Addiction and Recovery

By Bob Gaydos

Summertime and alcohol — a risky combination for teens.

Although alcohol abuse is a daily issue in this country, April has been specifically designated as Alcohol Awareness Month by the National Council on Alcoholism and Drug Dependence to put special emphasis on the problem, especially as it relates to under-age drinkers.

The legal drinking age may be 21, but underage drinking is defined by the Centers for Disease Control and Prevention as “a major public health problem.”

According to the CDC, according to several surveys, although use is down a bit in the past year, alcohol is still the most commonly used and abused drug among youth in the United States and is responsible for some 4,000 annual deaths among underage youth. According to the CDC, even though drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11 percent of all alcohol consumed in the United States. Much of that is binge drinking (five or more drinks on one occasion for males, four for females). And of course, drinking alcohol often leads to use of other mood-altering substances.

The government conducts regular surveys of teenagers to gauge alcohol use and other risky behavior. The CDC notes that the 2019 Youth Risk Behavior Survey (the most recent available one) found that among high school students, during the past 30 days:

— 29 percent drank alcohol

— 14 percent binge drank

— 5 percent of drivers drove after drinking alcohol.

— 17 percent rode with a driver who had been drinking alcohol.

Along with those deaths, there are tens of thousands of alcohol-related emergency room visits by teenagers each year. Perhaps not surprisingly, but worth pointing out, the CDC notes that “studies show a relationship between underage drinking behaviors and the drinking behaviors of adult relatives, adults in the same household, and adults in the same community and state.” One example cited: “A 5 percent increase in binge drinking among adults in a community is associated with a 12 percent increase in the chance of underage drinking.” Something for communities concerned about underage drinking to consider.

But it’s not all on the adults. Parental indifference to their children’s behavior and the friends they choose or ignorance of the harm alcohol can do to young minds and bodies are certainly key factors in the way many teenagers spend their free time. But teens aren’t wholly clueless about their behavior. In fact, it’s not unthinkable that a teenager whose social life revolves around alcohol has asked himself or herself if, just maybe, drinking is becoming a problem.

What follows may help answer that question. For teens wondering about their use of alcohol or other drugs, the National Council on Alcoholism and Drug Dependence has prepared a self-assessment test to help determine if they — or someone they know — is at risk and in need of help.

This test is for teens. Read each question carefully and be honest. Consider your actions over the past 12 months. Answer yes or no and be sure to answer every question.

NCADD Self-Test for Teenagers:

1. Do you use alcohol or other drugs to build self-confidence?
Yes   No
2. Do you ever drink or get high immediately after you have a problem at home or at school?
Yes   No
3. Have you ever missed school due to alcohol or other drugs?
Yes   No
4. Does it bother you if someone says that you use too much alcohol or other drugs?
Yes   No
5. Have you started hanging out with a heavy drinking or drug using crowd?
Yes   No
6. Are alcohol and/or other drugs affecting your reputation?
Yes   No
7. Do you feel guilty or bummed out after using alcohol or other drugs?
Yes   No
8. Do you feel more at ease on a date when drinking or using other drugs?
Yes   No
9. Have you gotten into trouble at home for using alcohol or other drugs?
Yes   No
10. Do you borrow money or “do without” other things to buy alcohol and other drugs?
Yes   No
11. Do you feel a sense of power when you use alcohol or other drugs?
Yes   No
12. Have you lost friends since you started using alcohol or other drugs?
Yes   No
13. Do your friends use “less” alcohol and/or other drugs than you do?
Yes   No
14. Do you drink or use other drugs until your supply is all gone?
Yes   No
15. Do you ever wake up and wonder what happened the night before?
Yes   No
16. Have you ever been busted or hospitalized due to alcohol or use of illicit drugs?
Yes   No
17. Do you “turn off” any studies or lectures about alcohol or illicit drug use?
Yes   No

18. Do you think you have a problem with alcohol or other drugs?                                                                                Yes   No
19. Has there ever been someone in your family with a drinking or other drug problem?                                                                 Yes   No
20. Could you have a problem with alcohol or other drugs?
Yes   No

The results

Number of Yes answers

Zero-2: May not be an immediate problem. Continue to monitor.

3-5: You may be at risk for developing alcoholism and/or drug dependence.  You should consider arranging a personal meeting with a professional who has experience in the evaluation of alcohol and drug problems.

More than 5: You should seek professional help. You may have a serious level of alcohol and/or drug related problems requiring immediate attention and possible treatment.

There are, of course, ongoing efforts to reduce underage drinking, including stricter enforcement of the law, advertising campaigns on the dangers of alcohol abuse by teens and school and community-based informational and educational classes. These are all helpful, but a bit of old-fashioned, honest, self-assessment may be a teenager’s best defense.

More information:

https://ncadd.org

http://www.cdc.gov/alcohol/index.htm

A double dose of danger

Energy drinks, beverages that are loaded with caffeine, other plant-based stimulants, simple sugars, and other additives are popular among young people. The CDC says they are regularly consumed by 31 percent of 12- to 17-year-olds and 34 percent of 18- to 24-year-olds. When not abused, they may seem comparatively harmless, but they are also often combined with alcohol, resulting in a cocktail with potentially serious consequences.

According to the CDC: When alcoholic beverages are mixed with energy drinks, the caffeine in these drinks can mask the depressant effects of alcohol. At the same time, caffeine has no effect on the metabolism of alcohol by the liver and thus does not reduce breath alcohol concentrations or reduce the risk of alcohol-attributable harms.
Drinkers who consume alcohol mixed with energy drinks are three times more likely to binge drink (based on breath alcohol levels) than drinkers who do not report mixing alcohol with energy drinks.
Drinkers who consume alcohol with energy drinks are about twice as likely as drinkers who do not report mixing alcohol with energy drinks to report being taken advantage of sexually, to report taking advantage of someone else sexually, and to report riding with a driver who was under the influence of alcohol.

rjgaydos@gmail.com

Bob Gaydos is writer-in-residence at zestoforange.com.

Addiction and Recovery

By Bob Gaydos

Free time and alcohol — a risky combination for teens.

Summertime is fast approaching. It can be a fun time for teenagers. For starters, there’s no school for most of them. Even if they’ve got a job, and, Covid or no, there’s plenty of time to hang out with friends. Go to the beach. Parties.

But lots of free time and limited responsibilities can also come with risks, especially if the fun often revolves around drinking. The legal drinking age may be 21 in this country, but underage drinking is still defined by the Centers for Disease Control and Prevention as “a major public health problem.”

The CDC, monitoring several different surveys, says alcohol is the most commonly used and abused drug among youth in the United States and is responsible for some 4,000 annual deaths among underage youth. According to the CDC, even though drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11 percent of all alcohol consumed in the United States. Much of that is binge drinking (five or more drinks on one occasion for males, four for females).

The government conducts regular surveys of teenagers to gauge alcohol use and other risky behavior. The CDC notes that the 2019 Youth Risk Behavior Survey (the most recent one) found that among high school students, during the past 30 days:

— 29 percent drank alcohol 

— 14 percent binge drank 

— 5 percent of drivers drove after drinking alcohol.

— 17 percent rode with a driver who had been drinking alcohol.

Along with those deaths, there are tens of thousands of alcohol-related emergency room visits by teenagers each year. Perhaps not surprisingly, but worth pointing out, the CDC notes that “studies show a relationship between underage drinking behaviors and the drinking behaviors of adult relatives, adults in the same household, and adults in the same community and state.” One example cited: “A 5 percent increase in binge drinking among adults in a community is associated with a 12 percent increase in the chance of underage drinking.” And drinking often leads to other risky behaviors. Something for communities concerned about underage drinking to consider.

But it’s not all on the adults. Parental indifference to their children’s behavior and the friends they choose or ignorance of the harm alcohol can do to young minds and bodies are certainly key factors in the way many teenagers spend their free time. But teens aren’t wholly clueless about their behavior. In fact, it’s not unthinkable that a teenager whose social life revolves around alcohol has asked himself or herself if, just maybe, drinking is becoming a problem. 

What follows may help answer that question. For teens wondering about their use of alcohol or other drugs, the National Council on Alcoholism and Drug Dependence has prepared a self-assessment test to help determine if they — or someone they know — is at risk and in need of help.

Remember, this test is for teens. Read each question carefully and be honest. Consider your actions over the past 12 months. Answer yes or no and be sure to answer every question. 

A Self-Test for Teenagers

Do you use alcohol or other drugs to feel more self-confident, more sociable, or more powerful?

YES NO

Do you ever drink or get high immediately after you have a problem at home or at school?

YES NO

Have you lost friends because of your alcohol or drug use, or started hanging out with a heavy drinking or drug-using crowd?

YES NO

Do you feel guilty or bummed out after using alcohol or other drugs, or ever wake up and wonder what happened the night before?

YES NO

Have you gotten into trouble at home or school, missed school, or been busted or hospitalized because of alcohol or other drugs?

YES NO

Do your friends use “less” alcohol and/or other drugs than you, or do you consume alcohol or other drugs until your supply is all gone?

YES NO

Do you think you have a problem with alcohol or other drugs?

YES NO

The NCADD states: “The results of this self-test are not intended to constitute a diagnosis of alcohol or drug dependence and should be used solely as a guide to understanding your alcohol and drug use and the potential health issues involved with it. The information provided here cannot substitute for a full evaluation by a health professional.”

That’s their disclaimer. But obviously, the more “yes” answers, the more cause for concern. This is not a test to cheat on.

More information:

https://ncadd.org

http://www.cdc.gov/alcohol/index.htm

Bob Gaydos is a freelance writer and retired award-winning journalist.

rjgaydos@gmail.com

By Bob Gaydos

The Arecibo Observatory in Puertu Rico is being decommissioned.

        While states were counting and recounting votes to keep proving that Joe Biden convincingly won the 2020 presidential election, there were three significant scientific events the past week. This is a brief look at all three. It is offered as a kind of public service, since, if there’s one thing the last four years have demonstrated, it’s that many Americans have a tenuous, at best, relationship with science.

1. Atlas shrugged. Dr. Scott Atlas, the quack White House coronavirus adviser, told Fox News viewers to ignore the advice of public health experts who warned Americans to avoid indoor family gatherings this Thanksgiving because the virus was spiking again in America. Atlas is a professor of neuroradiology with no background in public health. Not only did he tell American families to gather together for the holidays, he said it was for the good of their elderly relatives, those most susceptible to being seriously impacted by the virus. He said: “This kind of isolation advice is one of the unspoken tragedies of the elderly who are now being told don’t see your family at Thanksgiving. For many people, this is their final Thanksgiving, believe it or not. What are we doing here?” In other words, hey, they’re probably gonna die soon anyway, let them eat turkey on the way out. Never mind that gramps might be planning on a few more Thanksgivings. Callous doesn’t even cover this attitude. Atlas also says masks don’t protect against the virus and is a fan of so-called “herd immunity” — let the youngest and strongest prevail. The doc’s Stanford colleagues disagreed with his prescription, as did many members of the White House task force and pretty much every public health expert, all of whom were shocked at his casual disregard for older Americans. Of course, this anti-science attitude is what got him named to the Trump task force in the first place. Only the best.
2. The CDC spoke up. Basically, it said do the opposite of what Atlas said. This is significant because, for much of the pandemic, the Centers for Disease Control, which should have been leading the effort to control the spread of the virus, has been muzzled by the Trump Administration. Here’s what the agency said: “As cases continue to increase rapidly across the United States, the safest way to celebrate Thanksgiving is to celebrate at home with the people you live with. Gatherings with family and friends who do not live with you can increase the chances of getting or spreading COVID-19 or the flu. Travel may increase your chance of getting and spreading COVID-19. Postponing travel and staying home is the best way to protect yourself and others this year.” This is not necessarily what you want to hear, but it’s short and to-the-point science with Covid-related deaths approaching 250,000 in this country. 
3. Arecibo went silent. Oh no, what will Jodie Foster do? The famed radio observatory in Puerto Rico, which was featured in the movie, Contact, has suffered damage to two major cables that suspend the platform over the dish. Engineers for the National Science Foundation say it is not reparable because of the danger to the people who work there. Scientist said they should be able to preserve the visitors center and a couple of other scientific programs at the site, but the telescope, which has produced many scientific discoveries over nearly six decades, will be decommissioned. This is a major loss not only to NASA, but to the promotion and appreciation of science in general. That’s because Arecibo, which was vital to research in radio astronomy, atmospheric science, and radar astronomy, also was involved in the search for extraterrestrial intelligence (SETI) programs. This is one area of science in which Americans actually demonstrates an interest, even if it is often based on science fiction. Its role in the search for ET gained Arecibo prominence and popularity with the general public through movies and TV shows. The observatory was featured in the James Bond thriller, GoldenEye, the sci-fi horror flick, Species, and the afore-mentioned Contact. The popular film was based on Carl Sagan’s wonderful novel of the same name. The observatory was also featured on TV in the X-Files episode “Little Green Men.” In the movie, Contact, Foster’s character, Ellie Arroway, gives up a teaching position at Harvard University to take a seat at Arecibo’s radio telescope. Why? From the movie: Her supervisor says, “Dr. Arroway will be spending her precious telescope time listening for … uh … listening for …”  Ellie Arroway replies: “Little green men.” Precisely. We get it. They’re out there. Basically, Arecibo is a movie star and we miss movie stars when they leave us. The difference here is that this star shone even brighter in real life. Maybe we can scrap Trump’s Space Farce for a new set of space ears.

rjgaydos@gmail.com

Bob Gaydos is writer-in-residence at zestoforange.com.

My sister, Ann Bradford Morrison, 1952-2010

By Emily Theroux

For me, May Day will forever be a yawning chasm of unmet expectations, a muffled cry for help I never heard.

On one side of the precipice is a younger me, stretching my arms across the open space, hoping not to fall over the brink. On the other side is my sister Ann at 21, barreling straight toward me in her sky-blue Jeep, her bags packed with elaborate stripper gowns and sequined G-strings. Tucked in a zippered side compartment of her make-up case are two pairs of false eyelashes and a vial of Valiums, her drug of choice for that particular decade.

I call her name, terrified she won’t stop in time. “Turn back!” I cry. “It’s never too late. You can start over.”

She waves at me, manic, artificially cheerful. Her mouth is moving but I can’t hear the words. Instead of stopping, she accelerates. I cover my eyes with my quaking hands, plagued by a tremor of kinship to her plight. I hear the screech of metal, but the anticipated crash never follows. Opening my eyes, I find myself in bed. I see the quilts, tangled from night sweats, thrashed to the floor. I must have been napping, just as I was the day the phone call came, three years ago today, from Tampa.

Once again, it’s Saturday, May 1, 2010, at 5:46 p.m., one agonizing moment trapped for eternity inside the cultured pearl ring that is Ann’s talisman, the one I thought I’d kept but can’t find anywhere. I awake from the dream of everything that might have been, but never from the nightmare. My sister is gone, her indefatigable life force reduced to an urn of ashes on my mantel. Whatever I once foolishly imagined was salvageable is lost to the brutal, inexorable forward slog of time.

A sudden death is always the hardest kind to comprehend, to assimilate. One day, I was on the phone, long-distance to Tampa, just as I had been three or four times a week since my sister had moved there from upstate New York six years earlier. The next day, the phone jangled again, jarring me awake.  I heard the  familiar voice of Ann’s partner, Paul, uttering three dreadful and unfathomable words: “Ann is dead.”

I couldn’t process it; I didn’t believe him, and I told him so. I had just talked to her, and everything was fine. She was writing her new novel, begun just two weeks earlier. She wasn’t suicidal and she wasn’t ill. She was only 57 years old.

Paul had very few details to impart to me. When he left for work that morning, Ann was awake and getting ready to begin her very circumscribed day. (Over the years, she had become agoraphobic and rarely left their small apartment. Most days, she sat in her recliner all day with her laptop and a glass of white wine, chain-smoking as she wrote.) Paul tried to call her several times throughout the day, but she never picked up. That was unlike her, and Paul grew worried, but he worked as a security guard and he couldn’t clock out early.

When he got home at 4:30, he found Ann in their bed, lifeless and very cold. The medical examiner was there, Paul was telling me. I could barely hear him for the dull roaring in my head, as if I were at Folly Beach again, where our Charleston cousins took us as children, holding a conch shell against my ear.

It appeared that Ann had died some time in the morning. The police had found half-empty pill bottles on her nightstand, but that wasn’t unusual. Ann spent the latter part of her life in chronic pain from herniated discs that developed years after she had competed as a bodybuilder.  Nothing in her life was done in half-measures. She “lifted heavy,” right along with the men, and had bulging muscles throughout her thirties.

Ann lived her life in an extreme fashion and paid dearly for her choices farther down the road.

We wouldn’t know for weeks exactly what had happened to her, not until the toxicology report arrived — although I already realized that if she hadn’t had a heart attack or an aneurysm (which I knew were unlikely because she was found in her bed, under the covers), it must have been the pain pills.

Ann’s body lay in the morgue that first night, awaiting autopsy. I couldn’t bear the thought of her in that place. She was two years younger than me. I was her protector, and often, her enabler; like my mother before me, I took her in when she had nowhere else to go. I couldn’t think rationally; what if she was lonely or afraid or needed a blanket?

It dawned on me that I would never talk to her again; I couldn’t ask her any of the unanswered questions that such a death inevitably leaves in its wake. I listened frantically to my voice mail; the only tangible remnant of her, if you can call it that, is the recording of a single pathetic call made late at night when she was so high, I couldn’t understand what she had been trying to tell me. She had needed me, and I wasn’t there to help her — neither that night nor the day she died.

When the medical examiner’s report finally arrived weeks later, the results were stark and unavoidable. Ann had died from a drug overdose — a combination of three prescription pain medications and a cough suppressant.  “Accident (prescription drug abuse)” was listed on the report as the manner of death.

My tragic, flawed, beautiful sister had attached four transparent, 50-microgram fentanyl patches to her skin at various points on her torso.

The sheer heft of the grief that followed, its ponderous weight on my chest — as if a powerful raptor were perched on my sternum, clutching my flesh, squeezing my lungs together — astounded me. There was simply no remedy for it, nowhere to flee.

But one thing gradually came into focus at the periphery of that pervasive fog: I needed to understand what combination of circumstances made it possible for my sister to procure a substance as potentially deadly as fentanyl, which I knew she’d never been prescribed before. A strong opioid originally developed as a surgical anesthetic, fentanyl is 100 times more potent than morphine and “very easy to overdose on,” according to a Toronto drug program coordinator, particularly when more than one patch at a time is used.

My sister had always been an expert manipulator. She started drinking straight vodka at 15, filching it at first from my parents’ liquor cabinet and later persuading an 18-year-old friend to buy it for her. She stowed the bottles in her bedroom closet with a hoard of  emergency “puke bags.”

Within a year, Ann graduated to street drugs — heading to Rochester’s Midtown Plaza in search of a dealer known as “Frog,” who was rumored to lurk in the mall’s underground parking garage. This punk-ass kid sold her an ample supply of “black beauties,” an amphetamine that had my erstwhile A-student sibling speeding her brains out for three days and then crashing for the next two, a devastating routine that caused Ann to flunk out of the eleventh grade and led my poor, clueless parents to surmise that she was “manic-depressive.”

By this time, Ann had also become a proficient “doctor shopper.” By 17, she could talk circles around a physician three times her age with a prescription pad in his hand. She consumed quantities of sedatives, speed, opioids, and muscle relaxants that would have flattened a horse.

Once, during an overnight hospitalization after Ann swallowed six Quaaludes, the emergency room doctors were astonished when she emerged from a coma they had predicted she wouldn’t survive. My mother, jaded by a decade of Ann’s escapades, shocked the chief resident when she deadpanned, “It’s the God’s honest truth: You couldn’t kill her.” Sadly, I believed from then on that Mama’s pronouncement must have been true — until the day it happened.

The fact that Ann stayed alive as long as she did, I realized later, was not so much a miracle as a one-off, an aberration, a fluke of cosmic proportions.

According to a November 2011 study of prescription painkiller overdose deaths released by the Centers for Diseases Control and Prevention, Ann ranked in every single parameter defining people most at risk for overdosing on opioids:

• People who obtain multiple controlled substance prescriptions from multiple providers — a practice known as “doctor shopping”
• People who take high daily dosages of prescription painkillers and those who misuse multiple abuse-prone prescription drugs
• Low-income people and those living in rural areas
• People on Medicaid (who are prescribed painkillers at twice the rate of non-Medicaid patients and are at six times the risk of prescription painkiller overdose)
• People with mental illness and those with a history of substance abuse

The only endangered demographic that Ann didn’t belong to was rural residents.

I knew several months before Ann’s death that when the Medicaid doctor who prescribed her pain meds finally balked at her request for an increased dosage, Ann “fired” him and lit out for a local pain clinic. Earlier, she had continued to frequent the doctor while supplementing her “stash” with prescription painkillers supplied by illegal Internet “pharmacies,” which sold controlled substances to customers who lacked valid prescriptions.

Illicit “pain clinics” soon began to spring up, taking advantage of lax state regulations, particularly in and around Houston, Los Angeles and South Florida. Addicts and legitimate pain sufferers alike flocked to these locales to stock up on their scrips of choice, arriving by the busload. (Ann, I should add, was a card-carrying member of both groups; plagued by chronic, unrelenting back pain and unable to afford surgery, yet also hooked on the prescribed remedy for it.)

The Obama administration’s first National Drug Control Strategy for reducing drug use and its consequences, published in 2010, included initiatives to help states address doctor shopping and “pill mills,” drive illegal Internet pharmacies out of business, and crack down on “rogue pain clinics” that failed to follow appropriate prescription practices.

But coordinated efforts to root out the criminals, monitor addicts, and expand addiction treatment services came too late to help my sister. A year after she died, Florida state lawmakers finally passed legislation designed to derail “the Oxy Express.” By that time, according to state attorney general Pam Bondi, her state had become “the epicenter for pill mills in the nation, and prescription drug overdoses cost at least seven Floridians’ lives per day.” In 2012, two years after Ann’s death, the FDA targeted 4,100 illicit online pill vendors with criminal charges, seizure of illegal products, and removal of websites.

Ann slipped through the cracks — or, more accurately, the gaping fissures in prevailing drug policy. Even worse, I’ll never know who helped her do it. She didn’t tell me the name or location of the clinic, and Paul couldn’t remember it or find any record of it. I couldn’t track her former Medicaid doctor, either. Addicts are secretive people, and Ann took hers with her to oblivion.

Dredging up the details won’t bring my sister back, but who knows? Maybe persisting in my quest to find out what’s being done about the problem will some day avert this nightmare for some other tormented family.

Failing that, may it restore my dreams to flashbacks of a less complicated time, when Ann and I, at 4 and 6, lay on our backs in the grass and gave names to the shapes we perceived in the mobile cumulus clouds above us. When the sky was finally dark enough for stars, we watched them twinkle “on,” one at a time at first and then a gathering expanse of them, a canopy of gemstones against velvety blackness.

If there was some kind of order to it, a pattern of galaxies or constellations, our untutored eyes couldn’t discern it. Too young to fathom either limits or infinity, we settled for random bursts of wonder, daring to imagine that such a spectacular light show had been devised for our viewing pleasure alone.

Logic was not what we were looking for anyway; unfettered splendor was what we had in mind.