Monday, December 5, 2022

Hallie: Writing too many condolence cards

 

HALLIE EPHRON: Indulge me in a serious detour, a bit of a PSA to kick off WHAT WE’RE WRITING week. Serious, because this week it feels like the writing I’ve been doing lately is on condolence cards--condolence cards for the loss of friends, relatives, friends of relatives, most of them people in their 30s and 40s dying after overdosing on fentanyl.

Stupid, pointless deaths.

Apparently I’m not alone. The numbers are staggering. A piece in last week’s Washington Post reported that “More than 71,000 people died of synthetic-opioid overdoses in 2021 — more than the number of U.S. military personnel killed during the Vietnam, Iraq and Afghanistan wars combined.”



Think about that number.

I’m sure many of you were like me as a teenager, smoking my parents cigarettes behind the garage, trying marijuana in college. Wondering about LSD and sorely tempted to try it. And living to tell about it.

Today it’s a little white (or pastel-colored) pill, and there’s no way to know whether it’s going to get you high or kill you.


It takes about 2 milligrams of fentanyl to overdose. That’s all. A single tiny pill. And it's 50-100 times stronger than morphine and up to 50 times stronger than heroin. The CDC provides more information.

When given in time, Naloxone can reverse an overdose from opioids—including heroin, fentanyl, and prescription opioid medications. The CDC recommends: If you or someone you know is at increased risk for opioid overdose, especially those struggling with opioid use disorder (OUD), you should carry naloxone and keep it at home. It comes as a prepackaged nasal spray (generic naloxone, Narcan®, Kloxxado®). You can get naloxone without a prescription from pharmacies like Walgreens.

Please, talk to the young people in your life and put the fear of God in them. Exhort them: DO NOT TRY any pill anyone offers to you. Or even a drink a drink someone offers you in a bar. And if you’re addicted, get help.

I’m sure some of you are writing far too many condolence cards, too. Or, even worse, receiving them. Any advice on the best way to get the message across to folks who are willing to “try anything” once?

57 comments:

  1. Although I desperately wish I had an answer for you, Hallie, I have no idea why people still take chances when they know what could happen. This sense of “it will never happen to me” seems so foolish, yet it is obvious folks are convinced of that. Obviously, there is no easy answer here . . . . perhaps, instead of addressing the issue with those willing to “try anything,” we ought to enact laws to make the distributors responsible/accountable for the deaths caused by the drugs they sell . . . .

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    1. I totally agree with making distributors accountable for the deaths. They know what they are selling and the possible consequences. Although I haven't so far had to write any of those condolence notes, it's so heartbreaking for those who do.

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    2. It makes no sense to create a product that kills your consumers. And yet they've managed to flood the market.

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    3. Sorry, that last comment was me...

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  2. Absolutely heartbreaking, and I'm sorry you've had people you know die that way, Hallie. My little bubble hasn't included any such deaths so far (knock on wood), for which I'm grateful.

    When I started to read your post, I thought the deaths were going to be from COVID, since it's definitely not gone and is having another cold-weather upsurge.

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    1. Yes the upsurge of covid along with flu and that virus that's affecting children is very worrisome. Please, everyone, get vaxed and boosted.

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  3. HALLIE: That's a heartbreaking, sobering statistic. Sadly, the ophoid crisis is killing too many people here in Ottawa, too. But it's not just the young people who are indulging. I can see signs of drug addiction throughout the Byward Market neighbourhood.

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    1. For those of us who aren't familiar with it, Byword Market is a wonderful tourist area where museums, cafes, specialty food shops, boutiques, galleries, restaurants, pubs... are packed together. I'm not surprised to hear this, Grace.

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  4. It's a terrible problem! The WaPo also had a long piece about 8 young people in Greenville NC who all died of overdoses. It just broke my heart, thinking of the parents and the community. Here's a gift link: https://wapo.st/3Vz5oL3

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    1. Thanks, Gillian - parents, sisters, friends, and it's not like they don't know the risks. Yes, heartbreaking. You don't get a do-over.

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  5. Ah, Hallie, this is such an important thing to talk about--thanks for writing about it. As for figuring out a way to convince young people between fourteen and thirty that they are not invincible nor the exceptions to statistics and even laws of nature, that is very hard to do. Of course it's not the same thing, but when I remember that I never thought twice as a teenager about getting into a car with a friend who'd been drinking alcohol all evening (and what a comparatively sensible young person I was), then I truly can't imagine what would make most of today's kids take risks seriously. Except losing someone themselves, and I don't wish that on anyone.

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    1. I DO remember having had too much to drink myself and foolishly getting behind the wheel, gripping it and gritting my teeth to stay "in control" - such a stupid risk to take and yet... I"d never do that now, and I try never to drink so much that I have to make that choice.

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  6. Like you, Hallie, I tried a bunch of things in my young adulthood and got away with nothing worse than disappointment or a hangover. The dangers these days are, literally, life threatening. Part of being human is believing that the worst won't happen to us and then being shocked when it does. I think a powerful deterrent can be hearing from someone who has been through it and come out the other side -- like the 'scared straight' program.

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    1. It's why addicts in recovery can be effective counseling addicts or convincing the curious NOT to try.

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  7. This is also a huge problem in Northern Ontario, where I live. https://www.saultstar.com/news/local-news/opioid-deaths-hit-algoma-district-hard The chef at the golf course I belong to OD'd this past summer. He was 38. Not a naive kid. An adult with a drug addiction. I don't know what the answer is, but I do know it's not just kids.

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    1. Definitely not "just" kids - the people I know who've died lately were in their late 30s and 40s.

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  8. Hallie, it truly is a scourge. Our small, relatively rural community is not exempt from the problem. When fentanyl first hit the streets, we had a number of people die--one found dead in a friend's driveway. The county sheriff warned that fentanyl had been passed off as heroin, coming out of Cleveland into our area. And the deaths were not just young people, although many were.

    Older nephew had a few rough years in high school--he loved his cigarettes and weed but told me that although he was offered other stuff all the time, he always turned it down. I wish I could bottle his fortitude, because I'd give it away for free. Too many of the kids he hung out with in those days never made it to their 21st birthday.

    And to add to earlier comments--I have read about prosecutions of distributors when people have died from overdoses--no matter if that 'distributor' was a dealer or just a friend. It is a trend I applaud.

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    1. "told me that although he was offered other stuff all the time" - that's chilling.

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    2. I was terrified throughout those years, Hallie.

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    3. Drug abuse is much worse in rural areas without much hope or opportunity. If they can’t arrest dealers for selling, how will you relate them to a drug death? Literally impossible to prosecute and no legit prosecutor will bother. The problem is too endemic, Ohio and Kentucky are the worst places for this issue. Pharmacies refuse to stock the rescue drug, so your deaths will be much higher.

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  9. Oh gosh, Hallie, I’m so sorry. And thank you for writing about this. I think there is at this point almost no one in America left whose life hasn’t been touched by this; the place I grew up was the subject of an HBO documentary about the heroin crisis. Which is awful but hopefully helps with some of the stigma of speaking up about it. <3

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    1. Thanks for sharing, Zac - Heroin has its own kind of hell.

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  10. I have not been personally affected by this. However, in my virtual bereavement group there have been people who lost loved ones to overdoses. The people they lost were all seemingly successful in life, had a string of degrees, were beloved by nieces and nephews. Their families are fractured now and will never be the same. If really intelligent people in their twenties and thirties can get addicted, I don’t know what we can say to adolescents who are curious about trying drugs.

    DebRo

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    1. Thanks for sharing, Deb - I think once you've experienced the sudden (or even not so sudden) loss of a loved one to any cause, it changes your perspective on what risks you're willing to take. I know in my 30s I hadn't really grieved or felt profound loss.

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  11. We kept the dialogue going with our teens, and told them about the decisions we had made in high school regarding drugs, alcohol, and driving. We had a family code: if a teen phoned and asked "what time did you want me home?" our response was we would come get them immediately.

    Fentanyl is a terrible problem in Cincinnati.

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    1. Sounds like good parenting. I can't say we were ever that clued in as parents... and were lucky that our kids didn't need us to be.

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  12. So sorry, Hallie. How sad that you have a connection to so many whose hearts have been broken by the opioid epidemic.
    The risks we took seem mild in comparison. It surely is one thing to accept a toke on a joint being passed around the room, and accepting a pill that could hook you for life on opioids or snuff you out. As I recall my own risky behavior, I think that I had a line I wouldn't cross. But, would I have crossed it if I were young now? I did surprise myself quite often.
    The biggest question now is how can we raise our kids to understand the real risk.

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    1. What breaks my heart is that so many of the victims aren't kids. They're young (and older) adults. Often with kids of their own to raise. It's just devastating.

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  13. The thing about fentanyl is its amazing power. For doctors it must be a miracle drug. Last March I had my first ride in an ambulance. Due a meds mistake, I was bleeding into my replacement knee joint and my knee had swelled to the size of a ham. The pain was out of control — I have a high pain tolerance and had worken up in the middle of the night screaming. My husband frantically called an ambulance. The young women rushed into the house, strapped me to a gurney, and carried me through the snow to the ambulance. The whole time I was crying and screaming — and of course, apologizing. The girls said, 'Don't worry, we'll give you something." "Nothing works!" I sobbed between screams. (I had been on oxycodone uselessly for weeks.) "This will work." They found a vein, started an IV, and... instant silence. The pain was entirely gone. "Oh my goodness," I said, tears still wet on my cheeks. "What IS that?" "Fentanyl." A few months later my appendix ruptured (yes, 2022 has been a bad year for me) and I was once again writhing in agony. At the hospital they gave me morphine so they could try to get a CT scan. Morphine hardly took the edge off the pain as they struggled to hold me in place. "I know fentanyl works," I suggested helpfully. The anesthesiologist laughed. Apparently it ALWAYS works, but they were about to put me under general anesthesia for abdominal surgery.

    It seems the problem with fentanyl is that it is SO powerful and SO quick and takes SO LITTLE to have an effect. An addict accustomed to other drugs -- like oxy or heroin -- could easily be dead before realizing the mistake.

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    1. That IS the problem. It's a miraculous drug. I know people who got hooked on it just that way, from a doctor ordering it for otherwise intractable pain.

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    2. Does anyone else remember the ER storyline, where Dr. John Carter became addicted to fentanyl? I think that was the first time I'd heard of the drug, and the story made such an impression on me that I've never forgotten it.

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    3. I remember. Watched every episode of that show and still miss it.

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  14. I read the article, Hallie, so chilling. I don't know what to say, just so sorry for all the families out there because the pain of addiction and related death carries on in the survivors for the rest of their lives. You can see it all the photos of their parents and loved ones. Joyce W.

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  15. This is so sad. I cannot imagine how hard it is to be a parent or grow up now, one pill and that's it. No second chances, no feeling lousy enough the next day to swear you will never do it again, and then not doing it. The number of condolence cards say it all. It boggles the mind.

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  16. This is so profoundly sad. And no, I have no idea. It's so..inexplicable, and I know people sometimes feel sad or immortal or some of each, and kids have absolutely no idea of reality. WIth one grandson in college and one about to go into high school...this is such a terror.

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  17. HALLIE: This is so sad. A friend of a friend died from taking it because they thought it was candy! Just found out recently. I have known about fentaynl since people were trying to use it to lose weight. A college classmate was always worried about her weight and she was never fat, just pear shaped. A pear shape IS NOT fat! This same person was always trying to kill herself since both of her grandfathers, who were her anchors, died within weeks of each other. I warned her about the fentaynl and she did not care.

    Really hard to tell someone who is Hell Bent on killing themselves or "wanting to try fentayl" not to do it. Easier said than done?

    All I can think is to explain the risks to someone who is casually thinking of trying it and if that person will listen to you. That may work. Otherwise, if that person will NOT listen to you, then it is futile. I'm so sorry that is happening. So many people are in pain. And that darn pandemic is not helping either.

    When I had surgery, I made it clear to the surgeon team that I REFUSE any kind of opioids.

    Diana

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    1. Good for you, Diana - the first time I heard about Fentanyl was in connection with weight loss as well.

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  18. Oh Hallie, I'm so sorry.

    And it's not just taking "a little pill." Police are finding that many other drugs, including heroin and marijuana, are being cut with fentanyl. My brother told me a teenager in his high school died from smoking fentanyl-laced marijuana. So kids think they are "just smoking a weed" and it's much worse.

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  19. And you have great kids, Jenn... Sadly loosing someone does seem to be one of the few ways that the message gets through. Parenting through adolescence is challenging and this certainly raises the stakes.

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  20. Such horrors created by greed and addiction. It just sears the soul. I'm heartbroken for all your losses, Hallie.

    It's a mistake to think this is only an urban problem, too. The rural county where our farm is located has had a huge issue with fentanyl, as have many Ohio counties along the river. In fact, the oxycodone problem took wing in that rural area, thanks to one particularly unscrupulous doctor.

    What I can never understand is how otherwise intelligent people can watch friends die taking a single dose of this merde and STILL take it themselves. They know it could kill them, and they still want it. To me, that power is the real horror, the self-harm is an insufficient deterrent.

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    1. Karen in Ohio: Did that horrid doctor go to jail? Or did people file lawsuts against that horrid doctor?

      Diana

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    2. Jail, but not until many people went through hell and back.

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  21. Alcoholism is laced through my husband's family. My brother-in law is an alcoholic (struggling with sobriety) two of my children are alcoholics (one sober over four years, one working hard on it) and my husband has a "disordered relationship with alcohol," which dances around the borderline but doesn't quite go over. My third child has never had a drink and says she never will - and I believe her.

    All the love, support and education about alcohol abuse didn't prevent my kids from developing alcoholism, and all the tears, pleading and bribery didn't make them stop. So the only advice I can pass on is:

    Recognize addiction is something that has a genetic predisposition Some people can drink a glass of wine five times a week with dinner and never have any problem; others cannot.

    Read up on addiction. It's a whole set of behaviors, and for some people, rooted in untreated mental illness like anxiety, OCD, depression or BPD.

    Join Al-Anon or Nar-anon.

    Keep the lines of communication open. Just like when they were little, I kept reminding my kids that I didn't love their behavior, but I always loved them.

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    1. JULIA: Thank you for sharing. My father was orphaned because of alcoholism - his parents died too young. Because I was aware of the family history concerning alcoholism, I was always very careful with drinking alcohol. I would hold a glass of wine and maybe take one sip then stop drinking.

      If I happen to drink more, I always refill the glass with WATER so the waiter/caterer will think my glass is full and not add more alcohol. I remember an alcoholic refusing to take responsibility by saying that she did not ask for more wine - the waiter just refilled with more wine. Keeping that in mind, every time I took a sip of wine in a restaurant, I immediately refilled the wine with WATER.

      Someone sitting at my table noticed this and said that is a very good idea.

      And I never ever drink on an empty stomach.

      Very important to be aware of alcoholism. A friend and I met for dinner to celebrate our birthdays. She has been sober for a long time and we ordered NON alcoholic version of the lemon drop drink.

      Diana

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    2. Alcoholism is a curse that keeps filtering down through generations. My dad died from cirrhosis of the liver at age 39 after a life of pretty desperate alcohol abuse. One of my younger brothers committed suicide after trying to get clean and being unable to cope; the other brother has a serious drinking problem (my sister does not drink alcohol at all). One of my sons-in-law, whose own father was a bottle of whiskey a day alcoholic, is on that same path, and the other, whose mother is a recovering drug addict, has to struggle all the time with trying not to abuse alcohol.

      I never used to drink, at all, but have slowly added more alcohol to my life, which worries me. Way too many of our family times center around drinking, I'm afraid, and it's hard to see how my grandson will avoid that same temptation, with all the immediate examples in his life.

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    3. Julia, thank you for an excellent description of alcoholism and addiction, and suggestion about Al-Anon and Nar-Anon.

      My understanding of addiction is from a 12 Step perspective. The disease (and it IS a disease) is presented as threefold - physical, mental, and spiritual. And it is in NO way a respecter of *anything*, including age, education, social class or intelligence. Addicts, and I am one, incredibly fortunate to be clean and sober for 41 years, at times have absolutely no effective mental defense against the first drink, pill, or fix. For anyone who wants to know more about the topic, I highly recommend reading the chapter The Doctor's Opinion in the book Alcoholics Anonymous. It was written in 1939, but is still right on target. ~Lynda

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  22. My nephew died from fentanyl poisoning. My sister and the women she has met in similar situations call it murder. Because the people who make and pedal the drug do not care that it kills. They want it to addict. And that it does. For the peddlers, there will always be another behind the one that dies. And it isn't hard to target individuals.

    How do you stop this? Ye gods, I wish I knew. I know that my nephew self-medicated his ADHD and anxiety with the "help" of people he met in school. People who showed him how to make money off his prescribed medicine in exchange for something more exciting. The school's treatment of the situation exacerbated his social isolation and encouraged others to offer a place to belong, in the gang. Their threats against his mother (she is a single mom, he was an only, adopted child) kept him in line. He was dark skinned and even though not genetically black, the police in his town regularly referred to him with racial slurs and treated him roughly. Some of the same were directed to his mother -- his white, adoptive mother -- from strangers. I'm not saying that he wouldn't have found his own way to the drug, only that the world around him helped him to find it. His social isolation only increased with COVID. When BLM protests broke out, some of the demonstrations, gunfire included, were 2 blocks from their home. He didn't survive that summer.

    He was 19, My sister draws birthday cards to him in chalk on her driveway every year. This is our 3rd Christmas without him and I worry about her, too. She belongs to a large group of women in the same situation. There are that many. They would like you to know that there kids do not deserve vilification as "drug addicts" or whatever. They would like you to know that the people making money off the deaths of these people are murderers. They would like you to speak the names of their sons and daughters out loud and remember them. But can we stop it? I don't know. My nephew's friends grieve for him, and yet.....

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    1. Oh, C D Moulton, I'm so sorry for you and your sister. Addiction doesn't happen because of a lack of willpower or because a person is 'bad.' Stopping the drug production seems almost impossible.

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    2. Oh, C D … I am weeping for you and your nephew and his family …

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  23. Thank you for raising this, Hallie. The stories here are truly heart-breaking. I served on a federal grand jury in 2019-20 and probably 75% of the cases presented involved drugs, almost all meth and fentanyl. There are hard-working teams in every law enforcement agency, from the FBI to the post office, many in multiple-agency drug task forces, working to cut off the supply lines, but it's a many-headed monster.

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  24. Thanks for the thoughtful essay, Hallie. This is so terrifying. I already worry for my six-year-old granddaughter. I know I did a lot of stupid things as a teenager, but there wasn't the threat that one tiny pill could kill you. It is truly heartbreaking.

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  25. Drug addiction is simply a plague, but it's a plague we treat with shaming, incarceration, and worse. You can't discuss it with friends. Our family has struggled with a heroin addict for years and often street drugs are laced with fentanyl. He has overdosed multiple times and has indeed been saved several times by narcan, which is an incredible drug. I'm not sure what the answer is, but certainly rehab should be more accessible. Drug courts should always be preferable to jail for addicts. We are lucky. We could afford to send our loved one to rehab. He has been multiple times and he is at the moment sober, but it's like living on a knife's edge. I do indeed try and live one day at a time, as does he.

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    1. Robin, my heart is with you. I know what it's like. So difficult. Hugs. Valerie

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  26. My condolences, Hallie. My granddaughters have friends who have died from fentanyl. Early on my son was addicted to meth. But he has been clean for 25 years, has three beautiful and smart daughters, and owns his own business. But as I've seen with addicts, the stories aren't like that. I know your heart must be heavy with all the losses. Big hug.

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  27. Yes, it feels very much like a suicide... even when it emphatically is not deliberate.

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