i love drugs but im so picky about what ill do. ill smoke floor joints but i tested my k 4 times before trying it

Health stuff under the cut - discussion of menstruation and pain and useless doctors and being suicidal. Long. I have a lot of distress regarding this topic. No obligation to read even if you're my friend (same as any post but just don't upset yourself you know?). I just need to get it out and maybe it will help somehow. I'm writing this after and it hasn't helped so far but like maybe lol.

I want to try stopping taking the contraceptive pill to see if it is responsible for any of my fatigue. I thought I was ready but I'm much too scared and every time I try and think about I cry.

Along with the general inconvenience of bleeding and other inconvenient symptoms plus ruining a couple of pairs of knickers every time, it was just really painful.

I'd have half a day at about 8 on the pain scale I guess. Plus maybe a bit of throwing up, and rocketing between sweating and freezing. Then that would go away and there'd be 2-4 days of feeling lesser pain and feeling miserable, the level of miserable more or less equivalent to a bad cold where you can make yourself to do stuff but preferentially would just curl up in bed all day, then another 2-4 reduced symptoms again about the equivalent of a mild cold e.g. where you'd preferentially do light activities like read a book and play computer games but you can make yourself go to work/school and feel miserable.

I used to be suicidal thinking about how I had to go through this every month for the rest of my life until menopause. I was so anxious all the time that I'd get my period at the same time as something important (it was not predictable). I had to lie to my doctor (tell them I had a boyfriend and wanted to have sex) to get on the contraceptive pill because I'd been refused 3 times to be prescribed it to see if it would help manage symptoms. The only help I got was the advice to use OTC pain killers (which didn't work at all), a hot water bottle (no effect, possibly worse), and "light yoga" (did try this but any movement of my abdominal area made it worse).

When I went on the pill I got told I had to have those "breaks" where you take the sugar pills and get a small period or it would be bad for me. That was much better but still somewhat unpleasant physically and very unpleasant emotionally. Period products have a particular smell - I don't know if it is the plastic they use or the glue or what - and every time I had to get out a pad I would smell it and have a spike of anxiety/panic. I couldn't even walk down that aisle in the supermarket or the smell would set it off. Eventually I found some earthy organic cotton pads in a recycled cardboard box in a health food shop that I could use without panicking.

Eventually I went on a continuous pill and didn't have to think about it again until recently.

I've got some codeine I didn't use for my wisdom teeth removal but its pretty strong. Its almost not worth taking it for half day of pain and I don't know what to do for the week of misery afterwards for which codeine would kind of knock me out so I wouldn't be able to do anything anyway (and I don't have enough for three weeks worth - doctor suggested 3 months trial to give things time to settle and see if it helps the fatigue).

Its possible the symptoms won't come back. Its possible that even if they do then I feel better in other ways and then the doctor can work out a way to have the best of both worlds. I just don't know if I can do it.

breaking curfew [part eight] || th x reader

A/N: day idk of quarantine. time is meaningless. 

Summary: When you got the job to be a counselor at the summer camp you’d grown up attending all your life, you expected to see some familiar faces. But you certainly hadn’t counted on having to work alongside the boy who had made it his life’s mission to make your life a living hell every summer. In fact, you thought you’d never have to see Tom Holland again. But he’s is in the cabin right across from yours with campers of his own- smirk, jawline, and all. If you didn’t know any better you might’ve thought that he applied for the position just to spite you, but who were you kidding? What kind of asshole would do something like that?

Warnings: swearing, prescription drugs, alcohol mention, anxiety mention

What I listened to while writing: the breaking curfew playlist by @cinnamon-roll-peter​ + CALM by 5sos

Word Count: 2.4k

Series Masterlist

You’ve only been x-rayed twice in your entire life- not counting regular trips to the dentist- before now. Once when you thought you broke your ankle, (but it was really just sprained) and another time when you had pneumonia. Still, neither of those times had been quite as intense as this. Maybe that was because your mom wasn’t with you like she had been before. Or maybe it was because Tom, the boy who was pretending to be your boyfriend, the one that had just undressed you minutes ago, was standing just a few feet away behind the glass. Or in all honesty, maybe it was because you were hopped up on codeine, but who could say?

The x-ray technician draped the lead apron over you and told you to hold your breath while she ran back to operate the machine. She had you lay in a few different positions and had a nurse help her move your arm gingerly each time to lessen the strain on your end. 

It was a painful process, but they moved as fast as they could so that you were back in your room within a few minutes. 

“How’re you feeling?” Tom asked as he sat back in the plastic chair by your bedside. 

“Kinda dizzy.”

“Yeah, you couldn’t walk five steps without running into a wall, I practically had to carry you back here.”

“Fuck off!”

“Glad the pain meds haven’t completely altered your personality,” he said, shaking his head. 

“I feel a little nauseous too,” you added and rolled your neck uncomfortably.

Tom sat up a little more, eyebrows raised in concern. “Are you going to throw up? Do I need to get someone?”

“It’s probably fine,” you shrugged.

“I don’t know about that...  you took those meds on an empty stomach- and that’s probably why you’re smashed to hell too.”

“It’s fiiine, Tom.” You yawned. “I just wanna nap.”

He chuckled and pulled the sheet that had been gathered around your waist up to your shoulders and laid it gently over them. 

“That seems like a good idea.”

“Okay, good night.”

“Good night, y/n.”

It felt like you blinked and you were being shaken awake again. You groaned and attempted to sit up on your elbows, cursing when you tried to put pressure on your injured arm.

“Easy, easy,” Tom said, helping you lay back down on your back. “Um, the doctor’s here, babe.”

“Babe?” you wondered aloud, still clearly disoriented as fuck. 

“Yeah, love. He’s here to tell you about your arm.”

Tom was pretending to be your boyfriend. Right. That made a lot more sense. Why else would he call you babe? 

The doctor introduced himself to you and Tom and talked briefly about what he was looking for in the x-rays as he set them up in the light display for you both to see. 

“So the bad news is that your arm is broken,” he explained, and you felt your heart sink even though you knew it was coming. “But the good news is that it’s just a minor fracture- barely visible on your radius there. It’ll only take about four to six weeks to heal in a cast, and you’ll be good as new.”

You bit your bottom lip wilted visibly. “Six weeks? The summer will be over by then!”

“It shouldn’t be an issue, unless you’re involved in a super active sport or-”

“We’re camp counselors-” Tom said abruptly, irritation at the edge of his voice.

“Oh, yes well you might run into some complications, but you should still be able to do most everything. Even with a cast.”

“Are you sure?”

“Definitely,” he nodded. “I’ll print out a couple pamphlets and some other literature for you on how to care for your arm and cast and etcetera, and you should be fine.”

“Okay, thank you.”

“I’ll also prescribe you some pain killers. Probably not as strong as the codeine they gave you earlier, but a lighter dosage for a few days before switching to extra-strength ibuprofen might help you get back into the swing of things.”

You just nodded, not really understanding any of the words he was saying. You hoped Tom absorbed more of it than you did because you were honestly checked the fuck out. 

“I’m just going to grab the plaster and gauze for your cast and I’ll be right back. What’s your favorite color?”

“Orange,” you said without a second thought.

Tom waited until the doctor was gone before giving you a confused look. “Why’d you say that?”

You gave him the same look back. “What do you mean?”

“Orange isn’t your favorite color.”

“Says who?”

“Your favorite color’s always been green.”

“H-how’d you know that?”

“You really think I don’t remember you cheating your way onto the green team at mega relay every summer?”

“I would not cheat!” you argued.

“You’re supposed to pick a headband out of the box randomly! I don’t think peeking through your fingers and conveniently grabbing a green one every single time counts as random.”

“Well you don’t have any evidence, so good luck proving that in court.”

Tom held his hands up in surrender. “Damn, who said anything about court?”

“I just like being prepared.”

“But wait, why did you get orange?”

You shook your head absentmindedly and shrugged. “Oh, I don’t know. It’s Theo’s favorite color. I thought she’d like it.” 

“That’s... really sweet.”

“Don’t sound so surprised, Holland. I can be nice sometimes.”

“Didn’t know you had it in you.” 

Before you could say anything snarky back the doctor came back in with a written prescription and everything he needed to set and wrap your arm. You tensed and looked away as he set to work on it, using an alcoholic wipe to sanitize your hand and forearm before wrapping it.  

“You can hold her other hand if you want, Tom,” the doctor said, probably thinking that would reassure you, even though in reality it made you way more anxious. 

You had reached for his hand just a few minutes ago, unprompted. But in your defense, you were very out of it. You were still out of it now, but the thought doing it again was ironically making your hands sweat. You guys didn’t really know each other... like that, and even though it was just pretend it felt weirdly intimate.You wouldn’t blame him if he stayed put where he was.

But to your surprise, Tom didn’t even hesitate before grabbing your hand and interlocking his fingers with yours. His palm was a little clammy too, which was a relief. You didn’t want to be the only one with a sweaty hand and gross him out or something, even if you were the one in agonizing pain. 

You squeezed tight as your arm was moved into position for the cast. It hurt like a bitch and for a hot second the nausea returned and you thought you might pass out. 

“So, how did you guys meet?” the doctor asked casually as he worked. “Tom, if I’m not mistaken you’re English? And y/n you’re not? How did that play out?”

“We met at work,” Tom said without missing a beat. 

You were kind of taken aback by how seriously he was taking his role. It really didn’t matter if he was actually your boyfriend or not, it’s not like he’d get kicked out if they found out he wasn’t. 

“At the summer camp?”

“Yeah, it’s really well-known for its international program. We get a lot of campers from all over.”

“Ah, that makes sense. Are you long distance during the year then?”

You and Tom traded looks with each other. Why did you have to get stuck with the chattiest orthopedic surgeon ever? Your fucking luck.

“We are, yeah.” Tom answered for you both again. “We trade off who visits who. We’ve both been in school so we don’t get to see each other very often, but I’ll take what I can get.”

“Summers must be nice then, no? You get to see each other all the time.”

He forced a chuckle. “You have no idea.”

-

The girls practically tackled you the second you got back to camp, and you were immediately bombarded with a chorus of “can I sign it? can I sign it?” from every single one of them. 

“You can all sign it!” you promised. “After you brush your teeth!”

You had never seen them so excited to get ready for bed ever. They were almost giddy about it. 

Your arm was still pretty sore, and the pills were starting to wear off, but you were glad to finally be back in your cabin. You couldn’t wait to knock the heck out and sleep for as long as possible. 

The ride back from the emergency room had been much more peaceful than the ride there. Zendaya was a little pissed you’d disappeared from the waiting room without a word, she was mostly just glad you were getting to go home and rest. You ate your fries and chicken nuggets in the car, and accidentally ended up dozing off on Tom a few times, only to be jostled awake by bumps in the road. 

And now that the day was winding down you could relax and spend some time with your campers. 

“Me first!” Theo exclaimed, racing up to you with toothpaste still in her mouth. You laughed as she scribbled her name in jagged letters across your arm, putting a smiley face in the O. “We have the same favorite color!”

You didn’t have the heart to tell her so you just laughed and nodded. “Now, go spit your toothpaste out before you choke!”

May was next. She signed her name right where your pinky was, almost as if she was trying to hide it. Amalia wrote her name in cursive just above your elbow, Grace signed her name with a heart at the end right next to Amalia’s, and Eva scrawled hers on top of your hand at the edge of your cast. 

You admired the girls’ masterpiece and showed it off to them. “What do you guys think?”

“It’s cool!” Amalia said, and the other girls added their agreements. “I’ve always wanted a cast!”

“Me too!” Grace chimed in. “Or crutches!” 

“I think it’ll definitely make me stand out,” you said as you sat on the floor and settled against one of the bunks for your girls’ daily Good Night Circle. 

“Maybe it’ll help you get a boyfriend!” Theo piped up, now wearing her big metal retainers.

“Or a girlfriend?” Evangeline pointed out very matter-of-factly.

The others were quick to jump on board. 

“Maybe one of the other counselors will see it and fall in love with you!”

“Do you want a boyfriend or a girlfriend?”

“We could help you!”

“Yeah! My dad says I’m a really good matchmaker!”

“You girls are silly!” you said, sighing in exasperation. “I think it’s time for bed.” 

There was less resistance than usual- maybe they were taking pity on you because you were broken- but there were still the typical whines and protests as you tucked them in. 

“Good night, sleep tight, don’t let the bed bugs bite!” you said in a singsong voice as turned off the lights and climbed into your own bed. 

And you finally.... laid there staring at the ceiling. For hours. Despite being completely drained in every sense of the word, you couldn’t sleep. Your mind was racing and you couldn’t get comfortable with your arm bent at a weird angle. And were you remembering everything that had happened that day wrong- or had Tom actually helped you get undressed? And then get dressed? Had he really held your hand? Twice?

You wiggled your fingers as if the movement would replicate the feeling of his hand in yours, or give you an answer of some kind, but of course there was nothing. Just that same emptiness you felt in the pit of your stomach. 

Realistically, you knew all of those things really had happened, and even if you couldn’t remember the specifics, you remembered the little things. Like the pink tint that highlighted Tom’s cheeks when he edged the straps of your swimsuit down your shoulders, or the rough calluses that had tickled your palms when you held hands with him. They reminded you that it wasn’t all some weird dream... or nightmare, rather. 

You pushed your covers off, suddenly feeling very hot. You sat upright and took a few deep breaths to steady yourself, trying to force all the thoughts from your mind. Thinking about Tom in a positive manner was one of, if not the number one way your brain could betray you. Even barely brushing the subject had you breaking out into a cold sweat. The boy was really living rent free in your mind and not in a good way. 

Everything felt wrong, and not for the first time this summer you wished you could pour yourself a drink. Maybe it wouldn’t help with any of your problems, but it sure would take the edge off. 

Even though it was futile, you flopped back on your bed in the hope that sleep would have mercy on you and finally let you rest. You shut your eyes and tried a few of the meditation methods you’d learned from YouTube to make yourself sleepy, but even then you couldn’t shake the low buzz of anxiety that nudged at the back of your mind.

Fucking Tom Holland. 

If you weren’t going to get any sleep you might as well waste time on your phone. You unlocked it, fought the urge to google ‘can you pass out if you punch yourself hard enough,’ and opened Twitter instead. You didn’t need to show up to breakfast with a black eye and a broken arm tomorrow morning. 

Your eyelids were finally starting to feel heavy and the screen on your phone was getting dimmer and dimmer as you began to drift off when sudden knocking at your window startled you out of your half-asleep state. 

The first thought you had was that someone was trying to break in, but then you remembered that you were at a summer camp and there was literally nothing valuable in the cabin so you let yourself relax a little bit. 

When you squinted a bit, you recognized the figure on the other side of the glass and flicked them off with your casted hand, even though you were fairly sure they couldn’t see you sitting there in the dark. It was confirmed when they knocked again and you had to scramble to push open the window so they wouldn’t wake your campers- at this God-forsaken hour. 

“What the fuck do you want?”

this one was tricky to get figure out but lmk what you think i always appreciate feedback!!

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prescription/oxymoron school boy q

Prescription drugs, show me love Percocets, Adderall Xanny bars, get codeine involved Stuck in this body high, can't shake it off I'm falling off, I can't hold a thought What's wrong with me? Now the pressure creep I'm stressing deep, even in my sleep My mommy call, I hit ignore My daughter calls, I press ignore My chin press on my chest, my knees press the floor I'm blanking out, woke up on the couch Dinner on my shirt, my stomach hurts I had a bust out in the 80's but yo, the karma's worse I cry when nothing's wrong, I'm mad when peace is involved My senses harmed, sluggish ruggish A couple Xannies popped, open my pill box Prescription drugsWhat's wrong, daddy?! Wake up! Wake up!Prescription drugs, I fell in love My little secret, she gon' kill a thug My body numb, she like to give me hugs I love her touch, I get a rush When she don't come around, I start to go nuts My heart erupts, I'm curled in pain My phone ring, ring and ring and ring If you ain't selling drugs, then I don't hear a thing May 7, Ali calls, p.m. of 6: 45, I finally answer this time He said "Come to the stu', I'm mixing all your rhymes" I don't decline, at least that's in my mind Grab the keys, need some wood for the trees Dap the clerk 'fore I leave, max on my AC Continue right, remember seeing light Wise night, but that's my life Prescription drugsWhat's wrong? You tired? You mad? Okay, I love you, daddyI just stopped selling crack today I just stopped selling crack today (What you say? What you say?) O-X-Y, a moron, O-X-Y, a moronI just stopped selling crack today I just stopped selling crack today (What you say? What you say?) O-X-Y, a moron, O-X-Y, a moronCrazy, got my sex on wet in her Mercedes Ladies, get these off new shoes for my baby Oxy, I don't know no Pablo or no papi What you know about a pill, plus a 8-ball You gotta re-up 50 times just to get a rack off, ungh I can get a hundred of 'em, make over 3 G's Only took two days, only re-up'd one time Where the sun barely shine and it rain for about Nine months out the year, man it's something right here For Seattle nigga, cheers, when I look up at y'all city like lookin' in the mirror Damn near had a career, just might shed a tear, ungh Man, this shit right here for my niggas who ain't make it home Sitting on a tear, got a dap to a nigga bright in here, feeling life ain't fair If I was in your shoes, I would've copped, don't care Had a scene, had the medics like clear, ungh Big body cold like a Polar Bear, ungh I done sold more shit than hookers, expensive tees, resemble a push up Stopped selling crack, cause white don't fuck with narcos Vanity slave, got whips and chains Dirty money, clean money the same, even if I got life, I ain't saying a nameI just stopped selling crack today I just stopped selling crack today (What you say? What you say?) O-X-Y, a moron, O-X-Y, a moronGroovy, when I die tell Spike Lee make a movie Oh wee, cops bringing dogs so they don't sniff my bitch booty Oxy, O-X-Y, only feel like I could stop me Quincy, now how you nigga sliding up every now and then in a Bentley? Easy, 60-40-50, you can get one for 30 if you let me hook this titty Let a nigga fuck then my dogs see your kitty Just stopped selling crack today When it get hot, smoke a pill, watch it glide like Dr. J I prescribe you I'm your doctor, kay? You can crush this shit, you can sniff this shit You can take this shit, you can smoke this shit Do you like this shit, nigga? Your brain go numb, synthetic heroine Without the injections, do the same love and affection How could they say feeling good is an addiction? But the world is full of shit, so I don't listen In fact "We living to die" is a contradiction So trapping in a Nissan, O-X-Y, I keep 'em, O-X-Y, you need oneI just stopped selling crack today I just stopped selling crack today (What you say? What you say?) O-X-Y, a moron, O-X-Y, a moron

Grief in all its Glory

Written: 10/08/2020

Posted 5/01/2021 - 4 years since Brandon’s passing.

Content warning: death, suicide, grief, drugs, addiction, swearing.

I recently came across a website for Australians to speak openly about grief. It was startling. Not what was said on it. But the fact that a website like that now existed. I’d never seen anything so open and frank before. What should be startling is that humans still live in this discomfort of talking about certain sadness's, bereavements, pains and anguish. The most inevitable experience is still faux pas - we all die, but talking about it is not altogether acceptable. Along the journey of life, there are other sadness’s and struggles which, once brewed in scalding waters of unsavoury conversation, now seep in tepid tolerance. For the most part, I refer to this broadly as ‘mental illness’, and while its garnered greater awareness, it is still riddled with stigma and misunderstanding. Similarly, discussions around addiction are typically soaked in the self-aggrandising dogma that this only happens to the lower echelons of society; those plagued by weaknesses that led to their inevitable misfortune. And then the doozy of ‘grief’ – talking about it makes many people uneasy; people hold an expectation that you transcend these melancholy confines in a swift enough fashion that you don’t leave them feeling uncomfortable. Yet, grief is unfortunately something every adult will likely experience at some point. Another scandalous topic is that of suicide, despite it sadly becoming an increasingly more and more common way of dying. Then there is the matter of suicide survivors – the one’s who must continue their life with a chasm formed by the absence and loss. Grief with the awareness that someone chose to die is something very staggering.

One of the things that I find most difficult when talking about mental health is that I am in part supporting a system that I do not have faith in. You can tell people that help is out there, but when it comes down to it, the mental health care system in Australia is wildly ineffective (globally, I daresay, and infinitely worse in many locations; however my experience is significantly with Australia so I’ll refrain from speaking too broadly). Worse, it can be even more detrimental than the ills that plague the human mind.

It is hard trying to get help when you need it. It is harder getting the right help. It is a battle. It is a challenge and sometimes it feels like the world is working against you. That's probably because it is, albeit not always intentionally. This is what happened to my brother, to my family, to me.

I should note that he was a very private person, with a strong distaste for the narcissistic realms of social media. I wholeheartedly acknowledge that I am possibly doing something so deeply against his wishes by speaking openly about him and the situation, but to be blunt, he lost the privilege of secrecy. Others too, may not agree with how I elect to narrate this, but from my perspective, you can’t grow awareness and fuel prevention without the discourse.

I understand that this is in part a unique occurrence that I will expand on, but because of this experience I was exposed to a great deal more stories of a similar nature where the health care system let people down. However, this isn’t an ‘all hope is lost’ memoir. To the contrary.

I have…had an older brother. His name was Brandon. He took his life at the age that I am while writing this - 29. Brandon saw mental health specialists. He did try to get better, although arguably not nearly hard enough. In fact, when I cleared out his room after his passing, I dug through the referrals and prescriptions. There was a blister pack of antidepressants. Without the other appropriate tools to recover, or at least to find a semblance of stability, anti-depressants can only do so much. By this point he had very evidently given up on these little dosages of ‘here-this-will-help-but-may-also-increase-your-risk-of-suicidal-ideation.’ Only one pill was missing. The anti-depressant was not in his toxicology report, although the post-mortem showed many, many other drugs. In clearing his room, I later read his journaling scrawls that he had found drugs that numbed his pain more effectively than anti-depressants. Some of these are ones that Brandon got hooked on due to an overzealous general practitioner. And then another general practitioner. His addiction began with prescription opioids and graduated with drugs acquired from the dark web including heroin and fentanyl, amongst other things. My family and I only found out about this after his passing. 

TOXICOLOGY:

Codeine (free)

Codeine-6-glucuronide

Diazepam

Fentanyl

Mirtazapine

Morphine (free)

Morphine-3-glucuronide

Morphine-6-glucuronide

Nordiazepam

Oxazepam

Paracetamol

Pholcodine

Quetiapine

Temazepam

Tramadol

This part isn't altogether unique. We take suppressants to deal with pain…to deal with life. A hard day at work - have a drink. Can't sleep - have a vali. Can't survive the never-ending and all-encompassing pain - take it all.

The opioid problem in the US is significant and garners a fair amount of attention. It exists here in Australia, too. That is why legislation came into effect to further regulate practitioners from prescribing them. This took place about a year after Brandon’s death. This blanket restriction isn’t an entirely curative solution. There are those that genuinely need these medications for chronic pain who now must jump through hoops to get their treatment. There are those who still have the wherewithal to find a source, even if through illegal means (queue Brandon). This form of paternalistic legislation does not solve the problem at its root – why there is a mental health epidemic; where is society failing that the individual solution appears to be a sturdy dose of numbing or a leap of faith into the dark abyss. Opioids work in a manner of escalation. A dosage that was once satisfying does less and less. So, you need more and more. Price can also become a factor, so you salvage heavier shit for a lower cost.

Brandon wound up in hospital only a few days prior to taking his life. He had collapsed in my father’s kitchen. My dad thought he was losing him right then and there. An ambulance came and he was rushed to hospital. He had 'accidentally' taken too much tramadol. During this incident, the ambulance respondents commented in front of my younger brother on the visible track marks on Brandon's arms. Brandon was released from hospital the following day. Simple as that. My father didn't know that the foreboding premonition of losing Brandon would be the stark reality a few short days later as he tried to perform CPR on his eldest son.

The ambulance workers that saw Brandon's track marks would not have consciously made the choice to neglect a person who clearly needed help. But somehow, he fell through the cracks of a less than fastidious system. In some ways, learning about Brandon's history with prescription drugs was more difficult than his actual suicide. Learning how he had been failed was, and is, harder to come to terms with than the fact that he recognised he had been let down. The thing that came as a shock to Brandon's friends (and subsequently me) was that he did not die of an overdose. He did not take his life in that way. That is something I have battled with. He made a very different sort of deliberate effort in how he left us which I may never understand. That’s suicide though – you often don’t understand and are left wondering so many things.

We won't ever know if the tramadol overdose was intentional or not, but it was explained to me by my older brother as an 'oopsy-daisy' in an email. I was overseas at that time. Ironically, I took one tramadol tablet for my flight back and found the experience horrible and was sluggish for days after. The same day that I had recovered from my singular adventure with tramadol my brother made that irreversible choice.

I was at the pub with friends when Brandon made that fateful choice to dive into that dark void. I had missed calls on my phone from my mother. I called back and didn’t receive an answer. I later found out my younger brother and mother were debating just driving straight to me in order to not have to tell me over the phone. It was my younger brother's birthday that day and I had presumed they were contacting about that. I texted back that I was currently out and tried calling again. ‘Brandon hung himself’, my mum said. I dropped to my knees on the outskirts of the bar and wailed, ‘no’. In a daze I went back to my friends, grabbed my bag mumbling that my brother had killed himself. A friend walked me home. My mother and brother arrived some period of time after. I still don't understand how my mother was capable of driving. She drove us to my dad's house where the suicide had occurred. We weren't permitted near that section of the house and the police referred to it as a 'crime scene'. We sat outside the house as a family, coming in and out of tears and shock.

At one point I had to go to the bathroom and went up around the other side of the house – the side that wasn’t deemed part of the crime scene. Through the glass I saw my brother lying on the cold stone floor with a neck brace on and a sheet pulled midway up his chest. I went to the bathroom and vomited. I stared at my face with mascara smeared everywhere and recognised that while I looked so distraught, that was possibly the most peaceful I'd seen my brother in a long, long time. I took some breaths and went back to my family. I have never really been able to leave my family since that point. I will have panic attacks if I can't reach one of them, thinking that something bad has happened. That is part of the PTSD of losing a loved one in a shocking way.

On my family's healing journey, we attended suicide survivor groups. At these I heard other tales of the health care system having failed them and/or their loved ones. One that stuck with me the most was a suicide in the middle of a hospital ward while under 24/7 suicide watch. On my personal healing journey, I've had several problematic run-ins with the health care system. To name a few:

I had a psychologist tell me that Brandon's choice to take his life in the family home was a sign that he blamed the family. Guilt is such a huge thing that follows a suicide. Psych 101 is alleviating that form of mental anguish for suicide survivors. That mental health practitioner failed at the first hurdle. Despite me having the knowledge that you cannot blame yourself, having someone - who is meant to understand the human mind, with all the complexities of grief and guilt – tell you that you are blamed is a pretty heavy cross to bear. I had found Brandon's parting note. It was on stained paper, written a long while ago. On it he said that he was sorry, but the pain was too much. A psychologist I had sat in a room with for all of 15 minutes told me that he blamed us. A sister riddled with guilt that she didn't save her brother. Brandon said a lot of things, but Brandon did not outright blame us. Still, in most ways, he did not say enough.

Sitting in anger about Brandon's introduction to prescription opioids, I had a different psychologist tell me that I shouldn't make noise because it would cause me more distress, that people can't change and the system won't change so it's best I change my view on things. That was her response to most things. No inclination to think that holding someone accountable for some of Brandon's struggles would have offered me enormous relief. One of his original GPs died two weeks prior to writing this. I honestly felt a sense of liberation but also a sense of loss, primarily because I never got to lambast them. Only last week did I learn that the best avenue would have been to make a complaint via the Health Care Complaints Commission so that this GP would not make the same grave errors. That would have potentially changed a person and a segment of the system, as well as maybe saving others from addiction. But in a system where health care providers would prefer you don't 'rock the boat' it's better you just sit quietly in your grief.

I have struggled with this loss. I wasn't close with Brandon anymore. We had a dysfunctional relationship and I had honestly largely tried ridding my life of him. Subsequently, as mentioned, I felt overwhelmed with guilt. I myself turned to ways to numb this feeling. I drank too much and partied more. I made reckless choices, acted rashly, behaved erratically. A psychiatrist put me onto medication to help me deal with these stages of grief. This is now a medication that I have been unable to get off because of the withdrawal side-effects. The mental health industry prefers a quick-fix solution such as medication. It appears as though they are making effective progress. Brandon's pain was 'effectively' dulled by opioids. My grief was 'effectively' subdued with medication rather than giving me the tools to process the grief and miss my brother in whatever way I needed to. I’ve learned the hard way, but the greatest remedy for some of the most common forms of mental illness doesn’t come in the form of a pill. It is habitually changing the way you think, how you perceive yourself, how you see the world. There are tools and techniques you can learn to make these changes, and these are not measured in milligrams or dosage frequencies. They do not have side effects. Tell a depressed person that one of the potential side effects of their anti-depressant is to experience depression and see how much hope you give that down-trodden soul.

Grief is a peculiar thing. It can come in waves. It can come in so many ways. But something I can definitively say is that you can be stronger than the grief and you can be strong enough to survive, whether the system lapses or not. I am testimony to that.

To mental health generally, in the end, only you can make the best decisions for yourself. That choice is yours. Yes, addiction can make that a whole lot harder, and the crutch can create a cyclic pattern in a self-fulfilling prophecy of defeat. A lot of external factors can impact your choices and make it more challenging to make the right decisions. But you’ve been through harder things. To climb out of those dark places is entirely within you. Sometimes you don’t have great footing to help get you out, be it the health care system, employment strife, financial burden, or friends letting you down. But it doesn’t mean that the required strength isn’t still inside of you. YOU have that strength. YOU have all that within you. You need to see that power in all its glory and grace, and you will see that your situation can, and will change. The first step to that change is what you decide to do.

Yes, I am placing blame on the shoulders of some others besides Brandon, while in a contradictory fashion saying you make your own choices. That’s another thing about grief – you want to assign blame somewhere. So, for clarity, Brandon made his choice and might have made it irrespective of the system. But our broken system sure as hell got him there prematurely, not even seeing 30.

I have shared this because I absolutely know that it is hard. That it is not always easy to get help. That the system is fucked. But that is not enough reason to give up. I sit here in my anger and sadness that the system let both my brother and me down countless times. But it is still not enough reason to give up. You can always be stronger and will get back up. Each. And. Every. Fucking. Time. Some people have said to me that it’s impossible to get better, that they can’t be fixed, that they can’t find help that works. There are many different ways of getting help, and if the ‘traditional’ mechanisms of speaking to a shrink doesn’t float your boat then it doesn’t mean all hope is lost. On the contrary – you’ve found one approach that doesn’t aid you and the process of elimination on your mental health journey should be valued. Knowing what doesn’t help can sincerely lead you to learning what does help.

I have also shared this because this is just a small portion of what losing someone to suicide does. This is the honest truth of what grief looks like. I recognise and admit that I have struggled so much with it. As I said, Brandon and I weren’t even close anymore. This is the pain that I feel from losing a dysfunctional sibling relationship. Do not think that you won’t leave people in agonising pain, no matter your relationship with them.

A further reason why I’ve written this is what I alluded to at the start – these are topics that people don’t like to talk about or hear about. But this is reality. These conversations are fucking triggering and upsetting. Hell, it’s taken a god damn lot of strength for me to write this. However, the more we elect to not talk about what’s wrong with the world, these social maladies will continue under the cloak of secrecy, the guise of accepting the status quo, and within the nonchalant notion that we can’t change things.

The final reason for why I’ve shared this is for my own personal growth and to voice some anger and dissatisfaction. I am so tired of the way the world operates. The abuse of power. The legitimisation of harmful actions in the name of greed. You don’t need to spend $490 (not an exaggeration, this is an actual amount) for 45 minutes at a psychiatrist’ office to ‘get better’. Being told that costly drugs are your only cure isn’t the singular answer. Not banking your hope for a tranquil mind on external sources should be a part of psych 101. It’s a hard fucking slog, and I get to say this from my ivory tower of white privilege. Likewise, my older brother won’t fit the stereotyped bullshit of a lowly sort destined for failure who succumbed to addiction. He wasn’t deprived of finances and destitute; he was extremely intelligent and had potential beyond belief. The ineptitude of the mental health system might fail us privileged ones, but the collateral damage is far greater than just us. Quite often those who are struggling the most do not have the financial stability to even contemplate these forms of ‘solutions’. It is a mental health system supported by greed and the foundations of neoliberalism. If we are forced to adhere to this approach – that the onus is always on the individual to better their personal situation – then use this to your advantage. Say fuck the system, I’ve got this with or without you. I am a strong human and I will carry myself through.

There are some ugly things being put on full display because of Covid19. But there are also some good things that you can't lose sight of. We might feel alone, either physically or mentally, but I promise you that you are not. Please get in touch if you need to talk and I will be there. Sometimes even a stranger can extend a kindness to you that you so desperately needed. This is a huge part of why I always say to be there for the people in your life. There is something so significant that loved ones can provide. Although, this is just the icing on the cake of what a gift your life is. You don’t need this affirmation and support from others because you’ve bloody well got this on your own. Albeit, it sure does help having someone care, so don’t forget that part when you’re given the opportunity to be kind to someone else. We are all part of a thriving organism called society that breathes and glistens on the basis of human connection and the human experience. It reaffirms that we are not alone. You are not alone, even when you feel as though you are.

That voice calling for calm or a cessation to the pain isn’t asking for the dark abyss; it’s asking you to stand up and fight the battle worth fighting. Your life is worth fighting for, even against an invisible enemy.

Hi. I'm sorry to bother you. I just had my fourth knee surgery, this time with microfractures being cemented. Even the ER won't prescribe anything; they say the doctor has to but he won't do anything other than tylenol #3. I feel like my leg is in a car crusher. The ER gave me a shot. It has dulled only slightly. The pain is so bad I'm in tears. You're the only one I can thing of who is so knowledgeable. What can I do to help reduce the pain? I have a nerve blocker and ice man already.

I’m sorry you’re going through this, I don’t know how much help I can be but I will try. Tylenol #3 means it has codeine which is a narcotic. How strong it is compared to vicodin or oxy, I don’t know. But it’s something and certainly better than just Tylenol.

Have you also been prescribed an anti-inflammatory? If not you may want to consider taking some ibuprofen. It might not dull the pain as much as you want, but it can help you heal faster. Make sure to check for any drug interactions before you take anything.

Now, for your Tylenol #3, count your pills and figure out the earliest date for you to get a refill assuming you have one. This advice may not be 100% doctor approved but I promise every pain patient has had to do this to some extent. Figure the minimum amount of medication you need to just get by, not the amount the RX says, but your personal minimum and check how many pills you need at that minimum to get to your next refill. The pills left over are what you can take to deal with the worst of the pain.

Consider also you are a surgery patient, your pain will lessen as you heal (unless the surgery went wrong I guess) so you can choose to take from future days assuming you will probably feel better. It’s a gamble, and could bite you in the ass. I wouldn’t take pills from future days first, I’d try figuring out your minimum and using the leftover pills carefully before resorting to that. It’s up to you.

As far as other things you can do, the only thing I can think of is lidocaine cream or cbd oil as a topical pain reliever. You can’t put it on the surgery wound but around it. The last thing you need is an infection. I find these products to be fast acting but not long lasting. However when you need relief from severe pain, it can be enough.

Lastly, don’t underestimate the power of distractions. If you’re just watching tv it may not be enough but playing a game might help you forget about your pain even if just for little while.

Make sure that through all this you keep a record of your pain, and note any increases or decreases. Doctors will take you more seriously about your self reports when you have stuff written down, I shit you not. That might make the difference between getting a refill or change in medication if your pain levels do not abate in a timely manner after surgery. I hope something in this answer is helpful and you find pain relief. Followers, if you have any thoughts, please feel free to comment.

REGARDING OPIOID-RELATED CONSTIPATION:

A PERFECTLY GOOD AND USEFUL POST FROM SOMEONE WHO HAS BEEN AROUND THIS BLOCK THREE TIMES

When I first had surgery no one told me this was a thing. It was 2015 and I had the surgeon go into my right knee and clean up my meniscus. It was minor, non-invasive, and recovery took about a month. Very simple. They gave me a super small amount of codeine, maybe 15 pills. I split them in half once I realised how wonky they made me feel. After three days, I realised my bowel movements weren’t happening anymore and I was feeling very uncomfortable.

At the time I was extremely active and ate a lot for weightlifting. I continued my diet the same way, so you can imagine how bloated and terrible I felt. I didn’t know what do to, so I started taking a stool softener. Laxatives were too harsh for me and reminded me of the days I had an eating disorder, so I avoided them.

What no one tells you is that stool softeners do not promote peristalsis. Peristalsis is the involuntary muscular movement of your intestines that pushes the bolus (post-stomach food blob) through the lower GI tract. This is what opioid use affects, and so while your stomach is doing a great job mixing it up and digesting, your intestines come to a full stop. It doesn’t matter how liquid or solid your stool ends up being in the colon, it will not move. Pushing does not help. As embarrassing as this is, I developed an external hemorrhoid from straining on the toilet. While I still have it, t’s not painful, it doesn’t get in the way, and I’ve kind of accepted it as “cute”. It’s like a skin tag or mole. I had a previous partner who was charmed by it call it my “notch” and I think of it now as a weird beauty mark. I hope this is not disgusting for anyone, but it depressed me for a long time to have before I accepted it, especially because surgical removal of external hemorrhoids is more pain and torture than just, having one, which does not cause any pain to me at all. Back onto the subject:

While laxatives and enemas are helpful as a short-term solution, they have a very, very harsh affect on the body. They are dehydrating (the opposite of what your intestines need, since the colon leeches water from stool), and they disrupt the normal function of your lower digestive tract. Laxatives cause intense diarrhea are also insanely unpredictable, meaning you could have one, and if it doesn’t work when it says it will, you’re caught with your pants down (sometimes literally, and multiple times within the hour).

Senna tea is the only thing that helped me with this. Senna is technically a natural laxative/stimulant, but when consumed as per instructions, it helps produce a perfectly normal stool on a fairly regular schedule. Once I started using it, my digestive system was acting as though it was almost back to normal. It does create a slight sense of urgency, meaning you might run to the bathroom in the morning, but not at all like a laxative pill does. The brand I use is Traditional Medicinals Smooth Moves tea. You’re supposed to have it just before bed. You brew it with boiling water, and letting it steep for 10-15 minutes. Once it’s done steeping, you have to squeeze out the bag like a little sponge and let it drip into the tea. It almost feels oily, kinda slick and weird, but it tastes good and it’s a really nice bedtime tea. You could probably put honey and lemon in it if you wanted.

Depending on the amount of opioids you’re taking, it might not happen right away, but be persistent. The tea instructs you not to take it for longer than a week, but that’s only because they’re assuming your constipation isn’t related to another medicine. If you have Crohn’s disease or IBS or any similar chronic intestinal issue, please talk to your doctor first. I am not a doctor. I am not in a medical field, I am a patient giving my first-hand experience. I’d say after the first two nights, you should feel like you need to have a movement. If your constipation continues, definitely see a doctor. Again, I am not a doctor, this is just based on my experience.

When your doctor prescribes you the opioids, talk to them about using senna to supplement your diet. My nurses always like to hear that I have a strategy and they seem to encourage the use of senna tea with opioids. In my experience, the best strategy is to start having the senna tea before bed the same day as you start your opioids, and see if it helps keep you fairly regular. You might not be as regular, it will not bring you to 100%. But you will experience relief and I think that’s really important to know. If there’s any debate, feel free to send me an ask and I’ll publish it for general knowledge.

The 100 5x11 "The Dark Year" Review

Episode 11 picks up where Episode 10 left off, shortly after Clarke’s found her mother unconscious from an overdose. With Madi’s help, she pumps Abby’s stomach and gets her conscious again, but Abby is ashamed of her state, much as she was after coming out of the City of Light in Season 3. At Abby’s recommendation, Clarke ties Abby down and administers an opioid blocker to put her into detox quickly. As Abby fades in and out of consciousness, we see her flash back to two years after Praimfaya, the beginning of the ominously-named Dark Year.

Everything in the flashbacks is filmed with a shorter focal length than normal, with lots of camera tilts, giving everything an unsteady, upsetting feeling. A fungus has destroyed the soybean crop, meaning they have no source of protein. Cooper was able to salvage some seeds, but it’ll take a year before they can eat from them again. And if they don’t get 10% of their calories from protein, Abby says, they’ll starve.

Abby immediately knows that they need to eat the executed criminals, suggesting it so quickly that it seems she must have thought ahead to this possibility. It’s ironic that Abby used the horror of cannibalism to convince the Sky People to let the grounders back into the main part of the bunker during "Red Queen" (remember, she painted a pretty horrific picture for Cooper about how as the people starved, they’d turn to cannibalism) only to have to encourage cannibalism less than two years later.

A group of people sit in the bunker, palm-sized cubes of a red, gelatinous substance before them on each of their lunch trays. Octavia takes the first bite, encouraging the rest to do the same, but Kane stands up and tells them that it’s their choice. Several people get up and leave along with Kane. But Abby later tells Octavia that she can’t allow them to abstain from eating; if they do, they’ll starve to death, but their muscles will atrophy and there won’t be enough meat on them to eat. She doesn’t even want Octavia to make an exception for Kane, because she knows that he’s the key.

At the next meal, Octavia confronts those who refuse to eat, ultimately shooting and killing several, before Kane breaks and takes a bite, which leads the rest of the people to. Octavia and Abby knew that Kane wouldn’t break if Octavia threatened to kill him, but he would do it to save other people’s lives.

As Abby detoxes, she becomes cruel, struggling against the restraints that she had Clarke put on her. Much like when Raven was possessed by ALIE, Abby tears into Clarke for being the one who decides who lives and who dies and tries to convince Madi to stop Clarke from continuing the detox. Once she gets through the worst of it, and out of her Dark Year flashbacks, however, Abby confides in her daughter what she had been responsible for and why she became addicted to the pain medication.

The detox works, and Abby is able to resume her work curing the miners. Madi is less than thrilled that they’re helping McCreary, and tries to sneak up and stab him while he’s on the examination table. Clarke sees the knife and heads her off, but Madi can’t understand why Clarke is siding with McCreary over Octavia. “She bore it so they didn’t have to,” she says, echoing Dante Wallace’s and Clarke’s words from the past. We never saw Clarke say the phrase to Lexa, so the few hours the Flame was in Clarke’s head must have been enough for it to record her memories as well as those of the past commanders. But Octavia didn’t bear anything for her people; clearly Wonkru is still traumatized. “We’re on the wrong side of this war,” Madi claims, but Clarke says, “But you get to live.” Madi echoes Abby’s words, asking how they can live with themselves.

Most of Spacekru, Kane, and Zeke are all hiding out in a cave with Diyoza and her people. As they try to set up a radio so they can contact Bellamy, they realize that McCreary’s men are mobilizing at the entry points to the valley, which means Wonkru must be marching. Echo manages to get in touch with Bellamy, both of them speaking Trig in case McCreary’s men intercept it. Bellamy points out that if Clarke is with McCreary, she could translate, and Echo says that she’ll “deal with Clarke later.”

(Girl, if Bellamy was willing to poison his own sister to keep her safe, I highly doubt he’s gonna let you “deal” with her. But at Conageddon, Tasya Teles teased that there would be a big action sequence between Clarke and Echo.) Echo takes charge and leads Raven, Murphy, and Emori out to scout for ways for the Wonkru army to get into the valley and defeat McCreary. Kane wants to come, but Echo refuses, saying he has to earn her trust. (Funny, since she hasn’t really earned anyone else’s.)

As the four Spacekru members crouch in the snow at the top of a pass, watching Eligius building gunner positions, Murphy spots a box of guns and ammunition. “They can’t shoot us with what they don’t have,” he points out, so they creep over to steal them. But they get caught and surrounded. Just as they think they’re about to die, Zeke bursts out of the underbrush and offers a trade: himself for their lives. The Eligius men decide to take him and still kill the others, but as they grab Zeke, he surprises them with his hand-to-hand fighting skills and kills them all. He tries to talk to Raven, but she’s furious and storms off.

It’s possible that him offering to surrender himself reminded her of Finn’s surrendering to the grounders and subsequent death, and Raven avoids Zeke because she’s realizing her feelings for him. After they report their findings to Diyoza, she realizes she dropped her notebook when they were fleeing — a notebook that had plans for every possibility she could think of. And we all know how brilliant she is. She does manage to think of one plan, but we don’t get to hear it yet…

When Octavia’s army first starts their march, Bellamy and Indra warn her that she’s leading them into a trap, because McCreary knows they’re coming, but she doesn’t care. When they later get the plan from Echo, Octavia seems grateful to Echo for once, and tries to reconnect with her brother (who has just ignored a proffered hand from Miller). Bellamy tells Octavia that his terms for helping her are that they accept Eligius’ surrender; no executions, no fighting pits, and that they live in peace.

Octavia agrees, upset that he doesn’t think that’s what she wants, and says that they’re back to how they’re meant to be: fighting side by side. But Bellamy has had enough and tells her, “I’m not fighting for you. I’m fighting to get back to my family.” He leaves as tears rise in Octavia’s eyes, and she angrily tells Indra that once they’re in the valley, everything they’ve had to do will be worth it. “I hope you’re right,” Indra responds.

Four days later, the night before the war, Diyoza’s people and Spacekru are all in their position in the woods, ready to put their plan in motion in just a few short hours. Zeke approaches Raven, asking why she’s mad at him for saving her life. She continues to ignore him, so he starts to walk away, only to be stopped by Raven grabbing his jacket and pulling him in for a kiss. “I’m not mad at you for saving my life, I’m mad at you for making me care about yours.”

They kiss again, and we see Echo watching in the background. Emori sits down next to her and slings an arm around her shoulders, assuring her that she and Bellamy will be together soon. But this doesn’t seem to make Echo feel any better; is she realizing that everything did change on the ground, despite Bellamy’s assurances otherwise? She goes over the plan one last time, and the shot of her map transitions into the map Bellamy is using to go over the plan with Octavia and her generals.

The night before the war, Bellamy sits alone by a fire, his hand on Echo’s sword sheath. He’s lost Octavia, he’s lost Clarke; Echo and Spacekru are all he has. Monty joins him, and they discuss the future. Once the war is won, Spacekru will take 80 acres separate from the others. “Grow something other than algae,” he teases Monty.

But of course, things aren’t going to go as planned. The last few episodes have set up a very similar plot to Mount Weather in Season 2, and right on schedule comes the betrayal. Kane and Diyoza come to McCreary to doublecross Octavia; Kane would rather have the monster win the valley than the devil.

Abby’s Addiction

Let me start this section by saying that I’ve been kind of uncomfortable with Abby’s storyline ever since her addiction was introduced. With this being my last episode to review and it being nearly the end of the season, I decided it was time to address it. My heart sank a little when we saw her take pain medication on-screen in 5x02, “Red Queen,” because more often than not, onscreen pain medication use leads to an addiction storyline. And in my opinion, these storylines contribute to the stigma surrounding pain medication, specifically opioids.

In this episode Diyoza says, “Opiates are a bitch. Back in the service, I lost more men to pills than war.” (Let me just say that when you’re in the kind of pain that tylenol and mindfulness won’t do a thing for, opioids are definitely not “a bitch.”) Yes, of course opioid addiction is a very real and serious thing that many people deal with. But as someone with chronic pain who has a prescription for codeine (an opioid) for as-needed pain relief, I know that the panic around the opioid epidemic has made it exponentially more difficult for people with chronic pain to get the pain relief they need.

Statistically, addiction is far more likely to happen with patients with acute (temporary) pain who get over-prescribed opioid pain medications than it is with chronic pain patients, which is one thing The 100 got right with Abby’s storyline. She did have some longer-term pain from being removed from the City of Light, as Raven did, and she started taking the pain meds then. But after she fixed the source of the headaches, she continued taking them. If they had done this with Raven (who still has chronic pain), I’d have been very upset.

But why does this matter, Michaela, you ask, it’s just a TV show. Well, let me talk about something happening in the US right now. Currently before Oregon Medicaid is a plan to force a taper to 0 mg of all opioid-receiving pain patients. If this plan goes through, every person with chronic pain in the state of Oregon will no longer have access to much-needed pain relief, with the replacement treatments being cognitive behavior therapy, acupuncture, mindfulness, pain acceptance, and treatment with non-opioid medications, such as Tylenol.

Now, if these things work for you, great! But opioids are generally only prescribed to chronic pain patients after exhausting many other possibilities. My old primary care physician refused to prescribe me a low dose of codeine (the most mild of the opioid pain medications) for times when my pain was high enough that I couldn’t stand it — and I (and most chronic pain patients) have a pretty high pain tolerance — even when no other options would help.

I’ll stop before I get on too much of a soapbox here, but basically: television has an impact on society, as I’m sure everyone in this fandom knows. And when every character who ever uses pain medication long-term on television is an addict (another notable example is Dr. House from House, MD), the general public, who don’t know any people with chronic pain, are going to associate long-term pain medication use with addiction, which only hurts pain patients further. While Paige Turco is absolutely doing an incredible acting job as Abby, I’m disappointed in The 100 for perpetuating this.

Something that could have made this storyline work is showing Abby’s point of view on it, but instead we only see her addiction through the eyes of other characters and how it affects them; Kane, Diyoza, and Raven, for example. This storyline feels like something pulled from a different show and not successfully woven in with this narrative, unlike the other addiction storylines we’ve seen (Jasper’s alcoholism and wanting to stay in the City of Light, and to an extent, Raven’s City of Light story). Because it’s not successfully done, Abby’s storyline only takes time away from other plots that are more central to the story.

There Are No Good Guys

Octavia continues to cry out “CHOOSE,” but consistently takes away her people’s choice. She asks for her advisors to give her another choice, but when there is one clearly available, she refuses to take it. As Clarke pointed out in Season 4, “only choice” is an oxymoron.

While it’s true that there wasn’t really another choice during the Dark Year when they needed a source of protein, she has certainly had other options since then, most notably that Wonkru could have survived in Polis once Monty got the hydrofarm running, with the long-term plan of using his algae to make the soil fertile again. But rather than giving her people the option to stay there and live in peace, or to surrender to Diyoza and live in the valley in peace, Octavia burned down the hydrofarm to force the war she’s been hankering for. Octavia keeps thinking about the next thing; “Once we get in the bunker, things will be better.” “Once I unite the clans, things will be better.” “Once we get through the Dark Year, things will be better.” “Once we get out of the bunker, things will be better.” “Once we get to the valley, things will be better.” It’s never-ceasing, and things never are better. If Wonkru wins the battle for the valley, there will just be another thing, and Octavia will continue doing more and more horrible things.

As Clarke said in the season premiere, “what happens to the Commander of Death when there is no one left to kill?” Clarke was able to wash away the pain of the past and start fresh (as much as one can after going through what she has), but I don’t see any realistic way that Octavia will be able to — all the huge moments that could have snapped her out of her tyrannical state have had no effect on her, and she has just dug herself further into the darkness.

Abby is doing this to an extent, too — in the promo for 5x12, “Damocles Pt 1,” we see her repeat, “First we survive, then we find our humanity again.” But what happens if you’ve gone too far? What a contrast it is from Season 1 when Marcus told her, “I choose at every turn and at every cost to make sure that the human race stays alive,” and Abby responded, “That’s the difference between us, Kane. I make sure we deserve to stay alive.”

That’s still the difference between them, though their roles have switched. Marcus knows that there are some lines you can’t uncross, and would rather die than lose his humanity and compromise his morals. But Abby wants to survive at any cost, and even encourages Octavia to do something unthinkable — execute those who won’t become cannibals — to keep Wonkru alive.

The show’s insistence that “there are no good guys” also conversely implies that there are no bad guys, which isn’t the case. Moral greyness has always been a The 100 specialty, but this season they’re trying to make it all equally grey, when in fact some things are still black and white. There are good people, and there are bad people, and there are people in between — none of them is innocent, to quote Maya Vie, and none of them is 100% evil. They all do have their reasons for what they’ve done, and while we’ve seen two flashbacks of how Octavia became Blodreina, this in no way excuses what she — or any of the characters — has done. As Jake Peralta would say, “Cool motive, still murder.”

Looks Like Meat’s Back on the Menu, Boys

A big question raised by "The Dark Year" is whether cannibalism is ever morally acceptable. For me, the answer is “possibly.” While I would never be okay with killing people just to eat them, if the people were already dead (from a non-transferrable cause) and I were starving, I would probably be okay with it — I’ve never attached all that much significance to a body once it’s dead.

But what Octavia did (at Abby’s advice) — killing anyone who refused to eat the human flesh before them — was objectively morally wrong, no matter how much the show tries to push the “there are no good/bad guys” theme. And forcing a fight to the death as punishment for crimes, and then EATING THE LOSERS is just awful. I mean, as harsh as the Ark was, they executed people humanely. I feel like there must have been better options for entertainment than actual gladiator fights — too bad they killed the guy with the guitar in the "Red Queen" flashback.

Before Season 5 premiered, the cast teased that there was a scene that made everyone on set sick, and I’m guessing that was the cannibalism flashback. Those weird jello cubes looked pretty gross, and with the association of them as human flesh… well, you can imagine. Also, what was with the perfect tuna-sashimi-looking cubes?! Like, if you have to eat people, at least try to make it not-gross. Cut it up and put it in the soup; make tacos out of it; ANYTHING but just a hunk of raw-looking grossness.

Human flesh would not be safe to eat raw, so they must have treated it in some way; my roommate suggested that it looks like it may have been ground it up and made it into a spam-like food. Mechanically-separated people, if you will. Yummy. “I’ll have a Big Gulp of highly-filtered urine and some Bunker Nuggets!” “Would you like Palm Frites or Ta-toe Tots with that? Any Man-na Cotta for dessert?” (You have my roommate to blame for that one.)

It’s possible that they intentionally dwelt on the meat as being human to keep from normalizing it, in contrast to Mount Weather hiding the grounders from sight and sanitizing the whole process, dissociating from what they were actually doing. After so long of using grounders to filter their blood, the residents of Mount Weather were mostly okay with it, whereas the people in the bunker are still horrified and traumatized five years later from the cannibalism.

And it’s a good thing that they didn’t normalize it — many fans think they might still be supplementing their rations with human flesh, but I don’t think they are, because it was always a necessary-but-horrific thing. And in Mount Weather, they allowed people with moral objections to abstain from the blood transfusions, but that came back to bite them because those same people helped the delinquents overthrow the mountain. I wonder if Abby had this in mind when she encouraged Octavia to enforce the cannibalism, breaking the people’s spirits and forcing unity.

An Echo in Space

Before Season 5 premiered, we were told many times by actors, writers, and other crew on The 100 that Echo would be much changed from where she was before the time jump, and that she would be an integral part of the self-titled Spacekru who we would love. But honestly, nearly every time Echo is on screen I find myself rolling my eyes.

The rest of Spacekru keep talking about how she proved herself during the six years they were in space, but really, those six years were more like stasis. There were no enemies to fight, no options for betrayal. They simply lived. But now that they’re back on the ground, with outside forces exerting pressure on their little family, Echo has been slipping back into her old ways, betraying Raven’s trust in Shaw, threatening to kill him despite Raven’s pleas, saying she’ll “deal with Clarke,” and all-around just...not being very likeable.

It’s no secret that I ship Bellarke, but my dislike of Echo barely even has anything to do with her relationship with Bellamy. Back at the end of Season 2, when she was introduced, I was intrigued and actually thought a relationship between her and Bellamy could be interesting. Her character has had so much potential, but keeps falling flat. Imagine if she had decided to stay behind when Lexa ordered the retreat from Mount Weather, because she believed that it was wrong, like Lincoln did.

I mean, if we even had a single flashback of her so-called “proving” herself in space, I could swallow it. When she decided to “defect” to Eligius and spy, and hid the flash drive in the other woman’s bullet wound, I was excited to see her actually be the spy she’s been described as, but again, she betrayed the one friend they had as well as Raven’s trust (side note: it’s been said multiple times that Echo and Raven are close, but I’ve seen no evidence of that). Echo continues to be just that; an echo, continuing old habits and rarely showing any dimension.

Zaven

The best moment of the episode was undoubtedly when Raven pulled Zeke (still not calling him Miles) over to herself for a kiss, after avoiding him for four days. She’d realized when he put his life in danger to save hers that she cared for him, and finally acted on her feelings. Many fans of Raven’s had been shipping the two ever since Jordan Bolger’s character was announced for Season 5 and described as “a self-professed adrenaline junkie brimming with brains, wit and bravado.”

It’s been nearly three seasons since Raven has had a love interest, and has had to go through some incredibly difficult things by herself. Of course, romantic love isn’t all that matters, but the girl deserves to kiss a cute boy every now and then. I’m going to be pretty upset if Zeke doesn’t survive the season, after everything they’ve put Raven through. He and Diyoza have been such a wonderful addition to the cast, especially as characters from closer to the present, and I sincerely hope to see both of them (and Diyoza’s baby) in Season 6!

Honorable mentions:

I loved the guy who said “Brother, it took me 10 minutes to find rewind.” MAKE HIM A MAIN IN SEASON 6.

More cannibal puns we didn’t have room for: Cadaviar, Spicy Vinda-Who?, Blood Sausage, Gingerbread Men, Steamed Muscles, Split We Soup, Toe-Furky, Manwich, Dead Velvet Cupcakes, Serf and Turf, Man-icotti, Chili Con Carnage

I’ve been excited to get a good look at Bellamy’s new outfit for quite a while, partly because I’m an artist and partly because he looks darn good in that armor.

I’m SO HERE for Bellamy deciding he’s had enough of Octavia’s treatment of him.

When Echo told Shaw “You can stay,” I actually laughed out loud. She’s not really in charge of that, and he and Raven have been pretty allied for a while now.

The 100 airs Tuesdays at 8/7c on The CW.

Michaela’s episode rating: 🐝🐝🐝

An Inconvienient Womb

I got my period at 8 years old and it was mostly regular right away. For three (or more) days every month, I would lie to my mother to skip school, cancel plans with friends and just die for a few days. I was told that this was the way it was: my mother suffered, and my mother’s mother suffered. I remember being in Gaspe with a friend at 9 or 10 and sitting on the bathroom floor crying until her Mom came in and coaxed the information out of me. She gave me a Tylenol and I slept until the next morning.  I was prescribed the pill at 14 years old and I jumped from birth control to birth control, plagued by side effects and restrictions. I tried Yasmin, Micronor, Ortho Tri-Cyclen, Yaz and at least three others I can’t remember names of - all in the name of getting some relief. At 23, I had surgery to cure my cervical dysplasia and ended up with pain related to the scar tissue. 

At 24, I had a single migraine with aura that landed me in the hospital. I remember thinking that I knew how being hit with lightning would feel like. As a result, the neurologist I saw told me I couldn't take any form of hormonal birth control anymore because it was a major countraindication.  That ended up being extremely necessary for me to realize that something was wrong. 

A few months later, my doctor suggested I see a gynocologist (Dr. Lortie) so that I could discuss family planning and my never ending cramps. I was in a super stable relationship, but we were not ready to have children. That’s when she suggested I get Mirena, the IUD. I remembered my aunt telling me her horror story with the copper IUD and did a lot of research before I accepted.  The actual procedure to get it done was extremely painful and I remember worrying that people in the waiting room would hear me scream, becoming irrationally angry at the clownfish mobile dangling above me. I took a few days off afterwards, even though I was supposed to be able to go back to work the same day. Three days later, I was still spending my days and nights crying in the tub and my partner urged me to go to the hospital. Turns out that my cervix was too small and inflexible due to the scar tissue I had from surgery. I then spent a few weeks waiting for my appointment with the gynocologist and the pain subsided with hydromorphone, allowing me to return to work. Dr. Lortie told me that there was a new type of IUD, much smaller than the first. I reluctantly accepted to remove the old IUD and put in this one.  The removal was quite painful and she had some difficulty putting the new one in, but I was more prepared this time as I was given cervix softening medication and an Ativan to manage anxiety. I took a taxi home and slept the rest of the day. I tried to go to work, hydromorphone in hand and heating pad in the other. I made it through a few months with intermittent visits to the hospital and way too many sick days. That’s when the doctor finally discovered what had happened: the IUD had become imbedded into my cervix and was causing contractions. I took advantage of the short-term disability at work and impatiently waited for my surgery with Dr. Lortie. The surgery itself was the most pain I have ever been in my entire life, even with sedation. I had to be in a birthing position and therefore I couldn’t be put under. I remember one nurse talking to me and holding my head up while holding a tray with the other and people running around the room, but I can’t tell you how long it took, what was said or done. Again, I remember thinking about how scary it must be for people in the waiting room hearing me scream. Fast-forwarding a year or so, I quit my job because of the pressure my boss was putting on me to get better, taking way too much hydromorphone and sleeping the days away. My pain was still way too significant and I had been bleeding on and off (but mostly on) for three years after coming off birth control and into the time I had the IUD.

My marriage ended two and a half years ago, when I was at my lowest physically. I had been going back and forth between my family doctor and gynocologist and I was skeptical I was ever going to get better. I couldn’t work, eat or shower properly. Walking was usually done bent at a 90 degree angle. My doctor  accused me of “drug seeking behaviour” and sent messages to specialists requesting that only she prescribe the hydromorphone. This was said after I admitted to smoking marijuana because I felt the hydromorphone wasn’t helping enough. She also told me it was probably just anxiety or “all in my head.” The only outing I can remember from those days was to Ikea in a wheelchair and I was mortified that an old coworker saw me. It wasn’t until my lovingly stubborn best friend Jessica brought up taking birth control pills again that I rallied again to make a change. She also had migraines and was allowed to take pills, albeit different ones. I made an appointment to discuss with Dr. Lortie, and she had just come back from a conference or speech of some kind where they had questioned the contraindication of taking birth control. She subsequently agreed to give me continuous birth control. I started to get small moments of relief, where I was able to get outside. I even managed to keep a job for a few months!  In November of 2016, I was officially diagnosed with endometriosis based on my symptoms and ultrasounds. I had seen and heard the word bounced around so many times, as early as 18, but no one had ever followed through. Dr. Lortie provided me with two sheets of paper that included all the possible treatments that I could try to alleviate endometriosis and pelvic pain. I started an endometriosis specific birth control, Celebrex for pain and an anti-depressant that would help block pain centres in the brain. The birth control reduces the effect of estrogen on tissue, preventing further growth. The Celebrex and anti-depressant help me manage my every day pain and I take the over the counter Codeine with Tylenol for breakthrough pain. I’ve changed my diet to exclude dairy and other inflammatory foods, get massaged and will be starting physio in April to get my body back up to par.   I now spend time on Endometriosis groups, cheering people on and giving advice. I’ve referred tons of people to Dr. Lortie, because she has made such a significant impact on my life. I’ve come a long way from that girl hiding in Ikea, but I could have prevented all of this if someone had prescribed me continuous birth control. We need to do better for women. No person should have to go through almost fifteen years of this.

https://www.nytimes.com/video/opinion/100000005618112/birth-control-your-own-adventure.html

Over the Hill (part the second)

So we left off with me on pain meds and an appointment with a urologist to take care of my 7mm kidney stone that the ER doc said I probably wouldn’t be able to pass. Now it’s Friday, and the urologist is saying that, indeed, I probably won’t pass this thing, so we have an appointment for Monday. I’d been taking the pain meds (alternating between 800mg Tylenol and Ibuprofen), but once they scheduled the surgery, the Ibuprofen was out (blood thinner), so now I was only able to take Tylenol for the pain ALL WEEKEND!

To make matters worse, while we were getting all the paperwork ready for the surgery, the doctor’s office called and changed it to Tuesday! Whew! Needless to say, that was a difficult weekend of pain. Sunday afternoon I was tempted a few times to go to the ER and have them perform the surgery. Same thing Monday evening, but by the I just decided to grit it out since my surgery was in the morning.

The surgery itself was uneventful. The experience was strange to me, however. It was odd being wheeled off on a gurney to some room where an army of health-workers are there FOR ME, but aren’t really talking to me. They put the oxygen mask on me and said it was only oxygen. I don’t remember hearing any kind of warning about when the anesthesia was coming, but the next thing I knew I was waking up in recover with R at my side, and everything was over.

The urologist did a lithotripsy and used a basket to remove the largest fragments, and he also installed a stent, which he told me I’d have for a while to enable urine to pass through the ureter, which would be swollen. More on the stent later.

I was prescribed Tylenol with Codeine (Tylenol #3)—an opiate, which has become quite controversial of late with lots of folks becoming addicted—along with something else I can’t remember right now, and sent home. That night before going to bed I took the pills as prescribed at 9pm, and I was supposed to take them every four hours. Here’s where things got weird again.

At about 12:30am, T (my son) came home with some friends, and his arrival startled me awake. I could tell that I had been lying in exactly the same position in which I’d fallen asleep (flat on my back) from how the bed felt and how sweaty my back was. The codeine really worked! I decided to roll over to check what time it was to see if I needed to take another, but I realized I was paralyzed! I felt very groggy, almost dreamlike, but I knew I was awake. I was shivering somewhat, but I didn’t feel cold. My breathing was normal, and my heart didn’t feel like it was racing, but I just couldn’t move my arms or legs! After a few moments of struggling to roll over, I decided to try and wake up R. My voice was a stuttering whisper (again, similar to someone in extreme cold whose teeth are chattering), and with great effort I was able to swing my arm from the elbow to bump her enough that she woke up, where I haltingly told her I couldn’t move. She jumped up, turned on the light, and I continued trying unsuccessfully to control my body. Oddly enough, in all of that I wasn’t panicked. On the inside, I felt calm. I was simply confused at being unable to move. R went downstairs to get T to figure out what to do. They debated whether or not to call 911, and T quickly replied, “yes”. R asked me if she should, and I was once again faced with that question about using emergency services on my own behalf.

Again, questions regarding cost and false emergencies flashed through my mind, so I sputtered out, “I…I…I…d…d…don’t…huh…n…know.” They called, and, fortunately, we live only a couple of blocks from the firehouse, so the paramedics arrived almost immediately. This was another very strange experience for me, as five firemen are ushered upstairs into my bedroom at 1 in the morning, and there I am lying on the bed unable to move. They didn’t know what to do, as they’d never experienced it before. R handed them the paperwork that came with the meds to see if there was any warning of these symptoms, but they couldn’t find anything. So now the next question: “Do you want us to take you to the ER?”

Why am I the one that has to answer this question? Here we have five medical professionals along with my wife and son, and yet they’re asking my opinion on my medical needs! I mean, really, I get it, but at the moment, I just wanted someone to make a decision for me! They checked my vitals, and everything was normal. I finally told them that I really needed to pee, and so they helped me sit up on the side of the bed. By now I was beginning to feel a little more normal: breath becoming regular, a little more control over my motor functions, and so they helped me stand and make my way to the bathroom. Once I finished up (which with the stent, took a little while), I came out of the bathroom feeling relatively normal. We signed the necessary refusal of service forms and returned to bed. I noticed that it was just after 1am, which was 4 hours after I’d taken the T#3, and so my theory is that being jarred awake before the meds wore off, along with some residual anesthesia in bloodstream, was probably the cause of all of this. However, I decided not to take those pills anymore, which meant I was back to only the pain meds I’d originally been given by the ER doc that first day of all this mess!

Stent talk and recovery next time…

This was by far my favourite typographic assignment yet. The freedom to address social/ political issues through any type of medium really allowed me to explore different ways of allowing the connections I made flow together in more expressive ways.

I was immediately interested in the subject of “Drugs vs. Medicine”, two opposing forces that in the world of traditional medicine, appear to have no real distinctions. Pharmaceuticals in the eyes of the doctors or chemists creating these compounds see the substance as it is– a prescription drug, in the eyes of billions of patients seeking medical advice and remedies, we are lead to believe that these drugs are safe medicines that are recommended to us to improve our health and cure health issues. The amount of misleading information that the health system imposes upon us has lead me to very seriously question the moral and ethical principles behind the pharmaceutical industries and the doctors contributing to this questionable form of un-natural, un-sustainable “health” that can often lead to toxic cycles of dependency, addiction, and life-threatening substance abuse as much as, if not more than, any other form of drug. Pharmaceuticals, prescription drugs, traditional medicine– it’s all a paradox... seemingly absurd and contradicting.

Pharmasave? 

I thought of many different ways I could create thought provoking, questionable connotations that referenced to the world of medicinal drugs and I seen so much opportunity to express this through making my own prescriptions using the same layout that world-known pharmaceutical industries use for their labels. I began exploring different pre-fixes to throw in front of the word “Pharmasave” but came to find the most effective way to encourage people to question it from the “grey area” stand-point that is associated with it, was just by simply adding a question mark. I gathered statistics in relation to the amount of deaths and prescriptions handed out each year/day and applied these to the information on the labels. The phone numbers on each label are help lines that relate to the subject of each substance (Mental health, and Drug addiction). The expiry date on each bottle is R.I.P, due to the fact that so many people taking opiods and anti-psychotics develop such extreme dependencies that the use can last a life time. Dr. I. N. Genuine is to address the issue of impersonal relations that doctors and patients share. Sadly, doctors treat patients with cookie-cutter type band-aides that do not fix the issues at hand as much as they do just send them on their way with more later questions and unresolved issues. 

Worldwide pharmasave #224- This number is an area code that is associated with Ontario, where I tried to find most of my statistics that I referenced on the label.

Doctors Note:

All prescriptions drugs are considered illegal unless prescribed by a doctor. This alone demonstrates the authority that doctors have over their patients and society at large. If doctors are doing their jobs effectively then why do the rates for addiction, mental illnesses, and prescription drug over-doses continue to rise? Are these substances being prescribed, really effective? Do they really “save” and resolve the issues that so many people are experiencing? Do anti-depressants alter the chemistry in the brain to synthetically produce happy-endorphins, or perhaps, are they suppressing “negative” emotions that don’t want to be felt, understood, or properly handled and dispersed of in order for true healing to occur.? Anti-psychotics have become so normalized, that people experiencing mental-illnesses, that are being prescribed these medicines are basically told that a pill will make their problems go away. This is alarming, upsetting, impersonal and an in-valuable way of approaching the sadness, anxiety, confusion and over-all feelings of disconnection in the world. 

Prescription Receipt:

Many doctors receive commission for the drugs that they prescribe each day, they write their client a note and then pass them along to the pharmacy where the next service will be received as a customer rather then a client. It is for this reason that where I created the bar code/number I distorted the words “THANKYOUFORYOURMONEY” within the bar code. The price of prescription drugs is money, but the cost is well being. 

Why Candy& Tylenol? 

Prescription drugs often times are handed out like candies. They are given to bring temporary satisfaction for relief, are highly addictive, in-effective and impose more adverse health effects/risks then they do promote it. Both candy and drugs are taken for pain and for pleasure. 

T3′s are a very commonly prescribed pain-killer, it is a mixture of acetaminophen (Tylenol) and codeine (opioid). Tylenol in it’s simplest form is readily available to almost anyone– when you take the compound of Tylenol, multiply it by 3 with the addition of other drugs you are given an opioid.

Typeface:

Selecting the typeface was an easy step in my process. I soon cam to discover upon research, that one of (if not the most) commonly used typeface in the world of medicine is Arial due to it’s illegibility and sans serif. With that being said, this is the very font that PHARMASAVE uses for their prescriptions and labels. 

Layouts/Grids: Essentially the layout for my prescription labels, doctors note, and receipt were referenced off of originals prints. I began by measuring the size of the labels and logo’s for the best accuracy. I formatted everything to be almost identical with some typographic adjustments/alignments that are clearly over looked when pharmacies print off the actual labels, haha. After a few test prints to ensure the font, sizes and layouts were all accurate I decided to print the real thing. I purchased some sticker paper from staples and was impressed with how well everything turned out. Once I had my printed copies I had to cut them out and then cut off the corners of each rectangle in order to give it the rounded look that most prescription labels have.  I used somewhat of a grid when creating my doctors note in order to ensure consistency and accuracy in alignment. I wanted to give the real feeling of a doctors note so I decided to tear the top side of the sheet to give it the feeling as if it had been torn right out of a note book. I thought it would be interesting to hand-write the information I wanted to include in the doctors note– my hand-writing is small and may be hard to read, just like an actual doctors note. I wrote it fairly quickly while still trying to make the information eligible because I did decide to use this piece of my project to write out the warnings that can often be over-looked. When creating my receipt, I wanted to make it feel and look like an actual receipt, to do this I printed small dotted lines were each fold/tear would be on the actual receipt and very lightly ran an exact knife along the line of it so that it gave it flexibility.

I created everything completely from scratch using in-design only. The warning label on the side of the bottle, the prescription label, the doctors note, and the receipt were all created just by referencing/ measuring for actual sizes and then tweaked with the information I gathered and a bit of my own personal twist. 

My thoughts: 

My perception of medicine is sustainable, naturally-sourced herbs, plant, fungi’s, foods, and compounds that promote health, well-being, balance and wellness in practical and more readily available ways. True health is a life style... not a drug. Organic forms of medicine have been used and worked for many cultures for years and years before us and have not had the same adverse effects that modern/traditional prescription drugs now do. I am not against the health industry or what doctors, nurses and the healthcare provides to their patients but I do and will forever question the system and encourage any alternative measures to prevent declining health rates. Certain belief systems have been imposed upon me that I've began questioning from a fairly young age. Please note, both of my parents work at the hospital &one of them happens to manage it. Growing up in a family where traditional medicine is so widely accepted and practiced has encouraged me to really question the system in order to find alternative ways of implementing natural& sustainable health into my experience& being able to educate myself to encourage others to do the same.

Saving Bobby

Renee Hodges, Saving Bobby: Heroes and Heroin in One Small Community (She Writes Press, 2018).

by Agnieszka McCort

On average, 115 Americans die every day from an opioid overdose.[1] That is one American every 12.5 minutes, a staggering statistic. As a public health professional with over a decade experience in injury and violence prevention, which includes poisonings such as drug overdoses, reading Saving Bobby: Heroes and Heroin in One Small Community provided me a rare perspective. I am familiar with the mind-boggling statistics in the scientific literature such as: 1) Clinicians wrote nearly a quarter of a billion opioid prescriptions in 2013, which is enough for every American adult to have their own bottle of pills[2]; 2) in 2014, nearly two million Americans either abused or were dependent on prescription opioids[3]; and 3) in 2016, drug overdoses became the leading cause of death among Americans under 50 years old.[4].

Saving Bobby, put a human face on an epidemic that is currently impacting millions of people in the United States, from those who are living with opioid addiction to the loved ones, community members, and care takers of those individuals. Renée Hodges describes her experiences of preparing for, welcoming, and caring for her nephew, Bobby, during a difficult and profound time in his life involving addiction. Bobby started taking prescription opioids under the care of his doctor in college for debilitating back pain. By the time Bobby graduated from college in 2009, he was addicted to prescription opioids.

Opioids are prescription medications used to treat pain. The most commonly prescribed opioids include codeine, hydrocodone, and oxycodone; however, heroin is the same substance. Scientists are researching the pathways of addiction including one which illustrates a person starting to take prescription opioids to treat pain as instructed by their doctor or dentist, inadvertently becoming addicted to these medications, and switching to using heroin after their formal medical care ends because that person has become addicted and heroin is cheaper and readily available in most American cities.

Hodges describes receiving her despondent nephew, Bobby, at her home in Durham, North Carolina in the Spring of 2013 so that he could seek further treatment at Duke University after he had spent time in various rehabilitation centers throughout the country since his college graduation. She structures the book chronologically, starting with the preparations for Bobby’s arrival. As his aunt, she is in regular communication with Bobby’s parents who live in Louisiana and clearly describes her evolving revelations of the commitment she is making for his care. Simultaneously, while preparing for Bobby’s arrival, she learns of the death of one of her dearest friend’s sons due to overdose, which immediately crystalizes the life-or-death circumstances surrounding the care of her beloved nephew.

Hodges documents the sixteen-month experience of caring for Bobby, by including emails, texts, and journal entries, which describe the heartbreaking reality of how insidious escapism and stigma of addiction live on the pages and in the airwaves of mainstream media. Becky Georgi, a licensed clinical addictions specialist, also captures some of these phenomena in the Additional Notes section of the book:

Addiction occupies space in the public mind as a failure of character rather than a medical affliction, a lack of willpower rather than a legitimate disease, a choice that’s made rather than an illness that strikes. On an individual level, shame drives addictive illness and interferes with a family’s ability to get help. On a much broader scale, the shame associated with heroin use carries such a powerful stigma that the culture itself interferes with family members supporting their loved one.

When family members see their loved one suffering, what can they do to stop the downward spiral of this insidious illness? The family must reach out beyond the shame, talk to each other, and get help.

That is exactly what Hodges did. Hodges was forthright about the circumstances around Bobby moving in and living with her family to her community of friends. She did not hide in the shadows of shame surrounding her nephew’s addiction. Instead, she reached out to provide Bobby with opportunities to learn, engage in and contribute to his new community, and recover his health. Hodges describes her heartfelt struggles in caring for Bobby, and requests help not only for Bobby, but also herself as his primary caretaker, providing a perspective that is not often discussed. For this reason alone, Saving Bobby, is worth reading. Hodges includes personal reflections and communications with her therapist, family members, and friends seeking guidance and support regarding the decisions she makes related to Bobby’s care. Each decision is considered independently and as part of a bigger picture, which requires a steadfast commitment to the dynamic nature of addiction treatment and recovery. Her community abides and Hodges’ determination to provide comprehensive and holistic care for her nephew is notable. She seeks out and secures substance use disorder treatment, and therapies that address Bobby’s physical, mental, social, and spiritual health. Hodges’ commitment to Bobby, her other family members, and her community of friends is palpable.

Candidly, Hodges admits some of the mistakes she made in Bobby’s care and shares glimpses of the impact the experience of loving and caring for someone who lives with addiction had on her family. She shares some of her own family’s history with addiction and notes the changing cultural dynamics of addiction in the United States, including the incongruous past social acceptability of addictions to substances such as alcohol, in contrast with the current lack of social acceptability of other substances, such as heroin. Though she focuses a lot of her energy on addressing the shame and stigma associated with addiction in her family, she does not examine the language that she uses to describe people living with addition. In the beginning of the book, Hodges uses charged words to describe people living with addiction like junkie and addict and people who are in recovery as “clean.” These words are limiting, hold judgment, and perpetuate the misconception that addiction is a choice or a moral failing and not a chronic brain disease, which should be treated like other mental health conditions. Understanding that addiction impairs an individual’s decision-making ability by changing the actual structure and function of the brain needs more so than ever, to be translated into the language we use to describe it. Individuals are a sum of many parts, of which for some people, addiction is only one. The words we use around addiction can either support a path to recovery or dissuade it. Regardless of the language that Hodges used to describe people living with addiction, her compassionate care of Bobby and personal exploration and edification of this issue were pivotal to Bobby’s recovery.

Lastly, of note, Bobby’s experience of addiction treatment was well resourced with his immediate and extended family. This should not and does not take away from the bravery and compassion that is described in Saving Bobby; however, not everyone is so lucky. Both abstinence-based and medically assisted treatment options are expensive and access is limited. Though there is much work happening to address these concerns, the trends in the data do not yet demonstrate that the epidemic is abating. Many people around the country are working hard to understand and provide evidence to prevent opioid overdoses and enhance treatment options. In my opinion, Bobby is the hero of this and his story and Renée Hodges is the warrior that lifted him up and protected him with the ferocity of a loving mother and friend. May all individuals living with addiction be so lucky.

 1.       Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2017. Available at http://wonder.cdc.gov.

2.       IMS Health, National Prescription Audit (NPATM). Cited in internal document: Preliminary Update on Opioid Pain Reliever (OPR) Prescription Rates Nationally and by State: 2010-2013.

3.       Centers for Disease Control and Prevention. Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012. MMWR 2014; 63(26);563-568.

4.       Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2017. Available at http://wonder.cdc.gov

Writing Prompt 2

6. “Opioid Overdose Deaths and Opioid Overdose Deaths as a Percent of All Drug Overdose Deaths.” The Henry J. Kaiser Family Foundation, 31 Jan. 2018, www.kff.org/other/state-indicator/opioid-overdose-deaths/?currentTimeframe=0&sortModel=%7B%22colId%22%3A%22Location%22%2C%22sort%22%3A%22asc%22%7D.

Tra’Von Jones

Prof. Shelby Hallenbeck

WRTG121

12. March 2018

Most dangerous drug

Healing and killing is the sole purpose of this drug. The drug I'm talking about is opioids. The drug was made to benefit humanity but it also has another use. That use you might ask is destroying a human every day that has to take it. This has left many Americans is confusion on rather they should take the drug when they have a chance of becoming an addict. Americans should not be left with this choice when the drug is ten times more dangerous than many of the drugs we allow. Opioids should not be legal if its intended purpose is not what it is used for the majority of the time.

Imagine seeing someone you have known for years acting differently. Watching your whole community being affected by the destruction of a single drug. A drug taking families and friends one by one every day. Thinking your whole life that people that did drugs did it voluntary not because it was prescribed to them by their own doctor. Thinking of them as a something below a human being just to find out that it was not their fault.

When I was a kid I would walk around my hometown of Detroit Michigan and see heroin addicts everywhere. I would walk around and see people stealing, just to get money so they could get some heroin. I’ve seen addicts do sexual favors just so they could supply their addiction. I have seen that for years and all that time I thought they just did it voluntarily until I got to sit down with an addict that was apart of my family.

Speaking with addict changed my whole perspective on the situation. He had explained to me that they had first become an addict after he got into an accident. He then said they were prescribed painkillers in which they became addicted to at first. He mentioned how at first they would just keep buying painkillers from a local dealer. He told me that he had tried to stop popping pain pills because they had got to expense but he could not do it because of the withdrawals he would face every time he went more than a day without it. Saying how he would sweat all day, vomit everywhere, and would have hallucinations whenever he went without it.

My family member told me how he changed from pills to heroin because it was less expensive to get. He explained how it gives you more of a better feeling and it cools his withdrawals down. He told me how he has to go out and do certain things just so he can get money to supply his addiction. He told me how everytime he goes out to go get his supply, he is playing a game of life and death because if the dealer is having a bad day he could lose his life. He also explained that the dealer keeps making the drug stronger and stronger which can kill someone that has never done it before very easily.

Having this talk with my uncle showed me that things are not how they always seem. Things have a deeper meaning to it you just have to search for it. He showed me that doctors are the reason why a lot of America is addicted to the drug.

   Knowing the info I know I started to see things for what they really are. I noticed how a doctor can destroy a city person by person. I have seen how they can destroy a community. I have seen how one drug can flood a lot of money into a community too. That many being put into a circuit of addicts to the dealers to the government to the doctors who start the cycle over again.

   When Ever I listen to music I hear a song making it acceptable to drink Lean or Percocet. They also talk about sipping lean which also contains opioids inside of it. Before the talk with my uncle, I would think that the songs were cool and it would be cool to just try some of the things they were talking about. Now that I know what I do, I know that all of the people rapping about popping pills are just addicts in disguise trying to justify what they are doing by making it cool to do

   Now when a person tells me what I think of the opioids crisis I tell them I believe we should just get rid of opioids all together so we can stop all the addictions that are happening in the country. I tell them about how it destroys a community and how it will eventually destroy the nation completely. I tell them how I have seen the effects of opioids up close and personal.

Opioids are used in medicine such as painkillers, Oxycontin, Percocet, morphine, and codeine (National Institute of Drug Abuse). All of these drugs can be prescribed to a person via their doctor. Opioids are not just used in medical supplies they are also in one of the most addictive drug in the world which is heroin. You may not think the two are related but they are because many people who become addicted to painkillers after they had to take them because their doctor prescribed it to them. At a point, a doctor can no longer prescribe a person medication anymore. The people who are cut off from getting their daily dose of opioids move on to heroin because it is the closest thing they will get to the pleasure they were having when they were on their medication.

The drug is affecting more than just an older person who body hurts. It is also affecting the youth.According to National Institute on drug abuse (In 2012 more 100,000 young adults in America ranging from eighteen to twenty-five admitted they did heroin) .This shows that the youth is in danger of becoming addicts of a drug that can be easily controlled. They admitted that the drug they first got addicted to were pain relievers. They later would become addicted to heroin because they could not get their hands on their medication anymore. Majority of the people who admitted they did heroine admitted to only doing it because the prescription drugs were more expensive and harder to obtain.

Drug overdose is the leading cause of accidental death in America with 50,000 while opioids overdose is the leading cause of over 20,000 deaths yearly(National Institute of Drug Abuse). The drug is easily one of the most powerful drugs in the world that's why it leads to so many deaths. Deaths that some people do not even mean to happen, such as a person who is prescribed to take morphine overdosing. The person overdosed because the drug is too powerful for some people's’ bodies.

Doctors have prescribed more than 200 million people with opioids. Twenty-five percent of the people who are prescribed it will improperly use the medication(CDC). If this is the case why do doctors keep prescribing it? Why should they even be allowed to prescribe a drug like this?

Why should doctors be allowed to prescribe that much of a drug? Not everyone in America needs to be on painkillers or morphine. Doctors should not be allowed to do this. They are one of the main reasons why people are addicted as badly as they are. They are also the reasons opioid usage is at an all-time high. They should not be allowed to prescribe as much as they do. They should not be allowed to prescribe any at all.

As of 2013 opioids use it at an all-time high(Mark Edmund). People are also getting addicted to it at an all-time high. A reason for this is because opioids are supposed to treat severe pains people are having. It keeps people from feeling pain which is not a good thing because they could be injuring themselves without them knowing. Some people will do things such as playing in traffic or worst.

Opioids purpose is to help stop pain after someone has had an accident. It is intended for that purpose but a majority of the time people are prescribed it without even showing signs of being injured or even hurt. These doctors are killing a lot of people because they give regular people medicine that is way too strong for them which will lead to them becoming addicted.

Since 1999 opioids usage has increased by thirty percent(shatterproof). This increase has lead to a lot of people dying every year. The increased amount of people who become addicted shows the future generation and they will eventually follow in their footsteps.  In 2015 the rate of teens that had an overdose of opioids increased by 19 percent from 2012.

Opioids are not just a drug it is a murder. It will destroy the country by itself because as more people keep getting addicted to the more people will die from it. They will die from overdose like more 1.500 people did in Michigan in the past year (Kaiser family foundation). That number will only increase as time goes on if we do not do anything about this.

This generation is more likely to become an addict just because the people who are abusing opioids are having kids and the kids are born being addicted to it. The kids will then become more susceptible to become an addict.

The only way we can fix the problem is by banning opioids in the medical field altogether. We must vote on the issue in order to get rid of the problem. We have to vote to get rid of the drug completely. We must also put the people who are addicted to the drug in rehab as soon as possible. That's not the only thing we can do we must completely erase the drug from our societies in order to protect the future generation from becoming addicts just like this one.

We must stop what they are doing because they are influencing the next generation to become addicts. They are making it seem cool to be an addict instead of trying to get help.  They are influencing the youth to become just like them.

American rappers must stop rapping and be singing about the use of drugs. They are destroying whole communities through their lyrics. They are one of the main contributors for why opioids is on the rise  

America as a whole has to change in order for this crisis to be over with. We must all band together to stop this crisis. Until then people will keep getting addicted to it and they will keep dying from it.

Reference page

1.“Opioid Overdose.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 Aug. 2017, www.cdc.gov/drugoverdose/epidemic/index.html.

2. Abuse, National Institute on Drug. “America's Addiction to Opioids: Heroin and Prescription Drug Abuse.” NIDA, 14 May 2014, www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse.

3, “Opioids | Shatterproof.” Stronger Than Addiction, Shatterproof, www.shatterproof.org/about-addiction/substances/opiods?gclid=Cj0KCQjw7Z3VBRC-ARIsAEQifZTljIR8EjiBmYLwc8szn-pnS1WNscEqxEwvNJGo_ZD4fAYPVKLYYJAaAl1rEALw_wcB.

4.Rose, Mark Edmund. “Are Prescription Opioids Driving the Opioid Crisis? Assumptions vs Facts | Pain Medicine | Oxford Academic.” OUP Academic, Oxford University Press, 27 Dec. 2017, academic.oup.com/painmedicine/advance-article/doi/10.1093/pm/pnx048/3583229.

5. Abuse, National Institute on Drug. “Opioid Overdose Crisis.” NIDA, 6 Mar. 2018, www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis.

Documentary Unveils America’s Pharma-Driven Opioid Crisis and the Heartbreak It’s Causing Families Dr. Mercola By Dr. Mercola The HBO documentary “Warning: This Drug May Kill You,” details the devastating effect America’s pharma-driven opioid crisis is having on families and the victims themselves. The film, made by Perri Peltz and Sascha Weiss, features the perspectives of four families whose lives have been ripped apart as a result of opioid and heroin addiction. Opioid and heroin addiction — which public health officials have described1 as being the worst drug crisis in American history — affects about 2.5 million Americans, nearly half a million of whom are addicted to heroin,2 a dangerous street drug that prescription pill addicts can quickly turn to because the cost is significantly less than that of prescription painkillers. The term “opioid” is used to describe a class of drugs that includes the illegal drug heroin, as well as the legal prescription painkillers oxycodone, hydrocodone, codeine, morphine, fentanyl and others. Ironically, the silent but deadly opioid epidemic often starts with some of society’s most trusted professionals: doctors. As noted in the film, a significant number of opioid addictions begin with a trip to the doctor’s office or a hospital as a result of an injury or medical problem for which addictive painkillers are carelessly prescribed. It seems no medical problem is too minor for powerful prescription painkillers to be prescribed. This is depicted in the film, which details the story of a young woman from Beach Park, Illinois, who became addicted to OxyContin after being prescribed the medication for kidney stones. Not only are opioid pain medications (also called narcotic prescription painkillers) wildly overprescribed, but they are also often given without warning of the potential risks for addiction and/or resources to help deal with the possible risk of addiction. Nearly 260 Million Opioid Prescriptions Are Written in the US Each Year The number of opioid prescriptions has increased substantially over the last few decades. “In 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills,” according to the American Society of Addiction Medicine.3 The result? Drug overdose is now our nation’s leading cause of accidental death. In 2015, accidental drug overdoses accounted for 52,404 deaths, with 20,101 of those deaths related to prescription pain relievers, and 12,990 linked to heroin. However, 80 percent of heroin users start out on prescription opioids.4 Despite the fact that Americans are dying at unprecedented rates due to Big Pharma’s prescription painkillers, the pharmaceutical industry is rarely named by the establishment media for its deadly role in the growing opioid epidemic. Kidney Stone Pain Morphs Into Deadly Opioid Addiction for Unsuspecting Teen Stephany Gay should have been getting her license and learning how to drive when she first became addicted to prescription painkillers. It all began when, at the tender age of 16, she started suffering from kidney stones and was prescribed OxyContin and Vicodin. It didn’t take long before Stephany, who had never done illegal drugs, developed a full-blown dependency on opioids. The teen confided in her mom after realizing she had developed an addiction. Her mother urged her to see a doctor, but when she did she came home with another prescription: This time it was for Percocet. Stephany also got her younger sister, Ashley, addicted to opioids after offering her the medication for headaches and a better night’s sleep. Stephany’s doctor eventually stopped prescribing her opioids, causing the sisters to turn to heroin to get their fix. Stephany says: “It made me feel like I could do anything. I felt like superwoman. I didn’t have anxiety. I didn’t feel depressed. I felt happy. I felt warm. I felt like it loved me and I loved it back. I felt like I had a relationship with heroin.” The sisters snorted heroin for a year before experimenting with a needle. Soon after Stephany started injecting, she lost the three-bedroom home she owned and custody of her young daughter. Ashley, who once told her mother she was “too pretty to die,” overdosed on heroin and died alone in a hotel room. Eighty Percent of Heroin Users Start With Prescription Opioids Part two of the documentary, “Addicted to Pills,” details the heartbreaking story of a wife and mother of five children who became addicted to opioids after being prescribed the medication for a Cesarean section. Wynne Doyle, from Mill Valley, California, stopped getting out of bed just one and a half months after giving birth to her third child. She became addicted fast, says Britt Doyle Sr., who later divorced his wife following years of addiction. Like many opioid addicts, Wynne went in and out of rehab multiple times, only to relapse again. The second rehab she entered was three times as costly as the first, says Britt Sr. But 28 days later his wife returned home with a “whole bunch of pills,” and her addiction started all over again, he says. Wynne’s addiction grew so intense that she would purposely injure herself in order to get more pills. “I watched her slam her hand in the car door one time, just so she could go to the emergency room,” said Britt Sr., adding that the doctors would always give his wife more pain medication. At one point, Wynne had shattered both of her wrists, but as soon as they healed she would hurt herself again just to get more pills. My wife became a “totally different person,” says Britt Sr. “It was like Jekyll and Hyde.” Seven years into her addiction and on his wife’s 11th stint in rehab, Britt Sr. had finally had enough. He moved the children out of the house and filed for divorce. Sometime later, Wynne, suffering from kidney stones, was prescribed more painkillers. She had eight bottles filled to the top sitting on her nightstand when her children found their mother lifeless in her bed. “When I saw the pills on her bedside table when she had passed, that was probably the most anger I could feel, ever, because she’s been to that hospital easily like 50 times,” said Britt Doyle Jr., Wynne’s daughter. “They’ve seen her there unconscious and had to like [sic] pump her stomach so many times. And yet she comes in there and they leave her with more?” she asks angrily. Adolescents Are 33 Percent More Likely to Misuse Opioids as Young Adults Part three of the documentary tells the story of Brendan Cole from Allendale, New Jersey. The teen was prescribed opioid painkillers after having a cyst surgically removed. Four years later he died of a heroin overdose. Before his death, Cole overdosed on heroin but was revived with Narcan after his dad woke in the middle of the night to find his son lying in an unnatural position on his bed. His lips were turning blue and “we heard the air come out of his lungs when we moved him,” said his parents tearfully. Narcan, or naloxone, is an overdose-reversal drug. It’s made by Amphastar Pharmaceuticals, which began what appears to be a clear case of price gouging, raising the cost of Narcan by as much as 100 percent. Cole recovered from the overdose, but the hospital failed to warn his family that patients revived with Narcan may experience intense cravings and withdrawal symptoms. As a result, no plan was put in place to help Cole overcome the cravings that would soon follow. The very next day, Cole overdosed again, and this time he could not be revived. 5In people with little drug experience, scientists theorize that “the initial experience of pain relief is pleasurable, and a safe initial experience with opioids may reduce perceived risk.” Synthetic Opioids Sold Via ‘Dark Web’ Implicated in Growing Number of Overdose Deaths In addition to prescription opioids, another threat looms: synthetic (and illegal) opioids sold through the dark web — the secret underbelly of the internet, initially created by American intelligence agencies for encrypted communication purposes. A recent piece by The New York Times6 sheds light on an emerging illicit drug trade involving dangerous synthetic opioids that are being shipped into the U.S. via small packages in the mail. The report reveals “that most of the illicit supply of synthetic opioids is produced in labs in Asia and especially China, where many of the precursor chemicals are either legal or easier to procure.” The synthetic opioids are said to be so potent that they “have become the fastest-growing cause of the overdose epidemic, overtaking heroin in some areas,” reports the Times. Synthetic opioids being shipped overseas include fentanyl, the infamous drug responsible for pop icon Prince’s death. Fentanyl is so potent that two milligrams is enough to kill and, unlike prescription pills, “enough fentanyl to get nearly 50,000 people high can fit in a standard first-class envelope,” the report warns. Synthetic opioids obtained through the internet are responsible for the deaths of two teenagers from Park City, Utah. Grant Seaver and Ryan Ainsworth, both 13 years old, died after taking a synthetic opioid known as U-47700, or Pinky. The boys reportedly obtained the drug from another teen who purchased them on the dark web using bitcoin. While synthetic opioids account for a small portion of overall trafficked drugs, law enforcement says “that dark web markets have quickly assumed a more prominent and frightening role.” Opioids Actually Alter Your Brain Structure Studies also suggest that drugs for physical and emotional pain may change your brain. In a study by researchers at the University of Alabama, people with chronic low back pain received either morphine or a placebo daily for one month. Both groups experienced similar reductions in pain, but there was a major difference among those taking morphine — changes in the brain. Magnetic resonance imaging (MRI) scans showed the patients taking morphine had a 3 percent reduction in gray matter volume over the course of the study. The reductions occurred in regions of the brain that regulate emotions, cravings and pain response.7 Further, the morphine group had increases in gray matter volume in areas related to learning, memory and executive function. Lead study author Joanne Lin told Reuters,8 "Because we are seeing that opioids rapidly change the brain, our take-home message is that opioids should be reserved for cases when most other treatment options have failed." Millions of Taxpayer Dollars Used for Opioid Prescriptions The Centers for Medicare & Medicaid Services (CMS) is a branch of the Department of Health and Human Services. CMS runs the Medicare program and monitors Medicaid programs run by the states. According to the Office of the Inspector General (OIG), spending on opioids in the Medicare system, which is funded by U.S. tax dollars through Medicare trust funds, grew at a faster rate than spending for all drugs. Data from the OIG shows that between 2006 and 2014, the number of Medicare recipients on opioids grew by 92 percent, compared to 68 percent for all drugs. Medicare recipients are also receiving multiple prescriptions for opioids for reasons other than cancer pain or terminal illness, the traditional uses for these strong medications. Medicaid programs, supported by taxpayers but administered by states, also reveal excessive opioid use and probable fraud.9 In 2010, 359,368 Medicaid enrollees received an opioid prescription amounting to over 2 million prescriptions, and again suggesting many prescriptions per patient.10 While Medicaid programs likely provide generic combinations of the active ingredient in OxyContin, hydrocodone, to patients, which costs about $28 for a 120-day supply (compared with $632 for the brand name OxyContin),11 taxpayers are still paying at least $56 million for Medicaid opioid prescriptions. The cost of the opioid prescriptions does not take into consideration state-run drug treatment programs and services that are required if and when enrollees become addicted. OxyContin Manufacturer Pays One of the Largest Pharma Settlements in US History In December 2015, Purdue Pharmaceuticals, the maker of OxyContin, settled an ongoing lawsuit brought by the state of Kentucky for $24 million over presenting OxyContin as "nonaddictive."12 Purdue contended that the pill slowly releases the drug over 12 hours when swallowed, omitting the fact that, when crushed, OxyContin lost its time release protections and created an instant high. "State officials said that led to a wave of addiction and increased medical costs across the state, particularly in eastern Kentucky where many injured coal miners were prescribed the drug," reported The Associated Press. The 2015 settlement is similar to one Purdue agreed to in 2007 with the state of West Virginia, when it agreed to pay out $634 million because "fraudulent conduct caused a greater amount of OxyContin to be available for illegal use than otherwise would have been available."13 Despite the lawsuits, OxyContin remains on the market. FDA Orders Drugmaker to Stop Selling Opioid Painkiller Opioid manufacturer Endo Pharmaceuticals hasn’t been so lucky, however. In an unprecedented move by the Food and Drug Administration (FDA), health officials have ordered Endo to remove the opioid painkiller Opana ER from the market due to the conclusion that “the drug’s risks outweigh its benefits,” reported CBS News.14 “It's the first time the FDA has asked a drugmaker to remove an opioid painkiller from the market,” CBS said. “The agency said it has seen a ‘significant shift’ from people crushing and snorting Opana ER to get high to injecting it.” If the drugmaker refuses to comply with the FDA’s request to pull the opioid from the market, the agency can begin a “formal process for rescinding its approval.” Drug Companies Try to Cash in on Opioid Epidemic While an increasing number of Americans suffer the devastating effects of opioid addiction, pharmaceutical companies are battling it out to become the top seller of addiction medications. As was highlighted in a recent NPR report,15 rather than working to make various effective treatments for opioid addiction more readily available to those who need it, the pharmaceutical industry is actively trying to stomp out its competitors by restricting access to important addiction medications. One example of this includes the global biopharmaceutical company Alkermes and its non-opioid addiction medication, Vivitrol, a monthly injection that costs around $1,000. Alkermes, based in Waltham, Massachusetts, is working vigorously to promote its drug at the legislative level as a solution to our nation’s growing opioid epidemic — and while doing so (in some cases) is restricting access to other opioid addiction medications through policy that makes it harder for doctors to prescribe alternatives to Vivitrol. “An investigation by NPR and Side Effects Public Media has found that in statehouses across the country, and in Congress, Alkermes is pushing Vivitrol while contributing to misconceptions and stigma about other medications used to treat opioid addiction,” NPR reports. Experts disagree about which opioid addiction medications are most effective. Some argue opioid maintenance drugs like methadone and buprenorphine — both of which contain opioids — are fueling the opioid crisis due to their street value and the idea that offering them to addicts means replacing one opioid for another. Others argue that opioid maintenance medications relieve painful withdrawal symptoms and reduce or eliminate intense cravings. Federal health agencies and the American Society of Addiction Medicine agree that “opioid abstinence can be dangerous,” says NPR. While there are no studies comparing Vivitrol to methadone or buprenorphine, Alkermes touts Vivitrol as the more effective, opioid-free solution. Alkermes has significantly increased its spending on federal lobbying, spending $4.4 million in 2016 compared to less than $200,000 in 2010. “Last year, Vivitrol's sales reached $209 million — up from just $30 million in 2011,” NPR reports, adding that Alkermes projects sales could reach $1 billion by 2021. Treating Your Pain Without Drugs While opioid painkillers may relieve pain temporarily, the addiction risks can quickly send you spiraling out of control down a dark and dangerous path. As shown in the film, many families touched by opioid addiction end up suffering for years before finally losing a loved one to addiction. The good news is there are many natural alternatives to treating pain. It’s particularly important to avoid opioids when trying to address long-term chronic pain, as your body will create a tolerance to the drug. Over time, you may require greater doses at more frequent intervals to achieve the same pain relief. This is a recipe for disaster and could have lethal consequences. Following is information about non-drug remedies, dietary changes and bodywork interventions that can help you manage your pain. ✓ Medical cannabis Medical marijuana has a long history as a natural analgesic and is now legal in 28 states. You can learn more about the laws in your state on medicalmarijuana.procon.org.16 ✓ Kratom Kratom (Mitragyna speciose) is a plant remedy that has become a popular opioid substitute.17 In August 2016, the DEA issued a notice saying it was planning to ban kratom, listing it as a Schedule 1 controlled substance. However, following massive outrage from kratom users who say opioids are their only alternative, the agency reversed its decision.18 Kratom is safer than an opioid for someone in serious and chronic pain. However, it’s important to recognize that it is a psychoactive substance and should be used carefully. There’s very little research showing how to use it safely and effectively, and it may have a very different effect from one person to the next. The other issue to address is that there are a number of different strains available with different effects. Also, while it may be useful for weaning people off opioids, kratom is in itself addictive. So, while it appears to be a far safer alternative to opioids, it’s still a powerful and potentially addictive substance. So please, do your own research before trying it. ✓ Low-Dose Naltrexone (LDN) Naltrexone is an opiate antagonist, originally developed in the early 1960s for the treatment of opioid addiction. When taken at very low doses LDN, available only by prescription, triggers endorphin production, which can boost your immune function and ease pain. ✓ Curcumin A primary therapeutic compound identified in the spice turmeric, curcumin has been shown in more than 50 clinical studies to have potent anti-inflammatory activity. Curcumin is hard to absorb, so best results are achieved with preparations designed to improve absorption. It is very safe and you can take two to three every hour if you need to. ✓ Astaxanthin One of the most effective oil-soluble antioxidants known, astaxanthin has very potent anti-inflammatory properties. Higher doses are typically required for pain relief, and you may need 8 milligrams or more per day to achieve results. ✓ Boswellia: Also known as boswellin or "Indian frankincense," this herb contains powerful anti-inflammatory properties, which have been prized for thousands of years. This is one of my personal favorites, as it worked well for many of my former rheumatoid arthritis patients. ✓ Bromelain: This protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful. Keep in mind most of the bromelain is found within the core of the pineapple, so consider eating some of the pulpy core when you consume the fruit. ✓ Cayenne cream Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting your body's supply of substance P, a chemical component of nerve cells that transmit pain signals to your brain. ✓ Cetyl myristoleate (CMO) This oil, found in dairy butter and fish, acts as a joint lubricant and anti-inflammatory. I have used a topical preparation of CMO to relieve ganglion cysts and a mild case of carpal tunnel syndrome. ✓ Evening primrose, black currant and borage oils These oils contain the fatty acid gamma-linolenic acid, which is useful for treating arthritic pain. ✓ Ginger This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea, or incorporated into fresh vegetable juice. Dietary Changes to Fight Inflammation and Manage Your Pain Unfortunately, physicians often fall short when attempting to effectively treat chronic pain, resorting to the only treatment they know: prescription drugs. While these drugs may bring some temporary relief, they will do nothing to resolve the underlying causes of your pain. If you suffer from chronic pain, making the following changes to your diet may bring you some relief. ✓ Consume more animal-based omega-3 fats. Similar to the effects of anti-inflammatory pharmaceutical drugs, omega-3 fats from fish and fish oils work to directly or indirectly modulate a number of cellular activities associated with inflammation. While drugs have a powerful ability to inhibit your body’s pain signals, omega-3s cause a gentle shift in cell signaling to bring about a lessened reactivity to pain. Eating healthy seafood like anchovies or sardines, which are low in environmental toxins, or taking a high-quality supplement such as krill oil are your best options for obtaining omega-3s. DHA and EPA, the omega-3 oils contained in krill oil, have been found in many animal and clinical studies to have anti-inflammatory properties, which are beneficial for pain relief. ✓ Radically reduce your intake of processed foods. Processed foods not only contain chemical additives and excessive amounts of sugar, but also are loaded with damaging omega-6 fats. By eating these foods, especially fried foods, you upset your body’s ratio of omega-3 to omega-6 fatty-acids, which triggers inflammation. Inflammation is a key factor in most pain. ✓ Eliminate or radically reduce your consumption of grains and sugars. Avoiding grains and sugars, especially fructose, will lower your insulin and leptin levels. Elevated insulin and leptin levels are some of the most profound stimulators of inflammatory prostaglandin production, which contributes to pain. While healthy individuals are advised to keep their daily fructose consumption below 25 grams from all sources, you’ll want to limit your intake to 15 grams per day until your pain is reduced. Eating sugar increases your uric acid levels, which leads to chronic, low-level inflammation. ✓ Optimize your production of vitamin D. As much as possible, regulate your vitamin D levels by regularly exposing large amounts of your skin to sunshine. If you cannot get sufficient sun exposure, taking an oral vitamin D3 supplement, along with vitamin K2 and magnesium, is highly advisable. Research by GrassrootsHealth suggests adults need about 8,000 IUs per day to achieve a serum level of 40 ng/ml, but you may need even more. It’s best to get your blood level tested to be sure you're safely within the therapeutic range. Bodywork Methods That Reduce Pain Due to the inherent risks of addiction and the other unpleasant side effects of prescription painkillers, I recommend you pursue one or more of the following bodywork methods before taking a narcotic for pain. Each one has been demonstrated to be an effective treatment for lasting pain relief and management. • Acupuncture: According to The New York Times,19 an estimated 3 million American adults receive acupuncture annually, most often for the treatment of chronic pain. A study20 published in the Archives of Internal Medicine concluded acupuncture has a definite effect in reducing four types of chronic pain, including back and neck pain, chronic headache, osteoarthritis and shoulder pain — more so than standard pain treatment. • Chiropractic adjustments: While previously used most often to treat back pain, chiropractic treatment addresses many other problems — including asthma, carpal tunnel syndrome, fibromyalgia, headaches, migraines, musculoskeletal pain, neck pain and whiplash. According to a study21 published in the Annals of Internal Medicine, patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain-free in 12 weeks compared to those who took medication. • Massage: Massage releases endorphins, which help induce relaxation, relieve pain and reduce levels of stress chemicals such as cortisol and noradrenaline. A systematic review and meta-analysis22 published in the journal Pain Medicine, included 60 high-quality and seven low-quality studies that looked into the use of massage for various types of pain, including bone and muscle, fibromyalgia, headache and spinal-cord pain. The study revealed massage therapy relieves pain better than getting no treatment at all. When compared to other pain treatments like acupuncture and physical therapy, massage therapy still proved beneficial and had few side effects. In addition to relieving pain, massage therapy also improved anxiety and health-related quality of life. • Emotional Freedom Techniques (EFT): EFT continues to be one of the easiest and most effective ways to deal with acute and chronic pain. The technique is simple and can be applied in mere minutes, helping you to overcome all kinds of bodily aches and pains. A study23 published in Energy Psychology examined the levels of pain in a group of 50 people attending a three-day EFT workshop, and found their pain dropped by 43 percent during the workshop. Six weeks later, their pain levels were reported to be 42 percent lower than before the workshop. As a result of applying EFT, participants felt they had an improved sense of control and ability to cope with their chronic pain. In the video featured below, EFT expert Julie Schiffman, teaches you how to use EFT to address chronic pain.

A (rather long) account of being sick and remembering how good it feels to breathe

Three weeks ago I caught a nasty cold that flattened me in the span of about twelve hours. Fearing that it was the flu going around both my schools, I dragged myself to the doctor which apparently is a thing that people do often in countries where there is good health insurance.

When I showed up to Tada Clinic, the small doctor’s office down the street from my school, the waiting room was full. I went up to the two girls in uniform behind the reception desk.

“Hi,” I said. “I have the chills and my throat hurts. Can I talk to the doctor?”

One of the girls handed me a thermometer to put under my armpit to take my temperature, which was a rather embarrassing ordeal since my hands were full, I had on four layers of clothes, and was standing in front of about twenty people, but I managed to somehow accomplish it. Then I sat in the back of the room, waiting for about thirty minutes before a smiling nurse in light pink scrubs called my name.

“Amber-sama,” she waved, knowing exactly who I was as the only foreigner in the building.

The doctor told me that since I didn’t have a fever, it seemed I didn’t have the flu after all, and prescribed me three days’ worth of ibuprofen and a powdered Chinese herbal remedy meant to help with the chills. When I got home, I examined the prescriptions. The ibuprofen was half the strength of the over-the-counter ibuprofen I had brought with me from America, and I had no idea how to take the powdered herb mix sealed into a series of silver packets.

“I think you shake it into your mouth and wash it down with water,” my friend texted me after I asked her what she thought I should do with the instruction-less packets.

“You should mix it with hot water and drink it like tea,” texted another friend.

“How am I supposed to know?” said a third.

I tried both of the first two methods, and they each seemed to work fine, and the herbal mix tasted faintly like snickerdoodles thanks to the cinnamon inside, which gave me a pang of homesickness. I googled it and discovered that Japanese doctors often prescribed kanpo, specific blends of herbs according to Chinese medicine, and that these blends were approved by the country’s Ministry of Health and manufactured by pharmaceutical companies alongside Western drugs.

“Wow,” I thought. “How holistic,” all of a sudden inspired to re-balance my chi and fight off this cold the ~natural~ way.

I stumbled through that week somehow, which also happened to be the last week of classes for the ninth-graders, who graduated on a beautiful sunny day. I cried throughout most of the ceremony, voice gone, shaking from the chills, secretly yearning for DayQuil and emotionally exhausted. After work, I wanted nothing more than to fall face-first into bed, but instead decided to stop by a pharmacy on the way home.

“Fuck kanpo,” I said to myself in my car. “I need some real medicine.”

I told the woman behind the counter that I had developed a cough that kept me up at night, so I needed whatever their strongest cough medicine was and stat. She immediately produced a purple glass bottle from a shelf behind her.

“You need this,” she said. “Take it right before bed, and every four hours as often as you need. It’s the strongest thing we have. Hey, do you teach English?”

I cradled the cough syrup the whole way home like the sacred elixir I believed it to be. That night, just as the pharmacist directed, I took a dose before bed, and then took an extra swig too because, hey, Japanese medicine was weak as shit.

Yesssss, I thought, propping up my pillows and turning on my humidifier. Sleeeeeep, beautiful sleeeeeep, come to me finally!

But I did not sleep that night. I felt the medicine working as my cough subsisted, but as the minutes stretched into hours it began to feel as if my whole body was on fire. My heart began to race.  My palms were sweaty. I couldn’t stop my brain from conjugated every Japanese verb that came to mind and also reliving every conversation I’d had in the past few weeks.

“I don’t know what’s happening,” I texted Marcus frantically around two a.m. “I feel like I’m going insane.”

“Are you okay???” he replied, by some stroke of fate still awake. “It’s okay, I’ll stay awake until you fall asleep.”

Talking with Marcus calmed me down and I felt my heartbeat slow to the kind of range expected for a person lying in bed, but I only slept for three hours that night, finally falling asleep sometime just before five a.m.

The next day, with dark bags under my eyes, we drove to the city to watch an annual bilingual musical in Kitajima. Somehow wide awake, I snuck the cough medicine in my purse inside the theater, where I took sips from the purple glass bottle throughout the show, trying to calm my lungs down. By the time evening came and we left the city for the long drive back to Mima, I felt the sleepless night come crashing down on me as I tried to pay attention to the narrow country roads in front of me, trying to ignore the feeling of my face melting off. This is it, I thought. I’m exhausted. I’m finally going to sleep tonight.

I put on pajamas. I washed my face. I measured the cough syrup dosage in a little plastic cup, and then doubled it for safe measure. I crawled into bed and pulled the comforter up around my chin.

At three a.m., as my heart body lay there jittering once again, I admitted defeat and turned on my lights and made myself a cup of tea. What the actual fuck, I thought, and then decided to google the cough medicine I’d been swigging like juice.

The main active ingredient in my elixir turned out to be codeine, meant to suppress severe coughing, which immediately made me wonder why on earth I could buy liquid codeine over the counter but had to have ibuprofen prescribed to me by a doctor. I decided to look up the other ingredients to see if there was something else that would make my body react so poorly - and as my eyes scanned the back of the purple glass bottle, actually reading the Japanese on the back for the first time, my jaw dropped.

There it was. The last active ingredient listed. 90 mg of caffeine per 60 ml.

WHAT THE FUCK, I wanted to scream. WHY THE FUCK IS THERE CAFFEINE IN NIGHTTIME COUGH MEDICINE. I quickly did the mental math and realized I’d been drinking the equivalent of about two cups of coffee every four hours ever since I bought the goddamn bottle that Friday after work. No wonder I was lying in bed heart racing, brain on fire, unable to sleep.

I texted just about everyone I knew to complain, and then went to the bathroom and took two sleeping pills I had with me leftover from my insomniac days in America. I dragged my futon to the living room floor where I finally slept for ten hours in an uneasy, medicated haze.  

The next day I asked Mika why on earth a Japanese pharmacist would tell me to take cough syrup loaded with caffeine right before bed, but she didn’t seem to understand what my problem was. “So the caffeine made you unable to sleep?” she asked me.

“Yeah,” I said. “Of course.”

“What do you mean of course?” she said.

“What do you mean, what do you mean?” I said. “Caffeine wakes you up, like drinking coffee in the morning.”

“You drink coffee in the morning to wake up?”

“Um, yes,” I said. “Why do you drink coffee in the morning?”

“Um, because I like the taste,” said Mika.

“It goes well with bread,” added her husband. “We drink it before bed too and sleep fine.”

After a brief survey of my coworkers, who it turned out all drank coffee before bed to no detrimental effect on their sleep, I was left to wonder if caffeine somehow affected Japanese bodies differently than my own. Or perhaps Japanese people were simply so exhausted from their long overtime hours that nothing could prevent them from falling asleep once they were horizontal.

“Oooooh, you’re like a child!” they said, amused, when I told them I couldn’t sleep after drinking coffee.  

For the next week, I tried every other non-cough-syrup remedy I could think of to stop the coughing and get some sleep. I drank honey tea before bed. I cranked up the humidifier. I vacuumed and washed every corner of my bedroom to collect any dust that might be making it harder for me to breathe. I took sleeping pills at night. My Japanese mother gave me a home remedy of diced daikon in honey, which I drank before bed to no avail. I went back to the pharmacy and bought cold medicine without caffeine. One particularly difficult night, I began to get a piercing pain in the right side of my chest when I inhaled. I slept about four hours and tried not to cry the entire next day at school as the pain continued.

“Don’t get any more over-the-counter medicine from the pharmacy again,” Bando Sensei told me that day. “The medicine from the doctor is so much better and cheaper.”

“You’re not in America anymore,” the other teachers told me. “We go to the doctor when we’re sick here!”

And so I dragged my ass back to Tada Clinic. The same girls who were working before smiled at me from behind the reception desk. “Hi,” I said. “I’m back.”

I stumbled through another appointment with the doctor, who listened to my breathing with a stethoscope and then closed his eyes, furrowed his eyebrows, and rested his face in his hands.

“It sounds like you have asthma,” he told me in Japanese. “Did any doctor in America ever tell you that you had asthma?”

“………………No…………….” I said.

“Your right lung is damaged from coughing so much. It’s probably a complication from the seasonal allergies,” he continued, pulling a laminated sheet with colorful charts off his desk, covered in kanji I couldn’t read. “Course – course of treatment –” he said suddenly switching to rusty English. “Treatment One. You’re wheezing.”

I left the clinic with a prescription allergy medication and an inhaler to try to calm the inflammation in my lungs over the next two weeks. The girls at the reception rang me up.

“That’ll be five hundred and ninety yen,” they told me. Five dollars.

That night, I stood in front of the mirror in my bathroom, hands curled around the plastic purple inhaler, and when I flipped the lever that released the medication and took a deep breath in, I felt the effects immediately. My lungs stopped shaking. The choking feeling in the back of my throat went away. This is so much better than kanpo, I thought. I slept on and off all weekend, the bags under my eyes slowly disappearing and the pain in the right side of my chest getting better with each passing day.

“You’re getting genki again!” my friends and teachers told me.

“I’m 80% genki!” I’d tell them. “Almost there!”

Each night, when I used the inhaler and sank into my futon, able to breathe again, I couldn’t help but feel pretty damn lucky to live in the age of modern medicine, and also pretty damn lucky to live in a country where my two doctor visits, three prescriptions, an inhaler came to a grand total of about $45.

“You are pretty lucky,” agreed my mom on the phone.

“Even if the cough syrup does have caffeine in it,” I conceded.