Can We Stop Prescribing Seniors Opiates?

From After Party Magazine

Seniors and Opiates

I live in a walk-up building three floors above an old lady with the name of a Neil Simon character: Mildred Plotkin. Mildred is 84 years old, approximately five feet tall, and batshit crazy. She regularly greets my upstairs neighbor with a heartfelt “Hello, Bitch,” and a few months ago accompanied the hello with a punch to the stomach. Last week, Mildred assaulted another person in the building. Cops were called, heated discussions ensued, but little was done. What can you do? As the cop said, “I don’t want to haul an old lady to the nuthouse.”     

So What Do We Do? Prescribe and Hide.

We all have the instinct to protect our elders. Cops—and doctors—are no exception. That instinct could, however, be not only why doctors are prescribing seniors opiates at alarming rates but also why their overdose deaths are going under-reported. As Andrew Kolodny of Physicians for Responsible Opioid Prescribing told Al Jazeera, “No one wants Grandma to have died of a drug overdose.”

So many senior overdoses are falsely marked down as being of natural causes. And odds are that this is happening all the time. According to the CDC, more than 70 percent of prescription drug deaths in America are the result of opioid painkiller abuse. And 20% of our 40.3 million seniors received opiate prescriptions from their doctors in 2014. That’s 8.5 million prescriptions last year. As the population continues to age (the senior population will more than double in the next few decades), how are we going to manage pain without causing death? Seniors’ family members don’t know where to turn, and reputable doctors are torn as to whether they should write these prescriptions or tell their patients to live with pain.

How Marketing Changed Grandpa’s Trip to the Doctor

Kolodny, who is chief medical officer at Phoenix House, says that pain management for seniors changed due to drug corporation marketing. Previously used treatments like Tylenol or Advil began to be described as risky when used for long-term pain management. Enter the new opiates—admittedly expensive and constipatory but also ravishingly effectual drugs that were (according this Braun Medical media pamphlet) “rarely addictive when used properly for the management of chronic pain.”

Of course, that’s bullshit. Which might not be Kolodny’s idea of le mot juste, but he would support the sentiment. Kolodny says, “When we talk about opioid painkillers, we’re essentially talking about heroin pills.” Opiates, in his opinion, are useful for end-of-life care or for short-term pain issues. But otherwise people exposed to opiates on a daily basis “can easily become addicted…and it doesn’t make a difference whether or not they’re young or old.”

To Further Complicate The Issue. . .

There are two things that make it more difficult for our seniors as chronic pain becomes a part of their lives. First is our cultural Pollyanna-ism: We’ve all been taught that, in our endless American pursuit for happiness, there should be no pain. This point of view allies nicely with pharmaceutical marketing. Kolodny states, “The message there is that the patient shouldn’t have to feel any pain. They should just take the medicine around the clock, whether or not they’re experiencing pain. That message, that way of promoting opioids, has led to a public health crisis.” In short, we need to stop replacing reality with advertorial fantasies of pain-free existence.

Secondly, it turns out that there can be issues with taking Advil or Tylenol too frequently. In 2012, the British Medical Association reported that that normal three-times-a day doses of Ibuprofen triple the risk of strokes and increase the chances of a heart attack. And frequently ingesting slightly too much Tylenol can seriously damage our over-worked livers and lead to what the British Journal of Clinical Pharmacology calls a “staggered overdose.”

Caught Between Pain Management, Inertia, and Mistrust

So it’s a minefield, choosing when and how we as a culture will manage pain. Preventing or managing pain through healthy living and physical therapy is of course ideal. Perhaps it’s not a case of us marketing a better answer for the issue, but one of accepting the realities of life (pain and all) as it is. But that’s a pretty brutal thing to tell an elderly person with chronic spinal pain.

I don’t know if poor Mildred’s craziness is caused by dementia, drugs, or a combination of the two. And, as with so many seniors across the country, no one knows what to do with her. One thing seems clear, though—just like Mildred, opiates are best avoided or treated with a great deal of wary, mistrustful respect.

Continue reading

Advertisements

New Book on Garland Spills Sad Revelations

Tags

Judy Garland Sad Revelations

This week brings us a new Judy Garland book upon which one should look down with a high-browed disdain for salacious gossip.  I’ll definitely remember to do that later, once my hands aren’t so busy plonking down hard-earned coin as I buy the book TODAY.

Oh, Poor Judy. And yes, ghastly Judy. According to the NY Post Article and Vanity Fair, we didn’t know the half of it. The incessant and hysterically public breakdowns, the rage-filled complacency of her constant suicide attempts. This book promises some strong stuff and Holy Rainbow, Toto–it delivers!

Stevie Phillips, who wrote the memoir, Judy & Liza & Robert & Freddie & David & Sue & Me, worked for Garland for four years. She deserves both a medal and a lobotomy for having done so. Or perhaps a double of each, since Philips then turned around and worked for Liza, too. She must be the Catholic Saint of Enablers.

Old school star dish doesn’t get much better than this. I promise to be thoroughly, heartily ashamed of myself. But first–page one. . .

Also linked: My earlier Judy obit, written last year.

Judy Garland: The Blue Bird Has Flown

Tags

, , , ,

Judy Garland Tribute

As a kid I watched her early movies—the cheesy faux-America Andy Hardy ones—on an old TV I stole from the attic. I had a special routine for watching Judy Garland (June 10, 1922-June 22, 1969): lying on my bed, propped up on my elbows and peeling a McIntosh apple with the rusted bean peeler from our kitchen. It was obvious that the pale, big-eyed girl was someone you like—compelling and astonishingly natural. No question that Andy Hardy’s other girls—Lana Turner and Esther Williams and the rest—were the sort that come and go, the ones a smart girl waits out. As Judy once said about Lana (in real life, after Lana married one of Judy’s crushes), “It’s like talking to a beautiful lamp.”

The non-Garland parts of the movies were unbearably cutesy. I’d wait for her while trying to peel my apple in one long string: If the McIntosh was too young, the tough red skin would break; if too old, it would crumble. In the final reel, Judy always got Mickey. Because if you had Judy Garland in your movie, you’d be an idiot not to have her voice be the last thing the audience hears. When the pale girl opened her mouth to sing, all that lace-curtained, smotheringly smug MGM crap fell by the wayside. It was an instrument for the ages—an infinitely flexible and sweet, sad soul massage.

And though Garland was tough, in the end she both broke and crumbled. Rotted a bit, too (self-pity marred her performances, from A Star is Born on). That astonishing core of talent saved her and damned her again and again. She went from being run out of small towns with her shamed father to joining the greatest studio in Hollywood, from skipping out on hotel bills to performing Carnegie Hall’s most legendary show ever. In her final weeks, she married a man no one much liked in a wedding no one showed up to (her daughter Liza promised, “I’ll go the next one, Mama”). Continue reading

Picture Cary in a Boat on a River. . .

Tags

, , ,

PoliceGaz1967_2Here’s a piece I wrote for Afterpartychat.com on how acid is coming back into play for scientific experimentation. Naturally, I had to take a look at early experimenters–like the sadly tormented, surprisingly intrepid Cary Grant: Continue reading

A Surrealist Poet, Francois Truffaut, and Jane Russell’s Nipples Walk into a Bar. . ..

Tags

, ,

You Have Complaints, Howard?

You Have Complaints, Howard?

Let’s all enjoy the moment when, in 1958, Francois Truffaut made a sudden leap from high art to low neckline. In a graceful segue, France’s premier filmmaker and critic, pivoted from a quote by Guillaume Apollonaire (France’s great surrealist poet of World War I), to Howard Hughes’ obsessive presentation of Jane Russell’s nipples. Now that is an impressive display of dexterity!  Shall we? Mais Oui!

L'Américain est un idiot quand il s'agit de graisseurs! (Trans: Hughs is a Dolt.)

L’Américain est un idiot quand il s’agit de graisseurs! (“Hughs is a Fathead.”)

The Postscript from the end of Truffaut’s Von Sternberg Essay in The Films in My Life, on Howard Hughes’ Production Notes

. . .Paraphrasing Guillaume Apollinaire without realizing it (“Your breasts are the only shells I love”*), Hughes demonstrates in the following memo what happens when an actress’s brassiere undergoes aerodynamic design analytics: Continue reading

Star Crossed: Morrissey + Charlie Brown

Tags

, , ,

Image

“Ohhh sweetness, sweetness. I was only joking when I said I’d like to smash every tooth in your head. . .”

A graphic artist in San Francisco has come up with the most delicious and disconcertingly perfect pairing since peanut butter and sriracha sauce–Charlie Brown and Morissey.  Oh, had they only met! What late night door-banging sulks, lexapro-vivid dreams, and brooding breakfasts the two of these could’ve savored, Charlie B. yearning to please and Morrissey determined to be disappointed. But it was not to be. One was just a caricature of melancholy, and the other drawn by Charles Schulz.  These are just a few samples from Loren LoPrete’s Tumblr, This Charming Charlie.  Enjoy.

ScreenHunter_09 Aug. 22 17.49 ScreenHunter_10 Aug. 22 17.50 ScreenHunter_11 Aug. 22 17.50 ScreenHunter_12 Aug. 22 17.51

Clothing of the Future. . .or is it the Past?

 

ScreenHunter_08 Apr. 16 17.17

Clothing Of The Future

In case you were wondering, at the link above are the fashions of the year 2000.  No one, I assume, in the 1930s could have dreamed of idiocies like the “It” bag (there’s nothing more reeking of a mindless herd instinct than waiting lists for handbags), super low rise jeans that make you look both short and fat (now there’s a score!), or of the pervasive influence of porn on the fashion industry (Schiaparelli will wreak vengeance one day).  Instead, here in the future/past we have climate control belts, glass wedding dresses, and rather prescient cantilevered heels.  Also, got to dig an updo that looks something like a knotted babka.

A Star is Born Part II: Backstory (& Foreshadowing)

Tags

, ,

sib poster

Well, whether you accepted last week’s challenge or not, it’s time to lay down a few little riffs on how this film brilliantly–and in at least one case, unintentionally– mirrors Hollywood history:

1. Norman Maine’s descent has been described as what happened to Johns Barrymore and Gilbert (below left and right), neither of whom were exactly amateurs at bending their elbows. 

john_barrymore

john gilbertBut I choose to believe another story that’s been mooted; that the inspiration for this was the Frank Fay/Barbara Stanwyck marriage (below right).  Fay was a huge star on Broadway and came to Hollywood with fanfare and a fat contract.  His thin-skinned orphan of a wife accompanied him, and got little work–until Fay talked Capra into auditioning her, and one of the great collaborations of 30s film began with Ladies of Leisure in 1930.  faystanwyckCapra fell in love with Stanwyck’s naturalness and her ease, and filmed the young actress so her skin glows like wet paint, lush in its tactility.  She became one of the greatest actresses of the era, and was the highest paid woman in America by 1944.  Fay meanwhile, leaned hard on the bottle, lost work, began to knock his wife around and basically bought himself a one-way ticket out of town. 

2. The sanitarium scene is said to be based on the a visit George Cukor (a frequent Selznick collaborator) made to a facility where Barrymore had been sent to dry up.  Cukor was there to talk about a potential role in “Camille”, and was touched by Barrymore’s gentle awkwardness on this rare sober occasion.  

3. The scene where Vicky’s veil is snatched off is modeled on Continue reading

A Star is Born, Again and Again

Tags

, , ,

ScreenHunter_02 Feb. 10 18.13

Oh, winter.  Ah, howling wind and careful stepping through yesterday’s detritus as the snow, once so gleaming, turns into dirt-sullied slush.  And after dark, when things get bitter and the stars have lost their glitter, it becomes treacherous beneath unsteady feet.  We’ve had a storm here in New York and I’m cozying inside in that half-melancholic February nostalgia one can savor when forced into quietude. 

I’m as pure as the driven slush, Tallulah Bankhead once said, and having watched the original Selznick-produced A Star is Born (1937), one gets the feeling that it was only family money that allowed her such honesty–which otherwise was and is rare in a business built on selling dreams.  A Star is Born, which is showing on TCM this week in an orgy of Selznick produced gems, is all about Hollywood, and about the sweet poison of success.  Continue reading

“Whatever Happened to Baby Jane”? Another Unncecessary Remake, That’s What!

Tags

, , ,

Is a Remake Sacriligious? Even if it gives us more Crazy to Love?

So it’s official, and has been for a month or so.  Whatever Happened to “Baby Jane”?  It’s Getting a Remake.  Which seemed to me to be one of the silliest decisions I’ve encountered since Hollywood tried to remake The Women and ended up pouring bong water over the embers of Meg Ryan’s career.

But naturally they’re at it again.  It’s clear they’ll never learn, because here’s a little sample of Hollywood logic for you:  “The idea is to make a modern film without modernizing the period.  It needs to resonate the golden age of Hollywood.”  These words were uttered by Walter Hill, who was chosen to be the director of this remake.  The man is doubtless an artist, whose upcoming Stallone film, Bullet to the Head, will rival Grand Illusion for delicacy and depth.  How the hell could anything resonate the golden age of Hollywood more thoroughly than Bette Davis impaling herself on Joan Crawford’s falsies, before kicking her to the head? 

Continue reading