Wealth, fame, and addiction

George Carlin (or Robin Williams, depending on the source) said it well,

"Drugs (cocaine) are God's way of telling you that you make too much money."

We are seeing that very thing played out with Michael Jackson. It's one glaring example of the progressive nature of the disease. Mr. Jackson had 2 things that allowed him to continue using mood altering substances until it finally killed him...

• money
• sycophantic enablers (fawning parasite; A servile self-seeker who attempts to win favor by flattering influential people)

By the very nature of the disease, an addict is incapable of stopping by their own force of will. This is why some sort of intervention is required to get them into treatment. Once they detox and their brain begins to recuperate, THEN the education and techniques provided by evidence-based treatment can actually be retained and used to stay "clean".

Intervention takes many forms. The most common type is what we see on the A&E television show "Intervention". It's a technique used to create a "bottom", that magical place and time where the addict will enter treatment. For an addict with unlimited resources and surrounded by people who will give them whatever they want, that bottom is death.

Intervention is difficult. It appears to go against all definitions of love and logic. But continuing to "rescue" the addict from the consequences of their drug misuse allows them to continue to believe they are in control. The longer it takes to get the person into treatment, the more the disease progresses and the tougher it becomes to effectively treat the disease. When you are surrounded by people who want to please you just to be near you, the intervention is unlikely to take place. Or, if someone tries to make it happen, the sycophantic enablers sabotage the very thing designed to help the addict.

Yes, there has been unethical, unprofessional, and undoubtedly criminal activity involved in the death of Mr. Jackson. However, the medical providers aren't the only people to be held accountable (although I have no doubt that's exactly what will happen). Mr. Jackson's family and employees share that responsibility as well.

I hope Mr. Jackson's life is studied closely in order to learn the valuable lessons it holds. While he was an unparalleled entertainer with unlimited talent, his troubled life and premature death could provide the positive move forward when dealing with all apsects of the disease called addiction.

Michael Jackson, Addiction, the Media, and the Medical Profession

I've been following the Michael Jackson saga since the first news alert of his "possible" death. The first thing that went through my mind was he died from an accidental overdose. Little did I realize it would take us to the "propofol" thing. And while his death is tragic, so are the deaths of all addicts. They are tragic because many, many, MANY of them don't have to happen.

So why DO they continue to happen? And why do they appear to be increasing? Because our culture continues to follow the same failed ways of "dealing" with this "issue".

First of all, it's NOT an issue...it's a disease. Until we treat it that way, this kind of crap will keep happening more and more. "Dealing" with a disease in a punitive way...i.e., with the police department and jail instead of with interventions and treatment leads to continued progression of the disease and ultimately death.

"BUT TREATMENT DOESN'T WORK!"

Of course it does, when it's started as early as possible, is evidence based, and is ongoing. Currently, that doesn't happen in too many cases.

Why not? Because we approach this disease with what I call the "3 Ms" of addiction: Myth, Misbelief, and Misinformation. One of the predominant myths is known as "hitting rock bottom".

"Treatment doesn't work until the addict HITS ROCK BOTTOM!"

What is rock bottom? I'm sure there are numerous definitions. I think the most accepted one is this...the addict has to lose most (if not all) of the things that are important to them....job, marriage, family, money, car, etc. before they will be willing to enter treatment. But without an intervention of some kind...the bottom for all too many addicts is death.

Mr. Jackson is just one example of what happens when treatment is withheld until the addict "hits bottom".

Goodness, he even had a physician with him at the time of his death! It will be interesting to see what happened leading up to his death that day (if we ever really find out). But there are some clear things that DID happen.

First, Michael Jackson was surrounded by sycophants (self-seeking, servile flatterers; fawning parasites...according to dictionary.com). Some of these people were health care providers, some even (gasp) physicians! As you can see, doctors, nurses, pharmacists, etc. are not immune from all of this. There are star struck individuals in all walks of life, just as there are unethical people in all areas of business and government. When someone told Mr. Jackson no...he found someone who would say yes. My guess is the physician with Mr. Jackson at the time of his death thought he was skilled enough to prevent what happened. Guess what...MD doesn't automatically endow the person with the ability to manage an airway or prevent them from making a mistake in administering a medication they have no business administering. Combine that with administering this medication in a place where it should never be administered and you have the very situation on June 25th in his rented home.

Second, let's compare how we (meaning society and the medical community) approach other chronic, progressive, potentially fatal diseases.

Diabetes. We teach about the disease, that if there is a family history, the risk increases. We teach early signs and symptoms. We suggest early EARLY treatment, aggressive treatment, and evidence based treatment.

Cardiovascular disease. Early recognition of signs and symptoms. Immediate intervention at the first sign of possible heart attack or stroke. Get to the ER now! Education about prevention (family history, diet, exercise, check ups, etc.).

Cancer. Education about the disease, causes, risk factors...like family history (where have we heard that before?), early signs and symptoms, and early, aggressive treatment.

Addiction. How do we handle it? Don't talk about it. Ignore family history...hell, don't even THINK about talking about it! Ignore the early signs and symptoms (it's a phase, it's part of "growing up", they're in the "wrong crowd", they made "bad decisions" or "mistakes"), cover up the consequences for their "bad decisions" (called co-dependent behavior), and WAIT UNTIL THEY HIT BOTTOM. Does anyone see how completely crazy this is? Does anyone see how it makes absolutely no sense from a medical stand point? And yet we keep doing the same stupid stuff over and over hoping the outcome will be different. Didn't Einstein say that was INSANITY!?

If you don't see the idiocy, you're part of the problem. If you do see the idiocy and do nothing, you're part of the problem.

Several family members and friends have said over and over, "We tried to save Michael but we just couldn't. We did everything we could and it just wasn't enough."

BALONEY! Did they hire an interventionist? Did they require him to enter treatment and refuse to provide him with drugs? Did they hire recovering addicts to keep the sycophants away? Did they fire the doctors who were unethically and unprofessionally supplying him with addictive drugs?

Let's stop the insanity and actually start doing what needs to happen. Education, early recognition, intervention, aggressive treatment, and long term follow up...just like we do for other chronic, progressive, potentially fatal disease.

I hope Michael Jackson's death won't be in vain.

Video of Nurse Discussing Propofol Use by Michael Jackson

Video is at the end of the article at this link:

Jackson Begged for Sedative, Nurse Said.

http://www.cbsnews.com/stories/2009/06/30/entertainment/main5126529.shtml

Michael Jackson's Death Might Change the Status of Propofol

Propofol (also known as a Diprivan) is a medication used to induce anesthesia for a variety of procedures. It's also not a controlled substance.

What does that mean?

It means it's not considered "dangerous". It means it has a "low abuse potential".

Those of us in the anesthesia profession, especially those of us who deal with professionals who are dealing with substance abuse and chemical dependence, have been trying to get propfol's status elevated to a controlled substance. This means it would be more difficult to obtain and misuse. The FDA and the DEA have continued to resist this change in status. The American Association of Nurse Anesthetists (AANA found at www.aana.com) has just published (to their credit) Position Statement 2.14, "Securing Propofol".

Apparently, the deaths of anesthesia professionals aren't enough to change the minds of the FDA or DEA. Perhaps the death of Michael Jackson from a possible propofol overdose will change their minds. If so, his death will not have been in vain.

"Dangerous Drug Found in Jackson Home"
http://www.tmz.com/2009/07/01/michael-jackson-propofol-lidocaine-overdose-criminal/