Cody’s gift: One Father’s Response to the Opioid Crisis

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from the Missouri Pharmacist, Jan-Mar 2018 by Justin Ricklefs

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.