Opioid Summit Involves Google and Facebook

opioid

The U.S. Food and Drug Administration (FDA) is hosting an Opioid Summit today, June 27, 2018, in Washington D.C. Government entities, academic researchers, and advocacy groups are attending the event, as you’d probably expect. Unexpectedly, internet stakeholders, as well as senior executives from major search engines like Google and social media platforms such as Facebook and Instagram are also participating. Why would the FDA, led by Commissioner Scott Gottlieb, M.D., invite the movers and shakers of Silicon Valley to such an event? The answer, to combat illicit opioid sales over the internet.

Most people have heard or know a little bit about the “dark web;” home to multiple online marketplaces that allow people to exchange illicit goods. Users can peddle and procure just about anything in the far corners of the world wide web; and, those engaging in such activities are, theoretically, protected by proxy servers and virtual private networks (VPNs). Disguising one’s internet protocol (IP) address allows people to buy and sell things like heroin and counterfeit passports, evading the watchful eye of authorities, most of the time. You have probably heard about the dark web marketplace known as The Silk Road; if so, you know that the FBI shut it down and arrested its founder Ross Ulbricht in 2013. Ulbricht is now serving a life sentence without the possibility of parole, which you’d be right to think should deter others from having similar aspirations. It didn’t!

Today, the internet is home to even more black marketplaces than before. The number of sales and profit generated on the most popular sites people now rely on for illicit goods dwarfs that of the preceding Silk Road, according to findings by RAND Europe and researchers at Carnegie Mellon University.

Hiding In Plain Sight

Not everyone looking to sell opioids online has the know-how to set up shop on the darknet. An even more significant number of people on the hunt for prescription painkillers or heroin do not understand how or have the tools to access dark marketplaces. Many people take a more cavalier approach to purvey and procure opioids over the internet; advertisements for online pharmacies abound on the plain old internet on search engines and social media sites. While some good many websites are scams to harvest private information from the naive, plenty of these sites make good on their promise.

Earlier this month, the FDA reached out to some 53 online pharmacies instructing them to cease and desist, or face severe legal consequences, Wired reports. A study conducted by Carnegie Mellon University shows that online illicit drug sale revenue increased from between $15 and $17 million in 2012 to between $150 and $180 million in 2015. Whether more people are acquiring their drugs from internet pharmacy sites or on the dark web is somewhat irrelevant, what is salient is how to stop the practice.

Addressing the problem of drug dealing on the web is more urgent than ever considering the rise of synthetic opioids like fentanyl, carfentanil, and U-47700 or Pinky. Dealers disguise the substances mentioned above as more popular and less dangerous opioids like OxyContin, and they carry an enormous risk of fatal overdose. On average, 115 Americans succumb to opioid misuse every day in the U.S.

Opioid Summit May Devolve Into A Blame Game

At this point, it is hard to tell what, if anything, will come out of the meeting in Washington today. Reports show that in the days leading up to the summit, tech representatives and lobbyist began tossing blame around. The Center for Safe Internet Prescribing (CSIP) released a report showing that majority of drug sales happen on the dark web, and that open web offers for opioids were more likely to be scams. Libby Baney, an advisor to the Alliance for Safe Online Pharmacies, argues otherwise to Wired:

If all drug sales happening on the internet were on the dark web, I'd throw a party. Then the vast majority of Americans would be safe."

Tim Mackey, an associate adjunct professor at the University of California, San Diego, and fellow researchers found that online links on Twitter and Facebook offering up for sale illegal items originate on the darknet. Professor Mackey, who will speak at the summit, says:

What’s happening on the dark web is a lot of business-to-business sales. The digital drug dealers are sourcing from the dark web and using social media to sell directly to consumers.”

It’s worth noting that Facebook will direct users attempting to purchase opioids to addiction treatment resources, instead. Google played a significant role in the most recent National Prescription Drug Take-Back Day. And, according to CSIP—which is backed by tech giants—117 million ads attempting to sell illicit goods were blocked last year.

Proactive Approaches to Opioid Use Disorder

Dark web, open web, prescribed by doctors or not; lives hang in the balance if significant corporations in the tech sector cannot work together with government agencies to stem the tide of opioid addiction in America. There is an opportunity here to put a stop to illicit online opioid sales. The problem is here, and we cannot afford to ignore it, the United States Senate Permanent Subcommittee on Investigations released a report presenting incontrovertible evidence that average Americans can purchase illicit opioids online. Another report from the National Association of Boards of Pharmacy shows that when searching online for prescription opioids, nearly 91 percent of the first search results led users to an illegal online drug seller offering prescription opioids—regardless of the search engine.

Social media companies, search engines, and domain registrars are in a unique position to nip, at least some of these kinds of practices, in the bud; not only redirecting people to addiction treatment services but having a hand in saving countless lives.

Opioid Use Disorder Treatment

If you or a loved is struggling with opioid use disorder, please contact PACE Recovery Center. We offer clients gender-specific, extended care treatment for males in the grips of progressive mental health disorders.

If you have suicidal ideations, please contact the National Suicide Prevention Lifeline: 1-800-273-8255

WHO Adds Gaming Disorder to the ICD

gaming disorder

The World Health Organization’s (WHO)11th edition of its International Classification of Diseases (ICD), released Monday June 18, 2018, includes "gaming disorder." The addition of “digital-gaming” or “video-gaming” addiction to the ICD as a new mental health condition probably doesn’t come as much of a surprise for most people; especially considering just how far the industry has come since the advent of games like pong and how many people are spending multiple hours a day “leveling-up.”

Once video games found their way into people’s households with Atari, followed then by the Nintendo Entertainment System (NES), it was clear that the sky was the limit. Today, the myriad of games and various types of games is unbelievable; and, the emergence of online gaming allows users the ability to play endless games endlessly. Yes, that’s right, there isn’t a finish line or final stage in the most popular titles people are engaging with; ostensibly, an individual can play ad infinitum. Even if someone manages to find the end of a particular maze, game developers will promptly release a patch expanding the border of the playable realm.

Not long ago there were limits on how far a person could go in a game and the amount of money they could spend. Take a game like Super Mario Brothers for instance; people bought the game and played it and there was a final stage with a boss to be vanquished. Upon beating the boss that was all she wrote! Sure, you could play the game again, but you were not going to spend more than your initial purchase. Conversely, the games people play today, regardless of the gaming system (i.e., PlayStation, XBOX, or PC), offer players downloadable content(DLC); attaching credit card numbers to "Gamertags" allows users to buy DLC to give their character an edge or a custom look.

How Many People Play Video Games?

It’s safe to say that there was a time that the majority of people playing video games in the early day were young males. While young men continue to make up the market share of gamers, a good many females play regularly. There was, and still is, a number of stereotypes that people attach to gamers, social recluses, and nerds to name a few; however, as the technology gets better and more take part, it becomes difficult to blanket label the types of people who game. The result: gaming becomes normalized; a significant number of celebrities fancy “first-person shooters” or racing games. There isn’t anything inherently wrong with digital-gaming, to be sure.

When we talk about gaming, we would be remiss if we fail to point out that smartphones open up a whole new market. App games like Candy Crush eat up a significant amount of time of millions of people each day; even though they lack some of the bells and whistles video game systems boast, apps are quite captivating and allow people to play-on-the-run.

The annual Global Games Market Report shows that there are 2.2 billion active gamers in the world in 2017; of which, 1.0 billion players (47%) spend money while playing and generated $108.9 billion in game revenues. People pay to play smartphone games which produced revenue of $46.1 billion in 2017, claiming 42% of the market. The above figures make clear that an unbelievably significant number of people are not only gaming, but they are also spending money to play after the initial purchase. It is also safe to contend that some individuals are spending money they don’t have to continue to chase after an in-game item, often called “loot,” the acquisition of said item elicits a particular feeling. Sound familiar?

What is Gaming Disorder?

WHO’s website defines “Gaming Disorder” as a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.

For gaming disorder to be diagnosed, the behavior pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.

Preëexisting Mental Health Conditions

There is still much to learn about the dangers of devoting increasing amounts of time to offline and online gaming. However, the available research shows stark similarities between problematic gaming and other forms of addiction. Researchers who had a hand in the World Health Organization's landmark decision to include gaming disorder to its list of mental health diseases write, “Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated.”

You probably would have guessed that there are critics of WHO’s decision to include gaming disorder to the ICD. Some opponents are working for the industry, so we all should meet their opinions with some skepticism; however, Dr. Netta Weinstein, a senior lecturer in psychology at Cardiff University, tells The Guardian, “I just feel like we don’t know enough yet.”

Weinstein points out that only a statistically small number (nearly half that of gambling disorder) of gamers experience adverse symptoms that affect their lives. A big concern of hers is about comorbidity, having more than one mental health condition. In the field of addiction medicine, more times than not, people presenting symptoms of addiction also meet the criteria for a co-occurring mental health disorder such as depression, PTSD, or bipolar disorder. In many cases, mental illnesses like depression often give rise to addiction via the process of self-medication. Could it be that people are excessively gaming to the point of disorder, in order to cope with a preëxisting mental health condition? Weinstein says:

We need to know that it is about the gaming [gaming disorder] itself, or we’re treating something that’s not the actual problem.”

Dual Diagnosis Treatment

If you or a loved is struggling with alcohol or substance use disorder and any one of many mental health diseases, please contact PACE Recovery Center. We offer clients gender-specific, extended care treatment for males in the grips of progressive mental health disorders.

If you have suicidal ideations, please contact the National Suicide Prevention Lifeline: 1-800-273-8255

Suicide Rates Steadily Rising In America

suicide

The majority of people with a history of alcohol and substance abuse wrestles with the life and death quandary of how — and whether or not — to live. It is probably fair to say that most people in recovery can remember a time when they gave some consideration to calling it quits (i.e., suicide) on the enterprise of existence. In the darkest hours of one’s addiction the mind is no longer an ally; and, it can be hard to move forward when an individual can no longer trust him or herself to make rational choices. A quote from William Burroughs, “every man has inside himself a parasitic being who is acting not at all to his advantage,” might tolerate an update; each person living with a mental illness, has inside himself a parasitic…

The desire to end one’s life is compounded too when attempts at sobriety fall flat; adopting a program of recovery is no simple matter, and those who might characterize themselves as chronic relapsers are apt to lose hope. If the term “chronic relapser” resonates with you, it is worth trying to keep in mind that relapse is part of many people’s story; there are a good many people with long-term sobriety who came in and out of the rooms of recovery for years before finally grasping what was necessary for lasting progress.

Those who were once the epitome of hopelessness find themselves, now, living fulfilling lives; what finally changed in each of the individuals mentioned above is subjective, but more times than not treatment reignites the fires of hope for a meaningful life. Such people ultimately find the courage to carry on, even when their disease tries to reassert itself, vying for the spotlight once again.

Suicide in America

There is only one really serious philosophical question, and that is suicide. —Albert Camus, The Myth of Sisyphus

Vital Signs, a report by the Centers for Disease Control and Prevention (CDC), shows that the rate of suicide in the United States increased 28 percent from 1999 to 2016; almost 45,000 Americans age 10 or older died by suicide in 2016. In the last half-decade, we’ve seen many notable people succumb to suicidal ideations; attempting to understand why individuals who have everything (seemingly) would opt for deliberately killing oneself has had a lasting effect on all of us.

Robin Williams committed suicide in 2014. Nearly four years have passed, but doesn’t it feel like yesterday? It is difficult to not think about all the remarkable people that left indelible marks on society and then checked out prematurely. Even a cursory inquiry reveals several parallels between famous people committing suicide; mental health disorders are a foregone conclusion and, more times than not, substance use plays a significant role. And finally, the ever insidious stigma of mental illness continues to prevent people from getting help.

There is almost too much to consider when it comes to trying to make sense of the driving forces behind felo de se (Latin for "felon of himself"). The act of deliberate self-destruction is a discussion that we have to have, especially in the light of the recent deaths of fashion icon Kate Spade and culinary raconteur Anthony Bourdain. In every sense, the Internet is abuzz with rumor and speculation regarding the untimely demise of both stars; and, in almost every case, that which people are focusing on misses the most salient point. Rather than blaming, we must center our attention on dismantling stigma and encouraging treatment.

Stigma is The Key

The topic of stigma is one that comes up often; in fact, this blog features several articles on the subject. The two recent suicides, occurring just days apart, demand that we discuss stigma at greater length. Some of the reports circulating the web right now include interviews with people close to both Kate and Anthony. One such instance is an interview between the designer's older sister, Reta Saffo, and the Kansas City Star; the other is an open letter from actress and activist Rose McGowan who was close friends with Anthony and his partner, Asia Argento.

In order, Reta Saffo tells the newspaper that Kate’s death was not unexpected. Saffo says that on numerous occasions she made attempts to get Kate into treatment, “we'd get so close to packing her bags, but — in the end, the 'image' of her brand (happy-go-lucky Kate Spade) was more important for her to keep up. She was definitely worried about what people would say if they found out." Kate’s husband published an open letter in the New York Times stating that she was seeing a doctor for the past five years and was taking anxiety medication for a mood disorder but was not abusing alcohol or drugs. There seem to be differences in opinion regarding Kate’s relationship with alcohol; some fashion insiders claim that her drinking was significant.

If Saffo view is accurate, that concerns about brand and image stood in the way of Kate seeking treatment, it something that millions of people can relate to today. Being “branded” as mentally ill prevents people from seeking the care they need; without treatment, such people are exponentially more susceptible to suicidal ideation and making good on their intentions. The case of Bourdain, it seems, is something altogether different.

Men Don’t Ask for Help

In an interview, Bourdain gave to addiction expert, and father of an addict, David Sheff (Beautiful Boy), Anthony says he struggled with cocaine and heroin since he was around 13-years old. When asked about getting clean in the 1980’s, he reveals a less-than-orthodox approach to recovery; while he gave up the coke and heroin in rehab, Anthony never wholly turned his back on marijuana and alcohol. Instead, he tells Mr. Sheff:

I reached a point where I thought, This is horrible. I’m not saying it’s any particular strength of character or anything like that. I’m definitely not saying that. This notion that I’m so f*cking tough and such a badass that I can kick dope without a 12-step program—that’s not what I’m saying. I don’t hold myself up as an example or an advocate or as anybody, okay? I made my choices. I’ve made f*cking mistakes. I made it through whatever confluence of weird, unique-to-me circumstances—I’m not going to tell anybody how to live, how to get well or any of that sh!t.

In the end, though, it wouldn’t be heroin that killed Mr. Bourdain; instead, a decade's long battle with depression, likely compounded by the use of alcohol. In McGowan’s open letter at the behest of Asia Argento, Rose points out that Anthony was the product of a generation that solves problems on sheer will alone. Hubris, perhaps?

Don’t Let Stigma and Pride Stand In the Way of Recovery

The life-and-death problem of whether, and by what method, to exist was likely on the minds of both Kate and Tony. Countless people will offer insight into their suicides; some will get things right and others will not. We will never know for sure what was going on in the troubled minds of the above icons, and that is OK. Moving forward, we all must set ourselves to task in reinforcing the possibility of recovery; Our mission is to encourage people to look past the barriers to treatment and fight for their lives. There is no shame in asking for help!

Anthony was 61, the same age my father was when he died. My father also suffered from intermittent deep depression, and like Anthony, was part of a “pull up your bootstraps and march on” generation. The a “strong man doesn't ask for help” generation. I know before Anthony died he reached out for help, and yet he did not take the doctor's advice. And that has led us here, to this tragedy, to this loss, to this world of hurt … Anthony's internal war was his war … There is no one to blame but the stigma of loneliness, the stigma of asking for help, the stigma of mental illness, the stigma of being famous and hurting. —Rose McGowan CC: Asia Argento

Help is available to all who can bring their self to surrender. Each time a person seeks help the stigma of mental illness becomes weaker and snowball recovery is a real possibility. When people seek treatment and find recovery they empower others to do the same; a life in recovery is not perfect but the joy of striving for something meaningful outweighs the alternative.

Dual Diagnosis Treatment

Life is complicated, made even more challenging when substance use and misuse accompany mental illness; but, you are not alone, treatment works, and recovery is attainable! If you would like to begin a journey of lasting recovery, PACE Recovery Center can help. Please contact us today.

The Gentlemen of PACE Recovery Center would like to offer our heartfelt condolences to the friends and families of Kate Spade and Anthony Bourdain.

If you have suicidal ideations, please contact the National Suicide Prevention Lifeline: 1-800-273-8255

PTSD Awareness Month: Learn, Connect, and Share

PTSD

June is PTSD Awareness Month; we can all help those affected by post-traumatic stress disorder. PTSD is a severe iteration of mental illness that requires treatment and daily maintenance; those who recover rely on a combination of trauma-focused psychotherapy, counseling, and non-narcotic medications. Unfortunately, the overwhelming majority of individuals living with the affliction never receive the kind of care they require; such persons are apt to turn to drugs and alcohol to cope which only serves to make the underlying condition more serious.

Those of you in recovery from alcoholism and substance use disorder are no strangers to trauma; after all, people’s active addiction often involves one uncomfortable experience after another. In some cases, traumatic experiences precipitate the use of mind-altering substances; in other scenarios, people’s substance use puts them into situations where experiencing trauma is almost a foregone conclusion. Human beings are capable of putting themselves at great peril due to mental illness; as a result, one both inflicts wrongs upon others or are their self the victim of another person's’ wrongdoing; in either case, being OK in one’s skin and sleeping at night is not an easy endeavor.

The painful incidents that occur during active addiction often lead to a vicious cycle; using leads to trauma and one of the reasons people continue to use is to quiet the internal echoes of one’s past discomforting episodes, and at a certain point, one loses sight of where the trauma ends, and they begin.

Trauma is a time traveller, an ouroboros that reaches back and devours everything that came before." —Junot Díaz

Signs and Symptoms of PTSD

Not surprisingly, PTSD is one of the more common co-occurring mental health disorders accompanying alcohol and substance use disorder. While treatment is effective and long-term recovery is possible, people living with the afflictions like PTSD often struggle accessing assistance. Encouraging people to seek help is of the utmost importance, and society benefits when those struggling receive aid.

In order for individuals to get treatment we first need to discuss what the condition looks like; the signs manifest differently in each person, but the National Center for PTSD lists four symptoms:

  1. Reliving the event (also called re-experiencing symptoms). You may have bad memories or nightmares. You even may feel like you're going through the event again. This is called a flashback.
  2. Avoiding situations that remind you of the event. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
  3. Having more negative beliefs and feelings. The way you think about yourself and others may change because of the trauma. You may feel guilt or shame. Or, you may not be interested in activities you used to enjoy. You may feel that the world is dangerous and you can't trust anyone. You might be numb, or find it hard to feel happy.
  4. Feeling keyed up (also called hyperarousal). You may be jittery, or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. You might suddenly get angry or irritable, startle easily, or act in unhealthy ways (like smoking, using drugs and alcohol, or driving recklessly.

PTSD, Self-Harm, and Suicide

Most people associate post-traumatic stress with combat; those returning from conflicts overseas often experience lingering effects from exposure to trauma. However, PTSD doesn’t just affect veterans, a noteworthy percentage of general public struggles with the condition, as well; in fact:

  • About 7 or 8 out of every 100 people (or 7-8% of the population) will have PTSD at some point in their lives.
  • About 8 million adults have PTSD during a given year. This is only a small portion of those who have gone through a trauma.
  • About 10 of every 100 women (or 10%) develop PTSD sometime in their lives compared with about 4 of every 100 men (or 4%).

In the absence of treatment, people rely on using drugs and alcohol to cope with their feelings of hopelessness, shame, and despair. While mind-altering substances may quiet one’s anxiety and depression, alcohol and substance use tend only to exacerbate the underlying condition. It’s worth mentioning again that self-medicating mental illness is a vicious cycle; the behavior is a sure path to addiction, self-defeating behaviors, and self-harm. There is a robust association between PTSD and suicidal ideation or attempts. If you or a loved one is contending with thoughts of self-harm, please call the National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255).

Encouraging PTSD Treatment

Greater understanding and awareness of PTSD will help Veterans and others recognize symptoms, and seek and obtain needed care." - Dr. Paula P. Schnurr, Executive Director of the National Center for PTSD

During June, the National Center for PTSD asks that everyone take some time to Learn about PTSD and the valid forms of available treatments; Connect with support services for yourself or a loved one—reach out for help; and Share what you learn about PSTD with the world via social media. When we work together to take the mystery out of mental illness, we can encourage more people to seek help.

At PACE Recovery Center, we can help you or a loved one learn how to navigate life without resorting to drug and alcohol to cope with symptoms of post-traumatic stress disorder. Our highly qualified team of addiction professionals can address your co-occurring mental health disorders and teach you effective coping skills. Please contact us today to learn more about our programs.

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