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Don’t Wait for “Rock Bottom” 

Today we launched the fourth episode of ADDICTION, our animated video series that turns the science of substance use disorder into stories that stick.

Don’t Wait for ‘Rock Bottom’ explains why a substance use disorder should be addressed as early as possible–before it progresses and increases in severity. The idea that we should wait for the disease to get worse before seeking treatment for ourselves, or intervening with a loved one isn’t backed by science, which tells us that treatment works even if a patient isn’t feeling “ready.”

Help us spread the science and banish the myths by sharing the newest episode with your networks! Click here to tweet about it.

Each episode in the series is the result of intensive collaboration among scientists, patients and families impacted by addiction, the Addiction Policy Forum, and animator Patrick Smith. A special thanks to the National Institute of Drug Abuse (NIDA) for the science highlighted!

2018 © Addiction Policy Forum | All rights reserved

History of Drinking

I remember days as a child that my Dad and friends drank crappy beer (by today’s terms) out by the pool. It ·was a stapl1e of family /neighborhood cook-outs. My dad sat in the Lazy Boy recliner at night and always  had a, night cap.i would climb in his lap ,and take a sip,so that was probably the first thing.

Fast forward though, because           I was able to avoid for many years. I was in 8th grade, My friend’s parents were out of town and her then 20-something aunt decided it was a good idea to buy alcohol for her and her friends.”Cool Aunt”. NOT!!! DeeDee then tried to commit suicide that night, after (at 13) having too much Peach Schnapps. After the EMS and police left ,my mom picked me up, we called my pastor, and I have never touched anything peach flavored again.

I didn’t drink again until enticed by peer pressure at 15.First boyfriend, etc. It was short lived until was 20 and in college. I(regrettably) married at that age and we drank socially. Private parties, corporate  parties, new friend ,Vacations, etc.

I did go, through a sour spot with drinking 10 years ago. My marriage which lasted 22 years was falling apart. I was alone and trying to hold my household together. I realized I had to rise above and be better for my kids. I made good changes ln my life And then one stupid day changed it all.

One night. One bad decision. Wouldn’t wish on ANVONE!! Thankful that I have learned so much in the interim.

 What  l’ve learned about  DWl’s  at BK Counseling!

 Fortunately ,I have not had any experience whatsoever with the  world  of DWI / DUI in my  46 years until! 3 months ago. I guess I should say unfortunately  I had my experience  then.

Obviously, you’d have to pretty much be dead or off the grid to not know the dangers  that drinking and driving  cause. But the ramifications were news to  me.

The night  I had my our I was hurt, humiliated and shocked. I was thankful to, have someone rescue me ,even though I was a mere 500 yards from home. I was, in handcuffs, as a PTA mom, devoted loving mother who has done everything “right”. And then there is this.

So the things, I have learned……Mitigating and Aggravating fact1ors..WHAT? No Idea  that was a thing . As, I said l -this was allll new to me. thankfully  those things weighed in my favor. No minors ,no accident, no priors, just a really bad judgement call.

I have heard amazing stories about past experiences. that make you take pause, and  I am thankful for that I have shared stories from class so many times and I hope that I have helped others learn from what I have experienced! Probably the scariest thing was that I was completely cognizant (in my mind), during my DUI. The way that it affects your brain is something that people don’t realize and/or think about. I asked the score of the Carolina game. I listened to the officer tell the agistrate then she asked if I gave him any prob1ems – nope, nicest person I ever arrested. So that’s scary. In my head I was fine. Thankfully he was kind to me that night.

I have heard the stories of people who have NO REASON to get a DWI down to those who yeah ,it was a matter of time. I’m super thankful for those who needed help and sorry for those who fell to the system. But either Way, we’ve all learned in the process . Thank you, Rhonda,

June Newsletter

Thanks to Florida’s Sober Home Task Force, overdose deaths in Palm Beach County are down 60 percent!

FL State Attorney Announces Overdose Deaths are down 60%
Workplaces Fighting Opioid Addiction on WXYZ News Detroit

What can employers do about addiction?

Opioids in the workplace lead to unsafe working conditions, decreased productivity and high turnover rates, costing US businesses an estimated $2.6 billion every year. Some employers are fighting the stigma by offering workers a chance to get help.

Read Sivia's We Do Recover Story

“I am so happy and so grateful to be where I am. It’s never too late to change your life, one day at a time.”

Here for you 24/7 • Call or Text (888) 492-3658

Vol. #16, No. 3                                                                    June 2018
Welcome to the June edition of Tips and Topics (TNT). Glad you could join us this month and if you are in the Northern Hemisphere, enjoy your summer. If not, stay warm.
David Mee-Lee, M.D.
DML Training and Consulting
SAVVY

The June 25, 2018 edition of National Public Radio’s (NPR) “Here & Now” news show had a segment titled: “Trump Pardon Of Nonviolent Drug Offender Raises Hopes For Others Currently In Prison“. President Trump recently pardoned Alice Johnson, who had been in prison for more than 20 years for a first-time drug conviction, and is considering commuting the sentences of more nonviolent drug offenders. You can listen to the 10-minute segment:
TIP 1
Consider if it is worth incarcerating people who committed nonviolent crimes due mainly to the disease of addiction and/or related social ills.
The statistics jolted me again:
  • About 2,000 people with nonviolent drug offenses are incarcerated and serving life without parole.
  • Just under half of the total federal prison population of 185,000 is serving some time for a nonviolent drug offense.
  • By far, drug offenses (46.2%) make up the federal prison population. See the Federal Bureau of Prisons’ bar graph statistics updated May 26, 2018: Bureau of Prisons Statistics
  • In California, it costs over $75,000 to house a prisoner for one year. While it is about half that in Federal prison, that is still a great amount of money.
What is a drug offense?
“A drug offense refers to the possession, use, sale or furnishing of any drug or intoxicating substance or drug paraphernalia, prohibited by law. Most drug offenses are felonies.” Definition of drug offense
All too rare bipartisan initiatives continue to transform criminal justice services to help people with drug offenses, who have addiction and/or social problems like poverty, rather than just lock them up. However, there are not a lot of Alice Johnsons of the world who have Kim Kardashian advocating for them. (“Who is Alice Johnson and Why is Kim Kardashian involved”)
 
TIP 2
Come together to achieve public safety, promote recovery and justice for all.
The National Association of Drug Court Professionals (NADCP) just completed their 2018 NADCP Annual Training Conference. With over 5,000 attendees and 300 educational sessions this is “the world’s largest conference on addiction, mental health, and recovery in the justice system!”
I was privileged to present five sessions. I met and interacted with judges, attorneys, probation and parole officers, law enforcement, treatment court administrators and coordinators, recovery coaches, peer mentors and treatment providers. All of these professionals comprise the “team” who can bring about transformation of justice and treatment services:
  • To incarcerate those who truly threaten the public safety.
  • To treat those with addiction and mental illness whose only threat to the public was behavior caused by untreated and unstable behavioral health conditions.
  • To be good stewards of all resources and spend our tax dollars wisely to increase public safety by promoting recovery and well-being for the sick; and for the socially and economically-disadvantaged people driven to crime to survive.
The Multidisciplinary Team
NADCP Practice Standards define the Multidisciplinary Team like this:
“A dedicated multidisciplinary team of professionals manages the day-to-day operations of the Drug Court, including reviewing participant progress during pre-court staff meetings and status hearings, contributing observations and recommendations within team members’ respective areas of expertise, and delivering or overseeing the delivery of legal, treatment and supervision services.
A. Team Composition
The Drug Court team comprises representatives from all partner agencies involved in the creation of the program, including but not limited to a judge or judicial officer, program coordinator, prosecutor, defense counsel representative, treatment representative, community supervision officer, and law enforcement officer.”
Source: National Association of Drug Court Professionals (NADCP), ADULT DRUG COURT BEST PRACTICE STANDARDS VOLUME II
It is going to take more that just drug and treatment court teams to advance justice services evolution. If President Trump was on board, as was President Obama who granted final commutations to 330 nonviolent drug offenders, we’re off to a good start.
SKILLS & STUMP THE SHRINK

During my presentations at NADCP, my goal was to bridge the gap between justice services and treatment services:
  • To help court teams know what good treatment should look like.
  • To help treatment providers understand what to put in update reports so court teams can know if participants are progressing or not.
  • To find ways to work together to protect the public and use resources wisely – treat participants for flare-ups of addiction or mental illness; sanction and incarcerate for threats to public safety.
  • To promote recovery and well being to achieve public safety, rather than compliance and incarceration.
As part of that process of bridge-building, I had many conversations and questions during and after the conference. Here is one of those.
TIP 1
How to craft policies allowing for mistakes and promoting honesty; not zero tolerance.
In part, this is what one attendee wrote to me:
Our court already has “warnings” for a lot of the supervision pieces – first missed curfew is a warning, first missed drug screen is a warning and loss of clean time, if admitting to drug use there is no sanction.
 
However, we have a “zero tolerance” policy for honesty. I tried to argue that these folks have spent the better part of their lives lying about anything and everything and the expectation that they are going to join this program and immediately start being honest in unrealistic. I suggested we have a “warning” for their first lie – when it is an honesty issue only. For example, a drug court participant may own up to the fact that: “I lied on my AA meeting sheet”, “I lied about leaving the jurisdiction”, “I lied about going to community service” – etc.
 
I would still address this in treatment with a redo of Step 1 if they have even passed that step, but as far as the sanction of a day in jail for an honesty violation – my hope is that we add in a warning to give them an opportunity to learn the system and learn how to be honest.

Do you have any hard research evidence indicating that this is best practice? The judge specifically said, “What are we losing by doing it the way that we do it?”

Drug Court Therapist
My Response
Thanks for writing and I think you have a tough task getting these points across. Here are some thoughts and resources:
Look at “Principles of Drug Abuse Treatment for Criminal Justice Populations – A Research-Based Guide” is from the National Institute on Drug Abuse. Here is a link if you haven’t seen it already  NIDA Principles of Drug Abuse Treatment
Principle #1, Drug addiction is a brain disease that affects behavior
Addiction is a brain disease, it isn’t just a behavioral disorder where behavior modification is the only method to address behavior. The behavior modification method of escalating warnings/sanctions does not address the complexity of addiction. Behavior modification is a single-theory approach to a complex multidimensional disorder.
Principle #2, Recovery from drug addiction requires effective treatment, followed by management of the problem over time; and….
Principle #3, Treatment must last long enough to produce stable behavioral changes.
Principles 2 & 3 require engaging participants in an ongoing therapeutic process focused as much on dropout prevention as on relapse prevention.
With any behavior problems it is important:
  • To understand what went wrong in the therapeutic process so poor outcomes like missed drug screens, positive drug tests, lying, attendance problems etc. are occurring.
  • To identify what the problem is and focus on how the participant can learn from their mistakes.
  • If the participant is willing to follow a new treatment plan addressing whatever problems were behind the behavior (e.g, hanging out with the wrong friends; not knowing how to deal with anger without using; struggling with a flare up of PTSD or chronic pain; scared to be honest about drug use, because of zero tolerance policies etc….) then treatment should continue, not warnings and sanctions.
  • Treatment is not about having people be perfectly well-behaved, but in helping them change attitudes, thoughts and behaviors around the assessed problems they have which threaten public safety. If they could be perfectly honest, abstinent and pro-social, they wouldn’t need treatment!
Principle #4, Assessment is the first step in treatment; and..
Principle #5, Tailoring services to fit the needs of the individual is an important part of effective drug abuse treatment for criminal justice populations.
These principles emphasize:
  • How important assessment is.. how important individualized treatment is to improve services to fit whatever new needs are assessed and discovered.
  • Assess and treat, instead of activating a series of warnings when something goes wrong in addiction flare-ups, such as substance use, lying or antisocial behavior.
  • This is important not just at the start of treatment, but in an ongoing process. Self-defeating choices and flare-ups of old and new problems can occur at any time of the recovery process.
Principle #6, Drug use during treatment should be carefully monitored so that any “detected use can present opportunities for therapeutic intervention”.
  • Policies permitting mistakes and honesty allow the participant to move away from criminogenic thinking and antisocial behavior.
  • Zero tolerance pushes any impulses or actual substance use underground preventing “opportunities for therapeutic intervention”.

How to respond to the judge who says: “What are we losing by doing it the way that we do it?
Unintended negative consequences of a predominantly behavior modification approach of warnings and sanctions and zero tolerance:
  • Creates an environment that fosters participants’ need to lie about any use they have from an addiction flare-up;
  • Causes participants to be more focused on looking good and compliance, rather than on learning from mistakes and changing their treatment plan if things are not going well.
  • Increases the need for participants to “con” the treatment and court team if they make a mistake. Instead they could be putting their energy into being honest about their struggles to use, cravings and triggers, ambivalence about changing people, places and things like hanging with certain friends; or going to certain neighborhoods.
  • If a participant misses a curfew or receives a positive drug test, it creates the incentive to lie to save face and use criminal thinking to scam the system, a behavior they are already too good at.
What you have to lose is to see:
  • Continued high dropout rates and poor “graduation and completion” rates.
  • Continued recidivism of participants who graduated but didn’t really change in their attitudes and behavior which threatens public safety.
  • Incentives for participants to focus on compliance and avoiding warnings and sanctions, rather than focus on adherence to an individualized treatment plan to achieve real, accountable and lasting change in function.

SOUL

This must be my NPR Here & Now month.
Last month, there was a May 21, 2018 segment about the Supreme Court’s ruling that struck down a 1992 federal law preventing states from permitting sports betting. I was interested not just because it raised awareness about the neglected manifestation of addiction, gambling disorder, but because of the lawyer who spoke about his addiction and recovery.
Michael Burke, now executive director of the Michigan Association on Problem Gambling, said:
  • “I stopped drinking 40 years ago. But what I did is I traded it for another addiction. I never got involved in drugs after my treatment because the people at the treatment center terrified me about trading an alcohol addiction for drug addiction.”
  • “I probably had gambled 14 or 15 years…..They opened a casino in Windsor that was less than an hour from Howell, where I lived. I found that I started going over a couple days a week, spending what I thought was a reasonable amount of money – up to $300. I set the limits, I maintained them. But …it changes and I start chasing the money I’ve lost. And I actually ended up embezzling $1.6 million from my clients, and I spent 3 to 10 years as a result of this in Jackson [State Prison].”NPR’s Here & Now Gambling Addiction
Here was a lawyer who was dishonest, told lies and cheated his clients – all because of the ravages of addiction. His addiction first manifested as alcohol use disorder but then later, a gambling disorder.
I hope one day all the judges and lawyers who want to sanction, give warnings and incarcerate people with addiction who lie while in treatment will have a chance to talk to the Michael Burkes of the recovery community.
Of course, it is not OK to lie and be dishonest. I bet lawyer, Michael Burke, in long-term recovery, knew that, while he continued lying to his clients, embezzling their money. That is the cunning and baffling nature of addiction – to say and do bad things you know you shouldn’t do.
But when participants in treatment courts are in the throes of their addiction (using or lying) with no recovery time or skills, that is the time to “do treatment” not “do time”.
Craft policies that allow for mistakes and promote honesty; not zero tolerance.

Until next time
Thanks for reading Tips & Topics this month. See you soon again in late July.
                                                                                                                        

David

                                                                                                                        
David Mee-Lee, M.D.

916-715-5856
davidmeelee@gmail.com

The first time I have ever drank was my sophomore year in high school i drank socially not really to get wasted but just to hangout. It was never much fun though because I had aspirations to play basketball in college and was worried about getting in trouble and ruining those chances. I did it occasionally having a girlfriend and other friends who enjoyed it I also enjoyed doing it too at times. The first place I ever drank at was an older kids house after one of my high school basketball games on a Friday night. I wasn’t peer pressured into it i wanted to drink but knew that I had to drink responsibly because I didn’t want my parents finding out about it and also i wanted to stay out of trouble, 1 can’t really tell you how much I drank that night but I can tell you that I drank enough to realize that I was drunk. I learned the next day for the first time what it felt like to have a hangover and did everything I could to hide it from my parents in fear of getting in trouble. I never drank during the week in high school because I usually had practice and for a couple years I was playing basketball 11 months out of the year so I never really had much free time to do what I wanted or to go out and drink.

Occasionally I would go out with friends and continue to drink but things were never out of control where I felt like 1 need to drink during the week or was upset about not being able to drink on the weekends. As I got older the amount of times I drank increased but not by much, once I became a senior in high school I no longer played basketball for 11 months out of the year because I had committed to play basketball at uncc, and no longer played basketball over the summer. That being said the pressure was even higher for me being committed to the school in fear of losing what I had worked so hard for, But with more time on my hands now it gave me more time to finally be able to relax and hangout with my girlfriend and people that I had to sacrifice my time with when I was working to get to where I wanted to be. The next time I noticed an increase in drinking was probably when my girlfriend and I broke up last summer. I never felt that I had to start the day off drinking or that it was the only way to feel better about my situation, I was heart broken and when I would go out 1 noticed that I drank more not really admitting to myself or anyone else that I was drink in more probably because of her. In college I didn’t drink any more or less than I did in high school and with us practicing all the time we never really had time to go out but on occasion we did. The night I got arrested I had been drinking throughout the day with my teammates before a football game that we were going to watch we ubered to the game and ubered back.

We went to a party later that night continuing to drink as we had done other times in the past. I got an uber home from the party and my teammate and some of our friends were stuck at the party and 1 told them that I could come over that it was only just down the street and that it wouldn’t be a problem. Long story short I got pulled over and my life kinda flipped upside down but this time I didn’t notice and increase in my drinking when or if i would even go out. I was actually refraining from drinking for a while told petrified of ever getting in trouble again and afraid of going back to jail and losing everything I have worked so hard for throughout the past 5 or 6 years of my life. I drank maybe once or twice before I left the school and transferred one of the nights being my last night there before I transferred out almost as like a toast to the friends and everyone I would be leaving behind. lve only drank 1 more time since I left that school in the beginning of november and that was maybe a week later when 1 went to my cousins wedding Again nothing crazy just socially drinking with my family.

Since then 1 have not had anything to drink and still to this day have not drank while attending this class. I do not believe that I have a problem with alcohol or that I am an alcoholic I believe that I made a mistake and that I deserve to suffer the consequences of whatever happened and I did I served jail time and I did learn my lesson… never to get behind the wheel of a car after you have been drinking. I do not believe that I will never drink again I would not want to lie to you because I do not feel that I have a problem with it.

I would like to share something with you that I have gone through and by no way do I want you to feel like I am complaining because I do know that there are people out there that have it way worse than I do right now but its kinda a little story about how I changed my life for the better and probably how I managed to make it through all of this without going totally insane and if you would like to share this with the group or other groups later on that is totally fine with me and I would talk to them openly about it if I had to but if it can help people later than it will feel good to know that people can learn from me and hopefully open someones eyes to a different perspective on life.

So as i mentioned earlier I had been in a relationship with a girl for 5 years. I am currently 19 so I was pretty young when I started dating this girl. Never had another real girlfriend in my life thought she was the one honestly thought we were gonna make it together for forever. Well about four years into our relationship when we finally decided on schools to go to I went to my school she went to her school which was about four and a half hours away from each other. For a couple that had been together for five years and never really been away from each other for more than a couple days it hit pretty hard. Hard enough for her to feel that the relationship wasn’t working out so we went on a break about four months later we started talking again and eventually started dating again. It was brought to my attention by her that she had tried a handful of drugs that I would of never expected her to do. Slowly I see a different side of a girl who I thought I new so well. After she told me this I made her promise that she would never do any of these drugs again other than smoking weed and drinking those I was okay with but anything worse than that and we are talking about major addiction.

We actually had a friend go into cardiac arrest and die when we were in high school from taking the same drug she had taken. Anyways we started arguing more and more looking back now seeing how unhealthy this relationship was I should have been out a while ago. Come to find out about 6 months after we had gotten back together she had done cocaine again and did a few other things that were not acceptable for any couple no matter how long you have been dating. Hearing this broke my heart thinking how could she do this, she never loved me, what else has she been lying about. I was depressed I didn’t go looking for alcohol, or drugs, I didn’t leave my room much. So much anger and hate and sadness were inside I was losing my mind. This is where I get to the moral of the story. I felt that if we would of just got back together then everything would be alright, and that was how I always have felt “oh it will be better maybe if I change who I am things will work out between us” but she didn’t want anything to do with it she apologized and said that maybe it was better if we just stopped dating for a while and did our own thing. I didn’t want to give up on her I thought she was the best thing for me and the best thing for what I was trying to do with my life.

I realize to this day that I was co-dependent on her and the relationship we had. So co-dependent that I let her walk all over me hurt me, upset me, lie to me, break my heart all because I was blinded by what I thought was love, by what I thought was normal for relationships. Now please do not get me wrong I loved the girl to death and I still do and honestly there probably isn’t anything I wouldn’t do for her but I do realize now that I do not need her in my life to be happy. That me doing everything I could to make her happy was me getting away from who I truly was. I wasn’t doing anything for me but all for her. I had to start doing things to make me happy because if I do not make myself happy I can not expect others to be happy around me. Again I want you to understand that all five years of the relationship was not horrible i had plenty great memories with her but there were a lot of bad ones too that I would hide away and keep bottled up afraid of losing her. My mother is actually the one that brought me out of my depression she said that every day that she is alive she strives to create lasting memories each and every day CREATE LASTING MEMORIES (CLM) that the lasting memories that we create are those that we will remember forever and can help us in our darkest time.

She is also the one that told me “you can not change the past nor predict the future” and that we can only truly control one thing in this world and that is ourself and to live in the present. So after we had that discussion my mom, her boyfriend, my cousin, and I all got CLM tattooed onto our bodies for us to remember each and every day create lasting memories and I can honestly say it has helped me to remember this because I’ve been through a lot lately but no matter how bad your day can seem you cant change it it already happened but you can make the most out of every day. Even if this only helps one person at least I helped someone I hope that while you read this you see how much I changed and I just wanted to thank you for everything you have done for me this place has really helped me to understand and learn a lot about alcohol and drugs and what to do to prevent this from ever happening again.

I will never forget the walk home after my second DWI. It was late November in Illinois. Freezing. Wet. Dim. It was 4 am by the time I left the police station. I pointed myself in the direction that I thought was home and started walking. Just wanting to be anywhere else. Or nowhere. After an hour, I realized I was going the wrong direction. I doubled back and took me almost 3 hours to get home that night with nothing but shivering wind and self-loathing to keep me company. Once I got to my door, I realized my house key was with my car keys. With my car, impounded. I had to make the trip again.

Just thinking about that night makes me sick to my stomach. When I think of getting drunk, there isn’t a single night out that I remember. I never think about college parties, or dunk hookups or celebrations, I remember that last night every single time.

Since that night, I have made some major changes in my life. I looked at myself and decided my goal had to be not only to quit drinking but to better myself. I have moved to the east coast to be closer to my family, which makes me happier every day I wake up. I have re-enrolled in school, so I have positive goals to work toward. I quit smoking and I learned how to cook. I hit the gym more frequently and I have taken up evening running. I like myself again.

Those classes and those experiences has given me a new perspective on alcohol and sociability. I think by the time we finish our classes, we all feel closer to each other than I ever did to my bar friends. Now I want to take that outlook and apply it to everything in my life and hopefully make myself and those I care about better for it.

I remember drinking my first beer the night before I turned 13 because I didn’t want to become a teenager without having tried it. Yes, I know how dumb that sounds, it was a Guinness. I hated it.

I still didn’t like beer very much in High School, but somewhere between Junior and Senior year, I started partying almost every weekend. I discovered that I do like weed. I used to smoke almost every day. Even occasionally throwing down with a few friends to pick up an OZ. and roll the whole think in a day. At parties I would smoke more than I drank, usually nursing a beer to give the impression that I was drinking more than I was.

College was the same, just with even more weed. By the time I was 24, I had dropped out of my second college. On the bright side I had become kind of a health nut. I worked out twice a day, ate a health diet and quit smoking. A year later, I started going out after work with a group of friends on Friday Nights. Still relatively innocent, but I discovered that I enjoyed Whiskey.

When I switched jobs and started working downtown, I started hanging out with a new group. Just like that. It was like college all over again, only this time with my newfound affinity for whiskey. I started drinking several times a week. I drank for fun and somehow, I also drank to wind down. I started smoking again both weed and cigarettes. Even after I left that Job, I carried that behavior with me and within a year and ½ I had picked up 2 DWI’s.

My last arrest was in November. My last cigarette was in December. My last court appearance was in March and so was my last drink. I feel good about where I am now. I recognize that I have been in this position before. A few short years ago, I was looking back at my past behavior, wondering how I could have possibly been so stupid. I feel the same way now but this time I have the benefit of experience. I know what is at stake and I know how easy it is to fall back off that cliff. I know I can’t be cocky. But I also know that there are places like this and people like you. And I think if I ever catch myself slipping again that might just make all the difference.

First, Rhonda, I want to thank you. My time here has been a rewarding, positive experience and your passion and support is genuinely inspirational. I hope it is as clear to you as it is to all of us that your trials and tribulations were not mistakes, because they brought you right here to us. Where you need to be-leading others out of the darkness. Your work helps us through our most trying times, but your influence doesn’t stop with us. You make our families better, our friends better, our communities and our unborn children all owe you a debt of gratitude. Thank you.

Name withheld due to confidentiality.

Paxton West’s words speak volumes about the strong hold opioid addiction has on users.

“I would beg myself not to use as I was sticking a needle in my arm,” said West, a Statesville native now serving a four-year prison sentence.

How do we deal with the epidemic that has ripped through our community and so many others nationwide?

Over the past several months, the Record & Landmark staff talked to those on the front lines of the crisis. We interviewed deputies, doctors, counselors, addicts, pharmacists and others.

This three-part series examines how we got here and where we’re going.

» TODAY: An overview of how the epidemic has affected Iredell.

» MONDAY: How addiction happens and how public safety agencies have responded.

» TUESDAY: Local treatment options and where we go from here.

Data in this series comes from the North Carolina Event Tracking and Epidemiologic Collection Tool (NC DETECT), a state resource created by the N.C. Division of Public Health.

By Jennifer Dandron

Statesville Record & Landmark

One summer afternoon several years ago, Paxton West walked up to the edge of the Radio Road Bridge overlooking Interstate 40.

Frightened, frustrated and coming off a high, West watched as dozens of cars and trucks passed underneath him.

The relentless summer heat beat down on the Statesville native’s frail, gaunt body as he searched for the one vehicle to end it all.

Soon enough, he found the one. A large tractor-trailer barreling down the interstate would work.

The only relief West ever felt came from a syringe. That was about to change, he thought.

Once the truck got close enough, West would no longer be a slave to the needle. He wouldn’t continue tearing apart his family. The shame he endured would vanish.

No turning back. It was the only way out.

“I was tired of feeling the way I was and doing things that felt like were out of my own control,” West, now 28, said. “I would beg myself not to use, as I was sticking a needle in my arm.”

He closed his eyes, stepped forward and prepared to jump.

IREDELL’S OPIOID PROBLEM

West is one of many Iredell residents who struggle with opioid addiction, by far the most widespread drug issue here, according to Iredell County Sheriff’s Office Capt. Bill Hamby.

“We’ve arrested everyone from elderly females all the way down to … school kids,” he said. “So I don’t know if you can say there is a typical drug dealer.”

As of June, 250 people were admitted into local emergency rooms for drug overdoses this year.

One in 12 people suffer from substance use disorder, but one in 10 seek treatment.

Statewide, heroin deaths have increased 800 percent since 2010.

“We don’t have any other chronic disease in America where that is the case,” said Dr. Omar Manejwala, an internationally recognized addiction psychiatrist who delivered the keynote address during February’s opioid crisis summit in Mooresville. “That’s not true for diabetes, congestive heart failure, COPD or any other disease. It’s not even true for any other mental illness like depression. The statistics are terrible. People don’t get help.”

But there’s a push in Iredell to change that.

A UNIFIED FRONT

Mooresville substance abuse counselor Rhonda Lazenby, who herself battled an alcohol and drug addiction for the better part of three decades, spends her sessions preparing her patients for recovery.

“We treat the whole person. If someone needs a job, (we can help),” Lazenby said. “If they need to write a resume, I’ll do it for free. I provide free case management services. Drug addiction is a medical issue. If someone’s diabetic and they relapse and gain weight, we don’t dog them and send them to prison. If an addict relapses, we send them to prison. You’ll see people getting help when we get rid of the stigma.”

The stigma of addiction stems from a societal belief that it’s a moral failing rather than a legitimate disease scientifically proven to alter the brain, according to Manejwala.

“These are the patients that most physicians hate to see,” said pain management expert Dr. Bobby P. Kearney of Addiction Recovery Medical Services in Statesville. “Their disease and how it changes the brain causes behaviors that aren’t so attractive … the lying, stealing, manipulating.”

These behaviors are the disease, not the patient, he said.

“These are the modern day lepers, isolated from the rest of society,” Kearney said. “It’s a lot of pressure for them. These people deserve love. They’re some of the best people I’ve ever met. They’re some of the strongest people I’ve ever met. It takes tremendous courage to come in and get help, when only one in 10 will come for treatment.”

Kearney joined the Statesville practice in 2003. At the time, it was one of only three pain programs in the entire state, he said.

Now, however, he said there multiple programs in Iredell County alone.

So how did we get here?

“Physicians being as territorial as they are, when other practitioners saw what pain management physicians were doing, they didn’t want to lose their patients to pain management programs,” Kearney said. “They began writing medications that they weren’t trained to write. This began a process that has escalated over the last 25 years, to the point where we’re in an epidemic.”

HOW IT ALL BEGINS

Paxton West is now inmate number 1048049. He hasn’t been home for a Thanksgiving or Christmas in the last six years.

It will be 2020 before he sets foot outside a prison.

“I’m full of regret, shame, remorse,” he said after a brisk walk through Pender Correctional Institute on a recent Wednesday afternoon. PCI, in Burgaw, is a medium-security state prison. “All those things go hand in hand. I put a lot of wedges between my family and pushed a lot of my family apart. It’s not something I’m happy about or proud of, but I just have to get clean, stay clean and live my life.”

West’s drug abuse started in high school, where he first experimented with marijuana. He progressed to harder drugs after receiving prescription painkillers for a sports injury and then again after having his wisdom teeth removed.

Soon he was snorting cocaine and buying prescriptions off the street.

“I moved back to Statesville after living in Asheville for awhile and a lot my friends were already using oxycontin on the IV level. I was very stand off-ish to them about that,” he said. “Then one day, I was like I’ll show you it’s not a big deal. They kept saying they couldn’t stop, so I thought I could show them that you can.”

West shot a solution of crushed pills into his vein about 7:30 one night. By 9 a.m. the next morning, he bought his first pack of syringes from CVS.

‘I DIDN’T WANT TO LEAVE HER’

West’s addiction drove him to one of the lowest points in his life and landed him on the edge of that bridge four years ago.

Standing there, eyes tightly closed, he wanted his final moments to be filled with positivity.

He thought of family dinners, holidays and graduations. But his transgressions quickly surfaced and the guilt overwhelmed him again.

“I tried to get rid of the negative thoughts and replace them with good ones, but I couldn’t,” West said. “I thought of all the good people in my life and the ones I loved the most, but then all I would think about is the huge amount of pain I’ve caused. I felt so ashamed.”

As the traffic sped forward, and the transfer truck drew closer, one last memory came to mind.

All he could see was his daughter’s face. All he could hear was her laugh.

For an instant, his life had purpose again.

“Nothing could replace her,” he said. “… I thought about how much I loved her. I didn’t want to leave her.”

In his momentary hesitation, a gust of wind knocked West down and breathed new life into him.

He realized he had another option.

He had hope.

Paxton sprinted to his childhood home on West Bell Street, where he fell to his knees and begged for help from his parents, Gary and Patti West.

“We had no idea how bad he was using,” Patti West said. “Looking back I kept thinking, why did I not immediately pick up on everything that was happening? Why did I listen to him when he said everything was OK? We found syringes in his room and our spoons started (going) missing, but we had no idea.”

BY THE NUMBERS

9,950,699

Total opioid pills prescribed in Iredell in 2016

155,284

Total opioid prescriptions written in Iredell in 2016

44,703

Number of Iredell residents who received an opioid prescription in 2016

Paxton West’s words speak volumes about the stronghold opioid addiction has on users.

“I would beg myself not to use as I was sticking a needle in my arm,” said West, a Statesville native now serving a four-year prison sentence.

How do we deal with the epidemic that has ripped through our community and so many others nationwide?

Over the past several months, the Record & Landmark staff talked to those on the front lines of the crisis. We interviewed deputies, doctors, counselors, addicts, pharmacists and others.

This three-part series examines how we got here and where we’re going.

» SUNDAY: An overview of how the epidemic has affected Iredell.

» TODAY: How addiction happens and how public safety agencies have responded.

» TUESDAY: Local treatment options and where we go from here.

Data in this series comes from the North Carolina Event Tracking and Epidemiologic Collection Tool (NC DETECT), a state resource created by the N.C. Division of Public Health.

»»»

By Jennifer Dandron
Statesville Record & Landmark

Paxton West’s heroin addiction nearly turned deadly while he was visiting Wilmington five years ago.

His pale face went blue. His pulse weakened. His pupils constricted to a pinpoint.

The rhythmic beeps of his heart rate monitor faded into a steady tone as he flatlined in the back of a New Hanover County ambulance.

“Dying was the most painful thing I’ve ever done,” West recalled.

It’s happened to him more than once.

SERVING ONE PURPOSE

Addiction has defined West’s actions for the last decade.

From forging prescriptions to selling stolen goods, every day West has spent addicted to opioids, he’s had one goal: Finding the next fix.

“It has such a grip over every single aspect of your life,” West said. “It does not matter who or what stands in your way to get to that substance to make you feel better. … Every moral went out the window. I had to obtain the dope to make me feel better.”

Last November, just months removed from a 29-month prison sentence, he was convicted of four counts of breaking and entering. He’s now serving four years at Pender Correctional Institute in Burgaw.

“It really sucks being where I am,” he said. “Emotionally, it’s up and down for me right now, but I’m happy to be alive. … Every now and then I feel the urge to use, especially struggling with being in prison. When I get in my head sometimes I think if I could use, I would. I do my best to push that out of my mind, though. I’ve learned as an addict usually my first thought is wrong.”

PRESCRIPTIONS GIVE DANGEROUS DRUGS LEGITIMACY

West traces his addiction to legitimate opioid prescriptions. He was first prescribed low-level painkillers for a sports-related injury.

He got more for the removal of his wisdom teeth in his sophomore year of high school.

Like it is with many users, the addiction progressed.

People tend to view prescription pills as safer than other controlled substances, according to Capt. Bill Hamby with the narcotics unit of the Iredell County Sheriff’s Office.

Users know where pills are made. They know that each pill is exactly the same dosage. They know the side effects.

“I can go buy a rock of cocaine and it may be coke, it may be a macadamia nut,” Hamby said. “I could buy methamphetamine and it could be cocoa powder. I could buy heroin and it might be gum. But … if I’m buying a 20 mg oxycodone or a Percocet and that’s my pill of choice, my drug of choice, I know what that looks like. I’m not as apt to get ripped off. I know what I’m taking. I kind of know the side effects of what I’ve got.”

The opioid epidemic is a source of endless frustration for Hamby and his team.

Hamby has nearly two decades of experience in law enforcement. He’s arrested countless cocaine dealers and shut down his fair share of meth labs.

But opioids, he says, are different. They’re easier to get because they’re prescribed so frequently.

Pills come from doctors, not drug cartels. Pills are manufactured by pharmaceutical companies, not homebrewed in a pot.

The truth is, there is a lot about these pills that is legal — and that’s what is so vexing to law enforcement.

In Iredell County last year alone, 9,950,699 opioid pills were prescribed from 155,284.

That’s about 59 pills per Iredell resident.

“This is not a supply-side problem. It is a demand-reduction problem,” internationally recognized addiction psychiatrist Omar Manejwala said during his keynote speech to area prescribers in February. “If you look at the Florida experience, they cracked down on the prescribing of opiates and had a reduction in deaths. Then, Ohio cracked down on the prescribing and had a reduction in prescribing of pills but an increase in overdose deaths. It’s a complex problem.”

LAW ENFORCEMENT DIVIDED ON RESPONSE

In his nine years as a superior court judge, Joe Crosswhite said he has seen an increase in opioid-related crimes each year.

“It’s bad here. It’s bad everywhere,” he said. “I don’t think I could have seen how big of a problem opiates would have become.”

Crimes associated with opioid addiction are clogging the justice system, but local law enforcement agencies are taking different approaches to handling it.

The Iredell County Sheriff’s Office has taken a hard stance on drug abuse, while the Statesville Police Department is working to implement a drug user diversion program.

“Drug dealers and drug houses attract other crime,” Sheriff Darren Campbell said. “Drugs cause people to commit other crimes like larcenies to support their habits. … And that’s why we are so proactive on the drugs. … It just shows being aggressive on the drugs and the dealers helps us stop other crimes and stuff. … Anytime we arrest a drug dealer, that’s a community enrichment program.”

West agrees, in part.

If it weren’t for his drug habit, he says he would never have committed any crimes.

West hasn’t been home for the holidays in six years. By the time he is freed from his second stint in prison, West will have missed eight years of his 11-year-old daughter’s life.

“I don’t think incarceration in any means is a fix for an addict committing crimes,” he said. “We’re not given resources and tools to function and survive. We need treatment and education. We should be making people that are victims of the crimes a part of the recovery process. It needs to be a re-building process for the addict. Incarceration is not going to help.”

The Statesville Police Department applied for a $400,000 grant over a three-year period to manage the Law Enforcement Assisted Diversion (LEAD) program, which will allow officers to divert low-level drug offenders to intervention rather than to take them to jail. The offender must go through the program to clear any criminal charges.

LEAD, which is operating in seven states with more exploring the program, has a successful track record, according to program coordinators.

A 2015 study conducted in Seattle “found that LEAD participants were 58 percent less likely to be arrested after enrollment in the program, compared to a control group that went through ‘system as usual’ criminal justice processing,” according to the LEAD National Support Bureau.

It’s unclear when LEAD will go into effect, but West, an advocate of the alternative program, says it won’t be soon enough.

‘MORE PEACEFUL TO DIE’

The back of an ambulance is all too familiar for West.

When EMS administered the life-saving, opioid-effect reversing Naloxone in New Hanover County, West immediately regained consciousnesses, yanked the IV tube from his body and sprang forward, ready to fight the paramedics who saved his life.

“In that instance, I remember being mad for one because the paramedics ruined my high,” West said. “Secondly, I just didn’t want to go on anymore. It would’ve been more peaceful to die than to continue being an addict.”

EMS once again saved his life when a group of friends shoved him out of a car, left for dead next to a Catawba County ambulance outside of the Chuck E. Cheese in Hickory.

He was spared yet another time when a friend dragged his limp body into a blistering cold shower and shook him until he became conscious.

With every injection, the risk of overdosing amplifies, West said. It eventually becomes inevitable.

“Addiction doesn’t discriminate,” he said. “From country club to crack house, the only thing addiction wants to do is kill you and it eventually will, if you don’t get help.”

»»»

BY THE NUMBERS

9,950,699

Total opioid pills prescribed in Iredell in 2016

155,284

Total opioid prescriptions written in Iredell in 2016

44,703

Number of Iredell residents who received an opioid prescription in 2016

Source: Iredell County Health Department