Drug War in San Francisco, CA
San Francisco, an industrial city in northern California sits on the tip of a peninsula surrounded by the Pacific Ocean and San Francisco Bay. Home of the Golden Gate Bridge, cable cars, and old Victorian houses, this city brings adventure to tourists and residents alike. With an estimated population of 864,816, San Francisco is the fourth most populous city in California.
Unfortunately, this diverse area has hard-core drugs circulating various neighborhoods. Mike Moffitt, writer for SF Gate News, reports, “Meth is king in San Francisco, at least in terms of police interdiction,” adding, “there were 755 meth-related incidents from September 2016 through August 2017, nearly [doubling] the incident reports for heroin and crack cocaine combined”. Likewise, author for alltreatment.com, James Schergen, informs that, “The drug war is real and ongoing in San Francisco”.
However, penalties have increased in severity for those charged with drug-possession and distribution: drug peddling gets a five-year prison sentence and thousands of dollars in fines. Even if one gets caught with the ‘legal’ amount of 28.5 g of marijuana, there will likely be a one-hundred dollar fine and a warning. Shockingly, the underground sale of cannabis and other illicit drugs “has pushed the drug market’s profit upwards of four-hundred million” (Shergen). According to this same article, the top five drugs in San Francisco as 2017, includes: methamphetamine, marijuana, cocaine, heroin, and hydrocodone
San Francisco: The Third-Drunkest City in the US
Eve Baty, of The San Fransisco Appeal, reports that in San Fransisco, the statistics for alcohol consumption includes the following:
- Average drinks, per person, per month: 12.06
- Percent of adults who are heavy drinkers: 8.2
- Percent of adults who are binge drinkers: 19.6
- Deaths per 100,000 residents from alcoholic liver disease: 6.9
Binge-Drinking and Gender Trends
According to Barbara Feder Ostrov, writer for The Mercury News, San Franciscans “were the most likely Californians to report binge drinking in 2012”. Binge drinking refers to consuming five or more beverages for men and four or more for women on a single occasion. Comparatively, heavy drinking is defined as drinking more than two beverages daily for men, and more than one for women. Statewide, the upward trend in heavy drinking and binge-drinking is mostly driven by women. For example, Santa Clara, the next county over, reports a 35.8 percent increase in women’s binge-drinking rate, wheres men had a 23.1 percent rise. Perhaps the rise in alcohol consumption for women has resulted from the change in social norms—it’s now more acceptable for them to drink the way men always have. On a similar note, Ostrov states that both young and affluent residents tend to drink more (socially) in the Bay Area.
DUI Rates in San Francisco
In 2013, the number of DUI arrests in San Fransisco totaled 1,377. Compared to San Diego at 12,298 and Los Angeles at 37,559, this amount appears small. However, MADD claims that, “An average drunk driver has driven drunk 80 times before first arrest”. Therefore, this number could mean more residents are using Uber and Lyft, and not getting behind the wheel, or the level of policing is less strict in San Fransisco. Statewide, the 21 to 30 year age group made up the largest amount (70,775) of DUI arrests in 2013; the 31 to 40 year age group came in second, with almost less than half at 35,339 arrests. Interestingly, the San Fransisco Chamber of Commerce president, Tallia Hart, says, “The number of annual drunk-driving arrests in San Francisco decreased by 42 percent between 2012 and 2017” (The Bold Italic). Thus, it’s more likely that residents are making smarter choices as of late.
Why is Meth Popular in San Fransisco?
Generally speaking, Keith A. Spencer, writer for The Bold Italic, jokingly says, “To blame Breaking Bad’s Walter White for making meth glamorous again”. All kidding aside, Spencer reports that, “Medical data indicates that meth use rose across the Bay Area in the first half of 2013”. Additionally, compared to 33 per100,000 population for the overall nation, San Francisco emergency-room visits for meth were estimated at 139.5 per 100,000 in 2011. Why has meth use increased in San Fran? Although it’s difficult to say, the vastness and close proximity to others in the city has made meth labs and activity highly profitable. For instance, author, Katie Hempenius, points out the busiest streets for meth activity as of 2017: 6th Street between Jessie and Natoma Streets, Turk & Hyde Street, Bryant between Langton and Kate Streets—and that’s just naming several publicly known sites. Hempenius also claims “There were 755 meth-related incidents within the past year, which almost equals that of crack (440 incidents) and heroin (402 incidents) combined”.
What is Meth Addiction?
“Meth,” the American Addiction Centers (AAC) claims, “floods the nervous system and penetrates the brain to a far greater degree than amphetamine”. Reportedly, the substance’s effect remains in the patient’s system for much longer than the initial inhalation, “Scrambling and rewriting the brain’s reward and pleasure centers, and sowing the seeds for a painful addiction” (AAC). Highly addictive, meth, forces the brain to pump out dopamine, the neurotransmitter that induces a sense of satisfaction. Pushing the brain to secrete excessive domaine, over time this drug actually destroys dopamine receptors in the brain, causing the user incapable of experiencing pleasure aside from meth. Thus, this substance becomes the user’s main focus in all areas of life (eg social, psychological, and physical).
Signs and Symptoms of a Meth Addiction
Several physical and psychological symptoms of meth use includes:
- Intense scratching
- Rotting teeth
- Weight Loss
- Irritability
- Paranoia
- Acne or sores
- Confusion
Withdrawal Effects of Meth
According to Acadiana Addiction Center, “Meth detox should always occur in a proper rehab center under the careful eye of trained medical professionals”. Common withdrawal symptoms involve:
- Anxiety
- Craving meth
- Teeth grinding
- Depression
- Decreased energy
- Night sweats
- Increased sleeping
- Irritability
- Weight gain
- Lack of pleasure
- Anhedonia
- Suicidal thoughts
Does Meth Have Long-Term Consequences?
Past chronic abusers of meth may experience psychotic symptoms that last for months or years after quitting, especially during times of stress. Psychotic features include: paranoia, delusions, and visual and auditory hallucinations. Most users will start to feel much better around three to four weeks after withdrawal—sleep, energy levels, and mood stability will improve. For those who’ve used meth longer and more frequently, will more likely endure psychosis every so often.
How to Recognize and Diagnose Alcoholism
One should consider the following when figuring out whether or not an individual has alcohol addiction:
- alcohol consumption interferes with work, school, family, and/or other responsibilities
- Consumption continues despite the negative impact it’s having on one’s relationships
- Risky behavior results after drinking, such as driving, fighting, or having unprotected sex
- Needing more alcohol over time to achieve the desired intoxication state
Withdrawal Symptoms From Alcohol
The American Addiction Centers breaks alcohol withdrawal down into three stages. Stage 1 begins 8 hours after the last drink, and involves: anxiety, insomnia, nausea, and abdominal pain. Stage 2 occurs 24 to 72 hours after the last drink, and includes: high blood pressure, increased body temperature, unusual heart rate, and confusion. Finally, stage 3 arises around 72 hours after the last drink, which involves: hallucinations, fever, seizures, and agitation. Since alcoholism usually has underlying mental and psychological factors associated, its important to receive proper treatment after or during withdrawal.
When to Hold an Intervention
For some, addiction may require an intervention. By joining forces with others and taking action through a formal intervention, your loved one will receive a structured opportunity “to make changes before things get even worse, and it can motivate him or her to seek or accept help” (Mayo Clinic). In addition to family and friend involvement, an intervention, includes a consultation with a licensed alcohol and drug counselor, or is directed by an intervention professional. Gathering together, these people collaboratively confront the addicted individual about the consequences of addiction and ask him or her to accept treatment. Typically the intervention points out specific examples of destructive behaviors and instances that the substance-user or alcoholic engaged in that greatly impacted family members and friends. In conjunction with this, the intervention provides a prearranged treatment plan with clear steps, goals and guidelines, and warns what each person will do if the individual refuses to accept treatment (eg break off communication, kick the person out of the house). Notably, careful planning determines whether a successful intervention will occur; by contrast, poor planning can worsen the situation, as the addicted person may feel attacked and become more detached or resistant to treatment.
Intervention-Steps in Detail:
- Make a plan: the concerned friend or family member should propose an intervention and form a planning group; a qualified professional counselor/interventionist will help organize an effective intervention; its essential to have expert guidance, as an intervention has potential to cause resentment, anger, or a sense of betrayal.
- Gather information: With other group members, find out about the extent of the sufferer’s problem and research the condition and treatment programs—perhaps agree on a specific treatment program.
- Form the intervention team: The “planning group” forms a team of participants for the intervention. This step includes setting a date and location, and working together to construct a consistent, rehearsed message and a comprehensive plan. Notably, the loved one shouldn’t know what’s occurring until the day of the intervention.
- Decide on specific consequences: If the addict refuses treatment, each person must decide what action he or she will take.
- Make notes on what to say: Each individual should cite specific incidents where the individual’s addiction caused major problems. However, in doing so, the speaker(s) must also express care and expectation that he or she can change.
- Hold the intervention meeting: Bring the addicted individual to the intervention site, without revealing the reason. Team members then take turns sharing their concerns and feelings. Afterwards, the addict is presented with a treatment option and asked to accept that option on the spot; meanwhile each member warns the individual what will happen if he or she refuses.
- Follow up: If all goes well, and the individual goes through with a treatment program, members of the intervention-team should assist them in staying on track in order to avoid relapse. From changing patterns of everyday living, such as ridding of alcohol in the house, to attending counseling meetings with your loved one, healthy changes will avoid destructive behavior.
Whether the individual gets help through an intervention or by choice, the main aim is to recover from a life dictated by substances.
Steps to Full Recovery
- Detox
In order to begin a recovery program, the patient must detox— this means, ridding of all toxins in the body’s system by staying clean for at least five to ten days. Usually, rehab programs reject those who aren’t fully detoxed. However, many centers have medically supervised detox programs for those whom struggle to abstain from substance and alcohol-consumption. Detoxing without further therapy, though, will inevitably lead to relapse. Therefore, detoxing is just the first step in a series of phases for full recovery.
What is withdrawal and how long does it last?
- Assessment
For rehabs dealing with any major addiction—meth, heroin, alcohol, other opiates, etc—assessments must take place before accepting a patient. Assessments typically come in the form of questionnaires, self-evaluations, and/or a physical exam. By answering questions and recording health-data, the assessor can accurately determine whether an addiction is fully present, to what extent, whether or not it pairs with co-occurring condition(s), and how to treat the specific, individual. Usually doctors, nurses, social workers, and therapists carry out these assessments. Though assessment strategies may differ from rehab to rehab, all locations carry out comprehensive analyses’.
- Intake
During the intake process, the patient will meet individually with a counselor or therapist, a doctor, and/or a psychologist. Establishing these relationships with the staff helps them communicate with each other to collaboratively develop a methodical treatment plan. Typically, documented notes describing medical and mental health history, will be reviewed from the session(s), and specialized screenings and physical exams might also take place. Additionally, the patient will be asked about major events or certain instances that might have triggered the addiction. Important to note—the intake process usually involves some form of payment and/or a financial plan, and fortunately, many facilities offer a number of payment and insurance options.
- Inpatient Treatment
Residential treatment centers (RTC), are highly structured, and evidence-based programs that typically follow the 12-step model of recovery (Alcoholics Anonymous). Additionally, inpatient rehabs offer emotional process groups—e.g. CBT (for obsessive thoughts and compulsions), DBT (for stabilizing moods), and work-return planning, etc. RTC works especially well for individuals who have recently received hospital-care, or who need more structure, and stability than outpatient care. Average length of stay is typically three to six months, and is usually all residential-based (no returning home each night).
- Outpatient Treatment
Partial hospitalization drug rehab programs (PHP), and intensive outpatient programs for substance abuse (IOP), differ from RTC in that patients go home in the evenings. PHP, also referred to as “day rehab,” provides the patient with the intensity of RTC, but for six hours a day, five days a week. Using many of the same tools and resources, PHP can be just as effective; individuals receive group-therapy, counseling, medical assessment, etc. Due to cost-reduction and flexibility, many drug and alcohol rehab centers now offer this style of treatment.
Intensive outpatient programs for substance abuse (IOP), offers the same services, but goes for three hours a day, three days a week. Typically, this option suits those who’ve completed an inpatient program, like RTC, or for individuals that require an outpatient setting (due to professional or personal reasons). Additionally, IOP focuses on group therapy, while using one-on-one counseling less often. Length of stay differs from person to person, depending on the individual’s emotional and psychological progress.
Should I choose inpatient or outpatient?
- Aftercare
Immediate, and continuous follow-up treatment for substance abuse, should occur after the completion of an initial rehab program. Addiction aftercare programs aim to encourage recovery maintenance, and helps develop ways to prevent relapse, to achieve a fulfilled life with healthy relationships and a sense of purpose. Longstanding substance abuse can de-normalize cognitive-function and altar parts of the brain long after rehab, therefore continuing treatment is extremely important. Beyond physical impact, several long-term psychological changes may affect thoughts, feelings, and behaviors (as another consequence to prior intoxication). Therefore, its essential that aftercare proceeds.
What happens after discharge?
Consider a Sober Living Home
Another idea to consider is living in a sober living home— a group home for addicts, that allows one to come and go as they please, as long as they follow curfew-rules and complete standard chores. Before moving in, the recovering-addict should find a 12-step sponsor (a family member, a friend, or an acquaintance, that will support, listen, and hold you accountable). Once, enlisted, residents in these homes must remain sober, and be willing to support others. Thus, this environment encourages sobriety and helps addicts adjust to a non-substance/non-alcoholic life. Many sober living homes include volunteer opportunities and therapeutic meetings, such as feeding the homeless at soup-kitchens, as well as, Alcoholic Anonymous (12-Step) gatherings, and job-search planning. Before moving in, each individual must complete the detox process.
