Hardly a week goes by without the Coroner’s office getting another request for statistics on the opioid crisis. My office is tasked to the maximum right now and we don’t currently have additional personnel on staff dedicated to answering the growing number of inquiries.
As I write this, sitting on my desk are two stacks of case files. The higher one is of cases that need to be closed out after my review of newly returned toxicology reports. The much shorter stack is of homicide cases I must review. Looking at the difference between the two piles, I marvel at how much knowing the numbers, statistics and data matters. Yet simply knowing this information doesn’t save any lives.
Ten years ago, I could see this coming. OxyContin became the solution to everyone’s pain, chronic or short-term. Suddenly, clinical treatment and all procedures were expected to be completely pain-free. When I had my wisdom teeth pulled as a kid, my dentist said to me as I left the office, “Now when the Novocain wears off, it’s going to hurt like hell for a day or two, but just keep washing out your mouth with salt water.” He was right. It hurt like hell, but in a few days, it was better. You just dealt with the pain.
Of course, I realize that in certain cases medications are indispensable to patients with specific conditions. I’m not disputing that. But today’s insurance companies and the government now tie reimbursements to a hospital or doctor through a survey of the patient’s reported pain. This led to the expansion of opioids in clinical medicine which became the gateway to the abuse of pharmaceutical opioids. Even today, prescribed opioids are more abused than street drugs.
In my view, the worst approach to this problem is for the federal government to throw money at it and build bureaucracies around it, as was recently suggested, to the tune of fifty-nine billion dollars. (Without, of course, any explanation of how the money would be spent, or for that matter, a clear definition about what the crisis really is. In reality the crisis is just another opportunity for the government to make more money.)
Every time a politician or the press asks me about this issue it is clear they don’t understand what is really happening across America. We don’t have an “opioid epidemic” we have an “addiction epidemic.”
Opioids exist to kill pain but we must define the pain. Why are the richest, most free people in all of history in such physical, emotional and (dare I say) spiritual pain?
My friend Tommy Rosen has a marvelous definition of addiction, which is found in his comprehensive book entitled “Recovery 2.0: Move Beyond Addiction and Upgrade Your Life”.
The definition is important because it takes us beyond the symptom (in this case, opioids) to the real dis-ease. Simply put by Tommy: “Addiction is any behavior you continue to do despite the fact that it brings negative consequences into your life.” Suddenly, it becomes clear we have an addiction epidemic and opioids are only one of the tools.
This is subtle but very significant.
I have seen this over the years because my job is to listen to the dead. I have seen that the patterns of addiction ultimately impact how, when and why we die.
This list could go on but I think you get the point. As a society we are more anxious, less healthy and more prone to all of the above. Yes, we are addicted to drugs... but as Tommy points out, we are also addicted to alcohol, food, people (relationships, sex and intimacy), money and the insidious newcomer... technology.
Tommy goes a step further to identify what he calls the four aggravations, or potential addiction triggers:
These root causes need to be deeply examined.
The money we put into this epidemic should be block granted to the states, meaning that each state would determine the best use of the funds. This would provide us with fifty different laboratories to develop the best approaches for true rehabilitation. There should be some use of methadone and buprenorphine to help with the chemical transition to detoxification, but the real issue is the addictive personality and how we got here.
I recently heard a public official say that the government was considering the development of a vaccine for addiction. Folks, there is no vaccine for the soul. One has to delve into the subconscious and realize their uncontrollable need to do negative things is the result of past pains. We must identify and face these pains. Pain can be a great teacher. The nationwide state of addiction we are in is an opportunity for each and every one of us to grow and evolve.
Tommy Rosen has the right idea. He is holistic in his approach and he shares it with thousands by creating a virtual community. His website r20.com offers sanctuary to anyone seeking to dig deeper into patterns, thoughts, beliefs and behaviors that no longer serve them. I encourage everyone to check it out.
Bottom line, there is no easy solution. There is no solution “from the government.” There is no pill and there is no vaccine. The only route is within. Recovery starts with each one of us, individually, and then as a community.
Drug overdoses are now the leading cause of death among Americans under 50. To say this is a crisis is an understatement.
One of the most frequently asked questions I am asked by fans is, "How do I get into forensics? What courses should I take? What should I get a degree in?"
The first thing that’s helpful to understand is the term “forensics” itself. Forensics is the process of applying a specific science to law. There are more sciences involved in forensics than you’d think... and they are usually under two large categories: Biological and Integrated. You could also add another category: Information Technology (IT). Most of the fields require a certain amount of training in science so if you want to get into forensics, start thinking scientifically, first!
Forensics has been well publicized over the last fifteen years or so and the portrayals on TV often give the impression that science holds the answer to all investigations. The scientific method is primarily used in forensic investigation, of course, along with meticulous detection, documentation and collection which is the major role of police and crime scene investigators. We are often required to testify as an expert witness, and must be qualified in a specific field of science in order to do so.
I’m a medical legal death investigator. That means I must have a knowledge of both the scientific method and the biological sciences. The data I need to tell the story of how and why a person died comes from an understanding the human body- both its anatomy and physiology. I must also understand odontology, entomology, radiography, taphonomy, toxicology, blood pattern analysis and DNA. In any of the integrated sciences there are a broad number of scientific studies in which the investigator needs to understand the data received from various experts. The data forms a web, with each aspect connected to another. The interpretive skill comes from making the connections.
A good scientist also understands the process of falsifiability. This means you form a hypothesis and then challenge it by testing and realigning your thinking to the data from your experiments. All of this requires learning the language of each particular science. If you want to go into police work, then a major in college like “Criminal Justice” is good, but may limit your options. (You may not get the job with a police agency. Security jobs pay almost minimum wage which is not very appealing considering student debt payments.) What is most needed in today’s society is the ability to think using deductive and inductive critical reasoning.
I can’t place enough emphasis on the importance of having a STEM background. STEM stands for a curriculum with emphasis on science, technology, engineering and math. With this broad base, you can pursue a forensic minor, and learn how to apply scientific knowledge to law.
Even if you can’t immediately enter a forensic position you can work in a scientific field in any number of positions in industry, research, medicine and government.
Dr. Robert Furey and I designed a forensics program at Harrisburg University School of Science and Technology. Our primary aim was to provide a major in the field of science and technology that was interesting for students and really engages them.
It’s a work in progress and a labor of love.
Today I remember the largest, most profound crime scene I have ever experienced. I was called to New York about a month after the horrors that happened on this day. A whole team of us, trained in Critical Incident Stress Debriefing, provided support to New York’s Police Organization Providing Peer Assistance (POPPA).
The POPPA Organization Office was right near the World Trade Center and 9/11 presented it with an overwhelming demand for response and action. POPPA had to deploy volunteer Critical Incident Stress teams as well as mental health professionals, all within a short period of time and under great strain. Teams of volunteers, of which I was a part, were sent to help people cope with Post Traumatic Stress Disorder, including officers who had worked at Ground Zero, the World Trade Center morgues, or in the retrieval operation at the Staten Island landfill. It is incredible to recall the professionalism, compassion and fortitude of those working there.
Studies have shown that when one is debriefed or can talk to a peer about their situation, it improves the chances of them being able to handle the aftermath of Post-Traumatic Stress Disorder. We were the first line of this process and we also worked the scene both at Ground Zero and at the landfill where there was an endless search for tissue, ID, and other artifacts. It was the largest crime scene in American history and the longest burning structure fire in America. I have seen humans perish in every possible way, but I never saw a death scene like that one. To this day September 11th brings back so much emotion it is hard to describe.
I will never forget walking up to St. Paul’s Chapel on Wall Street, and passing the old church yard cemetery. The tombstones were almost completely covered to their crescent tops with about two feet of grey, heavy, toxic dust. It looked like the cemetery was captured in a black and white photo of a snowstorm. A cosmopolitan power center had been reduced to dust. There was evidence of great melted and curved steel girders, rebar and some chucks of cement...but mostly there was dust; grey horrific dust... and the thought of “ashes to ashes, dust to dust.”
The city changed on September 11 and so did America. There was a clear reminder of that which is temporal and that which is immortal. People for a period of a year or so thought about the lasting values of truth and soul. People in movie theaters and meeting places would say, “God bless America.” Life kind of returned to a more basic premise, as communities helped their neighbors bury the dead. Sadly, in our busy world we have short memories from one week to the next and we forget the lessons learned that day. Life once again becomes about “me.” We now fight and fester over our differences rather than our common bond as human, mortal beings--Americans with a common dedication to freedom.
I remember sitting in St. Paul’s sanctuary. It was quiet even though it was full. Some people just stared and pondered their experience and others slept sitting up, exhausted. I thought about April 6th 1789 when George Washington came to this very church and expressed his thought that “Providence” was the reason American succeeded in conquering the British army. He believed, without defining it, that a great power was involved in this human experiment.
It is important that we learn our lessons from “Providence” both in victory and in distress. May we never forget the brave men and women who served our country, and all those who lost their lives, in the largest crime scene in American history.