Tag Archives: California Drug Problem

How One Town is Attacking the Opioid Epidemic and Succeeding

Dayton, Ohio, is one of the worst hit states by the opioid epidemic, but it’s also a town fighting to save lives with everything it’s got, and it sounds like the town has a plan that other cities and states can learn from. A November article in The New York Times (This City’s Overdose Deaths Have Plunged. Can Others Learn From It?) states that “it may be at the leading edge of a waning phase of an epidemic that has killed hundreds of thousands…in the U.S., including nearly 50,000 last year.” But now, deaths from overdoses are down more than 50% from last year.


This seems to be one of the few hopeful articles about the opioid problem, saying that all opioid deaths are decreasing, according to the CDC. Here’s how this town is doing it.


First
, the governor’s decision to expand Medicaid three years ago means that more people are able to receive free addiction and mental health treatment (and more than 12 treatment centers have opened as a result. Let’s hope they’re good.)


Second
, there is greater support available in the town after treatment, including tons of recovery support groups and the availability of (and training for) peer support personnel. In addition, teams comprised of social workers, police officers, medical personnel, and those in recovery visit people who have recently overdosed to try and persuade them to enter treatment.

Opioid Epidemic


Third
, Dayton has blanketed the city with Naloxone. The police chief is adamant that his staff carry it, unlike some of his peers in other cities who view administering Narcan as enabling. He sees it as a harm reduction tool that will help him achieve his goal of saving as many lives as possible.


Fourth
, Carfentanil (similar to fentanyl, a synthetic opioid 10,000 times more powerful than morphine) is not being found as frequently in overdoses. A DEA agent theorized that perhaps “traffickers realized how much of its base it was killing.”

Fifth, the police and medical workers agree with each other on an approach and are working together. The police often believe in “a punitive, abstinence-only approach to addiction,” while the medical community wants to eliminate deaths by any means possible. In Dayton, the chief supported a syringe exchange program (which was dropped in Santa Ana, ironically), and got a federal grant to distribute fentanyl test strips to check for fentanyl similarities in other medications.


You wonder: Would these steps work in cities the size of Philadelphia or San Francisco? And/or, there are enough smaller towns with a similar problem — couldn’t some of these steps be tried there?

A recent study shows what can happen when medical professionals don’t take every opportunity to help. These professional can be another part of the solution, at least when people start on opioids for pain relief and then become addicted. Researchers at the Washington State University College of Nursing studied a group of ten who fit this profile to answer two questions: How do people with chronic pain move from appropriate use of opioids to addiction? And what prompts them to seek drug addiction treatment?

Part of the reason for the study was that not many people had looked into these questions. It’s
not a large study, but all of those involved fell prey to cravings and then found they were dependent on the pills.

Many of the study participants said their medical professionals could have helped them identify their addiction and get into treatment but instead they felt the providers seem to judge them, didn’t believe them when they complained, or didn’t take their pain complaints seriously. The researchers said the patients’ “most challenging relationships” were with the healthcare workers they dealt with, and what’s needed is more compassionate, nonjudgmental care.

It would be helpful if this study could hit as wide an audience as possible.

If you need additional information about drug rehab in California and any other state, you’re welcome to call Summit Estate professionals at (866) 569-9391.

San Francisco vs. Philadelphia Substance Abuse

There are numerous American cities that stand out for certain characteristics. Madison, Wisconsin as a great place to bike. Cooperstown, N.Y., for the National Baseball Hall of Fame and Museum. Asbury Park, N.J., as the town where Bruce Springsteen got his start. The list goes on and on. Recently, San Francisco and Philadelphia, on opposite coasts, were characterized as standing out for similar reasons: the devasting consequences of addiction. 


In San Francisco, for example, an area of Hyde Street has “an open-air narcotics market by day and at night is occupied by the unsheltered and drug-addled slumped on the sidewalk.” Twitter, the article notes, is only a 15-minute walk from there, and other giants of the technology industry are not far away. (Note that the previous blog post dealt with substance abuse in Silicon Valley, not far from the San Francisco area in this post.)


San Francisco’s “persistent homelessness” is a big problem for such wealth so close to it, and a large part of the homeless are the drug dependent. There are hundreds upon hundreds of heroin needles lying around, along with the people who shoot up. The dealers and users are known as “the street people,” or the street population. One resident said it’s like “the land of the living dead” and accuses the city of allowing a containment zone so that the devastation doesn’t spread. The police say the drug trade is their most significant issue.

Substance Abuse

The problem is so dire that in August, San Francisco health workers walked the streets to find opioid users and offer them Suboxone prescriptions, according to another article. The recipients can get the medication the same day. “At the end of a recent yearlong pilot, about 20 of the 95 participants were still taking buprenorphine under the care of the street medicine team.”


It’s estimated that 22,500 people “actively inject drugs,” and the San Francisco medical director said there’s a strong trend of people using both meth and opioids in the city, which is really difficult to treat. But the goal of going to the streets to find users is to reduce the number of deaths.

 

Almost three thousand miles away, Philadelphia is known far and wide as “the largest open-air narcotics market for heroin on the East Coast” and so it draws people from “all over,” according to an article that appeared in the New York Times magazine last October. In one neighborhood known as Kensington, which actually takes in other areas as well, dealers hand out free samples with impunity and those on drugs are using them in the open or are already passed out. It’s known as the Badlands and supposedly has the purest heroin in a three-state area.

The author rode through the area in 2017 with a special agent with the D.E.A. According to her description, it looks like the apocalypse hit there – “Houses transformed into drug dens, factories into spaces to shoot up, rail yards into homeless encampments.” Sadly, the largest provider of drug treatment programs in the Bay Area is the prison system.


There’s history behind why this neighborhood is the way it is, starting with the fact that it had cheap housing, and once people moved in and a drug haven started springing up around them, they didn’t have the money to leave. That story, and the individual stories, go on and on, and it’s just so sad. Kind of like San Francisco.  Last January the governor signed a statewide disaster declaration—a public health emergency—to take concrete steps to try and address the devastation.


In the comments that appeared after the article, a San Francisco resident wrote in to say, “The article has allowed me to see how intractable our own ‘homeless’ problem in San Francisco will be without first addressing the drug epidemic….[It] shows what a death sentence heroin is, both for the users and for the community that the users (and pushers) inhabit. Why do we as a civilized, supposedly advanced society allow this?”.
 
If you need additional information on this matter or about Summit Rehab  plans, please call us at (866) 569-9391.

Silicon Valley Substance Abuse Redux

Do the West Coast papers cover drug use in Silicon Valley to the extent that other publications do? Because it certainly seems to pop up in other media. Take microdosing, as an example. It’s a valid way to study the effect of a new medication on the body more safely than administering a full dose, but workers in the Valley are microdosing LSD, saying it makes them more productive.

An internet search on “microdosing + Silicon Valley” turns up articles in at least two publications (Forbes was writing about it as early as 2015) and on several websites:  Business InsiderHuffpostMedium, and The Independent and Wired from the U.K…but it took going to the SFgate website and searching to find an article on Silicon Valley and microdosing.

This Summit Estate Recovery Center blog first wrote about drug use in Silicon Valley last winter (2018), and it’s important enough subject to revisit it. At the end of the summer, a contributing writer for The New York Timeswrote an opinion article about a recent visit to the Valley and what she found. There are online and hardcopy headlines: “How and Why Silicon Valley Gets High” and “Turn On, Tune In, Start Up.” The writer had lunch with a couple entrepreneurs there, which were sad upates on the current state of affairs there. One lunchmate told her “that magic mushrooms will help …[her]  become a better reporter … and … that Ecstasy will make …[her] a nicer person.” Seems he also suggested she try ayahuasca, a “brew made from plants that includes the hallucinogen DMT”. Soon afterward she learned that Tesla’s board was worried about company founder Musk’s admission that he has occasionally used drugs.


This was just before the popular Burning Man gathering, and she associated the festival with the use of ketamine. It sounded like that put her over the top:

“I spoke to just over a dozen people who all said consumption was increasing once again. Obviously, there are major problems with addiction to opiates and alcohol here, as elsewhere. But people in Silicon Valley tend to view drugs differently from those in places like, say, Hollywood and Wall Street. The point is less to let off steam or lose your inhibitions than to improve your mind.”
Silicon Valley

She quotes a tech worker as saying “It is all, about the ‘intellectualizing of drug use as a stimulant for the brain’ and refers to Michael Pollan and his book, “How to Change Your Mind,” about the resurgence of psychedelic drugs. He told her that “the exploration of drugs by tech workers remains part of the industry’s ‘hacking ethos’.”


A number of people commented on her article on their own blog. One wrote, “This is what you get when ordinary men aren’t calling the shots: society thinks nothing of pressuring unsexy men to work 200 hours a week, shooting up whatever drugs are needed to make Executive Chad’s arbitrary deadlines, using frickin’ hallucinogens for inspiration and friendship.” I won’t link to the post because he also makes misogynist comments and derogatory comments about one ethnicity.


The article itself had 229 comments on the paper’s website. Here’s one: “Is it any surprise that the gurus of AI and ‘the singularity’ would be taken in by pharmaceutical transcendence? Intelligence without thinking, ‘social media’ instead of culture, spiritual depth in a pill–it’s all about what sells, not what works. It would be funny if the world were laughing instead of throwing money at them.”


And here’s another: “I have always thought (and personally believed) that to expand one’s mind, first the person had to expand their empathy for all others. If you need a drug (natural or synthetic) with your sole purpose … to achieve some type of nirvana that will lead to you pushing yourself above another, then that sort of defeats the purpose, doesn’t it?”


You wonder about the future for these companies and their employees. Will things every change there? What will it take to turn it around? How do you change drug culture embedded in so many tech companies? How do you reach the hard-driving people at the top who are part of the problem if not the whole problem? And what about the individuals who are hurting themselves and their loved ones? What happens to them?

New Opioid and Fentanyl Strips Have Advocates and Critics

Dsuvia

There’s a new opioid in town called Dsuvia. It’s been all over the news lately, and it’s controversial.  An NBC News headline proclaimed “FDA approves powerful new opioid in ‘terrible’ decision.” The FDA was also accused of bypassing its own advisory process to approve the drug.

This drug, which is 1,000 time stronger than morphine, is usually given in IV form. This new formulation is a tablet taken sublingually and is to be used only in health care settings such as hospitals. According to the NBC article, it’s commonly used on the battlefield and similar emergencies “to treat intense, acute pain.”. It was actually the military that requested the pill formulation.

In the middle of the opioid crisis, the obvious question experts are asking is do we really need another opioid? Two criticisms are that there may be more deaths from overdosing with this drug, and health workers in confined health settings may find it easy to steal it. The FDA, however, says it has learned from the opioid crisis and has tightly restricted Dsuvia. It will not be available at pharmacies or for home use, the package is for single-use only, and it should only be used for 72 hours tops.

Side effects, not surprisingly can be horrendous: fatigue, possible breathing problems, and even coma and death. The cost will be $50 to $60 per pill.

Fentanyl

Test strips for Fentanyl

At the same time as a new opioid has been approved, there’s a new “tool” in the fight against opioid overdoses, according to several media outlets — a strip of paper that can test for fentanyl in batches of heroin. In October, The Atlantic reported a recent study found that drug users who employ them as a precaution before ingesting opioids or cocaine can possibly avoid overdosing.

Fentanyl is 50 times stronger than heroin and has been found in at least half of overdoses now. (As indicated, cocaine is often laced with fentanyl as well.) Researchers posit that if more people with substance use disorder had access to the strips, “they’d use less, or possibly not use … at all.” A YouTube video made by the Associated Press shows that when the strip is dipped into a drug, the appearance of two red stripes signifies fentanyl is present, and one stripe means it is not.

As we know, some states, and even cities, are more progressive than others. “… Baltimore; Philadelphia; Columbus, Ohio; and Burlington, Vermont—have started providing the test strips alongside clean needles. The California public-health department pays for the distribution of strips through needle exchanges.” Leave it to California to lead the way. 

However, some health agencies have questioned  the accuracy of the strips and whether or not a person would actually not take drugs they have right in front of them. Also, some experts want to see more research done.

There’s an obstacle as well: Some areas have “paraphernalia laws” that prohibit the use of devices to aid in doing drugs, except clean syringes, so these laws need to be amended to exempt test strips as well. 

The cost may also deter some users. Each strip costs $1.00, and users take drugs on average four times a day, so it’s not a cheap aid for people who don’t have money.

 

Diversion Programs Instead of Jail

The justice system has become a lot more just lately when it comes to people suffering from substance use disorders by offering diversion programs that allow people who abuse drugs and commit crimes to avoid jail time by attending treatment and engaging in long-term monitoring. Certain professionals such as police, doctors, and lawyers have their own way of offering support to those willing to accept help.


Pilots in the throes of addiction are another group that has benefitted immensely from caring colleagues.
Larry Smith, a former commercial pilot for Braniff and United Airlines who was addicted to several substances received incredible support from United Airlines, the FAA Medical Division, and the program for pilots called HIMS (more about that later). Today he is CEO of Get Real Recovery in San Juan Capistrano, CA, an FAA-approved treatment center he co-founded with his wife Lori in 2011.

In 2008, the Office of Aerospace Medicine of the FAA produced a report titled Drug Usage in Pilots Involved in Aviation Accidents Compared With Drug Usage in the General Population: From 1990 to 2005. It mentions a long list of drugs that pilots were using during that time, but what’s also scary is knowing that the report deals only with pilots involved in accidents. You wonder how many other pilots flew under the influence that weren’t involved in accidents.

Larry’s story is mesmerizing. In 1983 he received a DUI, although he was a furloughed pilot at the time. He received a second one that was reduced to a charge of reckless operation without alcohol. Larry now openly admits it should have been a DUI. He thought it was clever how he was able to duck under the radar for so long. Most alcoholics and addicts suffer from extreme denial, he says, and he was no different. Larry teaches that denial is the brain’s defense mechanism to protect the perceived right to use, not a character defect.  Addicted people will use every type of denial possible to avoid being detected. They hide their pain and self-disgust with charm or anger, whatever is necessary. Larry sees himself in others at every intervention, counseling session, and group that he facilitates.

Diversion Programs Instead of Jail

 Larry’s addiction to alcohol started in 1965 at 14 years old. He started using cocaine occasionally in the 1980’s, and by 1998 he advanced to smoking crack. “I recognized I had a serious problem then, but I didn’t know what to do,” he recalls. He was afraid to turn himself in to the EAP or HIMS programs as he mistakenly thought he would be immediately fired if the truth about his chemical dependencies was exposed. 

 On February 3rd, 1999, a vice squad of 12 masked men with shotguns and riot batons used a battering ram to invade his home in Ohio. His arrest quickly made the national news. Smith was released from jail on February 5th and received a call from his chief pilot. He thought he was going to be fired, but instead, his boss offered him treatment. His first treatment center was too lenient with clients, so United’s EAP transferred him to Cornerstone of Southern California.  He admits now, “I wasn’t a model patient; nevertheless, I fell in love with recovery!”

Nine months later Smith flew a 747 from SFO to Kona with 400 passengers on board. He gives all the credit to God and a forward-thinking airline. The FAA, United’s EAP and Management, an Aviation Medical Examiner, a psychiatrist and the Pilot’s Union (ALPA) all closely monitored Captain Smith’s progress for 5 ½ years. During this time, Larry became a licensed counselor and started speaking on addiction and the hi-jacked brain. Immediately after being released from FAA Monitoring, he spent eight years as a volunteer Union Rep to United Airlines EAP. Then and now, he guides and counsel pilots who abuse alcohol and drugs.

 As the HIMS website explains: “The HIMS program was established to provide a system whereby afflicted individuals are treated and successfully returned to the cockpit under the FAA Special Issuance Regulations (14 CFR 67.401).”

It’s rigorous:

“The purpose of the HIMS program is to effectively treat the disease of chemical dependency in pilot populations in order to save lives and careers while enhancing flight safety. The HIMS concept is based on a cooperative and mutually supportive relationship between pilots, their management, and the FAA. Trained managers and peer pilots interact to identify and, in many cases, conduct an intervention to direct the troubled individual to a substance abuse professional for a diagnostic evaluation. If deemed medically necessary, treatment is then initiated. Following successful treatment and comprehensive continuing care, the pilot is eligible to seek FAA medical re-certification.

The FAA requires the pilot to be further evaluated by a specially trained FAA Aviation Medical Examiner (AME) who then acts as the Independent Medical Sponsor (IMS) to coordinate the FAA re-certification process. The medical sponsor provides oversight of the pilot’s continuing care. This care includes a monthly interview by a trained flight manager and by a pilot peer committee member, as well as periodic follow-up observations. Because of the relapse potential of chemical dependency, the monitoring will typically continue for several years after the pilot resumes his duties. The HIMS program is designed to ensure the pilot maintains total abstinence and to protect flight safety.”

Larry explains some of the challenges pilots face this way: “Pilots are great at following directions, like the checklist we give them in recovery, but they’re not so great at processing what’s within. We find that some had trauma in their early life. For example, some were at war, and some grew up with rigid fathers and co-dependent mothers and so forth, and counseling helps them see what may have caused them to drink and help them get out of their own minds.”

In 2010 he wrote The Daily Life Plan Journal, a goal-setting journaling guide for people in recovery to be able to simply draw lines on airplane-like gauges to assess their feelings and emotions. For example, instead of asking them to mark their flight level, they’re asked, What is your motivation level “right at this moment?” It’s an effective way to journal for people who don’t like to write or have difficulty expressing themselves in writing. This journal allows a person to simply put pen to paper and measure their feelings by drawing a line. 

In addition, he wrote a book about overcoming addiction called Flight to Transformation. The book is part memoir and part a strongly spiritual walk through recovery. He’s also expanding his treatment knowledge to include MAT–Medically Assisted Treatment, and the use of Stem Cells in recovery.

Taking Drugs on the Job

With all the evidence available, there’s no denying some employees have used drugs while working, whether they shot up in a restroom, or popped a few pills at their desk, for example. An article in The New York Times holds that  ”As the opioid epidemic continues to rage…, the fallout is increasingly manifesting itself at construction sites, factories, warehouses, offices, and other workplaces.”

An earlier post on addiction in Silicon Valley mentioned that substance abuse in the workplace took place in offices there as well. But this article focuses on a construction worker, an employee in an industry that has been found in the past to have one of the highest rates of addiction of any field. Today it has “the second-highest rate of pain medication and opioid misuse after the entertainment, recreation and food business,”  according to the article, and construction workers also have “twice the addiction rate of all working adults.”

According to an 11-year old survey by the National Safety Council, at the time, 70 percent of employers said that prescription drug abuse had affected their businesses, relating to absenteeism, injuries, accidents, and, of course, overdoses even then. Understandably, there were positive drug tests as well.

Taking Drugs on the Job

The construction worker in the article has overdosed on the job several times, and was revived with Narcan by a coworker at least twice. He never went to rehab, until he was fired and returned to his hometown. He joined the local construction union, which was a lifesaver. He had an outstanding arrest warrant which proved troublesome in getting him into a program, but union officials talked a judge into letting him serve his time in rehab. So far, he has been clean and is working, thanks to his union.

The current statistics are not good: in 2016, 217 workers died from overdosing on alcohol or other drugs at work, which was a 32 percent increase from 2015. Overdose deaths in workplaces have increased every year since 2010. That includes someone at Fiat Chrysler Automobiles, a crawfish fisherman in Louisiana, and a Sam’s Club warehouse worker in Texas. The guy down the street in your neighborhood, the man sitting next to you on the bus, or the father of a boy on your son’s little league team.

The article reports that few businesses are willing to acknowledge the drug use at their company. Yet certain enterprising business people do and are willing to help, like Alan Hart, president of Giovanna Painting in Spencerport, NY.  Maybe it has something to do with the fact that he’s in recovery himself. He tries to help workers enter rehab, although he doesn’t offer employees health insurance. He also fires workers he suspects of abusing drugs while working.

It would be naïve to think drug use doesn’t go on in the workplace, and just like addiction can hit anyone, so drug use can appear in any business.  Perhaps you heard of the teacher who OD’d in a school bathroom and died, although his wife had no idea he was on drugs. The news traveled as far as the United Kingdom.

In the corporate world, perhaps disseminating more information about Employee Assistance Programs would help. (For that matter, a comparison of programs would be a good thing, along with what laws mandate as far as offering employees treatment.) In addition, perhaps there should be guidelines for what employees can do if they suspect a co-worker of taking drugs, not as a punitive measure, but to try and address the problem. And of course, Narcan could be made available in workplaces. At least companies could discuss these approaches and others.

 

Helping Addicted Inmates

The number of people suffering from substance use disorder who likely think they won’t end up in jail is probably large—especially if they have good jobs. They never think it will happen to them. But it can. As a recent episode of the TV program Dopesick Nation showed, even formerly responsible citizens may find themselves stealing, forging prescriptions, and so forth to support their habit.

 You may have heard we’re not doing nearly enough for substance abusers who end up in jail. But there are a few programs around the country that seek to help these people, often in small towns, that can serve as examples for other towns. Here are a few.

Peer recovery coaches in NJ

 In one NJ town, certified peer recovery specialists are volunteering to work with those suffering from substance use disorder who are incarcerated. In a new program called Next Step, the volunteers are called coaches, and they help to steer prisoners into treatment.

Bail reform in certain areas of the country means that nonviolent offenders are being released earlier, and for addicts, that usually means without treatment or the offer of treatment. (And many [most?] likely got little help in jail.) Although it’s too soon to comment on the program’s success, shortly after the program was instituted at the jail, nearly half of those screened entered treatment.

One of the county prosecutors noted that when people are sent to jail, it’s often their lowest point, a good time to try and convince them that treatment may save their life. Several local organizations have stepped up to provide clinical assistance, including a social services organization helping inmates find jobs, a recovery center, a peer recovery organization and a hospital.

 Having a peer in recovery work with an incarcerated person is another tool in the toolbox to help someone get healthy and return to society.

Helping Addicted Inmates

The Start Strong 3 E’s in Kentucky

There’s a new treatment program in the detention center in Kenton County, KY, in which inmates are expected to be “Employed, Enlisted, or furthering their Education,” 12 weeks after release, according to the program director. The key in this area, which has suffered greatly in the opioid addiction crisis? The jail is partnering with Aetna Better Health and getting help from the Hazelden Betty Ford Foundation.

 The concept involves giving medication not only to quell cravings or ease withdrawal symptoms, but to stabilize patients getting therapeutic care in jail. They will then have the option to stay with medication assistance during and after their incarceration, according to a local TV station. And, luckily for these inmates, there’s an aftercare program with intensive job training.

Vivitrol and Counseling in Central New York State

In Onondaga County, NY, addicted inmates are given the opportunity to have injections of Vivitrol and attend counseling sessions. According to the Vivitrol website, the medication “is a non-addictive, once-monthly treatment proven to prevent relapse in opioid dependent patients when used with counseling following detoxification.”

Chicago’s Thrive program

Inmates suffering from substance abuse in a Cook County jail who are not in the drug court program are being offered naloxone on release and will be monitored “in a modified version of the sheriff’s electronic monitoring program.” (For example, caseworkers who worked with one woman on the inside will continue to work with her once she’s released.)

Other programs, in Indiana, Orange County, Florida, and Cincinnati, Ohio and Kings County, California, to name a few, show that a number of jails realize they can contribute to finding solutions to substance abuse in this country. Whether it’s to offer Suboxone, Naltrexone, Vivitrol, peer coaches, and counseling and job training, or a combination, these programs can serve as a blueprint for other jails.

 

Substance Abuse and the Legal System

How Many Chances Should a Drug User Get?

Recently, a letter to the editor in a newspaper from the managing director for policy at the Drug Policy Alliance asked the rhetorical question above. He’s a psychiatrist with a background in public policy and bioethics, and he wrote to the paper after reading that a patient with endocarditis was denied necessary surgery because of intravenous drug use. He called it abandoning a patient. Endocarditis, an infection of the heart, is life-threatening but treatable. Just as drug use has been compared to having cancer—a disease that we treat even if the person has smoked, when smoking is a known carcinogen—the psychiatrist argues that a known drug user shouldn’t be denied care. Should someone with a second heart attack be sent to hospice instead of being treated, just because he didn’t take his medication after the first one, he asks? He notes that several illnesses are accompanied by behavior that is self-destructive. And when the writer asks about how many chances drug users should get, he answers his own question: “The same number as a smoker with cancer, a drunken driver in an accident, and a father after a heart attack. The same number you would want for your loved one.”

Felons Becoming Lawyers

There’s one area in which the legal system is surprising a number of people—allowing former drug addicts who have been incarcerated to become lawyers. Yes, you read that right. If you watch 60 Minutes, you may have seen the segment where a man robbed banks, spent years in prison and went on to become one when he was released. But Tara Simmons seems to be one of the first people suffering from substance use disorder to get her law license. As an article about felons becoming lawyers explains, “Whether people like Ms. Simmons should be allowed to practice law is a hot question these days. Acceptance for those with less-than-impeccable pedigrees seems to be rising.” Ms. Simmons had to appeal after her application to even take the bar exam was rejected. And even if you pass in a similar situation, it may be difficult to be sworn into the bar. A former cocaine trafficker who did time spent $25,000 “going through the process.”

find a rehab in California

Relapsing Shouldn’t Be a Crime

Along these same lines, an editorial in The New York Times used the case of Julie Eldred to discuss the argument noted above—sending people to jail for relapsing because she broke her probation when she tested positive for fentanyl. That’s what often happens in the U.S. justice system, the paper noted. But her case is now being heard by the Massachusetts Supreme Court. Wil it change drug policy? That remains to be seen. Her lawyer is challenging the notion that it’s OK to require people with a substance use disorder not to use drugs while on probation, and of sending them to jail if they do. The prosecution rebutted the disease model of addiction as her defense. Using that very disease model, the editorial goes on to give a cogent argument for keeping addicts who relapse out of jail. The argument in favor is that those who suffer from a substance use disorder cannot choose rationally and consistently because their ability not to relapse is impaired by brain changes due to chronic drug use and the colossal force of addiction. Policies like the one that caught Julie Eldred in their net are part and parcel of the criminalization policy. While not everyone suffering from substance use disorder should be freed from all consequences, the consequences should be fair, says a professor of public policy.

Treatment of Opioid Use is Not a Mystery

In response to the editorial mentioned previously, a clinical professor of population health felt the need to point out a few facts about the fight against the opioid epidemic. People with opioid use disorder who are successful in overcoming it take methadone or buprenorphine and undergo behavioral therapy and counseling, he says. And sometimes it doesn’t even take doing both for them to succeed. He, too, complains that we criminalize the patient, the disease, and the treatment when we don’t have to. The writer is also the former chief of addiction medicine at the notorious Rikers Island prison, by the way, which was a big part of the movie “The Night Of.” Another writer, a director of the Program in Addiction Medicine at the Yale School of Medicine, had a great thought: “We need to teach addiction with the same attention to genes, physiology, cells receptors, transmitters and scientific evidence as we do cancer to try to capture trainees’ interest.” For more information or to find a Rehab in California, please contact Summit Estate at (866) 569-9391.

 

Heroin And Opioids Continue To Be A Runaway Problem In Northern California

Heroin And Opioids Continue To Be A Runaway Problem In Northern CaliforniaHeroin and opioid addiction continues to be a growing problem around the globe. Prescription pain relievers are incredibly addictive, damaging lives and increasing overdose death tolls in nearly every state. Opiate and heroin abuse affects the welfare of all societies, including Northern California. The problem in California has reached an all-time high due to low drug prices, easy access to drugs, and lack of awareness. Exploring the drug problem in Northern California can help our community find a solution.

Heroin And Opioids In NorCal: Surprising Statistics

Heroin And Opioids In NorCal- Surprising StatisticsIn 2013, California hospitals treated over 11,500 people suffering an overdose of opiates or heroin – the equivalent of one overdose every 45 minutes. This statistic shows a shocking 63% increase in overdose cases since 2002. Researchers believe this rise is partially due to consistently low prices and plentiful amounts of black tar heroin in California pipelined from Mexico. Every office in the Drug Enforcement Administration (DEA) in San Francisco reports the dominance of black tar heroin and that it’s easy to obtain.

According to data gathered by the Sacramento Bee, hospitals in rural superior California have the highest rate of opioid overdose patients. The county averages for overdoses per 10,000 residents were the worst in Northern California. Here’s an overview of the greatest county averages in overdoses per 10k residents from 2006 to 2013:

  • Plumas County: 9.1
  • Lake County: 8.8
  • Humboldt County: 8.4
  • Shasta County: 8.1
  • Tuolumne County: 7.5

Local counties faired slightly better on the scale but still had high overdose numbers:

  • Nevada County: 5.1 (400 total overdoses)
  • Yuba County: 4.1 (234 total overdoses)
  • Sacramento County: 3.3 (3,723 total overdoses)
  • Placer County: 3.3 (918 total overdoses)

Overdose Deaths In California

Heroin And Opioids In NorCal- Surprising StatisticsShasta County hospitals helped more than 1,150 overdose patients between 2006 and 2013—more than triple the average for the entire state. The rates of overdoses were also higher than the statewide average in Sacramento County, Placer County, and El Dorado County.

In 2013, there were a total of 6,108 ER visits due to opioid overdoses—a rise from 3,517 in 2006. The number has steadily increased each year, as have the number of hospital stays. The number of overdose deaths has risen since 2006, but there was a slight drop in 2012. This may be due to people seeking help before their problem gets out of control or advances in how hospitals treat patients suffering opioid overdoses. Still, an average of 1,752 people die from opioid overdoses in California every year.

The Relationship Between Opioids And Heroin Abuse

Recently, there’s been a statewide switch from prescription opioids to heroin, with a particularly high increase among young people. Evidence suggests that as prescription drugs become less available and more difficult to obtain, drug users are shifting to heroin. For example, a downward trend in OxyContin abuse directly correlated with an increase in heroin use in a study by the National Institute of Drug Abuse.

Additionally, drug users will build a tolerance for opiates and prescription painkillers, making them more likely to find heroin, which is easy and cheap to purchase in most major cities in California. In some communities, heroin costs less to purchase than prescription opioids. Between 2005 and 2012, the number of known heroin users in the United States almost doubled, from 380,000 to 670,000.

Unfortunately, the risk of overdosing is increased with heroin when compared to prescription opioids. Heroin addicts can’t control the purity of the drugs they purchase, leading to heroin that may be contaminated or mixed with other, unknown drugs. Previously, heroin use was a problem almost strictly in urban areas. Now, the DEA frequently encounters heroin in small towns and suburbs in California.

Sources Of The Heroin And Opioid Problem In Northern California

California officials attribute the ongoing problem to a number of different variables that have changed over the years. An increased patient awareness of the right to pain relief, various organizations that support the use of large doses of opioids, and aggressive marketing from the pharmaceutical industry have all contributed to the issue. Some doctors prescribe opioids loosely without properly educating patients on the addictive nature of such drugs.

Easy Access To Prescription Meds Through Family

Based on a survey by the National Institute on Drug Abuse, the majority of people (54.2%) aged 12 and older who used pain relievers non-medically say that they obtained the drugs from a friend or relative for free—whether by consent or theft. Reducing the number of unused painkillers improperly disposed of may help prevent people, especially young people, from developing a drug addiction. Keeping prescribed pain medications hidden or counting them carefully can also help.

Methods Addicts Use To Obtain Drugs

While only 18.1% of respondents said that they obtained the drugs from one doctor, the 54.2% of people who got them from friends state that 81.6% of their sources got the drugs from one doctor. Patients with addictions can gain access to prescription pain medications relatively easily across the United States. In 2001, there was a movement toward prescribing more opioids, stating that doctors largely undertreated chronic pain. This led to the Pain Treatment Act and Bill of Rights. Since then, doctors have more openly prescribed pain medications for common health complaints without fear of retaliation.

One of the methods addicts use to get their hands on large amounts of opiates and painkillers is “doctor shopping.” Doctor shopping refers to the act of going to multiple doctors and complaining of the same symptoms. A patient may go to one doctor complaining of a health issue, either real or fake, and obtain a legitimate prescription for pain relievers. Then, the same patient will go to a different doctor and do the same thing. Doctor shopping allows addicts to consistently receive a high number of opioids with real prescriptions.

Opioids are available for purchase online, without the need for a prescription, through illegal online pharmacies. Law officials do their best to locate and shut down illegal Internet pharmacies, but they still exist. Online pharmacies may not sell customers prescription-grade opioids, posing an even greater threat to users.

Easy Heroin Availability And Low Prices

Los Angeles is a known collection and distribution point for black tar heroin from Mexico—the primary form of heroin the DEA encounters in Northern California. From there, tight-knit groups transport the drugs to locations in the Central Valley. San Francisco is a significant destination for this heroin, as are San Jose, Redwood City, and East Palo Alto.

Heroin availability has quickly spread throughout California, cropping up in counties such as Sacramento, Placer, Nevada, and Yuba that didn’t previously report heroin problems. The plentiful amount of heroin results in low prices. Prices vary across communities and depending on the purity of the drugs, but heroin typically is less expensive than other addictive drugs. The average cost of 0.1 gram (a single dose) of heroin on the street is only $15.

Effects Of Heroin And Opioid Addictions

Drug addictions can lead to a plethora of negative outcomes, and the price it costs the individual abuser, the community, and the nation as a whole is high. Many drug abusers don’t realize the extensive consequences of heroin and opioid addictions and each drug’s effect on daily life.

Not only do heroin and opioids have devastating mental and physical health effects, but they also cause damages to a person’s finances, employment, quality of life, and relationships. A drug addiction can take over literally every aspect of life until the user has nothing left except his or her addiction.

Effects On The Human Body

Doctors often prescribe hydrocodone and oxycodone in drugs such as OxyContin and Vicodin to treat moderate to severe pain. These medications attach to proteins (opioid receptors) found on nerve cells within the body and brain. These receptors reduce the perception of pain, producing a sense of peace. Opioids can also lead to mental confusion, drowsiness, and nausea. When someone abuses opioids, that person is at risk for serious medical complications such as coma and fatal overdose.

Heroin is well known as a drug with a high risk of overdose. Since there’s no regulation for the drug, most users have no way to know exact dosages or purity levels. Chasing the rush, or the feeling of euphoria, that typically comes with heroin leads users to increase their dosages more and more. Heroin can cloud mental function, slow breathing and heart function, and sometimes result in coma, permanent brain damage, and death.

Costs Of Addiction For The Addict And The Community

Opioid and heroin addictions can severely damage a user’s personal life. Addicts no longer express interest in achieving goals, education, working, or cultivating personal relationships. Relations with spouses, children, parents, and friends suffer—sometimes leading to damages that addicts may never be able to repair. Drugs take over every aspect of life, making it impossible for an addict to see past his or her addiction. With intervention and treatment, addicts can take their lives back. Without treatment, they risk eventually dying from overdose.

The community cost of providing healthcare, emergency services, and treatment programs for heroin and opioid addicts is remarkably high. The Centers for Disease Control ranks California as the number one state in the country for total health care costs from opioid abuse, exceeding $4,263 million in 2013. This was $2,299 million more than the number two state, Texas, which totaled only $1,964 million by comparison. The estimated total cost of opioid abuse in America is $25 billion annually.

California’s Lost Work Productivity

In 2010, illicit drugs cost California more than $15 billion in tangible costs, and though this statistic has yet to be updated, other stats suggest this number is much higher now. This includes $5.321 billion in wage work costs alone. Addicts lose productivity while using and abusing heroin and opioids, losing the desire to go into work, and eventually failing to show up at all. Illegal drug abuse also leads to incarceration, resulting in lost time at work and being terminated from jobs. Business costs also include increased employee turnover and higher insurance costs. The citizens and state economy bear 76% of all tangible costs of substance abuse in California.

Violent Crime Increases Across Counties

Violent crime and property damages are often related to street gangs in California who distribute heroin, among other drugs. Street gangs are involved in crimes such as burglary, assault, auto theft, carjacking, mugging, and home invasion. The U.S. Department of Justice states that much of the violent and property crime is in the Northern California region. This is due to trafficking, group rivalry, and drug abuse. Often, illicit drug abusers commit crimes like robberies to pay for their addictions.

The Northern California High Intensity Drug Trafficking Area program strives to reduce drug trafficking, lowering the impact of illicit drugs like heroin in the ten Northern California counties within its region. Part of the Northern California High Intensity Drug Trafficking Area’s goals is to reduce drug-related crime and violence throughout the area. This program locates major drug threats in each region and implements initiatives to put an end to drug trafficking.

Neonatal Abstinence Syndrome In California

One of the most tragic effects of opioid and heroin abuse in Northern California is the rising number of infants born with neonatal abstinence syndrome (NAS), or a dependency on drugs from birth. In 2015, doctors diagnosed about 1,190 California newborns with NAS—up more than 50% from 2014. NAS leads to withdrawal symptoms as the drugs leave the baby’s system, including tremors, vomiting, fever, and restlessness. Neonatal withdrawal is painful for babies, although it doesn’t typically have a long-term effect on their health.

NAS causes lengthy hospital stays compared with normal births, resulting in increased healthcare costs. The average length of stay for a baby without NAS is about 2.1 days, costing around $3,500. In contrast, a baby with NAS has to stay 17 days or longer, costing $66,700. This resulted in an estimated total of $1.5 billion for hospitals in 2012—8% of which state Medicaid programs pay. As the rate of babies born with NAS increases, so does the total cost to California.

Finding A Solution For Opioid And Heroin Addiction

Opioid and heroin have become runaway drugs in California in part due to lack of community awareness and initiative to stop drug abuse. Currently, there are a number of anti-drug campaigns and programs running throughout Northern California, including the Northern District of California Project Safe Neighborhood, a state agency that focuses on areas of high violent crime and drug activity.

Staying on top of the growing trend toward heroin in NorCal and learning what you can do to prevent drug addiction and help current addicts are important steps to take during this time of high drug activity.

Reduce Future Drug Abuse

Addictions can start at an early age, with kids snatching prescription opioids from their parents’ medicine cabinets. Early intervention programs can help put young adults back on the correct path before a drug problem gets out of control and leads to tragedy. Research intervention centers in your area, and learn how to discuss a drug problem with your teenager. Preventing drug-related death, crime, and other tolls starts with spreading awareness to the next generation.

Many Northern California counties have launched community coalitions against drugs. They bring together leaders from the medical sphere, public health department, clinics, law enforcement, and addiction treatment providers to collectively work to decrease drug use and the overprescribing of pain medications within the community. The California HealthCare Foundation recently began an initiative to support new opioid safety coalitions throughout the state. Joining your local coalition can be a fantastic way to support local efforts against addictive drugs.

Support Sufferers And Addiction Research

Research on how best to treat opioid and heroin addictions continues throughout America, leading national recovery center leaders to discover new, more effective ways to reduce withdrawal symptoms and help abusers recover for good. Donate to your local recovery or research center to help further the knowledge industry leaders have about this growing epidemic. Northern California is just one region out of thousands across the country that can benefit from more advanced treatment research.

If you know someone who has a problem with opioids or heroin, learn how you can help them on the road to recovery. Getting past a drug problem is 100% possible with the right mindset and resources. In many cases, your friend or loved one will need an intervention to recognize that he or she has a problem and that treatment is the only solution. Once the addict agrees to seek help, support his or her efforts to embrace treatment and continue on the path to a drug-free life.

Get Professional Help

Drug addictions are complex—especially since there’s a medical component to the problem. Addicts need therapists, recovery programs, support groups, and treatment centers with the right tools and resources to facilitate healing. Thousands of people who have struggled with substance abuse have successfully overcome addiction and led normal, happy lives. Recovery isn’t possible without support from friends and family. Be there for your loved one, and know when to call in a professional for help.

If you feel you’re at risk of becoming addicted to prescription medications, heroin, or any other substance yourself, seek help from a treatment center such as Northern California’s Summit Estate Recovery Center immediately. Treatment centers are no-judgment zones where you can obtain the help you need to prevent or end a drug dependency.

If you would like to learn more news about addiction and drug, read more Summit Estate blogs.

Summit Estate News Blogs

Trends in Opioid Use, Strength, and Addiction

Opioid addiction continues to rise in the United States. Americans struggle with the consequences every day. Opiates come in many different forms and strengths. Increasing tolerance and downplaying the number of pills taken often marks addiction.

Identifying the Problem

An estimated 100 million Americans suffer from chronic pain. In 2001, The Joint Commission labeled pain as thefifth vital sign” in pain management. It required physicians to obtain a subjective measurement of a patient’s pain on a scale of 1-10. Feeling pressure to adhere to new quality standards, physicians overprescribed opioids for pain management. The result is an epidemic in opioid abuse. Opioid overdose-related deaths have quadrupled since 1999. Opioid addiction affects the health and well-being of all genders, ages, races, ethnicities, and classes. The National Institute on Drug Abuse (NIDA) estimates 2.1 million Americans abuse opioids. The Obama administration recently allocated $1.1 billion for drug abuse initiatives and treatment options.

Types of Pain Management

Opioids take different forms and strengths. Each type has a unique half-life (the amount of time it takes for half of a drug to metabolize). Below are some commonly prescribed opioids. Morphine – is known as the “gold standard” of opioids—the yardstick by which all other opioid analgesics are measured. Morphine has a half-life of 1.5-7 hours. Morphine is prescribed only in a clinical setting. It’s typically administered intravenously though it may be taken orally. Like other opioids, morphine may cause nausea, dizziness, constipation, respiratory distress, and certain cardiac problems. Unlike other opioids, morphine may also cause a histamine reaction. Tramadol –  is a synthetic opioid. It’s a relatively weak opioid with a half-life of 5-7 hours. Tramadol’s efficacy is about 10-20% of morphine. Tramadol is a centrally-acting pain reliever. It treats post-surgical, obstetric, and chronic pain of neurogenic or mechanical origin. Tramadol is the opioid of choice for those with poor cardiopulmonary function (such as the elderly, the obese, and smokers) or patients with impaired renal and/or hepatic function. Tramadol can be an effective treatment option for those who can’t take non-steroidal anti-inflammatory drugs or for whom these drugs ineffectively manage pain. Codeine – is another fairly weak opioid with a half-life of 9-11 hours. It’s often prescribed to combat chronic back pain. When combined to paracetamol (e.g., acetaminophen and Tylenol), it provides effective management for moderate-to-severe chronic pain and acute pain after dentistry. Codeine is more easily tolerated than tramadol and has fewer common side effects. However, tramadol is more potent than codeine and has fewer cardiopulmonary effects. Pethidine – also known as Demerol, is a synthetic opioid that works on mu and kappa receptors to relieve pain. Pain relief occurs quickly, making pethidine the logical option for relief of labor pains—particularly during the second stage. However, pethidine has a relatively short half-life of 2-3 hours. Pethidine is associated with a high risk of suicide. It has a high side-effect profile compared to other opioids. Hydrocodone – is a schedule II opioid with a half-life of 2-4 hours. Hydrocodone is reportedly equal to the gold standard morphine. In fact, some doctors have suggested that hydrocodone may be even more potent in analgesic quality than morphine. Hydrocodone is also more powerful than codeine or tramadol. It’s more efficacious in providing pain relief for acute musculoskeletal pain. Even though it has a fairly low bioavailability, hydrocodone isn’t available in pure formulations. It’s typically combined with acetaminophen for pain relief (e.g., Vicodin). Oxycodone – more commonly known as Oxycontin, oxycodone is a strong synthetic opioid with a half-life of 3-4.5 hours. It’s approximately twice as strong as morphine. Because of its high potency, oxycodone is only used to treat acute pain. Chronic pain sufferers are more likely to be prescribed tramadol or codeine.

Mechanisms of Action: How Do Opioids Work?

Opioids are known as mu antagonists because they work on the mu receptors of the brain. While opioids may have other differences—for example, some are also kappa antagonists—all opioids have mu antagonist qualities in common. Mu receptors are one of the brain’s endorphin receptors. Opioids work by triggering the rush of endorphins, which are the body’s natural opioids, to dull the sensation of pain. Endorphins also generate a sense of well-being.

How Does an Opioid’s Potency Relate to Its Addictive Qualities?

How Does an Opioid’s Potency Relate to Its Addictive QualitiesAny opioid can be abused, but some have a higher likelihood than others. The distinction lies in both tolerance and potency. Opioids work by triggering natural opioid receptors, but over time, synthetic opioids can actually inhibit the body’s endogenous endorphins. When the body can’t produce enough endogenous opioids on its own, patients experience the following feelings of withdrawal:

  • Discomfort
  • Shaking
  • Headache
  • Nausea
  • Sweating
  • Diarrhea

These symptoms, coupled with the return of moderate to severe pain, results in addiction-seeking behavior. Patients build a tolerance to the drug and seek more to experience the same effect.

Other Forms of Abuse

Abuse may begin when patients seek alternate delivery routes to achieve the “high” associated with a rush of endorphins. Patients may take their oral medications and crush them into a fine powder and snort them. For example, oxycodone is known for both its high potency and long half-life. Yet when an oxycodone pill is crushed and snorted, it not only produces a strong high, but it also increases the risk of negative side effects—such as respiratory depression, cardiac arrest, coma, or death. Extended release formulations are particularly dangerous. Abusers have access to all of the medicine at one time if they crush, snort, or smoke them. This increases the strength of the opioid and thus the high. Addicts may also find other ways to increase the relative strength of an opioid. A patient may take a relative’s Vicodin when a codeine prescription runs out. Since Vicodin has a stronger potency and a longer half-life relative to codeine, the patient’s body will inhibit his or her own endogenous opioid systems more quickly.

Spotting Addictive Behaviors in Opioid Abusers

Those who abuse opioids may display behaviors similar to alcoholics or other addicts. Much like an alcoholic may downplay how much he or she drinks in a day, an opioid abuser may downplay his or her habit. While admitting to taking a much weaker Tylenol with codeine recreationally, he or she may actually be taking hydromorphone or oxycodone, which are extremely potent and dangerous opioids. Addicts can become incredibly good at lying (even to themselves) about the extent of their problems. It’s important to realize that many opioid prescription problems have roots in real moderate to severe pain. When prescriptions run out, addicts may turn to other drugs of abuse, like heroin, to dull the pain and trigger a euphoric feeling. Indeed, heroin use is on the rise: according to NIDA, the number of heroin users doubled from 380,000 in 2005 to 670,000 in 2012. Prescription drug addicts are at risk for more than just an overdose, especially if they turn to heroin. Intravenous drug abuse can lead to other complications, such as HIV, Hepatitis C, and other blood-borne disease transmission from dirty needles.

The Dangers of Opioids and The Solution

The addictive qualities of an opioid depend on its potency and half-life. The stronger the drug, the quicker the path to addiction. As tolerance develops, abusers may turn to alternate avenues to experience the “high”, from crushing and snorting pills to switching to a stronger opioid to using heroin. Addicts are creative with the way they administer prescription pills, leading to an increased risk of overdose because opioids continue to build in their systems. High amounts of opioids can lead to organ damage, tissue death, respiratory depression, and cardiac arrest. As the full extent of the opioid epidemic comes to light, opioid abuse is becoming less stigmatized. Loved ones should be on the lookout for potentially abusive behaviors, such as downplaying the number of pills taken. Early intervention produces the best chance of opioid abuse recovery. Our staff here at Summit Estate specializes in Opioid addiction, let us help you or your loved one recover from this dangerous addiction. Click the button below to see more about our services offered on opioid addiction.

Prescription Drug Abuse Treatment Center