Tag Archives: drugs

An Unseen Epidemic: Indian Americans & the Opioid Crisis

On 5th July 2020, Ikonkar Manmohan Singh Sandhu, a young 23-year-old boy, died from an opioid overdose in Michigan just months before he was to be married. He is by no means an isolated case in the Indian American community.

A small group of doctors are sounding the alarm on the nation’s opioid crisis. Dr. Arun Gupta is one of those who is urging health authorities to wake up to this catastrophe, which is ripping through communities with scant regard for race, gender, educational level, or financial standing.

To be fair, before COVID-19 ravaged the country, the growing opioid addiction was giving the nation’s health officials sleepless nights. The pandemic put this issue on the back burner and while more Americans are dying from the virus, it can be just as deadly if left unchecked.

Opioid overdoses have killed more than 70,000 young people annually between the ages of 18-54 for the past five years. In 2011, the CDC reported that overdose deaths superseded auto accident deaths for the first time in 32 states This is now true for all 50 states. The organization also reported that more than 700,000 young Americans have died between 1999- 2017 from polydrug overdose. That number is expected to be as high as one million by the end of 2020. The report further states that “preventable disease & retroactive analysis show that most of these deaths were unintentional.”  Isolation, stress, and the depression, that came in the wake of the pandemic are shooting cases through the roof.

Dr. Arun Gupta

“Parents are burying their children and children are burying their parents,” says Dr. Gupta. 

Dr. Gupta is quick to rid you of the rosy view that Indo American families have been unaffected by this affliction. It is a growing trend in the community, he says, largely due to parents’ unrealistic expectations for their children and the reality of facing conflicting cultures. What worsens it, is that many are either in denial or wary of seeking professional help for fear of being stigmatized or shunned. These are lives that could have easily been saved, he laments, much like the case of a distant relative who died because the family hesitated to reach out for help or were unaware of the problem.

A physician for 34 years, of which 14 are as a doctor of addiction management, Dr. Gupta has seen enough to be worried. He has been charting the surge in cases throughout the nation for the past decade and is seeing it played out at his doorstep – the rural region of Monroe, Michigan where he runs his private practice.

For 11 years, Dr. Gupta was the local prison doctor where he saw the interplay of drugs and death up close and the ineffectiveness of the administration’s efforts to curb it. This pushed him to change tracks from being a general physician to addiction management. Rural communities, he observes, are more prone to opioid addiction than urban areas where the population is better educated and have higher-paying jobs. The problem is compounded when there is family instability, lack of education, poverty,  physical, mental and sexual abuse in childhood, mental illness, or addiction both in the family and the patient. 

So why are addictive opioids prescribed in the first place and how do they hook us? About 25 years ago, pharma company Purdue, manufacturers of the painkiller Oxycodone, pushed the government to sanction prescribing painkillers for non-cancer-related pain. The American Pain Society also classified pain as the fifth vital sign after blood pressure, pulse, temperature, and weight. Statistically, 40% of the country’s population is in chronic pain and many require pain medication to carry out their daily activities or even go into work.

Addiction starts innocuously enough with a prescription for a painkiller to treat post-surgery or chronic pain as in instances of back pain. Consuming these painkillers diminishes the pain but also brings on a euphoric feeling as it raises dopamine – the brain’s pleasure hormone. Celebrities like Michael Jackson were known to use them before a performance, a term referred to as, “spotlight euphoria.” Additionally, it changes the perception of reality for those dealing with psychological issues such as an inferiority complex or anxiety,  these people now start “liking themselves and feeling good.” This altered reality quickly spirals into an emotional and social need followed by dependence and cravings for the painkiller.

The signs of addiction are evident in drastic mood changes, lethargy, or impaired decision-making, among others. Discontinuing the painkillers could lead to a host of withdrawal symptoms such as chills, tremors, body aches, bone pain, vomiting, diarrhea, or irregular respiration. However, Dr. Gupta clarifies that not everyone gets addicted to painkillers and the risk of addiction is only about 10%.

Soon, Oxycodone grew so popular that it began to have, “street value.” When prescriptions ran out, users turned to the streets where it could be obtained illegally. Hustlers began faking health issues to procure and sell these painkillers giving rise to the term “pill-mill.” The cost of one milligram of Oxycontin is one dollar so someone using 1000mg was spending $1000 a day. While insurance took care of legitimate prescriptions, those who were addicted were shelling out their own money. This, of course, was done in connivance with “some doctors who played the game.” Dr. Gupta estimates that about 1000 doctors have been apprehended so far for violating this practice and have “tarnished the image of doctors.”

There is an obvious connection between mental disorders and addictive disorders and its consequences can sometimes be life-threatening. Doctors, however, are required by law to treat pain with painkillers even if there is a sense/awareness that this medication could become addictive to the patient. On the other hand, if doctors practice caution in prescribing pain medication, they risk a bad review on their practice, something every doctor understandably wants to avoid. 

In 1999, the Center for Disease Control went on record for the first time and shared its report of 4000 young Americans who died from drugs. The government scrutinized the problem and rolled out the Drug Addiction Treatment Act of 2000. For the first time, this law allowed practicing doctors to learn and treat addiction with an FDA approved drug. The law also stipulated that any practicing doctor could complete an addiction program and receive an X DEA license which would allow them to treat 30 patients per month for a year. If the doctor’s records are found in order, they could treat 100 patients per month. Past President Barack Obama signed a law that would allow some doctors with specific credentials to treat 275 patients a month. This number was controlled to prevent its misuse but sometimes the best-intentioned laws have unintended consequences.

This one did. 

Only 4300 doctors in the US can treat 275 patients a month and Dr. Gupta is one of them. It’s a drop in the ocean for the estimated 20-40 million people who need help overcoming their addiction. There are more than 100,000 healthcare providers in the country that include doctors, nurses, and physician assistants who have the necessary X- DEA credentials to treat opioid use disorders. But less than 20,000 are actively involved in dealing with the growing opioid epidemic in the country. This lack of access to a healthcare provider aggravates the problem leading to more deaths than recoveries. Meanwhile, the pandemic has not made things easier. There is excessive stress and limited counseling due to the shutdowns and prescriptions cannot be given on the phone without the necessary drug testing. This explains the rise in overdose deaths and addiction cases in the past nine months.

Apart from flawed policy, the American Society of Addiction states that every doctor who graduates from medical school is required to study addiction management. There are 179 medical schools and approximately 9000 residency programs in the country and not one of them teaches this course.  Moreover, addiction management is not considered on par with other areas of medical specialization and neither do insurance companies view addiction like other chronic diseases such as blood pressure or diabetes.

In 2002, the drug Buprenorphine was approved for addiction treatment and ten years later another drug Zubsolv made it to treatment plans. These drugs block the opioid receptors in the brain and reduce a person’s craving for the painkiller. Another ingredient in the drug, naloxone, reverses the effects of opioids. Together, they prevent withdrawal symptoms and deter the abuser from snorting or injecting it. Dr. Gupta pairs medication with counseling, and non-addictive medication in cases of insomnia or anxiety. Recovery takes anywhere from six weeks to six months depending on the severity of the addiction, but the struggle to remain clean continues for the rest of their lives.

With death rates from opioid misuse surging, more than 500 laws were enacted in the last 10 years against doctors, pill mills, and pharmaceutical companies to curb the problem but this has only exacerbated the issue. Addicts are now forced to go to the streets instead of visiting a doctor for treatment. Dr. Gupta notes that national autopsy results over the last 5 years consistently show that fentanyl, heroin, and cocaine are the first three drugs in more than 55% of the people with drug overdose deaths as opposed to prescription medication.

Over the past few years, Dr. Gupta has presented more than 150 talks to schools, doctors, healthcare systems, and social organizations like Rotary clubs and the Kiwanis Club to highlight the gravity of the problem and his message that addiction can be cured. He is talking to elected officials to leverage their influence and galvanize the government to rethink the limit of patients and allow greater access to people who want to overcome their addiction. 

Addiction, he warns, has become synonymous with a death sentence in this country.


Manu Shah is a freelance writer covering Indo American news.

Support to Help Your Children and Family During these Difficult Times

The current state of our country and world has been hard for us all, including the children in our lives. It is important that we all do what we can to take care of our overall wellbeing, including our physical and emotional health, and support our children to do so as well.

If your child has lots of worries, difficulty concentrating, is withdrawn or getting upset or angry more easily,  this may be impacting their ability to do well in school, in their relationships with family and friends, and sometimes even with managing daily activities.

Counseling can be a great support for them and AACI is here to help.

AACI provides individual counseling, family counseling, parenting support, case management and medication evaluation and support services through telehealth and in person, if needed. Contact us today to determine which of our programs best fits your needs.

For general program information, please contact Nira Singh, Psy.D., Director of Behavioral Health: Nira.Singh@aaci.org<mailto:Nira.Singh@aaci.org>

Eligibility for Family & Child Specialty Mental Health Outpatient Programs:

*   Child or adolescent between 6-21 years old
*   Must have full scope Medi-Cal and meets program parameters
Visit www.aaci.org/behavioral-health/family-children<https://aaci.org/behavioral-health/family-children/
Eligibility for ADAPT – Adolescent Outpatient Substance Abuse program

*   Adolescent between 13-21 years old
*   Struggling with Alcohol and Drugs and meets program parameters
visit: www.aaci.org/behavioral-health/family-children/adapt<https://aaci.org/behavioral-health/family-children/adapt/

Or call (408) 975-2730 and ask for our any of our Family and Children Department program managers for more information.

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Top Tips For Relocating To Qatar

With its high salaries, zero income tax, and glamorous lifestyle, it’s not surprising that Qatar is one of the hottest destinations for expats. Here are some top tips to help you prepare for moving there.

Get ready to embrace the heat

One of the biggest challenges expats face when moving to Qatar is acclimatizing to the intense climate. Temperatures can peak at around 50 degrees Celcius in summer and levels of humidity can reach around 40-60%. But you shouldn’t let this put you off, because every building has air-conditioning and there are numerous hotel pools to cool down in.  

Take advantage of the excellent healthcare 

Qatar boasts one of the top 5 healthcare systems in the world which is great news for expats. And because all employers in Qatar are legally required to provide healthcare for their employees, expats should be covered from day one. They can either access state healthcare services at a subsidized rate or buy private health insurance to access excellent private facilities and cover any costs not met through public healthcare. 

Remember to dress conservatively 

Qatari society is heavily influenced by Islamic customs, so expats should dress conservatively when out and about in public. Men should avoid wearing shorts and sleeveless shirts in public places and women should avoid wearing revealing clothes that don’t cover their shoulders and knees. It’s also important to respect local etiquette when it comes to greetings and general behavior. 

Be aware of the strict laws on drugs and alcohol

For most expats, drinking alcohol is a normal part of life, but in Qatar, there are strict laws to abide by. Drinking alcohol or being drunk in public are offenses and drink-driving and other alcohol-related offenses can result in imprisonment, fines, or even deportation. That said, alcohol is still available at licensed hotel restaurants, bars, and certain clubs and expats should carry their Qatar ID or passport with them. The use and selling of recreational drugs are illegal too, and offenders can face long-term imprisonment, heavy fines, and deportation. 

 

Congressman Khanna Informs Local Media on What Keeps Congress Awake at Night

Congressman Ro Khanna spoke with the journalists from ethnic media on 12th November 2019. The teleconference, organized by Vandana Kumar, Publisher India Currents, came at a timely juncture when the nation and community is gearing up for the 2020 Presidential elections and it is time to take stock of what the nation has gained and lost in the last few years. Cyber security and Healthcare emerged as two issues that impact the community and are close to the heart of the Congress.

Cyber security, with routine data mining in the face of the fast changing social media landscape, was raised as a special concern. As Internet becomes a large part of our daily lives what is Congress doing in terms of legislation to address the issue of cyber crime? The Congressman addressed the press’ concerns and spoke of his request for the Internet Bill of Rights.

Congressman Ro Khanna (California’s 17th district) has introduced the Internet Bill of Rights, a proposal that includes the right to know about “all collection and uses of personal data by companies,” and to be notified “in a timely manner when a security breach or unauthorized access of personal data is discovered.” He aims to strengthen people’s ability to correct or delete personal data in a company’s control, and require companies to obtain consumer consent before collecting or sharing data with third parties. In the Congressman’s words the bill would require people to give their consent making it harder for the companies to collect data, a situation better than the one in China where people have very little protection.

The Congressman also felt blatant falsity should not be allowed. There is an obligation on the part of companies like Google and Facebook to check for an obvious disregard of the truth. If copyright violation can be checked then surely they can remove false information by following the same procedure. Perhaps, he said, we need an independent depoliticized government agency that can define the rules and draw the boundary of truth.

Though there is a desire to regulate social media before the 2020 election, what really keeps the Congress awake at night is the question of healthcare. Khanna is hoping the social media corporations will hopefully voluntarily self regulate if no legislation can be passed in time for the 2020 elections. However, Congress must and has been working hard on providing affordable healthcare.

It is the Congressman’s view that “more than almost anything else, our health has a tremendous impact on our day-to-day activities, state of mind, and overall well-being. Good health is foundational to everything else we do – our ability to take care of our families, be productive at work, and pursue our passions and hobbies”.

“We need basic care and low premiums,” said the Congressman.

Congressman Khanna would like the creation of a single-payer health care system, or Medicare for All and supports legislation to allow Medicare to negotiate for more reasonable drug prices. This type of legislation will allow Americans below the age of 65 to buy into Medicare. A result of this would be that community members could save money through reduced fees and premiums.

Congressman Khanna also supports legislation to allow for the importation of drugs from nations that we trust. He was an original co-sponsor of legislation to allow for the importation of Canadian drugs.

“We must increase coverage, support small businesses, expand primary care, and provide lower premiums. Medicare for All is the next step toward addressing the high costs and inequalities in the current health care system,” said Congressman Ro Khanna. The congressman feels the states should be empowered to create their own solution if the federal government is unable to establish a single-payer system. We must guarantee health care as a right, not a privilege.

The telebriefing on “The Role of Silicon Valley in the 2020 Elections”, moderated by Vandana Kumar (Publisher, India Currents), gave Congressman Ro Khanna (California’s 17th district) an opportunity to share his perspectives as a key lawmaker representing the Silicon Valley. Sponsored by India Currents in partnership with Ethnic Media Services, it is part of the ‘Conversations with Candidates’ series initiated by India Currents to expand ethnic media news access to elected officials and presidential candidates.

Ritu Marwah is a citizen who would like to pay closer attention to the political issues that are bound to impact her life. She understands that an informed citizen is a safer citizen.