Purdue Pharma’s Billionaires Escape Jail and Our Cries for Justice #health #holistic

In the U.S. legal system, some say money - good, cold cash - talks far louder than the court judges or the prosecuting district attorneys can manage, and it appears this form of “justice” has been applied to the villainous criminals of the U.S. opioid epidemic - the Sackler family, proud owners of Purdue Pharma and the even prouder creators of OxyContin - who can now look forward to a future of unabandoned liberty and unreal, vast sums of personal wealth.On July 8th, an additional 15 U.S. states, including those attorney generals who had been the most vociferous in their previous rejections, like Massachusetts and New York, agreed to Purdue Pharma’s revised opioid crisis settlement proposal in a bid to access the promised funds as soon as possible.The newly revised proposal includes a new business model for the company, the release of tens of millions of internal documents, and (yes, you’ve guessed it) a further $1.5 billion of that good, cold cash. Additionally, if the plan is certified by Judge Robert Drain as expected, both the family and the company would be shielded from further opioid-related lawsuits.Let’s repeat that. “Shielded from further opioid-related lawsuits.” Money does indeed talk - and loudly, too.Among those who reneged on their previous promises to the families of opioid drug overdose victims (sadly, yes, they have) is the once-vocal Massachusetts AG, Maura Healey, who was the first to sue individual members of the Sackler family.She stated, “While I know this resolution does not bring back loved ones or undo the evil of what the Sacklers did, forcing them to turn over their secrets by providing all the documents, forcing them to repay billions, forcing the Sacklers out of the opioid business, and shutting down Purdue will help stop anything like this from ever happening again.”If you didn’t know, only four months ago, that’s the same lady who once said (on WBUR’s Morning Edition, Boston’s NPR radio news show), “There are many things that I don't like about this plan. It's not enough money. It's also a plan that doesn't provide what our families deserve, which is transparency and accountability. So this is not the end, and this deal is nowhere near acceptable.”Only last month, Healey again stated her disdain for Purdue’s plan in an interview, “The Sacklers are not offering to pay anything near what they should for the harm and devastation caused to families and communities around this country.”Well... apparently, now, they are paying enough and the deal is acceptable - certainly to the Massachusetts’ AG, at least.The Sacklers’ True Legacy: Over Half a Million U.S. DeathsOxyContin, and many other prescription opioids like it, have resulted in a man-made, yet totally needless national public health crisis and epidemic in the U.S. (and beyond, for that matter) that will continue for generations to come.Opioid-related drug overdoses are now the leading cause of accidental death in the U.S., overshadowing deaths by motor vehicle accidents and even gunshot wounds. In fact, more Americans have died from opioid overdoses than those lives lost in every war since World War II.And OxyContin? Well, that one little pill - “Oxy,” for short - did make the Sackler family a sizable amount - a colossal $35 billion, thanks to the huge criminal deception that fooled doctors, the law courts, and the unsuspecting U.S. public for way too long.Their own personal wealth? Much of that good, cold cash is now sitting happily, both earning interest or being used to purchase even more global real estate, in various off-shore bank accounts in paradisiacal locations such as the Cayman Islands. How? The Sacklers quickly made siphoning company profits an art form as soon as they realized the proverbial stuff was about to hit the fan.Over Half a Million Families: Mothers, Father, Sisters, BrothersAsk any parent who loses their child - through the clear and criminal fault of someone else - what they really want, and they’ll reply “justice.” Among other things, like the “5-minutes-in-a-locked-room” scenario… But always justice, too.As the U.S. opioid epidemic continues to claim too many lives every single day in the U.S., and turn good, hard-working people into backstreet heroin users, many will be wondering, as I certainly am:“Why didn’t they legally nail this family to the wall?”“No jail time, and not even an admission of their guilt?”“How have they legally kept all of their criminally-gotten gains?”Here’s the proof, according to the American Society of Addiction Medicine (ASAM) and The Centers for Disease Control and Prevention (CDC), of the damage opioid prescriptions have done to the U.S.:A massive 80% of the world’s opioids are consumed in the U.S.The #1 cause of accidental death in the U.S. is overdoseFurthermore:21-29% of patients prescribed opioids for chronic pain will misuse them8-12% will go on to develop an opioid use disorder (OUD)4-6% who misuse such opioids will transition to heroinFatal opioid overdoses among females have risen by a staggering 450% in the last 10 yearsThe CDC estimates that the "economic burden" endured in the U.S. from the misuse of prescription opioids stands at around $78.5 billion a yearLet’s look at more of the publicly available evidence. Firstly, what is the drug at the very heart of all this?What is OxyContin?Purdue Pharma’s OxyContin is the brand name of controlled-release oxycodone, a powerful, morphine-like opioid painkiller available only by prescription. It is primarily used for the relief of severe pain that is unresponsive to less potent pain-relief medicines (analgesics).Oxycodone binds to the brain’s mu opioid receptor, although it can bind to other opioid receptors at higher dosages. It is known as a “full agonist,” and belongs to the group of drugs known as opioids or opioid analgesics. Oxycontin can also be called a narcotic analgesic.Purdue began selling OxyContin just over 25 years ago, encouraging doctors to forget their reservations about opioids, and focus fully on easing the pain of patients. Court documents have shown that company officials continued to push to maintain sales even after it became clear to all concerned that the drug was highly addictive, and, furthermore, was actively being abused.The facts (and they are facts) speak for themselves...Purdue Pharma’s Fraudulent Activity Marketing OxyContinPurdue Pharma knew that OxyContin was more powerful than morphine - a highly addictive opioid drug used medically in cases of severe chronic pain, and with a wide range of strict warnings even about its directed use. However, they actively exploited the fact that medical doctors, such as family physicians, thought the reverse was actually true. In fact, a Purdue Pharma official once advised the company, “It is important that we be careful not to change the perception of physicians.”Purdue Pharma claimed OxyContin posed little risk of addiction, even though they had carried out no tests - zero - to that effect at all.Purdue Pharma knew they were relying on only a small amount of ambiguous medical literature (such as a short letter to an editor by a couple of doctors at Boston University) to reassure physicians about the safety of OxyContin, and not a peer-reviewed study, as such claims normally require.Purdue Pharma knew that OxyContin could actually be effectively injected into a recreational user’s body in the form of a solution, but they never made it public.Purdue Pharma argued that OxyContin’s slow-release mechanism was a barrier to possible abuse. However, at the same time as they (continually) made this statement, they also owned another company that made immediate-release oxycodone - the primary ingredient of OxyContin tablets.Purdue Pharma found that, by scrutinizing their sales data, they could find, locate and then maintain a secret list of doctors who regularly over-prescribed OxyContin. They did little to alert the relevant authorities to these “pill mills,” as they are legally required to do. Instead, Purdue Pharma were content to grow rich off the proceeds.These numerous criminal (and, at the very least, completely unethical) deceptions devised by the Sackler family and their company, were extremely successful, and Purdue Pharma subsequently earned at least $35bn from the sales of OxyContin.The Sacklers: Currently Guilty of NothingHowever, it came at a tragic, huge cost to the U.S. and the families who had to endure the loss of a loved one. To date, more than 500,000 Americans have now died from overdoses of both prescription and illegal opioids. The Sacklers? The family continues to refuse to accept the pivotal role they have master-minded in this horrendous crime, and, so far, they have been found guilty of nothing.For people in the business of supposedly alleviating pain, they continue to be the root cause of an unspeakable amount of it...“Those members of the Sackler family who were involved have endured nothing more distressing than a social downfall. Only in a deranged world can the erasure of their names from museum galleries be considered punishment enough for OxyContin.”- from Empire of Pain review by Patrick Radden Keefe – the dynasty behind an opioid crisis (The Guardian, May 13th, 2021)Knowing that the sales of OxyContin earned the Sacklers $35 billion makes their settlement proposal figure of $4.5 billion a little on the lean side, don’t you think? In fact, it’s about an eighth - 12.85%, to be exact - of the profits from their most profitable drug. Of course, the Purdue Pharma medicine cabinet is packed full of other types of opioid tablets, too.No Strangers to the U.S. Courts: The 2007 Plea AgreementPurdue Pharma, steered and guided by the Sacklers, are no strangers to criminal charges or litigation. Back in 2007, they were faced with both criminal and civil charges for “misbranding” their prescription drug OxyContin. Purdue were allowed and subsequently accepted a plea agreement - they, their parent company, and three top executives were fined a total of $600 million.A mere matter of months after the 2007 plea agreement took place, Mortimer Sackler wrote an email to cousins which stated, "While things are looking better now, I would not count out the possibility that times will get much more difficult again in the future, and probably much sooner than we expect."Kathe Sackler: The Deposition - Spring, 2019In the interests of fairness, it is only right that we share some of the legally sworn comments made by at least one member of the Sackler family.The beginning of O'Keefe's book, Empire of Pain, describes the scene in a packed conference room of the New York headquarters of legal firm Debevoise & Plimpton. With around 20 lawyers in attendance, the conference room would witness the deposition of reclusive billionaire, Kathe Sackler - her sworn, out-of-court testimony, a part of the discovery process in thousands of lawsuits involving herself, her family, and her company, Purdue Pharma.Asking the questions was one of the plaintiffs’ lawyers, Paul Hanley. It didn’t take long for Hanley to start asking the tough questions:Hanley: “Dr. Sackler, does Purdue bear any responsibility for the opioid crisis?”[Immediate shouts of “Objection!” from her lawyers]Sackler: “I don’t believe Purdue has a legal responsibility.”Hanley: “That’s not what I asked. What I want to know is whether Purdue’s conduct was a cause of the opioid epidemic?”[Further shouts of “Objection!” from her lawyers]Sackler: “I think it’s a very complex set of factors and confluence of different circumstances and societal issues and problems and medical issues and regulatory gaps in different states across the country. I mean, it’s very, very, very complex.”During the course of the deposition, Sackler continued to insist that the family had nothing to be ashamed of or even to apologize for, because they believed that there was nothing wrong with OxyContin.Sackler: “It’s a very good medicine, and it’s a very safe and effective medicine.” If that were really the case, would we really have so many deaths attributable to the opioid crisis? Remember, as O’Keefe himself comments, “Before the introduction of OxyContin, America did not have an opioid crisis. After the introduction of OxyContin, it did.”Oh, the Sacklers’ deception gets worse, by the way…The Story of the Fast-Tracked Approval for OxyContinAccording to author Patrick O'Keefe, one significant aspect of OxyContin’s approval by the Food and Drug Administration (FDA) looks decidedly questionable, to say the very least. The actual FDA official who granted OxyContin its various approvals in 1995 did so in an astonishingly short time - just 11 months.However, here’s the real kicker:The same “helpful” official promptly quit the FDA soon afterwards, and, within a year, was found to be working… (yes, you guessed it again) at Purdue Pharma, earning a remarkably improved salary, too. Around $400,000 a year.Furthermore, Oxycontin’s rapid approval was based on it being “safe and effective” when used only in the "short-term." However, six years later, in 2001, the FDA, under more pressure from “Big Pharma” (the entire U.S. pharmaceutical industry, in other words), took the ill-perceived decision to widen the use of Oxycontin to just about anyone, such as those with chronic arthritis and back pain.The FDA did this by simply changing a few words on the label - the “label” being the small, folded piece of paper full of the drug’s small print accompanying the pill bottle. The label change proudly stated these morphine-like pain pills were now effective for "daily, around-the-clock, long-term… treatment." Unfortunately, this meant any drug company could now market the similar drugs differently, and even allow them to sell more and more pills at higher and higher doses.In a 2016 interview with mainstream media, Dr. David Kessler, who was in charge of the FDA from 1990 to 1997, when asked about the opioid crisis, stated, "FDA has responsibility, pharmaceutical companies have responsibility, physicians have responsibility. We didn't see these drugs for what they truly are."When Dr. Kessler was asked about his own responsibility as the head of the FDA, he said the crisis began after he left the agency in 1997; however, he does admit he should have pushed for stricter prescription practices when he was still in charge.The rest, as they say, is history...“While some progress has been made - especially around the public document depository - this plan is far from justice. Purdue and the Sacklers have misused this bankruptcy to protect their vast wealth, and evade consequences for their callous misconduct. This deal alarmingly allows the Sacklers to still walk away with their personal wealth intact.”- William Tong, Attorney General of ConnecticutOnce Purdue had approval for OxyContin, in 1996, a company head salesman told company sales reps in Tennessee to now convince doctors to prescribe stronger OxyContin doses to pain sufferers. These are the words he used: “It’s bonus time in the neighbourhood.”However, as soon as the legal authorities eventually started taking a closer and more detailed look at the “bonus time” sales and information practices of Purdue Pharma, the end result was their court case appearance and plea agreement in 2007. For the Sacklers, it meant one thing only - move their money, and quickly.Oregon’s current lawsuit sums it up; it alleges, “Between 2008 and 2018, they directed Purdue to make nearly $11 billion in total distributions (including tax distributions) to partnered companies, foreign entities, and ultimately to trusts established for the benefit of the Sackler families.’’And the U.S. Opioid Crisis Goes On...All in all, the whole story of how the Sacklers’ strove to build their very real empire of pain should have resulted in very real justice for the victims, justice for their families and their loved ones, justice for the communities so badly affected by the opioid epidemic, and justice for the U.S. as a nation.However, as we said at the beginning of this article - money talks. It now appears to be speaking as loudly to the various state attorney generals spread across this nation of ours as it has always done to the Sackler family.Let’s give the last word to plaintiffs’ attorney Paul Hanly - the man with the tough questions that still remain unanswered. He believes the states who have now agreed to the revised settlement plan simply considered it the better option. The alternative?He referred to that as “probably a decade or more in the bankruptcy court, at the end of which will probably be a ham sandwich left over for our clients, the communities that are suffering.”

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How To Survive Summer Parties And Boozy BBQs #health #holistic

I used to love going to boozy BBQs and picnics – they were the perfect excuse to day drink. 

The warm weather made me crave alcohol and the idea of watching the sun go down, stone cold sober, seemed unthinkable. 

So when I quit drinking, I was surprised to discover that summer parties were still fun – even if everyone else was knocking back booze.

If you’re about to tackle your first ever sober party, boozy BBQ or wedding this summer, I’ve got four tips to help you through it:

Key points:

Get clear on why you’re meeting up

No matter how much booze there is, the gathering is about more than sitting outside and drinking. If that was all it was about then you’d just stay at home! The real reason you’re going might be to catch up with old friends, celebrate a birthday or spend quality time with family. 

When you know what the point of an event is, you should start to see that you’re going to get that no matter what you’re drinking. You aren’t missing out – all you’re doing is pouring a different liquid into your glass. 

 

Decide in advance that you’re not going to drink

It sounds obvious, but how many times have you decided to wait and see how you feel – only to end up drinking?! Save yourself the mental torture of going back and forth over the decision. Decide in advance that you’re going to stay committed, no matter what. 

Remember – you can’t figure sobriety out without overcoming a few challenges. Pushing through something like this, sober, is how you grow. This is how you teach yourself that you’re capable of more than you think. You don’t need alcohol to have a good time. 

 

Keep an alcohol free drink in your hand

When you’ve already got a drink on the go, it’s easier to turn down the offer of something you don’t want. It also gives you something to do with your hands if you’re nervous. Plus, staying hydrated helps prevent cravings for alcohol. 

If it’s appropriate, take your own drinks with you and pack more than you think you need. You’ll be amazed at how many people will choose soft drinks if they’re available. People aren’t as obsessed with alcohol as we tend to think!

 

Plan ahead

Think through the event in advance. How can you make your life as easy as possible? Think about what you’ll say if someone asks why you’re not drinking and plan a response now (I have some thoughts on this here).

Plan your exit. Can you drive there, so you can leave whenever you want to? Plan your next day too. No matter how things go, you must celebrate yourself for stepping out of your comfort zone and doing something different!

 

If you’d like some help and support to quit drinking, click here for details of my online course.

The post How To Survive Summer Parties And Boozy BBQs appeared first on The Sober School.

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The ‘Grief Pandemic’ Will Torment Americans for Years #health #holistic

Cassandra Rollins’ daughter was still conscious when the ambulance took her away.Shalondra Rollins, 38, was struggling to breathe as covid overwhelmed her lungs. But before the doors closed, she asked for her cellphone, so she could call her family from the hospital.It was April 7, 2020 — the last time Rollins would see her daughter or hear her voice.The hospital rang an hour later to say she was gone. A chaplain later told Rollins that Shalondra had died on a gurney in the hallway. Rollins was left to break the news to Shalondra’s children, ages 13 and 15.More than a year later, Rollins said, the grief is unrelenting.Rollins has suffered panic attacks and depression that make it hard to get out of bed. She often startles when the phone rings, fearing that someone else is hurt or dead. If her other daughters don’t pick up when she calls, Rollins phones their neighbors to check on them.“You would think that as time passes it would get better,” said Rollins, 57, of Jackson, Mississippi. “Sometimes, it is even harder. … This wound right here, time don’t heal it.”With nearly 600,000 in the U.S. lost to covid-19 — now a leading cause of death — researchers estimate that more than 5 million Americans are in mourning, including more than 43,000 children who have lost a parent.The pandemic — and the political battles and economic devastation that have accompanied it — have inflicted unique forms of torment on mourners, making it harder to move ahead with their lives than with a typical loss, said sociologist Holly Prigerson, co-director of the Cornell Center for Research on End-of-Life Care.The scale and complexity of pandemic-related grief have created a public health burden that could deplete Americans’ physical and mental health for years, leading to more depression, substance misuse, suicidal thinking, sleep disturbances, heart disease, cancer, high blood pressure and impaired immune function.“Unequivocally, grief is a public health issue,” said Prigerson, who lost her mother to covid in January. “You could call it the grief pandemic.”Like many other mourners, Rollins has struggled with feelings of guilt, regret and helplessness — for the loss of her daughter as well as Rollins’ only son, Tyler, who died by suicide seven months earlier.“I was there to see my mom close her eyes and leave this world,” said Rollins, who was first interviewed by KHN a year ago in a story about covid’s disproportionate effects on communities of color. “The hardest part is that my kids died alone. If it weren’t for this covid, I could have been right there with her” in the ambulance and emergency room. “I could have held her hand.”The pandemic has prevented many families from gathering and holding funerals, even after deaths caused by conditions other than covid. Prigerson’s research shows that families of patients who die in hospital intensive care units are seven times more likely to develop post-traumatic stress disorder than loved ones of people who die in home hospice.The polarized political climate has even pitted some family members against one another, with some insisting that the pandemic is a hoax and that loved ones must have died from influenza, rather than covid. People in grief say they’re angry at relatives, neighbors and fellow Americans who failed to take the coronavirus seriously, or who still don’t appreciate how many people have suffered.“People holler about not being able to have a birthday party,” Rollins said. “We couldn’t even have a funeral.”Indeed, the optimism generated by vaccines and falling infection rates has blinded many Americans to the deep sorrow and depression of those around them. Some mourners say they will continue wearing their face masks — even in places where mandates have been removed — as a memorial to those lost.“People say, ‘I can’t wait until life gets back to normal,’” said Heidi Diaz Goff, 30, of the Los Angeles area, who lost her 72-year-old father to covid. “My life will never be normal again.”Many of those grieving say celebrating the end of the pandemic feels not just premature, but insulting to their loved ones’ memories.“Grief is invisible in many ways,” said Tashel Bordere, a University of Missouri assistant professor of human development and family science who studies bereavement, particularly in the Black community. “When a loss is invisible and people can’t see it, they may not say ‘I’m sorry for your loss,’ because they don’t know it’s occurred.”Communities of color, which have experienced disproportionately higher rates of death and job loss from covid, are now carrying a heavier burden.Black children are more likely than white children to lose a parent to covid. Even before the pandemic, the combination of higher infant and maternal mortality rates, a greater incidence of chronic disease and shorter life expectancies made Black people more likely than others to be grieving a close family member at any point in their lives.Rollins said everyone she knows has lost someone to covid.“You wake up every morning, and it’s another day they’re not here,” Rollins said. “You go to bed at night, and it’s the same thing.”A Lifetime of LossRollins has been battered by hardships and loss since childhood.She was the youngest of 11 children raised in the segregated South. Rollins was 5 years old when her older sister Cora, whom she called “Coral,” was stabbed to death at a nightclub, according to news reports. Although Cora’s husband was charged with murder, he was set free after a mistrial.Rollins gave birth to Shalondra at age 17, and the two were especially close. “We grew up together,” Rollins said.Just a few months after Shalondra was born, Rollins’ older sister Christine was fatally shot during an argument with another woman. Rollins and her mother helped raise two of the children Christine left behind.Heartbreak is all too common in the Black community, Bordere said. The accumulated trauma — from violence to chronic illness and racial discrimination — can have a weathering effect, making it harder for people to recover.“It’s hard to recover from any one experience, because every day there is another loss,” Bordere said. “Grief impacts our ability to think. It impacts our energy levels. Grief doesn’t just show up in tears. It shows up in fatigue, in working less.”Rollins hoped her children would overcome the obstacles of growing up Black in Mississippi. Shalondra earned an associate’s degree in early childhood education and loved her job as an assistant teacher to kids with special needs. Shalondra, who had been a second mother to her younger siblings, also adopted a cousin’s stepdaughter after the child’s mother died, raising the girl alongside her two children.Rollins’ son, Tyler, enlisted in the Army after high school, hoping to follow in the footsteps of other men in the family who had military careers.Yet the hardest losses of Rollins’ life were still to come. In 2019, Tyler killed himself at age 20, leaving behind a wife and unborn child.“When you see two Army men walking up to your door,” Rollins said, “that’s unexplainable.”Tyler’s daughter was born the day Shalondra died.“They called to tell me the baby was born, and I had to tell them about Shalondra,” Rollins said. “I don’t know how to celebrate.”Shalondra’s death from covid changed her daughters’ lives in multiple ways.The girls lost their mother, but also the routines that might help mourners adjust to a catastrophic loss. The girls moved in with their grandmother, who lives in their school district. But they have not set foot in a classroom for more than a year, spending their days in virtual school, rather than with friends.Shalondra’s death eroded their financial security as well, by taking away her income. Rollins, who worked as a substitute teacher before the pandemic, hasn’t had a job since local schools shut down. She owns her own home and receives unemployment insurance, she said, but money is tight.Makalin Odie, 14, said her mother, as a teacher, would have made online learning easier. “It would be very different with my mom here.”The girls especially miss their mom on holidays.“My mom always loved birthdays,” said Alana Odie, 16. “I know that if my mom were here my 16th birthday would have been really special.”Asked what she loved most about her mother, Alana replied, “I miss everything about her.”Grief Complicated by IllnessThe trauma also has taken a toll on Alana and Makalin’s health. Both teens have begun taking medications for high blood pressure. Alana has been on diabetes medication since before her mom died.Mental and physical health problems are common after a major loss. “The mental health consequences of the pandemic are real,” Prigerson said. “There are going to be all sorts of ripple effects.”The stress of losing a loved one to covid increases the risk for prolonged grief disorder, also known as complicated grief, which can lead to serious illness, increase the risk of domestic violence and steer marriages and relationships to fall apart, said Ashton Verdery, an associate professor of sociology and demography at Penn State.People who lose a spouse have a roughly 30% higher risk of death over the following year, a phenomenon known as the “the widowhood effect.” Similar risks are seen in people who lose a child or sibling, Verdery said.Grief can lead to “broken-heart syndrome,” a temporary condition in which the heart’s main pumping chamber changes shape, affecting its ability to pump blood effectively, Verdery said.From final farewells to funerals, the pandemic has robbed mourners of nearly everything that helps people cope with catastrophic loss, while piling on additional insults, said the Rev. Alicia Parker, minister of comfort at New Covenant Church of Philadelphia.“It may be harder for them for many years to come,” Parker said. “We don’t know the fallout yet, because we are still in the middle of it.”Rollins said she would have liked to arrange a big funeral for Shalondra. Because of restrictions on social gatherings, the family held a small graveside service instead.Funerals are important cultural traditions, allowing loved ones to give and receive support for a shared loss, Parker said.“When someone dies, people bring food for you, they talk about your loved one, the pastor may come to the house,” Parker said. “People come from out of town. What happens when people can’t come to your home and people can’t support you? Calling on the phone is not the same.”While many people are afraid to acknowledge depression, because of the stigma of mental illness, mourners know they can cry and wail at a funeral without being judged, Parker said.“What happens in the African American house stays in the house,” Parker said. “There’s a lot of things we don’t talk about or share about.”Funerals play an important psychological role in helping mourners process their loss, Bordere said. The ritual helps mourners move from denying that a loved one is gone to accepting “a new normal in which they will continue their life in the physical absence of the cared-about person.” In many cases, death from covid comes suddenly, depriving people of a chance to mentally prepare for loss. While some families were able to talk to loved ones through FaceTime or similar technologies, many others were unable to say goodbye.Funerals and burial rites are especially important in the Black community and others that have been marginalized, Bordere said.“You spare no expense at a Black funeral,” Bordere said. “The broader culture may have devalued this person, but the funeral validates this person’s worth in a society that constantly tries to dehumanize them.”In the early days of the pandemic, funeral directors afraid of spreading the coronavirus did not allow families to provide clothing for their loved ones’ burials, Parker said. So beloved parents and grandparents were buried in whatever they died in, such as undershirts or hospital gowns.“They bag them and double-bag them and put them in the ground,” Parker said. “It is an indignity.”Coping With LossEvery day, something reminds Rollins of her losses.April brought the first anniversary of Shalondra’s death. May brought Teacher Appreciation Week.Yet Rollins said the memory of her children keeps her going.When she begins to cry and thinks she will never stop, one thought pulls her from the darkness: “I know they would want me to be happy. I try to live on that.”Subscribe to KHN's free Morning Briefing.

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Opioid overdoses spiked during the COVID-19 pandemic, data from Pennsylvania show #health #holistic

Since the first diagnosed case of COVID-19 in the United States on Jan. 20, 2020, news about infection rates, deaths and pandemic-driven economic hardships has been part of our daily lives.But there is a knowledge gap in how COVID-19 has affected a public health crisis that existed before the pandemic: the opioid epidemic. Prior to 2020, an average of 128 Americans died every day from an opioid overdose. That trend accelerated during the COVID-19 pandemic, according to the Centers for Disease Control and Prevention.We are a team of health and environment geography researchers. When social distancing began in March 2020, addiction treatment experts were concerned that shutdowns might result in a spike in opioid overdose and deaths. In our latest research in the Journal of Drug Issues, we take a closer look at these trends by examining opioid overdoses in Pennsylvania prior to and following the statewide stay-at-home order.Our findings suggest that this public health response to COVID-19 has had unintended consequences for opioid use and misuse.History of the opioid epidemicOpioid misuse has been a major U.S. health threat for over two decades, largely affecting rural areas and white populations. However, a recent shift in the drugs involved, from prescription opioids to illegally manufactured drugs such as fentanyl, has resulted in an expansion of the epidemic in urban areas and among other racial and ethnic groups.From 1999 to 2013, increasing death rates from drug abuse, primarily for those from 45 to 54 years of age, contributed to the first decline in life expectancy for white non-Hispanic Americans in decades.There was a modest national decline in overdose mortality from prescription opioids from 2017 to 2019, but the COVID-19 pandemic has upended many of these advances. As one of our public health partners explained to us, “We were making progress until COVID-19 hit.”We believe this presents an urgent need for research on the relationships between COVID-19 policy responses and patterns of opioid use and misuse.Opioid use increases during the pandemicPennsylvania has been among the states hardest hit by the opioid epidemic. It had one of the highest rates of death due to drug overdose in 2018, with 65%, a total of 2,866 fatalities, involving opioids.The state’s stay-at-home order, implemented on April 1, 2020, mandated that residents stay within their homes whenever possible, practice social distancing and wear masks when outside the home. All schools shifted to remote learning, and most businesses were required to operate remotely or close. Only essential services were allowed to continue operating in person.In the following months, the public’s overall cooperation with these mandates contributed to measurable declines in coronavirus infection rates. To learn how these mandates also affected people’s use of opioids, we assessed data from the Pennsylvania Overdose Information Network for changes in monthly incidents of opioid-related overdose before and after April 1, 2020. We also examined the change by gender, age, race, drug class and doses of naloxone administered. (Naloxone is a drug widely used to reverse the effects of overdose.)Our analysis of both fatal and nonfatal cases of opioid-related overdose from January 2019 through July 2020 revealed statistically significant increases in overdose incidents for both men and women, among whites and Blacks, and across several age groups, most notably the 30-39 and 40-49 groups, following April 1. This means there was an acceleration of overdoses within some of the populations most affected by opioids prior to the COVID-19 pandemic. But there were also uneven increases among other groups, such as Black people.We found statistically significant increases in overdoses involving heroin, fentanyl, fentanyl analogs or other synthetic opioids, pharmaceutical opioids and carfentanil. This is consistent with previous research on the main opioid classes contributing to increases in drug overdose and death. The results also affirm that heroin and synthetic opioids such as fentanyl are now the major threats in the epidemic.When a pandemic and an epidemic collideWhile we found significant change in opioid overdoses during the COVID-19 pandemic, the findings say less about some of the driving factors. To better understand these, we have been interviewing public health providers since December 2020.Among the important factors they highlight as contributing to increased opioid use are pandemic-driven economic hardship, social isolation and the disruption of in-person treatment and support services.From March to April 2020, unemployment rates in Pennsylvania shot up from 5% to approximately 16%, resulting in a peak of more than 725,000 unemployment claims filed in April. As workplace shutdowns made it harder to pay for housing, food and other needs, and the opportunities for in-person support disappeared, some people turned to drugs, including opioids.People in the early stages of treatment or recovery from opioid addiction may be particularly vulnerable to relapse, suggested one of our public health partners. “They might be working in industries that are closed down, so they have financial problems … [and] they have their addiction issues on top of that, and now they can’t like go to meetings, and they can’t make those connections.” (Under our clearance with Penn State for doing research with human subjects, our public health informants are kept anonymous.)[Like what you’ve read? Want more? Sign up for The Conversation’s daily newsletter.]An addiction treatment counselor told us that especially for those with past or present opioid use problems, or histories of mental health issues, “It’s not a good thing to be alone in your own thoughts. And so, once everybody was kind of locked down … the depression and anxiety hit.”Another counselor also pointed to depression, anxiety and isolation as driving increased opioid misuse. The pandemic “just spun everything out of control,” they said. “Overdoses up, everything up, everything.”One question is whether states like Pennsylvania will continue to support telehealth in the future. While the transition from in-person to telehealth services has increased access to treatment for some, it has raised challenges for populations like the rural and elderly. As one provider explained, “it’s really hard for that [rural] population out there” to utilize telehealth services due to limited internet and broadband connection. In other words, flexible modes of addiction treatment might work for some but not others.The goal of our research is not to criticize efforts to mitigate the spread of COVID-19. Without the mandatory stay-at-home order in Pennsylvania, both infection and death rates would have been worse. However, our research shows that such measures have had unintended consequences for those struggling with addiction and emphasizes the importance of taking a holistic approach to public health as policymakers work to confront both COVID-19 and the addiction crisis in America.Brian King, Professor, Department of Geography, Penn State; Andrea Rishworth, Postdoctoral Fellow in Geography, McMaster University, and Ruchi Patel, Ph.D. Student in Geography, Penn StateThis article is republished from The Conversation under a Creative Commons license. Read the original article.

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Self-Care: 7 Ways to Go Deeper #health #holistic

If you scroll through social media, #selfcare is likely to pop up, alongside pictures of people lounging in the tub, having a mocktail, or spending time in nature. While all of these things are great for making yourself feel better, true self-care goes beyond just chasing happiness. On International Self-Care Day, July 24, (7-24), people are urged to think about how they craft a self-care practice that lasts 24 hours a day, 7 days a week.According to the International Self-Care Foundation, self-care is defined as “a practical, person-centred set of activities that we should all be undertaking to maintain our health, wellness and wellbeing.” These activities are “a normal part of everyday life,” the foundation says, and are critical not only for feeling good, but also for staying healthy physically, emotionally and mentally.To help further the idea of true self-care, the International Self-Care Foundation created seven pillars of self-care. Here’s what you should know about each, and how it can be implemented in your life.Knowledge and Health LiteracyThe first pillar of self-care might be a bit unexpected. This pillar focuses on education. People who have knowledge and health literacy are able to understand the health challenges facing them, and how an unhealthy habit in one area of life can affect other areas. They know how to access treatments and resources that help them practice true self-care.Consider this in the context of substance use disorder and mental health. Having good healthy literacy might mean that you understand the ways that trauma can fuel substance use. It could also mean that you understand treatment options, and are able to seek out help when you need it.Mental WellbeingMental wellbeing is about more than just keeping it together by a threat. True mental wellbeing means being able to respond to life’s curveballs and stressors. It’s about being able to pursue fulfillment and contribute to your community.A critical part of mental wellbeing is self-awareness, or the ability to recognize when you’re struggling. According to the International Self-Care Foundation, self-awareness goes hand-in-hand with agency, or the ability to take action based on your understanding of your needs. For example, if your past trauma is causing you to drink too much, you might recognize that you need professional guidance. You could therefore use your agency to pursue trauma-informed care.Physical ActivityThis one is no surprise. Being physically active is linked to a host of mental, emotional and physical health benefits. Most adults should aim for 150 minutes of exercise a week. Although that might seem like a lot, you still get the benefits of exercise if you work out in short ten-minute increments, like on your lunch break or while dinner cooks.Healthy EatingSpeaking of dinner cooking, healthy eating is essential to self-care. While indulging in a slice of cake or a brownie now and then might feel like self-care, the more realistic way to take care of yourself is to nourish your body by eating a well-rounded selection of fruits and vegetables.This is particularly important for people with a history of substance use disorder. Using and abusing drugs or alcohol can deplete key nutrients in your body. Once you get your substance use under control it’s time to replenish those building blocks of health by eating lots of whole foods, fruits and vegetables.Risk Avoidance or MitigationWhen you’re actively practicing self-care, you do what you can to make sure that no harm comes to you. While we can’t control everything, we can do things to reduce our risk of harm, like wearing a seatbelt in the car, not using drugs or alcohol, and avoiding places and people that we find triggering.This is hugely important for people who are in recovery from substance use disorder. Abusing drugs or alcohol is risky in and of itself, and often leads to other high-risk behaviors like unprotected sex or drunk-driving. Everyday steps for risk mitigation, like wearing sunblock or using a helmet when you ride a bike, are simple ways to retrain your brain and remind yourself that you are worth protecting.Good HygieneSince the pandemic, there is a renewed focus on good hygiene. Although simple hygiene like washing your hands thoroughly might seem basic, it can help prevent disease and illness. Oftentimes, during active addiction, personal hygiene slips as a person becomes focused solely on finding their next fix. Once you’re in recovery, it’s a good time to reestablish a personal hygiene routine, including showering, brushing and flossing your teeth, and washing your hands frequently.Rational and Responsible Use of Self-Care Products and ServicesThese days, we’re all inundated with products and services that promise to make self-care easy. This might be a supplement that claims to help you sleep better, or a wellness program designed to help you drop weight.Remember — if something seems too good to be true, it probably is. Unfortunately, there are no shortcuts when it comes to self-care. Be a skeptical consumer and remember that true self-care starts with you taking the initiative for your own health and well-being.Sunshine Coast Health Centre is a non 12-step drug and alcohol rehabilitation center in British Columbia. Learn more here.

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The neuroscience behind why your brain may need time to adjust to ‘un-social distancing’ #health #holistic

With COVID-19 vaccines working and restrictions lifting across the country, it’s finally time for those now vaccinated who’ve been hunkered down at home to ditch the sweatpants and reemerge from their Netflix caves. But your brain may not be so eager to dive back into your former social life.Social distancing measures proved essential for slowing COVID-19’s spread worldwide – preventing upward of an estimated 500 million cases. But, while necessary, 15 months away from each other has taken a toll on people’s mental health.In a national survey last fall, 36% of adults in the U.S. – including 61% of young adults – reported feeling “serious loneliness” during the pandemic. Statistics like these suggest people would be itching to hit the social scene.But if the idea of making small talk at a crowded happy hour sounds terrifying to you, you’re not alone. Nearly half of Americans reported feeling uneasy about returning to in-person interaction regardless of vaccination status.So how can people be so lonely yet so nervous about refilling their social calendars?Well, the brain is remarkably adaptable. And while we can’t know exactly what our brains have gone through over the last year, neuroscientists like me have some insight into how social isolation and resocialization affect the brain.Social homeostasis – the need to socializeHumans have an evolutionarily hardwired need to socialize – though it may not feel like it when deciding between a dinner invite and rewatching “Schitt’s Creek.”From insects to primates, maintaining social networks is critical for survival in the animal kingdom. Social groups provide mating prospects, cooperative hunting and protection from predators.But social homeostasis – the right balance of social connections – must be met. Small social networks can’t deliver those benefits, while large ones increase competition for resources and mates. Because of this, human brains developed specialized circuitry to gauge our relationships and make the correct adjustments – much like a social thermostat.Social homeostasis involves many brain regions, and at the center is the mesocorticolimbic circuit – or “reward system.” That same circuit motivates you to eat chocolate when you crave something sweet or swipe on Tinder when you crave … well, you get it.And like those motivations, a recent study found that reducing social interaction causes social cravings – producing brain activity patterns similar to food deprivation.So if people hunger for social connection like they hunger for food, what happens to the brain when you starve socially?Your brain on social isolationScientists can’t shove people into isolation and look inside their brains. Instead, researchers rely on lab animals to learn more about social brain wiring. Luckily, because social bonds are essential in the animal kingdom, these same brain circuits are found across species.One prominent effect of social isolation is – you guessed it – increased anxiety and stress.Many studies find that removing animals from their cage buddies increases anxiety-like behaviors and cortisol, the primary stress hormone. Human studies also support this, as people with small social circles have higher cortisol levels and other anxiety-related symptoms similar to socially deprived lab animals.Evolutionarily this effect makes sense – animals that lose group protection must become hypervigilant to fend for themselves. And it doesn’t just occur in the wild. One study found that self-described “lonely” people are more vigilant of social threats like rejection or exclusion.Another important region for social homeostasis is the hippocampus – the brain’s learning and memory center. Successful social circles require you to learn social behaviors – such as selflessness and cooperation – and recognize friends from foes. But your brain stores tremendous amounts of information and must remove unimportant connections. So, like most of your high school Spanish – if you don’t use it, you lose it.Several animal studies show that even temporary adulthood isolation impairs both social memory – like recognizing a familiar face – and working memory – like recalling a recipe while cooking.And isolated humans may be just as forgetful. Antarctic expeditioners had shrunken hippocampi after just 14 months of social isolation. Similarly, adults with small social circles are more likely to develop memory loss and cognitive decline later in life.So, human beings might not be roaming the wild anymore, but social homeostasis is still critical to survival. Luckily, as adaptable as the brain is to isolation, the same may be true with resocialization.Your brain on social reconnectionThough only a few studies have explored the reversibility of the anxiety and stress associated with isolation, they suggest that resocialization repairs these effects.One study, for example, found that formerly isolated marmosets first had higher stress and cortisol levels when resocialized but then quickly recovered. Adorably, the once-isolated animals even spent more time grooming their new buddies.Social memory and cognitive function also seem to be highly adaptable.Mouse and rat studies report that while animals cannot recognize a familiar friend immediately after short-term isolation, they quickly regain their memory after resocializing.And there may be hope for people emerging from socially distanced lockdown as well. A recent Scottish study conducted during the COVID-19 pandemic found that residents had some cognitive decline during the harshest lockdown weeks but quickly recovered once restrictions eased.Unfortunately, studies like these are still sparse. And while animal research is informative, it likely represents extreme scenarios since people weren’t in total isolation over the last year. Unlike mice stuck in cages, many in the U.S. had virtual game nights and Zoom birthday parties (lucky us).So power through the nervous elevator chats and pesky brain fog, because “un-social distancing” should reset your social homeostasis very soon.[Understand new developments in science, health and technology, each week.Subscribe to The Conversation’s science newsletter.]Kareem Clark, Postdoctoral Associate in Neuroscience, Virginia TechThis article is republished from The Conversation under a Creative Commons license. Read the original article.

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Many QAnon followers report having mental health diagnoses #health #holistic

QAnon is often viewed as a group associated with conspiracy, terrorism and radical action, such as the Jan. 6 Capitol insurrection. But radical extremism and terror may not be the real concern from this group.QAnon followers, who may number in the millions, appear to believe a baseless and debunked conspiracy theory claiming that a satanic cabal of pedophiles and cannibals controls world governments and the media. They also subscribe to many other outlandish and improbable ideas, such as that the Earth is flat, that the coronavirus is a biological weapon used to gain control over the world’s population, that Bill Gates is somehow trying to use coronavirus vaccinations to implant microchips into people and more.As a social psychologist, I normally study terrorists. During research for “Pastels and Pedophiles: Inside the Mind of QAnon,” a forthcoming book I co-authored with security scholar Mia Bloom, I noticed that QAnon followers are different from the radicals I usually study in one key way: They are far more likely to have serious mental illnesses.Significant conditionsI found that many QAnon followers revealed – in their own words on social media or in interviews – a wide range of mental health diagnoses, including bipolar disorder, depression, anxiety and addiction.In court records of QAnon followers arrested in the wake of the Capitol insurrection, 68% reported they had received mental health diagnoses. The conditions they revealed included post-traumatic stress disorder, bipolar disorder, paranoid schizophrenia and Munchausen syndrome by proxy – a psychological disorder that causes one to invent or inflict health problems on a loved one, usually a child, in order to gain attention for themselves. By contrast, 19% of all Americans have a mental health diagnosis.Among QAnon insurrectionists with criminal records, 44% experienced a serious psychological trauma that preceded their radicalization, such as physical or sexual abuse of them or of their children.The psychology of conspiracyResearch has long revealed connections between psychological problems and beliefs in conspiracy theories. For example, anxiety increases conspiratorial thinking, as do social isolation and loneliness.Depressed, narcissistic and emotionally detached people are also prone to have a conspiratorial mindset. Likewise, people who exhibit odd, eccentric, suspicious and paranoid behavior – and who are manipulative, irresponsible and low on empathy – are more likely to believe conspiracy theories.QAnon’s rise has coincided with an unfolding mental health crisis in the United States. Even before the COVID-19 pandemic, the number of diagnoses of mental illness was growing, with 1.5 million more people diagnosed in 2019 than in 2018.The isolation of the lockdowns, compounded by the anxiety related to COVID and the economic uncertainty, made a bad situation worse. Self-reported anxiety and depression quadrupled during the quarantine and now affects as much as 40% of the U.S. population.A more serious problemIt’s possible that people who embrace QAnon ideas may be inadvertently or indirectly expressing deeper psychological problems. This could be similar to when people exhibit self-harming behavior or psychosomatic complaints that are in fact signals of serious psychological issues.It could be that QAnon is less a problem of terrorism and extremism than it is one of poor mental health.Only a few dozen QAnon followers are accused of having done anything illegal or violent – which means that for millions of QAnon believers, their radicalization may be of their opinions, but not their actions.In my view, the solution to this aspect of the QAnon problem is to address the mental health needs of all Americans – including those whose problems manifest as QAnon beliefs. Many of them – and many others who are not QAnon followers – could clearly benefit from counseling and therapy.Editor’s note: This article was updated to correct the description of the people whose post-insurrection court records were examined.[Deep knowledge, daily.Sign up for The Conversation’s newsletter.]This article is republished from The Conversation under a Creative Commons license. Read the original article.

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The Fentanyl Crisis Isn't Over. In Fact, It's Getting Worse. #health #holistic

You may recall reading alarming stories in the media about the synthetic opioid fentanyl in the last few years. The Centers for Disease Control and Prevention noted that the drug was responsible for a spate of overdose deaths that rose dramatically from 2013, when the first cases made headlines, to 2019.More than 36,000 overdose deaths from fentanyl took place during that year, which federal, state, and local officials battled through resources guides, community action, and efforts to expand access to naloxone, the opioid antagonist drug that can reverse the effects of a fentanyl overdose, to first responders.By 2020, fentanyl stories appeared to drop from the media spotlight, supplanted by news about the presidential election and the COVID-19 pandemic. But don't think that the drug went away. On the contrary: fentanyl use, and overdose deaths related to the drug, is steadily on the rise again.According to the CDC's National Center for Health Statistics, synthetic opioids like fentanyl were at the heart of a recent and dramatic spike in overdose deaths during a 12-month period ending in May 2020. Approximately 81, 230 drug overdoses involving synthetic drugs occurred during this time period, which is the largest number of such instances ever recorded. The increase after a relative decline in overdoses from 2017 to 2018, which began to reverse in June 2019 and climbed rapidly by May 2020. Drug overdose deaths increased in more than 25 states and the District of Columbia; in some states and major metropolitan areas like New York City, the increase was between 10 and 19%.How has fentanyl managed to retain a grip on the U.S. population? Part of the reason is its potency: fentanyl is a legal drug, used to treat severe or "breakthrough" pain, especially after surgery, or for patients who have a tolerance to other opioids. When prescribed by a doctor, fentanyl can be given as an injection, patch, or as a lozenge. Though similar in composition to morphine, it's actually 80 to 100 times more powerful, and equally as addictive. As little as two milligrams of fentanyl has the potential to be fatal.The other reason for fentanyl's longevity is that it's relatively cheap and easy to produce an illegal street version of the drug, and its potency makes it a frequent choice to be mixed with other opioid narcotics like heroin or cocaine for a cheap and powerful high. Many individuals with substance dependency issues are unaware of the presence of fentanyl in these narcotics, which can overwhelm their systems and lead to an overdose.While China has been in the past the primary source of fentanyl and dangerous analogues, or imitation drugs, like carfentanil, which were sold primarily through illegal web sites on the "dark web," the majority of fentanyl in 2021 enters the United States through Mexico. U.S. authorities estimate that 90% of all fentanyl entering the country originates in Mexico, where it's produced by drug trafficking cartels who buy the chemicals to produce the drug from China and India.Data from the United Nations found that while seizures of marijuana smuggled into the U.S. from Mexico dropped in 2020, seizures of fentanyl rose nearly 500%. COVID-19 has done little to halt the cartels' smuggling operations; as the DEA noted, they've simply sent larger shipments of fentanyl and methamphetamine to meet the growing demand in the States.The third factor in the recent fentanyl surge was undoubtedly the global pandemic. Experts predicted that quarantine conditions would cause a host of issues that would negatively impact mental health, from isolation and anxiety over financial and medical worries to the inability to access proper treatment from both doctors and treatment facilities. Studies corroborated these fears, as did data from the CDC's National Vital Statistics System (NVSS), which found that overdose deaths skyrocketed throughout 2020 before declining at the start of 2021: the center has estimated that the final total of such deaths could ultimately surpass 90,000 – the highest annual number on record. How to combat this rising tide of opioid and fentanyl overdose? At Waismann Method, an opioid treatment program and rapid detox center, they believe that mental health care should be accessible not just to those who can afford it, but also to those who need it most. In today's post-pandemic world, in which so many people are dealing with trauma caused by COVID and its attendant restrictions, it is critical that medical treatment for opioid dependence be available in public hospitals along with necessary psychological support. Additionally, we need a stronger commitment to combating the rise of opioids (and the influx of fentanyl in particular) at local and government levels. "We believe that additional resources need to be put into decreasing the availability of fentanyl in our communities and the demand for drugs by our citizens,” Clare Waismann, RAS/SUDCC, founder of Waismann Method and Domus Retreat, explains. “By protecting our borders and focusing on the root causes behind addiction, we can reduce overdose risks, crime, homelessness, and suicide."Sources:https://ift.tt/3dAuXYh

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