Cody’s gift: One father’s response to the opioid crisis

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Jim Marshall is just a regular guy, a humble one at that.

He’s spent more than 32 years in education in Jefferson City as a coach, physical educator and social studies teacher. He’s taught over a thousand students and, looking at him, he comes across as a pretty standard coach – dressed in an athletic polo with his hair cut short and neat.

But Jim has a hard-earned gift.

When Jim stands in front of an auditorium of rowdy students and speaks, everyone – from the boy who can’t stay seated to the girl that won’t stop talking – listens.

When he speaks, he speaks with humility, pain, intensity and truth. Because he’s telling his story, and it’s about Cody.

In September of 2011, Jim Marshall kneeled over Cody, his 20-year-old son, and performed CPR as he waited for the ambulance to arrive.

Once at the hospital, Cody was put into an induced coma to fight the mixture of heroine, Xanax and synthetic marijuana doctors found in his blood. When Cody was taken out of the coma, he was brain dead. Leaving his parents with the decision of whether, or when, to take him off life support.

Cody, like too many young men and women these days, was another victim of the opioid crisis.

Marshall aims to end tragic deaths like Cody’s, and he knows that means dealing with some harsh truths about how we got here.
“We are not raising our kids to cope with stress and anxiety,” says Marshall. “Instead, we’re enabling them, well-intentioned but trying to prevent them from feeling pain and sadness instead of teaching them how to cope with it.”

Marshall teaches that both schools and parents need to adopt more responsibility for educating our kids regarding how to face and cope with the problems kids face today. He believes kids haven’t had the chance to problem solve or experience real failure. Instead, he says, “We try our hardest to pull them out of failing situations.”

“Everything is harder on the kids these days. 17 year-olds and under are all post-911 children. They live in a physically disconnected world, the majority of their interactions are digital. There are lots of depressing situations, lots of comparison, lots of confusion. They have a good reason to be scared and sad lots of the time. What are we as parents doing to help them cope?”

He also believes we’ve just become too reliant on medication as a culture.

“We have created a culture where we think everything is solved by a pill,” says Marshall. “A month before my son died, he was given a bottle of Zoloft to fight his Xanax addiction.”

Marshall’s argument is backed by a long and sad history. Heroine – which contributed to Cody’s death – was initially marketed in the late 1800s as a substitute to individuals addicted to morphine. In the late ‘90s, OxyContin was marketed as a safer and less addictive opioid. Purdue Pharma would eventually pay $634.5 million in civil and criminal fines for that particular advertising claim.
We appear trapped in the same absurd cycle.

For the last hundred years, we have been developing opioids to replace other opioids. Always with the promise of eliminating or curbing one group of addicts, and only to end up creating a new group of addicts.

“Our kids have been born in a field of landmines, and instead of teaching them how to identify and avoid them, they’ve become so numb that they’ll walk on the landmine to try and feel better,” says Marshall.

People also have misconceptions on the current crisis. The statistics Marshall, and speakers like Marshall, present offer sobering clarity. They eliminate the belief that it’s only a certain demographic that are affected by opioid addiction.

“Some believe this only happens to the troublemaker, bully or kids with no real parent involvement,” says Marshall. “But they’re wrong. This crisis doesn’t discriminate. It’s rural, urban and suburban. And it’s far more pervasive than any of us would like to admit.”
The biggest stereotype is that people with opioid addiction have simply made a bad choice. This position leads to believing only those who seek out help can really receive help. But this is false in Marshall’s view.

“People won’t get help because they are embarrassed, feel judged and they’ve been taught they’re not allowed to fail,” says Marshall.

“No one wants to admit they’ve become an addict because it labels them, shames them, makes them feel like they’re bad.”
People who abuse drugs never start out hoping to become an addict and throw their lives away. “It’s not strictly a choice to live in that zone, this is a disease we’re dealing with, a sickness, not simply a choice,” says Marshall.
But more and more are becoming addicts.

According to the National Institute on Drug Abuse, 90 Americans die from opioid overdose every day. From heroine to fentanyl to prescribed pain relivers like hydrocodone, morphine and oxycodone, the opium like effects of these drugs have created over 2 million addicts searching for the euphoric high opioids promise.

The United States is also the worst kind of outlier when compared to the rest of the world. According to data from the United Nations International Narcotics Control Board, when compared to other countries like France and Portugal, Americans are prescribed about six times as many opioids per capita. The U.S. also consume 99 percent of the world’s supply of hydrocodone.

“We have created a culture where we think everything is solved by a pill,” says Marshall. “So, our kids think a pill can solve their problems.”

The pills become the gateways to heroine. As Marshall tells his audience, 85 percent of users start with a prescription pill addiction. On the street, a bottle of Vicodin costs $400, which gets too expensive to abuse. So, in the end, addicts turn to cheaper alternatives like heroine, which can be supported with a $20-40 a day habit. They become what Marshall refers to as the walking dead.

“They can’t have a job, raise a family…they’re basically gone,” says Marshall, “They’re playing their own pharmacists and doctors, trying to find self-medicated ways to make their pain and sadness go away.”

Marshall points out ways it can be different with kids. Kids slipping into substance abuse disorder have signs that parents can look for:

  • They tend to become more temperamental
  • They won’t want to bring their friends home anymore because they’re now running with a different crew
  • Their stories start to become inconsistent
  • They struggle to meet deadlines
  • Truth becomes harder and harder to tell

Looking for these signs can at least give parents a fighting chance against this deadly disorder. But most parents are completely lost, at least in Marshall’s estimation. They don’t have the courage or ability to dialogue with their kids about the issues they are really facing. So they end up just not talking about it at all.
Which is a shame.

“Most parents are completely lost in space, there’s no dialogue between the parents and abusing child, so they zip up their home and do their best to prevent the secret from being known,” he says. “The better way is to take whoever may be impacted, communicate it, make it aware to a broader circle and go get some help!”

Because only one in ten abusers will ever fully recover, so the education, understanding, empathy and prevention process proves to be far more powerful than the rehab process.

But Marshall is hopeful too.

He admits it’s not an overnight fix and will probably get worse for at least another decade before it gets better. He remembers 30 years ago when we decided to start a campaign against smoking. “You don’t see many kids smoking these days,” he says, “The educational campaign worked. Kids think it’s gross to smoke. And they know it kills them.”

Maybe, if we can make a similar effort, we can turn the tide.

If we do, it will be because of people like Jim Marshall.  A man who took his tragedy, pain and unthinkable grief and turned it into a story to be told and shared. A man who made Cody’s story a gift for anyone who will listen.

And when it’s Marshall talking, most do.

Drugs Don’t Discriminate

By Maddie Murphy

After Cody Marshall graduated from Jefferson City High School in May of 2010, his life was on a downward spiral. All of his closest friends packed up and moved to college, spreading out around the country. During his high school years, he had not applied himself enough to get into the “traditional college setting” so, he was saving money to apply to a technical school.

Marshall was working temporarily, bouncing around from factory job to factory job. He gained a new set of friends that were far beyond the experimental stages of drug use. Marshall was always low on cash and was left without a car after totaling his in an accident. Unhappy with his life, Marshall decided to experiment with substances that made him feel better about himself, desperately searching for a way out of the black hole he felt he was in.

On Sept. 25 of 2011, his father, Jim Marshall, experienced something he never thought he would. Cody Marshall was home alone, 20 years old at the time. Jim Marshall walked into the house to find his son unconscious, lying on the living room floor. His friends had picked him up from his family’s house, gotten high with him, then dropped him off at home where he overdosed on Xanax and heroin. Jim Marshall was fortunately able to revive him through cardiopulmonary resuscitation (CPR), but two short days later, his son was pronounced brain dead because of the time he was without oxygen.

“Cody was a trusting boy, and that was his downfall to the end,” Jim Marshall said. “He trusted the wrong people and made a poor choice.”

Cody Marshall didn’t fit the stereotype of a “bad kid” or a heroin abuser. He was a fun, loving young man that wanted nothing more than to make people laugh, his father said. At his funeral, Cody Marshall’s love and compassion for others became evident to his family. The diversity of the people he had touched in his life was moving.

“He had a good number of special needs kids at his funeral because he was one of the few that hugged, high-fived or stopped and talked to them,” Jim Marshall said. “Cody also gave a lot of his nice clothes to a homeless man named Lucky as well as giving him food. He did the same to kids without these things. He was just a good kid all around.”

Cody Marshall was an organ donor. After his death, he donated 33 organs including, but not limited to, skin tissue, bones and joints. Jim Marshall even received a letter from a mother of two under the age of seven that has Cody Marshall’s heart.

This inspired Jim Marshall to start a website called Cody’s Gift. He wanted to give a gift to others just as Cody Marshall had done his whole life, and even in his death. Jim Marshall’s mission is to make a difference, and he believes there is a lot that individuals can do to improve their perception. Jim Marshall believes the fear and stigma associated with those who struggle with drug addiction is one of the main reasons why people need to do better.

“When you see a newspaper thread from a Facebook post, you just want to shake your head in disgust,” Jim Marshall said. “This is why we’re having a problem.”

A study from the National Institute on Drug Abuse (NIH) reveals that many people don’t understand why or how someone could become addicted to drugs. People mistakenly think that those who use or abuse drugs lack morals or willpower and that they could stop by choosing to.

“So many people just don’t understand what an addiction is. They don’t understand that it’s a disease and not necessarily a choice once you begin to develop this tendency,” Jim Marshall said. “A lot of people say, ‘Well, we just need to throw them in jail,’ and that’s the answer to it. But that’s typically what I continue to see as I educate, the ignorance or lack of knowledge that blocks common sense solutions from being addressed.”

RBHS Outreach Counselor Lesley Thalhuber doesn’t think there is any particular way that works perfectly for dealing with an issue of this caliber, but sees the removal stereotypes as a major positive.

“Never judge a book by its cover,” Thalhuber said. “No one plans on becoming addicted to drugs or alcohol. It happens accidentally, slowly, over time. Think about the people who become addicted to pain medication after a surgery: a totally unintended consequence of relieving legitimate pain.”

A study on the impact of stigma conducted by www.drugabuse.com aligns directly with Jim Marshall’s findings. The study shows that stigma can lower the chances of seeking help and attending treatment, resulting in economic, social and medical costs.

“Quite frankly, this is what I believe normally shuts people down from wanting to reach out for help or even admit that they have a problem,” Jim Marshall said. “They hate the way that they would be viewed. They’re viewed as bad people who continue to make poor choices and don’t care about the condition they’re in, which is the farthest thing from the truth. There is always a deeper, underlying issue.”

He believes the lack of awareness surrounding this epidemic is life-threatening.

“I just think there is such a low level of knowledge by our youth and by our parents of youth that they continue to make poor choices, which lead or spiral to this epidemic getting worse,” Jim Marshall said. “I mean the kids make poor choices; they need knowledge. Then, the parents make poor choices on how they handle it; they don’t know what to do either.”

Junior Eric Van Delden believes that no matter how hard the school system tries to educate students about drug abuse, a student must first change their perspective in order for a change to be made.

“People shouldn’t stereotype drug abuse because neither race or socioeconomic status cause someone to abuse drugs,” Van Delden said. “It can be easy at times to try to blame a problem like this on someone else, but that isn’t ever going to fix the issue, doing that will only divide people further. The idea of doing more in schools to prevent stereotyping is a great thing, but in reality, nothing will change until people accept that stereotyping anything is wrong and pushes us in the wrong direction as a country.”

Jim Marshall has made it his mission to get more psychologists and psychiatrists in the school setting. For a school like RBHS, Jim Marshall said it could use two or three mental health professionals for the amount of students that walk through the school doors. Statistics show that one out of five adolescents are suffering from depression or anxiety, maybe even a combination of the two, at any given day of the year.

“If you have 2,000 students, that’s about 400 of them every day that are struggling from one of those mental health issues,” Jim Marshall said. “If not stressed because of whatever stress they put on themselves. Something needs to change, and it starts here.”

Prevention Plan Paper: Substance Abuse

by Lindsey Cunningham

According to the Center for Disease Control we are currently in “the worst drug overdose epidemic in U.S. history.” Substance use disorder has become a problem that impacts 1 in 3 families in the U.S. and the rise of opioid use has increased significantly. However, this epidemic isn’t lack of D.A.R.E. programs teaching kids to “Say ‘NO’ to drugs” it is the result of much deeper problems within today’s society. Now days, we cope with challenges the wrong way; we don’t know how to properly handle depression or anxiety and when faced with trials we would rather avoid through use of pills than attack it head on.

It is no wonder that so many families are affected by substance abuse because 1 in 5 12 year olds know where to get heroin and 1 in 5 college kids will take a prescription drug that isn’t prescribed to them. Drug overdoses killed 52,404 people in 2015 and was the leading cause of accidental deaths by far; the next was car accidents which killed 38,300. Of the 52,404 drug overdoses, 20,101 were prescription drugs and 12,990 were heroin. There is a young person dying every 8 minutes due to overdose and this epidemic is one that needs immediate action to prevent in people dying at such a young age.

This topic is of interest to me because of Cody’s Gift. Cody Marshall was a young kid out of Jefferson City, MO who was a loyal and trusting friend. The year after his high school graduation he worked and saved money with plans to attend technical school while the rest of his buddies went to college. He was working temporary jobs here and there in order to afford his schooling, but was frustrated, depressed, and unhappy with his life so he turned to drugs to help cope with those feelings. He denied that any substance abuse was happening and even visited a specialist regarding treatment, but continued to deny needing help. Cody’s parents came home on September 25, 2011 to find Cody unconscious on their living room floor; he had overdosed on Xanax and heroin and his “friends” had just left him there. Cody’s dad, Jim, was able to revive him, but he passed away two days later due to lack of oxygen to his brain for an extended amount of time. Fortunately for the school boards, parents, legislation, and students in Mid-Missouri Jim Marshall is a strong-willed man who has showed great strength in using his loss story to help make change in the surrounding communities. Jim Marshall was my mom’s high school coach and followed my athletic career very closely, traveling near and far to support my sister and I while we played the game we loved. He reminds us to never take a day for granted and supports us the way he wishes he could still be supporting Cody every single day.

With each generation there are more and more kids suffering from anxiety and depression, but unfortunately, with each generation comes less face to face engagement and poor coping mechanisms. We are at a time in society where parents don’t want their kids to have to experience failure or work through challenges. We are dealing with a post 9/11 generation, they’ve grown up with terrorist attacks, mass murders, and bombings. We are at a point in time when it is easiest to quit or avoid any situation that gets tough, this is when we run to self-medication. We have the mindset that pills are the cure all for anything and everything that comes our way and the most unfortunate part is how readily available these opioids are. Opioids, used to refer to synthetic painkillers such as Vicodin, but now describes all opium-derived drugs such as OxyContin, Vicodin, Heroin, Fentanyl, Percocet, and Morphine. Opioids and other prescription drugs are readily available in every town, community, and school district as early as middle school; they can be found in the locker rooms, in the libraries, and on the streets. Drug abuse does not discriminate.

Drug abuse doesn’t discriminate and has spread to every segment of society: white, black, rich, poor, young, old, those who are involved, and those who are outcasts. No one is immune to the disease of addiction. Those who get caught up in prescription and opioid abuse are not your stereotypical “druggies.” It is your 4.0 student who got a 34 on the ACT. It is the captain of your state championship basketball team and it affects every socioeconomic class from top to bottom. In Columbia, Missouri there were 378 overdose calls last year (that is 1 per day) and the majority of those victims were 18-25 years old. While this disease doesn’t discriminate, it is killing off the young people of our communities.

Medical staff has played a significant role in this epidemic and are quick to prescribe pills as treatment. There has been a spike in pain killer sales from 1999-2015. Prescription opioid sales have quadrupled in that time; opioid related deaths have increased at the exact same rate (4x). Statistics show there were 338 heroin deaths in 2014 and in 2001 there were only 18. It is important to note that 35% of the people prescribed 1 month’s supply of painkillers become addicted for 1 year and 4 out of 5 heroin users started with prescription drugs. There has to be more regulation. Until July 2017, Missouri was the only state without Prescription Drug Monitoring Programs (PDMPs). PDMPs are important because they track a patient’s opioid drug history, with hopes of preventing prescription abuse. In other states, doctors have full access to a patient’s medical history to help notice early signs of addiction. Having access to a patient’s information also reduces “doctor shopping” where patients go from doctor to doctor until they are prescribed the medication they wish to have. PDMPs play an essential role in stopping doctors from giving out too many pills and patients from getting too many pills; this is the key piece in prescription pills not being so readily available to people of all ages.

While opioid-related substance abuse doesn’t pertain specifically to athletes like a Performance Enhancing Drug would, it doesn’t also doesn’t exclude athletes. We saw above how every demographic is poisoned by the disease of depression, anxiety, addiction, and overdose. Coaches play such a vital role in the development of student-athletes into successful, prepared adults, but this is the next thing that they have to be educated on. It is important for coaches and athletic staff to understand the trends around substance abuse. The NCAA conducted a study and published the following reports: “NCAA National Study of Substance Use Habits of College Student-Athletes August 2014” and “NCAA Student-Athlete Substance Use Study: Executive Summary August 2014.” The findings of those studies, directly from the reports, are: Excessive drinking is down significantly among student-athletes. Alcohol excluded, student-athletes are much less likely to engage in social drug use than other college students. Self-reported substance abuse is highest among Division 3 student-athletes. Substance abuse is generally higher among male athletes. Student-athletes in lacrosse report substance use rates that are notably higher than in other sports. Men’s basketball student-athletes generally report using these substances at much lower rates than other student-athletes. Nearly one-quarter of student-athletes reported using prescription pain medication. Student-athletes who reported ADHD medication use were more likely to use without a prescription. These are the trends that leaders in sport need to be aware of.

What’s the next step in making positive chances surrounding this horrific epidemic? We need more “Jim Marshalls”. He travels all over the state sharing his story and educating kids (of all ages), parents, school boards, and he has fought endlessly to make legislative changes that limit access and increase monitoring of prescription/opioid drugs. First, we need to realize the size of the monster (drug abuse and addiction) we are dealing with. The solution is not to increase police staff, but we need more middle school programs that teach kids how to deal with anxiety. They have to understand what depression is and how to handle it. Kids need to learn how to deal with their emotional issues and how to solve their own problems; they need to understand how to “bounce back” from failure because growth can in fact occur through failure. There needs to be more mental health specialists available to kids at schools, the ratio of counselors to students is not efficient or effective. Classes that teach prevention of falling into this terrible trap need to be more accessible to kids; school districts haven’t failed, but for a problem this large more needs to be done. Parents need to be education, they have to understand their role in raising kids without coping skills, the modern day signs of substance abuse, and they must lose the “This can’t happen to me” mindset. 16% of state budgets are spent on addiction and substance abuse, we have to invest more money into better prevention and treatment programs.

Changes are being made and Cody’s story has lived on to prevent other parents from having to experience what his did 6 years ago. Bill 501, named Bailey and Cody’s, Law became effective August 28, 2017. This bill states that people who call 911 or bring in a person who has overdosed to the hospital can’t get in legal trouble; this encourages people to help those who have overdosed and will ultimately save more lives. Bailey and Cody’s Law is just one of the ways Jim Marshall has used his tragic story to help make change one speaking event, one school board, one struggling student, one naïve parent, and one state representative at a time.

References:

Cody’s Gift: Jim Marshall- Drug Awareness, Prevention, and Education. https://www.codysgift.org.

Opioids, Shatterproof, from https://www.shatterproof.org/about-addiction/substances/opiods.

Morgan, R. (2017, April 06). Running out of time: Missouri’s opioid epidemic. Retrieved December 15, 2017, from http://www.voxmagazine.com/news/features/running-out-of-time-missouri-s-opioid-epidemic/article_1b2d4f10-1ad2-11e7-a4e0-7f7f4ba7c6e6.html

R. (2014, August 27). NCAA Student-Athlete Substance Use Study: Executive Summary August 2014. Retrieved December 15, 2017, from http://www.ncaa.org/about/resources/research/ncaa-student-athlete-substance-use-study-executive-summary-august-2014

Overdose deaths rose 21% in 2016

Devastating news: Overdose deaths rose 21% in 2016. 63,600 Americans died—that’s 174 sons, daughters and loved ones every single day. It’s time for real action. Join Us.

Marshall shares tragedy to teach

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Missouri alone on addiction

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By JIM MARSHALL
published in the Columbia Daily Tribue

My son Cody helped people all of his life. He gave Christmas presents to underprivileged children and used his allowance to buy meals for the homeless. He was an outgoing and gentle boy. But as he was helping so many others, we didn’t realize he needed help himself.

Cody’s drug addiction began after high school. He watched his friends go off to college while he stayed home working temporary jobs. He started taking Xanax to fight off his depression and loneliness, and that eventually led to heroin.

Five years ago, Cody overdosed. Doctors put him on life support, but there was nothing they could do. He was just 20.

Doctors write prescriptions for sedatives such as Xanax and opioid painkillers such as OxyContin every day. This makes it shockingly easy for our children to fall victim to addiction. Whether they obtain their drugs with their own prescription or by purchasing them illegally from someone else, there are just too many pills in our communities, and they are ending up in the wrong hands. Recent statistics show that doctors write enough opioid prescriptions each year for every adult in America to have a bottle. These dangerous yet legal drugs must be more closely monitored to protect our loved ones.

One proven way to reduce addiction is with a prescription drug monitoring program (PDMP), basically a database that tracks prescriptions for addictive drugs and helps doctors spot early signs of addiction. We know they save hundreds of lives every year.

And every state has one — except Missouri. We are the only state that has yet to establish the system as a resource for doctors to access.

Our fellow Missourians are dying every day because a few state senators are blocking bills that would create a state PDMP. Even though there is enough support for it to pass, this small group of senators won’t let the bill even come up for a vote. They make all sorts of false assertions. First, they claim that PDMPs will lead to the government making your medical decisions. That’s a lie. PDMPs are just a tool — they give doctors better information so that they can make the safest decision for their patients. When making informed decisions can mean the difference between life and death, why wouldn’t you want that resource to be available?

They also claim that PDMPs violate patients’ privacy and that their medical information could even be hacked.

First, access to this information would be strictly limited. And there’s no evidence of a PDMP ever being hacked. By this logic, we should do away with electronic health care records altogether. I can’t imagine anyone supporting that. PDMPs are just as secure as any other digital health systems, and they utilize technology to doctors’ and patients’ advantages to efficiently keep track of medical records.

Even in death, Cody kept helping people. He donated his organs so that others could live. I try now to honor his memory with my not-for-profit, Cody’s Gift, and by speaking to kids about drug addiction and how we can stop it from ravaging our communities.

It’s a message everyone — including our representatives in Jefferson City — must hear. PDMPs could save so many of our friends and neighbors from losing a child. That’s why I am begging our legislature to create one.

Jim Marshall is a longtime educator and coach in public schools in Mid-Missouri and elsewhere and at the collegiate level. He is a substance abuse prevention educator and speaks at schools and universities around the Midwest. He established a not-for-profit, www.codysgift.org, after the death of his son in 2010.

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