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Tuesday, September 27, 2016

Scores Dead In Ohio -- Fentanyl and Carfentanil-Laced Heroin

 

After a devastating 52 heroin overdose deaths in August in Cuyahoga County, Ohio, more than a dozen people died from overdoses there in the first few days of September. Now, Cuyahoga County Medical Examiner Thomas Gilson confirmed that seven people died from heroin-related ODs in the Cleveland area in one day (September 24, 2016).

Cleveland.com reported Cuyahoga County, which has about 1.2 million residents, is on pace to record more than 500 overdose deaths this year.

What is causing the staggering figures?

Most deaths have been attributed to a wave of carfentanil-laced heroin or fentanyl-laced heroin. Fentanyl is a powerful synthetic opioid similar to morphine but 50 to 100 times more potent according to the Centers for Disease Control and Prevention. And, carfentanil is a powerful animal tranquilizer that is reportedly 10,000 times stronger than morphine and 100 times more potent than fentanyl.

Carfentanil is so dangerous the DEA warned law enforcement to take protective measures if they think they have encountered it since the drug can be absorbed through the skin (a tiny dose a fraction of the weight of a paper clip could send 500 people to the morgue).

Also, there is another synthetic painkiller – known as W-18 – that is also being used to cut heroin and is connected with recent overdoses and deaths. W-18 is similar to carfentanil in its extreme potency and equally dangerous.

The fentanyl and other super-potent synthetics used in heroin are illicitly manufactured rather than being taken from hospitals or pharmacies.

So, these substances are dangerous in a very small amount. And, DEA spokesman Russ Baer reports, “You can go on the Internet and anybody can establish an anonymous account and you can order carfentanil directly from China.”

“Just this morning we were able to go on the internet and get a quote for 100 grams of carfentanil, and that was $400,” said Keith Martin, head of the local office of the DEA.

According to him, 100 grams “would kill thousands of people.”

(“Dozens of Ohio overdoses blamed on heroin mixed with elephant tranquilizer.” CBS News. August 25, 2016.)

It is reported that fentanyl can cause a potentially fatal overdose much faster than other opioids. For example, morphine takes 20 to 30 minutes to peak in the bloodstream; whereas, according to a 2011 published review in the Journal of Midwifery and Women's Health, fentanyl peaks in the blood within five minutes.

And, this begs the question – “Why would anyone take such a deadly combination of substances?”

Many opioid users develop a tolerance to the opioids that they use regularly, so they begin chasing more intense highs. The intensified effect they seek is readily supplied by dealers, and it can have the potential to kill.

According to published reports, most users don’t know their heroin is laced with fentanyl. In a competitive business, drug dealers look for ways to distinguish their product and make it something people will seek, including by increasing the potency of the heroin they sell. Unfortunately this has resulted in the deaths of dozens of people who cannot tolerate it. Within minutes of using this contaminated heroin they lose consciousness, breathe ever more slowly until they finally stop—and die.

(Elinore F. McCance-Katz, M.D., SAMHSA Chief Medical Officer. “Fentanyl-Laced Heroin can Kill, but there are Steps we can Take to Save Lives.” Substance Abuse and Mental Health Services Administration. February 5, 2014.)
 
Ray Isackila, counselor and team leader of addiction treatment at University Hospitals Case Medical Center in Cleveland, says, “Heroin with illicit fentanyl laced into it makes it stronger, cheaper and more desirable on the street. People hear about this new heroin or this super strong heroin that someone is selling, and they want it.”

And, although health official and police have been warning potential users to avoid the drug, especially in light of the danger, Isackila said the warnings could backfire.

“There’s an odd mindset in the drug addiction world if people have overdosed on this, they think I’ve got to get some of it," said Isackila. They say "they’ll just use a little -- a dangerous drug becomes more desirable to the addict on the street.”

(Gillian Mohney. “Fatal Overdoses in Multiple States Show Dangers of Fentanyl-Laced Heroin.” ABC News. February 05, 2014.)

In an illegal drug market, suppliers, whether deliberately or accidentally, peddle a product that is sometimes weaker and sometimes stronger. Combine this with lacing a substance like heroin with another deadly substance and the results can be fatal.

Jacob Sullum, senior editor at Reason Magazine reports artificially high prices and profits give dealers a strong incentive to dilute their products, and the black market’s lack of legal accountability allows them to do so. If they go too far and customers start to balk, adding a little fentanyl is a cheap, easy, and occasionally lethal solution. Variations in heroin purity can have similar consequences.

Sullum explains how enforcement can even exacerbate drug activity: “Drug warriors commonly cite lower potency as a sign of success, equivalent to an increase in price for heroin of the same strength. Taking them at their word, successful enforcement leads heroin users to take larger doses for the same effect, a habit that can be deadly when they encounter an unusually potent batch. Successful enforcement also means that dealers are more likely to mix fentanyl into their heroin, so it magnifies the dangers that users face from unadvertised ingredients.”

(Jacob Sullum. “Fentanyl-Laced Heroin And Other Deadly Consequences Of Prohibition.” Forbes. October 01, 2015.)

 

I know. It all seems so unsure and risky, so much so that any rational human would never chance taking heroin or any other illicit drug. But, that is not reality in the world of addiction. The interplay between dealer and user – the insatiable supply and demand of the business – is fraught with irresponsibility and greed. The substances and profits in the market control not only the pocketbooks of those involved but also the minds of the players. Nothing is rational and nothing is compassionate. Death is a constant.

For many, the euphoria of the heroin rush is welcome relief. Yet, that same intoxication that reduces the brain's perception of pain affects the receptors controlling the breathing and transit of food through the GI tract. This “high” blocks transmission to the brain's receptor and stops the drive to breathe.

To users, an opioid escape from pain is a temporary substitute for sobriety that poses a great risk of developing into a full-blown disease. Illicit opioids greatly increase that risk. Whether chasing a high or self-medicating, a person who takes illegal substances like heroin or heroin laced with synthetics is betting his or her life with every use.

The Washington Post says the Buckeye State is ground zero of the fentanyl appearance. Like any other disaster area, Ohio needs assistance. Let's hope the residents and the government realize that need and respond. Let it begin with research-based intervention, and let's push for immediate action to stop the death toll from climbing higher and higher.


Sunday, September 25, 2016

Walls and Bridges: Trump's and Clinton's Vastly Different Plans About Fighting Substance Abuse

 

We Americans face a presidential election. How important is an issue that threatens every citizen? In 2014, deaths from overdoses reached a new high of 47,055 according to a report from the U.S. Centers for Disease Control and Prevention. That figure represents more than the number of people killed in car crashes or from gun violence.

Now, synthetic opioids — such as fentanyl and carfentanil, 50 and 5,000 times more powerful than heroin, respectively — have become increasingly popular. The resulting flood of overdoes have overtaken Ohio, Indiana, West Virginia, and Kentucky.

According to the National Institute on Drug Abuse, in 2013, an estimated 22.7 million Americans (8.6 percent) needed treatment for a problem related to drugs or alcohol.
The substance abuse epidemic must be a major concern for both Donald Trump and Hillary Clinton. Let's see where both candidates stand on the issue.

Donald Trump

If elected, Donald Trump says he will battle the addiction crisis on two fronts. “First, we have to support locally based and locally run clinics, and we gotta close up the border. That's where the drugs are coming in.”

Trump claims this will “cut off the source of heroin” and it will “stop the inflow of opioids into the U.S.” And, of course, he says he will make Mexico pay for a wall between the two countries. Those are pretty much all the details of his policy.

(Kelly Burch. “Donald Trump’s Solution to Opioid Epidemic: Build A Wall. The Fix. August 05, 2016.)

Trump added, “In the meantime, people are getting hooked, and we're going to take care of those people,” he said. “Many of them got hooked unknowingly.” Pretty unspecific?


Concerning the need for treatment, Trump says, “It’s very hard to get out of the addiction of heroin. We’re going to work with them, we’re going to spend the money, we’re going to get that habit broken.” He has not outlined a plan on where or how money would be spent in treatment, nor has he addressed issues related to prescribing or treatment in healthcare.

(David Solomon. “Trump takes on opioid crisis, eminent domain at 'Politics & Eggs' in Manchester.”New Hampshire Union Leader. November 11, 2015.)

Hillary Clinton

In contrast to Trump, Hillary Clinton calls for approaching the substance-abuse issue from a public-health perspective, rather than from a criminal-justice one.

Clinton's plan, called the Initiative to Combat America's Deadly Epidemic of Drug and Alcohol Addiction, would allocate $10 billion over the course of 10 years to combat the issue from multiple points. That figure would be divided between a $7.5 billion fund to help states create programs tailored to the issues specific to their area and $2.5 billion allocated to the Substance Abuse Prevention and Treatment Block Grant, which directly funds substance-abuse treatment and prevention programs.

(Harrison Jacobs. “Where Hillary Clinton and Donald Trump stand on the opioid epidemic.” Business Insider. September 24, 2016.)

The plan looks to boost treatment and recovery programs, ensure that first responders have drugs needed to stop opioid overdoses from becoming fatal and urges states to focus more on treatment than incarceration. Clinton specifically calls for creating a state fund to help police, fire departments, and EMTs purchase the drug, and to create naloxone training programs for first responders.

Clinton's plan would also direct state Attorneys General to prioritize "treatment over incarceration for nonviolent and low-level federal drug offenders." Clinton's campaign argues that the savings to the criminal justice system would be used -- in part -- to pay for the plan.

(Dan Merica. “Hillary Clinton proposes $10 billion plan to combat drug and alcohol addiction. CNN. September 02, 2015.)

Also, Clinton specifically mentions LifeSkills Training, a three-year program for middle-school students targeting substance abuse and violence, as a type of successful program that can prevent substance abuse later in life.

Clinton on the wall? In the past, she has supported some physical barriers to prevent illegal immigrants from coming into the country, specifically The Secure Fence Act of 2006. Nothing nearly as expansive as Trump's wall. And, she supports controlling the borders. Clinto believes border security involves a combination of “technology and physical barriers.”

Battle Lines Being Drawn

We all must consider substance abuse – dependence, addiction, and overdose – one of the most important issues facing the nation. Every family, in one way or another is negatively affected by abuse. It is clear how both candidates plan to solve the problem. It is not difficult to see that one has many more specifics in her plan than her opponent.

I believe Donald Trump's wall is not enough to stop heroin and other opioids from entering America. In fact, a wall would come at great expense. No, I don't believe Mexico is going to pay for a border wall. And, a wall is only effective where it can be patrolled. Surely, cameras would be required also. In the long run, it would be a tremendous waste of money.

The U.S. border with Mexico is roughly a massive 2,000 miles long. The Berlin Wall spanned just 96 miles comparatively, and it cost about $25 million to build in 1961, or around $200 million with inflation.

The best estimates of total construction for a wall like like Trump proposes range from $15 billion to $25 billion. In addition the U.S. government would have to pay to maintain the wall, which could cost as much as $750 million a year, according to an analysis conducted by Politico.

Consider that the tremendous amount of money for such a wall could be better spent to utilize other technology to help create a secure border.

Most important, research-based strategies to combat substance abuse support a comprehensive plan of prevention, treatment, and recovery. Donald Trump offers no real plans for a research-based solution. Like many plans Trump promotes, his drug policy lacks thorough consideration and offers a simplistic view of a very complex problem. Hillary Clinton, on the other hand, grasps the need for a comprehensive effort that supplies aid to all fronts.

I cannot be more committed to electing someone who understands the gravity of the situation of substance abuse. America is ill. I will be casting my ballot for Hillary Clinton. How about you?

Wednesday, September 21, 2016

8.3 Million Children In Danger -- Mom and Dad High On Endangerment

 


What if I told you that 12 percent of the children in a country are at great risk each day? That means that 8.3 million children under 18 years of age in this place are in peril and face constant danger? Isn't it terrible that young people anywhere should live with such strife and endangerment? It sounds like the horrible reality of existence in a terrorist state or in a third-world country like Iraq, Afghanistan, or Haiti. However, I am speaking of a modern, civilized place.

I'm talking about the United States of America.

It was reported that in 2014, 21.5 million Americans 12 or older (8.1%) have a substance use disorder.

(Substance Abuse and Mental Health Services Administration, Center for
Behavioral Health Statistics and Quality. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration.)

How does this affect innocent children, you ask?

In the U.S. an estimated 12 percent of children live with a parent who is dependent on or who abuses alcohol or other drugs. Based on data from the period 2002 to 2007, 8.3 million children in America under 18 years of age lived with at least one substance-dependent or substance-abusing parent. This, in the nation claiming to be the cradle of love and commitment.

(“Parental substance use and the child welfare system.” Child Welfare Information Gateway. U.S. Department of Health and Human Services, Children’s Bureau. 2014.)

Parental substance abuse is a major factor contributing to child abuse and neglect. In a 1999 report to Congress, the U.S. Department of Health and Human Services (HHS) reported that studies showed that between one-third and two-thirds of child maltreatment cases were affected by substance use to some degree. More recent research reviews suggest that the range may be even wider

(R. Barth. “Preventing child abuse and neglect with parent training: Evidence and opportunities. Future of Children, 19. 2009.)

(D. Traube. “The missing link to child safety, permanency, and well-being: Addressing substance misuse in child welfare. Social Work Research, 36. 2012.)

Addiction is a family disease that is in a class of its own – the physical and mental repercussions destroy not only the addicts but also everyone surrounding them. And, of course, the negative effects of parental alcohol and drug addiction continue as the children of addicted parents enter adulthood themselves with dramatically increased odds of being dependent and of being more likely to abuse their own children. This cyclic trend produces more and more children born into underprivileged homes and neighborhoods who face imminent endangerment and abuse.

The children in an addictive home develop unhealthy coping mechanisms while attempting to preserve the family unit. They experience extreme stress, guilt, anger, and denial, and they are often emotionally and physically deprived. Most feel confusion and a diminished sense of self-worth. Is it any wonder many of these children resort to taking drugs or to engaging in other addictive behaviors to escape their unhealthy family atmosphere?

Can you imagine being a youngster and developing perceptions based on so much deceit? Consider the truth of such statements as these:

“Mom's taking a nap.” Truth: She has passed out.

“Dad's working late.” Truth: He is out getting high.

“Grandma isn’t feeling good.” Truth: She’s dope sick.

“We can't afford to let you (the kids) go to the game.” Truth: We spent it all on drugs.

“Mom and Dad are going to town.” Truth: They are dealing drugs.

“Dad got laid off at work.” Truth: He failed the drug test.

Who faces irreparable damage as a substance takes control of a life? Of course, the addict does. But, consider the children. The tremendous burden of repairing these children – providing them needed care and taking control of their welfare and well-being – falls directly upon society. Relatives and foster parents, usually with aid from the government, must step up and properly raise these injured innocents.
 
So many mothers and fathers are not taking responsibility. Consider the numbers who do not raise their children and who do not contribute full assistance. Family structure is changing. According to U.S. Census figures, 1 in 3 children in America (15 million) live without their father. In addition, 4.9 million American children are being raised solely by their grandparents. This number is almost double that of the 2000 Census (2.4 million).

In Ohio, heroin use by the parents or caregivers is skyrocketing as a factor in child custody cases. Figures run by the state human services agency show almost 7,000 instances where heroin was cited in child custody cases in 2013, an 83 percent increase from three years earlier.

The state’s analysis found 3,726 references to heroin in child-custody cases in 2010, compared with 6,827 in 2013, according to the numbers produced by the Ohio Department of Job and Family Services.  
The average stay in foster care is 70 days, but that number jumps to 300 days for children of parents addicted to drugs or alcohol, says Gayle Channing Tenenbaum, governmental affairs director for the Public Children Services Association of Ohio. 
 
(Associated Press. “Heroin use soars as factor in removal of Ohio children from parents in custody cases. The Toledo Blade. May 14, 2014.)
 
The horrendous fact is that estrangement from family and other social supports also endangers an entire generation of youth. Admittedly, these children likely love their parents. Yet, great numbers of them are at significant risks from parents that abuse drugs and alcohol.

In early drug use, before family finances are affected, there may be no signs of neglect. But as drug use spirals out of control, that's usually when problems arise. Their lives turn chaotic and unpredictable. Many children lack even their basic needs of nutrition, supervision, and nurturing are lacking.

Often, due to this neglect, there is no choice but to have Children Services place endangered children in foster homes.

Patricia Harrelson, director of Richland County, Ohio Children Services, said ...

"We've had children as young as 2 years old testing positive (for drugs) as a result of inadequate supervision. ... That's what we're dealing with on a daily basis...

"I often see parents who know their kids are safe and continue to use. We remove one of the things that may make them think twice. Heroin pretty much makes you forget you have kids, at least when you're high.”


 
(Jona Ison. “As heroin use spikes, Ohio children feel the brunt.” The Newark Advocate. May 23, 2015.)

"The child welfare system in and of itself is not going to solve this problem," said Tim Dick, assistant director for Clermont County Children Services.

The problem needs a team approach from child welfare, judicial and drug treatment agencies, Dick said, adding that the primary purpose of the report was to get people talking and planning.

Ohio also has at least 16 similar courts targeted for families. Expanding those courts is among the solutions suggested.

The biggest hurdle is ensuring there is treatment not only available in the family's county but also that there's enough to serve the community's needs.

 "Regardless of what county these addicts live in and where their children are removed from, the treatment needs to be in that county. ... We can't have them be on a waiting list," Dick said.

The waiting list is especially problematic in child welfare cases because children services agencies are required to eventually file for permanent removal so children aren't languishing in temporary families, Dick said.

"With drug addiction, especially with an addiction like opiates, recovery takes a lengthy period of time. So to have a six-month delay, they're already being set up (for failure)," Dick said.

(Jona Ison. “As heroin use spikes, Ohio children feel the brunt.” The Newark Advocate. May 23, 2015.)

As responsible citizens, it is up to us to advocate for vulnerable children who are not in a position to advocate for themselves. To ignore this problem or to simply “wish it away” assures a future of escalating drug abuse. Saving these children with swift action is paramount. Addicts need rehabilitation, and children need adequate care.

Allow me to advocate. I believe we need to foster a change in attitude concerning parenthood. We need to hold each parent responsible for the welfare of their children. Relatives, friends, teachers, counselors, courts, and governments cannot replace the roles of “mom and dad.” The village is there for support, not for primary care. Becoming a parent demands a sober mind and a continued commitment for decades.

Now, it seems to me as if there is a significant attitude reflecting a lack of responsibility – a reliance of dependence upon someone else to raise needy children if the case may arise. I believe this is a fault of dependent parents, no matter how much they claim they may care for their children. As difficult as owning responsibility of raising children may be to consenting adults, they have chosen their circumstances. What once was “I” became “we” through free will, and this decision to produce offspring demands the couple accept the charge to raise healthy, happy children in a loving environment.

Oh, I know the disease of addiction controls the minds and actions of addicts. Addicts are the model of irresponsibility. They are sick and in need of help, in no condition to be around children, much less raise them. Therefore, drug dependency must prevent initial procreation. That view is harsh. It is realistic. It is not dependent upon a myriad of variables. Why? Because it helps insure proper child care for all innocent children.

Right now, we, as a nation, must stress the tremendous obligations inherent in being a father or a mother. Any person engaging in risky activities knowingly endangers a son or a daughter. Prospective fathers and mothers must choose not to risk substance abuse in the first place. And, if they do not care and do so anyway, they exacerbate the cycle of dependency and addiction that rips the fabric of American families to shreds. It is both morally wrong and criminal to subject children to abuse.

No person wants to share the misery of addiction with loved ones; however, by being linked with those who love them, millions do each day. Those are the cold, hard facts and the simple hope of a future generation. Prevention first and foremost.

 

Monday, September 19, 2016

Ohio and Scioto County -- Children Are the "Invisible" Victims of Drug Abusing Parents

 

"The children really are the invisible victims," said Scott Britton of the Public Children Services Association of Ohio. 
 
(Rita Price. “Parents’ heroin addictions put too many kids in foster care.”  
The Columbus Dispatch. September 19, 2016.) 
 
A recent survey by the association found that at least half of all children taken into custody last year had parents using drugs, a majority of which were opiates. 93.5 percent of agencies say heroin and other opiates are a serious problem in their communities.

The Columbus Dispatch reports after a decade of steeply declining foster-care rates, Ohio now has about 14,000 children in agency custody -- an increase of nearly 13 percent since the end of 2012, which doesn't include the likely faster-growing number of kids taken in by relatives.

In addition, Ohio's hospitalization rate for neonatal abstinence syndrome – a set of symptoms suffered by infants born dependent on drugs – has soared from 14 for every 10,000 live births in 2004 to 134 per 10,000 by 2014.

As federal and state legislative action has largely focused on opioid-prescribing practices and treatment for addicts, little attention has turned toward the child-welfare system. Lorra Fuller, head of the Children Services agency in Scioto County, confirms, "We have to keep children safe, and we rob Peter to pay Paul to do it."

The State of Ohio, which already ranks last in the nation for child-protection funding, has not sent county agencies new money to aid in the fight.

The agency has a $3 million budget that keeps taking hits, from the loss of more than $700,000 in state and federal funding by 2010 to a $16,000 penalty this year for not meeting the federal standard on parent-child visitation rates. Fuller said she can afford to pay local foster parents only $27.50 a day.

"More staff could help with these high-needs cases," she said. "We are in homes once a month. We need to be there at least weekly, maybe three times in a week."

Scioto County has some of the lowest property values in the state; thus, tax-levy revenue also is low. The agency had 80 children in custody four years ago and 173 by early this summer. More than 50 are younger than 2.

Rita Price of the Dispatch shares Fuller's words ...

“There would be fewer, Fuller acknowledges, if she hadn't drawn a line in the sand four years ago. 'I decided that if mom was positive on delivery and baby was positive and there was not a prescription, we were going to take custody,' Fuller said.

“Before 2012, caseworkers first might have worked with the mothers to offer treatment, services and support as part of an 'alternative response' approach that aims to reduce foster-care placements.

“But in the face of a full-blown opiate epidemic, 'alternative response didn't work for us,' Fuller said. 'We just weren't being effective as a child-welfare agency by leaving those children out there. What we saw was that these babies that weren't removed were coming into the system as 1- and 2-year-olds for neglect.'

“Although strategies and practices vary among Ohio's 88 county Children Services agencies, there is broad agreement that the system is facing a terrible foe — one that wrecks families, drives up costs, demoralizes workers and can drag cases out for years.

"'Unfortunately, we're not seeing great success with treatment and recovery,' said Catherine Hill, executive director of Athens County Children Services in southeastern Ohio. 'It's taking a whole generation of our young parents.'”

(Rita Price. “Parents’ heroin addictions put too many kids in foster care.”  
The Columbus Dispatch. September 19, 2016.) 

 
The Bottom Line

Responsible parents must provide loving, stable homes for their children. Being a parent is a full-time job that requires sobriety. Parents who shirk these responsibilities risk not only losing their children to Children Services but also losing their children to accidental injury and death.
Addicted parents define the model of irresponsible adults. Although they may struggle to maintain routine and structure in the home, the financial cost of drug use, itself, often prevents them from providing adequate food, housing and clothing for their children. When under the influence, they may also ask their children to assume adult roles such as cleaning, cooking and caring for younger siblings. This added responsibility in formative years can be devastating to a young life.

Furthermore, the effects of drugs can lead to inconsistent parenting. For example, a parent who is addicted to drugs might have difficulty maintaining a regular system of rules and consequences for breaking those rules. This can lead to extreme behavioral difficulties.

And, according to the National Center on Addictions and Substance Abuse, when children grow up in homes with parents who abuse drugs, the children are at a higher risk of becoming addicts themselves. This increased risk of substance abuse comes from the tremendous environmental stress associated with living with a parent who is an addict.

The National Institute on Drug Abuse (NIDA) confirms that risk factors can increase a person’s chances for drug abuse, while protective factors can reduce the risk. The table below describes how risk and protective factors affect people in five domains, or settings, where interventions can take place.

Risk Factors
Domain
Protective Factors
Early Aggressive Behavior
Individual
Self-Control
Lack of Parental Supervision
Family
Parental Monitoring
Substance Abuse
Peer
Academic Competence
Drug Availability
School
Anti-drug Use Policies
Poverty
Community
Strong Neighborhood Attachment


 

The more risks a child is exposed to, the more likely the child will abuse drugs. Some risk factors may be more powerful than others at certain stages in development, such as peer pressure during the teenage years; just as some protective factors, such as a strong parent-child bond, can have a greater impact on reducing risks during the early years. An important goal of prevention is to change the balance between risk and protective factors so that protective factors outweigh risk factors.

We must protect the children of Scioto County, the children of Ohio, and the children of America against drug abuse. It is unfortunate, often unthinkable, but that often means protecting children from their addictive parents. Research-based prevention programs focus on intervening early in a child’s development to strengthen protective factors before problem behaviors develop.

I know of no stronger incentive for prevention than recognizing the risk of losing precious loved ones to substance abuse. It is time for dependent parents to acknowledge and accept the risk of losing their most beloved possessions to their precarious behavior. No longer should an individual parent falsely believe that their addiction is a personal matter with strictly personal consequences. The truth is that addiction destroys families and creates cycles of destructive behavior that last for generations. 
 
I am reminded of Jamie O'Hara's song made famous by George Jones. Although the tune actually deals with love and heartache and not with drug abuse, the “cold, hard truth” of acceptance and responsibility pulls at the heartstrings and draws a significant parallel.


"The Cold Hard Truth"
You don't know who I am
But I know all about you
I've come to talk to you tonight
About the things I've seen you do.

I've come to set the record straight
I've come to shine the light on you
Let me introduce myself
I'm the cold hard truth.

There is a woman we both know
I think you know the one I mean
She gave her heart and soul to you
You gave her only broken dreams

You say your not the one to blame
For all the heartaches she's been though
I say you're nothing but a liar
And I'm the cold hard truth.

All your life that's how it's been
Lookin' out for number one
Takin' more than you give
Movin' on when you're done.

With her you could have had it all
A family and love to last
If you had any sense at all
You'd go and beg her to come back.

You think that you're a real man
But you're nothing but a fool
The way you run away from love
The way you try to play it cool

I'm gonna say this just one time
Time is running out on you
You best remember me my friend
I am the cold hard truth.

You best remember me my friend
I am the cold hard truth....

Friday, September 9, 2016

Colin Kaepernick Refuses To Proudly Hail -- Whose National Shame?


Although no human rights instrument or constitution grants the absolute right to protest, that right is a manifestation of the right to freedom of speech, the right to freedom of assembly, and the right to freedom of association. The right to protest or to peaceful assembly is critical to a functioning democracy and at the core of the First Amendment.

Protest, itself is a form of collective action and of social movement participation at the same time. There is a vast array of specific protest behaviors that people might exhibit. Wright et al. (1990) have proposed a framework based on three distinctions:

* The first between inaction and action,

* The second between actions directed at improving one’s personal conditions (individual action) and actions directed at improving the conditions of one’s group (collective action).

* The third distinction is between actions that conform to the norms of the existing social system (normative action like petitioning and taking part in a demonstration) and those that violate existing social rules (non-normative action like illegal protests and civil disobedience).

(S.C. Wright, D.M. Taylor, and F.M. Moghaddam FM (1990) “The relationship of perceptions and emotions to behavior in the face of collective inequality.” Social Justice Research. 1990.)

The preface to this entry may help people better understand the protest of Colin Kaepernick, the San Francisco 49ers quarterback who has refused to stand for the National Anthem. He is biracial and was adopted and raised by white parents and siblings. Kaepernick said after months of witnessing some of the civil unrest in the U.S., he decided to be more active and involved in rights for black people.

"I am not going to stand up to show pride in a flag for a country that oppresses black people and people of color," Kaepernick told NFL Media in an exclusive interview after the game. "To me, this is bigger than football and it would be selfish on my part to look the other way. There are bodies in the street and people getting paid leave and getting away with murder."

Both the 49ers and the National Football League recognize the right of an individual citizen to choose not to participate in the celebration of the national anthem. Yet, of course, the NFL encourages player participation.

Kaepernick said that he is aware of what he is doing, has discussed his feelings with his family, and knows it will not sit well with a lot of people, including the 49ers. He said that he did not inform the club or anyone affiliated with the team of his intentions to protest the national anthem.

(Steve Wyche. “Colin Kaepernick explains why he sat during national anthem.” 
nfl.com. Aug. 27, 2016.)

Even President Obama weighted in on Kaepernick's actions. The President said that he did not doubt Kaepernick's sincerity in attempting to highlight social issues and noted that the player was the latest in a long line of professional sports figures to do so. However, Obama also acknowledged that Kaepernick's silent protest was a "tough thing" for many members of the military to accept.

What about disrespecting that flag that has given 
you the freedom to speak out?

Granted, nothing ignites feelings of anger in me more than to see people disrespect what is arguably the most sacred symbol of America. At ballgames and at other public events, on more than one occasion, I have told other inattentive men they should remove their hats and stand at attention during the National Anthem. I expect decorum and a certain amount of solemnity for even simple gestures of patriotism, and I think Americans owe that respect for all that the flag represents.

What really frosts most of us with patriotism is the perceived lack of simple homage by Kaepernick. We view him as a successful, prosperous, American public figure choosing the wrong form of protest – refusing to honor the flag – at an inopportune time – during a widely covered NFL football game. We think he is “biting the hand that has fed him so well” and being a selfish opportunist.

Kaepernick’s former coach placed an interesting frame around the entire debate about the protest. Jim Harbaugh, who now coaches the University of Michigan football team, said, “I support Colin’s motivation. It’s his method of action that I take exception to.”

Yet, Matt Vasilogambros, a senior associate editor at The Atlantic, pointed out: “Reaction isn’t about his motivation. It’s about his method. Kaepernick’s motivation was lost.” He claims the out-roar is mainly about “how we should protest in this country.”

(Matt Vasilogambros. “Did Colin Kaepernick's Protest Fail?” The Atlantic. August 30, 2016.)

Should any employer or government limit “how” we should protest as long as it is legal? It seems that any such intrusion would destroy our absolute right to expression about present conditions.

So, to acknowledge that Kaepernick meant to use his celebrity and his position to address race and criminal justice reform is to understand that his protest against the norms of the existing social system is effective in bringing attention to needed change. His rightful expression may be distasteful, yet it must remain an ultimate gesture of protected protest in our great democracy.

Kareem Abdul-Jabbar, the NBA legend and activist, wrote in The Washington Post:
“What should horrify Americans is not Kaepernick’s choice to remain seated during the national anthem, but that nearly 50 years after [Muhammad] Ali was banned from boxing for his stance and Tommie Smith and John Carlos’s raised fists caused public ostracization and numerous death threats, we still need to call attention to the same racial inequities. Failure to fix this problem is what’s really un-American here.”
In the end, Colin Kaepernick is the sole owner of his unrest and protest. Others are joining him now, but only he understands his authorship of expression. We can argue about how Kaepernick is using the system to take out personal frustrations all day long, but, deep down, we know that we too have our individual beliefs – beliefs that include limits of intrusion and convictions of expressions. We too have rights to take actions when we feel oppressed or aggrieved. We too need no one else to approve of our protest.
We can damn Kaepernick for his lack of respect and his lack of patriotism. At the same time, we must each ask ourselves what we might do if confronted with similar oppression of our basic liberties. Some surely do choose much more violent and wrongful means of protest than refusing to come to attention for the National Anthem. In the case of Colin Kaepernick, his method of protest is highly symbolic. It may evoke hatred or esteem for the quarterback, yet it does not imperil innocent citizens in its shame of a nation still struggling to meet its promises.

 

Saturday, September 3, 2016

Unadorned -- More Beautiful Than Tats, Piercings, Plastic Surgery?

 

"Beauty when unadorned is adorned the most.” 

--St. Jerome (340-420)

After writing about young women and the current obsession with body art a couple days ago, I feel it may be appropriate to address the issue of feminine beauty as it relates to gender norms. I am certainly in favor of women expressing their feelings with honesty and commitment. Saying that, I understand that some young ladies get tattooed to commemorate others and to express sincere, honorable feelings. I support their choice of expression.

Someone asked why I limited my discussion of body art to women. I must admit doing so makes me appear to be extremely sexist. I believe I am not. Old-fashioned in some respects and appreciative of the natural female form perhaps, yet I am very supportive of women’s rights.

I want to tell women that their beauty is not dependent upon any particular standard or style. I want young women to know they do not have to possess fashion-model looks or cosmetic adornments to be absolutely alluring. I want them to know that their unique sensual attraction stems from so many different feminine graces and that imperfection is truly beautiful.

To me, excess makeup and outlandish fashion often betray feminine appeal. In fact, some say we are experiencing a sea change in how beauty is viewed in today's culture. Among them is Vivian Diller -- Ph.D., psychologist, and author of Face It: What Women Really Feel as Their Looks Change.
Diller says ...

“As I see it, the yearning for perfect beauty is beginning to lose strength among every day women and celebs alike. Boomers may have been the first to feel what I call 'image fatigue' as their attempts to appear younger led to too many inauthentic looking faces and bodies. That plastic, overly puffed up, frozen image has become a turnoff to many, in part because they have begun to all look the same. And the next generation is feeling it too: Millennials are experimenting with more fashion and makeup statements that express authenticity. For many young women, less is becoming more.

“(It) Seems like women's voices are joining together and are finally being heard: 'We want to feel and look attractive, but there isn't just one way to do that. We want to look like ourselves, not someone else.' At last, real may be the new beautiful.”

(Vivian Diller. “Building a Case for Real Beauty.” The Huffington Post. January 25, 2014.)

A study by researchers Alex Jones at Bangor University and Robin Kramer at Aberdeen University in the U.K. found “women are likely wearing cosmetics to appeal to the mistaken preferences of others.” Jones and Kramer reported men and women preferred the same amount of cosmetics. And that amount was less than the models had actually applied.

Specifically, people thought “the models looked best when they were wearing just 60 percent as much makeup as they had actually applied. But they thought women would want the models to be wearing 75 percent as much, and that men would want 80 percent.”

These mistaken preferences seem more tied to the perceived expectancies of men, and, to a lesser degree, of women. In other words, the models were primping for nonexistent ideals, not for actual humans.

(Olga Khazan. “Why Do So Many Women Wear So Much Makeup?”  
The Atlantic. April 28, 2014.)

 

What is the human preference of beauty as it relates to a woman's physiology? We know it has changed considerably over time as most aesthetic values do. A large group of people willingly adhere to ever-changing “beauty” standards of build, weight, and other physical attributes set by the media and fashion industries – extremely judgmental criteria that now seems to be at unrealistic levels of achievement.

We also know each woman must be true to her own beliefs about attraction – some truly have no desire to appear “beautiful” to others as long as they are honest with themselves. These women include those more concerned with proper exercise, diet, and health than with meeting fashion demands. And other ladies are just rebels who find the entire “body beautiful” argument unwarranted.

I believe perhaps the most alarming standards are commonly accepted artificial modifications – anything that presents the opportunity of completely selling out to fashion or to manufactured standards over unadorned, natural bodies.

To me, the beauty inherent in modesty and humility – the subtle graces – illuminates both the elegance and the beautiful mystery of a female. When glamor is glaring, upfront, and so dazzling as to make eyeballs bulge and drop jaws open, I think it often loses its charm. I hope young women understand how “too much” and “too drastic” can cheapen their image. And, again, if that is what is desired, far be it from me to preach the gospel of natural adoration. Yet, I strongly believe the work of art is the human form, not the chemical or plastic alteration of that form.

 

The delicate newborn female comes into this world in all shapes, sizes, and colors. It is beyond my conception how any adornment would be made to this baby to meet some artificial standard of beauty. Upon her first breath, she is supremely adorable. Yet, as she grows, this baby is increasingly bombarded by demands of beauty when the truth is nothing is more beautiful than her natural, human development. If nurtured, protected, and loved, she will be beautiful in her heart, mind, and skin.

I am confessing to my preference for moderation as it applies to a beautiful female. It is a prejudice I will likely continue to harbor, even in the face of overwhelming odds. I understand that body art, body piercings, plastic surgery, and scads of makeup are commonly employed in beauty makeovers today. Still, some of us find special grace in the imperfect – we love the image of a sweet being in her natural design. Simply beautiful and unadorned. 

 

Thursday, September 1, 2016

Young Ladies With Torrents of Tats and Disfiguring Pigments

 

I preface this entry by admitting I am 65-years-old, and I have developed a somewhat fixed set of cultural values. Oh hell, let's get down to it. I am a geezer who finds some changes increasingly difficult to endure. But, I also acknowledge I have little sense of modern fashion, art, or vogue concepts. If you are young, I promise one day you will reevaluate the fads and manners you followed in your youth. I say this from my own experience because so many of my early amusements now seem extremely juvenile and even downright regrettable.

Which brings me to … tattoos.

A 2010 Pew Research Center Report found that 38 percent of Americans ages 18-29 now have some sort of long-term body art. According to the Statistic Brain Research Institute, approximately 21,000 tattoo parlors in the U.S. provide services, and 32 percent of those with tattoos claim they are addicted to ink.

Women are getting inked more often these days. And they are not just choosing small, discreet tattoos on their ankles, their shoulders, and the small of their backs. Many are covering large portions of their anatomy with ink. The TV network behind show "Best Ink" and Lightspeed Research asked just over 1000 people across the United States about their perceptions of body art, and it turned out 59 percent of women have tattoos compared to 41 percent of men.

Why do so many young people – especially beautiful girls – become addicted to getting tattoo after tattoo? I understand the nature of pushing envelopes and how acquiring body art raises adrenaline. Combine the thrill with the desire to display a little “naughty” visibility on the canvas, and some young ladies can't seem to stop their desire to ink their bodies with words, symbols, and pictures. Exhibitionism fallen woman

One thing is for sure: Women who get body art are, in some way, seeking to redefine themselves.

Enter psychology. Getting tattooed can be an act of rebellion and a breaking of conventions. Some claim to love the endorphins that flood the body during tattooing while others even say they find solace in the pain the process produces.

Getting inked can be a form of attention seeking, especially when the tattoos are very conspicuous and very graphic. Due to the popularity of tattooing, it also can be an effective method of facilitating social interactions. Yet, I can see this as a possible cause of isolation also.

But, as with most popular fashion, I am sure young women think more about physiological reasons for having tattoos. The growing cultural acceptance of body art and the increasing media exposure of those with ink have created an insurgence of tattoo-related art and artists. To many women, tattoos represent a deep love of expression of what they consider to be beautiful, artistic freedom. To some, the more tattoos, the more beautiful becomes the display on their personal canvasses.

I also understand that tattoos have significant meaning. Ink becomes a self-satisfying way of expressing who people believe themselves to be on this inside. These people often use stock expressions, quotes, and poems to bolster body illustrations.

Yet, people age and change -- their self-images, their physical bodies, and their concepts of aesthetics transform. The permanence of bold expressions on human skin can cause deep regret. Don't even ask me how many young, extreme liberals I grew up with became staunch conservatives as they aged. And, removal of body art is costly and can be painful. 

 

I believe it is logical that many people question how naturally beautiful women could indelibly mar a lovely canvas by such subjective, artificial means. Hear me out, young folks. This is a pertinent question, and it always has been. Critical judgment by others is a part of life, and nothing can change the fact that getting a tattoo was once considered self-mutilatory behavior.

Living with the real consequences of choosing to display body art must be considered …

“Vintage salon owner ReeRee Rockette, 30, experiences extreme reactions to her extensive arm tattoos: 'I get a lot of positive feedback on my tattoos, although they seem to make people forget their manners. I get stroked, poked and touched by strangers – usually women – and it’s very unsettling. The negative reactions are quieter; stares and pointing, or questions tinged with passive aggression. I have had women at parties tell me why they don’t like tattoos. Despite me never asking.'

“'This has something to do with cultural expectations of what’s feminine,' explains Gemma Angel, from UCL’s History of Art department. 'A dainty little rose is an acceptably discreet decoration, but an entire back piece is much more confronting. The difference between these two examples is that one is about adorning the female form, perhaps to accentuate femininity, whereas the other is more about the tattoo itself – the body becomes a canvas onto which the person’s idea of themselves is projected. I think that Western standards of beauty do not accommodate heavily tattooed women because, like any form of body modification taken to an extreme, it disrupts the ideal of what is feminine.'”

(Anita Bhagwandas.“Women and Tattoos.” Stylist. 2016.)

A tattoo on a beautiful woman is like putting 
a bumper sticker on a Ferrari.”

I know many will hate this unattributed quote. Yet, like it or not, a stigma survives. A young woman would have to be in total denial if she thought tattoos weren't going to have a significant positive or negative impact on people she doesn't know well. And some of the variables that elicit judgment are the following:

How many tattoos does a person have?
What size are the tattoos?
Where on the body are the tattoos located?

In addition, right or wrong, people judge the behaviors of the tattooed. In actuality, some research has been done on those with body art that may reinforce those judgments.What behaviors are found to be consistent with women who are tattooed?

Research shows that body modification is associated with early sexual initiation and more liberal attitudes toward sexual behaviors but not with engaging in risky sexual behaviors.

(K. Nowosielski, et al. “Tattoos, piercing, and sexual behaviors in young adults.
 J Sex Med. 2012.)

In another stody, British researchers report significantly lower appearance anxiety and dissatisfaction immediately after obtaining a tattoo. Participants report significantly greater body appreciation, self-esteem, distinctive appearance investment, and self-ascribed uniqueness three weeks after obtaining a tattoo. But, women report significantly greater social physique anxiety three weeks after obtaining a tattoo, whereas men report significantly lower anxiety, and satisfaction with a new tattoo decreases significantly after three weeks, although a majority of respondents believe they are likely to get a future tattoo.

(Viren Swami. “Marked for life? A prospective study of tattoos on appearance anxiety and dissatisfaction, perceptions of uniqueness, and self-esteem.” Body Image. Volume 8. June 2011.)
 
Could tattoos affect a person's ability to find employment? Dr Andrew R. Timming of the School of Management at the University of St Andrews told the British Sociological Association (September 4, 2013) that having a tattoo reduces the chance of getting a job, but it depends on where the tattoo is, what it depicts and if the job involves dealing with customers.
"Most respondents agreed that visible tattoos are a stigma," Dr Timming told the conference. One woman manager told him that "they make a person look dirty". Another male manager told him "subconsciously that would stop me from employing them." Another male manager said "tattoos are the first thing they [fellow recruiters] talk about when the person has gone out of the door."

 

Health Risks – Important Considerations For Getting Inked

And, most important, what are the health risks of inking? In their usual “What? Me worry?” manner, the Food and Drug Administration says it knows little about the tattoo inks in use today. Tattoo inks are considered cosmetics, and their color additives are subject to regulatory authority. Yes, I said “cosmetics.” Go figure.

But the agency (FDA) says it hasn’t been using its authority “because of other public health priorities and a previous lack of evidence of safety concerns,” writes spokeswoman Lauren Sucher.
The facts: There have been no systematic studies of the safety of tattoo inks.

 Where does the pigment go?

Real concerns within the Arkansas-based National Center for Toxicological Research (NCTR) are the following:

• the chemical composition of the inks and how they break down (metabolize) in the body;

• the short-term and long-term safety of pigments used in tattoo inks;

• how the body responds to the interaction of light with the inks.

For example, some tattoos fade over time or fade when they are exposed to sunlight. And laser light is used to remove tattoos. “We want to know what happens to the ink,” says research chemist Paul Howard, Ph.D. “Where does the pigment go?”

NC TR researchers are exploring several possibilities:

• The body cells may digest and destroy the ink, just as they rid the body of bacteria and other foreign matter as a defense against infection. NCTR studies show that a common pigment used in yellow tattoo inks, Pigment Yellow 74, may be broken down by enzymes, or metabolized. “Just like the body metabolizes and excretes other substances, the body may metabolize small amounts of the tattoo pigment to make it more water soluble, and out it goes.

Sunlight may cause the ink to break down so it is less visible. NCTR researchers have found that Pigment Yellow 74 decomposes in sunlight, breaking down into components that are colorless. “The pigment components may still be there,” says Howard, “and we don’t know if these are potentially toxic.”

• The skin cells containing the ink may be killed by sunlight or laser light and ink breakdown products may disperse through the body. “Research has also shown that some pigment migrates from the tattoo site to the body’s lymph nodes,” says Howard. Lymph nodes are part of the lymphatic system, a collection of fluid-carrying vessels in the body that filter out disease-causing organisms.

Whether the migration of tattoo ink has health consequences or not is still unknown. NCTR is doing further research to answer this and other questions about the safety of tattoo inks.

According to the Mayo Clinic, other health considerations for tattoos include ...
  • Allergic reactions. Tattoo dyes — especially red, green, yellow and blue dyes — can cause allergic skin reactions, such as an itchy rash at the tattoo site. This can occur even years after you get the tattoo.
  • Skin infections. A skin infection is possible after tattooing.
  • Other skin problems. Sometimes bumps called granulomas form around tattoo ink. Tattooing also can lead to keloids — raised areas caused by an overgrowth of scar tissue.
  • Bloodborne diseases. If the equipment used to create your tattoo is contaminated with infected blood, you can contract various bloodborne diseases — including tetanus, hepatitis B and hepatitis C.
  • MRI complications. Rarely, tattoos or permanent makeup might cause swelling or burning in the affected areas during magnetic resonance imaging (MRI) exams. In some cases, tattoo pigments can interfere with the quality of the image.
(Staff Mayo Clinic. “Tattoos: Understand risks and precautions.”)

 


My Take

Rebellion, attention, beauty – all young women find themselves dealing with considerations of redefining themselves to achieve greater happiness and self-acceptance. This is very important in their development and often life-changing in nature. Very often, women make these decisions based solely upon the present state of their affairs – what's happening in their culture at the time and what's happening in their lives at the moment.

Most likely, a girl who chooses to cover herself with tattoos will be subjected to defending her decision to do so on a daily basis. It is difficult to have others consider a tattooed lady to be demure or innocent in character. Let me make this clear – I do not defend this judgment. In this entry, I hope only to speak honestly based on experience and personal research.

What I do wish to say to all young women is this. Nothing in God's creation is as beautiful as the natural body of a lovely woman. The features of imperfections and wonderful differences in faces, shapes, statures, and skins enhance sexuality and attractiveness.

I believe placing the depiction of the “art” of someone else on that skin does very little. In almost all cases it does nothing, to enhance lasting beauty. Symbolic of the talents of a tattoo artist -- what is original in ink applied by another? It is, at best, a decent rendering by a stranger.

I must be honest and tell you I don't like to see a gorgeous woman covered in ink. She may believe that ink may be a symbol of expression of her inner beauty; however, it is really nothing more than pigments of metal salts, plastics, and vegetable dyes that cover the real exterior of her being. Her truest -- and most sensual -- impressions come from the soul through her natural body.

To close, here is an excerpt from Covered In Ink: Tattoos, Women and the Politics of the Body by Beverly Yuen Thompson …

“Before women are ever exposed to the world of alternative body modification, they have been overexposed to the beauty culture through their personal interactions as well as the media. They have developed an identity based upon their gender performance, sexuality, race, nationality, age, and ability. 

“With the addition of becoming heavily tattooed, their embodiment identities intersect with these other factors. While White women may be given more space to experiment with their body modification, women of color, lesbians, disabled people, and other already-marked bodies will be interpreted more harshly, as multiply 'deviant.' 

“People of color’s bodies are often criminalized and discriminated against; with the addition of heavy tattooing, these pressures can become magnified. Lesbians and bisexual women may face additional stigma if their tattooing reinforces a butch appearance, but less so for a feminine one.”

I think body art elicits strong reactions. It may be attractive but the only true lasting attraction is the person displaying the tattoos. To some like me, a detraction is noticeable – one that makes me wonder why a person desires such artificial adornment, some of which seems so outrageous. OK, OK, I admit it -- it burns my ass to see a beautiful girl covered in shitty tattoos. There, I've said it. Please, girls, don't cover your skin with cheap renderings of supposedly wonderful sentiments. Don't become a walking exhibit of markings and designs. Be your beautiful self in your lovely skin.

And, I wonder if the fad will every stop. After all, how could any heavily tattooed parent regret that their son or daughter takes the same privilege with ink? I wonder if these parents even imagine what popular symbols, quotes, and artistic statements may be preferred in the future by their daring offspring. One thing is certain -- it will represent the cutting edge of redefining themselves.