Special Guests:
Susan Bartz Herrick
Slow Dancing with the Devil: A Son's Substance Use Disorder, A Mother's Anguish
AMA President-elect Dr Bobby Mukkamala and Dr. Arun Gupta
Quick Pulses of Full Conversation: Tachyons, Soundbites, Takeaways..
Call to Ban Fentanyl and Political Action
So what I'm saying is let's, have the federal government say, let's ban fentanyl. And I'm giving them some adjectives. You can call it poisoning, a federal crime, a public health crisis, a war against America, a weapon of mass destruction. And if they can't pass the law by that many adjectives, then I don't know, they need to consult more lawyers. But it has to be done. I am happy to see there are more and more, you know, we are living in this political season now of all the commercials, you know, but I'm happy to see both sides are starting to bring this to the surface. I hope they're serious about it. I, I truly do. There are some politicians that care, but they need really to be heard and they, they need to take it seriously. And I think now is the time for people who have lost loved ones to this, to push politically because you know, all these people are running for office. This is a good time………….
Struggles in Getting Suboxone for Addiction
I can comment on that a little bit. When we were going through even before Luke's accident, that he had gotten dependent on it. I had one doctor tell me he was bipolar. So we went through the Depakote, Seroquel, all this, and it made him almost crazy. And I found a psychologist who said, ma'am, your son is not bipolar. He is addicted to Oxycontin. And he is terribly depressed. What you need to do is to get some Suboxone. I said, well, great. Can you give it to me? And he said, oh no, only an MD. And I said, okay, fine. He said, but there's a catch. Only if you've had this certain class and Which is exactly what Dr. Gupta was talking about. And I said, what sense does this make? Doctors can pass out Oxycontin like pests, but you have to have this special class, only see so many patients. You know, I searched, I searched………..
Learning from Global Approaches to Addiction and Homelessness
So I'll say two things. Second thing, first, homelessness and street lives. I was in South Africa, Johannesburg in 2007. There's an area for roughly two miles by two miles, which had constructed living quarters for all the people with addiction issues. And that was built way before 2007. So everybody lives in this community. They have a roof, they have a bed, they have a toilet in there, and the needs are met. If Africa could do it 20 some years ago, why can't we do it in America? Okay, that's my challenge. regarding the Portugal stuff. So in 2008, 2009, they felt, it's a 10 million people population. They felt that the problem was at the peak. So they created a central agency and said, we're going to treat everybody with addiction like any other chronic disease. So they started the treatment and felt these patients needed more. They said they were demotivated in their life. They didn't want to do anything. But they created programs to reverse their demotivation. Then they rehabilitated them, educated them, job training, job placement……….
Addressing the Stigma of Substance Use Disorders
So I'm writing. Go ahead, Susan. All right. The only thing I would like to say is ask people to check themselves for a stigma bias that they might have and to look deeper into the problem and to encourage those who do have SUD or children with is to think about the big picture instead of what will people think about me, you will help to save lives. So that's my pitch. So regarding stigma, I say, I attend a lot of meetings and everybody says, let's get rid of stigma, let's reduce stigma. And I say, it's not like I step out of the building and it starts to rain. I'm going to open my umbrella and I'm not going to get wet. Stigma is not going to go away by itself. We have to put in effort. So I say we need to create mandatory education. Like we uselessly talk about implicit bias…….
Political Awareness and Grassroots Efforts Against Fentanyl
I am happy to see there are more and more, you know, we are living in this political season now of all the commercials, you know, but I'm happy to see both sides are starting to bring this to the surface. I hope they're serious about it. I, I truly do. There are some politicians that care, but they need really to be heard and they, they need to take it seriously. And I think now is the time for people who have lost loved ones to this, to push politically because you know, all these people are running for office. This is a good time. When you do the numbers, Michael, if you've got 300 people a day and they all have parents, And you times that by a year, by 10 years, that is an incredible amount of people who have been touched by this. Online, on Facebook, you know, we try to get together. There's a man by the name of Ed Bish who is just an incredible activist out there getting people together in Washington. Just the parents to make a stand and to get noticed. Is there yet a formal grassroots entity or organization to lobby to really do this yet? There are many small fentanyl awareness groups. One of the biggest challenges that we have in this is number one, we're so, uh, devastated, you know, that it, it's hard to be proactive, you know, when your heart's on, but also, and I think this is huge. It is the stigma.
Systemic Neglect in Handling SUD Patients
And that's what we ran into. My book documents our experience. Experiences at some of the best hospitals in the country. Nurses didn't know that he needed to be treated differently because he had SUD. He was going into surgery. You can't use just any anesthesia. They did not know. And they thought I was crazy. Because I did the research. I was fortunate that I had a girlfriend who was an anesthesiologist who stepped in and said, oh, no, no, no, no. Let's do it this way. But they didn't know. And furthermore, they didn't care. We had to go once into the ER. Luke had a blockage. And it was on his chart that he had SUD. And they treated him as you're just a drug seeking kid. And I'm there and they treated me as, and you are his enabler. And I said, Luke, open up your shirt so they can see. And of course they see this huge scar. So they decided to do a CT scan. And then they came in very apologetic and said, yeah, you have got a 35% blockage. But that's how people who have addictions are treated.
A Tragic Loss and the Need for Action Against Fentanyl
And it is so ironic and tragic, of course, that it was that that took him down. He was looking for a medication to help his anxiety. He had general anxiety disorder, which is one of the precursors. And he tried to go to a clinic first, but the line was three hours long and he knew better. He made a mistake by asking a friend because he knew the risk. He was a very popular speaker out in LA. In the AANA community. It was a bad choice. And he had a very high tolerance. What the police told me is that the amount that he took, that he was not alive by the time he hit the floor. It just, he was gone. It's terrible. So what I'm saying is let's have the federal government say, let's ban fentanyl. And I'm giving them some adjectives. You can call it poisoning, a federal crime, a public health crisis, a war against America, a weapon of mass destruction. And if they can't pass the law by that many adjectives, then I don't know, they need to consult more lawyers. But it has to be done.
The Unnecessary Stress and Regulation in Addiction Treatment
I mean, this underground great treatment, it made no sense. And it still makes no sense. In 2016, I was at a limit of 100. One of the major doctors in my town said, was shut down by the government because he was overprescribing. They accused him for everything. And I got scared because I said, if this highly qualified pain specialist, anesthesiologist, addiction doctor can be shut down, then government can come after that. So every two months, I'll put on my answering service, we are closed for new patients for addiction. So one lady, she wrote a page in my book, tried for two years during the time to get in as a new patient. She luckily survived during the time. And then she's very happy that she's here with me for the last seven, eight years and doing very well. So that's the kind of stress that not only put on the patients, but on the doctors and the families. And it's not necessary, right? Can you imagine that you can't get your insulin a day early?
How Suboxone Works and Its Risks
And so this is a real ignorant question, but how does it work, the drug? And is there no very limited risk of, there's no overdose from that? I mean, if you took just a gallon of it, I mean, what with Suboxone? So Suboxone can cause respiratory distress. So if you're taking benzos with or drinking alcohol with it, it will suppress your breathing and you could get in trouble. But otherwise, it's not a toxic drug in limited dosages. It binds to the mu-opioid receptors in the brain very tightly once the narcotics leave the brain. Whether you're taking heroin, fentanyl, methadone, bicarbonate, oxycontin, once you're in withdrawal and you take this new medicine, it binds tightly. And then if you need to take narcotics, you go for surgery today, the narcotics are not going to work. So I have to put these people into withdrawal for two to three days so that this medicine leaves the brain.
Fentanyl Issue: Beyond Politics
So much focus politically is, um, a political issue of fentanyl across the border. Yes, it's a problem. However, all of these other things, if we fix that, We have to just stop focusing just on that and get into exactly what you just talked about. Take it seriously and not just use it as a political tool. That to a parent who has lost their child to fentanyl and watch it just be a political tool is such an insult. There are a million kids that have been displaced because the only parent is not there anymore. We have a bigger problem brewing up. And it's going to get worse.
Systemic Issues in Addiction Treatment
But that's how people who have addictions are treated. This disease is not taken seriously. And that is because exactly what Dr. Gupta said, that doctors don't know, they're not trained. And there are studies out there to show that there is an innate like a stigma or a bias. Yeah. Yeah. It's really, it's just really unfortunate. Yeah. By doctors, a bias for the doctors. Susan, you're talking your experience, what happened 10 years ago. You'd be shocked to know I deal with a very large crowd of these patients. These things have not improved 1% even today. Okay. So the system really needs to be changed and educated.
Susan's Personal Tragedy and Mission
My name is Susan Herrick and I'm a retired professor of speech and theater. I also have a doctorate in human development. Years ago, I used to work at a substance abuse center. Little did I know that that experience back then would take me into the very heart of substance use disorder. And unfortunately, my son was addicted and he lost his life to a fentanyl overdose. And I decided to take my pain and turn it into a book, Slow Dancing with the Devil to help other people that hopefully they would never, ever have to get that phone call that I did.
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124 Raising awareness about how to fix the opioid epidemic in America, Dr. Arun Gupta, Susan Herrick