by: Jeff Noles, MA, RAC
I have worked as a substance abuse counselor for eight years with the last five at Palmetto Addiction Recovery Center. I am a registered addiction counselor with the state of Louisiana and obtained my master’s degree in clinical mental health counseling from the University of Louisiana at Monroe. I have been sober since July 17, 2006 and have worked with hundreds of clients and their families who are struggling with addiction. Recently heroin has had a large resurgence in our country and its effects are alarming.
The American Society of Addiction Medicine defines addiction as “a primary, chronic, and relapsing brain disease characterized by an individual pathologically pursuing reward and/or relief by substance use and other behaviors” (Administration). Heroin affects people of every age, gender, race, culture, and socioeconomic class. It is particularly insidious because many of the people who end up with a heroin addiction started on that road with good reason. Often, these people start out with legitimate medical problems that require opiates to treat their pain. Their tolerance for these drugs increases and they eventually become dependent. Once dependent on the effects of opiates, many of them continue to use the drugs long past when they are considered medically necessary. At some point, physicians become aware pain relief medications are no longer indicated and discontinue them. The patients find themselves in withdrawal and then discover heroin is much cheaper than prescription opiates on the streets. “Four in five new heroin users started out misusing prescription painkillers. As a consequence, the rate of heroin overdose showed an average increase of 6% per year from 2000 to 2010, followed by a larger average increase of 37% per year from 2010 to 2013” (Hedegaard MD MSPH). Unlike prescription opiates, however, heroin is not regulated and so the strength and composition of the heroin varies greatly to frequent overdose and death.
Not to be misleading, heroin is also used by many people who never have medical pain nor are prescribed prescription opiates. Pain medication is big business and as more and more of them have been prescribed and sold they have inundated society and become available to normal people looking to relieve emotional pain who underestimate their addictive properties. Eventually, after long term use, many of these people find heroin to be a cheaper or more readily available alternative and so become regular heroin users. According to the Center for Disease Control and Prevention (Today’s heroin Epidemic), the people most at risk of heroin addiction are:
- People who are addicted to prescription opioid painkillers
- People who are addicted to cocaine
- People without insurance or enrolled in Medicaid
- Non-Hispanic whites
- People who are addicted to marijuana and alcohol
- People living in a large metropolitan area
- 18 to 25 year old
The most effective treatment for heroin addiction in my opinion is some period of residential treatment paired with a medical detox where clients are introduces to the concept of a 12 step program. This should be followed up with after care groups, sober living facilities, and regular involvement in the 12 step support groups in order to achieve sustained recovery. There are other options that reduce the harm to society or the financial burden of addicts on the economy, but I find they may benefit the actual addicted person very little. In my experience, those clients who use Suboxone or methadone are simply participating in a form of addiction that society finds more acceptable.
If you suspect someone you know has a problem with heroin advise them to contact Palmetto Addiction Recovery Center and participate in a three day evaluation to determine which substance abuse treatment, if any, may be necessary to assist them in living a sober life. Things that may indicate heroin use or abuse are:
- Lying or other deceptive behavior
- Avoiding eye contact or distant field of vision
- Substantial increase in time spent sleeping
- Increase in slurred, garbles, or incoherent speech
- Sudden worsening of performance in school or work, including expulsion or loss of jobs
- Decreasing attention to hygiene and physical appearance
- Loss of motivation and apathy toward future goals
- Withdrawal from friends and family, instead spending time with new friends with no ties
- Lack of interest in hobbies and favorite activities
- Repeatedly stealing or borrowing money from loved ones, or unexplained absence of valuables
- Hostile behaviors toward loved ones, including blaming them for withdrawal or broken commitments
- Regular comments indicating a decline in self-esteem or worsening body image
- Wearing long pants or long sleeves to hide needle marks, even in very warm weather
Many of the clients I have worked with were hopelessly addicted to heroin and felt as though there was no way to overcome this problem. However, once they entered into treatment and addressed the pain that they were trying to avoid in the first place, many of them went on to lead meaningful and successful lives in recovery. Having an addiction is not a death sentence and does not make the person suffering with the problem any less important. There is help available and there are people who genuinely care and invest in assisting addicts regain purpose in life.
Administration, Substance Abuse and Mental Health Services. Behavioral Trends in the united States. 2015. Website. 20 April 2016.
Hedegaard MD MSPH, Chen MS PhD, Warner Phd. “Drug-Poisoning death involving Heroin: United States.” National Center for Health Statistics Data Brief (2015): 1-8.
Today’s heroin Epidemic. 2015. http://www.cdc.gov/vitalsigns/heroin/. 22 April 2016.