10/12/14 Doug McVay

Doug McVay: The CDC releases data on alcohol involvement on so-called opioid and other drug overdoses, we hear from ONDCP Acting Director Michael Botticelli and SAMHSA Administrator Pam Hyde on Recovery, and college debaters this season are discussing an end to prohibition.

Program: 
Century of Lies
Date: 
Sunday, October 12, 2014
Guest: 
Doug McVay
Organization: 
Drug War Facts
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Century of Lies October 12, 2014

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DEAN BECKER: The failure of Drug War is glaringly obvious to judges, cops, wardens, prosecutors and millions more. Now calling for decriminalization, legalization, the end of prohibition. Let us investigate the Century of Lies.

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DOUG McVAY: Hello and welcome to Century of Lies. I'm your guest host, Doug McVay, editor of Drug War Facts dot org. Century of Lies is a production of the Drug Truth Network, which comes to you through the Pacifica Foundation Radio Network and is supported by the generosity of the James A. Baker III Institute for Public Policy and of listeners like you.

Find us on the web at drug truth dot net, where you can find past programs and you can subscribe to our podcasts. You can follow me on twitter, where I'm at drug policy facts, and also at doug mcvay. The Drug Truth Network is on Facebook, be sure to give its page a Like, you can find Drug War Facts on Facebook as well, please give it a like and share it with friends.

Now, on with the show.

I've been complaining for a very long time about the fact that feds and states seem to ignore the role that alcohol plays in so-called drug-related emergency department visits and mortality, and in recent years specifically in regard to opioid overdoses and OPR-related deaths. Finally, the CDC has released a report with some data on the problem. The new issue of Morbidity and Mortality Weekly Report features this article: Alcohol Involvement in Opioid Pain Reliever and Benzodiazepine Drug Abuse-Related Emergency Department Visits and Drug-Related Deaths - United States, 2010. The following is from the report, quote:

"Based on DAWN ED estimates, in 2010 in the United States, there were 438,718 ED visits related to OPR abuse and 408,021 ED visits related to benzodiazepine abuse, alone or in combination with other drugs. Of the OPR ED visits, an estimated 81,365 (18.5%) involved alcohol; of the benzodiazepine ED visits, 111,165 (27.2%) involved alcohol (Table 1). When restricted to ED visits where OPRs or benzodiazepines were the only drug classes involved, alcohol was involved in 26,446 (13.8%) OPR visits and 38,244 (34.1%) benzodiazepine visits. "Of the 3,883 OPR deaths in the 13-state DAWN ME data in 2010, 860 (22.1%) involved alcohol. For benzodiazepines, 324 (21.4%) of the 1,512 deaths involved alcohol (Table 2). Among single-drug class deaths, 393 (26.1%) OPR and 44 (72.1%) benzodiazepine deaths involved alcohol. OPRs stronger than hydrocodone, such as fentanyl, methadone, and hydromorphone, tended to have less alcohol involvement for both ED visits and deaths. "In 2010, the percentage of ED visits that involved OPRs and alcohol was highest among persons aged 30-44 years (20.6%) and 45-54 years (20.0%) (Figure). For benzodiazepine ED visits, the percentage was highest among persons aged 45-54 years (31.1%). ED visits involving alcohol and OPRs or alcohol and benzodiazepines were significantly more common among men than women: 22.9% for men for OPRs compared with 13.5% for women and 30.6% for men for benzodiazepines compared with 24.1% for women. "Among OPR deaths, persons aged 40-49 years (25.2%) and 50-59 years (25.3%) had the highest percentage of alcohol involvement. For benzodiazepine-related deaths, the highest percentage (27.7%) was among persons aged 60 years." End quote.

The report notes that these findings are consistent with other research, quote: "The results of the FDA and CDC analysis are consistent with previous reports. In West Virginia in 2006, 17.3% of unintentional pharmaceutical overdose deaths had alcohol as a contributing factor. In the National (Nationwide) Inpatient Sample, the largest publicly available all-payer inpatient health care database in the United States, among persons aged 18 24 years, alcohol overdose was present in 20% of overdoses of opioids and related narcotics. Men had significantly higher rates: 25% compared with 15% for women, and were more likely to be hospitalized for overdoses combining opioids and alcohol. The nationwide study also found that the percentage of overdoses combining alcohol and drugs was higher among persons aged 25 years compared with those aged 18 - 24 years (8). " End quote. The CDC concluded that, quote: "The fact that approximately one fifth of OPR drug abuse related ED visits and drug-related deaths involve alcohol suggests the need for stronger prevention measures to mitigate this significant public health problem. OPRs and benzodiazepines are prescribed and dispensed by health care providers, and this presents an opportunity to discuss their risks, especially the serious risk of central nervous system depression when combined with alcohol or other depressants. However, only 16% of adults in the United States have discussed alcohol consumption with a health professional (9), and the percentage discussing other substance use is unknown. Interventions such as combined prevention programs that target alcohol and prescription drug abuse, systematic provider and patient education, and integration of screening and intervention services into the primary care health system to enable early identification of problematic alcohol and drug use might reduce the number of ED visits and deaths related to drug abuse and alcohol." End quote.

A bit after-the-fact but for those who are unsure, the CDC is of course the Centers for Diseases Control, DAWN is the federal Drug Abuse Warning Network. E Ds are Emergency Departments. M Es are Medical Examiners, and OPRs are opiate pain relievers.

We're going to take a short break. You are listening to Century Of Lies, a production of the Drug Truth Network. I'm your guest host Doug McVay, editor of Drug War Facts dot org. Century Of Lies is heard on 420 Radio dot org on Mondays at 11 am and 11 pm, and Saturdays at 4 am, all times are pacific. We are heard on time4hemp dot com on Wednesdays between 1 and 2pm pacific along with our sister program Cultural Baggage. And we're on The Detour Talk Network at thedetour.us on Tuesdays at 8:30pm. A few of the stations out there that carry Century Of Lies include WERU 89.9 FM in Blue Hill, Maine; WPRR 1680 am 95.3 FM in Grand Rapids, Michigan; WIEC 102.7 FM in Eau Claire, WI;A WGOT-LP 94.7 FM in Gainesville, FL; KRFP 90.3 FM in Moscow, Idaho; and Free Radio Santa Cruz 101.3 FM in Santa Cruz California.

Welcome back.

Last month, the White House hosted an event to celebrate Recovery Month. Here is some audio from that event, featuring the acting director of the office of national drug control policy, Michael Botticelli, and the administrator of the substance abuse and mental health services administration, Pam Hyde.

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[applause]

MICHAEL BOTTICELLI: Good afternoon, everybody. Good afternoon and, David, thank you for that introduction.

I want to welcome everyone on behalf of the President to the Whitehouse. It is an incredibly exciting day. It’s an exciting month and it’s an absolutely exciting time for people in recovery both here and around the nation.

To everyone who’s watching us on Livestream, thanks for joining us. We have friends from Alberta, Canada all the way to Austin, Texas and everywhere in between. I hope you’ll also make your questions on Twitter.

I want to begin by thanking and recognizing Senator Whitehouse who is with us here today.

[applause]

He’s going to say a few words here in a minute but I really want to thank him and his colleagues – particularly Senator Portman for their legislative support on many issues that are important to all of us in the room today and particularly his support for Americans in recovery.

Thanks to the co-chairs of the Congressional Addiction and Recovery Caucus who will be joining us shortly - Congressman Tim Ryan and Paul Tonko – for taking the time to be with us today.

I also want to recognize long-time friends former Congresswoman Mary Bono and former Congressman Patrick Kennedy who are here today.

[applause]

Despite the fact that they have left congress they have not diminished their passion for this work and they continue to be tireless champions in the community and in the nation for the work that they do.

I also want to acknowledge and thank SAMHSA Administrator Pam Hyde who is with us today.

[applause]

As well as Principle Deputy Administrator Kana Anamoto and the tireless SAMHSA staff especially Paula Devecio, Evette Taurus and our newest addition into the family, Tom Coderre from Rhode Island.

[applause]

SAMHSA’s leadership and support for recovery-based approach has been unparalleled and, Pam, we appreciate your leadership and all that you do.

We also want to recognize the Equal Opportunity Employment Commissioner, Hyde Felbum, who is expected to be with us today. We would like to thank her for partnering with us to address the barriers to employment for people in recovery.

We are also happy to see Al Hozania from Veterans Affairs. Al, where are you? I know we met earlier....there he is – welcome.

[applause]

He’s a great partner of ONDCP in working to address issues that affect veterans and veterans in recovery.

We also have great state champions with us today and we are pleased that the Secretary of Commerce from the state of Kansas, Pat George, who is right back here and has traveled with us. We are so glad that he is in the room.

[applause]

I think all of you know having champions and partners at the state level is really critical to our work.

I also want to point out that we have 2 ONDCP Advocates for Action who are in recovery and in the audience today – Dr. Stephen Loyld from the Mountain Valley Medical Center in Tennessee...Stephen – where are you? Good to see you.

[applause]
And Scott Stroud the founder of Phoenix Multisport...Scott? There he is over there.

[applause]

I would also like to acknowledge our partners in prevention who are here today and joining us online. While we are talking today about recovery we know fundamentally that this is a preventable disease and we are making great strides in progress in preventing substance use in the United States.

I would also like to give a special shout out to David Meneta, his staff and all of 6the ONDCP staff not only for organizing today’s event but for their tireless efforts. I am truly fortunate that I get to work with such committed staff on a daily basis.

I’m going to try to get through the next part without losing it but odds are not good. As a person in long-term recovery I am honored to join you today. Over 25 years ago when I began my recovery journey I could have never have imagined that I would be here today. I just wanted to stop drinking and for the hurt to go away. I wanted the pain in my soul to end.

I could not have foreseen that I would find joy and friendship and love, that I would be a responsible and contributing member of my community, that I would be a loving husband and family member, that I would get a life free of the shackles of addiction. I am sure many in the room can say the same thing today.

We all would not be here and I would not be here if it wasn’t for the courage, leadership and hard work of all the people that came before us and for all of the work that the people in this room and all around the country do on a daily basis. We are tremendously grateful.

It’s hard to believe they we’re already celebrating the 25th anniversary of Recovery Month. In 1976 the National Council on Alcoholism (now the National Council on Addiction and Drug Dependence) convened a national event to raise awareness in an effort to reduce the stigma associated with alcoholism.

That event, called Operation Understanding, marked an historic occasion. National figures such as Dick Van Dyke, baseball great Don Newcome, astronaut Buzz Aldrin and numerous other luminaries publically spoke about their substance use disorders and their recovery.

The event put a face on the disease of addiction and it began to chip away at the misconceptions and stigma too often attached to substance use disorders. The people who spoke out were well-known individuals – many like whom we have gathered here today – who are heroes in the eyes of many people.

Just two years later another historic moment occurred. First Lady Betty Ford spoke about her addiction to alcohol and prescription drugs – once again breaking the silence and shame that is attached to substance use disorders.

It’s unclear where it originated but there is a quote that says, “It’s hard to hate up close.”

Putting a face on disease and addiction and telling our stories is a vital part of our work. It is why we are here today. Many great social movements have been fueled by the simple yet courageous act of people who are affected coming out of the shroud of secrecy and invisibility. These efforts were often led by the youth of our country so we are particularly counting on you.

There have been many accomplishments over the past 40 years including the formation and expansion of drug courts, a dramatic increase in evidence-based prevention and treatment, decades of scientific research that has given us an irrefutable understanding of addiction as a health issue - the call by the American Medical Association to treat substance use disorders as a disease, the development of effective therapies and medications, better integration with the rest of the health care system.

More recently the passage of the Mental Health Parity and Addiction Equity Act and the Affordable Care Act which is ushering in a new era of fair and equitable access to treatment and recovery for the millions of Americans who need it.

There have been mistakes along the way. Too many people in need of treatment are simply incarcerated. Jails and prisons should not be our de facto treatment system and life-long consequences are imposed on those convicted of drug crimes. These consequences too often stand in the way of stable housing, employment and education. We are addressing these issues.

Part of what we’ve learned is the knowledge that we need to do more than just treat the symptoms of a substance use or mental health disorder. For people to reach their full potential and contribute to their communities we need to raise awareness and reduce the stigma associated with substance use and mental health disorders, build community–based recovery support services, promote wellness, and ensure that laws, policies and practices do not create unnecessary barriers to recovery.

Substance use disorders and mental health illness are still too often seen as moral failings through a lens discoursed by stigma, blame, fear and hate. One of the ways that we know we can reduce stigma is simply by changing our language. As Professor John Kelly (who is here with us today) from Harvard Medical School found out through his research describing someone as an abuser leads to blame and punitive attitudes even among trained clinicians.

As with other diseases it is important that we lead with the individual – not the disease. We are people with substance use disorders. We are not addicts, drunks or junkies.

[applause]

Thanks. I didn’t pause for applause I just needed to change the page. Recovery is possible and it can transform us into the very best and brightest this nation has to offer. There are millions of us. We serve in elected office and we are in our armed forces. We lead Fortune 500 companies. We are teachers, students, police officers, shop owners, researchers, athletes, journalists, entertainers, clergy, clinicians and advocates. We are your family. We are your friends. We are your neighbors and we are your colleagues.

Our community spans geographic, culture, social and economic boundaries. Together we have the power to transform our nation just as recovery has transformed us.

I am proud and tremendously excited to welcome all of you to the Whitehouse to celebrate this day and this month and this movement. We look forward to hearing from all of our guests today.

Thank you very much.

[applause]

Now it gives me great pleasure to introduce a dear friend and colleague, Administrator Pam Hyde from SAMHSA. I think many of you know the tremendous amount of leadership and advocacy and support that we’ve gotten through Pam and her staff’s leadership at SAMHSA.

I meant what I said when I think of under her leadership the work that we have done to transform our system into a recovery-orientated system of care. You have much to be proud of and we can’t say enough how much we value your friendship and your work. Thank you, Pam.

PAM HYDE: Thank you, Michael. I with the entire crowd am proud of being your biggest fans. I’m so pleased to be here. Thanks to him and all of the ONDCP staff for all the work they did to make this event happen and to, frankly, all the SAMHSA staff who are also here and who worked together and the dedicated people behind the National Recovery Month, partners - One-quarter of a century illuminating and validating the fact that people can and do recover from addiction and from mental illness. SAMHSA cares about both.

I want to especially thank the SAMHSA leadership that is here today and I won’t repeat because Michael did me the pleasure of saying something about a few of them. I do want to acknowledge that we are pleased as punch to have Tom Coderre on staff now. He is a senior advisor and that means we get to work him as hard as we want to...we are already working on that. We are thrilled that he is with us.

I think our country is at a tipping point. Several of us have said this but we are. We are at a tipping point. In the last 25 years since the Recovery Month began...in fact, just in the last few years since the recovery movement has really I think become more vocal and the research and the treatment of addiction and mental illness has become more accessible the country has really seen a tremendous change in the way people think and talk about recovery.

Now there are still some people who are skeptics. There are still some people who think we are wasting our time. I get that about SAMHSA from now and then...got that this morning as a matter of fact but we all have to make sure that we keep working together to make sure that people understand recovery is possible and it is legitimate and it is an important thing for us to spend time and effort celebrating and pushing.

Our vision is this future where people who are in recovery share and celebrate their successes proudly with family and friends and people with mental health and substance use issues aren’t hesitant to seek help or treatment and that it is there for them when they need it and communities recognize that prevention and treatment and recovery support initiatives are critical to their community’s health so they actually support and invest in those initiatives.

Those of you who participated in the event that happened at the Press Club on September 4th know that we released some data that day. Yesterday SAMHSA released more data on substance abuse and I want to share just a few numbers and trends with you to add to what we talked about a week or two ago because the 2013 data shows that we have actually some good things to celebrate and, frankly, some things that are not so good, that we need to still work on.

The 2013 data that we released yesterday show that there’s actually been a reduction in non-medical use of pain relievers among persons 12 and older since 2009. That’s good news. The problem is it hasn’t moved much in the last year or two and is sort of flattening out. There are some issues within that we need to pay attention to.

Past year heroin use continues to rise since 2007 and past month heroin use has risen as well but at a lower rate. The overall rate of heroin use is pretty low but it is rising and we need to pay attention to that.

Now the data gives us some particularly good news about young people age 12 to 17 which is something that we can really celebrate because we’ve been putting a lot of effort collectively on prevention for young people. Between the ages of 12 and 17 the rate of illicit drug use actually continues to fall since 2009. Marijuana use is actually even down among this group. The use of psychotherapeutics is down from 2012. Inhalant use is down. Hallucinogens are down among that age group.

Unfortunately between the ages of 18 to 25 we are not doing so well. For this group illicit drug use overall was kind of flat but that’s because there were some decreases in some areas and, frankly, a lot of increase in marijuana use. So we are watching this. There is a significant increase from 2008 to 2013 in marijuana use. Therapeutic use is down some. Hallucinogen is down some and cocaine use is down some from 2005.

In my age group past month “any illicit drug use” among 50 to 64-year-olds continue to trend upward since about 2002 so in the last decade. For those who are 55 to 59 if you are in that age group it was about 1.9% in 2002 and it’s now about 5.7% in 2013. That’s a problem.

Among 60 to 64-year-olds (which I will admit is my age group) there was a rise within the last ten years. These Baby Boomers are mothers and fathers and grandmothers and grandfathers of youth that we are trying to prevent from starting use in the first place so we have to get the message of prevention and treatment and recovery to my generation so our sons and daughters and their kids don’t see use of drugs as a way to enjoy life or ease their troubles or avoid the difficulties life inevitably brings and so they don’t deal with the issue of addiction.

I want to say a quick word about marijuana. We’re all concerned about it among all groups age 12 and older daily marijuana use has increased over the last few years and the percentage of those using marijuana 20 or more days in the last month has risen significantly in the last decade. That’s just to 2013. We’re watching closely to see what the decisions in various states and various communities are going to do in terms of those data.

As you know unfortunately the data show us that a lot of people that are indicating the need for treatment there is a profound gap between those who need treatment and those who get it. While we have much to be proud of we also have a lot more to do.

Today is not about data even though I wanted to share that with you. It’s about promoting the power of recovery. That’s what we are here today. As we look toward the future of the next 25 years we will soon move past this year’s celebrations and events and marches and even Whitehouse events and redouble our efforts because in the end we all know that Recovery Month is about lives. It’s about the lives of our friends and neighbors, our brothers and sisters, our aunts and uncles, our kids and grandkids. It’s about ourselves. It’s about our families, our communities. It about the human condition and, ultimately, it is about hope.

Getting people’s attention – the attention of nation is hard work. Part of that hard work is being done by those you are going to hear from today. They are making their voices heard and I just want to acknowledge that speaking up with a personal story of recovery is courage in the purest form. These folks are our heroes.

Advocating tirelessly on behalf of Americans who may have experienced addiction or mental illness and who are in recovery is the stuff of heroes – some who have already been introduced today. I have the pleasure now of turning over the mic to once such hero, the United States Senator from the great state of Rhode Island, Senator Sheldon Whitehouse.

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DOUG McVAY: And finally: The college Cross-Examination Debate Association debate season is underway. The core resolution which students around the nation are debating in the 2014-2015 seasons is, quote: "Resolved: The United States should legalize all or nearly all of one or more of the following in the United States: marihuana, prostitution, online gambling, the sale of human organs, physician assisted suicide." End quote. I would be remiss if I didn't direct any college debaters out there who may be listening to a website that will be incredibly useful: Drug War Facts dot org. With direct quotes, full citations, and links to the original source materials, Drug War Facts dot org is the premier information resource on drugs, drug use, and the drug war, with sections covering all aspects of drug control policy in the US and also in many other nations around the world.

Well, that's it for this week. I'm Doug McVay and this was Century of Lies. Thank you for listening. You can find a recording of this show and past shows at the website drug truth dot net, where you can check out our other programs and subscribe to our podcasts. Follow me on Twitter, where I'm @ Drug Policy Facts and @ Doug McVay. The Drug Truth Network is on Facebook, be sure to give its page a Like, you can find Drug War Facts on Facebook as well, please give it a like and share it with friends. Spread the word. Remember: Knowledge is power.

We'll be back next week with more news and commentary on the drug war and this Century Of Lies. For now, for the drug truth network, this is Doug McVay saying so long. So long!

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For the Drug Truth Network, this is Dean Becker asking you to examine our policy of Drug Prohibition.

The Century of Lies.

This show produced at Pacifica Studios at KPFT, Houston.

Transcript provided by: Jo-D Harrison of www.DrugSense.org