Drug Rehab & Addiction News

Heroin abuse, addiction, and overdoses have all been rising over the last decade. New users of heroin have risen from 90,000 to 156,000 per year. The use of other drugs in the U.S. has dropped over the same time period. In addition to the overall increase in use of heroin, demographics are also shifting. Once a drug concentrated in the inner cities, heroin has spread to the suburbs and to rural areas. Today a heroin addict could be anyone of any socioeconomic status, age or race.

Who Is Using Heroin?

There was a time when you would be shocked to learn that an upstanding citizen and contributing member of society was hooked on heroin, but today the drug has infiltrated all areas of the country and all levels of society. According to one newsworthy profile, a woman who is a teacher and a mother living in Putman County, New York is also a heroin addict with track marks running down her arms. She admittedly came to work high on heroin and even used the drug in the staff bathroom during the day.

Another story tells the tale of a retired police captain moving his family from the city to the Chicago suburbs, hoping to distance his children from harmful influences. Instead of finding a more wholesome environment, his teenaged son was introduced to drugs and eventually overdosed and died from using heroin. He was not the only one among his teenage friends to meet that fate.

In Vermont, one of the most rural and sparsely populated states in the country, heroin use has reached epidemic proportions. The situation is so dire that the governor devoted an entire State of the State address this year to the issue of heroin abuse and overdose deaths. These are just a few of the stories demonstrating how the face of heroin addiction has changed over the last decade. You can no longer assume that all heroin addicts are inner city junkies. They are all around you.

What Accounts for the Rise in Heroin Abuse?

The shift in populations that use heroin and just how epidemic the problem is seem puzzling at first glance. There is a simple reason for the changes and it can be traced back to prescription painkillers. Narcotic painkillers are similar to heroin. They are both opioids, meaning they are derived from the opium poppy. They act in similar ways in the brain, produce the same kind of high and lead to the same devastating addiction.

For years, doctors have been prescribing narcotic painkillers in large amounts because they are good at what they are supposed to do: they control pain. The downside is that these medications are highly addictive and susceptible to abuse. With more prescriptions floating around and being passed and sold from one person to the next, many people became addicted. As the problem grew, doctors prescribed fewer narcotics and tighter restrictions were placed on these drugs. Those already hooked on them struggled to get the pills they needed.

Drug dealers had the answer for these narcotic addicts desperate for the next fix: cheap and available heroin. Heroin is now cheaper and easier to find than pain pills, so addicts naturally turned to this illegal drug to feed their habits. The drug cartels have seen an opportunity and have made sure to meet the demand with supplies of cheap heroin in cities, suburbs and rural states like Vermont. The face of heroin addiction has changed and unless steps are taken to treat these people and to prevent new addictions, the problem will continue to grow.

Read More About The Chronic Use Of Heroin Being On The Rise

At one time Oklahoma ranked number one in prescription drug abuse. After implementation of a statewide prescription drug monitoring program (PDMP) and the concerted efforts of lawmakers and law enforcement the state has moved down the list to number eight in the nation. But Oklahoma is not satisfied and continues to try and overcome the scourge of prescription drug abuse.

How Big Is The Prescription Drug Problem?

Last year in Oklahoma doctors and medical professionals wrote 10 million prescriptions for powerful opioid painkillers and other scheduled drugs. Those prescriptions were written to 142,369 patients, which averages out to 68 prescriptions per patient. Pharmacists filled those prescriptions with 597 million pills.

The detailed information is available thanks to the state’s PDMP, which electronically records the data. The hope is that doctors would look online before writing a prescription to see how often each patient has been given a script for heavy-duty medication. But reviewing the data it became evident that few doctors, just one-fourth, were using the PDMP prior to writing prescriptions for patients. Doctors are not yet legally required to check the PDMP first, but that could change.

Death Toll Rising

In 2012 there were 844 fatal overdoses in Oklahoma. That means that year more people died from drugs than were killed in car crashes, at 708. The majority of drug overdoses were accidental, and 75 percent involved prescription drugs.

The most dangerous prescription drugs in terms of overdose risk are opioids (e.g.: Vicodin, Lortab, OxyContin, Percocet), and the anti-anxiety medication Xanax. Too often people mix medications with alcohol, or take multiple meds at the same time. The stats show that two people per day are dying in Oklahoma because of prescription drug overdose. Deaths related to prescription drugs have risen 80 percent there in the past 10 years, and Oxycodone and Hydrocodone deaths in the state have quadrupled in that time.

The problem is most acute among 18- to 25-year-olds with a 10.9 percent abuse rate. Overall, 5.2 percent of Oklahomans over age 11 abuse the medications. Apart from the risk of fatal overdose, another concern about the epidemic of opioid abuse is where it tends to take people. Experts in the state say that around 85 percent of heroin users started out abusing prescription opioids.

Oklahoma is not unique. Across the country abuse of prescription drugs continues to claim a shockingly high number of lives. And where opioid use is beginning to drop, there is the selfsame increase in heroin use. Which makes it that much more important that we stop the problem before it moves to the street. We can monitor and prevent much prescription drug abuse through PDMPs. If we don’t, the problem will quickly transition to street drugs like heroin where monitoring and intervention is far less likely.

Read How To Prevent Drug Abuse In Your Teen

In recent years, two federal laws have guaranteed fair and equal coverage for mental health and addiction treatment. Those working in the field of addiction care are not so sure that the intent of those laws is really playing out in reality. People struggling with substance use disorders may not be getting the insurance coverage they need in order to get well.

The Federal Laws

In 2008, President Bush signed the Mental Health Parity and Addiction Equity Act. The law is supposed to ensure that health insurance plans are no more restrictive when it comes to mental health or addiction care than they are with other types of medical care. In other words, deductibles, co-pays and limits on treatment cannot be greater for mental health or addiction than anything else in the plan. The law does not require that plans cover these types of care at all.

President Obama’s Affordable Care Act added to the previous law by listing mental health and addiction treatment as essential benefits that must be covered by all health insurance plans, including those offered by small businesses and those for individuals. Prior to this law, most large company group plans included such coverage, but smaller plans often did not.

Equal Coverage Not So Equal

The two laws signed by Presidents Bush and Obama were intended to make sure that people needing care for mental health issues or for addiction would get the treatment they need. One of the biggest barriers to getting treatment has always been cost. If an insurance plan does not cover treatment, or if the restrictions on treatment are significant, someone who needs help may not get it. Those who are in the field of treatment for addiction are finding that the laws’ intentions are not always playing out as intended.

The National Association of Addiction Treatment Professionals conducts ongoing surveys and has reported that there are many denials of coverage for addiction care. Behind more than half of those denials is a debate over what is medically necessary. Unlike other medical conditions, like heart disease for instance, medical necessity for addiction is not always perfectly clear. The insurance plans need not cover care that is not deemed medically needed. Caregivers cite the changing laws as the reason insurers are getting tougher about what they will and will not cover.

One of the biggest battles over care for addicts is the number of days of coverage for residential stays. Many insurers want to cap the stay at a week or less, while addiction experts insist that patients need up to three months of treatment. Some insurers insist that treatment need not be inpatient care and that they will cover a few months of outpatient care. What is right for each patient, though, is highly individualized. Some may succeed with outpatient treatment, while others have nowhere safe to go and really need a long stay in a residential facility.

The changing laws regarding care for addiction and mental health represent an important societal shift in attitudes toward those struggling with these very real medical conditions. The shift is positive and the laws help, but there are still many bugs to work out. As insurers debate how to implement coverage that meets the requirements of the laws, addiction caregivers try to pick up the slack. It may take more time to ensure that everyone gets the help they need, but the changes so far are just not enough to reach everyone.

The National Safety Council (NSC) is a non-governmental, not-for-profit agency dedicated to promoting health and protecting life in the United States. The organization reports on and works to improve conditions in homes, at work and on the road. A recently published NSC report finds that drug and alcohol overdoses are the number one cause for accidental death in New Jersey – more than car accident fatalities.

Like the rest of the nation, New Jersey recognized the wave of prescription drug abuse and responded strongly. State, along with federal officials, clamped down on access to prescription drugs. Making prescription drugs harder to get was seen as one way to reduce fatalities.

How Is The Problem Being Handled?

While efforts to place tighter controls has been effective to some extent, in another it may have only renamed the problem. Limited access has led to the street value of pills costing somewhere around $40 a piece, so many people simply switched to heroin, which is from the same family of drugs as prescription painkillers. It’s more powerful and less costly than it’s ever been, allowing drug abusers to switch to heroin when prescription pills are out of reach.

Substance abuse experts say that around 800,000 people in the Garden State have a drug or alcohol problem, yet just 10 percent ever ask for help. One clear way to bring down the number of accidental overdoses is to do a better job of convincing citizens to get help to break free of substance abuse.

The NSC says that the surge in overdose fatalities combined with the number of falls by senior citizens makes New Jersey homes the number one danger zone. New Jersey is not alone, however. Alcohol and drugs were reported as the leading cause of death in 20 states across the nation.

Read How Depression Increases Risks For Drug Overdose

Like people addicted to a range of other substances, people addicted to cannabis (marijuana, hashish or hashish oil) can develop symptoms of withdrawal when their brains don’t receive the expected amount of the drug. The presence of significant withdrawal symptoms can potentially stop a habitual cannabis user from successfully discontinuing his or her drug intake. In a study published in March 2014 in the American Medical Association journal JAMA Psychiatry, researchers from several Australian institutions investigated the potential effectiveness of a multiple sclerosis medication, called nabiximols (Sativex), as a treatment for people going through cannabis withdrawal. Nabiximols is derived from certain types of cannabis plants.

I Thought Marijuana Wasn’t Addictive?

The American Psychiatric Association acknowledges cannabis withdrawal as a distinct and diagnosable mental health condition. People going through this form of drug withdrawal can develop symptoms that include a prominent urge to consume more cannabis, increased levels of anxiety, an unusually agitated or irritated mental state, a reduced ability to fall asleep or stay asleep and a reduced interest in food. As a rule, doctors consider officially diagnosing these symptoms when they substantially impair the day-to-day functionality of affected individuals or produce a notable decline in mental/emotional well-being. As of early 2014, there are no medications available in the U.S. designed to treat people affected by cannabis withdrawal.

Nabiximols

Nabiximols is an oral spray chemically extracted from flowers harvested from a cannabis species known as Cannabis sativa. Rather than using plants grown through usual methods (which can have highly varying amounts of THC and other active ingredients), manufacturers of the medication use plants cloned in tightly controlled conditions. Compared to the THC derived from smoking cannabis, the THC contained in nabiximols produces its drug effects more slowly and also reaches a lower overall peak inside the bloodstream. Still, the medication has a fairly rapid impact and typically triggers noticeable effects in 15 to 40 minutes. Together, these properties make nabiximols a potential option for treating people affected by the autoimmune nerve disorder multiple sclerosis. As of 2014, the medication is not available in America; however, Canada and several European countries have approved its use. Currently, pharmaceutical companies are seeking approval for use of the medication in the U.S. as a treatment for certain forms of cancer-related pain.

Potential Effectiveness

In the study published in JAMA Psychiatry, researchers from the University of Sydney, the University of New South Wales and several other Australian institutions used a monthlong project to assess the effectiveness of nabiximols as a treatment for the symptoms of cannabis withdrawal in people affected by cannabis dependence/addiction. Half of the 51 participants in this project received the medication for six days; the other half received a placebo that mimicked the appearance of nabiximols for the same amount of time. Four weeks later, the researchers conducted a follow-up examination of each participant in both the nabiximols group and the placebo group. This examination included a test (called the Cannabis Withdrawal Scale) designed to measure the intensity of withdrawal symptoms, as well as assessments of such things as length of stay in a treatment program, involvement in cannabis use after going through withdrawal and experiences with cannabis-related harm.

After comparing the two groups, the researchers concluded that use of nabiximols does contribute substantially to the general reduction of withdrawal symptoms in physically dependent cannabis users. Specifically, the medication helps lower the intensity of cannabis cravings and ease the impact of the mood alteration commonly associated with cannabis withdrawal. In addition, nabiximols use has a smaller but detectable impact on the severity of several other withdrawal symptoms. Compared to the study participants who did not receive nabiximols, the participants who received the medication also stayed in treatment longer during the project’s initial phase.

The authors of the study published in JAMA Psychiatry note that nabiximols apparently only helps extend participation in cannabis treatment during its active use. Once that use came to an end, the individuals who received the medication did not stay in treatment any longer than the individuals who received a placebo. All told, the study’s authors believe that their findings support the potential usefulness of the medication as a cannabis withdrawal treatment and point toward a need for additional research.

An opioid overdose is a situation that occurs when a person using an opioid drug or medication takes too much of the substance in question and experiences a serious slowdown or complete halt of certain critical body functions. Some people die from such an overdose, while others survive after receiving treatment. In a study scheduled for publication in April 2014 in the journal Mayo Clinic Proceedings, researchers from Harvard-affiliated Massachusetts General Hospital looked at the potential health outcomes for people who experience repeated opioid overdoses. These researchers also examined the factors that make repeated opioid overdoses more likely to occur.

What Are Opioids?

n addition to producing a pleasurable sensation called euphoria and diminishing the ability to feel physical pain, opioid drugs and medications slow down the baseline rate of activity inside both the brain and the spinal cord (known collectively as the central nervous system). If a legitimate opioid user or opioid abuser or addict keeps his or her intake within certain limits, he or she will experience only fairly modest changes in the function of these organs, which together produce and coordinate the nerve impulses required to keep the heart beating and the lungs inhaling and exhaling. However, if he or she takes too much of the opioid in question, central nervous system activity will fall below a critical point and the required nerve impulses will not be maintained. This dangerous and potentially lethal nerve signal disruption marks the onset of an opioid overdose. People who die from such an overdose typically experience an unsustainable decrease in their normal lung function.

The United Nations Office on Drugs and Crime lists a number of common contributing factors to an opioid overdose. These factors include widespread access to both legal and illicit/illegal opioid substances, the use of opioids in combination with other mind-altering substances, limited access to treatment options for people addicted to opioid substances and an increased susceptibility to the effects of opioids in people who relapse back into drug/medication abuse after a period of full or partial abstinence. All individuals who abuse opioids run the risk of experiencing a fatal or non-fatal overdose, whether or not they have an addiction to opioid use.

Repeated Overdose Consequences

In the study scheduled for publication in Mayo Clinic Proceedings, the Massachusetts General Hospital researchers used information gathered from close to 20,000 adult opioid users to assess the health consequences of experiencing more than one non-fatal opioid overdose. All of these individuals had survived at least one overdose event involving a legal or illegal opioid; 1,400 of them had survived two to five such events. Although they represented only 7 percent of the study participants, the survivors of multiple events represented roughly 15 percent of the total number of overdoses among the participants. After comparing the single overdose survivors to the multiple overdose survivors, the researchers concluded that the multiple overdose survivors are significantly more likely to require hospitalization to deal with the effects of their condition. Once hospitalized, they are also significantly more likely to require breathing assistance from a ventilator to stay alive.

Repeated Overdose Factors

The researchers concluded that several factors contribute to the likelihood that a person will experience more than one opioid overdose. These factors include having relatively few financial resources, having public health insurance rather than private health insurance, having a diagnosable case of substance addiction, having a diagnosable mental illness, having an illness that affects normal nervous system function and having a chronic lung illness. The single demographic category most likely to experience multiple opioid overdoses is middle-aged white men.

The authors of the study scheduled for publication in Mayo Clinic Proceedings note that first-time cases of opioid overdose also frequently result in hospitalization. People undergoing additional overdoses merely have a higher chance of being hospitalized. First-time victims of opioid overdoses also sometimes require the use of a mechanical ventilator. Again, victims of multiple overdoses merely have greater odds of needing this extreme medical measure. The study’s authors believe that their findings point toward a need to improve local, state and nationwide efforts to lower the opioid overdose rate. They also point toward a need for improved understanding of the factors that contribute to overdose in people using prescribed opioid painkilling medications.

Read About IV Opioid Users Show Interest In Buprenorphine Treatment

The FDA’s approval of a drug it says “will fill an important niche” in the treatment of chronic pain has caused a huge uproar over fears about its potential for abuse.

Zohydro was given the go-ahead in October 2013 for the treatment of moderate-to-severe chronic pain. Developed by the pharmaceutical company Zogenix, Zohydro is composed of an unmixed, undiluted 50-milligram shot of the opioid analgesic hydrocodone, which is the primary ingredient in the well-known and widely prescribed pain-relieving drug Vicodin. Zohydro is approximately five times more potent than Vicodin, however, and according to FDA Commissioner Dr. Margaret Hamburg, it will fill “an important and unique niche” in the crowded prescription painkiller marketplace. Zohydro was released in March, and all patients who receive a chronic pain diagnosis will now be eligible to obtain a prescription for this powerful narcotic.

But the FDA’s decision to approve the release of Zohydro was highly surprising, since its own advisory panel had voted 11-2 against approval. The medical authorities appointed to this panel cited the highly addictive nature of opioid medications as the rationale for their thumbs-down verdict. In the months that have passed since the Zohydro ruling, the criticism directed at the FDA has only intensified, and the agency has been forced to repeatedly defend a decision that many see as indefensible.

Addiction to pharmaceutical-grade painkillers has reached epidemic proportions, and the U.S. Centers for Disease Control has confirmed that opioids like OxyContin and Vicodin are the primary villains in this unfolding tragedy. Many medical professionals apparently came to view these drugs as panaceas and began prescribing them for all degrees of pain and a vast assortment of conditions, and, as a result, opioid addiction rates exploded. Since Zohydro is just a turbo-charged version of Vicodin, it is likely to be far more addictive than its milder cousin, and many medical experts believe it is the height of folly, if not downright hypocritical, for the government to be putting such a potentially dangerous substance into circulation at a time when the fight against prescription drug abuse has just begun to pick up steam.

In September 2013, the FDA announced it was actually tightening label restrictions on opioid painkillers, recommending that physicians use them only with patients who needed round-the-clock treatment for chronic pain and when there were no other viable treatment options available. This action was unequivocally justified as a strategy to combat addiction, so observers were taken aback when only one month later the FDA chose to approve a drug that threatens to accelerate the opioid addiction problem.

Critics of the FDA’s decision launched a campaign to convince the organization to change its minds, and representatives of more than 40 influential healthcare/addiction treatment organizations signed and submitted a letter to the agency that outlined the dangers of adding Zohydro to the menu of available opioid painkillers. But this ardent plea from the experts was to no avail, and the FDA steadfastly refused to reverse its puzzling course.

The (Evil) Genie in the Pill Bottle

The FDA is often accused of having an overly cozy relationship with big pharma and big agriculture, the industries it has been tasked with regulating, and this decision to legalize a new narcotic painkiller despite the negative judgment of its handpicked medical advisors would seem to represent a triumph of favoritism over sensible public policy. In response to what many see as an outrage, separate bills have now been introduced in the House and Senate that if passed would compel the FDA to remove Zohydro from the marketplace.

Compounding the situation, later in the year the drug giant Purdue Pharma will release another single-ingredient/high-dose hydrocodone painkilling drug, in a tamper-resistant form that may render Zohydro obsolete. This company already sells a tamper-resistant version of OxyContin, which allegedly cannot be crushed or dissolved for chewing or snorting and therefore is not supposed to be as addictive (chewing or snorting opioids delivers a more concentrated dosage to the bloodstream). A less malleable form of mega-jolt hydrocodone would presumably offer the same advantages, and the folks manufacturing Zohydro would likely have to switch to a tamper-resistant form themselves if they expected their drug to survive.

But addiction treatment specialists dispute the notion that making addictive drugs harder to alter makes them less dangerous. They note that virtually every person who has become dependent on opioid painkillers started out swallowing pills and only later resorted to chewing or snorting when their substance abuse problems raged out of control. Nevertheless, many fear the positive PR that tamper-resistant technology has received may help to defuse some of the opposition that this new class of drugs has generated, assuming they do eventually show up on the marketplace in this more “respectable” form.

Read How Big Pharma Is Testing Super Painkillers

Prescription drug abuse is a major problem across the U.S. and for people of all age groups. Teens, however, are particularly vulnerable and if you have children you should be aware of the risks and dangers. There are two main kinds of drugs being abused by young people: narcotic painkillers and stimulants. The former are used to get a high, but the latter are often abused as a study aid. Stimulants, like those used to treat ADHD, produce wakefulness and many teens use them to stay up at night for studying.

The statistics regarding teen abuse of prescription drugs are alarming. Since 2008, abuse has risen by 33 percent. The statistics also show that most young people do not believe there are any risks in abusing prescriptions and that parents are largely ignorant when it comes to their children’s abuse of these drugs as well as the risks. Learn how to keep your teen safe.

 Where Do Teens Get Prescription Drugs?

The first line of defense against abuse of prescriptions by your teen is to limit her access to them. So where are teens getting these medications? The most common location for teens to find prescriptions is the medicine cabinet. Teens get drugs right from their own homes. If they can’t find them there, they turn to their friends’ medicine cabinets. Many people are prescribed narcotics and stimulants, so finding them in homes is not difficult.

If the drugs cannot be pilfered, your teen can most likely buy them. Buying and selling prescriptions in high schools are common. Your teen may also be able to purchase medications online. Illegal pharmacies will not hesitate to sell to a teen.

How Can I Limit My Teen’s Access To Prescriptions?

With prescription medications so prevalent in homes, at schools and online, you need to be especially vigilant to restrict your teen’s access. If you have prescriptions in your home, keep them in a locked cabinet. If your teen has been prescribed one of these commonly abused medications, keep it locked up and dose it out to her as directed by her doctor. A common source for stolen medications is expired pills that have been forgotten or thrown in the trash. Be aware of your unused drugs, keep track of them and dispose of them properly.

Unfortunately, limiting your teen’s access to drugs at home is where your control ends. You cannot control her access at school or at friends’ houses. What you can do, though, is educate your teen about the risks and dangers of drug abuse. First read up for your own knowledge and then talk to your children about how harmful prescriptions can be. Although they are legal and prescribed by doctors, these factors do not mean they are safe for everyone.

It is also important to educate your family and friends about prescriptions and keeping them under control. Your teen may be able to find drugs at a grandparent’s house or any other family member’s, but if everyone kept tighter control of their medications, fewer drugs would end up on the black market.

Finally, it’s important that you maintain a close and open relationship with your teen. The more time you spend interacting and talking, the more able you will be to detect when something is wrong or if she is showing signs of abusing drugs. This healthy relationship will also mean that your teen will be more likely to come to you with questions, concerns, and problems related to drugs and drug abuse.

Find Out How You Can Help Your Teen Resist Peer Pressure