Another “drug related death” ? How easy it is to “bend” the stats ?

Suicide and Pain: The Silent Epidemic

http://www.painmedicinenews.com/ViewArticle.aspx?d=Commentary&d_id=485&i=October+2015&i_id=1234&a_id=33865&tab=MostRead

On Oct. 26, 2003, two patients of mine, Randy and Helen—a married couple in middle age and both weary with chronic pain—attempted a dual suicide. Randy succeeded by overdosing on the methadone that was prescribed for his pain. His wife was either lucky or unlucky, depending on your point of view. She survived and was afterward confined to a psychiatric ward for several days.

The social worker who walked into their house that fatal weekend found not only Halloween balloons bobbing eerily but also Christmas presents neatly wrapped. Did this couple always shop early for presents, or had they determined that their plans to exit this life shouldn’t cheat the grandchildren out of holiday presents?

A pile of papers, suicide notes and a will left for family and authorities to find seemed to indicate that the plans had been percolating for several months at least. After the fact, Helen’s daughter conveyed to me her belief that the couple had been talking it over between themselves for at least a year.

After Helen was discharged from the psychiatric hospital, she returned to the clinic where I worked for further treatment of her pain. She opened up about the reasons why she and Randy wanted to die. Randy, she said, had 18 diagnoses and “his pain was outrageous.” Multiple illnesses are correlated with higher suicide risk, and multiple medical problems are common in patients with chronic pain.1 The pain turned to anger for Randy, Helen said. “Lots and lots of anger.”

“At whom?” I asked.

Everyone, Helen said. Everyone whom Randy believed had let him down. For instance, Randy was angry with the doctors who he believed were undertreating his pain. When I asked Helen for her reasons for trying to end her own life, she pointed to an abusive first marriage and a stressful relationship with Randy. Her own pain played a major role, too. She said, “I didn’t have anything to lose. I didn’t have anything to look forward to except pain.” She had fibromyalgia and cervical disk herniation with neck pain, causing constant headaches. She also wanted to be with Randy in the afterlife where they both would be free of pain.

How common is it for people with chronic pain—people such as Helen and Randy—to attempt or complete suicide? It’s difficult to know with any degree of certainty. A potential deficit in our ability to understand the real prevalence of suicides in people with chronic pain is the way the Centers for Disease Control and Prevention (CDC) classifies opioid overdoses. The source of the CDC data comes from medical examiners and coroners. In most states, if an opioid is believed to have contributed to the death but there is no suicide note or other overt evidence that the death was intentional, such as copious amounts of opioids in the stomach at autopsy, it will be classified as unintentional or intent undetermined. In the absence of concrete evidence, it is difficult to know whether the death was truly accidental or intentional. However, an unintentional or undetermined classification allows for civil insurance claims to proceed against the prescriber and for collection on life insurance. Although not a prime reason for classifying deaths as unintentional, such considerations may be factors on occasion. However, the reality of the decedent’s intention may be different in some instances.

A problem results in understating the prevalence of pain-associated suicides, thereby concealing the effect that pain has on the suicide rate. By not understanding the true contribution of pain to the prevalence of suicides, we tragically miss an opportunity to reduce the rate. Intentionality is obvious when someone uses a firearm to end one’s life, but it is less obvious when a person in pain chooses to end his or her life with the medications prescribed for pain.

It is hard to prove the correlation of opioid overdose deaths and pain, so we need to triangulate the data. One interesting observation is that the most common age for suicides from poisoning in the United States (namely, 45-64 years of age) corresponds to a similar age for unintentional overdose deaths (45-54 years of age).2 Furthermore, the CDC reported more than a 400% increase in opioid-related overdose deaths from 1999 to 2010.3 During that same period, the reported suicide rate for adult men increased almost 30% for 35- to 64-year-olds. This is the same age range with the highest prevalence of opioid overdose deaths.4 It is unlikely that we are looking at coincidence.

In addition, the means to end life when pain overwhelms is close at hand, because medications used to treat pain can also be used for the purpose of suicide. The CDC reports that, in 2013, there were approximately 1 million suicide attempts and nearly 40,000 completed suicides in the United States.5 The suicide rate has been increasing in parallel with the number of opioid prescriptions, just as the rate of opioid overdoses has paralleled opioid prescribing. This, too, is probably not coincidental.

People with chronic pain are at high risk for suicide for many reasons. In a recent registry study from Denmark involving 1,871 people with chronic pain, 6% had attempted suicide.6 The authors stated that this reflected a 3.76-fold increased risk for suicide attempts versus people without chronic pain. Risk factors included mental health disorders, social separation or isolation, substance use disorders and “intractable” pain.

Nicole Tang has recently reported that the most significant predictor for suicide attempts in people with pain is “mental defeat.7” Mental defeat is a state of mind marked by a sense of a loss of autonomy, agency and human integrity. It occurs when the fight just doesn’t seem worth it anymore. It is a person’s retreat from his or her battle with pain.

As with Randy and Helen, people may just find that there is no reason to live. If they have been dealing with a chronic pain problem, prescription drugs are likely close at hand. Feelings of hopelessness, seeing “no way out,” social isolation, mental defeat and severe pain intensity are all present in many with intractable pain. It is intuitive that some of the overdoses classified as unintentional are actually intentional, or at least the result of willingness to accept death in an attempt to escape pain.

The effects of suicide on family, friends and communities are devastating and far reaching even long after a loved one has taken his or her life. People in pain who take their lives have usually struggled with shame, the stigma of pain, marital problems and financial problems, and have been treated as if they are drug addicts or lowlifes unworthy of respect, attention or love. Unfortunately, public policy supporting our ability to collect data that could help us understand and prevent many of the tragic deaths has not been a priority. In fact, too often the finger points to the agent (drug) rather than the underlying cause (pain). Defining an overdose as unintentional when it may not be may mislead and conceal an epidemic of suicide.

There are important steps that we should take to address this lack of awareness and data:

  • First, we need to acknowledge that the CDC data may be incomplete and imperfect in defining the intentionality underlying the death.
  • Second, we must recognize that providing opioids to people with severe pain may be providing them the means to commit suicide.
  • Third, and most importantly, we should agree that pain not adequately relieved is a major public health problem that deserves more equitable research funding so that lethal drugs are not a necessary treatment.

It is time that people in pain, and we who have devoted our careers to helping them, demand better treatments. Lives depend on it.

References

  1. Juurlink DN, Herrmann N, Szalai JP, et al. Medical illness and the risk of suicide in the elderly. Arch Intern Med. 2004;164:1179-1184.
  2. Centers for Disease Control and Prevention. Ten leading causes of injury deaths by age group highlighting unintentional deaths, United States-2013. www.cdc.gov/​injury/​images/​lc-charts/​leading_causes_of_injury_deaths_highlighting_unintentional_injury_2013-a.gif.
  3. Centers for Disease Control and Prevention. Unintentional drug poisoning in the United States. July 2010. www.cdc.gov/​HomeandRecreationalSafety/​pdf/​poison-issue-brief.pdf.
  4. King SA. Pain and suicide. Psychiatric Times. June 13, 2013. www.psychiatrictimes.com/​suicide/​pain-and-suicide.
  5. Centers for Disease Control and Prevention. Featured topic: World Health Organization’s (WHO) report on preventing suicide. www.cdc.gov/​violenceprevention/​suicide/​who-report.html.
  6. Stenager E, Christiansen E, Handberg G, et al. Suicide attempts in chronic pain patients: a register-based study. Scand J Pain. 2014;5:4-7.
  7. Tang NK, Beckwith P, Ashworth P. Mental defeat is associated with suicide intent in patients with chronic pain. Clin J Pain. 2015 Jul 21. [Epub ahead of print]

Substance abuse is a mental health disease

https://youtu.be/pH1aJlquDm4

when the shoe is on the other foot

An emergency physician goes to the ER, and is shocked at the care she receives

http://www.kevinmd.com/blog/2015/11/emergency-physician-goes-er-shocked-care-receives.html

I have lately been discussing the state of health care with a lot of doctors. I’m a doctor, and I’m also a consumer of health care services.

Imagine my surprise when I visited a local ER on a three day weekend, hoping to get some advice from someone who might be able to use the panoply of diagnostic tools available in the ED to help me mitigate the pain of a finger fracture that was threatening to derail a visit by my grandchild?

Well, not only was I billed for an exam that never occurred, but I was billed way too much — totally out of proportion to any value received. As a physician trained in emergency medicine, I received my board certification in 2001 from the American Board of Emergency Medicine. It’s pretty unlikely that I would feel the necessity to consult with a physician assistant. In fact, I said exactly that as I registered in the ED, hoping I would be able to obtain some relief from a digital block and perhaps, if appropriate, a reduction of the fracture. I was, at the very least, curious about the nature of the obvious fracture I had incurred. I asked to see a doctor.

I’ve already discussed this with peers. One did ask: “Why on earth would you go to the ED?” Well, frankly, I went on the advice of other colleagues, who suggested it was a good idea to determine the extent of the fracture — I didn’t get that x-ray vision with my medical school diploma — and some fractures truly need a hand surgeon. Again, a three-day weekend and the pain was significant; the last time I went to an ED was for a lumbar puncture, so it’s not my first response.

The PA failed to examine my hand. In my own residency, I would have been fired for failing to document a patient’s neurovascular status in the presence of a fracture — but I suspect he documented something and I’m going to get my records this week. I sat in the ED for 90 minutes, and no one bothered to ask me where my pain was on a scale of 1 to 10. The first sixty minutes, I would not have cared.

But after 90 minutes, my ibuprofen was wearing off, and it would have been nice to have someone ask — maybe a nurse? Even a ginger ale would have been welcome. As it ended up, I said: “I’ve been here 90 minutes, can I see a doctor? No one has even offered me a Tylenol for pain and I would like to see my x-rays.” The nurse or assistant, who knows, returned twenty minutes later with a prescription for 12 Norco and a poor reproduction of my x-rays on an 8 x 10 piece of copy paper.

For this, I received bills of approximately $1,500. The hospital customer service representative implied that if I had not been paying the bill personally, the charge would not have been disputed. Well, as a taxpayer, I think it’s time to start disputing these absurd charges. In this case, if any documentation of an examination was submitted, it must be fraudulent. The PA stuck his stethoscope on my chest, and I’m sure that increased the bill. As far as the finger exam, it didn’t happen; he never got within 2 feet of my finger. And I never got a reading of the x-ray, except for this: “It’s broken.” Really? I knew that before I got the x-ray. That’s why I came to the ED.

Unbelievably poor quality care, but it’s motivated me to keep a closer eye on health care costs, both personal and global. If we don’t pay attention, we have no one to blame but ourselves.

Karen Shackelford is an emergency physician.

prodding government to treat it not as a crime, but as a disease

In Heroin Crisis, White Families Seek Gentler War on Drugs

http://www.nytimes.com/2015/10/31/us/heroin-war-on-drugs-parents.html?ref=health&_r=0

NEWTON, N.H. — When Courtney Griffin was using heroin, she lied, disappeared, and stole from her parents to support her $400-a-day habit. Her family paid her debts, never filed a police report and kept her addiction secret — until she was found dead last year of an overdose.
At Courtney’s funeral, they decided to acknowledge the reality that redefined their lives: Their bright, beautiful daughter, just 20, who played the French horn in high school and dreamed of living in Hawaii, had been kicked out of the Marines for drugs. Eventually, she overdosed at her boyfriend’s grandmother’s house, where she died alone.

“When I was a kid, junkies were the worst,” Doug Griffin, 63, Courtney’s father, recalled in their comfortable home here in southeastern New Hampshire. “I used to have an office in New York City. I saw them.”

Tracey Marino in her son’s bedroom in Stratford, Conn., in June. After her son, James, died of a heroin overdose at 23, she wrote about his drug dependency on Facebook.
Obituaries Shed Euphemisms to Chronicle Toll of HeroinJULY 11, 2015
Michael Kenney, a recovering heroin addict, with one of his children at his home in Barre, Vt. He is about to open a bank account for the first time.
Vermont Tackles Heroin, With Progress in Baby StepsFEB. 25, 2015
Stephanie Predel is off heroin. But the Bennington, Vt., area, where she lives, is in the throes of an epidemic.
Heroin Scourge Overtakes a ‘Quaint’ Vermont TownMARCH 5, 2014
Gov. Peter Shumlin, a Democrat, used his State of the State Message on Wednesday in Montpelier to encourage public debate on the growing problem of drug abuse and addiction in his state. There are possibilities of vandalism under the influence of drugs and there are lawyers for arson charges in California that one can contact and get help as well.
In Annual Speech, Vermont Governor Shifts Focus to Drug AbuseJAN. 8, 2014
Victoria DeLong of Rutland, Vt., pointing out a house where drug dealing occurs. “We know what they’re doing in there,” she said.
A Call to Arms on a Vermont Heroin EpidemicFEB. 27, 2014
Theresa Dumond said she works as a prostitute to support her heroin habit.
Heroin in New England, More Abundant and DeadlyJULY 18, 2013

Noting that “junkies” is a word he would never use now, he said that these days, “they’re working right next to you and you don’t even know it. They’re in my daughter’s bedroom — they are my daughter.”

A photo of Courtney Griffin, who died of a heroin overdose in 2014, with her sister Shannon, left, and her mother, Pamela. Credit Katherine Taylor for The New York Times

When the nation’s long-running war against drugs was defined by the crack epidemic and based in poor, predominantly black urban areas, the public response was defined by zero tolerance and stiff prison sentences. But today’s heroin crisis is different. While heroin use has climbed among all demographic groups, it has skyrocketed among whites; nearly 90 percent of those who tried heroin for the first time in the last decade were white.

And the growing army of families of those lost to heroin — many of them in the suburbs and small towns — are now using their influence, anger and grief to cushion the country’s approach to drugs, from altering the language around addiction to prodding government to treat it not as a crime, but as a disease.

“Because the demographic of people affected are more white, more middle class, these are parents who are empowered,” said Michael Botticelli, director of the White House Office of National Drug Control Policy, better known as the nation’s drug czar. “They know how to call a legislator, they know how to get angry with their insurance company, they know how to advocate. They have been so instrumental in changing the conversation.”

Mr. Botticelli, a recovering alcoholic who has been sober for 26 years, speaks to some of these parents regularly.

Their efforts also include lobbying statehouses, holding rallies and starting nonprofit organizations, making these mothers and fathers part of a growing backlash against the harsh tactics of traditional drug enforcement. These days, in rare bipartisan or even nonpartisan agreement, punishment is out and compassion is in.

The presidential candidates of both parties are now talking about the drug epidemic, with Hillary Rodham Clinton hosting forums on the issue as Jeb Bush and Carly Fiorina tell their own stories of loss while calling for more care and empathy.
On the campaign trail, presidential candidates acknowledge the problem of America’s growing addiction to legal, prescription and illegal drugs, and discover the bipartisan appeal of drug policy. By AINARA TIEFENTHÄLER on Publish Date October 30, 2015.

Last week, President Obama traveled to West Virginia, a mostly white state with high levels of overdoses, to discuss his $133 million proposal to expand access for drug treatment and prevention programs. The Justice Department is also preparing to release roughly 6,000 inmates from federal prisons as part of an effort to roll back the severe penalties issued to nonviolent drug dealers in decades past.

And in one of the most striking shifts in this new era, some local police departments have stopped punishing many heroin users. In Gloucester, Mass., those who walk into the police station and ask for help, even if they are carrying drugs or needles, are no longer arrested. Instead, they are diverted to treatment, despite questions about the police departments’ unilateral authority to do so. It is an approach being replicated by three dozen other police departments around the country.

“How these policies evolve in the first place, and the connection with race, seems very stark,” said Marc Mauer, executive director of the Sentencing Project, which examines racial issues in the criminal justice system.

Still, he and other experts said, a broad consensus seems to be emerging: The drug problem will not be solved by arrests alone, but rather by treatment.

Parents like the Griffins say that while they recognize the racial shift in heroin use, politicians and law enforcement are responding in this new way because “they realized what they were doing wasn’t working.”

“They’re paying more attention because people are screaming about it,” Mr. Griffin said. “I work with 100 people every day — parents, people in recovery, addicts — who are invading the statehouse, doing everything we can to make as much noise as we can to try to save these kids.”

Courtney Griffin’s father, Doug Griffin, in her bedroom, which he kept unchanged after her death. “We’ve pretty much given up what used to be our life,” he said. Credit Katherine Taylor for The New York Times
An Epidemic’s New Terrain

Heroin’s spread into the suburbs and small towns grew out of an earlier wave of addiction to prescription painkillers; together the two trends are ravaging the country.

Deaths from heroin rose to 8,260 in 2013, quadrupling since 2000 and aggravating what some were already calling the worst drug overdose epidemic in United States history.

Over all, drug overdoses now cause more deaths than car crashes, with opioids like OxyContin and other pain medications killing 44 people a day.

Here in New England, the epidemic has grabbed officials by the lapels.

The old industrial cities, quiet small towns and rural outposts are seeing a near-daily parade of drug summit meetings, task forces, vigils against heroin, pronouncements from lawmakers and news media reports on the heroin crisis.

New Hampshire is typical of the hardest-hit states. Last year, 325 people here died of opioid overdoses, a 68 percent increase from 2013. Potentially hundreds more deaths were averted by emergency medical workers, who last year administered naloxone, a medication that reverses the effects of opioid overdoses, in more than 1,900 cases.

Adding to the anxiety among parents, the state also ranks second to last, ahead only of Texas, in access to treatment programs; New Hampshire has about 100,000 people in need of treatment, state officials say, but the state’s publicly financed system can serve just 4 percent of them.

Since New Hampshire holds the first-in-the-nation presidential primary, residents have repeatedly raised the issue of heroin with the 2016 candidates.

Mrs. Clinton still recalls her surprise that the first question she was asked in April, at her first open meeting in New Hampshire as a candidate, was not about the economy or health care, but heroin. Last month, she laid out a $10 billion plan to combat and treat drug addiction over the next decade.

She has also led discussions on the topic around the country, including packed forums like the one in Laconia, N.H., where hundreds of politically engaged, mostly white middle-class men and women, stayed for two hours in a sweltering meeting hall to talk and listen. One woman told of the difficulties of getting her son into a good treatment program, and said he eventually took his own life. Another told Mrs. Clinton of the searing pain of losing her beloved son to heroin.

Many of the 15 Republican candidates for president have heard similar stories, and they are sharing their own.

Ginger Katz and her husband, Larry Katz, of Norwalk, Conn., lost their 20-year-old son Ian to a heroin overdose in 1996. She then started a foundation to try to end the silence surrounding addiction. Credit Katherine Taylor for The New York Times

“I have some personal experience with this as a dad, and it is the most heartbreaking thing in the world to have to go through,” Jeb Bush, the former governor of Florida, said at a town hall-style meeting in Merrimack, N.H., in August. His daughter, Noelle, was jailed twice while in rehab, for being caught with prescription pills and accused of having crack cocaine.

Carly Fiorina, the former chief executive of Hewlett-Packard, tells audiences that she and her husband “buried a child to addiction.” And Gov. Chris Christie of New Jersey released an ad here in New Hampshire declaring, “We need to be pro-life for the 16-year-old drug addict who’s laying on the floor of the county jail.”

Some black scholars said they welcomed the shift, while expressing frustration that earlier calls by African-Americans for a more empathetic approach were largely ignored.

“This new turn to a more compassionate view of those addicted to heroin is welcome,” said Kimberlé Williams Crenshaw, who specializes in racial issues at Columbia and U.C.L.A. law schools. “But,” she added, “one cannot help notice that had this compassion existed for African-Americans caught up in addiction and the behaviors it produces, the devastating impact of mass incarceration upon entire communities would never have happened.”

Now, all the political engagement around heroin has helped create what Timothy Rourke, the chairman of the New Hampshire Governor’s Commission on Alcohol and Drug Abuse, says is an impetus for change, not unlike the confluence of events that finally produced a response to the AIDS epidemic. “You have a lot of people dying, it’s no longer just ‘those people,’ ” he said. “You have people with lived experience demanding better treatment, and you have really good data.”
A More Forgiving Approach

Among recent bills passed by the New Hampshire legislature in response is one that gives friends and family access to naloxone, the anti-overdose medication. Mr. Griffin, a few months after his daughter died, was among those testifying for the bill. It was set to pass in May but would not take effect until January 2016 — until Mr. Griffin warned lawmakers that too many lives could be lost in that six-month gap. At his urging, the bill was amended to take effect as soon as it was signed into law. It went into effect June 2.

A gentler approach to drug addicts does not require a gentler approach to drug dealers. I’m all in favor of increasing funding for drug…

It is not a coincidence drugs were poured into communities of color just as the civil rights they desperately were fighting for was gaining…

Drugs alcohol sex food life in the most advance nation to date is so great that people want to escape emotionally and spiritually. That…

Other parents like him have successfully lobbied for similar measures across the country. Almost all states now have laws or pilot programs making it easier for emergency medical workers or family and friends to obtain naloxone. And 32 states have passed “good Samaritan” laws that protect people from prosecution, at least for low-level offenses, if they call 911 to report an overdose. A generation ago when civil rights activists denounced as racist the push to punish crack-cocaine crimes, largely involving blacks, far more severely than powder-cocaine crimes, involving whites, political figures of both parties defended those policies as necessary to control violent crime.

But today, with heroin ravaging largely white communities in the Northeast and Midwest, and with violent crime largely down, the mood is more forgiving.

“Both the image and reality is that this is a white and often middle-class problem,” said Mr. Mauer of the Sentencing Project. “And appropriately so, we’re having a much broader conversation about prevention and treatment, and trying to be constructive in responding to this problem. This is good. I don’t think we should lock up white kids to show we’re being equal.”

So officers like Eric Adams, a white former undercover narcotics detective in Laconia, are finding new ways to respond. He is deployed full time now by the Police Department to reach out to people who have overdosed and help them get treatment.

“The way I look at addiction now is completely different,” Mr. Adams said. “I can’t tell you what changed inside of me, but these are people and they have a purpose in life and we can’t as law enforcement look at them any other way. They are committing crimes to feed their addiction, plain and simple. They need help.”

Often working with the police, rather than against them, parents are driving these kinds of individual conversions.

Families of Courtney Griffin, left, and Christopher Honor, right, prayed during a meeting for family and friends of addicts as well as addicts themselves at First Baptist Church in Plaistow, N.H., last month. Credit Katherine Taylor for The New York Times

Their efforts include attempts to recast addiction in a less stigmatizing light — many parents along with treatment providers are avoiding words like “addict” or “junkie” and instead using terms that convey a chronic illness, like “substance use disorder.”

Parents are involved in many ways. To further raise awareness, Jim Hood, 63, of Westport, Conn., who lost his son, Austin, 20, to heroin three years ago, and Greg Williams, 31, of Danbury, Conn., who is in long-term recovery from substance abuse, organized the Oct. 4 “Unite to Face Addiction” rally in Washington. Featuring musicians like Sheryl Crow, it brought together more than 750 groups that are now collaborating to create a national organization, Facing Addiction, devoted to fighting the disease of addiction on the scale of the American Cancer Society and the American Heart Association.

“With heart disease or cancer, you know what to do, who to call, where to go,” Mr. Hood said. “With addiction, you just feel like you’re out in the Wild West.”

Ginger Katz of Norwalk, Conn., has equally lofty goals. After her son, Ian, 20, died of a heroin overdose in 1996, she founded the Courage to Speak Foundation to try to end the silence surrounding addiction, and she has developed a drug-prevention curriculum for schools.

For Doug and Pam Griffin Courtney is still their focus; her pastel bedroom is as she left it, with the schedules of meetings of Narcotics Anonymous taped to what she called her “recovery wall.”

“We’ve pretty much given up what used to be our life,” Mr. Griffin said.

But in addition to grieving and testifying at hearings and forums, the Griffins take calls day and night from parents across the country who have read their story and want to offer an encouraging word or ask for advice. They are establishing a sober house, named after Courtney. And they host a potluck dinner and church service once a month on Sunday nights at the First Baptist Church in nearby Plaistow, where they held their daughter’s funeral, for people with addictions and their families.

 

At last month’s service, more than 75 people filled the pews, including the family of Christopher Honor, who was Courtney’s boyfriend. He was also addicted to heroin. Last month, almost a year after her death, Chris, 22, died of an overdose — the 23rd overdose and third fatal one this year in Plaistow, a town of 8,000 people.

Chris’s mother, Amanda Jordan, 40, wanted to attend the Sunday night service last month, but it was just two weeks after she had buried Chris, and she worried it might be too soon to go back to that church, where Chris’s funeral was held. She sometimes thinks Chris is still alive, and at his funeral she was convinced he was still breathing.

She was afraid she would fall apart, but she and other family members decided to go anyway. During the service, her son Brett, 18, became so overwhelmed with emotion that he had to leave, rushing down the center aisle for the outside. Ms. Jordan ran after him. Then a family friend, Shane Manning, ran after both of them. Outside, they all clutched one another and sobbed.

“I’m a mess,” Ms. Jordan said after coming back inside and kneeling in front of a picture of Chris. In addition to yearning for her son, she had been worried that the Griffins blamed her for Courtney’s death. But at the church, they welcomed her. In their shared pain, the families spoke and embraced.

Ms. Jordan, one of the more recent involuntary members of this club of shattered parents, said that someday, when she is better able to function, she “absolutely” wants to work with the Griffins to “help New Hampshire realize there’s a huge problem.” Right now, though, she just wants to hunt down the person who sold Chris his fatal dose. “These dealers aren’t just selling it,” she said. “They’re murdering people.”
Correction: October 30, 2015

Because of an editing error, an earlier version of this article erroneously included one drug among the prescription opioids contributing to 44 deaths each day from overdoses. While OxyContin is a prescription opioid, heroin is not.

FBI: Animal cruelty a Class A Felony… cruelty to pts with subjective diseases ???

FBI Upgrades Animal Cruelty to Class A Felony

http://www.allgov.com/news?news=854546

Animal rights advocates have applauded the Federal Bureau of Investigation’s (FBI) decision to upgrade animal cruelty crimes, putting them in the same category as murders.

Going forward, anyone caught abusing animals will risk being charged with a Class A felony. That’s the same grouping of felonies for violent crimes, including homicides and assaults. Previously, animal cruelty was in an “other” crimes category, making them less important for law enforcement and prosecutors.

The changes are expected to result in more convictions for those harming animals, such as those involved in dog fighting rings.

“It will help get better sentences, sway juries and make for better plea bargains,” Madeline Bernstein, president and CEO of the Society for the Prevention of Cruelty to Animals Los Angeles and a former New York prosecutor, told the Associated Press.

Beginning in 2016, the FBI also will begin collecting data on animal cruelty. This will enable the bureau to learn more about a correlation between animal cruelty and other crimes. Serial killers, for instance, often have histories of torturing and killing animals.

Nurse/Mother with 2 Heroin addicted kids and the TRUTH

 

Indianapolis Metro PD employee busted with drug gang

IMPD employee busted with west side Ponds Army drug gang, two dozen guns and $15K in cash seized

http://fox59.com/2015/10/28/impd-employee-busted-with-west-side-drug-gang-known-as-ponds-army/

INDIANAPOLIS, Ind. (Oct. 28, 2015) – The arrest of a heroin supplier to students at Franklin Central High School has led IMPD detectives to the bust of a longtime west side drug gang called the Ponds Army.

Ramon D. Fox, known on the streets as “Cash,” was arrested. Police say he is the leader of the Ponds Army gang, which included a civilian employee of IMPD,

Deangra Williams, who used access to various confidential tracking systems to trace stolen firearms and the criminal records of her son and his gang associates.  Williams, aka “Dee Dee”, is listed on dozens of occasions, researching the status of firearms that often showed up in the hands of gang members.

Williams reportedly ran criminal background checks on her son, Bruce Williams, aka “B”, 42 times since 2009.

Search warrants served Tuesday and Wednesday resulted in the confiscation of several firearms, a sizable amount of cash and quantities of heroin and cocaine.

One of the addresses that was searched housed a private day care.

Fox was convicted in 2014 on a narcotics charge and sentenced to 10 years in prison with eight years suspended but eligible to be charged in the future as a Serious Violent Felon with a Firearm and, according to an informant, would “routinely keep guns around him and that he would trade heroin for guns.”

The Williams home, shared by mother and son, was the subject of numerous anonymous calls to an IMPD tip line and the target of a search warrant last month which recovered two handguns, cash and heroin.

An informant told investigators that, “Williams was benefitting from her son’s activities and that Bruce paid her bills and made sure she had a nice car in exchange for his mother’s assistance.”

Williams was said to witness several of her son’s narcotics transactions and another son, Henry Ingram, is currently serving a prison sentence related to drug dealing and his participation in the Pond’s Army in 2005.

 

How the media edits out the reality of it all

“I had no idea that we were addicting people”

http://www.cbsnews.com/videos/i-had-no-idea-that-we-were-addicting-people/

Tracy Morrison, a nurse and the mother of two daughters who are both recovering heroin addicts, says the medical profession has some responsibility for the rise in heroin use

In the piece that appeared on 60 Minutes, Nurse Morrison went on to say that we don’t criminalize a number of other people with chronic diseases, she listed several specific chronic diseases… she stated that opiate addiction is a chronic disease and needs to be treated as such.. but CBS decided not to share that on the “trailer” on this piece on CBS 60 minutes broadcasted on Sunday 11/01/2015.

CVS’ version of Logan’s Run ?

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http://www.tv.com/shows/logans-run/

Show Summary

Based on the popular movie by the same name, Logan’s Run portrays a futuristic society where citizens are only allowed to live until age 30.

After the holocaust of a nuclear war, a domed city was created to put the remaining humans from the United States into, in hopes that sometime in the future, those humans could once again populate the world. To keep the crop of humas “fresh”, they are only allowed to live until they are 30 years old, where they are terminated and a “replacement”, a genetically created test tube baby is provided, keeping the population constant. Occasionally, a citizen doesn’t want to be terminated and they “run” and try to hide.

Logan is a 26 year old police officer who job is to terminate runners. He is called a Sandman because they put you to sleep…forever. He is given a top secret assignment to try and escape to freedom and find the mythical place called ‘Sanctuary’ which is really just outside the Domed City. Only he is pursued by his former friend, Francis, another Sandman, who doesn’t know of his assignment and attempts to terminate him.

https://youtu.be/LSUAAKFLoL0

Bringing a new meaning to “you’re fired” ?

behinds the scenes