HEALTH
Wednesday, November 22, 2017
East Oregonian
Page 7A
Opioids haunt recovery: ‘It never really leaves you’
By LINDSEY TANNER
AP Medical Writer
NASHVILLE, Tenn. —
It’s hard to say whether busi-
nessman Kyle Graves hit rock
bottom when he shot himself
in the ankle so emergency
room doctors would feed his
opioid habit or when he broke
into a safe to steal his father’s
cancer pain medicine.
For
straight-talking
ex-trucker Jeff McCoy, it was
when he grabbed a gun and
threatened to blow his brains
out if his mother didn’t hand
over his fentanyl patches.
For newly minted lawyer
Bianca Knight, it happened
after hitting the street to
find pills when her opioid
prescription ran out, as she
envisioned her career dreams
crumbling.
Addiction to powerful
painkillers sneaked up on
Graves and McCoy and
Knight, ordinary Americans
who began taking the drugs
legitimately for pain, but
like millions of others, got
caught up in the worst opioid
epidemic in U.S. history.
Now they’re fighting the
same tough, slippery battle
for recovery, owing their
lives, they say, to an anti-ad-
diction medicine similar to
pills that nearly led to their
demise. They credit a Nash-
ville doctor too, an addiction
specialist who also works as
a Vanderbilt University pain
medicine physician — some-
times recommending the
same drugs to pain patients
that brought the others to the
brink.
The ironies and tragedies
of the crisis are not lost on
Dr. Dan Lonergan, who faced
his own dark abyss years ago
in medical school, when his
older brother died suddenly
of a possible opioid overdose.
He’s heard criticism about
doctors “who get ‘em hooked
on drugs and then turn around
and treat ‘em for addiction.”
And he’s seen the finger-
pointing from those who think
faith and willpower are the
answer, who say prescribing
opioid drugs to treat addiction
is trading one vice for another.
“Doctors have contributed
to this problem. In the past
three decades we have gotten a
lot of patients on medications
that can be very dangerous,”
he said. “The pharmaceutical
industry has contributed
significantly to this problem.
This is a problem that we all
need to own.”
But to stigmatize addiction
as a moral failing rather than
a brain disease is wrong,
Lonergan says. Research has
shown that opioid drugs can
AP Photo/David Goldman
Kyle Graves, who is in recovery for opioid addition, sits in the home he shares with his mother in Franklin, Tenn.,
June 6. Graves’ troubles began more than a decade ago when he sought relief for degenerative arthritis in his
hips, shoulders, feet and back. He was prescribed oxycodone, an opioid drug that works best for short-term pain
but is risky and potentially addictive when used long-term.
cause brain changes leading
to uncontrollable cravings for
drug use even when it leads
to dangerous and unhealthy
behavior. To not offer medi-
cine as a treatment, he says,
would be like withholding
insulin from a diabetic.
This is a snapshot of
Graves, in the trenches of
America’s addiction crisis.
More than 2 million people
are hooked on opioids. Over-
doses from these drugs have
killed more than 300,000
Americans since 2000, and
they are killing an average of
120 people every day. Even
for survivors, success never
quite seems certain.
The family man
Kyle Graves groans
slightly as he sits down on the
dark leather sofa in his apart-
ment living room, feeling the
stabbing pains that a daily
handful of pills used to ease.
At age 54, he shares the small
but comfortable space with
his ailing mother, bedridden
from a stroke, and two small
dogs in Franklin, Tennessee,
an affluent Nashville suburb.
Framed thrift shop art
posters and secondhand
knickknacks decorate the
place, fitting decor for a man
seeking a second chance at
life.
Graves’ troubles began
more than a decade ago when
he sought relief for degen-
erative arthritis in his hips,
shoulders, feet and back. He
“I lost my wife, my
kids, my home.
It just devastated
and ruined my life.
I never thought
anything like
that could
happen to me.”
AP Photo/David Goldman
A billboard advertising treatment for opioid addition
stands in Dickson, Tenn., June 7.
was prescribed hydrocodone,
an opioid drug that works
best for short-term pain but is
risky and potentially addictive
when used long term.
He got several refills for
persistent pain. But when he
lost his dream job as a car
dealership finance manager,
Graves found the pills helped
get him through that crisis,
too.
He was a functioning
addict when his sixth child
was born — a boy named
Joshua
Jeremiah
who
contracted spinal meningitis
during childbirth. The infant
clung to life for six weeks;
his death sent Graves sinking
deeper into addiction.
He’d use up a month’s
supply of pills from pain
clinics in days, followed
by terrible withdrawals —
vomiting, diarrhea, shaking
uncontrollably and intense
pain. It’s familiar territory for
addiction patients.
Graves turned desperate
after a doctor refused more
refills, suspecting he was
selling the drugs because
opioids didn’t show up in
a routine urine test — he’d
swallowed them all weeks
earlier.
With his wife at work and
kids outside playing basket-
ball, Graves grabbed a loaded
.22-caliber pistol from his
bedroom nightstand.
“I thought, ‘I really can’t
hurt myself by shooting
myself in the foot or ankle.’
I thought that story sounded
legit.” He pulled the trigger,
then called an ambulance.
At the hospital, two shots
of morphine “did the trick.”
— Kyle Graves,
recovering from
opioid addiction
The only pain he recalls was
when doctors removed the
bullet. Graves thinks only his
wife suspected the ruse.
She grew weary and left
with the kids — the harshest
blow to a man who worships
family.
Finally, jobless and living
in a lonely Nashville motel
room, Graves knew he had to
seek help. “I lost my wife, my
kids, my home,” he said. “It
just devastated and ruined my
life. I never thought anything
like that could happen to me.”
His sister helped send him
to a California rehab center
where hard work and prayer
were the main treatments. It
worked for a time, but after
relapsing Graves sought
help from Lonergan, who
prescribed recovery medicine
containing buprenorphine,
an opioid drug that reduces
cravings and withdrawal
symptoms.
Graves has been on the
pills for about three years. He
says weaning himself “would
be a struggle that I haven’t
wanted to try yet.”
He has had setbacks, the
most recent in 2015, when
money was tight, his youngest
daughter was distant and he
was facing another Christmas
without his kids. He knows
they won’t come around if he
falls back into addiction.
His hopes of rebuilding a
life with those five kids, now
grown, help keep him clean.
“I’d like to have a house,
a place they can come over
and have a cookout on the
weekend,” he said.
“They know I love ‘em
with all my heart,” he said.
“They still have issues. I’ve
offered to get them together
and talk to them. I guess
they’re not ready yet.”
Graves’ triggers
are
tragedy and misfortune; he
tries not to dwell on what the
future might bring.
“I don’t worry about it a
lot right now. Anything could
happen, though, that could
change that,” he said. “You
never know.”
Pain wakes Graves up at
night and greets him in the
morning. He takes nothing
stronger
than
over-the-
counter pain relievers. He has
stopped asking Lonergan for
opioid pain pills. The answer
was always no.
“I’ve come to tears in his
office,” Graves said. “I’m
going to get older and it’s just
going to get worse...what is a
guy like me supposed to do?”
He passed an important
test a few months ago when
another doctor prescribed
opioids
after
shoulder
surgery. Graves took the pills
as directed, then quit.
He’s on disability now;
looking after his mom keeps
him busy. Sometimes he
writes country songs — some
sound good enough to be
played in clubs 20 miles up
Highway 65 in Nashville, and
it doesn’t take much prodding
to get him to share one.
“A man’s gotta do what
a man’s gotta do, when he’s
loving a woman, a woman
like you,” Graves sings.
“He’ll sacrifice and give
all he’s got, to keep the fire
burning, to keep the fires hot.”
At times, in the middle
of the night, when back pain
flares, he still fights flickers of
temptation.
“It really never leaves
you,” Graves said. “The
voices always still call you
back to the darkness. You just
have to ignore ‘em and go
on.”
Big Tobacco’s anti-smoking ads begin after decade of delay
WASHINGTON
(AP)
—
Decades after they were banned
from the airwaves, Big Tobacco
companies return to prime-time
television this weekend — but not
by choice.
Under court order, the tobacco
industry for the first time will be
forced to advertise the deadly,
addictive effects of smoking, more
than 11 years after a judge ruled
that the companies had misled the
public about the dangers of ciga-
rettes.
But years of legal pushback
by the industry over every detail
means the ads will be less hard-hit-
ting than what was proposed.
Tobacco control experts say the
campaign — built around network
TV and newspapers — will not
reach people when they are young
and most likely to start smoking.
“Their legal strategy is always
obstruct, delay, create confusion
and buy more time,” said Ruth
Malone, of the University of
California, San Francisco, who has
studied the industry for 20 years.
“So by the time this was finally
settled, newspapers have a much
smaller readership, and nowadays,
who watches network TV?”
The new spots, which begin
Sunday, lay out the toll of smoking
in blunt text and voiceover state-
ments: “More people die every year
from smoking than from murder,
AIDS, suicide, drugs, car crashes
AP Photo/Mark Lennihan, File
Discarded cigarette butts in an ashtray outside a New York office
building. Decades after they were banned from the airwaves, Big
Tobacco companies are returning to prime-time television.
and alcohol, combined.”
Smoking remains the nation’s
leading preventable cause of death
and illness, causing more than
480,000 deaths each year, even
though smoking rates have been
declining for decades. Last year,
the adult smoking rate hit a new
low of 15 percent, according to
government figures. That’s down
from the 42 percent of adults who
smoked in the mid-1960s.
Experts attribute the decline to
smoking bans, cigarette taxes and
anti-smoking campaigns by both
nonprofit groups like the American
Cancer Society and the federal
government.
The new ads are the result of a
1999 lawsuit filed by the Justice
Department under President Bill
Clinton which sought to recover
some of the billions the federal
government spent caring for people
with smoking-related illnesses.
A federal judge ultimately sided
with the government in 2006,
ruling that Big Tobacco had “lied,
misrepresented and deceived the
American public” about the effects
of smoking for more than 50 years.
The decision came nearly a decade
after U.S. states reached legal
settlements with the industry worth
$246 billion.
But under the racketeering laws
used to prosecute the federal case,
the judge said she could not make
the companies pay, instead ordering
them to publish “corrective state-
ments” in advertisements, as well
as on their websites, cigarette packs
and store displays.
The campaign will be paid for
by Altria Group, owner of Philip
Morris USA, and R.J. Reynolds
Tobacco Co., a division of British
American Tobacco.
Altria, maker of Marlboros,
referred inquiries to a statement
it issued last month: “We remain
committed to aligning our business
practices with society’s expecta-
tions of a responsible company.
This includes communicating
openly about the health effects of
our products.”
Reynolds, which sells Camel
cigarettes, did not respond to a
request for comment.
Originally the U.S. government
wanted companies to state that they
had lied about smoking risks. But
the companies successfully chal-
lenged that proposal, arguing that it
was “designed solely to shame and
humiliate.” An appeals court ruled
the ads could only be factual and
forward-looking.
Even the phrase “here’s the
truth,” was disputed and blocked.
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“Here’s the truth: Smoking is very
addictive. And it’s not easy to quit,”
read one proposed message.
“This was a classic case of a
very wealthy set of defendants
willing to appeal every conceivable
issue time and time again,” said
Matthew Myers of the Campaign
for Tobacco Free Kids, one of
several anti-tobacco groups who
intervened in the court case.
More than half a century ago,
American media was saturated with
tobacco advertising. Cigarettes
were the most advertised product on
TV and tobacco companies spon-
sored hundreds of shows, including
“I Love Lucy,” ‘’The Flintstones”
and “Perry Mason.” People smoked
almost everywhere, in restaurants,
airplanes and doctor’s offices.
Congress banned cigarette
advertising from radio and TV in
1970 and subsequent restrictions
have barred the industry from bill-
boards and public transportation.
Yet companies still spend more than
$8 billion annually on marketing,
including print advertising, mailed
coupons and store displays.
Anti-tobacco advocates estimate
the upcoming TV advertisements
will cost companies a tiny fraction
of that, about $30 million. The
broadcast ads will air five times per
week for one year and the news-
paper ads will run five times over
several months in about 50 national
daily papers.
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