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Robert Louis Stevenson eloquently said that, “Sooner or later, everyone sits down to a banquet of consequences.” Sadly, sometimes people don’t see that until far, far later, sometimes when it’s too late. Herein lies the argument, at least about some people, regarding addiction as a disease vs. a choice. Some people begin drinking – their very first episode of drinking – as alcoholic drinkers. That first drink turns into that first episode of blind drunkenness which turns into being blackout drunk. And, too often, for these types of drinkers, the rest of their lives are spent chasing that first high, sometimes trying harder and harder drugs to reach it.

For others, though, that first drink or that first toke is just a bad choice, not an immediate descent into addiction. This blog is for them.

One moment can change your life.

We tell young people not to drink alcohol or use other drugs, but why?

Certainly every person who drinks while underage will not end up suffering from alcoholism, but we do know for a FACT that those who start drinking by the age of 15 are six times more likely to develop alcohol dependence or abuse than those who begin drinking at or after 21 years of age. (Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality; 2015 National Survey on Drug Use and Health)

And marijuana is no better for a young, developing brain. We know for a FACT that those under the age of 25, the age at which the brain is fully formed, face addiction, cognitive decline, poor attention and memory, and decreased IQ if they use marijuana regularly…even only once per week. (American Psychological Association, 2014)

So how do we make sure that one single moment doesn’t change our lives for the worse? We plan ahead.

Here are four ways to help ensure that decisions will be made well:

First, never drive then drink. Yup…that’s the correct order: never drive then drink. People never think they will drink and drive. The government and even beer companies have done a great job getting the message out that drinking and driving are a bad combination. EVERYBODY knows that. So why do so many people continue to do so? It’s not because they don’t know; it’s because alcohol acts on the part of our brains that makes decisions. And alcohol causes those decisions to not be good ones. It’s just how it works. So never give your brain the opportunity to make that decision once you’ve added alcohol. Never drive then drink. Instead, if you plan to drink, make other arrangements to get where you’re going in the first place. Then your alcohol-addled brain won’t convince you that you’re fine to drive.

Second, have a safety plan or an escape plan. Generally, we know when we’re headed for trouble or at least when trouble may rear its ugly head. Follow your gut and get out, but be sure that you know how to get out before you get in. Make your own travel arrangements so that you’re not relying on someone who may not have the same outlook as you do. That way, you can decide when to leave. And, if, for whatever reason leaving on your own isn’t an option, be sure that you’ve arranged ahead of time someone to call to come get you should the need arise.

Third, this is especially helpful for young people, but it also works for anyone who feels peer pressure to use substances. Talk about how to keep safe. Use the X-plan as described here or come up with another text as an exit route. Do you have a pet? It’s not suspicious for a person to be anxious about a sick dog, so a text about how Sam the dog is doing, for example, can be your cue that someone needs rescuing. A follow up phone call saying the dog took a turn for the worse is a great escape strategy.

Finally, just follow your gut. If something doesn’t feel right, it’s not. Gut feelings are real things – real neurons are providing us real messages. Women have to be more conscious of gut feelings because we are more vulnerable to others’ physical strength and speed. Still, we ALL have gut feelings that we should be in tune to. Too often we ignore our gut – because we feel silly thinking that our gut is right over our rational thinking, because we feel bad about what we’re thinking about others, because we aren’t sure what that feeling is. But gut feelings are important to our well-being. Pay attention to them.

Planning ahead may seem inconvenient, but it certainly beats the alternative. And it may be uncomfortable to discuss your rescue plan, but remember that uncomfortable conversations save lives.

Oh, the good ol days…when we thought flushing unused meds down the toilet was a good idea. We’ve now learned otherwise. Our meds – and we use a lot of them – have the potential to disrupt the biology of our waterways. Keeping them around provides a lot of potential for harm, too. Theft of medications is one of the most prevalent ways that opioids are available on the street.

Saving prescription drugs for later use is also a bad idea; sure, you may feel the need to keep your painkiller for the next time you have pain, but here are the ways in which you could be breaking the law:

• Taking a prescription drug for a reason other than the one for which it was prescribed;
• Having a prescription drug outside the original container, such as carrying it in your pocket, unless you’re actually taking it;
• Taking a prescription for the purpose for which it was prescribed but it’s more than a year later; and,
• Giving your prescription drug to anyone else for any reason.

So what should we do? Safely dispose of unused medications immediately after use in the following ways:

Kenosha County offers free, permanent disposal locations for unused, unwanted, and expired medication. No pre-registration or personal information is required. Simply drop off your meds after you’ve removed (peeled off or blacked out) any identifying information. Acceptable items for drop off are:

• Creams
• Ointments
• Over the counter medication
• Prescription medication
• Pet medication

Locations are:

• Kenosha County Safety Building
• Pleasant Prairie Police Department
• UW-Parkside Police Department
• Town of Salem Lakes Village Hall
• Silver Lake Village Hall
• Twin Lakes Police Department

Visit this website for more information: http://www.kenoshacounty.org/314/MedicationNeedle-Disposal

One other place in Kenosha for medication disposal is the Walgreens on 80th Street.

So what if you can’t get to a medication disposal site?

The US Food and Drug Administration (FDA) recommends the following steps if you have no access to DEA-authorized collectors (which you DO!):

• Mix medicines (do not crush tablets or capsules) with an unpalatable substance such as dirt, kitty litter, or used coffee grounds;
• Place the mixture in a container such as a sealed plastic bag;
• Throw the container in your household trash;
• Scratch out all personal information on the prescription label of your empty pill bottle or empty medicine packaging to make it unreadable, then dispose of the container.

And, as an absolute last resort in order to keep highly addictive prescription drugs off the street, the FDA recommends flushing certain medications if you have no access to DEA-authorized collectors…which you DO! https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm#recommend

There is a lot of potential for harm from prescription drugs, so please dispose of them properly. And if you’re not sure, ask. Uncomfortable conversations save lives.

September is Fetal Alcohol Spectrum Disorder Awareness Month because pregnancies last ninth months.

So let me start by saying that, regardless of what you’ve heard, even from your doctor, there is no known safe amount of alcohol to drink while pregnant. This includes all three trimesters of the pregnancy, despite any messages you have heard to the contrary. In fact, the Institute of Medicine says, “Of all substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus.”

Here are six things you need to know about Fetal Alcohol Spectrum Disorders (FASDs):

1. Alcohol – any alcohol – can damage a fetus at any point during pregnancy. According to the Centers for Disease Control and Prevention (CDC), no woman of child-bearing age should drink alcohol unless she is using effective birth control effectively. (Look here for common myths about light drinking when pregnant: https://www.nofas.org/light-drinking/)

Why so strident?

2. Because half of all pregnancies are unplanned, and most women won’t know they are pregnant until after the first four to six weeks.

3. Alcohol is the number one preventable cause of mental retardation in the US, and up to 1 in 20 school children in the US may have a Fetal Alcohol Spectrum Disorder (FASD) according to the CDC. For the purpose of comparison, in the US, children with Autism Spectrum Disorders are 1 in 68. Down Syndrome? 1 in 700. Zika Virus? 5 children in all of 2016.

FASD is a big deal!

4. Children affected by fetal alcohol exposure may look like any other child, but alcohol can cause the brain of the child to be permanently damaged, causing poor coordination, hyperactivity, attention and memory problems, learning disabilities and other difficulties in school, among myriad other problems.

5. Children with Fetal Alcohol Syndrome (FAS) have additional problems that are more easily observed: abnormal facial features, small head circumference, shorter-than-average height, low body weight, vision and hearing problems, and heart, kidney, or bone problems.

6. Are men off the hook? Honestly, we don’t know. There haven’t been enough studies about how alcohol affects sperm, but we DO know that an intimate partner who doesn’t drink is the best source of support for the significant other not to drink.

No one intends to have a baby with an FASD, and preventing them is pretty simple for women of child-bearing age: use effective birth control effectively or don’t drink any alcohol. And if you know a woman who may not be conducting herself this way, start a conversation with her. Uncomfortable conversations save lives.

No appointment with a doctor seems complete unless we’ve received a prescription, and far too many of us think that only a prescription for opioids will relieve pain. Sure, opioids are effective painkillers; how could they not be as they are simply synthetic versions of opiates like morphine and heroin. They certainly do help, but in many cases their dangers outweigh their benefits. In 2014, 20,000 people DIED due to overdose of their prescribed pain medication. Today, 4 out of 5 people addicted to heroin started with prescription opioids. That’s right: 80% of those currently addicted to heroin started first by using prescription opioids. Maybe they weren’t using their OWN prescriptions, but the idea that there are so many prescription opioids available should frighten us all; enough opioids are prescribed each year to equal one bottle for every adult in this nation. Additionally, though the United States makes up only about 5% of the population, we use 95% of the WORLD’s hydrocodone (typically Vicodin) and 80% of the WORLD’s oxycodone (typically Percoset and OxyContin).

In 1987, before the widespread use of opioids for anything but surgery, pain related to cancer, and end-of-life pain, my father, who was a practicing alcoholic, was lying in the hospital, dying of cancer that had metastasized to his brain, and the family was warned that he shouldn’t get morphine for his pain because it was “addictive.” That’s right… in 1987 in Kenosha, Wisconsin, the medical professionals didn’t want to give my dying father who suffered from alcoholism and brain cancer a painkiller because it was ADDICTIVE. My, how times have changed. Now, it seems, we get those same addictive opioid painkillers for everything from an ingrown toenail to chronic, excruciating pain.

What we didn’t know then was that in the 1980s, pharmaceutical companies and the medical profession used research in which only 38 patients were studied (https://www.ncbi.nlm.nih.gov/pubmed/2873550) to say that opioids could be safely used long term and for many more conditions than acute and end-of-life pain. More studies had been called for along with these findings, but those studies were never performed. NEVER.

“Houston, we have a problem.”

Actually, we have two: first, opioids are overprescribed. So, what can we do about that? We can learn what works and ask our doctors and dentists for alternatives.

• First, there are medical alternatives:
  • Ibuprofen is as effective for pain relief of broken bones as opioids, and it’s safer, especially for children.
  • Acetaminophen is recommended as a first line of treatment by the American College of Rheumatology.
  • Steroids can inhibit injured nerves, providing pain relief.
  • Anti-depressants can sometimes treat nerve, muscular, and skeletal pain.
  • Anticonvulsants can relieve neuropathic pain.
• Aromatherapy studies have looked at patients with chronic pain, pain due to labor, and pain with other symptoms and have found that aromatherapy encouraged relaxation through the effects of touch and smell. Admittedly, more research needs to be done on aromatherapy as a painkiller, but as a treatment option, it’s relatively harmless and so worth a try! (https://www.psychologytoday.com/blog/overcoming-pain/201201/chronic-pain-and-aromatherapy)
• Hypnotherapy, generally hypnotic induction followed by suggestions of relaxation and comfort, has been shown in a meta-analysis to reduce pain in a variety of conditions. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752362/)
• Low-impact exercise can help improve mobility and functionality, and studies have shown that yoga and tai chi are effective in reducing pain. (https://nccih.nih.gov/research/results)
• Acupuncture, which uses needles to stimulate specific points on or under the skin, has been used in Eastern medicine for centuries, and according to the Harvard Medical School, a meta-analysis of more than 29 studies indicated that acupuncture was effective in relieving pain by approximately 50%.  (http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1357513)
• Massage is another alternative to medical pain management and has been supported by several studies, especially for non-specific lower back pain.  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1876616/)
• Physical therapy uses exercise, manipulation, and massage to address inflammation, stiffness, and soreness as it also helps the body heal itself.

Our second problem is this: opioids work on our brains to make us think we’re in more pain than we are. We’re told by prescribing medical professionals, “Take one or two pills every three to four hours. Stay ahead of your pain.” But because of how opioids trick our brains, soon one pill every four hours or so becomes two pills every three hours…until we are taking them even more quickly and NOT as prescribed. Taking opioids for more than two to four weeks generally causes an increase in tolerance…meaning that we’ll need to take more of the pills for the same effect. And THIS is what is so frightening.

Once tolerance builds, withdrawal symptoms are generally felt, if the opioids are reduced.

We are a country of individualistic people who think this will never happen to them, but approximately 2.5 million people in the US can tell us otherwise.

Consider asking your medical prescriber for an alternative to opioids because uncomfortable conversations save lives.