Xanax the New Norm

Earlier today a young rapper that went by the stage name Lil Peep was found dead in Arizona. The cause of death? A coroner suspects an overdose of the anti-anxiety prescription Xanax.  He was only 21 years old. The latest case of prescription drug abuse sweeping the nation among young kids.  Xanax is a prescription medicine that when used correctly can treat anxiety, panic disorders, and anxiety caused by depression. It is a member of the benzodiazepines group of drugs more commonly referred to as benzos. Benzos affect the central nervous system and reduce the activity of neurons to the brain.

Xanax is increasingly becoming a commonplace in pop culture. With it’s rise as a recreational drug comes a higher rate of overdose. Xanax accounted for 31% of the prescription drug overdoses in 2013. The overdose rate has quadrupled in the period of 1999-2013 and those numbers are only steadily rising. The prescription abuse that comes with Xanax usage is overshadowed in part to the prescription opiate crisis. However, both opiates and benzodiazepines are substances that can users can easily become addicted to. Not only did the number of prescriptions in the 18 year period between 1996-2013 increase 67% but the amount of pills per prescription more than doubled.

Xanax has become increasingly popular because of the effects it has on the human body when mixed with other narcotics. Dr. Joanna Starrels a professor of Medicine at the Albert Einstein College of Medicine reported  75%  of people that overdose benzos had other narcotics present in their system.  Xanax when mixed with alcohol can make the user experience symptoms of drowsiness, fatigue, and clumsiness.  Xanax can cause memory loss and the effects similar to “blacking out” on alcohol. The drug is broken down by the same enzymes that break down alcohol and therefore produces withdrawal symptoms similar to alcohol. Withdrawal from the drug can cause seizures, anxiety, agitation, and delirium. 

Since 2010 it is reported that the overdose rate has leveled off for the general populations, however, the populations with the most rise in overdose are Blacks and Hispanics.  This number could be due in part to increasing references to Xanax in hip-hop/ rap songs. A prominent rapper in the industry Chance the Rapper chronicles his issues with Xanax in a lyric from his song “Finish Line” in which he raps “Last year got addicted to Xans , Started forgetting my name and started missing my chance”  Because of it’s glorification in hip-hop music and the false representation that it can’t be dangerous because it is a prescription drug the number of African-Americans overdosing from the drug is rising. In 2015 Chance the Rapper tweeted “Xanax  the new heroin, don’t let em fool you”.

While Chance the Rapper dedicated parts of his last album Coloring Book to speaking about the ill effects of the drug, many other prominent rappers have continued to glorify the recreational usage of the drug as a party drug. Xanax is commonly referred to as “bars” and individuals on Xanax refer to themselves as being “barred out”. Juicy J raps in his song “Geeked up Off them Bars” about his partying experience with Xanax. He raps “I’m on them Xany bars my weed is medical… Juicy J one crazy high ass n****”.

The Migos are a prominent rap group that dominated the charts in 2017. In their song titled “Designer Drugs” one member Quavo raps “I fell in love with the drugs, I think I’m a addict, Percocet, molly, and Xanax, I feel like I land on the planet, I’m on Designer drugs, on Designer drugs, on Designer drugs”. He then goes on to rap “Sober ni**** out of style” these lyrics further perpetuate the glorification of Xanax and other narcotic abuse in hip-hop culture and make the claim that sober people are out of style.

Not only can abuse of Xanax cause withdrawal symptoms commonly referred to as worse than heroin withdrawal but they can also carry legal issues. In the state of Virginia Xanax is considered a schedule IV narcotic. Possession of a Schedule IV narcotic is a class II misdemeanor. A class II misdemeanor can result in up to 6 months in jail and a $1,000 fine.  Drug possession charges can be placed upon anyone possessing Xanax without a prescription.

With the death of Lil Peep this morning November 16th I thought what better time to discuss the issues with Xanax Abuse in my blog. Just because it is a prescription drug does not make Xanax safe. The misuse and abuse of this prescription only creates a bigger hassle for those with anxiety that actually need the drug. Xanax is not just a buzzword rappers use to get more listeners on their songs, the problems that arise with misuse are real issues and must be taken seriously. Representation of this drug as a recreational or party drug in media is wrong. James Madison University is a school with a party reputation and the threat of Xanax abuse is prevalent on campus and in the surrounding area.  It is important to understand the risks associated with this drug and the potential for addiction that comes along with even recreational usage.

Heroin Treatment.. Do or Die?

Like most opiates heroin is a highly addictive drug because it gives off feelings of euphoria and pleasure. Overdoses are common with heroin because as users continue they build up a tolerance. This tolerance requires higher quantity of drugs at one time and more frequent usage. When users increase the amount they use in order to reach the same high as before they risk  the chance of overdosing.  Addicts need to continually use heroin because withdrawal symptoms are like that of having the flu. Symptoms include restlessness, muscle and bone pain, cold flashes, diarrhea and vomiting, and cravings. (DrugAbuse.Gov)

Overdose rates among heroin users are some of the highest among any abused drug.  In 2016 49,000 of 70,000 total overdoses were attributed to opioids. (Center for Disease Control) Opioids are the broader group of substances that heroin falls under. What is causing this high rate of overdose? Much can be attributed to the widespread usage of fentanyl lately. Heroin dealers have been utilizing fentanyl in order to strengthen their supply of heroin cheaply. Below is a photo provided by the New Hampshire State Police that visualizes the amounts of each substance it takes to lethally kill a male.

When users overdose on heroin their last hope is intervention by someone with training and equipped with an overdose reversal drug. One of the most popular reversal drug is narcan. Narcan can be sprayed in the nose and is packaged with two doses in the case of need for repeat dosing. These drugs can save lives but even after a near-death experience addicts continue to use this deadly drug. Why do individuals continue to use heroin even after they almost die, simply because they are addicted. One individual Reese talks in an interview about the need to always have more and more of the drug no matter what. He talks about leaving his house on a stretcher and scaring his mother but even though he wants to quit he simply cant.

All of the factors discussed above explain why heroin has a relapse rate of upwards of 90% in certain studies. One study in Dublin, Ireland found that out of 109 cases of individuals that completed a 6 week inpatient detoxification program 99 relapsed. Of those 99 individuals 54 reported relapsing within a week of leaving the facility. The withdrawal from heroin can be so painful and sickening that users are left with no choice but to start using again in order to make the feelings go away. One user chronicles his issues with withdrawal for the Discovery Channel when he is arrested and forced to become sober and therefore “dope sick”.

As justice studies majors with potentially a more open view of deviant behavior is there a just way to approach heroin addiction and other substance abuse? With confidence I can say our approach of labeling addicts as criminals stigmatizes those caught up in addiction. A Philadelphia cheesesteak shop owner and local celebrity Tony Luke started a campaign to change the conversation about addiction after his son’s heroin overdose. Tony Luke  argues that we need to see the people behind addiction first because by stigmatizing addiction and labeling those with substance abuse problems we are keeping them down. The argument claims that those with addiction problems will continue to see themselves removed from society and can not comprehend seeking help when they feel like outsiders in society.

The standard for a just approach to addiction needs to change. Addicts of heroin and other substances should no longer be thrown in jail and forced to deal with their addiction on their own.  The same study from Dublin that recorded relapse rates also speculated on why those relapse rates were high. Patients that stay for the full period of an inpatient detox program are more likely to have a delayed relapse and a lower rate of relapse. The researchers speculated that to reduce relapse and overdose rates addicts should be brought into an inpatient rehabilitation center. While in that center the individual should stay for the full time of the course and then find a program to attend after being released. Addiction is not a simple crime and those arrested are not truly receiving rehabilitation by being left alone in jail. Alternative treatment should be sought to reduce stigmatization and relapse rates of heroin users.

 

 

 

https://www.drugabuse.gov/publications/drugfacts/heroin

https://www.ncbi.nlm.nih.gov/pubmed/20669601

http://www.phillymag.com/news/2017/06/29/tony-luke-heroin-addiction/

 

Best Option for Managing Drug Usage?

Starting in 1971 the United States began a campaign to combat drug usage throughout the country. The then President Richard Nixon declared a war on drugs and labeled drug usage as “public enemy number one”.  Presidents after Nixon followed suit and continued this war on drugs and even added on  to campaign. Ronald Reagan for example presided as president when the Anti-Drug Abuse Act was passed in 1986. This act lead to mandatory sentence minimums for drug crimes and put non violent offenders in jail or prison for long periods of time. Even Ronald Reagan’s wife Nancy joined in on the campaign to end drug usage. Her campaign utilized a different approach and focused on educating the youth about the dangers of drugs and advocated for youth to “just say no”. 36 years later the federal war on drugs is still waged by agencies like the DEA and the drug abuse is still nationwide. What should be done to actually finish the war on drugs, and what can be used in place of mandatory sentencing and long jail terms?  After 36 years and a lack of actual societal change,where do we go from here?

Decriminalization and Legalization
An approach being used around the country to reduce the amount of individuals in prisons and jail for minor drug crimes and non-violent drug offenses is to decriminalize or legalize certain substances. The rationale behind those that adhere to this viewpoint is that individuals will always be deviant and choose to use drugs regardless of health hazards. Instead of focusing on making drug users offenders the government should legalize drug use or decriminalize offenses to better regulate sales, tax drugs, and reduce the number of individuals in overcrowded prisons that are non-violent drug offenders. An important distinction is the definitions of decriminalization and legalization. Decriminalization does not mean it is legal to posses substances however with marijuana as an example it is not a criminal offense to posses small amounts. Legalization is simply the legalization of recreational drug usage. Below is a map that details the current drug laws in the United States.

Countries with relaxed drug laws such as Denmark have implemented progressive approaches to clean up their streets by opening legal drug consumption rooms. These rooms allow the drug user to inject heroin or use cocaine without the fear of legal ramifications. Supporters of this approach claim users can be monitored to prevent overdose but also do not have to resort to using in public restrooms or on the streets. Those that oppose the approach believe it is only enabling drug usage and fear a society that allows drug usage.

Drug Courts
In an effort to reduce offending patterns and the traditional strategy of sending individuals straight to jail drug courts have sprung up for those who are eligible. Drug courts work more as a rehabilitative effort than the method of locking a drug user up and ignoring the root cause of their addictions or crime. Jail itself is not a rehab center and should not be used as one. Drug courts require random testing of participants to stay in the program. Participants are also provided treatment and counseling services to get sober and stay sober.

Drug courts are staffed by multiple types of people such as judges, officers, social workers and prosecutors. To encourage participation drug court participants are given chances to feel successful with their efforts to be rehabilitated. I feel this is an important step to bridging the gap of addiction. In my opinion those that are drug users should not feel stigmatized by being left alone in jail and shunned by the outside world but should be encouraged to continue and maintain an active role in society.  Participants stay connected to their community through hearings, programs, and graduation ceremonies.

There is no easy way to combat drug addiction and drug usage. The war on drugs should be seen as a thing of the past. Mandatory sentencing and strict laws on drug use have not worked seeing as drug usage is still a big problem in society. Progressive actions should be sought to replace the war on drugs. One plan of action may not be the solution, but we as a society should work to implement better solutions like drug courts or decriminilization

-http://www.americasquarterly.org/node/1915

-https://www.vox.com/2014/4/9/5595240/40-states-relaxed-drug-laws

– https://www.economist.com/blogs/economist-explains/2014/06/economist-explains-10

-http://www.history.com/topics/the-war-on-drugs

-http://www.nadcp.org/learn/what-are-drug-courts

-https://www.nij.gov/topics/courts/drug-courts/Pages/welcome.aspx

 

 

 

Prescription Problems

The American Society of Addiction Medicine released a facts sheet of opioid abuse and the statistics are startling. Opiate abuse is the leading cause of accidental drug overdoses in America. In 2015 52,000 Americans died from drug overdoses. Of those 52,000 deaths a combined 33,000 were caused by opiates.  Within that 33,000 more than 20,000 overdoses were caused by prescription pain relievers and 12,000 were caused by heroin. With 20,000 Americans dying because of  pain relievers deemed legal, there is an injustice being hidden.

Marijuana has always been labeled a gateway drug by people in places of authority like officers or teachers. What is often far too overlooked when discussing gateways to hard drugs is the negative path that can be followed when one is prescribed opiates. In a 15 year span between 1999 and 2014 the sale of prescription opioids has quadrupled, similarly the rate of overdose has quadrupled in the same time. (Center for Disease Control, 2017)

A startling statistic from a 2008 study on urban users of injectable drugs found that 86% of heroin users surveyed had previously used prescription opioids. (DrugAbuse.Gov) When the prescription stats to run out, or the insurance stops covering the medication, users are forced to switch to the  less expensive form of prescription pills. CNN special medical correspondent Dr. Sanjay Gupta  discusses in a report the financial aspect behind the switch to illegal heroin. An opiate pain medication will cost an uninsured individual on average $1 per milligram. For example one needing a 60 milligram pill would spend $60 or they could achieve the same results with about $6 worth of heroin.  Opiates produce a sense of euphoria and reduce the perception of pain. When the ability to replicate that feeling can no longer be achieved because of a prescription running out or lack of insurance individuals have been known to switch to the street drug. 94% of respondents in a 2014 survey answered they choose to use heroin over prescription pills because latter is far harder to obtain and more expensive. (ASAM)

Not all opiate addicts users are affected equally. Certain demographics are more likely to be susceptible to opiate addiction than others. Women are more likely to become addicted to their pain prescription. The reasoning behind this is because women are more likely to be given higher doses of pain medicine, suffer from chronic pain, and use them for longer time periods than men.  The prescription opiate overdose rate among women has increased 400% from 1999-2010 compared to 273% among men. (ASAM)

Another special population  affected by the boom in prescription rates and access to heroin is adolescents aged twelve to seventeen. From 1994-2007 the amount of adolescents prescribed opiate pain medication more than doubled. With that rate came a rise in heroin usage among adolescents. In 2015 an estimated 21,000 adolescents had used heroin in the past year, in 2015 it was also reported that 276,000 adolescents misused prescription pills while 122,000 reported having an addiction to non medical usage of prescription opiates. Those numbers are alarming with the knowledge that most adolescents are introduced to prescription pills by family members or friends. (ASAM)

 

Prescription opioids are an issue all across the United States, however even within the nation there are geographic abnormalities that affect certain populations. The deep south and parts of what can be defined as Appalachia are misrepresented by opioid prescriptions. Opioid pain pills have even been described as hillbilly heroin. As you can see in the above map, the states in purple are those with the most prescriptions per 100 people. These states range from 96-143 prescriptions. The states highlighted are Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, North and South Carolina Ohio, Oklahoma, Tennessee, and West Virginia. (CDC)

The United States is a consumer of 80% of the world’s pain pills but only makes up 5% of the world’s population. (CNN) When consumed legally pain medication helps individuals with chronic pain feel less suffering, however with the ability to be abused it can also lead to usage of heroin and potential overdose. What can be done to help minimize the risk?

The answer is not a fix-all however it is a start, it begins with greater regulation at a state and federal level. Virginia, whose opioid addiction problem was described as a public health emergency in November 2016 is starting the process to regulate. Patients are now required to be given a full analysis of their background by the provider and also supplied with naloxene an overdose reversal drug. The new regulations also determine the amount of prescription that may be given and stress the usage of alternative forms of pain treatment before opioids are prescribed. Guidelines like the ones now in effect in Virginia are a start to helping combat the prescription drug crisis in America. (WHSV)

Sources

https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

http://www.cnn.com/2014/08/29/health/gupta-unintended-consequences/index.html

https://www.cdc.gov/drugoverdose/data/prescribing.html

 

https://www.drugabuse.gov/publications/research-reports/relationship-between-prescription-drug-heroin-abuse/prescription-opioid-use-risk-factor-heroin-use

http://www.whsv.com/content/news/Virginia-board-creates-new-opioid-prescription-guidelines–414388153.html

Drug Epidemic Affects New Area, Small Businesses

Drug usage is no longer an issue that can be ignored by families in suburbia. It never should have been a topic left to the poor or inner city to figure out, but frankly in the past drug problems were not discussed in the suburbs and seen as only a problem for minorities in the city. The drug epidemic is truly that, an epidemic, in Pennsylvania drug overdoses accounted for more deaths in 2015 than cars and gun violence combined. (Baker 2016, 1) Drug usage  today transcends the line of race or class and is a burden equally shared by all.

 

In the past decade 90% of new heroin users were white. (NBC News, 2014 ) Drug addiction is now everywhere, those suffering with addiction are our classmates, peers and especially coworkers.  I have personally experienced a co-worker with a hidden drug addiction. I was not aware of the personal struggle she had but when she went off the grid for a week and stopped showing up to work we were forced to figure out a new plan of action. What is the right answer to that dilemma? Luckily I was not in the position to have to make a decision.

 

Americans are reminded daily by advertisements, politicians, and their peers the effect drug usage has. Drug addicts are portrayed in the media as hurting their family and hurting their personal relationships by becoming addicted. We see the negative health consequences of the opiate crisis, the devastating effects of long term alcohol abuse. What is rarely focused on is the effect of drug addiction on the business world.

 

Are we reminded of how our job performance can be hurt by drug dependence? Yes, but are we aware of the effects it has on small business? I would argue we are not cognizant.  An article by Joyce M. Rosenberg drew my attention to this issue. I always figured it was a cut and dry topic, if an employee fails a drug test the normal route is to fire them but it is not that simple. Much of our class will most likely go on to work in law enforcement or justice but those looking to start a company must be aware of their employees pasts and personal lives.

 

In the article “Small Businesses forced to deal with drug epidemic”, Rosenberg discussed with a small business owner the effects rarely brought to the forefront. How are business owners supposed to deal with cases of overdose, or drug usage on the job? With 20 million Americans reporting a substance abuse problem how does this affect the work force? Philip Cohen an employer looking to help those with past addiction problems with a job worries. In the past he has had employees overdose, employees fail drug tests, the same people he hires to run table saws and operate machinery for his architectural/ woodworking company. (Rosenberg, 2017)

 

Now what does this have to do with justice?

 

With the increase of drug users there is a need for legal action by small business owners. According to a survey by the National Safety Council 70% of companies with 50 or more employees report a prescription drug problem. 80% of companies do not a have a comprehensive drug policy. This means 80% of business owners are left vulnerable to lacking drug policies in their company. When an employee shows up to work hungover, or high it is important for business owners to be protected in their contracts. Philip Cohen decided after an employee overdosed he needed to hire a lawyer to design a contract specifying the need for random drug testing of his employees. (Rosenberg, 2017)

 

Drug addiction is growing and unfortunately I do not see a near future without it. Drug addiction affects all people, all races, all ages, in all types of occupation. In order for justice to happen a future with drug addiction must be met with new standards. Small business owners are being left vulnerable and must become aware of the need for legal safety and concerns when drug addiction becomes an issue at their company.  It is important for business owners to have a written policy and to really care about their employees.

Sources

Baker, M. (2016). The Worst Drug Epidemic in U.S History. The Journal of Global Drug Policy and Practice, 1-11. Retrieved September 21, 2017, from http://www.globaldrugpolicy.org/Issues/Vol%2011%20Issue%201/Commentary/The%20Worst%20Drug%20Epidemic%20in%20US%20History.pdf

New Face of Heroin Is Young, White and Suburban, Study Finds. (2014, May 28). Retrieved September 21, 2017, from https://www.nbcnews.com/health/health-news/new-face-heroin-young-white-suburban-study-finds-n115671

Rosenberg, J. M. (2017, September 20). Small businesses forced to deal with drug epidemic. Retrieved September 21, 2017, from http://abcnews.go.com/Business/wireStory/epidemic-work-businesses-forced-deal-drug-abuse-49980135