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addiction

Scientists and doctors say the case is clear: The best way to tackle the country's opioid epidemic is to get more people on medications that have been proven in studies to reduce relapses and, ultimately, overdoses.

Yet, only a fraction of the more than 4 million people believed to abuse prescription painkillers or heroin in the U.S. are being given what's called medication-assisted treatment.

During the 1930s, as Adolf Hitler was rising to power in Germany, the man who would turn out to be his most implacable foe was drowning — in debt and champagne.

In 1936, Winston Churchill owed his wine merchant the equivalent of $75,000 in today's money. He was also in hock to his shirt-maker, watchmaker and printer — but his sybaritic lifestyle, of a cigar-smoking, horse-owning country aristocrat, continued apace.

This story is part of NPR's podcast Embedded, which digs deep into the stories behind the news.

In the spring of 2015, something was unfolding in Austin, Ind.

This story is first in our four-part series Treating the Tiniest Opioid Patients, a collaboration produced by NPR's National & Science Desks, local member stations and Kaiser Health News.

The new movie Krisha is a family drama about addiction and chaos. In it, a recovering addict named Krisha comes home for Thanksgiving after being away from her family for years.

If the family in the film seems tighter than most acting ensembles, it's because they have history: The director and writer, Trey Edward Shults, cast his aunt as the main character, his mother as the family matriarch and himself in the role of Krisha's estranged son.

For many people struggling with opioid use, a key to success in recovery is having support. Some are getting that support from an unlikely place: their health insurer.

Amanda Jean Andrade, who lives west of Boston in a halfway house for addiction recovery, has been drug- and alcohol-free since October. It's the longest she's been off such substances in a decade. She gives a lot of the credit for that to her case manager, Will — who works for her insurance company.

Three decades ago, the treatment Michele Zumwalt received for severe headaches involved a shot of the opioid Demerol. Very quickly, Zumwalt says, she would get headaches if she didn't get her shot. Then she began having seizures, and her doctor considered stopping the medication.

"I didn't know I was addicted, but I just knew that it was like you were going to ask me to live in a world without oxygen," she says. "It was that scary."

When Jack O'Connor was 19, he was so desperate to beat his addictions to alcohol and opioids that he took a really rash step. He joined the Marines.

"This will fix me," O'Connor thought as he went to boot camp. "It better fix me or I'm screwed."

After 13 weeks of sobriety and exercise and discipline, O'Connor completed basic training, but he started using again immediately.

"Same thing," he says. "Percocet, like, off the street. Pills."

About 120 people a day are dying from unintentional drug overdoses, according the Federal Drug Enforcement Administration.

An increase in prescriptions for painkillers, like Oxycontin, is one reason. Another is that when opioids aren’t available, people often turn to heroin because it is cheaper, stronger any easier to obtain these days.

The problem appears worse in some communities, but it’s not often clear why.

Ten years ago, Chris Young was crushed by a car he was working under. “He was crushed accordion style,” says his wife Lesley.

The accident left Young, 45, almost completely paralyzed and in a wheelchair. He does have some sensation in his legs, but that is also where he experiences acute pain.

“It feels like electric shocks, like lightening bolts going down my legs and when it gets down to the bottom it feels like someone is driving a big metal spike up my legs,” says Young.

Dawn Brown in a trailer for the documentary 'A New High.'
YouTube

Jeannie Yandel talks with Dawn Brown, a participant in Seattle Union Gospel Mission's program that takes a team of homeless people who are also struggling with addiction up Mount Rainier. Brown's experience is chronicled in a new documentary, "A New High."

In a community center just south of Los Angeles, upwards of 50 people pack into a room to offer each other words of comfort. Most of them are moms, and they've been through a lot.

At Solace, a support group for family members of those suffering from addiction, many of the attendees have watched a child under 30 die of a fatal drug overdose — heroin, or opioids like Oxycontin or Vicodin that are considered gateway drugs to heroin.

Drug-caused deaths in King County from 1997 to 2014.
University of Washington's Alcohol and Drug Abuse Institute

Ross Reynolds talks with Dennis Donovan, director of the University of Washington's Alcohol and Drug Abuse Institute, about the loss of detox beds in King County and what that means for people struggling with drug and alcohol addiction. 

Kimberley Enyart was never interested in doing recreational drugs. But then she was in a car accident — and her doctor prescribed a powerful opiate for the pain.

"It just would put me off in la-la land, and make me feel better," she says. "I loved it. I loved that high."

When Enyart's prescription ran out, she did whatever she could to convince other doctors that she needed more. Eventually, she moved on to dentists.

"I even had two back teeth pulled over it," she says.

Thom Pasiecki, 24, says that after he lost his job in Connecticut and broke up with his girlfriend, he realized he needed help with an online gaming addiction.
KUOW photo/Jamala Henderson

Thom Piasecki is on day 19 of digital rehab at a rural retreat in eastern King County.

His daily routine is mostly outside, walking on dirt paths through forested areas, feeding chickens and doves, and checking on goldfish in a tub outside. 

File photo of cocaine.
Flickr Photo/DBDurietz (CC-BY-NC-ND)

Marcie Sillman talks with Washington State University neuroscientist Barbara Sorg about her new research into addiction and memory.

In murder mystery novels, when the hero, a private detective or homicide cop, drops by a late-night Alcoholics Anonymous meeting to stave off a sudden craving for a beer or two or 20, it's usually in some dingy church basement or dilapidated storefront on the seedier side of town. There's a pot of burnt coffee and a few stale doughnuts on a back table.

The Center for Students in Recovery at the University of Texas could not be more different.

Flickr Photo/MDMA (CC-BY-NC-ND)

Ross Reynolds talks with Howard Pellett, the facilitator of an Alcoholics Anonymous alternative called SMART Recovery. Pellett describes his own experience with alcoholism and SMART's approach to addiction recovery.

This story originally aired August 21, 2014.

Is Sugar More Addictive Than Cocaine?

Jan 8, 2015

The 2015 Dietary Guideline Advisory Committee just released new recommendations to limit added sugars to 10 percent of daily calories. Right now, Americans are eating more sugar than ever before — on average, about 160 pounds a year.

It's a tradition as old as New Year's: making resolutions. We will not smoke, or sojourn with the bucket of mint chocolate chip. In fact, we will resist sweets generally, including the bowl of M&M's that our co-worker has helpfully positioned on the aisle corner of his desk. There will be exercise, and the learning of a new language.

It is resolved.

So what does science know about translating our resolve into actual changes in behavior? The answer to this question brings us — strangely enough — to a story about heroin use in Vietnam.

KUOW/John Ryan photo

Eddy Mahon says the Aloha Inn saved his life.

Each day, thousands of people speed by the run-down old motel on Highway 99 just south of Seattle's Aurora Bridge. It's no longer a motel. Now it's a place where homeless people can stay for up to two years and get help while they try to get back on their feet; there's a long waiting list to get in. Mahon manages the Aloha.

He told his story to KUOW's John Ryan.

Ross Reynolds talks with Dennis Donovan, director of University of Washington's Alcohol and Drug Abuse Institute, about why it's so hard to determine what recovery strategies work best for overcoming addiction.

Murray Carpenter's book, "Caffeinated."

Ross Reynolds speaks with journalist Murray Carpenter about his book, “Caffeinated: How Our Daily Habit Helps, Hurts, and Hooks Us."

The book takes a closer look at the common drug we take for granted on a daily basis.

The new film Hateship Loveship was adapted from an Alice Munro short story and stars Saturday Night Live alumna Kristen Wiig in a performance that's a far cry from her outrageous characters on the comedy show.

In it, Wiig plays Johanna, a caretaker in Iowa assigned to help a grandfather, played by Nick Nolte, look after his 14-year-old granddaughter, Sabitha. Sabitha's mother died in a car accident when Sabitha's father, Ken, played by Guy Pearce, was driving drunk and high.

Since its founding in the 1930s, Alcoholics Anonymous has become part of the fabric of American society. AA and the many 12-step groups it inspired have become the country's go-to solution for addiction in all of its forms. These recovery programs are mandated by drug courts, prescribed by doctors and widely praised by reformed addicts.

Quixote Village: More Than Just A Place To Sleep

Mar 5, 2014
KUOW Photo/Elizabeth Jenkins

This past Christmas Eve, 30 homeless adults found a permanent residence in Olympia, Wash.

Before the move, the group lived in tents, hosted by different churches in the area. Many of the people had been sleeping in the woods and just wanted a safe place to stay.

Now, Camp Quixote is known as Quixote Village and comprises tiny houses for homeless adults. At 144 square feet, the homes are about the size of a one-car garage.

Relationship Between Writers And Alcohol

Jan 31, 2014
Nancy Pearl
KUOW Photo

Steve Scher talks with Nancy Pearl about two books that explores the relationship between writers and alcohol.

"The Trip To Echo Spring: On Writers and Drinking" by Olivia Laing explores the role that alcohol played in the lives of six great American male writers: F. Scott Fitzgerald, Ernest Hemingway, Tennessee Williams, John Berryman, John Cheever and Raymond Carver.

She also recommends an older book, "Drinking, A Love Story" by Caroline Knapp, which helps a reader understand addiction.

Flickr Photo/Crashworks

Marcie Sillman talks with Caleb Banta-Green, an addiction and drug expert from the University of Washington,  about heroin trends across Washington state.

Flickr Photo/Charles Williams

For thousands of service members who use opiates to manage chronic pain from war injuries, the road to dependence and addiction can be paved with compassion.

A facility outside Seattle, surrounded by pine trees, is a refuge for addicts — of technology.

There are chickens, a garden and a big treehouse with a zip line. A few guys kick a soccer ball around between therapy appointments in the cottage's grassy backyard.

The reSTART center was set up in 2009. It treats all sorts of technology addictions, but most of the young men who come through here — and they are all young men — have the biggest problem with video games.

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