Please, Take Time To Listen

"I know that you believe you understand what you think I said, but I'm not sure you realize that what you heard is not what I meant."    Robert McCloskey

We all have times that we just don't want to listen. We feel entitled to ignore the message because we have heard it many times before or because we feel we don't need the information or because we just don't feel like treating someone's words with common respect. Even when the coach or mentor begs "Listen up!" our mind's voice says, "Been there, done that." After all, we always get many opportunities to hear the same vital information, don't we?

These days we can easily suffer from "message overload" when so much content strikes our already full ears. Retention becomes impossible, and we zone out any more interference. Anyway, we are usually preoccupied with so much in general that good listening becomes difficult. The job, the economy, the family, the bills, the schedule -- all take priority before simplistic, well-meaning conversation. Besides, active listening is simply hard work: it taxes our patience, requires continuous concentration, and raises our anxiety levels as we begin to think about how to reply in a civil, courteous manner.

Even when we are listening we are continually chattering in our brains. We are formulating an answer or reacting to what is being said. We all want to talk, but so few wish to listen. We should listen; this we know. But, how much time do we devote to careful listening in our language processes? We have filled our lives with knowledge, beliefs, and opinions, which lead to prejudgments.

And, how about all that external noise around us? We are bombarded by environments that feature multiple sights and sounds. We easily get distracted by the movements and gestures of other people as we occupy spaces in which interruptions detract from our ability to hear clearly. Cell phones, computers, Ipods and 24/7 television invade our spaces. Even in places meant to be conducive to conversation, media devices blare, and we simply nod our heads in apparent approval of unheard moving mouths. For example, many sports bars now feature 50 or 60 televisions tuned to different channels for our so-called "pleasurable viewing convenience." There, we feel caught in strobes of images and sounds as we meet and greet our friends with largely artificial conversation. If we don't have hearing problems before entering these establishments, we have them upon exiting.

Then, we are always cognizant of those who speak to win advantage. Our listening is their benefit in such one-way conversations. We simply detest beginning to listen because we know doing so has punched our ticket to enter a long, drawn-out harangue of immense proportions. Congress has convened and we are caught in a filibuster promising no swift, gracious relief. Soon, our ears simply shut down as our mind wanders to some more pleasant subject.

The point is -- a million legitimate reasons to ignore a message exist. All we have to do is choose one, not wear the same reason out, and practice appropriate expressions and gestures of deaf approval. Deceptive communication abounds.After all, no one knows when a woman's beautiful smile is meant to carve tiny pieces from a man's heart or when a man's burly hug for his woman is synonymous with a python's deadly squeeze. Many cannot express their thoughts without emotion and body language, and many more don't have the skills required for listening.

Some Listening Research

Joel Rubinson's marketing research ("Transforming Research Through Listening," Advertising Research Foundation, 2009) noted, "Listening reveals insights via social and open-book approaches.  Listening is about studying the change-makers (people) in a way that is native to how they are increasingly living their lives. We must learn how to add listening to our survey-based approaches for generating anticipatory insights. Listening for the unexpected should be at the heart of the innovation process."

Rubinson's research is based on some amazing findings by Charles H. Swanson:

A brief narrative description of the journal article, document, or resource.

"Effectiveness in teaching and learning depends primarily on listening. Curriculum studies reveal that inclusion of listening as a subject to be taught is rare. While listening may be included as a unit within elementary or secondary classrooms, no specific instruction can be confirmed. The vast majority of America's college students can and do graduate without any listening training. Research about listening remains a minuscule portion of the research produced in the United States. Current research on listening, especially listening in the classroom, reveals a sense of idiosyncrasy: topics appear determined almost by chance. Teachers need to be trained in how to listen as well as in how to teach listening. While listening is an essential factor in classroom learning, few studies have examined that skill. In spite of the general lack of concern for classroom listening, efforts are being made to identify competencies of listening. The need and opportunity to study listening in the classroom are great."  ("Who's Listening In the Classroom? A Research Paradigm," Paper presented at the Annual Meeting of the International Listening Association -16th, Sacramento, CA, March 14-16, 1996).

The name assigned to the document by the author. This field may also contain sub-titles, series names, and report numbers. Consider this -- as we really listen, there are no reactions. There is no thinking. There is no talking. Listening is not judging. Listening involves being humble, so no "me" takes the stage. There is no "What I want to say." Pure listening is very revealing and extremely informative. In contrast, when we are not listening, we are preventing  opportunity through closing our minds. We exhibit a great lack of intelligence by not listening. In brief, the better at listening we become, the more productive we will be in our careers and in our lives. Talk show host Larry King once said, "I never learned anything while I was talking." We should consider this simple fact.    Most of Us Are Not Great Listeners In fact, it is difficult to admit it, but most of us (like me) are pretty bad listeners. But, a lot of people are just terrible listeners. Questioning our listening ability is actually the first step towards realizing our full potential – not merely as communicators but also as caring human beings. Listening sets no boundaries. Good listeners, though rare, are incredible assets.

Good listening is built on three basic skills: attitude, attention, and adjustment.These are the skills Walter Parks calls "Triple-A Listening." Active listening is actually a method of responding that encourages effective communication. These bits of knowledge are commonly known as the "Ten Commandments of Good Listening":  Stop talking. Obvious, but not easy. Put the speaker at ease. Create a permissive, supportive climate in which the speaker will feel free to express himself or herself. Show a desire to listen. Act interested and mean it. Remove distractions. External preoccupation is less likely if nothing external is present to preoccupy you. Empathize. Try to experience to some degree the feelings the speaker is experiencing. Be patient. Give the speaker time to finish; don't interrupt. Hold your temper. Don't let your emotions obstruct your thoughts. Go easy on argument and criticism. Suspend judgment. Ask questions. If things are still unclear when a speaker has finished, ask questions which serve to clarify the intended meanings. Stop talking. In case you missed the first commandment. (K. Davis, Human Behavior at Work, McGraw Hill, 1972)

Our Area and RX Drugs

 Would you deny this beautiful child a full, safe life?

RX Drug Task Force

I attended my first RX Drug Task Force meeting this Friday (February 26, 2010).  Members in attendance included Jane Murray, Portsmouth Mayor; Lisa Roberts, R.N.; Dr. Aaron Adams D.O.; Ed Hughes, LICDC; Troy Gahm, RPh; Peggy Burton, R.S.; Dr. Terry Johnson, Coroner; Charles Horner, PPD Chief; Marty Donini, Scioto County Sheriff; and people from the Ohio Attorney General's Office, the DEA, and the U.S. Attorney's Office, among many others.

The Mission Statement is 

"To serve Scioto County as the catalyst for collaboration to combat the severe prescription drug problem, to eliminate the epidemic of addiction, death, and disease, and restore our communities to recovery and health"

The Vision Statement is
 
"Region free of prescription drug abuse/misuse/overdose and the associated consequences to the individual and society."

The Purposes include  

"The Scioto County Rx Action Team will be an impetus for the coordination of efforts, development of effective services and strategies, and the elimination of the factors that foster and contribute to prescription drug-related consequences, and will advocate for the changes that are necessary to bring about long-term community recovery from drug abuse."

Many updates and reports during the meeting focused on the ongoing drug problems in the area. Needed finances, press coverage, pain clinic updates, dangerous drugs, essential legislation, and coalition activities were discussed. The group is presently formulating an Action Plan to address all phases of Rx drug abuse. Concerns will include initiatives on prevention, awareness, family education, and increased conscientiousness of prescribing practices and monitoring by physicians and Pharmacists.

I Found Something Inescapable

So much important information was disseminated at the meeting; however, I took one thing away from the panel of learned officials that sticks hard in my craw. Action Force means ACTION NOW. We must work to eliminate the problems with Rx drugs before it claims one other life. Please understand, that means ALL OF US must immediately take the pointed finger of accusation, uncomfortably turn it around, and stick it into our individual chests. This is not only the problem facing the Rx Task Force, it is also the problem facing you and me.

We have become content to let this cancer eat away the populace, the reputation, and the very integrity of our area. Many are willing to sit at a comfortable distance from something that they perceive is not their concern. The fight on hand to successfully curb the epidemic requires all to participate to guarantee success. Gone are the days of the "Just Say No" mentality. Bare simplistic warnings are not the answer to the myriad of problems related to the drug culture of 2010. Many social issues including unemployment, poverty, and family dissolution need utmost attention.

Prescription drug abuse knows no age. The elderly are vulnerable because they're more likely to take many medications, often long term. Also, women may be as much as 55% more likely as men to be prescribed drugs that can be abused, such as narcotics and tranquilizers; therefore, their risk is greater, according to the National Institute on Drug Abuse

Abuse is most common among young people, Wilson Compton, MD, director of the division of epidemiology services and prevention research at the NIDA says. "Prescription drug abuse -- like most drug abuse -- tends to peak in the teens and 20s," he tells WebMD.

Almost one in five teens -- roughly 4.5 million -- has tried getting high with prescription drugs (typically with pain relievers such as Vicodin or OxyContin, or stimulants, such as Ritalin and Adderall). That's according to a recent national study on teen abuse of prescription and over-the-counter drugs by the nonprofit Partnership for a Drug-Free America.

Who Is At Risk?

1. Mary is an average, ambitious college coed faced with the pressures of college and independent living.

2. Ted is a well-respected high school honor student under tremendous stress to perform, get good graded, be a good child and be a good athlete.

3. Jerry is a weary M.D. considering the risks of being somewhat impaired with stimulants to continue to serve the demanding regimen of his profession and patient care.

4. Susie is a great college athlete staring at erythropoietin (a drug that doctors use to treat anemia, also known as Epogen and Procrit) to boost production of red blood cells. She wonders if the increased numbers of red blood cells will deliver more oxygen to her muscles and improve her endurance.

5. Rich is a man who considers using Viagra while having unprotected sex with other men (studies show men who use the pill engage in unprotected sex with other men up to six times more often than nonusers). As a result, his abuse of ED drugs may dramatically increase the risk of sexually transmitted diseases and HIV infection.

6. Angie, a teen bombarded with messages of unrealistic body perfection, is worried about her weight, so she thinks that sneaking some of her brother's prescribed ADHD medicine will help her lose weight. She also has a friend who may consent to give her some of his meds as well.

7. Jimmy, a middle-aged, hard-working man sore and aching from the construction trade, considers "borrowing" some opioid painkillers such as Oxycontin or Vicodin from a friend or relative who has a prescription. Ninety-seven percent of the time, these drugs come from a friend or relative, and in most cases the drugs are handed over willingly.

8. Sally, an 80-year-old widow who has just lost her loving husband of 60 years, realizes she needs Benzodiazepines to help her through her recent depression. The drugs do help her sleep better and feel calmer. But, once she starts to take these drugs, it's very difficult for her to stop.

Take Individual Responsibility

Be heard with your concerns about drug problems. Be active in organizations and movements that are dedicated to eliminating the real causes of addiction. Let your one voice be the stimulus for changing many other people's opinions about giving up because past drug programs have not worked to their satisfaction. Above all, start TODAY to inform people that you have had enough and encourage them to help you take the streets back from the people who would poison you and your loved ones. Your fellow human, no matter his/her condition, is your concern and a part of your environment. To do nothing to solve the problems is to contribute to the lack of your own well-being.

Heroin - Xalisco in Ohio

Sam Quinones of The Los Angeles Times recently reported about a relatively new drug network. His three part series, "The Heroin Road," is a must read for those interesting in understanding the impact of drugs in our area. You may be surprised by both the scope of the problem and the ingenuity of those involved.

Have you ever heard of the Xalisco (ha-LEES-ko) boys? They have helped spread heroin addiction by leaving the wholesale business to the cartels and mining outsize profits from the retail trade, selling heroin a tenth of a gram at a time. Dennis Chavez, Denver police narcotics officer, has arrested dozens of them from Xalisco, an obscure corner in the Pacific Coast state of Nayarit, Mexico, and has diligently studied their recent activity. Competition among networks has reduced prices and now Xalisco connections are nationwide.

Unlike Mexico's big cartels -- violent, top-down organizations that mainly enrich a small group -- the Xalisco networks are small, decentralized businesses, each run by an entrepreneur whose workers may soon strike out on their own and become his competitors. "They have no all-powerful leader and rarely use guns," according to narcotics investigators and imprisoned former dealers. (Sam Quinones, "The Heroin Road," The Los Angeles Times, February 14 2010)

The Xalisco boys use convenient delivery by car and aggressive marketing to move into cities and small towns across the United States. The create demand for heroin in places where there was once little or none. And, of course, overdoses and deaths increase in their wake. The product is cheaper and more potent than Colombian heroin. It seems customer satisfaction is high based on both convenience and "bang for the buck."

Users do not have to drive into dangerous neighborhoods to get their fix. They simply phone in their orders and drivers deliver the product, sometimes even courtesy calling after delivery to check on the quality of service. Special sales are conducted in which dealers reward users with free heroin for bringing in new customers. Addicts in Columbus, Ohio, say they offered rewards for referrals to new users: eight or 10 free balloons of heroin for every $1,000 in sales an addict brought in. Also, the dealers have actively targeted recovering addicts at clinics.

When police do arrest a driver, a replacement arrives from Xalisco, and is usually fairly well set up to make $1,000 a week plus expenses within two weeks  The replacements already know where the customers live and go to their houses and introduce themselves.

Appalachia, Ohio and Xalisco

According to narcotics agents and former dealers, Xalisco immigrants drove black tar's eastward expansion, moving into Columbus, Ohio, and from there to parts of rural Ohio and Pennsylvania and to Nashville and Charlotte.

The Xalisco dealers have been particularly successful in parts of Appalachia and the Rust Belt where addiction to prescription painkillers like OxyContin, Percocet and other prescription painkillers was already widespread. They market their heroin as a cheap, potent alternative to pills. Many of those addicts, mainly young middle- and working-class whites, switched to black tar, which is cheaper and more powerful.

Among the distinctions of Xalisco dealers is that they generally do not sell to African Americans or Latinos. Instead, they have focused on middle- and working-class whites, believing them to be a safer and more profitable clientele, according to narcotics investigators and former dealers. "They're going to move to a city with many young white people," Dennis Chavez said. "That's who uses their drug and that's who they're not afraid of." (Sam Quinones, "The Heroin Road," The Los Angeles Times, February 14 2010)

"The classic picture of a heroin addict is someone who steals," said Gary Oxman, a Multnomah County (Oregon) Health Department doctor who conducted the study of overdoses. "That disappears when you have low-cost heroin. You could maintain a moderate heroin habit for about the same price as a six-pack of premium beer." It was the same in other cities where Xalisco dealers settled. In Denver, addicts say the cost of a dose of black tar has dropped as low as $8.

In Ohio, where Xalisco networks arrived around 1998, black tar has contributed to one of the country's worst heroin problems. Since then, deaths from heroin overdoses have risen more than threefold, to 229 in 2008, according to the Ohio Department of Health. The number of heroin addicts admitted to state-funded treatment centers has quintupled, to nearly 15,000.


Ohio has become one of the centers of Xalisco networks. Quinones reported, "...it was through a junkie in Columbus that black tar made its way to Huntington, West Virginia. Competition among Xalisco networks kept prices low. OxyContin pills cost $80 apiece and addicts needed five or six a day. Black-tar heroin was stronger and cost less than $50 for a day's fix."

Preferring to stay clear of the nation's largest cities (avoiding established heroin trade organizations), Xalisco dealers have cultivated markets in the mountain states and parts of the Midwest and Appalachia. Before a string of fatal overdoses in 2007, "we didn't even consider heroin an issue," said Huntington, West Virginia, Police Chief Skip Holbrook. (Sam Quinones, "The Heroin Road," The Los Angeles Times, February 14 2010) Twelve fatalities shook Huntington during the fall and winter of 2007. All were caused by black-tar heroin.

By 2007, black-tar addiction had spread across Columbus, Dayton, Cleveland and other Ohio cities. "At Columbus-based Maryhaven, Ohio's largest drug-treatment center, opiate addicts made up 20% of the center's patients in 1997, and many were addicted to prescription painkillers. Today, 70% are black-tar heroin addicts," said Paul Coleman, Maryhaven's president. (Sam Quinones, "The Heroin Road," The Los Angeles Times, February 14 2010)

There are no official estimates of how much money Xalisco networks make, but narcotics agents who have busted and interrogated dealers say that a cell with six to eight drivers working seven days a week can gross up to $80,000 a week.

Origins of Xalisco

Quinones said, "Two pioneers of the Xalisco model met in the early 1990s in the Northern Nevada Correctional Center, where they were serving time for drug offenses. One of them agreed to discuss the system's beginnings and its spread on the condition that he be identified only as Max, an alias he said he used as a heroin dealer." (Sam Quinones, "The Heroin Road," The Los Angeles Times, February 14 2010)

Max said he was familiar with the U.S. heroin trade and that his partner, a native of Xalisco, had access to supplies of black tar and workers from his hometown. When the two were released from prison, Max said, they set up a heroin ring in Reno.

At the time, dealers sold heroin from houses, which police could easily target. Max and his partner had a better idea: Dealers could circulate in cars and receive instructions via pager (and later by cellphone). So, a system evolved: Drivers carried heroin doses in their mouths in tiny uninflated balloons, each about the size of a pencil eraser. Addicts dialed a number, as if ordering pizza. The dispatcher would page the driver with a code indicating where to meet the addict.

Max, who went to federal prison for his role in the scheme, said one reason the system did not evolve into a cartel controlled by one person or family is that Xalisco County is made up of ranchos, small villages famous for their independent spirit and intense rivalries.

In Albuquerque, he bought a counterfeit birth certificate and driver's license; he crossed the border posing as an American from then on. Back in Xalisco, he hired drivers from villages near his own, paying smugglers to bring them across the border.

The county consists of the town of Xalisco and 20 villages with a total population of 44,000 -- about the size of Los Angeles' Silver Lake neighborhood. Landless sugar-cane workers, eager to grasp their version of the American Dream, provide a virtually endless supply of labor for the heroin networks, one reason the system has proved so hard to eradicate. Nayarit's mountains are filled with small poppy farms and that black tar is easily made.

The rise of the Xalisco networks is a peculiar tale of dope, poverty and business ingenuity that connects a remote corner of Mexico with vast stretches of America's heartland. Xalisco ostensibly still depends on sugar cane. But it is now among the top 5% of Mexican counties in terms of wealth, according to a government report.

Portsmouth, Ohio - A "Bitchin' Town"

 

 

Portsmouth, Ohio -- "The city where Southern hospitality begins." Remember this slogan for our once-revered home? Some of you young people do not, I am sure, and for good reason. For many years now, the sleepy little Appalachian town of 21,000 inhabitants has been a hotbed of alleged political misconduct and criminal schemes amid public unrest. Young people, you may have the unfortunate opportunity to view your hometown at its worst.

In a new report from the Portsmouth Daily Times (Frank Lewis, "Mayor Says Council May Ask Her To Pay For Renovations, or Resign," February 20 2010), Mayor Jane Murray claims she has been frustrated while working on the city's financial issues and on a request by City Council to pay for the renovations to her own office. She also believes that if she does not resign, members of Council are going to actively work to have her recalled.

 

In Lewis's report, Mayor Murray said, “I’ve had it. They’re (Portsmouth City Council) not administrators. That’s my job. I was elected by the public to administer.They’re trying to impede every executive function that they can, because they want to find as much that can be said negatively to the public, because their ultimate goal is to regain control of this city, so that the same old paws that have had control of this city for the last 50 years will once again have control.”

Murray said she believes the public knows, “this city has been run by a handful of people for the last 50 years.” She goes on to explain that the public is tired of the "handful of people" and they have a right to be "infuriated at these political games."

At Issue

Since nothing could seem to worsen the lines of communication at city hall, I would make all public servants complete a small homework assignment to be completed and published in the Daily Times.


1. The Integrity of City Government
   
    a. Have the mayor name the alleged "handful of people" bent on control of the city.

    b. Have the mayor tell in exact detail what they are trying to control and by what means they are doing it.

2. The Climate for Change

    a. Have each City Council member and the Mayor identify the #1 budget concern in Portsmouth.

    b. Require each City Council member and the Mayor to offer the single best solution for accomplishing the #1 budget concern in Portsmouth.

3. The Personalities of Elected Officials

    a. Require each City Council member and the Mayor to name the #1 impediment to getting along and to working together. 

    b. Require each City Council member and the Mayor to identify the means of removing the #1 impediment to getting along and to working together.

4. The State of the City 

   a. Have each City Council member and the Mayor identify the #1 reason for the alleged deplorable state of the city.

   b. Have each City Council member and the Mayor write a brief plan for improving the #1 reason for the deplorable state of the city.

5. Common Sense

   a. Have each City Council member and the Mayor identify (in specific terms) one new, needed, positive step to be made in a short time that everyone in the government can agree to and accomplish.

   b. Implement the best of the new, needed, positive steps with foresight, cooperation and amendment.

 Why Are People Disgusted?

The people of Portsmouth have spoken their will time and time again. They have become accustomed to falsehoods, rants, and threats from within their city chambers. They realize the tremendous work it will take to improve their city within the budget and with the cooperation of dedicated, committed officials. The task is tremendous. But, does city government wish to confirm the work as an impossibility?

Portsmouth City Council has become the model for the non-working assemblage of individuals dedicated to disagreement. To each faction in charge, I would remind you that you represent the total population, not just your individual or group interest. Take into account the negativity generated by your petty arguments and the wasted time spent in delaying progress because of your own personal shortcomings.

As our town stagnates with see-saw decisions and rank discontent, we continue to lose the benefits of any present satisfying existence. No one of our officials should represent special interests in conflict with the general public good. For those who stand in the way, it is time to get together, get to work, or get out if you do not want to represent those trying to contribute to the solution.

Information About OxyContin From Readers

So, the Blog post and the following Facebook discussion revealed some very interesting comments about the OxyContin problem facing the nation and particularly devastating to our Appalachian region. This post will share comments from those who read the blog entry and who responded with knowledge from various fields of employment such as the health field, the counseling profession, the military, and social service agencies. These people live and work all over the country, and I consider their unique perspectives very valuable.

If you take time to read these grass roots comments, you will be blessed with information that will allow you to seek answers for troubling questions. Thanks to the many people who cared enough to share their views and concerns. I truly believe much is to be gained by reading today's blog entry. Please read this post and feel free to add to the wealth of information here. Thank you, readers.

Jody wrote, "I see this problem every day. I work as a home care nurse. I no longer wear a uniform and carry my equipment in a grocery sack as not to identify myself as I enter a clients home for fear that my patients or I could become targets of thieves and addicts."

Yolanda said, "... as you know I founded my nonprofit Treatment Centers, Inc. I am a licensed alcohol and other drug counselor. Oxycontin is the worst I have seen. But, it's too expensive so addicts are now shooting up herion because it's cheaper. Anyone who does not feel there is a drug problem.......crawl out from under your rock, but wait, it may be safer there to stay .... when Oxy is snorted it has the opposite effect but, there have also been cases when the inside lining of the nose develops holes. Imagine what the nose would become...."

Sandy added, "Did you hear about  the kids that got suspended for having Oxy's at our Middle School?"

Barb said, "The worse thing I see is when people overdose and live, they end up on a ventilator and don't know they are in this world. They are usually young kids too, what a shame. One case I know, his friends let him lay there, didn't get any help because they were "afraid." Who knows - he might have had a chance. A lot of people I work with has either a child or other family member hooked on oxy's or Lortab and they send them to rehab over and over, it's like they can't give it up. More times than not they usually end up in prison. It is VERY prevalent in our community! Doctors give RX's for Xanax and Ativan - both very addictive. So in a sense they are drug addicts. Where do we draw the line? Who should get it and who shouldn't?"

Derby commented, "It's (OxyContin abuse) is not a new problem in schools...anywhere (it's happened at the school where I work). Kids get it from their parents', grandparents' and neighbors' medicine cabinets. They get it at parties... and yes it starts in middle school. Kids are snorting their Adderall (or friend's)...so some of the prescribed meds are the kid's own. They MUST be supervised. Remember...an adolescent's brain isn't fully formed (the frontal lobe that handles the decision making capabilities) until age 21. So, no...kids don't always KNOW better...or make good decisions...Just look through the magazines you read...and all the ads from the pharmaceutical companies... even look through magazines that kids read... are those ads there?"

Tom said, "The country is seeing a major shift in the age that people begin abusing prescription drugs. It seems it is now beginning at the age of 12, which historically has been the age where kids began experimenting with cigarettes. One problem us as health care workers experience -- providers need to fix treating the patient for pain. Once stable on a drug such as Oxycontin less than 5% become tolerant to the pain effects that the drug is exhibiting. Yet the patient will tell the physician or other health care provider the drug is not working any more for them. Patients say this because they actually become tolerant to the euphoria and sedation effects of Oxycontin not the pain effects. As health care providers we need to realize this concept and not just increase the patient's dose of the Oxycontin or other such opioid."

Dave reported, "I wonder how much of this abuse plays into the overall costs of prescription drugs. It sounds like legalized dealing to me. What role, if any, should the government play in curbing the abuse? Should the government have greater oversight on how these type drugs are being issued and to whom and under what circumstances? Aren't these type drug prescriptions reported to the DEA? Do they maintain a database on whom is receiving what and at what frequency? Does the DEA monitor doctors who write large numbers of these prescriptions and if not, should they? Who is really at fault? The user, the physicians with revolving doors, the pharmaceuticals, the parents, etc....?" 

 
Tom answered, "Ohio now has what is called Ohio Automated Rx Reporting System. Pharmacies in Ohio must submit all prescriptions for controlled drugs to the State every 2 weeks. This helps detect patients who are doctor shopping and getting pain medicines early or at another pharmacy. It has certainly helped physicians and pharmacies catch and dismiss patients. West Virginian and Kentucky have similar systems. The problem is, which they are currently working on, is we live really close to these other states. With that being said it is hard to detect if a patient got a prescription filled in Kentucky or West Virginia unless they used their prescription insurance to get it. Needless to say, residents of Scioto County have figured this out. This is why they need to link the systems of Kentucky, West Virginia, and Ohio together, it would be very beneficial."

Dave then admitted, "That's interesting. Sounds like they may need to nationalize the system. As automated as we are, I would think it would be fairly simple to piggy back off other national programs to monitor the abuse more closely."

Jim looked closely at the posts and stated, "The automated Rx reporting systems work only if the state(s) deploying them actually mine the reams of data they collect to put the dots together and make arrests. We also have a similar system in MS but my wife, who is a pharmacist, has never seen any of the known drug addicts who come into her pharmacy picked up by the police based on the data reported to the system. Rather, it's the pharmacist that always has to call to report the obvious doctor- and pharmacy-shoppers. This has become particularly annoying here since the legislature just passed a law requiring a prescription for pseudoephedrine so as to have it included in the reporting system (although they could have done so without making it a prescription-only Schedule III) - but this will ultimately do nothing to combat the meth problem since the state does nothing with the data."

Tom posted again, "Jim, I agree unless law enforcement acts on these people the data doesn't help. I don't know if it is true but every now and then extra state troopers from all over the state come to the county and make drug stings; rumor is that it is based off this data reported to the state. You are 100% correct though we can use the automated system to dismiss patients all we want, but without law enforcement helping out, they are going to find a way to get their drugs."

Debbie, rightly frustrated, replied, "I can't even begin to understand any drug usage (for pleasure as opposed to health, like cholesterol meds) much less addiction. I had a lot of surgery about five years ago, and once I got home from the hospital, all I took was tylenol and ibuprofen. All the other stuff, including oxyContin, made me sick. I have always been horrified of the results of drug use, ever since those books about drug use I read in middle school a million years ago. I just don't understand the attraction. What a waste of lives." 

Dave, joining in her displeasure, wrote, "We, as a society, hiding behind our 'FREEDOMS", have allowed Hollywood, and others, to glorify the abuse of drugs and other illegal and immoral activities....IMO!! Until "we the people" demand change, nothing will change!!!"

Derby further illustrated the problem as she said, "At the prescription drug conference I recently attended ( and I'm a school counselor) I learned that Kentucky, Ohio... And other surrounding states are working on linking up their systems for "doctor shopping," etc. Our issue in Kentucky seems to be the docs who don't use the monitoring system. It's free... And not hard to use. They claim it's time consuming... Seriously? Yeah... It's a pain for me to hand over my drivers license to get my zyrtec d @ the pharmacy, and I have to wait in line. But you know... I'm cool with it. And many of my docs use a computer in the exam room and fax in my scripts. If all docs could do that, they'd see a patient's script history... Maybe. But another issue are the folks flying down to Florida. Or it has been. The cheap fares on air... Like $29 each way... It's called the drug bus. And they go to the pain clinics. I think our legislature is working on that with florida's."

Yolanda confirmed, "And you have Florida with a 'pain' clinic on every corner. A lot of people from the tristate area go there to get their Oxys."

Travis read the comments and added, "...as you might know, my mom is the director for children's services in the county. She see's this problem everyday. She has commented to me how this particular drug is becoming a HUGE problem recently."

Ken noted, "Ever notice that as a society we try to blame our problems on a thing or an organization. I don't mean to be the bad guy here, but as I read your article, and it’s exactly what we are still doing. The billboard that had the picture of the kid saying that “Oxycontin Took My Life” may be saying a little self responsibility is what we need as a society. There have been billions of federal dollars spent over the years on “The war on drugs," and no progress so far: new generation new drug. Sorry, but it’s not the fault of the drug companies, or the oxyContin itself. KNOW WHAT YOUR KIDS ARE DOING."

And, to end the dialogue, Debbie reported, "I agree with Ken that as a society we need to stop blaming other "entities" and take responsibility for ourselves and our children. That means parents have to communicate in words to their children that substance dependence is not a desirable way to live. But they also have to communicate in actions the same message. So if you're telling your kid not to do drugs because it's bad as you're opening your fourth bottle of beer, you're sending a very mixed message.

"And I agree, Frank, that scare tactics are not the only message to be communicated, but honestly, I think there's a place for them. Kids have got to know the reality of the life substance abuse can bring them. I had no problem with showing my son the cover of NewsWeek when they featured a meth addict. He needed to see what meth can do to a person. And we talked about how easy it is to take the first step and then be sucked down a black hole you can't easily escape. 

"I use opportunities out of the paper to just point out the role substance abuse plays in crime and in motor vehicle crashes. I also point out when people are blaming other things on their drug use. He's only 13 - who knows what the future holds, but I hope I'm making an impact on him."