Wednesday, February 29, 2012

Talk to Me Now

Americans and Nevadans are discussing, debating, and struggling with many issues such as the national debt, health care reform, the upcoming presidential election, and more. One of the topics on that list is "what to do about marijuana" At this very moment if you read any number of articles, blogs, op ed, and more you'll find convincing arguments for and against legalizing marijuana for recreational use, for and against marijuana as medicine, and for or against marijuana as a substance that the American citizen should be able to choose to use or not to use.

All of these thoughts, opinions, and, in some cases, emotional pleas, have some valid points and both sides point to scientific facts, civil liberties, and common sense. And the debate has become heated.

Like so many other controversial topics, I am afraid that the real messages about marijuana and other drugs of abuse are becoming lost in the debate. While JTNN has a position on marijuana and we will continue to make the case for that position, we also need to be careful NOT to lose sight of the fact that we are preventing drug abuse. That is why JTNN has started the "Talk to Me Now" campaign. This is a campaign that encourages parents to talk to their children factually about all substances of abuse, including marijuana.

So, regardless of one's position on marijuana, here are a few facts that need to be stated,re-stated, and discussed with children and teens.

First and foremost, marijuana is an addictive drug. In the treatment field our experience used to be that people coming for help would often have marijuana on the list of drugs they used but rarely did anyone come in just for marijuana addiction. That is not true anymore, particularly with adolescents. Today marijuana dependence represents more admissions to treatment in adolescents than all other illicit drugs combined.

Second, marijuana use can affect learning, memory, and other important brain functions. This is of particular concern among young people whose brains are still developing.

Third,I've heard many people say that alcohol is much worse than marijuana so, "What's the big deal?" Basing the argument on alcohol being more dangerous than marijuana is like trying to compare a bullet wound to the stomach to a deep stab wound in the shoulder. No one would ever say, "Give me the stab wound!" They are both terrible and both are to be avoided for their own reasons. The point here
is that marijuana use has its concerns and while some of those concerns don't intersect with the dangers of alcohol, they are still concerns.

Finally, marijuana use is increasing in our youth. With widespread availability and a general decrease in society's view of marijuana as a drug of concern, more youth are using the drug. In the latest surveys of youth nationally, in Nevada, and in Washoe County, marijuana use among youth is rising. That point combined with the points above should give us something to talk about with our children or with any youth with whom we have contact.

JTNN will continue to provide sourced information and data to the community about marijuana and other drugs. We want parents to be informed so they can talk with their children about marijuana and other drugs (alcohol included) of abuse. For more information on the "Talk to Me Now" campaign, please go to or call 775-324-7557.

A parent is the biggest influence on their children. Children may not
always act like they'd like their parents to talk with them about these
issues but they need it. If their parents won't talk to them, someone else will and that person may be providing the wrong information.

Sunday, April 24, 2011

Let's Not Legalize Another Addictive Drug

Sometimes I think about whether this world we live in makes sense. I'm also old enough to know that sometimes what makes sense to me won't make sense to you and vice versa. So, that said, let me talk with you about something that doesn't make sense to me.

There is a growing number of people that seem to think that legalizing marijuana for recreational use is a great idea. In fact, it seems to be an idea that many are so ready for that they can't see the forest for the trees. Or should I say they can't see really big problem with marijuana for the pro-legalization rhetoric.

Here are some reasons given for legalizing marijuana:

1. Tax it and we'll make money for social services.
2. Marijuana is way less dangerous than alcohol and tobacco. Since those two are already legal, then it only makes sense to put marijuana in the same legal category.
3. Marijuana is not addictive so what's the big deal anyway?

FACT 1: We tax alcohol and the damage done by drinkers far outstrips the money brought in from taxes. On top of that, raising alcohol taxes is next to impossible due to the distaste in most legislative bodies for so called "sin taxes." So the alcohol taxes in Nevada are those that were set in 1981 with not a whole lot (if any) change in 30 years.

FACT 2: I'll admit that marijuana is not as dangerous in many ways as alcohol. But that's not the point! Saying that we shouldn't legalize marijuana because alcohol is already legal and way worse than marijuana holds no logic. In addition, the two legal drugs (alcohol and tobacco) are the most used drugs. Do you see any connection for what will happen if we legalize this drug? Oh, and by the way, marijuana does have its own dangers, one of which is the potential for addiction.

FACT 3: Marijuana is addictive. Those that want to legalize the drug say adamantly that it's not addictive. But it is. The single biggest reason for adolescent treatment admissions in Nevada is for marijuana. I've known several thousand addicted people in my career, many of whom also were addicted to marijuana. The science and our experience say that marijuana is addictive. Why do we want to add another addictive drug to our list of legal drugs?

I realize that this little blog may get some attention from those who deeply believe we should legalize the drug. I understand that and even understand the reasoning behind it. That said, legalizing marijuana for recreational use is bad policy. I invite your comments and ask only that anything submitted is respectful and I will be the same.

Wednesday, March 16, 2011

The Worst Drug

What is the worst drug that someone can use? That sounds like it could be the proverbial "million dollar question." So what is it?

In the 1930s and 40s, it was the Demon Weed or marijuana. Remember Reefer Madness?

In the late 1960s it was heroin. Remember? Vietnam vets coming home. The news was full of stories of veterans returning to civilian life but only now "hooked" on heroin. We just knew that heroin was the worst drug ever.

Then in the early 1970s, it was LSD. You know, acid. The media portrayed a whole psychedelic picture of long haired, peace loving but not so hygienic hippies rocking out to the Grateful Dead and wearing tie dye clothing in the Haight Ashbury district of San Francisco. LSD certainly was the demon drug that we all feared.

Along came the 1980s and cocaine. We were inundated with stories of people smoking crack (smokable form of cocaine) on the street corner, school children having access to the drug, and Richard Pryor running down the street on fire after his free base cocaine exploded all over him. Cocaine was definitely the demon drug of the century.

In the late 1990s and well into the new century we were faced with a "new" drug called methamphetamine. More powerful than most anything we'd known and so addictive, our collective attention was caught and held for quite some time. We learned new words like "tweaker" and "meth." It seemed like everyone was using this newest scourge. This was the worst ever.

Next, opiate based painkilling drugs were upon us. We heard about mothers, teens and executives using drugs like Oxycontin, Hydrocodone, and Methadone. We heard about them getting addicted and we heard about some of them dying. How can a little pill do so much damage? Seems like meth has gone away and we're now stuck with this prescription drug problem.

Finally, in the last couple of years we hear about teenagers smoking heroin. What? I thought that went away 35 years ago! Everyone knows that you have to use a needle with heroin, right? Then we heard about heroin smokers graduating to injecting or "shooting" it into their bodies. Seems like a nightmare revisted. So maybe heroin is the worst drug.

So what is the worst drug? In reality, all drugs of abuse hold their own specific dangers. That includes heroin, LSD, cocaine, prescription drugs, alcohol, marijuana, and more. But as a culture, we tend to want to focus on one at a time. We then demonize that drug and then we forget about everything else.

For example, was heroin still being used in the '80s and '90s? You bet and it was used a lot by a lot of people. Before Meth was called Meth, it was called Crank and it was used prolifically in Nevada in the '70s, '80s, and '90s. But, like target practice we seem to gravitate toward picking off one at a time. When that's done, we go to the next.

In reality, we need to focus on everything and be aware of everything. Right now we are paying a lot of attention to heroin but meth is still being used by many. We need to gear enforcement, prevention, education, and treatment efforts to all of these things. And there's a reason why.

Here it is. It's the answer to the question, "What's the worst drug?" The answer to that million dollar question is this: The most dangerous or worst drug is the one you (or someone you care about) is using right now. That could be heroin or marijuana or alcohol or anything else on the list. That's the important point. Sure, we still need to do campaigns and raise awareness but let's not forget the big picture.

Friday, December 10, 2010

The Heart of a Parent

Just a couple of weeks ago, JTNN and a number of our partners held a press conference at Reno City Hall featuring Mayor Bob Cashell, his wife, and his son, Pat who is openly in recovery from an addiction problem. The purpose of the press conference was to raise awareness and money for a heroin prevention campaign that we are putting on early in 2011.

During the event, Mayor Cashell faced the media, who were there in force, and said, "When my son Pat had an addiction problem, his mother and I didn't know what to do." Here is one of the most influential people in the Reno community saying, "I didn't know what to do." With tears in his eyes, the Mayor went on to talk about how his son had a problem for many years but now is sober and doing well.

There's a lot we could talk about in that story but what really reaches out to me is the heart of a parent.

When a child, whether grown or not, has an addiction problem, so much goes through the parent's mind. Some of these thoughts include, "I'm a terrible parent," "What did I do wrong?" "What happened to my little one that used to play with toys and watch cartoons and was so excited about birthdays and Christmas?"

When a child becomes addicted, a parent's heart breaks. It may look like anger or disappointment or depression or any number of things but it's all about a broken heart.

I've talked to many parents and they all say something similar: "I didn't know what to do but I would do anything that I could." A parent's heart may be broken, but that heart still hopes and prays and wants and works for the best outcome for his or her child.

Some parents get their child back and some don't. Some of these children get into recovery and all is well. Some die. Others keep using drugs. And others may quit but they are never the same again. I remember one mother telling me that after her daughter used methamphetamine for a number of years, she finally received treatment and is doing well, "But," the mother added, "She's not the same person that she was...I miss that part of her." That mother still loved her child and was thrilled that she made it out to the other side but she grieved for the child she lost to
the addiction.

There's more on my mind but what I've also learned about a parent's heart is that most want to help. We are excited about the number of parents that have come forward during our heroin campaign. We hope more parents come forward for support from other parents, to volunteer, and to share their stories. I look forward to meeting each an every one of you.

Saturday, November 13, 2010

Much Ado About Nothing?

There has long been controversy about women who drink alcohol during pregnancy. In fact, the problem of birth defects and other problems caused by maternal drinking has become such an issue that the advice now given (at least officially) is, "No level of alcohol is safe for the unborn baby during pregnancy."

This abstinence advice has been challenged by the findings of a study reported this fall in The Journal of Epidemiology and Community Health. According to one source, "Using data from the Millennium Cohort Study in Britain, a data-rich look at 11,500 children born in the U.K. 2000 and 2001, researchers at University College in London concluded that the children of women who drank 'lightly' — meaning up to one to two drinks a week — during pregnancy did no worse on cognitive tests at age 5 than children of mothers who did not drink at all. Actually, they did slightly better on the tests, which included things like 'naming vocabulary,' 'picture similarities' and 'pattern construction.'”

According to the study, the children of mothers who went beyond “light drinking,” however, had noticeably lower scores.

This could be great news for women who would like to imbibe a little while pregnant but there are some troubling issues still.

This reminds me of a study published by the Rand Corporation in the late 1970s that proclaimed some alcoholics who were sober could possibly return to social drinking without ill effect. Regardless of the soundness of that science the real issue here is that every alcoholic I knew back then said, "I'm one of those. I can return to social drinking!" Disastrous thinking for a person who has the disease of alcoholism.

So, I see the same thing here. As many of the bloggers on the pregnant women and alcohol issue said, my mom drank alcohol (moderately I presume) during pregnancy and I'm pretty sure that I turned out OK in terms of thinking abilities and related items. But the point of telling women that no alcohol is safe isn't about answering the question, "Is one drink safe? Is two safe? How about three?"

The point really is about what how close to the cliff do you want to go without falling off? For instance, what is one drink? I have known people who think that one drink was an 8 to 12 ounce martini. For another instance, the answer from an alcoholic when asked, "How much did you drink when you were arrested for drunk driving (for example)?" the answer is often, "I just had a couple." As that elusive number is pursued, it often turns into 4 or 7 or 12 drinks. In other words, a
pregnant woman, especially one with a drinking problem, may THINK she's drinking one drink but is actually drinking more.

For a final instance, what's the big deal about not doing something for 9 months, especially when the potential for harm is so great?

Many of the blogs written in response to the research article talked about how scared we make women in America about being pregnant and they were full of testimonies (like mine) that "my mom drank and I'm OK." But if we are going to err, let's err on the side of safety.

I don't want to scare anyone and I don't want to oppress pregnant women with rules and regulations and do's and dont's that make them feel persecuted for being pregnant. But I have to say that I have known many women who have given birth to children with Fetal Alcohol Spectrum Disorder (FASD). While these are lovely and loved children, that condition can be devastating to the child and the whole family (not to mention the price tag to society). In addition, FASD is totally preventable.

Why shouldn't we warn and encourage women to do everything they can to have the healthiest baby possible? A human life and preventable disabilities that last a lifetime are worth the conversation and the effort.

Friday, October 15, 2010

Different Day, Same Story (Sort of)

I was in high school in the late 1960s when the news began to report on soldiers from the war in Vietnam coming home addicted to heroin. Now, most troops didn't take heroin but there was enough to make it something to talk about. This may have been the beginning of America's modern day awareness of heroin addiction.

I remember those days and how the drug seemed so awful, especially because it was associated with injection, crime, and a lifestyle that most of us can't relate to in the least. Then Hollywood took over and showed us a sometimes realistic and sometimes exaggerated view of heroin use. I'd say we had a very negative view of heroin and everything related to it. I'd also say that I was afraid of the drug and would never have tried it. My reaction then was kind of like the reaction of many kids today with methamphetamine. I saw it as a "dirty" drug.

But times change and people sometimes forget. Heroin addiction and related problems have never gone away but our general consciousness about the drug waned for a number of years. I remember when I first moved to northern Nevada 25 years ago, the prevailing wisdom was that there were very few heroin addicts in the area. Not true.

Fast forward to a year or two ago. Painkilling, opiate based prescription drugs are becoming a much talked about issue. At the same time, we begin to notice that youth coming to treatment are showing up more and more for heroin. Adults, too. But this is a smokable heroin. The old fashioned heroin "junkie" of the 60s and 70s seems gone.

But what happened that heroin just seemed to jump back on the drug scene? First of all, it never left. But I will say that I think today it's reaching a wider audience and, like the heroin epidemic of the 60s, we're noticing it more because it's affecting younger people and even teens. And for some, injection is still part of the culture of use.

What's different now is that we are seeing a pattern of use that seems to start (for many) with prescription painkiller use. Then, for some, abuse. Finally, for some of those that abuse, heroin. So far we've been seeing and hearing about smokable heroin. But now treatment providers and others are noticing more injection use of the drug, as well.

I bring this up because while we've been focusing on methamphetamine and more recently on prescription drugs, heroin has been making a major comeback. JTNN is looking into the reasons and will be reporting more as we learn more from the data. But for now, we are looking at the fact that heroin use and addiction is still with us. More to come later.

Wednesday, September 1, 2010

Uncle Bob

Everyone has a story about a person in their life who has a drinking or drug problem but can never seem to get better, despite the best efforts of those around them. Unfortunately, this person's story is often used to prove that treatment for substance use disorders doesn't work and that recovery from said disorders rarely happens. "My Uncle Bob has been to treatment 12 times and he never lasts more than a week after he gets out." "My Uncle Bob quits from time to time but he just can't quite get on track." "Uncle Bob just Bob just doesn't seem to care about staying sober even though he has been given SOOOO many chances. I guess he just doesn't care."

Everyone has an Uncle Bob. It may really be an aunt or a dad or a sister or a best friend or a co-worker or a next door neighbor. But we all have at least one person in our life that seems to symbolize the fact that chemical addiction is a hopeless disorder from which very few get better or recover. You're probably think I'm going to launch into a sermon on how effective treatment is and "Shame on you for believing in the Uncle Bob Myth!"

Actually, I won't do any of that but I will make a statement and then I'll tell you a story. The statement is this: "For every Uncle Bob you tell me about, I can counter with a story about someone who was a 'hopeless' alcoholic or drug addict and who is fine today." In fact, I challenge you!

Now, here's the story: Lori is a 37 year old female with a 21 year history of alcohol and drug addiction that started with alcohol and marijuana but over the years included methamphetamine addiction and prescription pill abuse. She was pretty functional until she tried methamphetamine at 24 when she was a young mom with two young children and a marriage that started off well enough but now was facing some trouble. There's not enough room here to tell you all the details but through her drug use Lori lost her marriage and custody of her children. In fact, it got so bad that she actually chose drugs over raising her children.

Over the years Lori managed to scratch out a marginal living doing various jobs and living in a small apartment or sometimes with a man that would take care of her. But her life mainly consisted of using alcohol and drugs and just surviving the best way she could. She often thought about quitting but would always remember her Uncle Bob (Remember, everybody has one!) who seemed to try and try but never could quite help himself.

Then Lori really got into trouble. She was arrested for a drug related charge and was looking at serving some time in prison. Life had never been so bad. Lori was convicted of the crime but was given a chance to attend something called drug court and treatment instead of one to five years in prison. She thought about treatment and how it sounded kind of useless but she visited her counselor and group sessions each week, as required. She also went to self help meetings (Alcoholics Anonymous and Narcotics Anonymous).

She began to keep track of how long she was drug free and she began to think that maybe there was hope after all. She met people who were sober, just like her with stories a lot like hers. Life still was hard but as the weeks and months passed, she began to realize that with some effort on her part, some honesty and integrity, and a strong support system, life might be OK after all without alcohol and drugs.

Fast forward 10 years. Looking back at that day that she went into drug court (with some misgiving, at that), Lori decides that it's been worth it. All has not been perfect. She had a relapse about 6 months into her recovery. Then she had some health problems about 5 years ago. She and her kids talk now and spend time together, although she knows that she could of spent more time being part of their lives but she can't undo that. She has to deal with the remorse but she also works on that by forgiving herself and making "amends" whenever and wherever possible. Now she lives in the day but also looks to sunny days ahead. She has a grandbaby who she adores. Her Uncle Bob died last year and he never did get sober....but Lori did. She mourns him but she celebrates her own recovery.

Not everyone gets sober but many do. Recovery happens all the time not just occasionally. September is Recovery Month. You'll be hearing more from me about that later. Let's celebrate and remember the thousands and the millions in recovery from a substance use disorder. In the meantime, remember Lori.