Tag Archives: addiction

Surgeon general report: ‘Addiction is not a character flaw’

In what may be his last significant act as President Barack Obama’s surgeon general, Dr. Vivek Murthy released a report calling for a major cultural shift in the way Americans view drug and alcohol addiction.

The report, “Facing Addiction in America,” details the toll addiction takes on the nation — 78 people die each day from an opioid overdose; 20 million have a substance use disorder — and explains how brain science offers hope for recovery. While its findings have been reported elsewhere, including by other federal agencies, the report seeks to inspire action and sway public opinion in the style of the 1964 surgeon general’s landmark report on smoking.

With President-elect Donald Trump taking office, it’s uncertain whether access to addiction treatment will improve or deteriorate. Trump and the Republican-led Congress are pledging to repeal and replace the 2010 Affordable Care Act, which made addiction treatment an essential health benefit.

In an interview this week, Murthy said he hasn’t spoken to Trump but looks forward to working with his administration to save lives with expanded access to treatment.

“We have made progress,” Murthy said. “How do we keep that progress going? A key part is making sure people have insurance coverage.”

The Associated Press reviewed the report ahead of its official release. Here’s a look at what’s in it and some early reaction:

 

MEDICATION MYTHS

The surgeon general’s report refutes abstinence-only philosophies as unscientific and supports medications such as buprenorphine and methadone that are used to treat opioid addition. That may annoy supporters of traditional 12-step programs who see medications as substituting one addiction for another.

Medication-assisted treatment for opioid addiction can take time. “One study suggested that individuals who receive MAT for fewer than 3 years are more likely to relapse than those who are in treatment for 3 or more years,” the report states.

 

TV-STYLE INTERVENTIONS

Staged interventions, like those depicted on TV, may backfire. Planned surprise confrontations “have not been demonstrated to be an effective way to engage people in treatment,” the report says. The trouble with the approach? According to the surgeon general’s report, it can heighten resistance and attack the self-worth of the addict.

 

ALCOHOLICS ANONYMOUS

Alcoholics Anonymous was founded in 1935 because mainstream medicine wasn’t treating alcohol disorders. That started a legacy of separating addiction treatment from the rest of medicine.

The report makes room for AA and other recovery support services, noting they don’t require health insurance and are free, but it also says they “are not the same as treatment and have only recently been included as part of the health care system.”

AA gets praise for adaptability. American Indians, for instance, have incorporated Native spirituality and allowed families to attend meetings. Research shows AA to be “an effective recovery resource,” the report concludes.

 

HIGHER ALCOHOL TAXES

Alcohol tax policies get a nod in a section on evidence-based prevention: “Higher alcohol taxes have also been shown to reduce alcohol consumption.” Other policies suggested by research include limiting the density of stores selling alcohol, banning Sunday sales and holding bars liable for serving minors.

 

WHAT ABOUT MARIJUANA?

The report suggests learning from alcohol and tobacco policies to find out what works to minimize harm as marijuana becomes legal.

Voters in eight states have approved adult use of recreational marijuana and more than two dozen states have medical marijuana laws. The report cites “a growing body of research” suggesting marijuana’s chemicals can help with “pain, nausea, epilepsy, obesity, wasting disease, addiction, autoimmune disorders, and other conditions.”

Murthy supports easing existing barriers to marijuana studies, but said that he’s worried the legalization movement is moving faster than research. “Marijuana is in fact addictive,” he said.

 

NOT A MORAL FAILING

Addiction is a chronic illness, not a character flaw or a moral failing, the report says. Stigma and shame have kept people from seeking help and weakened public investment.

Murthy issues a call to action in the preface: “How we respond to this crisis is a moral test for America. Are we a nation willing to take on an epidemic that is causing great human suffering and economic loss?”

 

RED STATE-BLUE STATE ISSUE

Ohio Republican Sen. Rob Portman, co-sponsor of bipartisan legislation passed this year that creates grants to expand treatment programs, said he hopes the report raises awareness.

“We have to change the way we talk about addiction and break the stigma to help more Americans suffering from this disease get the treatment and recovery they need,” Portman said.

Addiction should be a bipartisan issue, said Democratic former U.S. Rep. Patrick J. Kennedy, an addiction treatment advocate.

“This affects all of America, but it really affects the Trump voter,” Kennedy said. Red states such as West Virginia, Ohio and Kentucky have the highest overdose rates, Kennedy said. Enforcing laws that require insurers to cover addiction treatment will be a test of Trump’s “promise to put average Americans ahead of corporate interests,” said Kennedy.

Wisconsin man sentenced for sex trafficking

Monta Groce, 30, of Sparta, Wisconsin, was sentenced this week to 25 years in prison for using violence, threats and coercion to compel three young women suffering from heroin addiction to prostitute for his profit in Wisconsin and Minnesota.

In July, a  jury convicted Groce of three counts of sex trafficking by force, threats or coercion; one count of conspiracy to engage in interstate transportation for prostitution; one count of interstate transportation for prostitution; one count of maintaining a property for drug trafficking; one count of using a firearm in furtherance of drug trafficking and one count of witness retaliation.

The sentence was announced by Deputy Assistant Attorney General Vanita Gupta, head of the Justice Department’s Civil Rights Division, along with U.S. Attorney John W. Vaudreuil of the Western District of Wisconsin and Special Agent in Charge R. Justin Tolomeo of the FBI’s Milwaukee Division.

“Groce beat, tormented and enslaved vulnerable young women struggling with heroin addiction,” said Gupta.  “He treated them as sex slaves rather than human beings and his unconscionable actions offend the most basic standards of human decency.  Nothing can undo the harm Groce inflicted or the pain he caused, but hopefully this sentence provides some measure of closure and relief for the victims.”

“Sex trafficking is modern slavery, and cannot be tolerated in any civilized nation,” said Vaudreuil.  “These crimes, which took place in a small Wisconsin city, demonstrate that sex trafficking is not just a big city issue; it is a horrible problem in rural America too.  We will continue to work with our local, state and federal law enforcement partners to bring to justice those who violently exploit vulnerable victims in Wisconsin.”

“Sex trafficking has no boundaries and can occur anywhere,” said Tolomeo.  “When combined with drug addiction, the results are devastating.  Groce used heroin and violence to force victims into prostitution.  The FBI will continue to work with its law enforcement partners to target these predators.”

Evidence presented at trial included the testimony of the three victims identified in the indictment as Jane Does 1 through 3. They testified that Groce sold heroin in Sparta between December 2012 and April 2013.  During that time, he enticed the victims to begin prostituting for his profit by providing them with heroin .  As their dependency increased, he turned to violence and threatened to cut off their heroin supply if they disobeyed him, withheld money earned from prostitution or otherwise refused to prostitute.

Groce further kept some of the victims in perpetual debt by fronting them heroin and charging fines as punishment.

He advertised the victims on Backpage.com and paid other addicts to drive them from Wisconsin to Minnesota to prostitute.

 

The case was investigated by FBI’s Milwaukee Division with assistance from the Sparta Police Department and Monroe County, Wisconsin, Joint Investigative Task Force.

What’s Fentanyl? The facts about the synthetic opioid

Prince died of an overdose of the powerful opioid fentanyl, according to autopsy results released in June.

Among the questions investigators were reviewing was whether Prince had a prescription for painkillers before his death.

A person close to the investigation of Prince’s death told The Associated Press that pills found in Prince’s home marked as acetaminophen-hydrocodone actually contained fentanyl, suggesting they were counterfeit pills obtained illegally.

Prescription opioid overdoses reached nearly 19,000 in 2014, the highest number on record.

Total opioid overdoses surpassed 29,000 that year when combined with heroin, which some abusers switch to after becoming hooked on painkillers.

Some information on fentanyl:

 

WHAT IS FENTANYL?

Fentanyl is a synthetic opioid, 50 times more potent than heroin, that’s responsible for a recent surge in overdose deaths in some parts of the country. It also has legitimate medical uses.

Doctors prescribe fentanyl for cancer patients with tolerance to other narcotics. It comes in skin patches, lozenges, nasal spray and tablets.

Because of the risk of abuse, overdose and addiction, the Food and Drug Administration imposes tight restrictions on fentanyl; it is classified as a Schedule II controlled substance.

Some pharmaceutical fentanyl is illegally diverted to the black market. But most fentanyl used illicitly is manufactured in clandestine labs.

The U.S. Drug Enforcement Administration has tied fentanyl seizures to Mexican drug-trafficking groups.

On the street, fentanyl is sold alone as powder, added to heroin or made into counterfeit OxyContin pills. Users don’t always know when they’re taking fentanyl, increasing the risk of fatal overdose.

The DEA issued a nationwide alert about fentanyl overdose in March 2015. More than 700 fentanyl-related overdose deaths were reported to the DEA in late 2013 and 2014.

Since many coroners and state crime labs don’t routinely test for fentanyl, the actual number of overdoses is probably much higher.

WHAT IS A LETHAL DOSE?

It’s tricky with opioids like fentanyl.

Anyone who takes prescription opioid painkillers for a long time builds up a tolerance to the drugs. A dose that could kill one person might provide medicinal pain relief to another.

Experts in medical toxicology say it’s important to know how much opioid medication a person has been using before a death to know how to interpret post-mortem blood levels. Pill bottles and medical history may become crucial evidence.

DOES PAIN TREATMENT LEAD TO ADDICTION?

Prince had a reputation for clean living, and some friends said they never saw any sign of drug use. But longtime friend and collaborator Sheila E. has told the AP that Prince had physical issues from performing, citing hip and knee problems that she said came from years of jumping off risers and stage speakers in heels.

Becoming tolerant to opioid painkillers may lead some patients to seek stronger drugs from their doctors.

Some users — whether they start as recreational users or legitimate pain patients — become addicted, experiencing an inability to control how much they take, so they use much more than is prescribed or seek out drugs on the black market.

With good management, however, opioids can offer relief to people with only a small risk of addiction, according to a 2010 review of the available studies.

Confronting the ‘heroin tsunami’ in Kootenai County, Idaho

Crushing news came shortly after Cindy Schaffner heard sirens just a few blocks from her Post Falls home.

The sirens, Schaffner learned, were for her 19-year-old daughter, Cathryn Mason.

Cathryn, who loved the outdoors and was majoring in recreation management at North Idaho College, was in critical condition. She’d overdosed on heroin and alcohol.

Cathryn died two days later after she was taken off of life support. That was in May 2014.

“She was a very driven and focused person,” Schaffner said, fighting back tears. “She loved to go on hikes and was full of life. She was celebrating getting good grades for the semester.”

Schaffner said it was the first time she was aware of that her daughter had used drugs.

“She had a strong sense of morals and values and she had faith, but, for whatever reason, she decided to compromise those values,” Schaffner said. “It was a surprise to all of us because she wasn’t a user.”

Cathryn was caught on the edge of what officials refer to as the “heroin tsunami,” a nationwide opioid abuse epidemic that Kootenai County has not been immune to in recent years.

“We have seen a significant increase in the usage of heroin in our community,” Post Falls Police Chief Scot Haug said.

Haug said the rise of heroin usage is due to two reasons. It is not only used as a recreational drug for the intense euphoria it induces, but it is an opioid painkiller that people turn to when they are taken off prescription medications or those medications aren’t offering as much relief as desired.

Heroin is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. It appears as a “China white” or brown powder or as a sticky black substance as “black tar” heroin.

Heroin can be injected, inhaled by snorting or sniffing, or smoked. All three methods deliver the drug to the brain rapidly, contributing to its health risks and high risk for addiction.

“Some experts believe that heroin is more addictive than meth and more difficult to detox off of,” Haug said.

The street value of heroin is about $300 per gram, according to police. It is usually sold by the “point” — or tenth of a gram — for $30.

While Cathryn, who graduated from Post Falls High in 2012, was not on painkillers, her sudden and unexpected death shows how lethal heroin can be, Schaffner said.

“Some do it for years and years, while others may try it once and it kills them,” she said. “It’s like playing Russian roulette.”

Rising numbers

News earlier this month that multiple law enforcement agencies had busted an alleged heroin ring that included a Coeur d’Alene physician put a local point on the severity of the problem nationally.

At least 28,648 people in the U.S. died of causes linked to opioid drugs in 2014, according to the U.S. Centers for Disease Control, almost as many as are killed annually in car crashes. The class of drugs includes heroin and prescription painkillers such as oxycodone.

A CDC report released last year revealed the number of U.S. heroin users has grown by nearly 300,000 over a decade.

Haug said heroin has surpassed methamphetamine as the most common drug behind marijuana in the community.

PFPD processed no heroin into its evidence storage in 2010, but it obtained 20 heroin items in 2013, 19 in 2014 and 21 in 2015 (the numbers do not reflect heroin-related medical calls).

Haug said he’s aware of several heroin-related deaths across Kootenai County around the time that Cathryn died. Investigations into some of those cases, including Cathryn’s death, continue.

Haug said his department receives heart-wrenching calls on almost a weekly basis from families of those using heroin who are desperate for help.

“But many times the users don’t want help,” he said. “The challenge for us is that we can’t knock down doors and force people to get help, but we point them and their families in the right direction when there’s opportunities.”

Kootenai County Sheriff Ben Wolfinger said the rise in heroin has a ripple effect in the community, from law enforcement to substance abuse councils to the mental health sector.

“It’s not just a law enforcement problem; it’s a community problem,” he said.

Dr. Joseph Abate, medical director at the nonprofit Heritage Health, said he believes one reason heroin has regained momentum is because it’s cheaper than some prescription painkillers.

“That’s an attraction to people who are using opioids without a doctor’s recommendation,” Abate said. “But people who have been on opioids with a doctor’s recommendation turn to heroin too because they have a problem with tolerance to pain, especially younger people. They may start on low doses of pain medication, then they take more and more to get the same amount of relief. It may not make sense to you or I, but to patients who are trying to get relief . 

“Part of the rise of heroin is that people start on painkillers for legitimate reasons and then it just gets out of control. In the past people received the message that pain could be controlled with the right dosage, but now we’ve learned the hard way that it does nothing more than make a person worse over the long term rather than better.”

Spirit Lake Police Chief Keith Hutcheson said as prescription drugs have become more regulated in response to the rise in addictions, people revert to illegal drugs such as heroin. It’s a vicious cycle, he said.

“Instead of buying pills on the street, they’re now buying heroin because it’s cheaper and they can get a higher high for a longer time,” Hutcheson said.

Combating the epidemic

One of the ways Heritage Health is trying to right the ship when no opioid is enough is to educate on “mindfulness-based solutions.”

“It’s thinking of pain differently, just something you learn to deal with,” Abate said. “It’s not us saying that pain is all in your head. What we’re saying is how you perceive your pain makes a difference in what you search for as the solution.”

Part of the program is sharing with others how pain affects your daily life and how you label it.

“A lot of people don’t have a chance to tell about how it affects your life,” Abate said.

Abate said if the only weapon in one’s toolbox to fight pain is opioids, it’s not likely you’ll find relief in a fashion that will allow you to live a reasonable life. Mindfulness solutions, exercise, physical therapy and acupuncture are other tools people can use to treat pain.

“There are better ways to treat pain rather than assuming the only thing that will make it go away is pain medicine,” he said. “If people are willing to look at why the pain is not very well-controlled, we can offer them other options so they are safely and reasonably treated without fear of an unintentional overdose.”

Abate said while there are good substance abuse treatment programs available, there aren’t a lot of affordable ones. He said providers also need to be educated on who the highest-risk populations are before prescribing medication.

Abate said there has been a push in recent years for providers to monitor patients more closely and lower the maximum doses of painkillers. He said emergency doctors will now often times refer frequent patients back to their primary care providers for pain medication.

At the national level, President Barack Obama will ask Congress for $1.1 billion in his next budget to combat the opioid abuse epidemic, which has emerged as a 2016 campaign issue. The amount Obama wants to spend over two years is slightly more than the $1 billion he’s requested to expedite cancer treatments.

“Prescription drug abuse and heroin use have taken a heartbreaking toll on too many Americans and their families while straining resources of law enforcement and treatment programs,” the White House said in a statement.

Abate said the number of people who seek urgent medical care after using heroin is limited.

“We usually don’t see them,” he said. “They don’t wander into the clinic looking for care. They’re more likely to be found by law enforcement.”

Lisa Aitken, Kootenai Health spokeswoman, said there also hasn’t been an increase in people coming to the hospital’s emergency room with heroin-related issues.

“That’s definitely not to say that the use of heroin is not on the rise; they are just not making it to the hospital at this point,” she said. “It’s sad to think that there are people not coming to the hospital if they are in need of medical care related to heroin use.”

Schaffner said that since her daughter died, young women who have struggled or have been tempted have gravitated toward her for support.

“You need to have open communication with your kids and you’ve got to know where they are at,” she said. “If they think you are overbearing, too bad. It’s for their own good.”

Schaffner said she still struggles with what caused Cathryn to make a “foolish choice.” She said her faith and two other daughters have helped her from “rolling into a ditch” after the tragedy.

“You’ve got to stay focused on the things you do have,” Schaffner said. “You can’t stop living when other people love you and need you. I have good memories of Cathryn, and I think about her every day. There’s a purpose and reason for things and some day I’ll understand.”

Published via the AP member exchange. 


Should Philip Morris pay for lung cancer screenings? Case goes to trial

A decade after a group of smokers from Massachusetts sued Philip Morris USA to try to force the cigarette maker to pay for lung cancer screenings, the case goes to a jury trial.

Smokers in the class-action lawsuit allege Philip Morris manufactured a defective cigarette knowing it could have made a safer product with fewer carcinogens.

They are not seeking money, but instead want to compel Philip Morris to pay for highly detailed, three-dimensional chest scans that can detect signs of early-stage lung cancer that may be too small to show up on traditional X-rays.

The closely watched case going to trial this week in federal court in Boston.

The jury will be asked to decide whether Philip Morris made Marlboro cigarettes that are unreasonably dangerous. If the jury finds in favor of the smokers, a second phase will be held to determine how a medical monitoring program will be administered.

No smokers are expected to testify during the first phase. Instead, it will be a trial of dueling experts.

The plaintiffs plan to call a former Philip Morris employee to testify that feasible alternative designs of Marlboros have existed for decades. They also plan to call a psychologist who will testify that given a choice between Marlboros or a safer cigarette, a non-addicted, informed person would choose the safer alternative.

Philip Morris is expected to call experts in cigarette design and marketing who are likely to testify that the company’s lower-tar and lower-nicotine cigarettes — on the market since the late 1970s — have failed to gain a significant market share among any group of smoker.

Richard Daynard, a law professor at Northeastern University and anti-smoking activist, said past lawsuits seeking to force tobacco companies to provide medical monitoring have failed. But Daynard said he believes the Massachusetts case has a stronger chance of succeeding because recent studies have found that the sophisticated screening can save lives.

“What’s happened is you have better technology which captures the tumors at a much earlier stage where there’s a very good chance that if you get them that the person … is probably not going to die from it,” Daynard said.

A Philip Morris spokesman declined to comment, and lawyers for the company did not respond to messages.

In court documents, the company denied that its cigarettes are defectively designed and argued that three-dimensional chest scans would not be effective or necessary for every person covered by the lawsuit.

The case covers Massachusetts smokers who, as of February 2013, were at least 50, had at least a 20 pack-year history of smoking Marlboros and have not been diagnosed with lung cancer. Pack-years are calculated by multiplying the average number of packs per day by the number of years a person has smoked.

The two sides agree that the chest scans are “reasonably and periodically necessary” for smokers 55 to 74 with at least a 30 pack-year history. They disagree on the rest of the smokers in the lawsuit.

Since the case was filed in 2006, insurers have begun to cover the screenings for certain smokers. Last year, Medicare announced it would pay for annual screenings for beneficiaries 55 to 77 with at least a 30 pack-year history.

U.S. District Judge Denise Casper rejected a request to exclude evidence about insurers agreeing to pay for three-dimensional chest scans, but said she’ll instruct jurors that they are not allowed to consider whether any of the smokers have insurance coverage for screening.

“The fact that insurance now covers it and it’s recognized for certain groups as being efficacious may have some evidentiary value in the case, but it does not change the fact that Philip Morris could be liable for the cost of the scans,” said Christopher Weld, an attorney for the smokers.

Celebrity is the villain in new Amy Winehouse film

Asif Kapadia’s Amy Winehouse documentary “Amy” is a slow, tragic zoom out. It begins with the intimacy of home movies and ends in far-away paparazzi footage. Our VIP access has been revoked.

First seen as a bright-eyed 14-year-old girl singing a knockout “Happy Birthday,” Winehouse gradually recedes from our view as her renown grows, obscured by a blizzard of flashes and a deadening haze of celebrity. Fame arrives like fate: a destiny foreshadowed by Winehouse’s self-evident talent and her own ominous misgivings. “I would go mad,” she says of fame before its tidal-wave arrival. 

“Amy” is an exceptional, emotional portrait of a pop star who perished too young. But it is, more broadly, a clinical case study of celebrity’s crushing onslaught and an indictment of its tabloid apparatus. It’s a horror movie.

The ingredients of Winehouse’s swift demise (she drank herself to death at age 27 in 2011), as seen in the film, are many: a broken family, her own self-destructiveness, a lack of timely intervention. But most haunting is the film’s close-up of a toxic celebrity culture where out-of-control addicts are merely punchlines for late-night hosts.

Kapadia, a British filmmaker who started in fiction film, eschews talking heads. His tremendous documentary “Senna,” about the Formula One racer Ayrton Senna, who died at 34, relied entirely on archival footage, and he’s done the same with “Amy.” It’s an elegant, uncluttered approach that maintains closeness with the subject and gives “Amy” an unbroken drama.  

Both films replace hagiography with evidence (archival video, audio testimony, even old voicemails), but the purity of Kapadia’s aesthetics shouldn’t be mistaken for perfect objectivity. He and editor Chris King have pointedly, expertly assembled snapshots of Winehouse’s life to lend a particular view of it.

Winehouse’s family — especially her father, Mitch — have publicly denounced “Amy” as “misleading.” That, though, should be taken as a good sign of Kapadia’s independence in making “Amy.”

The film is disarmingly intimate. There is Winehouse, an aspiring singer, playful and flirty in the backseat of a car, goofing around with friends and a video camera.

The rise of this insanely charismatic Jewish retro-soul singer from North London seems a certainly to all who encounter her. The voice, smoky and soulful, is unmissable. “A charmer,” describes Yasiin Bey (Mos Def), immediately infatuated by “a sweetheart” who could drink anyone under the table and roll a smoke.

Her upbringing casts a pall. The divorce of her parents when she was nine (also the age when Kurt Cobain’s parents split, as noted in the recent documentary “Kurt Cobain: Montage of Heck”) after an admitted seven-year affair by her cab driver father, is cited as a turning point for the worse. Mitch Winehouse also figured into his daughter’s autobiographical hit “Rehab”: “I ain’t got the time and my daddy thinks I’m fine.”

Winehouse’s early, friendly entourage give way to more professional and an arguably less protective group of promoters. The missed opportunities to help her slide by. She and her eventual husband, the troubled Blake Fielder-Civil who introduced her to crack, descend into drugs. In a mocking video Fiedler-Civil shoots while both are in rehab together, she’s less inclined to make a joke out of it: “I don’t really mind it here,” she says.

Kapadia has gotten everyone close to Winehouse to speak, and the interviews are more personal having been  taped off-camera. A sense of helpless mounts as Kapadia searches for a guardian for Winehouse. Instead, he finds her father arriving at her post-rehab getaway in Saint Lucia with a TV crew for his reality show, “My Daughter, Amy.”

There may be something a tad callous in seeking blame among those she loved and who loved her, four years after Winehouse’s death. Black-and-white villains rarely suit such tragic stories. But “Amy” is a clear-eyed, deeply empathetic view of Winehouse, whose huge talent and sudden fame made too many forget she was still just a vulnerable young woman in serious need of help. 

Galano Club helps LGBT people get sober

Every alcoholic and addict hits bottom differently.

For some, it might be breaking a family heirloom piece of china due to shakiness from cocaine. For someone else, it might be killing someone during a drunken blackout.

But for all alcoholics and addicts, the bottom is that moment they realize that their drinking or addictive behavior has taken control of their lives. Only then can the process of recovery begin — a lifelong process that requires a lot of support.

Since 1973, LGBT Milwaukeeans and visitors to the city have found the support they need at the Galano Club, currently located at 7210 W. Greenfield Ave. in downtown West Allis. The club hosts meetings for a variety of 12-step programs and is paid for by voluntary dues, contributions and fundraisers. It also provides socializing opportunities and group events. Straight people, of course, are welcome at the meetings, which are for anyone with a genuine desire to get clean and sober.

The club also has meetings that support people who are involved with someone struggling with addiction (Al-Anon) and a recovery book club, Pages of Healing. In the latter, people read books such as Co-Dependent No More to help them heal from addictive relationships and other harmful behaviors. 

“I think that many times people don’t know that help is available for improving your own sanity when dealing with a loved one who is an addict,” says Raymond K-K, a charter member of the club and former board member who’s been clean and sober for 30 years. (Members of 12-step programs remain anonymous in the press by not using their last names.)

Raymond has seen membership and participation ebb and flow over the years. Currently about 160 people are regularly involved with the club. Over the years, Raymond has witnessed varying trends in addiction, from cocaine to crack to meth to heroin.

Some of the meetings hosted at Galano focus on alcohol, others on narcotic substances and others on behavior, such as sex addiction. But all follow the same 12-step format and principles, which is based on peer support from other alcoholics and addicts.

Recovery is a deeply personal journey that involves sharing one’s innermost thoughts and private experiences. No one in recovery can afford to hold back. For those reasons, many LGBT people feel safer with a group such as Galano Club, which was founded by and exists for them. Before Galano Club came along, 12-step programs in Milwaukee that were welcoming of LGBT members were coded using the numbers 94 as their last two digits for identification. 

Despite the enormous gains in visibility and social acceptance LGBT people have experienced since 1973, a lot of people still feel more comfortable being out and open around people like them. Many of them also feel as if other LGBT people understand issues that are unique to them, so they don’t have to explain aspects of their lives that are familiar to people who have lived in the same culture and shared many of the same kinds of experiences. 

“As a member of the LGBT community, the Galano Club is a great place to get into recovery because you’re not afraid to talk about things that relate to your personal life,” says Deb S., who’s been sober for 20 years. “It’s safe within those rooms. There’s that community feeling.”

For Deb, like many other LGBT people, struggles with sexual identity helped fuel her drinking. Numbing herself with alcohol helped her cope with the nascent realization that she’s a lesbian. 

“When I first discovered my sexuality, I wasn’t accepting of myself and I drank a ton,” Deb says. “It was a (way) to avoid who I was. I thought it helped relieve some of those (negative) feelings. No, it wasn’t the answer I was looking for — not one bit.”

Twenty years ago, when Deb was coming out, socializing in bars was an LGBT tradition. That’s changed as society has grown more inclusive. Now LGBT people feel free to socialize in the world at large.

But alcohol is a traditional way of socializing in all of America, and having a non-drinking community of LGBT people to associate with — a community such as Galano offers — is vital to helping people like Deb stay sober, she says. 

“I need to put myself in situations that support my sobriety, like hanging around with people who aren’t using and are having a good time without drinking,” says Raymond K-K. “Going out to dinner after a meeting, going on road trips with other people who are sober helps me stay sober.”

The National Council on Alcoholism and Drug Dependence says that nearly 15 percent of the U.S. population — 18 million people — abuse alcohol. Statistics also show that 100,000 Americans die each year of alcohol-related causes and that driving under the influence is a factor in nearly half of the nation’s highway deaths.

In the LGBT community, the numbers are even scarier. Studies have found that LGBT people abuse alcohol at three times the rate of heterosexuals. 

Raymond K-K says that being LGBT is not the only risk factor for becoming alcoholic or addicted. Socioeconomic factors also play a large role, as do aging, racism and other characteristics.

But no matter what their race, age or sexual orientation, all addicts have one thing in common.

According to 12-step philosophy, Raymond K-K says, “When you’re dealing with somebody who’s chemically dependent, there’s these two specific things that are different from people who just abuse chemicals or just get drunk now and then. (Addicts) have this obsession of the mind and an ‘allergy’ of the body. Something happens different to a person who’s an alcoholic or an addict when they use.”

Raymond K-K believes that “there’s a genetic predisposition that’s clearly marked. You can’t separate far from the DNA of another addict.”

Coping with addiction is a lifelong battle, according to 12-step programs. There’s a saying among alcoholics that “one drink is too many and a thousand not enough.” If an addict starts drinking or using again, no matter how long he or she has been sober or clean, it’s the beginning of an inevitable spiral back into what Raymond calls the “horror” of active addiction.

The first of the 12 steps is accepting “powerlessness” over one’s addiction. That powerlessness never goes away.

“I’m 30 years sober and I still need this program,” Raymond says. “I need to continue to use this program. It’s not just like I go to it to help others. This really helps me. Without it I am selfish, I am that rude person on the telephone, I am self-centered. This helps me to live differently.”

For more about the Galano Club, visit galanoclub.org.

Liza Minnelli back in rehab

Liza Minnelli has checked herself in rehab and is making “excellent progress,” her representative says.

Minnelli spokesman Scott Gorenstein said Wednesday night, “Minnelli has valiantly battled substance abuse over the years and whenever she has needed to seek treatment she has done so. She is currently making excellent progress at an undisclosed facility.”

In September, the legendary entertainer underwent back surgery to help heal an injury that prevented her from performing most of the year or attending the funeral of Joan Rivers in New York.

The 69-year-old entertainer, who has had alcohol and drug addictions, is one of the few artists to win an Oscar, a Tony, an Emmy and a Grammy. Perhaps her greatest role was as cabaret singer Sally Bowles in the film version of Cabaret.

Minnelli’s mother Judy Garland also battled addictions before dying of an overdose in 1969. Garland’s death is said to have helped sparked the Stonewall Riots in New York’s Greenwich Village, which inspired the LGBT civil rights movement.

Selfie satisfaction: Today’s selfie is yesterday’s portrait

The morning after Spain lost to Chile in World Cup play, soccer fan Tony Andres snapped a sour selfie and grumbled on Twitter. “The World Cup will produce more selfies than goals,” he tweeted to #WorldCupSelfies.

He most certainly is correct. The 2014 FIFA World Cup is taking place in Brazil, where soccer fanatics, players and coaches are seemingly producing selfies by the second. The event kicked off with a celebration that featured hundreds of thousands of selfies draped across the field in the “Happiness Flag.” The massive photomosaic, sponsored by Coca-Cola, contained 223,206 soccer selfies and spanned 11,800 square feet.

Beyond Brazil, social media has been flooded with selfies by soccer enthusiasts showing agony and ecstasy and also a lot of boredom and boozing. Most of the images come from smartphones or digital cameras. They are making their way to friends and fans, as well as strangers on Instagram, Twitter and Facebook.

The self-portraits express loyalty to a team and allegiance to a nation. They also help to transform the events in Brazil into global happenings.

The same day that those selfies of sour and grumbling fans of Spain showed up, there were selfies coming out of blood-soaked cities in Iraq and retweets of selfies by Jennifer Lopez and Demi Lovato minus makeup. There also was strange news of a warning from Madison police against posting #naked selfies.

The selfie as portrait. As documentary journalism.  As celebrity pop shot.  As porn.

The image-makers may be using new tools and reaching vast audiences, and the “selfie” may be a relatively new term, but self-portraiture is a very old form of art and method of expression.

Old style

Jan van Eyck’s Portrait of a Man in a Turban, painted in 1433, is described in art history books as one of the earliest panel self-portraits. In medieval and Renaissance works, artists may appear as faces in their crowds. Rembrandt painted a range of self-portraits in the 17th century. The world treasures self-portraits from artists as diverse as Frida Kahlo, Andy Warhol, Marie-Denise Villers, Raphael, Anthony Van Dyck, Gerard Sekoto, Gustave Courbet and, of course, Vincent Van Gogh, who painted himself dozens of times as a means of self-expression but also because he could not afford models. Writing to his brother about a painting he dedicated to Paul Gauguin, Van Gogh said, “The third picture this week is a portrait of myself, almost colourless, in ashen tones against a background of pale veronese green.”

American photographer Robert Cornelius created a daguerreotype of himself in 1839 that is one of the earliest photographs of a person and possibly the first “selfie,” though he recorded it as “the first light picture ever taken.” An early self-photograph by a teenager was taken by 13-year-old Russian Grand Duchess Anastasia Nikolaevna and sent to a friend in 1914, four years before she was executed by the Bolshevik secret police.

There’s also a long history of self-portraits by average Janes and Joes. The Zimmerli Art Museum at Rutgers in New Brunswick, New Jersey, recently exhibited “445 Portraits of a Man,” a collection of photobooth self-images taken by Franklyn Swantek from the 1930s to the 1960s.

The individual in the photos had been a mystery until a news story about the collection caught the attention of a man living in Minden, Nevada, who recognized his Uncle Franklyn, who had run Swantek Photo Service in Michigan for years.

Susan Sidlauskas, who co-curated the exhibit, said Swantek was able to elevate photomatics into museum-quality conceptual art.

“There’s a twinkle in his eye that suggests he had a reason for holding on to all those photos,” she said.

This summer, the museum is exhibiting “Striking Resemblance: The Changing Art of Portraiture,” an examination of the portrait as a social medium, as a way of linking people together, which is what NASA accomplished with its Global Selfie from Earth Day.

Worldwide Hug

On April 22, NASA invited people to step outside to take a selfie and share it with the world on social media. NASA created a new view of the planet made entirely of those photos, a mosaic consisting of 36,000 individual images from 113 countries and regions — Antarctica to Yemen.

“We were overwhelmed to see people participate from so many countries,” said Peg Luce, deputy director of the Earth science division at NASA headquarters in Washington, D.C.

“It’s like being part of a worldwide hug,” said Kimberly Rawlings of Chicago, who said her image is included in the Global Selfie. “The cranks who say we’re narcissistic for posting selfies, who complain about me-obsessed millennials, they miss the point of them.”

And there are critics of the selfie phenomenon. Bloggers have complained that girls posting selfies are being exploited. Plastic surgeons say the selfie trend is increasing demand for rhinoplasty, hair transplants and eyelid surgery. Mental health professionals have suggested a link between body dysmorphic disorder and a compulsion to take selfies.

But there’s little science behind the medical and mental health assertions and easy rebuttals to the exploitation assertion.

“Taking selfies, that’s empowering, that’s being proud of yourself,” said Wisconsin pediatric counselor Helen Cox, noting that one recent survey of young women found that 65 percent said taking selfies boosted their confidence. “When you share selfies, that’s bringing you into a community of people.”

Sometimes the community is small, a circle of friends.

Sometimes the community is massive, a world of Earth Day celebrants or World Cup soccer fans.

***

Did you know?

Generally, under copyright law, unless there is an agreement to the contrary or a photo is shot as part of a job, it belongs to the creator, the person who pressed the button on the camera. And the owner holds exclusive rights to display, copy, use, produce, or distribute the creation. The subject in a photograph has some rights but not ownership, as do social media services where photographs are shared.

Add an app

Popular portraiture apps for smartphones and tablets:

• CamMe: Take photos using hand gestures. Can take several photos sequentially, like the old photo booths. Enhance photos with cutouts. Easy sharing options. 

• Aviary: Touch up with red-eye removal. Add or remove color with splash. Add drama with sharpen. Stylize with filters and stickers.

• Mextures: Apply film grain, textures, light leaks and gradients to images — from landscapes to portraits.

• Facetune: Touch up portraits Hollywood-style. Remove blemishes. Even out skin tone. Brighten teeth. Color gray hair. Change eye color.

• Instagram: Apply filters. Easy share options. Front and back camera support. Add depth of field.

• Frontback: Shoot from the front and the back of the camera at the same time for the full story.

• Slingshot: From Facebook. Allows users to send photos, to friends, who must reciprocate before
viewing the photo. 

Heroin use, deaths on rise in Wisconsin

Some states, including Wisconsin, are reporting a rise in heroin use as many addicts shift from more costly and harder-to-get prescription opiates to this cheaper alternative.

Here’s a look at what’s happening in Wisconsin:

THE PROBLEM:

Heroin use and overdose deaths have increased dramatically in Wisconsin, according to the state Department of Justice. The increases reflect the national trend of prescription opiate addicts turning to heroin. Every time an addict uses heroin, he or she could die, according to DOJ, because it’s impossible to know how strong the dose is or what’s in it.

THE NUMBERS:

According to the state Department of Health Services, the number of deaths with heroin as a contributing factor more than quintupled between 2003 and 2011, from 25 to 134.

Heroin-related emergency room visits rose from 56 in 2003 to 329 in 2011, according to DHS. Heroin-related inpatient hospitalizations increased from 46 to 170 over that span.

Heroin-related arrests more than doubled statewide between 2008 and 2012, from 267 to 673, according to local law enforcement statistics the DOJ compiled.

Wisconsin emergency medical technicians deployed Narcan, a drug that counteracts overdose effects, in the field 3,730 times in 2012, up from 2,915 times in 2010, according to a 2013 study by the Wisconsin State Council on Alcohol and Other Drug Abuse’s prevention committee.

SOLUTIONS:

Rep. John Nygren, R-Marinette, who nearly lost his daughter to a heroin overdose, introduced several bills to curb use of the drug.

The measures including allowing more EMTs to administer Narcan; providing legal immunity for anyone who reports an overdose; creating regional opiate treatment centers; allowing municipal prescription drug collection drives; requiring identification to obtain opiate prescriptions; and creating quicker sanctions for parole or probation violators in hopes of getting addicts treatment faster.

All the bills have passed both the state Assembly and Senate and are now sitting on Gov. Scott Walker’s desk. The governor supports all the proposals.

DOJ also launched a public relations campaign last fall to raise heroin awareness.

— The Associated Press