One of the ironies of Mikhaila dying of an overdose is that just a few weeks prior to her death, she and I had a conversation in which she shared with me, and more importantly admitted to herself, that she was addicted to prescription drugs and needed help. In the last two weeks of her life she took important steps to change her life; she severed a dysfunctional long-term relationship with a controlling, self-serving boy who is also an addict, and moved out of his parent’s house where they were staying. She began attending recovery meetings at a local church, and from what the meeting leader tells me (Hi Stacy!), Mikhaila was very motivated to begin her journey toward sobriety. She was actively look for a job, and was looking forward to enrolling in school in the upcoming semester.
She told me that she just didn’t want to live how she was living anymore. She felt as if time was slipping away from her, that she didn’t feel like she was the same person she once was… She was tired… sick and tired of being sick and tired, and hearing that from her was music to my ears.
Most Opiate Overdoses Occur After Periods Sobriety
An opiate addict develops a tolerance rapidly, thus needing a stronger dosage of the drug to achieve the desired effect. Opiate addicts typically enter treatment on such a high dose and with such a high tolerance that it would most likely be fatal to an individual who was not addicted. As addicts recover, their opiate tolerance decreases. If a person relapses, he or she is likely to consume the same dose that he or she had become accustomed to before sobriety. Because this person had abstained from opiate use and has little to no tolerance to the drug, relapses often result in overdoses.
Diseases involve cycles of relapse and remission
Like other chronic diseases, addiction often involves cycles of relapse and remission. The last time I spoke with Mikhaila, she told me that she was almost two weeks clean. Was she telling me the truth? Maybe, maybe not, but if if we give her the benefit of the doubt, which I do, it wouldn’t have taken relatively much for her to OD.
So the irony is this: it was not until the time that she chose to get clean, and relapsed in a moment of weakness, that she OD’d and died. How fair is that?
This answers the question that asks, “Why is it that Mikhaila, the girl who realizes her addiction is out of control, and that takes steps toward sobriety the one that OD’s, while those that don’t want to change, continue to use and sell the drugs?”
There is a medication out there called Naloxone, (its brand name is Narcan) that can be administered either nasally or by injection. It can rapidly reverse the potentially deadly effects of opioid drugs, which include heroin and prescription pain relievers like OxyContin and Vicodin. It does not produce a high — quite the opposite, in fact, because it blocks the effects of opioids. Naloxone is much safer than some drugs currently available without a prescription. Both insulin and Tylenol (acetaminophen) can be deadly if misused, but it is impossible to overdose on Naloxone and it has few side effects.
Currently, Naloxone is available only by prescription and is otherwise accessed easily only by health professionals and law enforcement. Overdose now kills more people in the United States than car accidents, making it the leading cause of injury-related mortality according to the latest statistics from the Centers for Disease Control and Prevention. The number of deaths — 37,485 in 2009 — could be cut dramatically if Naloxone were available over-the-counter and placed in every first aid kit.
Once again, I am not condoning nor condemning the recreational use of drugs by suggesting that Naloxone should be more readily available to the general public. What I’m saying is that there are addicts that want to get clean and getting clean is a process – sometimes a long process, involving times of relapse and remission. It’s at this time, when a recovering addict takes the initial steps toward sobriety that he or she is the most vulnerable and that the chance of an overdose is highest, and one can’t be given the chance of a a sober life if one is dead.