disaster and withdrawal

When I watch the disaster news, what I think about is withdrawal.

Everyone who is on a substance that causes dependence or addiction is withdrawing.

They don’t seem to ever discuss that, but think…. if you are in Houston or Florida when everything floods, are your cigarettes dry? I don’t think so. And put multiple people in close contact in a shelter, with many withdrawing… I am not surprised that tempers flare.

Let’s look at numbers.

Tobacco: in 2013, 21.3% of the US population age 12 and older, smokes tobacco. Disasters are a reason to quit. It’s hard enough to quit tobacco, but imagine going cold turkey if we have our Pacific Northwest really massive earthquake. Quit smoking now, don’t wait for a disaster. And think about being in a stadium with one in five of the people over age 12 withdrawing from tobacco. Is that fun?

Alcohol: “In 2013, 30.2 percent of men and 16.0 percent of women 12 and older reported binge drinking in the past month. And 9.5 percent of men and 3.3 percent of women reported heavy alcohol use.” Ok, that’s rather vague. If you have a drink or two after work every day or with dinner, will you notice the lack? Yes, I think so, but maybe only 10% of the adults are really going into alcohol withdrawal. That’s a conservative estimate. 30% are probably grumpy.

Illicit drugs: 4-8% of the 40-70 year olds used something in the past month. Are they addicted? Well, some are. And the 18-15 year olds are the most active, around 20%. Methamphetamines, cocaine, crack, crank, heroin, eeee-yuk.

Prescription drugs: “More than half of new illicit drug users begin with marijuana. Next most common are prescription pain relievers, followed by inhalants (which is most common among younger teens).” So let’s see, what percentage of the population is on prescribed opioids, benzodiazepines and barbituates? Ooooo, 1/3 of the US population has been prescribed opioids (2). Chronic opioids are prescribed to 3-4% of the US population, but of course, that is the prescribed chronic pain ones, not the illicit ones. Now, those can have a withdrawal. Alcohol and benzodiazepine withdrawal are the most dangerous for the patient, but in opioid withdrawal the pain receptors go absolutely crazy, like a volcano blowing up. And the tweakers withdrawing from methamphetamines. The sleep medicines like sonata and ambien avoid the issue of whether they are addictive by saying they are for “short term use” — 6 weeks for the former and 2 weeks for the latter, but some people have been on them for years. And marijuana daily, I have seen great difficulty with anxiety and sleep when people are trying to quit.

Marijuana: 7.5% of the population over age 12. How many of those are addicted? I see varying numbers, ranging from 10% to 50%. If you use marijuana regularly, check. Stop it for a week. See if there is a problem. I’d try it before a disaster, because it would add to the stress during….

Caffeine: Ok, I would withdraw from caffeine. 90% of US people are addicted to caffeine. I get a massive headache for 24 hours and then I am ok. I have gone off it more than once….

With ADHD medicines for children, a “drug holiday” is sometimes recommended. If you are regularly using any potentially addictive substance, try a “drug holiday” of your own.

And I think it’s the best motivator ever to quit smoking. Friday I had a couple of dedicated smokers and when I talked about flooded cigarretes, they blanched. Quit now, before you quit in circumstances…

And prayers for everyone in the disaster areas.

1. https://www.drugabuse.gov/publications/drugfacts/nationwide-trends
2. https://www.cbsnews.com/news/more-than-one-third-americans-prescribed-opioids-in-2015/
3. https://www.cnbc.com/2016/04/27/americans-consume-almost-all-of-the-global-opioid-supply.html  Hey, 80% of the world opioid supply is eaten by the US population! Why are US citizens in so much pain? Or are we under the impression that we shouldn’t have to feel pain and by gosh, we can afford the drugs….
4. http://www.nejm.org/doi/full/10.1056/NEJMra1507771#t=article Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies.

So WHY doesn’t the news talk about this? Because the cigarette and alcohol and prescription drug companies would yank the advertising?

4 thoughts on “disaster and withdrawal

  1. Susanne says:

    A perspective I’d never heard. All that anxiety in a shelter from the situation at hand AND people withdrawing. It is a sad and frightening scene to consider.

  2. I can’t imagine what some of those shelters were like with all the people withdrawing. I remember all too vividly while in an in-patient rehab watching the guy in front of me go into detox convulsions on his first day at the facility. (i’m clean and sober now).

    On the lighter side, i went on a desert hike outside of Moab, and forgot the asprin and spent the first couple of days with a hatch-in-the-head headache. Six days later, after we were first back to “civilization” we stopped for gas and from the van I spotted the coffee pot inside the statition. The others immediately noticed what I was seeing and shouted “don’t do it,” but i made a beeline for the coffee. It must have been on the burner all day and was awful tasting, but i drank it all the same. Such is addiction.

  3. HesterLeyNel says:

    This scared the living daylights out of me. No, I’m not addicted to anything (anymore), not even coffee, but I’d be afraid, very afraid, to take shelter with so many addicts in withdrawal. I know what it feels like – I smoked for 40 years before quitting and I’ve dealt friends and family members in recovery after treatment for hard drugs and alcohol addiction. Scary. So yes, it is a valid question – why is there no mention of this in the media?

    • drkottaway says:

      Apologies for scaring you, but I think the absence of any discussion in the media is really glaring. Not that I think they should interview people who are ill from withdrawal, but I asked the disaster preparedness person who spoke to our Rotary about the topic. He said rather grimly, “We don’t talk about it and I don’t know what to tell you.”

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