Opinion: Where addiction and tragedy can confuse issues

It is a sad story

I just read an article posted on LinkedIn titled, Opioids, My Mom's Death, and Why People Trust Science Less and the human side of the story is very sad, however, the additional narrative is opinion, conjecture, suspect and unfortunate.

There is a conflation of issues along with unresolved conflicts that need to be separated before this article tagged as an Editor’s Pick, Healthcare and Pharmaceutical are taken in without questioning or review.

Separate the issues

Walking back the issues, there is grief at a mother’s death, addiction to pain-killers that came as a result of prophylaxis for osteoporosis, estrangement, and then the machinations of the pharmaceutical industrial complex, known as Big-Pharma.

There is no doubt that Big-Pharma, Big-Tobacco, Big-Oil, Big-Manufacturing, Big-Agriculture and Big-Anything have a lot to answer for about their products and the effects of the production and use of those products on people, on the environment, and everything that makes for the wellbeing of our common humanity, but that is addressing the symptom.

The fundamentals would always be down to the individual, their personality and their experiences in how persuadable they are and this is not to castigate the strength of character of anyone, but missing that point would allow for drawing the wrong conclusions.

Scientific advancement has done wonders

For instance, it is thanks to the contributions of scientific research and medicine that I am alive today, having at one time been at death’s door with a prognosis of 5 weeks to live if my physiology could not tolerate and respond to the regimen of therapy I was being prescribed.

At the lowest point, I was in such unbearable pain that if not for the need to monitor my vitals, I would have been anaesthetised to manage the stress of it. Before I was admitted to the hospital, I was on Tramadol, then on the day I was admitted, I was given a morphine skin patch that had to be taken off after two days because I could not keep my food down and from then on, I was put on Oxycontin and Paracetamol with Codeine.

Whilst it appeared to manage the pain, when a deep biopsy was done on the fungating tumours under the sole of my left foot, 7 shots of local anaesthetic did very little to deaden to the pain. I simply bit on a think piece of a folded napkin as they prodded the anger in my foot.

Managing pain alone

On leaving the hospital, I was prescribed a list of pain and nausea management drugs that I was concerned about the cumulative soporific effects of the drugs. In addition to the earlier prescribed drugs, I was given a Fentanyl patch and that dosage was doubled when I reported that I was still in very much pain. That was when the equilibrium for my pain management was reached, I was not as pre-occupied with the pain as I took in 7 sessions of chemotherapy and the cancer lesions healed.

Whilst the lesions had gone and all the necrotised skin had been removed to reveal fresh skin, I was still in pain into the 4^th month of my diagnosis, then the pain began to subside. One Sunday, the patch fell off my skin, I did not know until then that a patch retainer film could be worn to keep the patch in place. Until the effects of the new patch kicked in, I was in such pain I began to laugh almost into delirium, but that produced endorphins to ease the pain. My friend thought I was going crazy, but I knew what I was doing.

Coming off pain killers

The pain of cancer is in another realm, it cannot be explained, the therapy for chronic pain has addictive qualities too. When the pain had gone, I could not just take off the patch, I had to wean myself off it, this is where the mind and the will come to play. Addiction has much of its roots in the psyche first than in its palliative effects. The palliative which is in itself a kind of comfort has to be consciously managed.

In my case, it took another 2 months to come completely off the patch and other pain medication. With the patch, I cut it in half and left it on for longer, each patch dosage halved and left on for much longer until my body could do without the drug.

Then, we all have innate tendencies to addiction and some people might be able to avoid addiction. There was another instance where a change in drug regimen meant I could not sleep, the first suggestion was to put me on sleeping medication, however, I thought of working a plan to take my pills at a certain time and avoid completely drug-induced sleep. I could see the dangers of becoming dependent on sleeping pills.

Addiction is first personal

Going back to the purpose of writing this blog, addiction has social, emotional, economic, relationship and physical consequences. In my view, addiction is not just to drugs or the abuse of drugs, alcohol, it could be sex, it could be religion or any other activity. The person and people around that person suffer, and that is very sad.

Regardless of what brought on the addiction, it is always first a personal struggle, what other factors contribute to it does not take away from how the person might have succumbed to addiction. Whether we fail to be better informed of the debilitating side-effects of a drug does not take away from the balance between efficacy and damage.

Apportion rightly

The science would suggest a drug can do something, most drugs have to recoup research and development costs and it unfortunate that some people put the profit motive well and above the welfare of patients and customers – that is commerce, we cannot avoid it.

It is, however, a long stretch to conflate personal tragedy, addiction, the science and the commerce into one clickable title of Opioids, My Mom's Death, and Why People Trust Science Less and draw the conclusions in the piece without properly assuming personal responsibility on the one hand and understanding that every individual has a unique physiology that adapts to medication in different ways which could influence the mind too.

I recall my doctor saying they could treat my condition but it depended on my physiology to tolerate the medical regimen. I lost a friend to a similar condition because his physiology did not have the capacity to tolerate the regimen of chemotherapy.

The responsibility of addiction remains a personal thing, the responsibility for being properly informed lies within the person, their medical support, the pharmaceutical companies and the science that balances efficacy with possible side-effects, with the hope that efficacy outweighs side-effects.

I am sorry, the writer lost his mother to addiction, but if we are to trust science less because of the conflicts of interest between treatment and commerce, we would all die sooner in more misery and pain with respite or comfort. That is why these issues need to be treated completely separately even if they are linked in a personal tragedy.

Though Picnic: On the home I lost and the life I gained

Telling it again

It is with a sense of gratitude and good fortune that I have enjoyed and do continue to enjoy many of the good things in life.

In one way of another, experience, education, example, and explanation has given me the capacity to view life as a story, one that probably never gets told to the depth of the feeling that inspired the need to tell the tale.

However, counting one’s blessings leaves one very much on the side of happy, fulfilled and content. Things may not be perfect, but what is a story if everything is as predictable as to become unexciting and pretty boring?

The long tail of cancer

Yesterday, I found myself combing the archives of the Internet for a piece of my history. I once had an apartment overlooking two harbours from the 7^th in Amsterdam. I spent a wonderful ten and a half years there until I had to sell it at a loss following the long tail of cancer.

I say the long tail of cancer because, for the few of us who have been granted the second life of living beyond the ravages of cancer, once health is sorted out, you begin to realise that you have no new excuses for not going back into the world to live, that requires either going back to where you left life before cancer or having to start all over again.

Taking pills doesn’t pay the bills

As you ingest the pills to make you better whilst being too incapacitated to do any reasonable work to earn a living, the bills pile up and have to be paid. In my case, all my creditors, the bank, the mortgage company, the utility company were sympathetic apart from one credit card company – American Express – I guess they are not in the amelioration and respite business. C’est la vie!

Invariably, I had to sell my house, my illness, the credit crunch, comatose property market all united into a perfect storm that I sold the house at a just under a 10% loss after paying almost half of the value of the apartment in interest over 126 months or thereabouts.

Letting go of the thing

It was an investment I had to walk away from with sadness, but also with a sense of freedom to attempt to build from scratch again, because in the three years after cancer, the long tail of cancer that I talked of earlier, I lost everything.

So, I found out yesterday that the young couple I sold the place to just over 4 years ago had now sold it again and walked away with a cool profit of 38.5%, such luck and I am happy for them.

I bought the place at the height of the market and basically the value never really appreciated over the time that I lived there, but it was my home, so it did not matter until circumstances necessitated drastic action.

Concentrating on the pursuit of happiness

Then again, one cannot live a life full of improbables and regrets, the gift of life alone is one for which I would always be grateful. The story of life which might be punctuated with profits and losses is diminished if that is the only account one has of living. In mine, I have suffered loss, obtained gain, been sad, been happy, gone on many adventures and have continued to fulfil my dreams in ways many others cannot begin to conjure the imagination for.

The bigger lesson in all this is about things, being able to let go of things regardless of the cost to be able to go onto other things. In that, I am blessed with the force of hope and the reality of achievement, I am grateful for the opportunity to tell this story in good health.

Let the pursuit of happiness continue. Happy New Year!

Christmas is today, the feast of thieves

Between God and mammon

One is almost driven to distraction about the way Christmas is so yoked to retailing to the complete exclusion of the Christmas story in the United Kingdom.

Originally, as varied historians assert, what became the Christmas [1] feast was once a pagan feast, not that it so matters now, but the contemporary message of Christmas should for all intents and purposes retain a link to what gives rise to the celebration.

What I see on the English channels on my hotel television is the great lament about retailers, shopping, bargains and profits – Baby Jesus cannot seem to get in edge-ways.

Buying at every cost

Materialism has pervaded the atmosphere, even customers are rushing into the upscale Selfridges, it really makes you wonder as people queue up for shopping in the winter cold just to grab a cheaper handbag, shirt or dress.

In my view, what you cannot afford at the full price you probably should not have, the victory of a bargain or a price reduction by omission or commission rely belies a poverty of spirit that people fail to understand. However, sometimes shops have deals or promotions but we should not be waiting for the stirring of the water by angels [2] for cripples to “jump” in.

Between affordability and bargains

For instance, when I was buying my home, my unspoken prayer was to be able to afford it whenever I was ready rather than having to wait for prices to collapse before I stepped in – what if prices did not collapse but doubled, then I would never get to buy my home.

Equally, much as we live in a debt-fuelled world where the ability to pay off a debt depicts your seeming creditworthiness especially if you are middleclass, the received wisdom should be that one should not spend what you do not have in the bank to pay off – regardless of the reach of your credit cards.

But people are trapped in a hedonistic addiction to goods and the need to be able to show off, Christmas should never be a time for bargains and really, I have no sympathy for retailers who fleece their customers throughout the year and plead low till receipts at the end of the year.

Not in that demographic

If most customers were like me, retailers would have to get into better logistics to keep in the market, the competition would be so keen that only retailers with durable, sophisticated and valuable goods would remain in the marketplace.

Behind all this lament of the retailers stands the shareholders who have raked in profits like money is going out of fashion and even in these lean times, they still expect those atrocious profits – my wallet is closed because, the shoes I buy, last; the clothes I wear are durable; I am not a fashion slave, my old television still shows good pictures and I am not given to unnecessary ostentation.

The government would like the economy to recover through more consumer spending, which is a fine macro-economic idea, but customers as individuals need to be wary of situations where they are more exposed financially than they should be – thrifty is the word, regardless of the national call to spend; except where you have received a bailout from the government.

Bring Christmas back

Since Christmas is about the roots of Christianity, if the retailers are having a really tough time this Christmas without any mention of Christ, we can look at it as the proverbial overturning of the tables in the temple – then Jesus took exception to making His Father’s house a den of thieves [3], today, the climate takes exception to making a holy and religious time of celebration and reflection a trading day for cheaper tat.

Maybe one should have some sympathy for the impoverished, seeking the unaffordable but who think overpriced goods they crave are now a bargain to be had – conversely, maybe that is the real price of the goods with a little markup – we have all been had and we think we have had them.

In fact, Christmas becomes a good cloaking scam for a more sinister con, but if it costs less, it is worth less or should that be worthless?

Sources

[1] Christmas - Wikipedia, the free encyclopedia

[2] John 5:4 For an angel of the Lord went down at certain

[3] Den of thieves

Nigeria takes Big Tobacco to court about kids

Why kids smoke

Sometimes one can wonder how kids get into smoking and eventually get hooked on the thing for life.

Growing up in Nigeria, there was a bit of a rascal in me and I remember times with my cousins we had a puff at strips of matting (sleeping mats) which had the look and feel of real cigarettes but their potency and efficacy was not known apart from the fact that they were unsmokable.

I had a puff or two before I was a teen but only really started when I was 14, however, it was a secret act of rebellion and quest for adulthood – however, kids caught smoking exacted the highest penalties of corporal punishment and serious ostracism from older members of society along with status amongst peers.

Resisting peer pressure

I always drew the line about what I would try and I remember one episode when I was in company of people more wayward and off the rails than I was, who were smoking pot, I refused to participate whilst others did – a few days after, one of the tough girls in that group leapt out of a first-floor window to escape many things I cannot recount.

She spent a few weeks in hospital and returned to her ways and people usually do.

I did have an inclination to start smoking pipes, but never got that far with the threat that someone at polytechnic was going to inform my parents of my smoking; one had to be more discrete about these vices.

Quitting by religion

At 18, I got religion and it just stopped, the desire, the craving and wanting and I did not have another puff till 17 years later and none since.

Whilst religion seemed a good thing, one must say that there is nothing that preaches against smoking as one can find preaching against alcohol. Basically, smoking is just a “social vice” which has been promoted into a sin because basically, it is what adults do rather than kids.

If however, one sees smoking as an addiction and hence a type of bondage from which one would want to be delivered then there is scope for belief systems to help.

There is also the matter of stewardship of your body in such a way as not to bring it into harm’s way – though not many take the body as seriously as they show even though it is the only shell of representation we have to interact in this world.

Those rotten companies

I am quite interested in the move by Nigeria of suing international cigarette companies on the matter of childhood smoking. They probably have a cause, I am not sure if they have a case.

Indeed, there should be serious educational material that talks about the dangers of smoking and the consequences of the same beyond threats and housewife tales.

When I was a kid, the most glamorous adverts were the smoking ones which showcased Marlboro Man and made every kid want to live their lives like him.

Tobacco companies would want to present a responsible corporate image to the West whilst they aggressively ply their trade in developing and emerging economies because that is where the growth for their market is, until some smart head shows to replace fossil fuels with tobacco.

Intoxicating Africa for Western profits

These emerging economies would usually not have addiction mitigating services or disease amelioration systems to handle cancers and other smoking-related disorders such that once people are hooked, they are truly hooked as they dig their graves with each long draw of the puff.

It is a welcome move and if does not get the companies doing something positive about eliminating access to the toxic weed to children they would know that the times of dumping poisons in Africa to keep their profits in the West are coming to an end.

In general, smoking is becoming less a social statement with smoking bans in New York, London and many other cities, smokers are finding ways of a healthier outlook to life; there are some who see a human-rights element to the freedom to puff, hopefully the quest of a healthier life would outweigh any temporary benefits that lead to long-term terminal illness.

References

Illicit tobacco trade contributes to global disease burden

Smoking curbs: The Global Picture

The African tobacco conundrum

Taking the World Up in Smoke

Tips to stop smoking