Enter Zohyrdo

Just heard on the radio this morning that in a few weeks a new painkiller called Zohydro is about to hit the market. A single 50 mg capsule contains 10 times the hydrocodone than a regular Vicodin. An adult with no tolerance could potentially overdose on two capsules and a child on a single capsule. And the capsules are easily crushable.

Zohydro "was first developed in 2002 by Elan, which merged with Alkermes, and Zogenix acquired the U.S. rights in November 2007."* Elan's parent company Perrigo is based out of Dublin. 

Given the recent surge in painkiller-related overdose deaths and increase in heroin abuse and overdose deaths — experts in the field, even doctors specializing in pain management are puzzled if not extremely concerned. I am quoting from Huffingtonpost below (see the link below):

"Concerned about FDA approval of Zohydro? You are in good company. This morning a letter signed by more than 40 organizations was sent to FDA Commissioner Hamburg, urging her to keep Zohydro off the market. The organizations include some of the most prominent addiction-treatment agencies in the country, including Hazelden, Caron, and Phoenix House. Other co-signers include CASA Columbia, the American Society of Addiction Medicine, Blue Cross Blue Shield, the consumer advocacy group Public Citizen, and dozens of community-based addiction-prevention organizations."

http://www.huffingtonpost.com/andrew-kolodny-md/zohydro-the-fdaapproved-p_b_4855964.html

BTW, Elan plans to introduce a non-crushable form in three years, which I believe has something to do with limiting generic versions being produced by other manufacturers.

Here is another block quote from Huffingtonpost:

"Second, please make your way to Washington, D.C., for the FED UP! rally on Sept. 28, 2014, where you will be joined by thousands of people who are equally fed up by the FDA's long track record of putting opioid manufacturers' interests ahead of public health."

*Read more from Journal Sentinel: http://www.jsonline.com/watchdog/watchdogreports/zohydros-maker-not-required-by-fda-to-take-abuse-deterrent-steps-b99129543z1-229528381.html#ixzz2uR0NfR1S 

What Kind of Love Do You Desire?

Love is our true destiny. We do not find the meaning of life by ourselves alone - we find it with another.  –Thomas Merton

Today being Valentine's Day I thought to write about love.
Oh, how very original.

John Lee, a Canadian psychologist who wrote The Six Colours of Love (it's out of print). It's somewhat like Erich Fromm's The Art of Loving, a book which I read. Fromm's book is a classic, but for cynical New Yorkers it's a bit out there. It's aspirational at best. We all want to cultivate a loving, supportive, mutually dependent relationship. Something would be wrong if we didn't want this.

There is no single ideal way of loving another. At some point we have to decide whether we can be okay with what we don't get from a relationship. We have to deal with the ambivalence — what it is that frustrates us. More on that another time.

In the meantime, here are the six types of LUV.

• Eros: a passionate physical and emotional love based on aesthetic enjoyment; stereotype of romantic love. What is aesthetic enjoyment? Aesthetics is the philosophic study of beauty. You love each other so much you can just enjoy how good looking you are together. This type of love is the mainstay of "date movies," and selling point of everything from cars to perfume.
• Ludus: love as a numbers game, a game of winning hearts. The aim of this sport or past-time is the conquest and so more the merrier. This type of lover is able to love multiple lovers at one time. Perhaps an indication of a narcissistic person trying to fill a big old hole in the heart, or a spiritual void, or sex addiction?
• Storge: an affectionate love based on mutual commitment, which slowly develops from friendship, based on similarity. What an unromantic sounding word. It's Greek and means natural affection, like the affection of a parent toward their child. Probably the type of love that will endure and the basis for our notion of "marriage." Passion becomes familiarity and bears true friendship. Probably what keeps couples together for 50 years plus.
• Pragma: Head over heart. Love that is akin to a coalition or corporation. You agree on your core values and assign duties and responsibilities and march towards the end. And, the end justifies the means. The end is beneficial to both partners, whether it is mutual gain of power and prestige or 2.5 children, new Lexus every year and a summer home in the Hamptons. The Clintons, and Anthony Weiner and Huma Abedin come to mind.
• Mania: The stuff of novels, poetry and opera from a few centuries ago. It was common lovers out of jealous passion committed suicide and even killed their rivals (it still happens.) Men would have duels with firearms or blades. Now, it's considered more of a female problem and deemed unhealthy and pathological. Even at the height of Romanticism passion slid into the darker ideé fixe.  What we term codependency is at the lighter end of manic love. Jealousy and possessiveness are its markers. To paraphrase Andrew Solomon, a little mental illness can be a good thing. A bit of jealousy and possessiveness is okay, as long as it doesn't become violent and stalky.
• Agape: I think this is the most idealistic form of love. It's all about being selfless, sacrificing, accepting, giving without expectations. It's unconditional love. It sounds unrealistic and dated. In fact, it is very dated. It is the basic principle of Christian love, embodied in the historical/mythical figure of Jesus. And he was martyr numero uno. 

French Youth Turn to Smoking Hydrangea Flowers for a High

http://www.albion-prints.com/

Hydrangeas, perennial flowering shrub found in many private and public gardens, are being stolen by recreational drug users in France. Personally they don't hold much appeal for me horticulturally; I find them old fashioned and uninteresting. But little did I know about their hallucinogenic properties. 

It's been reported that gangs of kids are indiscriminately lobbing off flowers from gardens private and public with the intention of drying the petals which then are mixed with tobacco for a flowery blunt. 

Botanists and pharmacists confirm that the smoking the flowers induce a similar high from that of THC, but (this is a big BUT) the resulting smoke also contains hydrogen cyanide. 

I am quoting the Guardian here:

"'The secondary effects of it are very bad for the health,' Hostettmann told Le Matin newspaper last year. He said the flowers could provoke stomach and respiratory problems, speed up the heart, cause dizzy spells and, if consumed in large quantities, produce hydrogen cyanide (also known as prussic acid), the base of Zyklon B, the poison gas used in the Nazi death chambers, causing a slow and painful death."

Yikes! 

Economic troubles are forcing people to turn to cheaper alternatives for intoxication. And my position is that the desire for intoxicants or mind-altering experiences is human, it has been and it always will be"; it is neither criminal (although stealing is) or pathological. 

Here is the link again:

http://www.theguardian.com/world/2014/feb/06/high-danger-hydrangea-french-police-hunt-gang

What If Money Were No Object? Asks Alan Watts

"Better to have a short life that is full of doing what you like doing than have a long life spent in a miserable way."

Alan Watts

Addiction Is a Chronically Relapsing Disease: Philip Seymour Hoffman Part 2

There isn't much I can add to the very sad story. As more details emerge, the more depressing it becomes.

Addiction kills. Relapse is a boogeyman who stalks his prey, always looking for a crack in the armor. PSH's long-term partner left him and took their three children with her. It's not clear if she left because he relapsed or the separation caused the relapse. It's easy to get drawn into this sensational story, but I will leave those details for others.

But I do like this piece from the Slate.com about relapses and why they are to be feared.

Philip Seymour Hoffman's Overdose

It's the latest story of a very successful artist dying from addiction. I didn't say celebrity because he didn't strike me as such. A celebrity is someone famous who is compelled by fame to continue his or her work. I once saw him in Othello that had been readapted by a living playwright and staged at NYU. I found it unbearably pretentious and long, but then again everyone hated it including all the critics. Still, even as an unsophisticated theater viewer I felt his amazing stage presence; it was clear he was an artist, a very serious artist. 

Studies have linked creativity to susceptibility to mental illness. And the connection between mental illness and addiction is undeniable. “Mental illnesses can lead to drug abuse. Individuals with overt, mild, or even subclinical mental disorders may abuse drugs as a form of self-medication,” according to the National Institute on Drug Abuse — addiction is a mental illness. The problem is that drugs, especially opiates are extremely addictive (psychologically and physically) and the possibility of overdose increases as tolerance builds — the longer you use you need a bigger dose of the drug to for the same level of euphoria. 

What's more troubling is that when a recovering opiate addict relapses, they face a greater risk for overdose. It's because physical tolerance decreases during recovery, but the psychological craving for the drug persists. 

Sadly, the often-quoted AA/NA mantras "one day at a time" and "once an addict, always an addict" ring too true.

There are tons of interviews and articles about PSH talking about acting and his struggle with addiction. After attending NYU as an undergraduate, he went to rehab and was sober for 23 years. This past year he publicly admitted to relapsing on painkillers that led to sniffing heroin. He then went into a drug treatment program for ten days, which really means he detoxed from opiates for ten days. 

Why did PSH only spend ten days in "treatment"? If he did get treated in a proper rehab program (28 days or longer), would I be writing about him along with so many others?

Relapsing after 23 years of sobriety, he does "rehab" for ten days. And less than a year later he is found dead in a luxurious bathroom with a needle his arm, in his underwear, next to baggies of heroin. 

Of all the great movies he's been in, I remembered Before the Devil Knows You're Dead, a dark comedy (the internet says a thriller) about a very anxious man, his dysfunctional family and the desperate measures he takes to escape his life. PSH plays the man who plans to "rob" his parent's jewelry store with the help of his useless brother. Things go wrong, and his situation worsens. And behind all his trouble is his addiction to heroin. Near the end of the movie, we find him in a luxury apartment, no ordinary shooting gallery. He makes his purchase, shoots up and is left alone to nod off on very expensive furniture.