The Neighborhood Has Seen Better Days

This is a piece I wrote using the writing prompt, “The Neighborhood Has Seen Better Days.”

I’m twelve. Feels like I’ve been twelve forever. Time has been standing still this whole, hot steamy summer. There’s been plenty of chances to sit here on my steps and watch the cars whizz by. Oh, but the motorcycles. They are wonderful. Most people today ride without helmets. Hair flying about. Tee-shirts. Shorts. So cool. So absolutely dangerously cool. I’m so happy lately, living in a fine house with a wonderful mom, belly full, shoes on my feet. Plenty of shoes. Pretty shoes. Lots of dresses and dollies and teddy bears. My room is so nice and warm and purple. I think I even have six pillows. There’s nothing I love better than to climb up on my bed and bury myself in my blankets and dream of days when the neighborhood was a nicer place.

But today, right now, I am sitting on my stoop watching Mrs. Pauley argue with a man in a black suit holding a piece of paper. I remember playing hopscotch with Mrs. Pauley’s kids, racing bikes around the block, selling lemonade at our corner stand, and lazily brushing the dog on her front porch. Lilly, her middle daughter, was my best friend. I had her over to my house for a sleepover at least half-a-dozen times. Lilly kind of liked Tom, Ernie Conrad’s son. Ernie Conrad ran the neighborhood barber shop. My brother Steve was good friends with Tom. They spent many hot summer days in the air-conditioned shop reading Archie comics and sucking on Tootsie Roll Pops. The shop had mirrors on both walls, and the boys would stand and look at themselves in the never-ending reflections. Tiny copies of themselves over and over without end.

But poor Mrs. Pauley. She is right in the middle of trying to live her life. Raising a family of six. Happily married. Always smiling. Buying Girl Scout cookies. Feeding the birds. Serving as a Block Parent. A regular at PTA. Taking us to the community swimming pool, and even braving the cold in December to take us ice skating. A mom’s mom. A real nice lady. So it was very sad when her husband passed away. He had a great job at the railroad. My dad said Mr. Pauley made a lot of money. Things were fine at first, then the trouble started. The two-car family soon became a one-car family. My friend Lilly started going hungry. She ate at our house a lot. She told me her brothers and her sister were living with Mrs. Pauley’s parents. Notices started being posted on the front door. The porch wasn’t swept. Someone stole the wicker chairs. The windows remained filthy. I didn’t see Lilly as much. In fact, she missed a lot of school.

Which brings me to the afternoon I was sitting on the front steps of my porch. It was hot out. No air was moving. Mrs. Pauley was standing in the doorway, looking rather upset. There was a policeman and a county sheriff standing on either side. A man with a briefcase and handful of papers was arguing with Mrs. Pauley. She was starting to cry. I could tell the county sheriff was being sympathetic. Mrs. Pauley pleaded one last time, asking “Isn’t there something I can do?” The official-looking man in the dark suit shook his head no and reached out to post a paper on the door. I could see what it said from across the street. NOTICE TO VACATE.

I looked up and down the street. Trash littered the gutters. A car sat in front of Mr. Baker’s house with four flat tires. There was an empty lot where Ernie Conrad’s barber shop used to be. Most of the front porches were piled up with old furniture, busted exercise equipment and beat-up bicycles. There were broken mini blinds in the windows, and many had no curtains.

It seems the neighborhood had seen better days.

©2015 Steven Barto

A Fundamental Orientation of the Heart

Perhaps one of the hardest things we face is taking stock of whether our actions match what we claim to believe. Our worldview – that is, how we see the world and our place in it, or, if you prefer, our “philosophy of life” – should be obvious from our behavior. A worldview is not just a set of basic concepts but a fundamental orientation of the heart.

Since the events of 9/11, the term worldview is often used as a very general label for how people view the cultures with which their culture clashes. This is very important to note, as a worldview is a set of presuppositions (assumptions which may be true, partially true, or entirely false) which we hold (consciously or unconsciously, consistently or inconsistently) about the basic makeup of our world. A worldview is sometimes considered to be the fundamental perspective from which we address every issue of life.

From a Human Perspective

Imagine someone who thinks life has no true purpose. For that person, events are random. “I live, then I die.” A meaningless existence requires nothing from anyone. There is no need to check our bearings along the way to see of we’re “on track.” There is no need to justify our choices, values, or goals. There is a quiet desperation that drives humanity to think about the question, “Does life have meaning?” Even non-religious people understand that man has a burning desire to make sense of his life. Humanist Deane Starr writes, “Humans find their most complete fulfillment, whether real or imaginary, in some sort of intimacy with the Ultimate.” Our greatest and most difficult achievement is to find meaning in life. It is well known that many people lose their will to live because such meaning evades them.

What happens when someone fails to find a reason for living? Often they experience a spectrum of emotional and behavioral aberrations. Jay Asher published a book in 2007 titled Thirteen Reasons Why. Netflix has produced a mini-series based on Asher’s book, which has caused quite an uproar across the country. The story begins when Clay Jensen returns home from school to find a strange package with his name on it lying on his porch. Inside he discovers several cassette tapes recorded by Hannah Baker—his classmate and crush—who committed suicide two weeks earlier. Hannah’s voice tells him that there are thirteen reasons why she decided to end her life. Clay is one of them. If he listens, he’ll find out why.

Suicide is the third leading cause of death in the age group of 10 to 24 years. It is a critical problem in America. Educators and mental health professionals have mixed feelings about Thirteen Reasons Why. Dr. Nicole Quinlan, a pediatric psychologist at Geisinger Medical Center in Danville, PA, objects to the show’s graphic, gratuitous portrayal of Hanna Baker’s suicide. I watched the mini-series, and I was shocked and upset by the final scene. I didn’t expect to see Hanna Baker drag a razor blade up both of her arms while sitting in a bathtub of warm water. It was, indeed, horrific.

Hanna Baker is a fictional character, but her plight is far from pretend. She was hounded by classmates, bullied online, and was labeled a “slut” after a football jock posted a random shot of her dress flying up when she came down a sliding board during her date with him. He intimated in his online post that Hanna was “easy.” Hanna’s problems worsened when she was raped by another member of the football team. On each side of the cassette tapes, she exposed one person (one “reason”) why she decided to end her life. Her thirteen excuses. Teenage angst is a very real and difficult emotion. Hanna, as are many teens, was trying to find meaning in what she felt was an already meaningless existence. Her worldview was that life was without purpose. The fault of the story depicted in Thirteen Reasons Why is its lack of providing meaning, hope, or the option of seeking treatment.

From a Biblical Perspective

Developing a biblical worldview involves both a mindset and a willset. First, how does the Bible explain and interpret my life and the world around me? Once this question is answered and accepted, the next aspect of a biblical worldview presents the challenge of putting this view into practice. A worldview is the framework of our most basic beliefs that shapes our view of and for the world, and is the basis for our decisions and actions. Worldview leads to values, which lead to actions. Beliefs clearly shape our behavior.

Man’s attempts to explain his existence are just that: man’s attempts. Within the world, man’s experience and perceptions of the infinite universe are limited and inadequate. We need help from the “outside.” This is what a biblical worldview is. Help from the outside. More fundamental than any worldview that can be delineated by ideas and propositions is the religious or faith orientation of the heart. There are only two basic commitments, leading to two basic conditions of life: “man converted to God,” and “man averted from God.” The commitment one makes is decisive for all life and thoughts. From a Christian perspective,  worldview is not so much a matter of theoretical thought expressed in propositions, but is a deeply rooted commitment of the heart. Theory and practice are a product of the will, not the intellect; of the heart, not the head.

How Would My Life be Different if I Lived Out my Convictions?

I have spent most of my life manipulating others. For reasons best understood by reading my testimony, https://theaccidentalpoet.net/about/, I felt the need to hide, run away, or escape. I had a difficult time telling the truth, and, because of a victim mentality, I was able to rationalize my behavior. I became a born-again Christian at age 13, but never fully developed a relationship with, nor the mind of, Christ. When I began escaping through drugs and alcohol, I set off down a road that ultimately took me until August of last year to get off of and head in the right direction.

How could I act in such a callous and selfish manner if I was a Christian? I now understand the reason. One of my sponsors in Alcoholics Anonymous kept saying, “I hope you get God out of your head and into your heart.” Each time I heard that, I became defensive. Who are you to tell me I don’t have God in my heart? My former pastor said the same thing when he commented, “You don’t seem to have a heart for God.” What? I continued becoming defensive.  Several things happened over the past year that finally got through to me

First, I returned to the church of my youth where I accepted Christ. Within a few months, our church got a new pastor from New Jersey. Pastor Mike is exactly what I needed. He has a wealth of experience counseling Christians struggling with addiction. In our several one-on-one meetings, he has been able to help me restructure how I see my addiction and the many excuses I was holding on to as justification. He has also helped me take a different approach to my chronic back pain. He made an amazing statement: “Have you ever considered that your chronic pain gives you the opportunity to share in the sufferings of Christ?” Whoa!

Last August I made the ridiculous decision to “help myself” to some of my mother’s oxycodone. Unfortunately, this was not the first (or second, or third) time I’ve done so. The result was serious damage to my relationship with her and the rest of my family. Interestingly, this is something I feared would happen if I did not stop using drugs. Especially using mom’s medication! I remain estranged from the family, and can only continue on my road to recovery, turning my relationship with the family over to Christ. I know I am delivered from the bondage of addiction. I have to live that freedom all over again each day. One day at a time.

Luke 6:45 is a Scripture I meditate on daily. It is very convincing, and seems to confirm what my former pastor and a former sponsor said regarding my lack of having God in my heart. The verse states, “A good man out of the good treasure of his heart bringeth forth that which is good; and an evil man out of the evil treasure of his heart bringeth forth that which is evil: for of the abundance of the heart his mouth speaketh.” Proverbs 23:7 says, “As a man thinketh in his heart, so is he.” God is concerned about the hidden man of the heart, which is our inner life. Our inner life is what we think about. And like the Scriptures above indicate, how we live and who we are.

A Change of Behavior Requires a Change of Heart

It says in Jeremiah 17:9, “The heart is deceitful above all things, and desperately wicked: who can know it?” Why do we sin, do bad things, and make mistakes? Because of our heart, which the Bible says is desperately wicked. Why do so many people struggle with drugs and pornography, returning again and again to these sins and vices even though they know their lives are being ruined by them? Because our heart often leads us astray. We cannot live perfect lives, and we cannot save ourselves from the punishment that we deserve. Moreover, it is impossible to deny the flesh, resist temptation, and stop living a self-centered and sinful life without a true change of heart.

Can this explain my constant relapsing over nearly forty years? Can it account for my selfishness? The disrespect and dishonor I’ve shown toward my parents and siblings? Does it help explain how I can “believe” and “speak” about Christ and recovery while secretly using drugs? Worldview, as I mentioned at the beginning of this post, is how we think about the world and our place in it. This basic belief establishes our values, which directly control our actions.

O Lord, how heartily sorry I am for failing to establish the proper Christian worldview, and to hide your Word in my heart that I might not sin against Thee.

It is only through my embracing a true Christian perspective and asking Christ to take away my heart of stone and give me a heart of flesh that I can hope to act from a position of love and respect.

The Narrow Way

“Enter through the narrow gate. For wide is the gate and broad is the way that leads to destruction, and many enter through it. But small is the gate and narrow the way that leads to life, and only a few find it.” (Matthew 7:13-14, Berean Study Bible)

Jesus was essentially saying there are only two options: heaven or hell. There is no middle ground. Remember Revelation 3:15-16, where God told the Laodiceans, “I know thy works, that thou art neither cold nor hot: I would thou wert cold or hot. So then because thou art lukewarm, and neither cold nor hot, I will spew thee out of my mouth.” Concerning the way of sin and sinners, the gate is wide. It stands open. Inviting. You may go in at this gate with all your lusts about you. It gives no check to appetites or passions. It is a broad way. Truly, it is an easy way. There are no qualifications. There are many paths, and a choice of sinful ways. There is company in this way. But what profit is there in being willing to go to hell with others?

In saying “difficult is the way which leads to life,” Jesus was explaining how hard being a Christian really is. I am reading a book by Kyle Idleman called Not a Fan: Becoming a Completely Committed Follower of Jesus. http://www.notafan.com/ Idleman reminds us of the words of Jesus in Matthew 15:8: “These people honor me with their lips, but their hearts are far from me.” We are to be more than whitewashed tombs, beautiful on the outside, but full of dust and dirt and spiderwebs and dead man’s bones on the inside. Likewise, it is wrong to appear righteous on the outside, but full of hypocrisy on the inside.

Idelman makes an important comment in his book. Many people take the wrong road, and only a few find the narrow path. If that’s true, then wouldn’t it make sense for us to slow down? Shouldn’t we hit the brakes, pull over to the berm, and make sure we are on the road that leads to life? Is it possible that you think you are on the narrow road but you are actually on the broad road? Could it be that you have set the cruise control, turned up the volume on your local Christian radio station, and are unwittingly traveling down the road of destruction with a Jesus fish on your bumper?

Donald Whitney, of the Southern Baptist Theological Seminary in Louisville, Kentucky, once said, “If a person is wrong about being right with God, then ultimately it really doesn’t matter what he or she is right about.” So before you continue driving down the road, assuming you are on the “right” or “narrow” path, Idleman is suggesting that you slow down and look at some of the billboards and road signs and ask yourself what road you’re really on. Is it possible that you are wrong about being right with God?

Just How Narrow is the Gate?

Jesus is the door through which all must enter eternal life. There is no other way because He alone is “the way, the truth and the life” (See John 14:6) The way to eternal life is restricted to just one avenue—Christ. In this sense, the way is narrow because it is the only way, and relatively few people will go through the narrow gate. Many more will attempt to find an alternative route to God. They will try to get there through man made rules and regulations, through false religion, through good deeds, or on their own self-effort.

These who are “many” will follow the broad road that leads to eternal destruction, while the sheep hear the voice of the Good Shepherd and follow Him along the narrow way to eternal life. (See John 10:7-11)

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Entering the narrow gate is not easy. Jesus made this clear when He instructed His followers to “strive” to do so. The Greek word translated “strive” is agonizomai, from which we get the English word agonize. The implication here is that those who seek to enter the narrow gate must do so by struggle and strain, like a running athlete straining toward the finish line, all muscles taut and giving his all in the effort. But let me be clear. No amount of human effort saves us; salvation is by the grace of God through the gift of faith. (See Ephesians 2:8-9) No one will ever earn heaven by striving for it. But entering the narrow gate is still difficult because of the opposition of human pride, our natural love of sin, and the opposition of Satan and the world in his control, all of which battle against us in the pursuit of eternity.

Jesus says the narrow gate leads to a “hard” road, one that will take us through hardships and difficult decisions. Following Jesus requires crucifying our flesh (Galatians 2:20, 5:24, Romans 6:2), It involves living by faith, enduring trials with Christlike patience, and living a lifestyle separate from the world. When faced with the choice between a narrow, bumpy road and a wide, paved highway, most of us choose the easier road. Human nature gravitates toward comfort and pleasure. When faced with the reality of denying themselves to follow Jesus, most people turn away. (See John 6:66) Jesus never sugar-coated the truth, and the truth is that not many people are willing to pay the price to follow Him.

The famous biblical scholar Matthew Henry (Here is a link to his commentary on the entire Bible book-by-book: http://www.biblestudytools.com/commentaries/matthew-henry-concise/) addressed this issue in such a beautiful and comprehensive manner that I am including his words verbatim. Henry said

Christ came to teach us, not only what we are to know and believe, but what we are to do; not only toward God, but toward men; not only toward those of our party and persuasion, but toward men in general, all with whom we have to do. We must do that to our neighbour which we ourselves acknowledge to be fit and reasonable. We must, in our dealings with men, suppose ourselves in the same case and circumstances with those we have to do with, and act accordingly. There are but two ways right and wrong, good and evil; the way to heaven and the way to hell; in the one or other of these all are walking: there is no middle place hereafter, no middle way now. All the children of men are saints or sinners, godly or ungodly. See concerning the way of sin and sinners, that the gate is wide, and stands open. You may go in at this gate with all your lusts about you; it gives no check to appetites or passions. It is a broad way; there are many paths in it; there is choice of sinful ways. There is a large company in this way. But what profit is there in being willing to go to hell with others, because they will not go to heaven with us? The way to eternal life is narrow. We are not in heaven as soon as we are got through the strait gate. Self must be denied, the body kept under, and corruptions mortified. Daily temptations must be resisted; duties must be done. We must watch in all things, and walk with care; and we must go through much tribulation. And yet this way should invite us all; it leads to life: to present comfort in the favour of God, which is the life of the soul; to eternal bliss, the hope of which at the end of our way, should make all the difficulties of the road easy to us. This plain declaration of Christ has been disregarded by many who have taken pains to explain it away; but in all ages the real disciple of Christ has been looked on as a singular, unfashionable character; and all that have sided with the greater number, have gone on in the broad road to destruction. If we would serve God, we must be firm in our religion. Can we often hear of the strait gate and the narrow way, and how few there are that find it, without being in pain for ourselves, or considering whether we are entered on the narrow way, and what progress we are making in it?

Matthew 7:13-14 simply says, “Enter by the narrow gate; for the gate is wide and the way is easy, that leads to destruction, and those who enter by it are many. For the gate is narrow and the way is hard, that leads to life, and those who find it are few.” (RSV)

I can think of no better way to end this critical discussion than to provide an example. Picture this scene with me. You’re walking along an old country road with thousands of other people, and you come to a dead end. There at the end of the road you see two gates. One gate is very large, and you can see that if you enter through that gate, there is a very wide, well worn dirt road on the other side. The road looks very pleasant and easy to travel on. What’s more, the vast majority of people are going through that wide gate. It looks like easily 95% of them are going in through that gate. It’s very tempting to just go that way. After all, everyone else is going that direction. You think to yourself, all those people can’t be wrong, can they?

Then you look at the other gate. It’s narrow. In fact, it’s so narrow, that only one person can go in at a time. And on the other side of that narrow gate, is a very narrow path. Again, it’s so narrow, that only one person can walk it at a time. Also, this path looks like it will be very difficult. You can see that it heads steeply uphill into the mountains with thousand foot drop-offs on both sides. What’s more, only a few people are deciding to take this path. You stand there, looking at both gates, and both ways. Which one should you take? All of us have to make a choice about which gate we will enter, and which path we will walk. In fact, we have already made that decision. Some of you have entered the narrow gate, and you are walking on the narrow way that leads to eternal life. Others of you have entered the wide gate and are walking on the broad way that leads to eternal destruction. The good news is that it is not too late to change paths! If you have entered the wrong gate, you can still go back to the narrow gate, enter through it, and begin walking on the narrow path that leads to life.

I hope this post will serve to guide you in making one of the most important decisions of your life. One that will effect you for all of eternity. May God bless you and guide you as you ponder the dubious benefits of the “easy life” versus the spectacular rewards of choosing to take the hard road.  As Robert Frost so prophetically said in “The Road Not Taken,”

Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.
©2017 Steven Barto

Lynn

I’ve been less than connected to others during much of my life. I’m not so sure it was by choice. I often felt dark inside. Unable to receive light. To use illumination in any way. Such as to cast meaning and clarity on a situation. To show me a direction. To give sight where it didn’t seem to exist. It’s a singularly lonely feeling. An inability to latch on to others in any significant way. Sometimes it would feel like I was the only one in the room despite the cast of thousands swarming around me. I couldn’t even hear others breathing. Eye contact was not possible. The gaze of others was so bright it would cause me to squint and guard my eyes. All that content, all those queries, coming at me all at once. Blinding me. Confusing me. Causing me to shut down, which made it all the more impossible to go outside myself. Which, of course, led to cold, smothering, deep isolation.

I felt that way a lot. Communication was painful. Nauseating. I was fully shut down most of my childhood and teen years. We moved a lot as a family, which made my social awkwardness commonplace. It wasn’t just about girls. I liked girls. Obsessed over them. Oh, their lips and their curves. I was aware of every girl in the room. Not that I believed they were interested in me. I had too many problems dealing with people in general. Add sexual tension, and I was frozen in place.

I think that’s why it’s so fascinating to me that my first best friend was a girl. Lynn. She was cute. Not gorgeous. She had a fast reputation as a young woman, which sort of frightened me. (There’s no way I would know what to do.) Lynn was unique and otherworldly. She danced her own way. She did things she wanted to do, and she had no real sense of restraint. Her eyes were bright. Wide open. Telling. Funny thing though: I didn’t have to squint when I looked at her. The brightness I shied away from in others was warm and subdued in Lynn’s gaze. It was beyond a gaze, actually. It was a gentle peek inside. There was nothing threatening or overwhelming about her contact. I felt shallow and warm and alive when she looked at me. I felt aroused. Nothing too deep or complicated. No rules. No agenda. Just a slow sucking in. A natural feeling of compatibility. A very special feeling.

I didn’t quite understand what was going on between Lynn and I. We were not officially dating. But we were joined somehow; spiritually, maybe. It was as if we’d been gliding on a pathway of discovery and comprehension. No one ever understood me before Lynn. Freak that I was, I couldn’t understand me. I was lost even to myself, and so I couldn’t explain it. I had no respect for the feelings of others. You were no more than an object for me to use for my own ends. My ends were justified in my mind. There was only one way: the way I chose to go. I saw no other paths. I considered no consequences. Certainly, it was no concern to me how my behavior would effect someone else. This is, of course, the very root of my lack of friends. Even when my mistakes were pointed out to me, I couldn’t see them.

Except when they were pointed out by Lynn. She was gentle about it, and that was a first for me. No one had ever been gentle or respectful to me. It seemed that Lynn wanted me to learn something about myself that would lead to a happier life. She understood my isolation, and hoped to teach me of its source. She knew it wasn’t of my own doing. It was because of things that were done to me. My isolation was because of others. Lynn didn’t want me blaming myself for my lack of friendships despite my bad habits and selfish behaviors. She knew the egg (in this case) came before the chicken. My personality was hatched, in other words. Who I was and how I acted was a byproduct of how I was treated. Things were done to me in the name of love that affected me deeply.

Some days I wish Lynn were still here. She died of ovarian cancer ten years ago.

©2017 Steven Barto

Day

‘Please state your full name,’ and so you

do. ‘Can you tell us today’s date?’ Staring out the

window, you shake your head no. ‘Do you practice any

religion?’ You expose the tattoo on the right side of your rib

cage, ‘maybe I did, I think I used to.’ They ask to take a picture.

You let them. ‘Where were you?’ You scratch the back of your left

hand and talk about the ink shop that was owned by a man with

two heads. ‘No. Where were you when the sun left?’ You take in

their question and throw a quick grin, ‘there was a funeral.

The family couldn’t afford a decent casket, so a couple

of friends chipped in. The day the Sun divorced

the Earth, I woke up from my death.’

Jacob Ibrag

Check out more from Jacob Ibrag: https://eyespluswords.com/

 

First National Youth Poet Laureate

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Nineteen-year-old Amanda Gorman of Los Angeles was named the first national youth poet laureate on April 26, 2017. The unprecedented title, to be awarded annually, honors a teen poet who demonstrates not only extraordinary literary talent but also a proven record of community engagement and youth leadership. For me, this is a great development. Although I am long past my youth (58 years old), the institution of national youth poet laureate is something that was long overdue.

For Gorman, poetry and civic outreach aren’t separate interests. The Harvard University freshman knows firsthand that creative writing can build confidence and a sense of community among young people whose voices are often underrepresented in mainstream dialogue. In 2016 she founded One Pen One Page, a nonprofit organization that provides an “online platform and creative writing programs for student storytellers to change the world.” She continues to serve as the organization’s executive director.

Gorman’s own writing often addresses the intersections of race, feminism, and adolescence, as well as the changing landscape of her native Los Angeles. For both her poetry and her advocacy, Gorman has been recognized by Forbes, the Scholastic Art and Writing Awards, the YoungArts Foundation, and the OZY Genius Awards. She has also performed on The Today Show, ABC Family, and Nickelodeon News, and helped introduce Hillary Clinton at the 2017 Global Leadership Awards. In my opinion, there is far too little emphasis, on any public or national level anyway, regarding the often painful process of growing up.

Gorman said, “For me, being able to stand on a stage as a spoken word poet, as someone who overcame a speech impediment, as the descendant of slaves who would have been prosecuted for reading and writing, I think it really symbolizes how, by pursuing a passion and never giving up, you can go as far as your wildest dreams. This represents such a significant moment because never in my opinion have the arts been more important than now.”

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Michael Cirelli, executive director of Urban Word NYC, says the program was founded on a belief that “young poets deserve to be in spaces of power, privilege, and governance, and to have their voices front and center of the sociopolitical dialogue happening in our city.” The role of poetry, especially in marginalized communities, is to provide a voice to those who are traditionally silenced, and the best way to effect social change is to provide platforms for youth to tell their stories. We hope to leverage our work to allow these diverse stories to be told in spaces that have historically omitted youth voices, and to energize and engage the issues that they are most passionate about.”

“I am so grateful to be part of this cohort of young creatives who are taking up their pens to have a voice for what is right and what is just,” Gorman said in her acceptance speech. “I don’t just want to write—I want to do right as well.”

Steven Barto

Opioid Use Disorders and Suicide

The following is a guest blog taken verbatim from the monthly blog post of Dr. Nora Volkow, director, National Institute of Drug Abuse published April 20, 2017.

“At a Congressional briefing on April 6, the President of the American Psychiatric Association, Dr. Maria Oquendo, presented startling data about the opioid overdose epidemic and the role suicide is playing in many of these deaths. I invited her to write a blog on this important topic. More research needs to be done on this hidden aspect of the crisis, including whether there may be a link between pain and suicide.” – Nora

In 2015, over 33,000 Americans died from opioids—either prescription drugs or heroin or, in many cases, more powerful synthetic opioids like Fentanyl. Hidden behind the terrible epidemic of opioid overdose deaths looms the fact that many of these deaths are far from accidental. They are suicides. Let me share with you some chilling data from three recent studies that have investigated the issue.

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In a study of nearly 5 million veterans recently published in Addiction, scientists reported that presence of a diagnosis of any substance use disorder and specifically diagnoses of opioid use disorders (OUD) led to increased risk of suicide for both males and females.  The risk for suicide death was over 2-fold for men with OUD.  For women, it was more than 8-fold.  Interestingly, when the researchers controlled the statistical analyses for other factors, including co-morbid psychiatric diagnoses, greater suicide risk for females with opioid use disorder remained quite elevated, still more than two times greater than that for unaffected women.  For men, it was 30 percent greater.  The researchers also calculated that the suicide rate among those with OUD was 86.9/100,000.  Compare that with already alarming rate of 14/100,000 in the general US population.

You may be tempted to think that these shocking findings about the effects of OUD on suicide risk are true for this very special population.  But that turns out not to be the case. 

Another US study, published last month in the Journal of Psychiatric Research, focused on 41,053 participants from the 2014 National Survey of Drug Use and Health.  This survey uses a sample specifically designed to be representative of the entire US population.  After controlling for overall health and psychiatric conditions, the researchers found that prescription opioid misuse was associated with anywhere between a 40 and 60 percent increased risk for suicidal ideation (thoughts of suicide).  Those reporting at least weekly opioid misuse were at much greater risk for suicide planning and attempts than those who used less often.  They were about 75 percent more likely to make plans for a suicide, and made suicide attempts at a rate 200 percent greater than those unaffected.

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Using a different strategy, a review of the literature in the journal Drug and Alcohol Dependence estimated standardized mortality ratios for suicide.  This is a way of comparing the risk of death in individuals with a given condition compared to individuals from the general population.  The researchers found that for people with OUD, the standardized mortality ratio was 1,351 and for injection drug use it was 1,373.  This means that compared to the general population, OUD and injection drug use are both associated with a more than 13-fold increased risk for suicide death. These are stunning numbers and should be a strong call to action.

Persons who suffer from OUD are highly stigmatized. They often talk about their experience that others view them as “not deserving” treatment or “not deserving” to be rescued if they overdose because they are perceived as a scourge on society.  The devastating impact of this brain disorder needs to be addressed.  People who could be productive members of society and contribute to their families, their communities, and the general economy deserve treatment and attention.

As a country, we desperately need to overcome stigmatizing attitudes and confront the problem. We need to understand what causes some individuals to become addicted when exposed to opioids and thus study the biological basis of the disease of opioid addiction. We desperately need to know what the best treatments are for a given individual, and for that too, we need research to identify biomarkers for treatment response. Given the fact that effective medications exist but are drastically underutilized, we need to overcome institutional and attitudinal barriers to these treatments and deliver them to the 24 million people who could benefit. It can prevent not only the suffering of addiction and the danger of unintentional overdose but also help prevent the tragic outcome of opioid-related suicide.

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