WHAT’S KEEPING YOU UP NIGHTS?

By SHAGORIKA EASWAR

With files from NEWS CANADA

I don’t do well with calls from India at five in the evening our time. I see the name on the call display and my heart thumps – it can’t be good news at what is 3:30 in the morning for my cousin.

Turns out it isn’t, but not of the kind I fear. She can’t sleep. And the only person awake she can talk to at this hour is me, wide awake on the other side of the world. After ascertaining that there are no underlying health issues and no overt causes for worry, I am stumped.

Why can’t she sleep? It’s a whole lot of things and nothing, my cousin sighs. Little things that assume scary proportions in the middle of the night. Stress about her job. Exhaustion from looking after home and an ageing mother-in-law while working from home. Anxiety about rising cases of COVID-like infections which remind her of her son stuck in a lockdown in another city when the pandemic was at its peak.

Try reading a book, I suggest. Or a warm bath and a glass of warm milk before bed. A walk in some fresh air. Or meditation. Try cutting down on screen time before bed. She dismisses all my helpful suggestions. Nothing works, she insists. “Now not even the tablets help,” she says.

I am suddenly on high alert. What tablets?

The ones she takes to “calm her nerves” she informs me, in a matter-of-fact tone. Over that long conversation and several others that follow, all at unearthly hours for her, I am unable to convince her that self-medicating with over-the-counter stuff is perhaps not the best way to deal with stress.

That wouldn’t be allowed here, I tell her confidently. And then I see an ad for ointments and sprays for pain relief with cannabis sativa oil – available without prescription. They list natural ingredients such as eucalyptus, menthol and camphor that make it sound like your desi grocery staple pain balm. But they are also infused with cannabis sativa seed oil.

There is another product that helps people sleep which claims to be natural and non-habit-forming and which contains ingredients used in herbal medicine. Except that the extract is from Eschscholzia Californica, which is nothing but the California poppy!

I know people are divided into opponents and proponents of cannabis, but whichever camp you may belong to, do we really want to be dispensing stuff without knowing how it will affect people years later?

I recall the time a popular paediatrician in Bombay prescribed Piptal drops for my son to help prevent colic. Instead of calming him, however, it seemed to have the exact opposite effect. Not only was he still crying with pain, he was bouncing off the walls. Back we went to the good doctor who said one in so many thousand babies react adversely to it – or words to that effect.

I looked up Piptal while writing this and found that it is listed as having no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.

The doctor was neither irresponsible nor ill-informed. She prescribed what was then a popular cure for colic in babies. The current info on it was probably not available then. I am willing to give her the benefit of the doubt because no lasting harm came to my son. As a panicked, first-time mom, I called my mother for help. She asked me to try giving him sips of water infused with saunf (fennel seeds) to help with the gas. I did, and it worked like magic. But the outcome is not always so benign.

To put the problem in perspective, with 21.5 million opioid prescriptions dispensed in 2016, Canada is the second highest per capita consumer of opioids worldwide. Hospitalizations related to opioid overdoses now account for more than double the number of those resulting from car accidents.

Here are three things you can do to help a family member or friend:

Know who is at risk. Anyone who uses opioids (prescription or otherwise) including young people that are prescribed opioids for a number of reasons such as dental surgery or sports injuries can be at risk of an accidental overdose. Also, older adults experience higher rates of chronic pain and disease than the general population and are therefore routinely prescribed opioids to deal with pain associated with conditions such as arthritis and cancer. This may help explain why they have a higher rate of hospitalizations due to opioid poisoning than any other age group, according to a recent report.

Misuse of medication, confusion surrounding dosage and mixing prescriptions are some of the risks of opioid use. If there are opioids in your home, everyone who lives there or visits there is exposed to some risk. One in 10 students report taking an opioid without a prescription – higher than the number of students reporting having taken other drugs such as cocaine or methamphetamine. Furthermore, a recent study showed that approximately 55 per cent of young people who reported taking someone else’s prescription opioid said they found the drug at home from a parent or sibling.

Learn the signs. An opioid overdose can look like slowed or stopped breathing, deep snoring or gurgling sounds, dizziness and confusion, passing out, inability to be woken by touch, slowed to no heartbeat, skin colour changes and pinpoint-sized pupils. If you suspect someone is suffering from an overdose, call 911 immediately.

Carry a naloxone kit. Most pharmacies across the country can provide you with a naloxone kit, and in some provinces you can even get the nasal spray and injectable versions of naloxone for free. Your pharmacist can train you quickly on how to use the kit and respond to an overdose. Talk to your local pharmacist about getting a naloxone kit so you’ll be prepared to help someone when they need it.

Our lives are stressful enough on many fronts. Throw in the high rents, job insecurity and what have you and anxiety can skyrocket. However, there are options to self-medicating. Remember that we all react differently to medication, and we don’t know who will become addicted to a painkiller or a sleep-inducer until it is too late. Talk to your physician, to family members and friends who know you and care about your health and welfare.

You don’t have to lie awake at night.