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By Lev Facher Jan. 17, 2023
Increased injection drug use has led to a spike in cases of the life-threatening heart condition endocarditis, with cases rapidly accelerating since the onset of Covid-19.
The increased case count is one of the lesser-known side effects of the deadly addiction epidemic. But patients with endocarditis, an inflammation of the heart lining caused by infection, require complex, thoughtful care — care that the U.S. health system is ill-equipped to provide.
With drug deaths hovering at an all-time high and endocarditis cases among drug users up nearly tenfold in the last decade, physicians, researchers, and health officials have begun to confront the problem with more urgency. In particular, doctors are coming to terms with a basic reality: Their hospitals often have few protocols for treating endocarditis patients who use opioids and the withdrawal they’ll likely experience upon admission.
Between 2011 and 2022, the rate of new endocarditis among patients with opioid use disorder increased dramatically, according to new research published by the National Institute on Drug Abuse and scientists at Case Western Reserve University. Among drug users, most endocarditis infections stem from the use of non-sterile syringes, allowing bacteria to enter the bloodstream and, eventually, the heart.
Among people with opioid use disorder, the rate of endocarditis jumped from 4 per million per day to 30 per million per day. The sharpest increase occurred between 2021 and 2022
Such care is complicated to begin with. But for patients with addiction, each of those steps adds a new layer of complexity — in particular, lengthy hospital stays and ensuing withdrawal for patients accustomed to regular opioid use.
“You have someone that has very strong physical dependence to opioids, they go into the hospital, and they go into withdrawal, and that withdrawal can be very, very severe,” Nora Volkow, NIDA’s director and the co-author of the recent study, said in an interview. “They may leave the hospital against medical advice, because they’re not being treated for the severity of the withdrawal symptoms.”
Even when patients’ withdrawal is treated, Volkow said, patients “stay throughout the whole hospitalization as needed — and then they get released with no linkage to treatment or care.”
Keeping patients in the hospital, however, is only half the battle. In cases where patients remain in treatment, many still don’t receive the resources they need, or the expertise their care requires.
Even once patients’ infection and heart condition has been addressed, discharging them from the hospital can present unique challenges. Many of those who inject drugs are also experiencing dangerous or unpredictable housing situations, and those whose addictions remain untreated often quickly return to use.
For complete article Serious heart inflammation spikes amid injection drug crisis - STAT (statnews.com)
(Dalgarno Institute Comment: “Walking” into drug use is easier and easier; With Harm Reduction mantras of ‘personal liberties’ ‘rights to use in one’s own body – autonomy’ and ‘right’ to health care, all with impunity, bludgeoning the surrounding culture into compliance with faux pity declarations, that are all masking this growing anarchy.
So, what is the response to this convoluted, intricate, and intensive care required mess?
To continue to enable, equip, empower and by default completely endorse, ongoing drug use.
- More syringes
- Drug Consumption Rooms
- Greater permission models, both tacit and direct, with weakened policy and legislation.
- Continuing drug use
- No facilitated path to exiting drug use
These, as all pro-drug activists know, will actively undermine both Demand and Supply Reduction policies and practices, enabling the chaos that is dependency and addiction to grow – and glibly spruiking to the uninformed non-drug user that… “see prevention doesn’t work, just make it a health issue and we’ll fix these incidental unpleasant anomalies with the health care system!”
Of course, the black hole of public health debt just keeps growing as many of the short and long term harms of drug use assault the health and welfare system with inexorable demands – not least permanent negative mental and physical health outcomes.
Ah, then comes the well scripted… “See, if you legalise drugs and sell them, the revenues can be used to pay for this humanity diminishing and destroying outcomes”. The obvious answer in this article context is that opioids, for the most part, are legal but are being misused. So, there is not ‘revenue stream’ from this nightmare. Touting the cannabis option will fail too, as we have now seen in US and Canada that no such revenues eventuate, but to the contrary, even greater expenses are incurred.
- Up In Smoke – The Californian Legalization Disaster
- No State Successful in Regulating Marijuana
- Economic & Social Costs of Legalizing Marijuana
- Then There were Three – Marijuana Markets paper
When we ask the following questions in forums, the answers are always silence or in the negative.
- Does anyone here believe their children or grandchildren will be better off on illicit drugs?
- Does anyone here believe their children or grandchildren will be better off with easier access to illicit drugs?
Our movement has interacted of many decades with thousands of individuals and families who all too well know the utter grief that drug use brings. Many of those voices were heard and recorded in Federal House of Representatives Standing Committee on Family and Human Services Report – The impact of illicit drug use on families in 2007, but have been ostensibly ignored.
We know prevention and demand reduction work – Tobacco decline in Australia has proved that. When all of the community – Government, Education, Health, Media and Community sectors act with One Focus, One Message and One Voice, change happens.
We did it with Tobacco, with Litter, with seat belts, speed limits and the list goes on. You don’t reduce demand by prohibiting on paper and permitting in practice, that cognitive dissonance right there undermines public will.
The health harms of tobacco pale next to the health, well-being, familial and safety harms of illicit drug use – so what is stopping us, stopping this?
The War We Never Fought – a Review of Journalist Peter Hitchens Book.
By Dalgarno Institute Communications Team
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Trends in intentional abuse and misuse ingestions in school-aged children and adolescents reported to US poison centers from 2000-2020
Between 2000 and 2020, there were 338,727 cases regarding intentional misuse and abuse exposures for children ages 6 through 18 years old. Overall, misuse/abuse ingestions fluctuated over time, with a peak in 2011. The majority of intentional misuse/abuse ingestions occurred in males (58.3%), and more than 80% of all reported exposure cases occurred in youth aged 13 to 18. 32.6% of ingestions resulted in worse than minor clinical outcomes. Older age groups had a greater number of severe medical outcomes compared to younger age groups. Major or life-threatening exposures (including those resulting in death) were more common in males. Overall, deaths were rare (n = 450), 0.1%). Male sex, older age, abuse ingestions, exposure site of a public area or other residence, and multiple ingested substances were other factors associated with increased mortality. Marijuana exposure rates had the highest average monthly increase overall, with the most dramatic rise occurring from 2017 to 2020. Edible marijuana preparations accounted for the highest increase in call rates compared with all other forms of marijuana.
(Drug use normalisation messaging – not least the permission model of ‘legalization’ – is poisoning a generation of children, and this is ‘progress’? D.I.)
https://www.tandfonline.com/doi/full/10.1080/15563650.2022.2120818
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Timmen L. Cermak MD December 2, 2022
KEY POINTS
- Motivation is a subjective experience and therefore extremely difficult to measure objectively.
- Motivational syndrome has long been seen as a sign of cannabis addiction, but has only recently been measured.
- Liking and wanting are two different forces. Drug use changes the brain in ways that stimulate wanting the drug.
Until recently, I ignored the idea of a cannabis-induced amotivational syndrome. Of course, I was familiar with the stereotypical view of potheads couch-locked into immobility, but this could have a variety of causes other than amotivational syndrome. Besides, I could not imagine how motivation could be measured objectively.
Then Meghan Martz[1], at the University of Michigan, published research that changed my mind. Martz used a delayed monetary reward protocol, which means people were given a simple computer task that promised cash rewards at the end of the test—a low monetary reward for poor performance and a higher reward for better performance. While watching the computer screen and pressing a button whenever a stimulus appeared, and before any money was received, Martz used functional magnetic imaging (fMRI) to measure activity in a small part of the brain called the nucleus accumbens, the reward center. She tested individuals three times, at ages 20, 22, and 24. She also recorded their report of marijuana use at each age.
Her data showed that, while everyone at age 20 had the same level of reward center activation in anticipation of the cash reward, those who most increased their cannabis use over the next four years showed progressively less activation at ages 22 and 24. Cannabis users no longer viewed cash with as much anticipation of the reward. Martz concluded that the effects of long-term cannabis use results in a general blunting of reward response. While it could be argued cannabis produces enlightenment and freedom from materialistic desires, a deeper look at nucleus accumbens functioning points in other directions.
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After nine years as a homeless drug addict in Los Angeles, Jared Klickstein finally checked himself into a drug treatment center. Unlike the program he had gone to six years before, which had hot tubs, acupuncture, and trips to the beach, this one, in North Hollywood, was deadly serious about personal responsibility. Clients kept a strict schedule. They did chores. They scrubbed toilets. “No hot tubs,” Klickstein said.
Most important, they couldn’t use drugs. “If you use, they kick you out,” he said. “There’s consequences.”
It took him two attempts, but Klickstein, now 33, finally got clean. Four and a half years later, he’s independent, employed, and emotionally stable. “I was a person that you would see on one of these videos, screaming with blood and shit all over them,” he said. “And now I’m not.”
Klickstein attributes his success to the North Hollywood program’s emphasis on sobriety and accountability. “Without sobriety, there is no mental or emotional stability for me and most other drug addicts, meaning homelessness was inevitable,” he said. “Half measures and coddling do not work. Period.”
But tough-love centers like the one that turned Klickstein’s life around are becoming harder to come by. The idea that you have to quit drugs to recover from addiction has become old-fashioned, and treatment centers that insist on abstinence are disappearing. In California, changes in state law have made it virtually impossible for any program that accepts public funds to push clients to quit using.
... and before he got himself cleaned up. “Half measures and coddling do not work," Klickstein says. "Period.”
“You cannot intervene or even speak to someone regarding their alcohol and drug use,” said Reverend Andy Bales, who has worked in drug recovery in Los Angeles for decades. As a result, most homeless services and housing providers in the city allow, in his words, “a free flow of alcohol and hard drugs.” This permissive approach, Bales believes, is why California has more people living on the street than any other state in the country.
The repudiation of abstinence-based treatment in California and many other states represents the broad embrace of an approach called “harm reduction.” Instead of seeing addiction as a serious illness whose treatment ultimately requires addicts to stop using drugs, it casts addiction as a risky health condition to be managed, and insists that different people benefit from different management strategies, not all of which require abstinence.
But as the addiction crisis has deepened across the country, with the highly toxic and addictive opioid fentanyl killing addicts at record rates, homelessness exploding in California and throughout the West Coast, and drug cartels operating in the open in cities like San Francisco, the ascendance of a particularly dogmatic form of harm reduction may be exacerbating the crisis instead of mitigating it. By normalizing drug use, eschewing intervention, and shutting down abstinence-based treatment programs, critics of this radical harm reduction philosophy believe it’s keeping people trapped in addiction.
“It’s just going to end up with more death,” said Klickstein.
Also see
The inevitable outcome of ever permissive drug policy interpretations and
The Disastrous Californian Cannabis Legalization Experiment – More than promises ‘Up in Smoke’!
- The inevitable outcome of ever permissive drug policy interpretations
- More and More Kids Poisoned by Cannabis Candies and More!
- Physical domestic violence was 11 times more likely on days of heavy drinking or drug use – The link between alcohol/drug addiction and domestic violence
- Prison scheme sees seven-fold increase in people accessing drug rehabilitation