DPP #24: Drugs, Dementia and a Little Bit of Dharma

When Sasha Shulgin was at the end of his life, experiencing dementia, I had the privilege of interviewing him. Then both my parents got dementia. These experiences taught me lessons in life I won't forget, and I want to share them with you.

ROUGH TRANSCRIPT

Hi everyone. I really hate that I have to begin my show again, for the third time in a row, with an apology for how long it’s taking me to produce new episodes. But I’ve really been 2020’d hard. Since the last episode I’ve had three people in my life die. My best friend from high school, Pat Welch, died in a motorcycle accident, my good friend and colleague, Kevin Zeese, who founded of the Drug Policy Foundation and served on the board of DanceSafe for a while, died of a heart attack, and just week ago my step father died of covid.

And… my mom also has covid, and she’s been in the hospital for the past two weeks. And for some unknown reason… it might be the covid… right around the same time she got it, she lost virtually all of short term memory, and she can’t care for herself.

So for the past two weeks I’ve been on the phone with doctors, nurses, lawyers, and her friends in England… to try to manage her care.

And I’ve been talking to her every day. And it’s tragic, because when you lose your short term memory you can’t grieve. Her husband died a week ago but she keeps asking her nurses, “where’s Jim?” And she has to re-learn over and over again multiple times a day that he died. It’s like she’s being continually re-traumatized. You need to be able to encode new memories or you can’t grieve. I can’t think of anything worse, and it’s really affecting me.

My mom has always been a smart, super competent, and highly motivated woman who took care of everyone around her, and now she’s in this horrible twilight zone hell of non-stop misery and I feel helpless to do anything about it.

The nurses aren’t allowed to tell me what medications she’s taking. She can’t remember obviously. All she does is cry and say, “what am I gonna do. I can’t live without him.” It’s just awful.

And because of the covid, it’s even worse. She’s not allowed visitors. She’s just alone in a hospital bed crying and confused. Even the doctors who might be capable of assessing her short-term memory issues aren’t allowed to see her. I’m not allowed to fly over there. Even if I did I couldn’t see her now. I’d have to quarantine for two weeks first. So I feel helpless.

FUCK YOU 2020! YOU FUCKING SUCK!

[MUSIC]

Hi again everyone. So I recorded that about a week ago. I don’t know what I was thinking, how I would possible have been able to record an entire show in the state I was in back then.

I t may have been because I started taking Adderall every day. I convinced myself it would help me manage my mother’s situation, and maybe it did, but I think it really just added to my overall stress. And maybe minor mania too. There was no way I record an episode in that state. No way in hell. Why would I even want to? I think I felt guilty that yet again a month was ticking by with no new episodes, and I do feel a commitment to you all. My listeners.

But anyway, I think I can do it now, and I’ll tell you why. First, my mother’s getting better. She finally tested negative for covid, and the past three days her memory is much better. Maybe it WAS the covid affecting her brain, but it also could have been this one medication she was taking.

After fighting with her nurses for a week I finally got a list of her medications, and she’d been on this Parkinson’s drug called Pramipexole. She doesn’t have Parkinson’s, but Pramipexole is sometimes prescribed for restless leg syndrome, this condition where your leg twitches when you try to fall asleep.

Anyway, as I was googling her medications, all these warnings popped up around Pramipexole about, I fucking kid you not, SEVERE SHORT TERM MEMORY IMPAIRMENT!

Are you kidding me? A twelve-year old could have discovered this about this drug, yet the nurses who were witnessing her memory problems on a daily basis were giving it to her every night.

So I fucking called them right away and told them to stop giving her that drug, and they told me they couldn’t without talking to her GP. In England a GP, or general practitioner, is like a primary care physician in the States.

I said, “what about a doctor there” and they said the covid ward doctors couldn’t make a decision about anything other than covid treatment.

Jesus fuck! So then I realized I had to talk to her GP, but for the past month her friends in England had been trying to get a hold of her GP and they would never call back. My sister tried also about a week ago… specifically to try to get a list of her medications, and they wouldn’t even put my sister (HER DAUGHTER) through. Everyone had been telling them that my mom had this sudden dementia and she needed to be assessed. I don’t know if it was the covid or bureaucracy or whatever, but her GP wouldn’t talk to anyone.

So I called and told the receptionist that I was a doctor in America, and my mother was likely suffering memory impairment from a certain medication she was on, and that we had been trying to get a hold of her doctor for a month, and the situation was critical now, and I want to the doctor to immediately call the hospital and have them discontinue this medication.

“Right away Dr. Sferios. Let me put you through to her doctor.”

Same conversation with her doctor, with an added, “didn’t you know Pramipexole has a common side effect of severe short term memory loss? And… why is it in England it takes a month to get through to a GP?”

Well, he called and had this Parkinson’s drug discontinued right away.

And the next day, my mom seemed a little bit better. Yesterday too, and today… I just got off the phone with her, and she’s back. I fucking have my mother back.

Now, it’s too early to know whether it will last. Maybe it was the covid. Maybe it was the medication, or maybe even she’s just having a good spell, which can happen with dementia. But either way, Pramipexole is contraindicated with dementia. You just don’t prescribe someone that drug if they are experiencing dementia, especially for an off-label use like restless leg syndrome.

I stopped taking the adderall, by the way. Can’t fucking do stimulants eery day. My blood pressure was high. It wasn’t good for me.

Drugs. This is a podcast about drugs. But look, if you’ve been following me, you know I don’t compartmentalize my life. I talk about everything. So this is my personal life. But I’m telling you, as I always do, because it’s who I am. Full honesty. Full authenticity. And I wanted you to know why, once again, I wasn’t putting out regular episodes.

But there are some drug lessons here, aren’t there. Other than watch out for adderall and high blood pressure, particular when you hit middle age… there’s also something obvious here, but I guess not obvious enough for my mom… who’s a hello a smart woman. And that is… don’t ever let a doctor prescribe a drug for you without researching it first yourself.

You can’t trust doctors to know everything about every drug they prescribe. New drugs are released constantly and they get pens and paperweights sent to them by the pharmaceuticals with the new drug’s name on them in order to convince the doctor to prescribe it… FOR MONEY!

If you wouldn’t take a new research chemical without researching it, why would you take a pharmaceutical EVERY DAY OF YOUR LIFE, without researching it?

And I get it. Some people want to trust their doctors. They don’t trust themselves to know what the truth is. But even if you are’t the brightest egg, at least google and read the top five links, and if you see side effects that bother you, like “SEVERE SHORT TERM MEMORY IMPAIRMENT,” at least ask your doctor about it?

Say, “hey doc I noticed this side effect of this drug you want me to take.”

And if you doctor says, “I’m not too worried about that” then ask, “why not?” And if you don’t get an answer that makes sense, you need to do a risk-benefit analysis for yourself.

Is a twitching leg at night worth losing all your short term memory? Is a night of cocaine fun worth dying because you didn’t test it for fentanyl first?

We’re a drug happy culture, and I’m not against any drug, as I’m sure all of you know. But remember pushers have an interest in getting you on their drugs. This is capitalism.

And to be honest, illicit drug makers are FAR MORE ETHICAL than the pharmaceuticals. The NBOMe’s have kind of disappeared. So have some of the dangerous cathinones. When a recreational drug comes out and people start dying, we’ve seen a tendency for manufactures to stop selling them. The dark net these days is mostly filled with the good drugs. You used to be able to get anything. Now most of them have banned fentanyl, and the nBOMe’s etc.

Pharmaceuticals won’t do that. They will lie about their studies. They will coverup the dangers, so with pharmaceuticals you need to be even more vigilant.

The cartels of course are an exception when it comes to illegal drugs. They’re more like the pharmaceuticals than they are small underground chemists. That’s why fentanyl is more prevalent than ever. Despite the dark net markets refusing to allow them, and small-time chemists no longer making it, giant Chinese labs in cahoots with Mexican cartels are still flooding our drug supply with fentanyl. So test your fucking drugs for fentanyl. Get your testing strips at dancesafe.org.

sigh…

Memory… it’s so fucking important. I remember when I saw Sasha Shulgin for the l