Addiction in Redding: Everybody Has an Opinion, But Where is the Solution?

Dr. Greg Greenberg

Dr. Greg Greenberg

I am fortunate that I grew up in a stable family and did not grow up around addiction. My only addictions are to social media and Diet Coke. I could quit any time. Just not today.

After over 20 years in medicine, my understanding of addiction has evolved from certainty to complete ambivalence. Going back to Facebook, ambivalence best describes the posts related to this issue where there are strong opinions on both sides with a clear absence of a solution.

After finishing residency in Ohio, I moved to Redding where I worked as family physician in a community health center. I was out to save the world. After a few years in family medicine, I realized that the world may be beyond salvation and eventually my moonlighting in emergency medicine became my full-time career. In both settings, it was clear to me that addiction was a matter of choice. The choice to take a pill, to smoke a drug, and certainly to inject a drug was a matter of free will. In retrospect, that was the benefit of youth and inexperience where the world was so black and white. Over time, the world has evolved into shades of gray.

I witnessed the depths to which those who suffered from addiction would sink. In the emergency department, I witnessed patients who suffered horrible side effects of the drugs they used but appeared powerless to stop. I saw an alcoholic fill a bag with his vomit and then drink it to recuperate the lost alcohol. That even grossed me out, and I see a lot of nasty things. I took care of a patient who was shot in the chest as a result of his addiction and continued use methamphetamines despite that experience.

I slowly began to realize what immense power addiction had over so many of my patients. I also was frustrated at the lack of resources for those who desired sobriety and needed help to get there.

Two years ago, I began working at a clinic again because I found myself a full-time single father. I was invited to the NoRxAbuse committee for Shasta County, a multidisciplinary group that includes physicians, pharmacists, case managers and law enforcement with the lofty goal of preventing all deaths from opioid overdoses in the county. I eventually began to provide outpatient treatment for addiction with generous support from the Redding Rancheria.

I have learned a great deal about addiction. Most of my patients have a family history of alcohol or opioid addiction, and 10 percent of the population has a genetic predisposition for addiction. That means that their first drink of alcohol or a Norco they may take after surgery may trigger a series of events that causes their lives to spiral out of control.

Many of my patients started with a prescription for opioids (Norco, Vicodin, Codeine, etc.) for a minor injury or surgery that triggered a loss of control that eventually destroyed their lives. When they could no longer get prescription opioids, they turned to heroin. What we may judge as a choice is often something that started from a legal prescription and snowballed into an otherwise good person’s life destroyed by drug abuse. With the help of treatment, many of the same patients have managed to get clean, get jobs, and are people that you would enjoy sitting down and having a cup of coffee with. Not a drink, a cup of coffee.

In the primitive part of your brain lies the Nucleus Accumbens. If you eat a great meal the dopamine released that makes you feel may go up to 150% of normal. If you have good sex, it may jump to 200% of normal. If you use heroin, that goes up to 800%; nothing you can reproduce in normal life. Combine methamphetamines and heroin, you’re over 1000%, a feeling that your primitive brain then has overwhelming cravings to reproduce. In mice who have an electrode that stimulates that area of the brain, they will keep pressing a button that stimulates that dopamine reward system until they die of starvation, ignoring food and water. This is a part of the brain that those of us without addiction just can’t understand.

I told you I can quit Diet Coke and Facebook at any time. Maybe tomorrow.

I drive around Redding and I lament how our city has gone downhill as many of you have. Unfortunately, I’m stuck somewhere between bleeding heart liberal and “get the hell out of my town”. These are real people who are suffering and the problem is far more complex than just more police or spikes on benches. They need treatment and compassion, but they also need accountability and responsibility. I don’t know the answer to our growing problem with drugs and homelessness, but clearly something different needs to be done.

I will continue to do my part treating addiction and working with the county to help those who want help. What will you do?

Greg Greenberg
Greg Greenberg grew up in Santa Monica, California. After undergraduate training at UCLA he attended medical school at Ohio State University and completed a residency in family medicine in Columbus, Ohio. He moved to Redding after residency in 2004 and has served the Redding community as a family physician, hospitalist, emergency physician, and, most recently, in addiction medicine. When he’s not enjoying the calm atmosphere of the emergency department he enjoys the chaos of being a full-time parent as well.
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83 Responses

  1. Beverly Stafford says:

    Thank you, Dr. Greenberg, for this explanation, unwelcome though your conclusion is.  If only we had to deal with the 10% who have a genetic predisposition, perhaps we could win this battle.  But add to that the people who crave the feeling a 1,000% jolt gives, the issue seems monumental.  Bless you for the work you are doing.  What should the rest of us do to help?  What can we do?  I haven’t a clue.

    • Greg Greenberg Greg Greenberg says:

      Beverly, that’s a great question.  I think we need to make it clear to our elected officials that we need more funding for the treatment of substance use disorder.  As we have put a lot of money into drug enforcement and prisons, we have only seen this problem get worse.  Regardless of your opinion of how the addiction started, success rates for abstinence are abysmal without treatment.

       

      This is also a strongly held opinion, but I think we all need to work together to change the culture.  We have a back ache and take a friend’s Norco, we feel some stress and ask our doctor for a Xanax.  Our pop culture is rife with references to getting drunk and smoking marijuana.  I think it is an absolute mistake for parents to smoke marijuana or get drunk in front of their children.  We can tell them not to use but they learn by our actions more than our words.   Adolescents who use marijuana have an associated decrease in 6 IQ points.  There is a big correlation between adolescent drug use and binge drinking as well as other drug use.   I have four teenage children and this scares the crap out of me.

      • Wow. It’s so refreshing to hear such straight talk – backed by science – about addiction, especially in terms of young brains. I’m loving this! Thank you!

      • Beverly Stafford says:

        You are so right about over-prescribing.  My retired-pharmacist husband once told me – without ever mentioning names, of course – that I’d be shocked at the number of prescriptions for controlled substances that he filled here in our small rural area.  But if the doctor writes the prescription and the patient wants it, its gets filled.  Same goes for antibiotics.  The patient is certain that an antibiotic will cure his flu or cold or sore elbow, and the doctor finally gets tired of the whining and writes a prescription.

      • cheyenne says:

        Colorado Public Schools have stated that since marijuana was legalized, recreational and medical, 30% of student suspensions are for marijuana possession including all grades.  When asked where they got their MJ the students overwhelming response was “From their parents stash”.  So all the talk about street corner dealers selling to kids is not as extreme as many try to make out.  Why buy off the street corner when you can get it from your parent’s stash.  This is no different then an earlier generation getting their first cigarette or beer out of the parents stash.

        Good article Dr. Greenburg.  You are right on about parents.

      • Common Sense says:

        Teens and young children learn more by watching adults behavior than by being told to not do something. The real gateway drug in this country is Alcohol! While I do NOT condone youngsters to get “High” I guess it depends on what study or info you pull from on I>Q going down with MJ use?

        Heavy use….different story….even adults who Heavily use MJ show a lot of issues over an extended time frame….as with anything….Moderation!

        You don’t think teen agers don’t take in when mom or dad has that glass or two of wine….or beer or two…..they are like sponges….

        • Greg Greenberg Greg Greenberg says:

          I agree to an extent common sense.  I mentioned heavy alcohol use because that’s what we have evidence of harm in children.  We don’t know the threshold in adolescents for harm from marijuana but many of us have seen single use of marijuana prescipitate a psychiatric disorder is adolescents.  I’ve seen in many times.

          I don’t have strong feelings about marijuana because we don’t have a lot of data.  For political reasons, research is scant.  My experience tells me that alcohol is more harmful than marijuana overall but marijuana may be more harmful to adolescents.  There is some data that associate (correlation, not causality) harm to adolescents from marijuana.

          • Kelly says:

            There are referred journal articles, research that indicates using THC before age 24, when the brain is fully myelinated, is extremely damaging. But yes alcohol affects every organ.

  2. Dr. Greenberg, this article is extremely timely and important. Thank you for taking the time to share what you see in the trenches of your work, and for bringing some understanding, compassion and humanity to the table on a topic that’s taken center stage in our community.

    I appreciate you and your work so very much. Thank you.

  3. A. Jacoby says:

    Thank you for the clear-eyed view that has been garnered from knowledgeable experience. You have a perspective that most of the rest of the community  will never be afforded . . . and for that I am grateful!. For the most part, most of us only see the results of addition and have little clue to the reality of the  lives involved.  One thing on which we can all agree: we do have a problem but as of yet, no one has proposed a viable answer to the problem.

  4. Virginia says:

    The saddest thing I found is that the overall rehab rate is only about 5%, and that actual rate has not changed in the many years since I volunteer at a drug rehab.  I have lived in a household with an alcoholic: one my stepdad and then my late husband.  Both men had a daily battle not to use.  I know as I lived through both their addictions and rehabs.   An addict needs a strong individual who they can feed off that person’s energy and hope to keep clean.  Some need to go to a facility to get clean, but others can do it “on the outside” as both my stepdad and husband did.   My stepfather failed a number of time until the last 25 years.  After being a controlled alcoholic (one (1) beer a day) for about 20 years, my husband did stop altogether, but it was still a fight.  He never believed he was an alcoholic, but just a drunk…..  To him that made more sense than admitting he was an addict.  There is no sure cure or ever will be.   A few days ago, I mentioned  to a friend that one day a handsome young man came to the live-in facility by his father.  The young man dropped 60 Seconal before he walk in the door.  The called an ambulance for him to be taken to emergency.  The man never came back.  Oh, he didn’t die in emergency, but he wanted to use more than get clean.    There is no easy answer to the problem.  Yes, opiates take their toll sadly.  Yet, then too there are others that I was told by an attic, they don’t want to be aware of the life in the ‘normal’ as they wanted to be in the “tune out state” more than someone like me who wanted awareness of what  life has to offer: the good and the bad.   Some do it through Religion.  Others take other courses such as NA.  Yet, others never find the will to do either or some other treatment.  Sad.   How do we change it, I have no clue, but legalizing Pot is just making the tuned outs easier.   Thank you for a very informative letter, Dr. Greenberg.    

    • Greg Greenberg Greg Greenberg says:

      Thank you for sharing your story.  I think it highlights the complexity of addiction.  What I didn’t mention in the article is how little we truly understand addiction and how unscientific our treatment strategies often are.  Quitting cold turkey works for some.  Impatient or residential treatment works for others.  Outpatient medical treatment (what I do) may work for others.  And many never seek treatment.  The other part that we don’t understand is why some people get addicted and others don’t.  It’s not just genetics.  Much of it seems to relate to the psychosocial context.  I majored in psychology and neuroscience at UCLA 20 years ago and took courses in addiction.  Now as I’m getting additional training I don’t feel like we know much more than we did 20 years ago.  Not very reassuring, huh?

  5. Hal Johnson Hal Johnson says:

    Thanks for sharing your perspective on a vexing problem, Dr. Greenberg.

  6. common sense says:

    Thanks for you input Dr G!…. I was hoping for a little chat about how Cannabis can help with getting many off the Opiates….but I will have to wait until main stream consciousness catches up I suppose.

    It starts with funding….then programs…..then you can only help those that want to help themselves

    Lack of Connection> Drug problems> Homeless problems

    I guess I am capped out at 200% with my Nucleus Accumbens…have to draw the line somewhere!

    • Virginia says:

      Feel you are replacing one drug for another.

      • Common Sense says:

        Virginia, you are certainly entitled to your Opinion….I too, was ignorant on the topic of Cannabis, until about 6 years ago, when I was presented some information on the plant. I opened up my mind only After I  said….”I have to prove this person WRONG!” So I dove in…..trying to Disprove her statement that “Cannabis works for almost everything!”…..I was raised in an Era that you don’t use it…its terrible and I hate to admit….I judged it! (and the people that used it)….Boy… was I embarrassed when I put in the first 10 hours of research on it out of the 500 thus far. I started with the Governments own Patent on the Cannabis plant….no way I told her….that is not the Truth!….Just could not and would not believe it…

        To learn that the Government has had a Patent on it (CBD) for the Medical Benefits was the first REAL eye opener.

        CBD is in the plant, one of the many Cannabinoids that helps with Pain….and a host of other issues….It’s also what the Government has the Patent on-the Medical Benefits of CBD.

        There are very few Medical Doctors that Understand the Benefits of the Cannabis Plant.Why is that you ask? Because they don’t learn anything about it in medical school. The RX industry is a Very Powerful Force…They make their $450 Billion a year on Patented Drugs….We can’t blame Doctors…they are doing what they are taught in Medical School!

        If you choose to learn something on the plant, instead of judge it like I did all the time, start with Raphael Mechoulam. He has been studying the plant for approx 40+ years…he is an expert on it….

        There is some truth to the toughening up needed on the kids nowadays…I agree with the Dr. on this…..and yes pain is a part of life….but if it boils down to 33,000 people dying per year from Opioids or Zero dying from Cannabis……I know which one I prefer to help people deal with their pain!

  7. Alan Ernesto Phillips says:

    WHAT A GREAT ARTICLE!!!

    In 1999, I was studying for my Chemical Dependency Counseling certification and was part of a small but very vocal group of citizens trying to encourage the Shasta County Board of Supervisors to use part of the approximately $25,000,000.00 Master Tobacco Settlement Agreement issued to Shasta County.  We intended to empower direct funding toward a wider range on the addiction severity index beyond tobacco products – as addiction, has many cross-components.

    As a HIGHLY addictive product that was being marketed by the Big Tobacco Industries, directly to what the industry termed, “Replacement Smokers,” they were really talking about our children. You may recall that over 280 BILLION dollars was delivered to the states and local governments under claims that deceptive advertising and marketing practices had harmed children and adults.

    But, in spite of the original intent and arguments for compensation and prevention programs, then California Attorney General, Bill Lockyer decided to let the Counties decide how to use the money.

    “The tobacco companies agreed to substantial monetary payments and to stop targeting young kids in their advertising and marketing in large part due to the determined and unified front presented by state and local governments in California. Californians now have a fighting chance to save current and future generations from tobacco addiction, disease and premature death.”

    ~ Bill Lockyer – February 7, 2000

    Shasta County CEO Doug Latimer and four of the five County Supervisors decided to use the lion’s share of that 25 Million dollars to instead build the County’s Taj Mahal-esque Administration building on Court Street. A small portion was given to Shasta Community Health Center in Redding. My hat is still tipped to County Supervisor, Dave Kehoe, who abstained from the vote. He indicated to us that he thought more could be done with the funding.

    While it is perhaps arguable that putting only five to ten million dollars into foundational addiction prevention and recovery services would have the efficacious outcomes we do not see currently, it does beckon the thought that much more now needs to be done. Because, what we have already done, and have been doing for the past decades is only producing a worsening situation.

    Thank you, Dr. Greenberg, for your insight related to the community DISEASE that is chemical addiction while respecting the humanity and dignity of those affected!  Not forgetting the highly addictive Tobacco Drug, Nicotine, I have counseled heroine addicts right out of prison who claimed kicking their tobacco addiction was more difficult than their tobacco habit.

    The actuaries behind many modalities of care providers seem at times to eliminate true compassion as a vital part of being thorough.  I am so damn proud to know you are here and doing HONORABLE and compassionate work for the people of Shasta County: The Supervisors, City Council members and other media could learn a whole heck of a lot from you and your work!

    AND… thank you, A News Cafe, for presenting such a seemingly neglected yet important and promising story that could build into a very healthy movement for all the people of Shasta County – Wow!

    https://oag.ca.gov/news/press-releases/attorney-general-lockyer-delivers-tobacco-settlement-funds-shasta-county

    https://oag.ca.gov/sites/all/files/agweb/pdfs/tobacco/settlements/tmsapc_1999_2013.pdf

  8. Roy says:

    Thanks Dr. Greenberg!

    You have been a great Doctor for me these past couple years and Viva Redding Rancheria

    They have the best staff. Good luck in your efforts to treat those with substance abuse, been there done that. The toughest to quit for me was Cigarettes but it seems that pot was also on the list of past addictions.

    I used cannabis for nearly twenty years, then decided a job was a better idea.

    There is definitely a difference with physiological and psychological addictions. Using the police force is not a workable solution for either of those candidates. Redding will be much better off with clear headed thinkers and doers like you. But like most people who work for a living or otherwise on a tight budget I can’t say if I am willing to pay more taxes.

    The waste I see in government solutions either local or state is not of a great value. Consider how places like Cascade circle use the funding mandated by the courts, its astounding that they are around.

     

     

  9. Matthew Meyer says:

    Kudos to Dr. Greenberg for letting his views on addiction evolve away from simple judgmentalism.

    But it seems incomplete to ask why we have an opioid OD crisis on our hands and merely to trot out the same-o: pleasure centers in the brain, genetic predispositions.

    The thing is, these factors fail completely to help us understand why this is happening *now*.

    Prescribing practices are part of the picture, but the mystery elephant in the room is demand. Why are so many people so miserable right now that they use opioid drugs in unhealthy ways? The best discussions I’ve seen include broader economic and social instability in their purview.

    That helps make sense of the timing of what is, by any measure, a serious health problem that’s really developed in the last decade.

    • Greg Greenberg Greg Greenberg says:

      There are so many factors that contribute to this problem and it still comes down to opinion.

      The drug companies are certainly at fault.  I remember hearing the OxyContin drug reps telling us that only 4 in 10,000 patients treated for pain become addicted.  It turns out this was based on an editorial in the New England Journal of medicine.  If you Google “John Oliver Opioids” it’s worth watching.  To make it worse, California in a completely political decision mandated all physicians to her 12 hours of treatment in pain. The courses basically told us that we were under treating pain and that we needed to believe patients’ reports of pain.  Then we had pressure from patients and pill mills prescribing large amounts of opioids that were being diverted for $5 to $40 per pill.

      In Ohio, West Virginia, and throughout the country we have seen cities where industry has left and unemployment and poverty increased resulting in increased substance abuse.  People who are happy, busy, employed, with good support systems are much less likely to have a substance use disorder.  Redding doesn’t have as much industry keeping us busy (although the trimmers seem to make a good living).

      I don’t know how we compare to other cities but we have a lot of undertrested mental illness in Shasta County and many of the patients I treat for substance use disorders have considerable adverse childhood experiences.  Some of the stories I hear are horrific and make me want to drink.

      As I alluded to in a previous comment I think the biggest problem is a reflection of our modern culture.  I’m not anti-marijuana but the normalization of drug use in our society sends our youth the entirely wrong message.  In the emergency department I see patients regularly who demand a controlled substance for their anxiety or their pain.  Life is painful.  Our bodies hurt.  I’m 44, I’m starting to learn that myself.  However medications have risks and it’s my job to try to determine if the risks outweigh the benefits.  We have learned to take a pill or hit the bong if we are anxious, sad, hurt, can’t sleep, or life is difficult.  We need to teach our children how to deal with the pain of life, not escape it.

      I think I’ve spent enough time on my soap box.

      • Virginia says:

        I like your soapbox, Doctor!  And the most important thing written is your last sentence is the best answer.

        “We need to teach our children how to deal with the pain of life, not escape it.”

        That was what was missing in 1960s and 1970 when I volunteered, and all these years later for the most part, is that one sentence of yours.

        THANK YOU !

  10. Crystal S says:

    Very interesting article, Dr. Greenberg. I was recently reading “a scholarly article” in which baseline dopamine levels were studied. It was determined that people who produced lower levels had a higher likelihood of becoming addicts as they were otherwise unable to easily get a lift or high. Perhaps recovering addicts should participate in physical challenging and exhilarating activities. I wonder what the ICD-10 code is for easily bored and difficult to excite because I believe that I may be suffering for this condition.

  11. Joanne Lobeski Snyder says:

    Excellent article Dr. Greenberg.  Professional people I know who have become addicted began their journey with prescribed drugs.  I know two people who became addicted to surgeries!   Who can’t sympathize with the guy in the FB post as he goes bravely into his next surgery…and a more drugs.  One gent had 12 surgeries on the same shoulder.

    Both are now dead.  As a friend in the medical profession says….”You initially get the drugs you need, but once you’re addicted you become a reviled drug seeker and are offered no help with your problem.”

    I learned from your description of the activity of the Nucleus Accumbens and your scale of dopamine involvement with different activities.   I believe we need dopamine every day of our lives; even if it’s just a tinch when we look forward to a cup of coffee in the morning.   What a complex problem.

    Thank you for a great article.

     

     

  12. Karen C says:

    What about personal responsibility  in all this?  I look back to my teenage years, and I knew I did not want to  get pregnant and upset my family and my great teen life.  I KNEW I did not want to get into drugs, for the same reasons.  I have always been aware of taking too many pills that were not necessary for my well being, it was common sense for me.  It helped that I paid attention in school and watched those dreaded movies they showed only to the girls.  I wondered why the boys were not allowed as they were in the ball game too!

    So much of the problems today are blamed on someone or something else.  I recently went through knee replacement surgery.  I was to take an array of pills several times a day, even awakened  by the nurse in odd hours of the night and morning.  I questioned every pill, what is it for, what are the side effects and many I refused to take.  I came through the ordeal just fine and took myself off the Oxycontin as soon as I was out of the hospital.

    I understand the need for taking some drugs and that they are necessary for quality of life, but to take them to excess is not an option in my way of living.

    • Greg Greenberg Greg Greenberg says:

      I agree that personal accountability should not be forgotten.  I personally never drank alcohol as a teenage, only drank rarely in college and medical school and didn’t smoke marijuana.  I had the intent to become a doctor and wouldn’t risk screwing it up.  However I had the biopsychosocial background that set me up for success.

      We can blame people for their addiction all we want but it won’t make it go away.  We can put them in prisons but that costs us money and there is a high rate of recidivism.   However they got to this point, treatment is the body options to get people with addictions drug free, working, not stealing, and contributing to society instead of being a burden on it.

  13. Tom says:

    Well stated, Dr Greenberg!

    We have a problem, nobody denies that. But the problem isn’t just one thing (“those damn homeless”) caused by just one thing (“and their dumb life choices!”). It’s bigger than that. The last commenter, before me, ended with a simple statement, “what a complex problem.” You mention the same. It is. I’m notorious for pointing out the big macro stuff that leads to the local micro stuff, but that’s where it all starts. The growth of economic inequality in this country, fueled by rampant greed, has put us in this place. Places like Redding see it worse, because the lack of opportunity (everywhere) affects smaller communities all the more.

    Back to greed. Greed fueled the redistribution of wealth from the middle and lower classes to the upper class. Over the last 40 years we’ve seen the stagnation of wages, the fall of the unions, economic collapses, globalization that benefited only the elite class, the rise of automation, and so many other factors that have destroyed not only jobs, but hope. Hopelessness leads to the kinds of escape that lead to addiction. Greed fueled the war on drugs that ruined lives and overflowed our prisons. Greed fueled the astounding rise of Big Pharma and the introduction and dissemination of new addictive substances.

    Like you, I don’t know what the big fix is. The factors that have created this crisis are ingrained in our society now, protected by so much of the electorate. We defend profits while cities die. We defend these culture-based wars like the war on drugs despite their exorbitant costs and zero successes. We vilify the homeless and transient, lumping them into one category like “lazy” or “criminal.” How long before we launch the War on Homeless?

    What we actually have is a percentage of the populace without hope.

    The big fix won’t come locally, though we can try our damnedest, like you do. You set an example for us all. But, ultimately, we have to fix the root causes of this problem and that will take a grand evolution in this country towards a more humanitarian outlook at its populace. We’ll have to stem the march of greed — a very anti-American premise to some — and redistribute our resources back to those who need it most.

    • Greg Greenberg Greg Greenberg says:

      Thanks for that response Tom.  I agree that the problem with homelessness is a symptom of our ailing society that is much more complex than addicts who “choose” that lifestyle or lazy bums who don’t want to work. In the realm of addiction, you can’t successfully treat addiction in a person who is living under a bridge and begging for their next meal (and their next fix).  I get frustrated at the Facebook posts where people state that they are lazy and “choose” to be homeless.  It’s easier for us to make it us versus them and dehumanize the homeless.  That’s a successful technique throughout history when we want to turn our backs on a group of people.

    • Common Sense says:

      Spot on there Tom!…..we have the haves now….and the have nots…..the middle class as evaporated….and for anyone that still believes the Trickle Down Rhetoric I have a couple pieces of swamp land left in Florida that I can sell to you!

      Cutting taxes on the super rich will only put more money into their pockets….it won’t help problems as are stated in all the responses….

      The Distribution of Wealth is what we need to talk about…..take that 20 Billion in Tax Cut Money for the Rich and put some Programs in place to help solve these solutions….

      I am all for Capitalism and people making money….don’t get me wrong! But when Walmart Gets Billions in Tax Breaks and they pay their people peanuts and the tax payers have to make up the difference….just doesn’t seem right to me!

      Doni wrote an Article a year or two back…..something to the effect of Many are one payment away from losing it all!

      No one can really understand this topic unless they have been on the street……no one….including myself….but one thing is for sure…..you can ONLY help those that Want to Change and CHOOSE to get help! And it takes Funding to do that….to put programs in place…..

  14. Eileen McKinnis says:

    This is a wonderful article and hopefully helps educate people on just how deeply addiction can affect an individual. I work as an addiction counselor and have heard many stories similar to what you highlighted in your article – and injury and prescription that spiraled out of control into illicit drug use. My thought is maybe the whole family needs to get education and treatment, not just the individual. Maybe then the epidemic of addiction can be addressed more fully and the statistics can be lessened.

  15. Marlene says:

    My husband and I both in the medical field and this is def an epidemic however the other side of this issue is there are people with legitimate chronic pain issues that have difficulty getting needed pain meds.  So much so I have heard them concider street meds this is also wrong people with cancer can’t get the proper pain meds Because of all the new regulations sometimes medical personnel can’t even help these people get what is needed and they suffer tremendously and unnecessarily I might add  govt wants to cut back production of pain meds this will affect those who need it no one thinks and reasons just cut across the board  and treat all patients on pain meds the same like it’s not needed this will cause law abiding citizens to go to the streets and become criminals should they become desperate enough but no one seems to be talking about this side of the issue !!!

  16. Cody Burnett says:

    Being someone who not even a yr ago was one of those addicts you seen on the streets in Redding this Article hits home. Everyone is complaining about the problem but not many are actively searching for a solution and somes solutions maybe aren’t the right ones. The homeless and the homeless that are addicts are 2 different kinds of people. If there’s anyway i can help in your solution I am willing to help

  17. I’m loving the civilized, open-hearted conversations here. Individually, there’s so much we don’t know. But perhaps collectively, we can find humane solutions.

    Thank you, Dr. Greenberg, for broaching this topic and facilitating the dialogue.

  18. Dr.Greenburg I would like to host a townhall style viewing of the PBS movie Chasing Heroine to help educate the community so we can continue to move beyond blame and shame into solutions.That’s what I will do perhaps you could join me in facilitating it?Christine Wright,CADCII

  19. Richard Christoph says:

    Thank you, Dr. Greenberg for sharing your experience, information, and possible solutions. There is no doubt that additional funding for treatment is needed nor that economic factors contribute to the opioid problem. But considering the expense and high rate of recidivism even with appropriate treatment, it seems that inculcating the imperative of avoidance might be more effective.

    I was fortunate to have been raised in an atmosphere where the perils of addiction to tobacco, alcohol, and heroin were a constant theme and 60 years later still recall acutely the stories and films of heroin addicts stealing from friends, family, and going through withdrawals; alcoholics losing their families, livelihoods, and ending up on skid row; and cigarette smokers unable to kick their habit. Frankly, that scared the Bejesus out of us kids and to this day, those who were terrified of losing our independence and  freedom of choice due to dependency on a substance have largely steered clear of life-altering addictions. Perhaps a program similar to “Scared Straight” could be effective in preventing the use of substances such as heroin, cocaine, fentanyl, and tobacco which have been shown to be highly addictive and very difficult and expensive to successfully treat.

     

     

    • Viree Cabral says:

      I think the “Scared Straight” seem to be right on. Like the guy who was in prison for murder. He said, “I am in here for murder and guess what? I can only die once”, so I can take your life right now and here.” That man was right and that is so scary…. The kids had success in straightening their lives up. To think of being in prison with those type of people….

  20. Common Sense says:

    Emotion loss or Trauma….when we get to the Root we see what is going on …..Loss of Connection……fix that…..help the problem!

  21. Marc Carter says:

     A new study found opioid abuse and overdose rates dropped in states with legal marijuana.

    http://www.newsweek.com/opioid-marijuana-legal-states-hospital-overdose-addiction-575385

    • Common Sense says:

      You are correct Marc!….RX companies do NOT want legal MJ….That is why Insys threw 500k to defeat the Arizona push to legalize…..would cut into the profits way too much!

  22. Common Sense says:

    Behind the scenes look at the makers of one of America’s biggest problems right now….. This is what happened when they took out ( Squeezed)  the Cartels and MJ….the Cartels switched over to Heroin…that is where the money is now for them!

  23. cheyenne says:

    Opioid use and overdose is because people fell there is no hope left in their lives.  Smoking marijuana eases the pain and makes life seem rosy and cheerful.  So do we want dead opioid users or live stoners?

    • Common Sense says:

      Good question cheyenne……which would you prefer your daughter or grand daughter be……living and happy or dead?

      • cheyenne says:

        As my daughter has been working with the mentally ill, disabled, and many are drug dependent, in Nebraska, for awhile in Redding, and now in Phoenix and she is raising my granddaughters to help the less fortunate that is the stupidest question you have ever asked.  This post will probably be removed but it is the truth.

        • Common Sense says:

          I think you misunderstood me. I was not alluding to your daughter or grand daughter using drugs….but if they did……what would you prefer……we have the option out there to help people with their Pain…..it’s a Natural Option…..one that doesn’t Kill people…..that’s all!

          • cheyenne says:

            I did not misunderstand you.  You do this all the time with posters who disagree with YOUR facts or YOUR opinion.  There are lots of disagreements between posters on Anews but only you relegate to name calling and dragging family into it.  This is what #45 does.  Nothing less than a full apology and a promise to leave derogatory family comments out of future posts is acceptable.

  24. Common Sense says:

    Relationship between Prescription Opioids and Heroin Abuse
    Let us not forget that Oxycontin was originally peddled as being “non addictive”…..

    In 2007, Purdue paid $635 MILLION in fines after pleading guilty to false marketing charges by the Dept of Justice…..

    The Sackler family is the world’s richest drug dealer (and it is all legal). The family owns  Stamford, Conn.-based Purdue Pharma. Purdue is the maker of OxyContin. Because of OxyContin, the Sackler family is now richer than the Busches, Mellons and Rockefellers.

    Estimated wealth of these fine folks…..$14 Billion!

  25. Virginia says:

    Having read all the comments, what the majority talks about is reason for use or maybe political ideas, yet each missed something that Doctor Greenberg wrote about responsibility of parents/families/friends need to take heed about doing themselves for the generations:

    “We need to teach our children how to deal with the pain of life, not escape it.”

    That is what I did with my son.   Why not try that idea beginning today instead of just wringing our hands over the horrible mess there is now and still growing?

    • Virginia says:

      Sorry I forgot something:

      Thank you, Doni, from the bottom of my heart, for printing Dr. Greenberg’s letter.  Just maybe something will happened just to slow down the pace of the addictions.

       

  26. R.V. Scheide Jr. says:

    Thanks doctor for confirming what I believe, that the notion that an active drug addict has a choice is a contradiction in terms. Whether he had a choice before becoming addicted is a philosophical quibble. He doesn’t have a choice now. That’s why you’ve got to throw him in a jail cell or sobering center, hose him down, and perhaps introduce him to Jesus or the 12 Steps, in the hopes that somehow you’ll be able to break the spiritual bond between the patient and his drug of choice. Addiction is ultimately a spiritual problem.

    • Greg Greenberg Greg Greenberg says:

      RV, I think addiction is a biological problem. And a psychological problem.  And a social problem.  And a spiritual problem.  The American Society of Addiction Medicine, of which I’m proudly a member, made a point out of including the spiritual manifestations of addiction.  Addiction has treatments that focus on medications, on biology, on thought processes, and on spirituality and all have varying degrees of success but one size does not fit all.  If there is one thing clear in this discussion, we cannot over simplify this huge problem!

      • R.V. Scheide Jr. says:

        Yes, I’m over-generalizing and perhaps playing loose with the definition of “spiritual.” In a certain sense, I’m using it in place of “irrational,” because people don’t understand just how powerful and persuasive these drugs can be. An 800 percent increase in dopamine will obliterate any sense of concern about one’s past, present and future, and if you’re concerned about any one or all of those at the same time–and you will be if you keep doing dope–welcome to heaven. You’re right, it’s a biological problem, because at least 10 percent of people, no matter the substance, seem pre-disposed to addiction. It’s a social problem because 90 percent of the rest of us find these substances in one way or another are useful in moderation and/or for approved medical purposes. It’s a psychological problem–and I suppose the word “spiritual” also stands in for that–because that’s where we turn to these days when we suffer from over-concern regarding the past, present, and/or the future … or actual organic medical defects. Even though the addict understands any addictive drug offers diminishing returns, he will continue using for that fraction of a second he is concerned about nothing, because it is everything to the addict. In order to beat that, we have to offer something more.

         

        • Greg Greenberg Greg Greenberg says:

          RV, I didn’t mean to sound like I was disagreeing with you.  I think it’s important to acknowledge the spiritual aspect of addiction in the broader sense.  It is a strong theme that runs throughout lectures at the American Society for Addiction Medicine’s annual meeting.  Those who deal with addiction recognize this as an essential component of recovery.  I appreciate your response because we shouldn’t forget the spiritual component of recovery.

  27. Greg Greenberg Greg Greenberg says:

    I’d like to address Common Sense’s comments about marijuana. You clearly have a positive bias toward marijuana.  That’s not a criticism, just keep in mind that such a bias affects how you assess objective data.

    I have had many patients who have had benefits from CBD oil for anxiety and pain. Anecdotally it may be beneficial.  I have had many patients who refused opioids but had significant pain relief from marijuana.  Although I’ve seen many people with addiction to marijuana, I think opioids are worse. But also keep in mind that the placebo effect for any therapy in pain or mental health studies is usually 30-40% so you can’t make clinical decisions about anecdotal evidence.  Freud thought that cocaine would be the cure for mental illness based on anecdotal data and he appears to be wrong about that

    As a physician, I treat based on evidence based medicine.  I cannot make statements on the efficacy of a therapy in the absence of good clinical studies.  I have not seen placebo controlled, double blinded, prospective trials for marijuana or CBD oil for pain, anxiety, etc.  as an allopathic physician, I cannot attest to the risk of harm versus the chances of benefit for marijuana and it’s components. I suspect there is benefit for some people and I suspect that it is safe for some people, but I can’t advocate for or against marijuana for pain until there is more clinical data.

    There are risks of marijuana that we should not take lightly.  It impairs your ability to drive. Some people have psychosis or worsening anxiety from marijauana.  We are seeing increasing numbers of patients with cannabinol hyperemesis syndrome, recurrent abdominal pain and vomiting, from marijuana.  There is data that marijuana causes memory loss, albeit association not causation. Although less addictive than many drugs, some people do have problems from marijuana addiction. Marijuana has definite risks with poorly defined benefit.

    • T.i.m says:

      What is the addiction rate for placebos?

    • Common Sense says:

      Greg Greenberg, yes I do have a bit of a bias on the topic.This is after reading study after study on it from Israel. Dr. Raphael Mechoulam has spent most of his whole Adult life researching the plant…with out bias like we have here in our Country.

      Does it Help Every Patient? No…..show me anything that does-without side effects! Does it help many people with many conditions….Yes…..and with virtually No side effects! It’s the only medicine that does not come with a Warning Label-“May Cause Death” on it.….along with stroke/heart palpitations/blindness and a whole plethora of other major side effects that traditional RX company products have.

      The issues on the street with MJ are usually with the Synthetic MJ….pure chemicals or with medicine that was grown with chemicals and pesticides!….and yes people have died from the street “SYNTHETIC” version….but it’s an adulterated version that is nothing like the natural pure plant-the Synthetic is laced with toxic chemicals…

      I don’t need double blind studies etc…as I am not prescribing it to anyone…just watching people cure themselves of Cancer with the concentrated oil…..incurable Brain Cancer….Cured…..Pain Relief….Help with Parkinson’s etc…the fact that it has worked very well with myself and my Veteran friends is all the proof I need.

      Should Kids be using it? NO…..I don’ t believe it’s good for kids with brains still developing….

      Many of my Veteran friends have used it for PTSD and Anxiety and Pain Relief….the majority have had positive beneficial experiences with it…and minor side effects….dry mouth/dry eyes….etc.

      There are studies showing it can help with Alz and the plaques in the brain….most of the research is not done in our country….the Government here has kept it next to impossible to study as the RX companies don’t want the competition! It was Nixon and Harry J Anigslinger that bastardized it all without any proof or scientific facts.

      “It impairs your ability to drive”…..I totally agree with that….and as we have seen….MANY more folks are arrested daily driving under the influence of Alcohol. At the end of the day, a DUI is a DUI.

      GW Pharmaceuticals is a leader and obviously, understands that there are plenty of benefits as they have created numerous “Synthetic” drugs based on the plant.

      I agree there are some people that exhibit anxiety and paranoia etc from using Cannabis….take into account there are approx 7700 strains right now….so not every strain is perfect for everyone. Proper selection should be used to match your illness with the strain that is known to help that particular issue.

      I acknowledge that there have been more cases of cannabinol hyperemesis syndrome. It appears they are all related….it’s in users that are HEAVILY using the medicine.As with anything…moderation is key.

      On the Memory loss….I have seen data that goes both ways….I have also seen data that shows it is promising on fighting the plaques in the brain! The Cannabinoids can pass the blood brain barrier.

      I am sure there many that have problems with MJ addiction….and I would bet they also had problems with other things also…as they have an addictive personality in general. I will take a MJ addict sleeping on the side walk any-day over a Heroin addict. In a perfect world….Neither!

      In comparison with the side effects of modern RX drugs….the benefits far out weight the risks if one is prudent on knowing what they are using….growing it themselves…organically or purchasing from a dispensary that TESTS the medicine with proof of purity/potency! Now that we can legally grow it in our own homes RX numbers might go down in the coming years…

      Thanks for sharing your in the “Trenches” report on what you are seeing…and making intelligent responses instead of judging it and criticizing it without a clue. It’s always refreshing to hear from one that doesn’t suffer from Reefer Madness!

      Three of my favorites are, Dr. Manuel Guzman from Spain/ Dr. Lester Grinspoon -USA / and Dr. Raphael Mechoulam-Israel for their take on 40+ years of research and studies.

      Two things I find Ironic….the Government having its own Patent on CBD and the fact that they funded Research on the plant in Israel for so many years….all the while telling the public how terrible it is!

      I also find it Interesting that Cannabis was in the Majority of the Pharmacopeia from the late 1800’s to approx 1930’s…..now why would all the Dr.’s back then be handing it out to patients if it didn’t work?

      To helping people!

       

      Best,

      • Virginia says:

        In 1970, the addicts at Crysalis, a drug live-in facility in South Bay Area stated to all, including when they did public talks, “You can’t handle marijuana no matter what name you use any better than any other drug!”   I’d take their advice more than any other “study”.  They were the living proof!

        • Common Sense says:

          Virginia my dear Lady…..YOUR bias is noted. They fall into the 10% the good Dr. talked about……and it your choice who to believe….we live in a Free Country! Well at least for now…..once Trump is gone…..we might even get back to some type of Normalicy….

          So by your very own statement….I take it you prefer a Heroin addict on the side walk over a guy with a smile on his face?

  28. Marc Carter says:

    Thank you, Dr. Greg Greenberg and Common Sense for an insightful and interesting conversation.

  29. Common Sense says:

    Virginia, perhaps you might consider re reading the Dr.’s statements on Cannabis. The Dr. is not only Educated….he is not biased and open minded…My kind of Dr. I must admit! He is saying that his patients have reported to him Benefits of the plant…..he himself needs more proof and needs to see more studies on it to be in a position to recommend it or feel better about it as a Medicine. I Respect that! Can you imagine a Dr that scours the internet and offers up the latest greatest thing that someone talks about….me neither!

    “I have had many patients who have had benefits from CBD oil for anxiety and pain. Anecdotally it may be beneficial.  I have had many patients who refused opioids but had significant pain relief from marijuana.  Although I’ve seen many people with addiction to marijuana, I think opioids are worse.” – Dr. G

    So….once we learn that our Government has a Patent on the CBD IN the plant..…for Neuroprotective aspects…we see that even the Government knows it potentials as Medicine…..but is obviously Hypocritical on the topic!

    The CBD oil the Dr is referring to comes from either the Cannabis Plant or the Hemp Plant….but is has shown to help some of the Dr.s Patients….isn’t that what we all want….help with our Medical issues?

    We are Blessed to have such a fine Dr in our Community!…and once the “Evidence” catches up with the experiences of those that have been healed and helped by this remarkable natural plant….who know….Dr. G might even recommend it someday in the future….Is it a Cure All….best thing God Ever put on this earth plant?…not sure…..but what I am sure of…it has helped many…..and will continue to….as in the Bible it states….. If it’s good enough for God….it’s good enough for me!

    “God said, ‘Behold, I have given you every herb bearing seed which is upon the face of all the earth.…To you it will be for meat.’ … And God saw everything that he had made, and, behold, it was very good.” (Genesis 1:29-31)

  30. Rick Caylor says:

    Dr. Greenberg;

    Please reccomend prescribing resources for providers facing these issues.

    Thank you.

    Richard C. Caylor NP-C

    • Greg Greenberg Greg Greenberg says:

      Rick, long time no type!  Think it’s been 10 years since we worked together!  I recommend reading the CDC guidelines that came out recently, they are rife with information. They are biased against opioids but they include the data they used for the recommendations.  It’s about 40 pages.

      If you have any questions feel free to text me at 530-355-2670.  Yes, I gave out my cell phone.  I give it out to a lot of my patients with the instructions to text and not call.  I’m happy to give advice, I think it’s my mission to help when I can.

  31. Virginia says:

    Common Sense you can trash me all you want.  I have big shoulders.  But I wonder about you.

    Have you ever been in a drug rehab facility where  the incoming addicts know it is “cold turkey”?  The reason the rehab was set up as cold turkey to help the addict remember when they sober up, don’t reuse.  I have talked with, held the hands of, and volunteer to help raise funds for their facility.

    Have you ever seen someone come off heroin?  Every bone in their body aches.  They can’t hold food down.  They sweat.  They can’t sleep.  At least with heroin, it takes about 14 days to clean out the system.  When it is meth, they go through all the same problems as heroin, but theirs is not a 14 day trial.  It can take many weeks because the drug fools you into thinking after a couple of day without reaction you are clean, but the drug hides itself, and pots up off and on.  I saw one man who had not had meth for six (6) months.  He was working in the kitchen and for no apparent reason he took a knife and tried to kill a fellow worker.  I came in about an hour after the attempted assault and his normally very white Norseman skin color was still a beet red.  And, Meth began as a legal diet drug!!

    I’d say the addicts I met  had courage to go through that torture because they believed they wanted a different life.  A living one.  They used NA to help them recover.  There is a higher power that NA gives as does AA.

    While a volunteer I read all kinds of reports from studies by doctors and police  that were available on marijuana and other drugs.  If an addict tells me “You can’t handle pot any better than any drug” it is a fact!  Yes, under some conditions, it can help patients who are suffering from cancer or possible other conditions.  That is good.  But, it is not a way of life.

    As Dr. Greenberg said:  “We need to teach our children how to deal with the pain of life, not escape it.

    But in the end, Common Sense please don’t try to play me for a fool for I am not!

    • Common Sense says:

      Virginia virginia virginia…..Your Cognitive Dissonance is also noted. Put down the knitting needle and take note to what the Dr. said….you seem to want to only take parts of his insightful response and not accept the fact that Cannabis helps many….Including those that want to get off Heroin!

      On the teaching our Children part….yes…they need to toughen up! 2 years Military for all of them would be good fit!///awarding trophies to Johnny that got 5th place at the track meet….that must stop…..

      Have I never seen someone that has come off Heroin?…..no thank god!….Give the poor bastard some Cannabis to ease the pain! Why watch them suffer like a rat in the lab?

      I am not trashing you…..I am pointing out your lack of education on the Cannabis plant…..simple as that.

      • Virginia says:

        Sorry you will never understand.  Too bad, Common Sense.

        I wanted to make sure my son didn’t end up as so many of his fellow students did.  And, he didn’t……. for which I thank God!

        Maybe if you went out in the weeds it would give you some insight into the problem(s).  It isn’t I haven’t read anything on Cannabis because I have for 50 years!

         

         

         

         

        • Common Sense says:

          Wow….I am guessing you voted for Trump?…..very off the cuff comments… I am good thanks…..glad your son is good too…..

        • Common Sense says:

          Right…there’s reading….and there’s Comprehension…..and learning…..and growing!

      • Hey, Common Sense, a reminder that we encourage civilized discussions here, and name-calling is grounds for removal.

        Thanks in advance.

  32. Shelly Shively says:

    Dr. Greenberg,  I appreciate your insightful and heart wrenching article.

    As a long-time former RDA (Registered Dental Assistant) ,  I have been chair-side to dental patients experiencing varied levels of  pre-treatment and post-treatment  pain.    Over the years, every dentist I worked with, except one,  treated patients in a responsible manner relieving pain, with careful and cautious consideration in prescribing narcotics such as Vicodin and Norco.

    I’d advise patients to be wary of a dentist or physician that freely offers narcotics when an  over the counter medication would serve for mild to moderate pain.  I’d be wary of dentists that offer nitrous oxide (laughing gas) for all procedures, and especially if offered at no charge.  While nitrous oxide is marvelous in use for high anxiety patients, or difficult procedures, I was concerned to see teenagers and adults that wanted nitrous solely for the experience of altered state.

    My family history,  with loved ones  that died from alcohol and drug addiction, leads me to a bias view that getting high is not so funny, even with laughing gas.

    Years ago, when I had oral surgery, the oral surgeon highly recommended that I fill the 30 tab RX of Vicodin for post-op pain.  I had the script filled, but instead,took Exedrin P.M., which covered the discomfort like a charm.  The next day, one of  of my daughter’s friends called, and said her dad heard that I didn’t use my Vicodin, and would I give them to him.   Needless to say, I got rid of the pills.

    “We need to teach our children how to deal with the pain of life, not escape it”,  is the nutshell.

    Thank-you, Dr. Greenberg

     

     

     

    • Greg Greenberg Greg Greenberg says:

      Thanks Shelly.  I agree that we should not be cavalier with harmful drugs.  I must admit that the pendulum is swinging too far the other way and those who would benefit from opioid pain medications are denied them.  The problem is that opioid abouse and sharing of prescriptions is so common that the harm to the community from opioids outweighs the individuals’ needs.  I still prescribe opioids in the emergency department but I do so carefully.  Next month I get surgery to repair a torn rotator cuff tendon and I’m pretty sure Ibuprofen alone won’t cut it.

      • Virginia says:

        Wish only success with your surgery, Dr. Greenberg.  And, little pain……

        Again, thank you for your original letter and your own comments.

        Blesssings………….

    • Virginia says:

      Shelly, thank you for telling your story.  Just maybe it will help someone to stay off drugs and/or alcohol.  It takes courage to bring the history forward.  Too often people tend to keep the history “under wraps”, which is a shame.  Bringing out into the open can possibly help others less fortunate than you and I to work their way back to freedom from drug/alcohol problems.

      Blessings. always……

  33. Frank Treadway says:

    Hill Country Community Care Center on Market and Gold.  Aegis Methodone Clinic on Hartnell. Empire Recovery Center on California St. and more resources like this in Redding/Shasta County…use them.

    • Virginia says:

      One needs to be careful with Methadone.  I know a young man on it for a number of years to try to beat the heroin addiction, and then when wanted to get off of it it was a hard struggle.  He ended up in the hospital near death trying to survive the effort.

  34. common sense says:

    While our are has some Overdoses it’s not as bad as other areas around us. A look into the problems

  35. Common Sense says:

    1 in 8 Americans is Addicted to Alcohol in the U.S.A….people complain that Cannabis will lead to more DUI’s….and it may….but with numbers like these…..it’s the Alcoholics that Cause the most accidents!

    • cheyenne says:

      Actually several new studies, printed in the locals, have shown distracted driving, cell phones and texting mostly, are the leading cause of accidents.  One study that was in the Denver Cannabis pointed out that distracted driving causes more accidents than cannabis.

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