Oh-Crap Sunday: Addiction, Family, and the Holidays

The treatment discussion revs up between Thanksgiving Thursday and Cyber Monday

Real talk: If you put off the substance use discussion until the New Year, you might not have a chance to have the discussion. Addiction is a disease. People die. And they only can dig themselves deeper into destruction during the Holidays without help.

That's news as ice cold as Wausau, Wisconsin or the turkey leftovers you stuffed into the back of the freezer. By the way, you're never going to eat that. It tasted dry on Thanksgiving... it won't get better by March by itself. Likewise, a drug user won't get better by March (or Christmas) by himself.

Oh-Crap Sunday means more than you blew through your entire holiday budget on Black Friday and Small Business Saturday. It's more relevant than your favorite NCAA team getting crushed on Rivalry Saturday, or your NFL team being worse than the Bears on any given Sunday at the twilight of the calendar. Oh-Crap Sunday is the pause at the start of the Holiday Gauntlet where you have an a-ha moment after the first of the season's socializing, realizing that a loved one is in over his or her head with alcohol or other drugs. Oh. Crap.

Help starts at home

What does 'in over their head' mean? Noticing someone's drug use – alcohol is a drug – means it is a problem. You don't notice someone's consumption otherwise. The nodding off is more than turkey's tryptophan. The slurred speech telling the same joke loudly for the third time isn't just because Uncle Dan is mixing the drinks. The fragrance in the bathroom isn't potpourri. Wise up. Trust your instinct. You're probably right about a drug use problem. If you're wrong, what does it cost you?

We've normalized drug use in the U.S. as pointed out in Look What Dragged the Cat In. With it being normalized, the tendency is to blow it off until it gets obvious. Then it's time to get help.

In looking for help, there is no substitute for intervention at home. You can go to every slick treatment website Google throws at you. Nobody's going for an evaluation until the personal, charged conversation takes place at home. Work with your M.D. or a treatment professional to find the right path toward 'clean and sober' after the Oh-Crap conversation. The first step is the conversation.

Drugs alter the mind, talk to the heart

Consider that all drugs of abuse licit and illicit alter the mind. An altered mind isn't going to decide for itself that it needs help. People don't take drugs to feel good, they take drugs to feel less bad. If the brain's user is going to feel more bad, he or she is going to be messaged by that brain that the drug isn't a problem. A person first needs to hear from family and friends that the drug use is concerning.

The talk is harder than you think. But not harder than talking to a corpse. Alcohologist.com has resources like videos (see the New Year, New You series opener here) that help ease into the conversation. The three-question AUDIT is also an ice-breaker/resolve-breaker.

Quick: What's the next holiday? Will you spend it without him or her in your life?

Image by Roman Stetsyk, used with permission.

Only officials drunk on alcohol money would call opioids the 'biggest health crisis'

The maker of OxyContin, Purdue Pharma, and the company’s controlling Sackler family agreed March 26 to pay $270 million to settle an Oklahoma lawsuit claiming they helped create the opioid crisis with aggressive marketing of the painkiller. “The $270 million is less than what the lawyering would have cost Purdue. The did the 'right' thing,” says author Scott Stevens.

This is the first settlement emerging from wave of nearly 2,000 lawsuits against Purdue threatening to push the company a bankruptcy safe-haven, says the author of Look What Dragged the Cat In: The Rise of an Opioid Crisis. In the book, presented in hardcover at academic conferences in Europe in 2018 and now available in e-book, Stevens demonstrates how the neither the drugmaker – nor doctors – are to blame in the 'ab irato' lawsuits. “Are their hands clean? No. But they didn't create this crisis, or the two it's spawned (benzodiazepines and methamphetamine),” according to Stevens.

Oklahoma Attorney General Mike Hunter announced the settlement, calling the crisis “this nightmarish epidemic” and “the worst public health crisis in our state and nation we’ve ever seen.” Stevens responds, “First, the death toll from opioids in Oklahoma is about 400. They're all tragic. No question. Alcohol kills at least 1,300 a year in that state. If opioids are an epidemic, alcohol is a pandemic that costs their state $4.5 billion a year, and the U.S. 90,000 lives and $250 billion a year.” His numbers are according to the Centers for Disease Control and Prevention (CDC). “We don't call out the real problem because the alcohol business is an an advertiser, a campaign contributor, and an adored and endorsed part of our culture.”

The fifth book by Wisconsin author, Scott Stevens, calls out the beverage alcohol business and a 'buzz' culture, not pharmaceutical companies and doctors, as the culprits behind the opioid crisis. Stevens says, “If you examine how many opioid-related deaths are alcohol-related, the answer is that they all are. Two thirds of illicit drug users point to alcohol as their first drug, and all of us learn to self-prescribe from alcohol.”

The book was released Aug. 23, 2018 at the International Conference on Addiction Therapy & Clinical Reports in Paris, France, capping two-years of research by the author into the escalation of opioid overdoses. “It's the same root cause of every drug 'crisis' we've observed. Cocaine in the 1980s, heroin again in the 1970s and before that the 1920s, and between the two prior heroin crises, a methamphetamine crisis in the 1950s,” says Stevens. “The thread cinching all of them together is alcohol: The drug we don't call a drug or treat as the deadly drug it is. We encourage use of this drug, then when users can't get where they want with alcohol, they up the ante with other, harder drugs. No runner runs a marathon as their first race out.”

The book examines the self-regulation of alcohol-industry ads, the pricing, and availability of alcohol. “There really is a straight-line relationship between the opioid crisis with the gateway drug, alcohol.”

The World Congress on Addiction Science in London in Sept. 2018, as well as the 2018 International Conference on Clinical Psychology in Amsterdam, also were forums for launch of Stevens' work. He's now doing radio and conferences in support of the e-book launch of the book March 26.

Stevens has no ties to the pharmaceutical industry, nor does he practice medicine, yet he finds only moderate culpability for either profession in the rise of the opioid situation. “They were accomplices to some degree, but we fail to look deeper. What causes problems is one. We just have this fear of tagging the alcohol business because of our glorification of drinking.” The book points out that society also has a notion that anything resembling reining in the alcohol business looks like Prohibition, generally considered a failure. Americans also don't 'want to believe alcohol is a drug or a problem outside of car wrecks, cirrhosis, and disease of alcoholism. “We're told we can drink responsibly when there is no responsible way to drink a toxin and known carcinogen. Buying into the glamour of the drug seduced Americans right into opioids.”

Americans defend the gateway drug, says the author. Among his solutions is a strategy like the anti-smoking campaign that began with the Master Settlement Agreement for tobacco companies in the 1990s. “We defend drinking as some sort of rite. All we're doing by guarding drinking as a personal choice is sacrificing our own children for a product with zero life-extending or life-saving properties.”


Stevens is author of five alcohol, health, and recovery books and is principal of alcohologist.com. He is a founding influencer of the world’s largest medical portal, healthtap.com. He Chaired the 2018 International Conference on Addiction Therapy and Clinical Reports in Paris, France, where Look What Dragged the Cat In was officially launched. He's also the Chair for Addiction Science 2018, in London, UK.

Image byTom Baker, used with permission.