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Some states became inundated with opiates. According to the Charleston Gazette-Mail , between and drug wholesalers shipped to West Virginia seven hundred and eighty million pills of hydrocodone the generic name for Vicodin and oxycodone the generic name for OxyContin. That was enough to give each resident four hundred and thirty-three pills.

The state has a disproportionate number of people who have jobs that cause physical pain, such as coal mining. It also has high levels of poverty and joblessness, which cause psychic pain. Mental-health services, meanwhile, are scant. Chess Yellott, a retired family practitioner in Martinsburg, told me that many West Virginians self-medicate to mute depression, anxiety, and post-traumatic stress from sexual assault or childhood abuse.

In , Purdue introduced a reformulated capsule that is harder to crush or dissolve. The Centers for Disease Control subsequently issued new guidelines stipulating that doctors should not routinely treat chronic pain with opioids, and instead should try approaches such as exercise and behavioral therapy. The number of prescriptions for opioids began to drop.

But when prescription opioids became scarcer their street price went up. Drug cartels sensed an opportunity, and began flooding rural America with heroin. Daniel Ciccarone, a professor at the U. They worked very hard to move high-quality heroin into places like rural Vermont. In West Virginia, many addicts told me, an oxycodone pill now sells for about eighty dollars; a dose of heroin can be bought for about ten. However, this drop coincided with an unprecedented rise in heroin overdoses. Louis, looked at some three thousand heroin addicts in substance-abuse programs.

Half of those who began using heroin before were white; nearly ninety per cent of those who began using in the past decade were white. This demographic shift may be connected to prescribing patterns. A study by a University of Pennsylvania researcher found that black patients were thirty-four per cent less likely than white patients to be prescribed opioids for such chronic conditions as back pain and migraines, and fourteen per cent less likely to receive such prescriptions after surgery or traumatic injury. But a larger factor, it seems, was the despair of white people in struggling small towns.

On heroin, you curl up in a corner and blank out the world. Much more so than coke or meth, where you want to run around and do things—you get aggressive, razzed and jazzed. Nearly everyone I met in Martinsburg has ties to someone—a child, a sibling, a girlfriend, an in-law, an old high-school coach—who has struggled with opioids.

Yet there is a chronic shortage of beds in the state for addicts who want help. Weeks, months. West Virginia has an overdose death rate of New Hampshire has the second-highest rate: Martinsburg, which has a population of seventeen thousand, is a hilly town filled with brick and clapboard row houses. It was founded in , by Adam Stephen, a Revolutionary War general. The town became a depot for the B. Railroad and grew into an industrial center dominated by woollen mills. Interwoven, established in the eighteen-nineties, was the first electric-powered textile plant in the U.

The Interwoven factory whistle could be heard all over town, summoning workers every morning at a quarter to seven.

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Nevertheless, many residents I met brought up this history, as part of a larger story of lost purpose that has made the town vulnerable to the opioid onslaught. The void has been filled, only partially, by people from neighboring states. The Eastern Panhandle is one of the wealthier parts of a poor state. The most destitute counties depend on coal mining. Berkeley County is close enough to D. Nevertheless, Martinsburg feels isolated. Several people I met there expressed surprise, or sympathy, when I told them that I live in D.

The Interwoven mill, derelict and grand, dominates the center of Martinsburg. A local police officer has proposed turning most of the mill into a rehab facility. Michael Chalmers is the publisher of an Eastern Panhandle newspaper, the Observer. It is based in Shepherdstown, a picturesque college town near the Maryland border which has not succumbed to heroin.

Chalmers, who is forty-two, grew up in Martinsburg, and in he lost his younger brother, Jason, to an overdose. I asked him why he thought that Martinsburg was struggling so much with drugs. The Interwoven mill, derelict and grand, still dominates the center of Martinsburg. One corner of it has been turned into a restaurant, but the rest sits empty. A police officer named Andrew Garcia has a plan, called Martinsburg Renew, which would turn most of the mill into a rehab facility. Maybe it will be drug rehab. In the past several months, I have returned to Martinsburg many times, and spoken with many addicts there.

Lori Swadley is a portrait and wedding photographer in Martinsburg. When I looked at her Web site, she seemed to be in demand all over the area, and her photographs were lovely: her brides glowed in afternoon light, her high-school seniors looked polished and confident. But what drew me to her was a side project she had been pursuing, called 52 Addicts—a series of portraits that called attention to the drug epidemic in and around Martinsburg. It was clear that Swadley had a full life: her husband, Jon, worked with her in the photography business, and they had three small children, Juniper, Bastian, and Bodhi.

Swadley is thirty-nine, tall and slender, and she looked elegant in jeans, a charcoal-colored turtleneck, and high boots. She and her husband had moved to Martinsburg in , she told me, looking for an affordable place to raise children close to where she had grown up, in the Shenandoah Valley. Soon after they arrived, they settled into a subdivision outside town, and Swadley started reading the Martinsburg Journal online. Because at that time it seemed like everybody else wanted to hide it. And, to me, that seemed like the worst thing you could do.

I said that it seemed like an extraordinarily high number, especially for someone who was not an addict. She agreed, but there it was. All thirteen were young men—Swadley had met most of them when she was in her early twenties, and she had been a tomboy back then. The first time she heard that a friend had died, she had been photographing a wedding for some mutual friends. They were sitting around a bonfire at the end of the day. When Swadley spoke of a crazy horror film that she and a guy named Jeremy had made in high school, somebody mentioned that he had recently died, from a heroin overdose.

She threw up, and wrecked her car on the way home. At the time, Swadley was hanging out with her old crowd in bars and restaurants every weekend. One by one, the group dwindled. As the overdoses piled up, she was appalled to find that sometimes she had trouble keeping track of which friends were dead. The funerals had a peculiar aspect. In January, , she started photographing addicts in recovery. For the first few portraits, Swadley reached out to her subjects, but soon people started coming to her. She took their pictures, asked them about their lives, and told their stories in a paragraph or so.

There are now two dozen images in the series. In one of the portraits, an E. A woman named Tiffany posed holding a snapshot of her younger sister, Tabby. Both women had started off on pills—Tabby had developed a problem after a gallbladder operation left her with a thirty-day supply of meds—and then became heroin addicts. Tiffany had received treatment, but Tabby had fatally overdosed while she was waiting for a rehab bed.

Swadley took the portrait in a park where Tiffany had once begged Tabby to stop using. When I called Tiffany, she told me that she had recently lost a second sister to heroin. Swadley hopes that her photographs will someday be displayed all around town—in coffee shops, restaurants, perhaps the library. I want to show people they deserve a chance. One day, Swadley told me about a local effort against heroin addiction, called the Hope Dealer Project.

It was run by three women: Tina Stride, who had a twenty-six-year-old son in recovery; Tara Mayson, whose close friend had gone through periods of addiction; and Lisa Melcher, whose son-in-law had died of an overdose, and whose thirty-two-year-old daughter, Christina, was struggling to overcome heroin addiction. All three had known addicts who wanted to get clean but had no place to go. Last fall, like car-pool moms with a harrowing new mission, they had begun driving people to detox facilities all over the state—any place that could take them, sometimes as far as five hours away.

The few with private insurance could get rehab anywhere in the country, and the Hope Dealer women were prepared to suggest options. But most people in town had Medicaid or no insurance at all, and such addicts had to receive treatment somewhere in the state.

Drug Crazy: How We Got Into This Mess and How We Can Get Out

Currently, the detox facility closest to Martinsburg is about two hours away. Stride works full time at the General Services Administration, in Washington, but spends up to twenty-four hours a week giving rides to drug users. The other two focus on reaching out to addicts and families. When Stride and her client arrive at a detox facility, nurses are waiting at the door. For them to walk in those doors, that takes a lot. After five to ten days in detox, patients are released. If beds are all full, a lot of times they come back here to Martinsburg, because they have nowhere else to go.

Stride usually drives clients to a detox center immediately after picking them up. I tried to stay up, but I knew I had to drive four hours to the detox place, and four hours back. So I slept some. We were up at 4 a. Stride, who is forty-seven, wore her hair in a ponytail and had curly bangs; Mayson, who is forty-six, had long, sparkly nails. They had spent the previous day working on behalf of a woman and her twenty-one-year-old son, a heroin addict.

He had private insurance, so they had signed him up for rehab in New Hampshire.


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What do I do? Samantha Engelhardt right , a recovering addict, shows her newborn baby to the photographer Lori Swadley, who has been documenting the opioid epidemic in the Martinsburg area. Because I want to know he makes it. Mayson, who works at the Department of Veterans Affairs and has two adult children, said that the Hope Dealer women had become like sisters. As mothers, they felt that they had a particular ability to communicate with women who needed help with their addicted children.


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  7. I was devastated. On May 21st, I received an e-mail from Melcher, informing me that Christina, her daughter, had fatally overdosed on heroin. Christina, she said, had completed rehab several times, and had been clean for ninety days before relapsing. Aldis is a family practitioner with a background in public health and tropical medicine. His mother taught nursing, and his father was an obstetrician. He spent most of his career in Asia and Africa, as a U.

    Navy physician and as a medical officer with the State Department. He retired in They filled it with art and antiques, acquired two Jack Russell terriers, and prepared for a quiet life filled with visits from their two daughters and the grandkids. He took a job at the New Life Clinic, in Martinsburg, where he could prescribe Suboxone, one of the long-term treatments for opioid addiction. He found it enormously frustrating that addicts were often urged to quit heroin cold turkey or to stop taking Suboxone or methadone or naltrexone, the other drugs used to treat addiction and counteract withdrawal symptoms.

    In his view, this was wholly unrealistic. Most addicts needed what is known as medication-assisted treatment for a long time, if not the rest of their lives. You could actually prescribe it to your patients. That might seem self-evident, but at this point in the opioid epidemic many West Virginians feel too exhausted and resentful to help. I remember one time, we had a kid who had O. A call came over the radio—someone about his age had just died from an overdose. Then again, Poe mused, when most of your neighbors—not to mention your mom and your grandma—already knew that you used heroin, shaming might have little effect.

    This past winter, I watched Aldis teach two classes in Berkeley Springs, an Eastern Panhandle town, at a storefront church between a convenience store and a pawnshop. The bare trees on the ridge above us were outlined like black lace against the twilight. Inside, a few dozen people, mostly women, sipped coffee from Styrofoam cups in an unadorned room with a low ceiling, tan carpeting, and rows of tan chairs. Aldis touched briefly on what an overdose looks like, but acknowledged that the attendees probably already knew. At the first meeting I attended, in November, a few women began to cry when they heard that.

    At the second, in January, Aldis had some good news: the state had agreed to provide a hundred and eighty free kits. Aldis had been invited to Berkeley Springs by Melody Stotler, who ran a local organization for recovering addicts. Aldis introduced Kathy Williams, a former patient of his and the mother of two little girls.

    She had twice saved people with Narcan. One time, while she was driving, she spotted a car on the side of the road, and a man lying on his back next to it. The other time, a neighbor in her apartment complex knocked on her door and said that a guy was overdosing in the parking lot. She saw a woman tending to a man. A woman named Tara, who was at the January meeting with her teen-age stepdaughter, told me that she had revived a guy who lived in the trailer park where she did some babysitting.

    Someone called the police. She was a recovering addict herself—seven years now. She was studying to be a medical assistant. John Aldis, at his home office in Shepherdstown.

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    In , he became the first doctor in West Virginia to offer free public classes to teach anybody—not just first responders and health professionals—how to reverse opioid overdoses with the drug Narcan. Jason Chalmers loved his children, that was for sure. He crawled around on all fours, pretending to be a pony, to amuse his daughter, Jacey, and her younger brother, Liam. He submitted to Jacey whenever she wanted to cover his face with makeup. Liam was born in His mother, Angie, had struggled with an opioid problem, and had taken Suboxone to combat it during her pregnancy. He was on morphine for two solid weeks in the hospital.

    Jason, who grew up in Martinsburg, was a heroin addict for most of his life, a fact that puzzled his family almost as deeply as it saddened them. He grew up in an attractive, wooded development on a country road, with horses and dogs, and a kindhearted mother. His grandparents lived in the development, too, and Jason and his two siblings waited for the school bus together on a wooden bench that a neighbor had carved for them.

    There were glimmers of an explanation here and there. But who knew, really? It was the beginning of a self-destructive pattern. He got into using heroin, then into selling it. He introduced heroin to a girlfriend—a good student who had a scholarship to an excellent university. Interesting book, material a little dated since it came out in , but easy to understand for an avid fan of The Wire, as the author talks about the ports and the buy bust mentality of law enforcement.

    And there was an experiement to push all drug use to one particular area, you don't say? Probably where David Simon got the idea. The author had a very measured solution in mind for curbing America's out of control drug problem. I expected that by the end of the book he would be calling for co Interesting book, material a little dated since it came out in , but easy to understand for an avid fan of The Wire, as the author talks about the ports and the buy bust mentality of law enforcement.

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    I expected that by the end of the book he would be calling for complete legalization, instead it's more like harm reduction. Sounds good to me, our current system is all about harm magnification. Really, should a segement of society routinely have to give up their civil rights so that we can have a few more ounces of heroin off the streets. This shouldn't happen in America. Apr 07, Robin rated it really liked it. One might expect that a book written almost twenty years ago on the drug war would be relatively out-of-date today.

    The fact that it isn't is yet another data point in defense of the claims of the book. Despite the massive amounts of money and political capital spent on the drug war, things don't change.

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    Though the book is merely One might expect that a book written almost twenty years ago on the drug war would be relatively out-of-date today. Though the book is merely adequately, rather than eloquently, written, and you sometimes get the feeling that the author is doing a great amount of summarizing of complicated histories, the author's argument is compelling. The reader may or may not ultimately be convinced, but this book at least starts the discussion, which is something that, even today, is difficult to do. This book was pretty good. Good facts and figures about the drug war, although the style it was written in wasn't always compelling.

    There are other books that do a better job of keeping the reader engaged. I do recommend this to anyone willing to read about the subject, though. It wasn't too difficult to read, seemed to be pretty well footnoted, and for the most part kept its tone pretty professional, although some snark did sneak in in well justified places however.

    Good overall book, nothin This book was pretty good. Good overall book, nothing too impressive, but nothing terrible either. Excellent historical review of the public perceptions and governmental interventions in the drug problem. Gives a rundown of how the drug wars have played out on our streets and those of other countries. Very readable, in an appalling way. Clearly exdplains how everything the government has done to fight the war on drugs has benefited dealers, drug producers and gangsters and actively damaged treatment and prevention efforts.

    Explains why other countries have better success in preventing and tre Excellent historical review of the public perceptions and governmental interventions in the drug problem. Explains why other countries have better success in preventing and treating addictions. Jan 28, David Ward rated it liked it Shelves: business , drugs , essays , finance-economics , history , non-fiction. Here is an interesting recounting of the history of America's drug laws along with the personalities and policies that have led to our current state of laws and law enforcement.

    From Harry Anslinger through Prohibition and on into the Reagan and Bush administrations, the players and their errors are all here. The answer to our current dilemma: look to Amsterdam! Despite reading a edition, I consider it a good book. I think the analogy the author makes with the history of alcohol Prohibition, helps understand how the "drug problem" is growing and why.

    I definitely believe that Mr Gray's theory makes sense. More than 20 years later, I think this book would only need a chapter with the latest facts to complete the story of a problem that stll has not been solved. Aug 08, Mark Slee added it. Absolutely fascinating account of the history behind America's prohibitionist drug laws. This information in this book is very well researched and presented.

    Subutex, Suboxone and Methadone users might want to BEWARE

    It doesn't come across as too prescriptive, though makes it painstakingly clear that almost all our current policies were enacted either in the absence of data or in direct opposition to it. Also, and perhaps most importantly, it clearly lays out the systemic racial injustice that is the result of current policies. A compelling recounting of America's second prohibition, the futile "war on drugs" that has cost some much wealth and so many lives. Mike Gray shows how we can and should take another path, emphasizing education and regulation.

    We have recently put a free online copy up with the author's permission www. It provided interesting perspective on the drug war and its roots. How choices in the past have lead to serious problems now. It also provided some insight into how to get out of the mess. The book was written with a 90s perspective, which is interesting, as the war on drugs has sort of fallen behind the war on terror now.

    Aug 26, Sammie rated it liked it. This book is a must read. There is so much valuable information in here, it is a bit overwhelming, but you will be astounded by this text. It is pretty amazing to see all of the different views of different people who fought against or with the Drug war. I had never heard of the term "drug war" before until I read this book, and I am shocked that was the case. Jan 25, Brandon rated it really liked it Shelves: Might write a review later.

    Hard to review because it's definitely outdated but that's not the author's fault and despite that there is a ton of interesting insights concerning the origins of our drug laws. Nov 05, Adam rated it really liked it. Prescient novel with some very deep bits on the legislative history of drug laws, which as I'm sure most literate folks acknowledge, were not so much based on empirical data as much as they were based on whatever the opposite of empiric data is. Mar 05, Sarah rated it really liked it. I learned so much about the creation of drug policy in the United States and it terrified me.

    Discussed several other countries approach to addiction management. In my opinion we could take some cues from the Dutch and the British. Really informative and engaging text. May 15, Heather rated it it was amazing. Nov 07, Nicole rated it it was amazing. This book is important! Please read! Dec 14, Kelly marked it as to-read. Mar 20, Benjamin rated it it was amazing. Dec 14, Albert rated it it was amazing. This book is awesome, If you can, give it a try. View 1 comment.

    Nov 03, Nick rated it really liked it. Sure makes you think about thinks. May 17, Prattle On, Boyo rated it it was amazing. The dirty truth behind why the American government keeps certain drugs illegal and others legal. Dec 24, Samantha rated it liked it. Had to read for World History class. Joan rated it liked it Sep 07, Sinead rated it really liked it Jul 29, Alissa Thorne rated it it was amazing Oct 12, Jennifer rated it really liked it Feb 26, There are no discussion topics on this book yet. Readers also enjoyed. About Mike Gray.

    Mike Gray. Harold Michael "Mike" Gray October 26, — April 30, [1] was an American writer, screenwriter, cinematographer, film producer and director. Gray's books include: The Warning , about the accident at Three Mile Island Drug Crazy: How we got into this mess and how we can get out Angle of Attack , a biography of Harrison Storms which also details America's race to the moon The Harold Michael "Mike" Gray October 26, — April 30, [1] was an American writer, screenwriter, cinematographer, film producer and director.

    Books by Mike Gray. No trivia or quizzes yet. Welcome back.