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First Signs of Alcoholic Liver Cirrhosis are Not in the Liver

Addiction Recovery Bulletin

First comes bloating, nausea, vomiting, gas and diarrhea  –  

Sep 29, 2020 – The combination of my father’s death and my personal background lit a fire in me to know more. He was admitted to the hospital on June 24th, 2016, and he died on July 18th, 2016. That’s only 24 days between the first sign there was a problem and his subsequent death.

Now, hearing that he was in end-stage cirrhosis didn’t surprise me, given his heavy drinking. What did surprise me was that he’d visited several doctors and specialists in the months before his death, and no one knew his liver was struggling either.

So what happened? Does end-stage liver cirrhosis really sneak up that fast? Were there other signs that would have alerted someone to his failing liver?

more@Medium

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Mother’s Little Helper Is Back

Addiction Recovery Bulletin

“What a drag it is getting old” –  

Oct 3, 2020 – That [message] is from a mother in California in early September, when she was trapped inside with her three children for days because the air was so thick with smoke that it was unsafe to breathe outside. Since the pandemic began, members of the group have experienced job losses, wildfires, weekslong power outages from tropical storms, political unrest, elderly parents with Covid-19, a news cycle on turbo and unending days filled with educating, feeding and caring for their children while also trying to fit in eight or more hours of work.

And we’re the lucky ones who can meet our children’s basic needs. Somewhere between 20 and 40 percent of parents of children under 5 have worried about their children getting enough to eat since the pandemic started, and many who cannot work remotely are scrambling for coverage with the fitful reopening of day care centers and schools.  The increase of substance use among parents is “just kind of understandable,” said Jonathan Metzl, the director of the department of medicine, health and society at Vanderbilt University. “This is an incredible, once-in-an-epoch stressful situation, and the kinds of outlets people usually have in their lives are just not available.” We can’t go to the office, we can’t go to the gym, we can’t really see friends or family, and we never get a break.” “My hobby is doom scrolling and learning the science of Covid and smoking weed and sitting on the toilet staring at the wall,” said Julie Kortekaas, 36, a mother of two children, ages 10 and 18, and a health-food restaurant owner in London, Ontario.”

more@NYTimes

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Two fentanyl deaths a day in San Francisco

Addiction Recovery Bulletin

Golden Gate Deaths –

Oct 10, 2020 – Paramedics revive an overdose victim in the Tenderloin in July. San Francisco is on track to lose more than 700 people to drugs in 2020 — or nearly two every day.

more@SFChronicle

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United States Chamber of Commerce does not support $465M Oklahoma opioid judgment

Addiction Recovery Bulletin

Business as Usual –  

Oct 9, 2020 – Cleveland County District Judge Thad Balkman last summer ordered Johnson & Johnson to pay $572 million to help address the state’s opioid crisis, saying the consumer products giant downplayed the risk of addiction and death while overstating the benefits of opioid painkillers. State attorneys have previously argued it was appropriate to file the case as a public nuisance lawsuit since the state was seeking money to abate the opioid epidemic rather than damages to pay for harm caused by the company. “Unless this Court overturns the decision, Oklahoma will become ground zero for every breed of public-nuisance claim imaginable,” the Chamber said. “The decision will chill business activity throughout Oklahoma.”

Prescription opioids have been linked to more than 6,100 deaths in Oklahoma from 2000-2017. Balkman reduced the amount to pay about a month later by nearly $107 million, acknowledging he miscalculated in determining how much Johnson & Johnson must pay the state to help address the state’s opioid crisis.  Attorneys for the U.S. Chamber of Commerce argued there was “no basis in Oklahoma law” for the way the state’s public nuisance statute was applied in this case, according to The Oklahoman.  “The trial court ignored the differences between actually false speech and speech that is only “potentially misleading,” attorneys for the Goldwater Institute said.

more@JournalStar

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FDA says anti-anxiety medications highly addictive: But is the warning too late?

Addiction Recovery Bulletin

Asleep at the wheel –

Oct. 7, 2020 – The FDA estimates that 92 million benzodiazepine prescriptions were dispensed from U.S. pharmacies in 2019.

In addition, an estimated 50% of patients in 2018 took benzodiazepines for two months or longer, even though the recommended use is no more than a few weeks or months, according to FDA statistics.

Patents have expired on familiar brand names like Xanax, Klonopin and Ativan, meaning versions can now be manufactured by pharmaceutical companies that make lower-cost generic drugs. Today, there are about 20 companies in the U.S that manufacture these medications.

All will need to comply with the new warning to continue selling the drugs. Genentech, the manufacturer of Klonopin, told ABC News that “patient safety is of the utmost importance to us and we take our responsibility very seriously. We are aware of the class label update for all benzodiazepines, which includes Klonopin, and we are working with the FDA to update the medicine’s label.”

more@ABCNews

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Coronavirus Deaths Account for More than 67% of Surplus Deaths in the US

So far during the pandemic, around 20% more people have died in the United States than the normal expectation in the period from March to August, and about 67% of them were coronavirus deaths, according to a research published by Steven Woolf, a professor at the Yale School of Public Health and the Virginia Commonwealth University School of Medicine, and his colleagues.

The research published in the journal JAMA stated that the deaths in the US are very consistent year after year but from March 2020 to July 2020 the deaths were increased by nearly 20% and for about two-thirds of them, coronavirus was the main cause stated in the documents.

Also Read: Coronavirus in Children is leaving its effects long after being diagnosed

The researchers for the purpose of this research studied death data from US Census Bureau and the National Center for Health Statistics. In total, around 1.3 million people died in the period between March and August in the US, however, usually, around 1.1 million people die in that period, so an increase of 20% was observed.

The ten states in the US which had the highest percentage of excess deaths including coronavirus deaths included New Jersey, Louisiana, Mississippi, Delaware, Michigan, New York, Massachusetts, Arizona, Maryland, and Rhode Island. The increase in the percentage of deaths ranged from 65% in New York to 22% in Michigan and Rhode Island. The states having the highest death rate including Massachusetts, New York, and New Jersey also made up almost 30% of the excess deaths in the US, according to the researchers.

Woolf said on Monday that people who are skeptical about the number of coronavirus deaths and term them fake and think that the real deaths are much less than reported, this along with many other pieces of research show that the reality is quite opposite to their beliefs. He further added that there may have been cases where people who never contracted the virus died because of the disruptions that the coronavirus pandemic caused. These deaths included people who were not given proper care, who had acute emergencies, and people who committed suicide due to emotional crises.

The researchers wrote that in the states that reopened later due to surges of the virus in April experience shorter epidemics, while the states that chose to reopen earlier faced tougher consequences including an increase in excess deaths throughout the summer.

After analyzing the deaths, the researchers found that an increase was observed in causes of death other than the coronavirus, including an increase in the death rate due to heart disease which was observed in the period between the 21st of March and 11th of April in the US, and coincided with the surge in coronavirus during the spring. Moreover, death rates for dementia and Alzheimer’s disease also increased by two times and were observed initially during the 21st of March and 11th of April and then between the 6th of June and 25th of July, driven by the summer surge in some states.

The study had some limitations as provisional data was used for it and assumptions and inaccuracies were applied, yet these deaths truly reflect the human cost that the pandemic caused. The researchers wrote that the deaths due to coronavirus exceed the number of deaths by Vietnam and the Korean Wars, and the swine flu of 2009, and are approximately equal to the deaths caused by the World War II.

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Acceptance?

By John B

Something about 12 Step recovery that continues to pique my interest is how some assertions that make absolutely no sense to me have been endowed with the status of AA infallibility. Very early I was astonished to hear, “my best thinking got me here.” I thought that statement ignored reality; after 36 years of sobriety, I’m still convinced that it was my worst thinking that led to my qualification as an AA member. The persistent warning to guard against a return to “stinking thinking” supports this view.

Another of the maxims clothed in infallibility is this sentence… “And acceptance is the answer to all my problems today.” (Big Book, 4th edition, p. 417) My intent in this essay is to address how I think the concept of ‘acceptance’ is misapplied in the Big Book by Bill Wilson and the doctor who wrote the chapter quoted from above, “Acceptance Was the Answer”. The views by these two authors are in direct confrontation with a non-God approach to recovery. But…

Before I take issue with Mr. Wilson and the doctor, I want to acknowledge how many of my sober friends have applied the concept of acceptance to Step 1, which is the point in recovery where I have heard it shared most frequently. I’d be amazed if you haven’t heard some version of this; it goes like this…”I just couldn’t get Step 1 done thoroughly until I fully accepted that I was an alcoholic. I admitted it to myself and to others, but it took more time for me to fully accept it.” I don’t pretend to know what motivates other alcoholics, what it takes for them to get sober and to stay sober, and my intent is not to engage in a semantic argument concerning any nuance between the meaning of the two words admit and accept. That’s up to each individual. Reason and personal experience lead us to discover what works for us, and it is important to remember that we are under no obligation to accept suggestions based solely on tradition or on some form of self-endowed authority emanating from a self-appointed Big Book guru.

In retrospect, it is clear to me that my major deficiency throughout the four miserable years that I failed to successfully complete Step 1 was lack of honesty. More drinking, more problems, and more pain shoved me over the threshed of honesty just far enough for me to make Step 1’s required admission and that admission placed me on the uninterrupted path of continuous sobriety. The completion of Step 1 quickly made it possible for me to admit the necessity for outside help. I can see where a person might see the influence of acceptance here, but I see it as the gradual awakening and the gradual strengthening of honesty which served to sustain my commitment to start living like a responsible adult. A life worthy of respect. Acceptance was the by-product of honesty, not a derivative of authoritative tradition designed to lead me to a relationship with God as portrayed by the Doc and Mr. Wilson in The Big Book. Without equivocation they both conclude that the most important function of acceptance is to accept the necessity to find God and put Him in charge.

Apparently it was the visit from Ebby Thatcher in late November, 1934, that jump started Wilson’s thinking that reliance on God would rid him of his addiction to alcohol. Having found God through his involvement with the Oxford Group, Thatcher had been able to stay sober for two months prior to his visit with his old friend Bill W, and Bill saw him as a miracle sitting, “across the kitchen table.” (Big Book, p. 11) At this point in his life Bill described his attitude toward God as “intense antipathy”. He tells us he could accept concepts such as, “Creative Intelligence, Universal Mind, or Spirit of Nature, but I resisted the thought of a Czar of the Heavens.” (Big Book, p. 12) Less than a month later after the Thatcher visit, Wilson checked into Towns Hospital on December 11, 1934, and it was here that he relinquished control of his life to God. “There I humbly offered myself to God, as I then understood Him, to do with me as He would. I placed myself unreservedly under His care and direction.” (Big Book, p. 13) Acceptance to Bill pointed in one direction – accept God into his life or remain a slave to alcohol.

I’ve noticed many sober alcoholics recommend that we don’t focus too much on Wilson’s earlier writings and instead concentrate on his later thoughts where he opened up a much wider interpretation to the clause, “as we understood Him”. I’ve done that myself on occasion to validate my own view, but there is a serious problem with that suggestion concerning newcomers. Those later thoughts are to be found in books like As Bill Sees It and The Language of The Heart. Those sources are unknown to raw beginners, and for that matter to a high percentage of Big Book worshipers. The Big Book is still the source placed into the hands of newbies, and there Wilson is all about God. It serves as the opening whammy to slap down any hint that a person might be able to use reason and willpower to build a sober life. Accept God or be a loser.

As a non-believer, freethinking alcoholic I’ve received an abundance of, “there he goes again”, body language in meetings. One certain way to get the eyes rolling is to challenge the validity of this oft quoted favorite of AA infallibility: “And acceptance is the answer to all my problems today.” (Big Book, 4th edition, p. 417) Like Wilson, the Doc emphasizes the need to accept the reliance on God as the driving force that leads to sobriety and also to get squared away to living life in general. The first ten pages of his story makes for a long drunk-drug-a-logue that paints a perfect picture of a high functioning alcoholic/addict. He lays out a vivid picture of his arrogant denial and after seven months of treatment and AA involvement, since he wasn’t staying sober, he decided to have a conversation with God.

The divinely inspired wisdom that ensued was this: “When I stopped living in the problem and began living in the answer, the problem went away. From that moment on, I have not had a single compulsion to drink.”(p. 417) That sounds a lot like what it takes to do Step 1, and that step contains the word admit, not accept. In addition, the sustained commitment necessary to remain focused on “living in the solution” requires action not acceptance. Quite simply, the author conflates acceptance with honesty and the necessity for corrective actions. His famous line, “And acceptance is the answer to all my problems today,” is just his intro to his claim that “nothing, absolutely nothing, happens in God’s world by mistake.” (Big Book, p. 417) To finalize this divine contract, he leaves us with this: “Acceptance is the key to my relationship with God today.” (Big Book, p. 420)

My objective has not been to denigrate the varied applications of acceptance that have been useful to many of my sober friends. I too applied acceptance to my own recovery with the belated decision to allow a select group of sober alcoholics to overrule my sick thinking, but I am also convinced that it’s a tool that needs to be used with caution. Over reliance on acceptance can lead to complacency and in the extreme can feed denial. What I had to do was correct the unacceptable attributes I had allowed to dominate my life. Acceptance was a derivative of honesty, not my primary motivator. Acceptance designed to ultimately rely on divine authority can lead to submissiveness, which has the potential to dis-empower the individual. On this count, Bill Wilson and the Doc need to be rejected. Just one more reason to view the Big Book as a museum piece. Look and move on to the next display case.

To date, John has written a total of 16 articles posted on AA Agnostica, five on various sobriety subjects and eleven on the Steps. Here they are:

Acceptance? (October 11, 2020)

Religion Free AA – Is It Possible? (August 9, 2020)

How It Works Without A God (May 31, 2020)

Schaberg’s book on the Big Book – A Few Thoughts (January 22, 2020)

My Recovery in Traditional AA (March 10, 2019)

And now on the Steps:

John’s Recovery: Step Twelve (February 26, 2020)

John’s Recovery: Step Eleven (February 12, 2020)

John’s Recovery: Step Ten (January 29, 2020)

John’s Recovery: Step Nine (January 15, 2020)

John’s Recovery: Step Eight (January 1, 2020)

John’s Recovery: Steps Six and Seven (December 11, 2019)

John’s Recovery: Step Five (November 27, 2019)

John’s Recovery: Step Four (November 13, 2019)

John’s Recovery: Step Three (October 30, 2019)

John’s Recovery: Step Two (October 16, 2019)

John’s Recovery: Step One (September 18, 2019)

John is an eighty-four year old sober alcoholic with 36 years of continuous sobriety. Married to Helen for 54 years; three kids in their 50’s. Spent 17 years teaching and coaching at the high school level in Indiana and Illinois. Owned and operated a bar and restaurant for 13 years which led to the acceleration of his alcoholism, which led to treatment, and eventually led to a career as an addiction counselor. Retired in 2001 from the Marion, In. V.A. Served as office manager for a major AA intergroup office in N.E. In. for six and a half years. Was an excellent high school and small college basketball player. Still goes to the gym three days a week and shoots 200 three point shots and does some light weight lifting. Passionate about family, recovery, basketball, and the St. Louis Cardinals. Reads 20 to 25 books a year, and three or four quality periodicals on a regular basis; mostly about politics, economics, science, history: about anything going on in the world that strikes his curiosity.

 

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Who is Better at Following Coronavirus Safety Precautions, Men or Women?

The best ways to stop the spread of coronavirus, as we know, are following the safety precautions including wearing masks, washing hands frequently, and following social distancing. According to a study conducted by researchers at Yale University and New York University, it is discovered that women are better than men in following these coronavirus safety precautions.

The researchers surveyed 800 people by using smartphone movement analysis and street observations. They said that men are less likely than women to say that they stayed at home, met less with friends and family, followed social distancing, and washed hands regularly. The only factor at which there was no difference between men and women was the frequency of meeting with people who were other than family or friends.

Also Read: Coronavirus Cases in the US in a Day Reach the ‘Highest in Months’

According to the study published in the journal Behavioral Science and Policy women are not only better at taking coronavirus safety precautions but that they were also more likely to heed the advice given to them by the experts. However, self-reports cannot always be trusted so in several different locations in the US including New Haven, Connecticut and New Brunswick, New York City, and New Jersey the researchers looked at people walking the streets to observe it first hand that how many people do actually wear masks. The researchers observed 173 men and 127 women and discovered that around 38% of men and 55% of women properly wore face masks or face shields.

To observe the population of the US in more detail the researchers tracked the movement of individuals and them visiting unessential places like fitness facilities, florists, and spas by using GPS data from the smartphones of nearly 15 million US people. It was found by the results that counties in which males were in higher percentages followed less social distancing.

According to the researchers, the discoveries made by this research were not surprising as it’s a long-known fact that women are better at handwashing than men. A review conducted in 2016 that observed researches from different countries discovered that men were 50% less likely than women to adhere to safety behavior like wearing masks, cleaning of surfaces, and handwashing in order to protect themselves from an epidemic.

A researcher at the New York University and lead author of the paper Irmak Olcaysoy Okten said that a study conducted before the coronavirus pandemic confirmed that women were more likely to follow the recommendation of doctors and also visit them more regularly in their day to day basis than men. She added that women are also more attentive to other people’s health-related needs. So Okten believes it is not surprising that women are better at following the coronavirus safety precautions and also in stopping the spread of the virus than men.

Okten believes that an effective strategy to combat the spread of the coronavirus could be the deliverance of health messages that are finely tuned to target men. Moreover, the researchers wrote in the study that policymakers should try to target the illusions of invincibility that men have and also make men remind that they have responsibilities towards other people and towards themselves in these difficult times. They added that an effective strategy could be to distribute prevention messages in non-essential places where men gather frequently.

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Coronavirus Cases in the US in a Day Reach the ‘Highest in Months’

The number of coronavirus cases in the US has already hit 7.6 million, which is the highest number in the world and makes 20% of the total cases worldwide, however the population of the US is only 4% of the global population. The initial spike was observed in the US in late March, but social distancing and other safety measures brought the number of cases down and stabilized the country by May. Now as the lockdown measures are eased, the coronavirus cases in the US are piling up again.

More than 56000 new coronavirus cases in the US were reported on Thursday according to data from Johns Hopkins, and the country is now averaging nearly 45000 cases of the virus daily. This is the highest daily number of cases the country has seen since August and twice of the number of daily cases in June, and the number of deaths from the virus in the country has already crossed 213,000.

Also Read: Coronavirus in the US could kill 400,000 people by the year-end, warns Dr. Fauci

The experts believe that the number of coronavirus cases in the US is very high ahead of the winter season which could be more challenging and deadly. According to the latest prediction by the US Centers for Disease Control and Prevention (CDC) the deaths from Covid19 in the US could reach around 233,000 by the end of October. The prediction made by the CDC was done by combining data using dozens of different models. They say on their website that there is an indication of an uncertain trend in the new coronavirus deaths in the country over the next month and they predict that around 2800 to 6800 more people could die from the virus in the country by the end of October. Previously they predicted that by the end of this week the deaths by the virus would reach 207000 to 218000.

Florida, California, and Arizona which were the hotspots of the virus in the summer season are now stabilized but the cases are surging in the other states including Wisconsin and North and South Dakota. Only Hawaii and Alabama are reporting a decline in cases. Moreover, the number of infections has surged in the whole country steadily for a consecutive of three weeks. However, the number of cases still haven’t reached the peak of July and August, when the country was averaging around 63000 cases a day. The number of people being hospitalized is also increasing as for the first time the number of hospitalizations has risen in the country since July with more than 33000 patients hospitalized.

As the winter season is nearing people with move their gatherings indoors, where the coronavirus is more likely to spread. Moreover, in flu season experts are worried that there could be a ‘twin-demic’. However, health experts believe that by adhering to safety measures of social distancing and wearing masks, and by getting the flu shots people can protect themselves.

So, why are the coronavirus cases in the US surging? The returning of students in schools could be one of the contributing factors. Almost 100,000 new infections were reported in the period when the students began returning to schools, and in that period the number of cases in a week in people aged between 18 and 22 rose by nearly 55% in the country. More than 130,000 new cases of the virus have been found at around 1300 colleges in America since the reopening.

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Zuckerberg Donates Half a Million to Decriminalize All Drugs…

Addiction Recovery Bulletin

So we stay online longer? –

Oct 7, 2020 – Facebook founder Mark Zuckerberg and his wife Priscilla Chan have put their weight behind a measure to decriminalize all drugs in Oregon. The couple contributed $500,000 to the campaign, which would also earmark a significant amount of state cannabis tax revenue toward substance abuse treatment.

Measure 110, the ballot item in question, aims to change the narrative around drug use in the state. Instead of treating drug users as criminals, campaign organizers believe substance abuse should be treated as a public health issue.

“The war on drugs has created stereotypes and misinformation about people who are addicted to drugs and people who use drugs and made it easy to make it afraid of people who use drugs,” Yes on 110 campaign manager Peter Zuckerman told The Willamette Week. “Our biggest obstacle is the stigma.”

more@LAWeekly

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