use in our society today is: “After that, I need a drink!” Or, “If you had to put up with that, you’d need a drink too.” The simple fact is, there has never lived the person who truly “needed a drink.” What such people are seeking is an escape. Most of those people will not become alcoholics but some will. But our society does not challenge the idea of a drink of alcohol as ever being a necessity.

For the most part, alcoholism and drug addiction starts at a young age. In meetings of alcoholics anonymous the story of getting drunk in the early teen years is quite common. But even though nationally the drinking age is 21, underage drinking is not only common but accepted. That being true, the fault lies in our society’s mores. With society allowing teens to have parties with alcohol, they are not considering that the use of drugs in such parties becomes quite possible. It is well-known that alcohol and drug addiction usually starts at a young age. This means as a society, we can do something about it by become vigilant and not turning our heads to underage drinking.

Medical research has shown that the brain is not fully formed in females until about their 21st birthday and for males it is even later. Research at the University of Rochester suggests that full development for everyone is about the 25th year. (https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=3051)

It is also well documented that the use of alcohol and drugs retards the growth of the brain as-well-as a person’s psychological growth. Sadly, the incident of alcoholism and drug addiction by age 25 is extremely high relative to other age groups after the 25th year. But this same research has shown that the person who becomes the alcoholic or addict has his ability to choose against drinking or drugging taken away. Alcohol and drug use has gone from choice to necessity. This, by definition, puts it into the category of a medical disease.

This all brings me to the law the state of Florida just passed requiring drug screening of welfare applicants. If a person tests positive for a banned substance, they are denied access to welfare. The problem with this approach is that is simply exacerbates the situation. It seems the rationale behind such a law is to curb the use of illegal drugs by welfare applicants. But that of course ignores the fact that these are sick people who need to get well and not bad people who need to become good.

It is time we all become “our brother’s keeper.” I mean that in the sense that we as a society must become responsible for all those suffering from alcoholism, drug addiction and all forms of mental disease and disorder. A disease of the mind is difficult to both understand and treat but it is none the less a disease just as getting the flu, cancer, or malaria is. We do not stigmatize, for the most part, people who contract diseases in the rest of the body, why must we continue to stigmatize those with diseases centered in the brain?

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Getting Sober in Your 20s — Part 2


Alcoholism and addiction are the diseases that will tell you that you do not have them.  The irony of the problem is that recovery from the disease does not require any expensive medication.  Still, it is a doctor who will absolutely confirm the diagnosis but the treatment, abstinence, seems somehow unacceptable to the individual in its clutches.  The rationalization that cutting back or controlling is all that is needed comes to the forefront.  But that is the lie the disease whispers into the ear of the afflicted.

Our society, to this day, is uncomfortable with the idea of alcoholism and addiction.  The picture that gets painted is one of old men who are either one step away from homelessness or already there as being the hallmark of most alcoholics.  And while it is true that those nearing homelessness and in its grips so frequently do suffer from the disease, the reality is that they make up only a very small percentage of all alcoholics in society today.  There is no such thing as being too young to be an alcoholic or too smart.  Alcoholics are frequently high functioning fully employed individuals.  It crosses all races, religions, nationalities, educational and socio-economic states.  It is sneaky, insidious and deadly.

The following are the 20 questions developed by Johns Hopkins University to help the individual with the identification of alcoholism.  Take a minute to read through them and see how many apply to you.

1    Have you lost time from your work because of your drinking?
2    Is drinking making your home life unhappy?
3    Do you drink because you are shy with other people?
4    Is drinking affecting your reputation?
5    Have you ever felt remorse after drinking?
6    Have you gotten into financial difficulties as a result of drinking?
7    Do you turn to lower companions or environment when drinking?
8    Does your drinking make you careless of your family’s welfare?
9    Has your ambition decreased since drinking?
10    Do you want a drink the next morning?
11    Do you crave a drink at a definite time daily?
12    Does drinking cause you to have difficulty in sleeping?
13    Has your efficiency decreased since drinking?
14    Is drinking jeopardizing your job or business?
15    Do you drink to escape from worries or trouble?
16    Do you drink alone?
17    Have you ever had a complete loss of memory as a result of drinking?
18    Has your physician ever treated you for drinking?
19    Do you drink to build up your self-confidence?
20    Have you ever been to a hospital or institution on account of drinking?

And their conclusion is: If you have answered YES to any one of the questions, there is a definite warning that you may be an alcoholic.
If you have answered YES to any two, the chances are that you are an alcoholic.
If you have answered YES to three or more, you are definitely an alcoholic.

Please remember, the above is the conclusion of experts in the field of alcoholism and addiction.

Below are 5 video which were created by Alcoholics Anonymous.  In the videos you will hear from people under 30 who will tell you about their alcoholism, what it looked liked, what happened, and what they have done.

Young People’s Videos

1. On the Beach Flash Player
2. Alcoholics Anonymous Flash Player
3. Young People’s Animation VideoFlash Player
4. 25 and Under New Flash Player
5. A Group of People Just Like Me New Flash Player

If you have more questions about alcoholism and Alcoholics anonymous follow this link:

www.aa.org

You should also feel free to contact me.

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Are You Sober or Do You Just Think You Are?


During most of my adult life it never occurred to me that maybe I should be in Alcoholics Anonymous, and yet for over 13 years now I have been.  I did not get there via a detox, or an intervention.  I was not court ordered nor did it follow any incident after which I knew for a fact that I needed A.A.

What I had become expert at was denial of the obvious.  I was never a daily drinker.  I did lose one job because of drinking but otherwise I was fully functional.  No one ever suggested that I possibly had a drinking problem.  That was until July 3, 1998.  But I will get to that in a minute.

Until I joined the Army I was not a drinker nor had I ever gotten drunk.  I did love the taste of my father’s port sherry but I never stole any from him. I only took the sip offered and nothing more.  But from a young age when I first tasted it, I adored it.  I was in flight school at Fort Wolters Texas when I got drunk for the first time. I managed to drink myself into a blackout.  From then on, the next 30 years, I would drink for effect and that effect was to change how I was feeling.  I would binge.  And that is what my drinking career looked like.  I would drink for a while and then not drink for a while.  But I always drank as a means of self-medication.

On July 3, 1998 I was on the banks of the Charles River in Boston enjoying the day.  I had been sitting for a while with a friend talking and enjoying the day.  We got up to move on and after we had moved only a few feet I was overcome with the feeling that it was difficult to breathe.  My friend looked at me and told me I was ashen gray in color.  She offered to call an ambulance, suggesting it a very good idea.  I said I knew I could make it the short distance to Massachusetts General Hospital.  I made it but I was very fortunate.  It took every ounce of strength I had.  Once there it took the doctor examining me about 17 seconds to decide I was having a heart attack.  After he told me that he suggested I stop drinking and drugging.  I told him that I did not drink.  The truth was I had started drinking around 11 that day and had done a good deal of that.  I did not use drugs so that was not an issue.  But there it was.  Denial in the first degree.  It was not 24 hours later a cardiac surgeon had to do emergency surgery on me, that was a Saturday and a holiday, July 4.  He said I would not live if it was put off any longer.

Still, it was not until late October of that year that someone suggested I might want to try an A.A. meeting.  I did and the rest, as they say, is history.  My life truly sucked in October 1998 and I was certainly feeling the desperation for a change that I had no idea how to make.  I embraced the 12-step program because all my previous attempts to make things better had failed.  At that time I did not believe A.A. would actually help, nor did I believe I had a problem with alcohol, in spite of the fact that a certified physician had suggested that I did have a problem.

My life today is fabulous, in no small part due to my active participation in A.A. and my complete acceptance of its principles.  I have managed to turn around every thing that I viewed as negative.  I now view whether I had a drinking problem or not as being irrelevant.  I do know there is no down-side to not drinking, nor is there an up-side to taking a drink.  I am not going to mess with success.

The reason I am writing this is to hopefully get someone who reads it to do a self-assessment.  I have seen too many people struggle with the concept of whether or not they are an alcoholic only to die in the process.  Most recently I had a very dear friend die.  She was only 31 years old.  She was very athletically strong.  She was very smart, a Yale graduate.  She was a veteran having served as a Naval intelligence officer.  She came from a wealthy family so she did not want for money.  She had lots and lots of friends.  She also believed she had another drunk in her, but she was mistaken.  To look at her you would say, “no way she was an alcoholic.”  But she was.  Alcohol wanted her alone, and then it wanted her dead.  It got both.  The two pictures below are of her just before she died, January 6, 2012.

My point in bringing up someone who young is that age is irrelevant.  A person’s income, social status, education, and most other things are irrelevant.

People who do not have a drinking problem do not plan their next drink.  A person who does not have a drinking problem is unlikely to get a D.U.I.  A person who does not have a drinking problem does not lose family, friends, jobs, or anything else because they had a drink, or even a few drinks.  A person who does not have a drinking problem does not worry who sees them having a drink, nor do they hide their alcohol at home, nor do they lie about having a drink.  A person who does not have a drinking problem frequently has a problem remembering when they had their last drink.  A person who does not have a drinking problem does not see running out of beer or any other alcohol as a problem.

One of the biggest problems in any person’s life is their ability to deny the obvious.  People with alcohol problems are particularly good at it.  People with a drinking problem frequently try to shift blame for their own problems to other people, institutions, or things.  They are seldom interested in taking responsibility for their own actions.  They are someone who, when faced with a problem, decide they “need a drink.”  Whenever I hear someone say that, my ears perk up.  That is because I have the simple belief that no one “needs” a drink, ever, for any reason.  To the contrary, the well-adjusted, together person, wants to plow through the problem fully sober.  A drink only serves to muddle.

You do not have to drink every day to have a problem with alcohol.  You do not have to have been in jail as a result of drinking to have a problem.  You do not have to be homeless to have a problem.  Shortly after I stopped drinking I met a man who had a Harvard MBA, was a high-powered financier, and was getting ready to do some serious jail time which he admitted had been the result of his drinking.  Drinking never seems like a problem until it is.  And when it is denial comes to the rescue that permits the person to continue drinking.  Like any disease, untreated, it always gets worse.

I hope this makes an impression on someone who might be wondering about their drinking.  Feel free to contact me if you want more.  Better yet, go to an A.A. meeting, if only to gather information.  You have absolutely nothing to lose by doing so, and everything to gain.  If you do not know where meeting exist close to you, go to www.aa.org and you will find everything you need.