Drug Abuse and Rehabilitation in Topeka, Kansas
Topeka, Kansas, as a capital city, has many of the amenities that are unique to America’s capital cities. The top employer for the city’s more than 120,000 residents is the State of Kansas itself, with the second highest employer the city’ educational system. Yet Topeka also has a sinister underbelly of drug crime and distribution.
Nationally, deaths due to opioids have achieved the status of a full epidemic, but locally, Topeka residents remain fully committed to various forms of speed. This includes crack, a freebased form of cocaine, and methamphetamine.
In addition, marijuana remains the most widely available controlled substance in the area. While marijuana is not considered to be a dangerous drug, at least not as dangerous as drugs like heroin, methamphetamine, and crack, and lawmakers debate the virtues of legalizing it, more Topeka residents are admitted to rehab for marijuana than any of the other drugs.
Topeka and Methamphetamine Abuse
Methamphetamine is an incredibly potent stimulant that activates the body’s central nervous system (CNS) and has wildly unpredictable results. Law enforcement considers it to be the most serious threat to the State of Kansas. This is largely because of the deleterious impact that it has on the user’s body, and the often psychotic impact it has on the regular user.
In addition, the trade of methamphetamine is controlled by Mexican cartels, that are responsible for manufacture and trafficking and local outlaw biker gangs that are responsible for sale and distribution. This has led to widespread availability throughout the state. As cartels and their affiliates become more adept at streamlining the distribution of methamphetamine, and other illicit drugs, the price decreases.
Topeka and Opioid Abuse
Despite the fact that opioid abuse is not as high in Kansas than other states, that factoid is deceptive. Since the year 2000, opioid deaths have increased by 121%. This is despite the fact that anti-opioid drugs that stop overdoses in their tracks are widely available to emergency medical staff.
What is the reason behind this nationwide epidemic? It appears to have originated with the pharmaceutical companies that supply us with the medicines that we use every day. Aggressive marketing campaigns geared toward selling doctors and patients on the virtues and safety of prescription opioid-based pain medication have resulted in a full-scale epidemic that has more Americans dying of opioid abuse than all other drugs, except alcohol.
During this same period, there has also been an uptick in the number of preventable heroin deaths. This is due in large part to the increasing availability and lower cost of Mexican-grade “black tar” heroin being imported from the Southwestern border into Kansas. From the East Coast come powdered varieties of extremely pure heroin known as “China White”, among other names.
In addition, street-grade fentanyl is now available on the streets and is responsible for a growing number of bodies, while the market for prescription opioid pills themselves, like oxycontin, has grown throughout that same period.
Topeka residents find themselves abusing opioids as voraciously as the rest of the country.
Topeka and Crack / Cocaine Abuse
Cocaine is a very powerful stimulant that refined from the coca plant which is indigenous to South America. Crack is a further refined variation of cocaine. With crack, the high is more potent but it lasts for a shorter period of time.
While abuse of crack and cocaine has plateaued here in the states, it remains a major problem, particularly for America’s larger inner cities. While crack is associated with the inner city, cocaine is associated with “weekend warriors” who party all weekend and work all week. It is generally consumed with alcohol or other club drugs, and binge use of the drug can result in a serious risk of overdose, particularly because of its effect on the brain.
While most drugs give you a few hours worth of a good feeling, cocaine wears off anywhere between 20 minutes and an hour. The user is then left with a debilitating feeling of wanting more cocaine. This feeling is typified by anxiousness. Crack accomplishes the same thing, but it takes even less time to wear off. This is why abusers of the substance often resort to crime. The fix simply doesn’t last very long.
Crack generally comes into Kansas’s cities from Mexico in the form of powdered cocaine. It is then refined in the destination market, and distributed by inner city gangs. The drug has a very high addiction profile due to the way it acts on the brain. Law enforcement currently considers it the second greatest drug threat to Topeka and the State of Kansas.
Topeka and Marijuana Abuse
While marijuana has a lower addiction profile than legal drugs like alcohol and tobacco, it is nonetheless, an addictive substance. Individuals develop addictions to all kinds of things that are not, in and of themselves, addictive. This includes food and sex, both of which produce a wide range of chemical reactions in the brain. Marijuana does the same thing.
Despite its low addiction profile and relative safety among users, there are more individuals in Kansas rehabs for marijuana than any other drug. We’ll discuss this in more detail later in the article.
While legislators debate the merits of legalizing marijuana and then regulating it like alcohol, neither alcohol nor marijuana is completely safe for users, and chronic abuse comes with a host of problems.
It is important for those that have loved ones who use the drug, or use the drug themselves, to understand those problems. It is especially important for those that are finding it difficult to kick the habit, even when they want to.
Drug Abuse Treatment: How it Works
Regardless of the drug, treatment for drug abuse is a process which can be broken down into steps. Those steps include:
- Assessment and Pre-Intake
- Intake and Detox
- Post-Acute Addiction Treatment
- Long-Term Sobriety Management
What will differ is (depending on the patient’s drug of choice) how this process plays itself out. For instance, detox for a heroin or opioid addict will be much different than detox for a marijuana user. In some instances, medical oversight will be required to ensure that the patient doesn’t suffer complications during the initial stages of detox. In other cases, outpatient programs may be more appropriate. A third option, partial hospitalization programs, are a bit of a hybrid between the two.
A drug assessment is meant to determine the extent of a patient’s drug abuse. For instance, if the patient has been using heroin for over a year, there are several complications that occur during the process of detox. A patient will likely need to be administered methadone with a suboxone taper in order to mitigate the worst symptoms of withdrawal.
For patients that are long-time cocaine or crack addicts, doctors might administer anti-anxiety meds to help with some of the effects of withdrawal.
Doctors will also need to assess the patient’s treatment history, prior surgeries, and other relevant medical history. In addition, the medical staff will want to assess the patient’s mental health, as that could provide valuable insight into the underlying reasons for their drug abuse.
Depending on the patient’s drug of choice, detox can range from mild depression and anxiety, to fits of psychosis, severe physiological symptoms, and extreme discomfort. We will cover this in more detail as we talk about the individual drugs and their impact on the brain and body.
For those that are long-time users of opioids, methamphetamine, and crack or cocaine, medical oversight over the process of detox is generally necessary. In some cases, alcohol abusers will require medical oversight for their detox period.
The process involves removing the drugs from the patient’s body and managing the side effects of that process. While heroin addicts will generally have the most difficult time in detox, medication is available to them to help reduce withdrawal symptoms.
It is thus during the post-acute phase that the majority of addicts, heroin or otherwise, relapse.
Once any remnant of the drug has been purged from the user’s system, the process of addiction treatment has only just begun. It is during the post-acute phase of patient care that the majority of addicts will relapse. This is caused by the impact that the drug has had on their brain chemistry.
Generally speaking, all drugs have some impact on the brain’s chemistry. For those that are or were chronic users, this creates imbalances within the brain. The brain is still expecting the drug to be there. In some instances, the brain has become dependent on the drug to produce key chemicals involved in mood and cognition. Users often report depression, anxiety, difficulty sleeping, and cravings for the drug. Even when the drug is “only” marijuana.
In the case of heroin, meth, and crack, the depression that former users will feel is especially pronounced.
Many users will need to come to terms with the fact that they can never go back to using their drug of choice, despite how much progress they’ve made in their rehabilitation program. It’s important to note that the majority of those that are addicted to drugs do not seek out treatment, and even become hostile at the suggestion.
For those of you that might not be aware, giving up a drug mirrors, in many ways, the stages of grief. Those are:
For crack abusers, heroin addicts, and chronic meth users, the drug was the most important thing in their lives. Not only will the drug punish them with withdrawal for walking away, but psychologically, they’re attached to the way it makes them feel. Even when the drug is “just” marijuana, this separation can be difficult and painful. It’s when individuals start getting their lives back together and start achieving some successes that they often find themselves returning to their old habits. Such is the lure of the 4th stage. The depression can be that hard to beat. And alongside a sense that you’ve lost something that’s within your power to regain, the psychological aspect of the addiction is often more difficult to break than the physical one.
Understanding the Effect of Opioids on the User
All opioids act in roughly the same way. They bind to opioid receptors in the brain which are responsible for the regulation of pain and the reward pathways. The difference is potency. An opioid as potent as heroin produces an incredible sense of euphoria followed by hours of peaceful tranquility. Most of the opioids that are produced for pain management do not produce the same level of euphoria.
The euphoric effect is caused by a flood of neurotransmitter dopamine being produced all at once. The immediate effects of opioids on the body are:
- Slowed breathing
- Reduced pain
- Pinprick pupil dilation
- A feeling of calmness and tranquility
When a user overdoses from an opioid, it’s usually because their breathing has slowed to the point of stopping entirely.
The release of the neurotransmitter dopamine is important as well. This is what produces the sense of euphoria. As the user ingests more and more of the drug, the brain becomes dependant on opioids in order to produce dopamine. Dopamine is produced whenever a major positive life event happens. It could be a promotion at work, graduating college, acing a test, or a new relationship you feel really good about. Long-time opioid useres can only feel that good when taking the drug. Those that are in recovery often feel a profound sense of depression, that they describe as a feeling of emptiness. The simple pleasures that we take for granted, those in the post-acute stage of recovery cannot feel. That’s why the majority of those who relapse do so during the post-acute stage.
In addition, chronic opioid users may experience:
- Loss of appetite
- Blood infections
- Collapsed veins
- Lung diseases
Heroin abuse has been noted to cause structural changes in the brain as well. These include:
- Deterioration of the brain’s white matter
- Decrease in gray matter density of the brain’s frontal cortex
This ends up compromising decision making processes and executive functioning as well as the ability to regulate behavior.
The more opioids a user takes the more dependent they become on the drug. In addition, they develop a tolerance that, over time, requires them to ingest more and more of the drug in order to produce the same effect. Addiction is inevitable and in some cases, the consequences cannot be altered with abstinence or by medical intervention.
Understanding the Effects of Crack, Cocaine, and Methamphetamine
Each of these drugs are stimulants, and they produce roughly the same sort of impact on the user and their body and brain. Immediately upon ingesting a stimulant, the user feels an increase in energy and vitality. They feel hyper-alert, invincible, and like a better version of themselves. The drug is producing a chemical effect that activates the user’s mesolimbic dopamine system, which is involved with the reward system of the brain. This produces a manic effect in the user. They make speak, think, and move very rapidly, but dopamine is not designed to be activated in this way.
For that reason, chronic users of methamphetamine often develop psychotic symptoms, losing touch with reality. These delusions may involve feelings of persecution, or a belief that they are on a special mission from God. When stories hit the paper of some particularly inexplicable thing that a drug abuser did, it’s usually attributable to methamphetamine.
Crack and cocaine behavior in a similar way, but the high is more short-lived. This makes the possibility of an overdose far more likely since users will simply continue using the drug in an attempt to produce the same effect. Meanwhile, the effect becomes less and less pronounced the more they take. Symptoms of an overdose include:
- High blood pressure
- Rapid heart rate
- Chest pain
- Extreme anxiety
- Excessive sweating
- (Enlarged) dilated pupils
In terms of recovery, meth, crack, and cocaine users will face a short-term detox process, followed by a period of intense depression in which their brains need to relearn how to produce dopamine properly. Rehabilitative therapies thus focus on retraining the reward centers of their brain to respond properly to the correct stimuli.
In addition, all stimulants have a side-effect profile that includes constricting the blood vessels that nourish major organs and severely damage the heart. And that is just the beginning. Long-term users report problems with their skin, teeth, and eyes. Those who abuse these drugs will find themselves at increased risk of heart disease and stroke for the remainder of their lives.
Understanding Marijuana Addiction
While some still say that marijuana is not addictive, the only sense in which that is true is that it does not carry with it any physical addiction. But neither do crack or meth. All three of these drugs activate the dopamine system through different channels. THC, the active ingredient in marijuana, activates it through cannabinoid receptors.
In the process, it activates the brain’s reward system, which is typically activated during sex, eating, or when someone experiences a success in their life. For that reason, marijuana is believed to produce amotivational syndrome, which prevents users from actively seeking out successful experiences in their own lives.
In addition, marijuana has a debilitating effect on the brain’s ability to produce new memories. It also significantly impairs judgment, reaction time, and the ability to hold your attention on something.
While some people use the drug in a similar way that people responsibly enjoy alcohol, marijuana can activate latent psychotic disorders in individuals that suffer from schizophrenia, bipolar disorder, or schizoaffective disorder. Generally speaking, they’re symptoms can be vastly reduced when they stop recreational use of marijuana. But like any drug that produces psychoactive effects, marijuana can have a vastly different impact on different individuals. It is by no means completely safe, despite the fact that it has been legalized in many states, and despite the fact that some individuals enjoy it without consequence.
Each of the drugs listed above can create an addiction in those that use them frequently. While the results vary wildly in terms of the impact that the addiction has on the individual user, each of these drugs is involved in exciting the reward center of the brain in various ways. In the process, the brain becomes used to the drug and confused about how to produce dopamine when something good happens.
All drugs produce this effect and it takes time for the brain to adjust itself to life without the drug. Even in the case of marijuana, this can take up to a year. Individuals going through this period may appear withdrawn, depressed, and anxious. While these can be treated psychiatrically, adjusting to sobriety takes time.
Treatment, through various levels of care, seeks to re-establish a new norm for the recovering addict and provide them with the resources that they will need to fight their addiction. For some individuals, this will mean linking them with housing and other public services. For others, it may mean returning to work or school once they have gone through the process of inpatient care.
For most, it means understanding that community engagement with others that are going through the same thing is vital to the process of recovery. This can include 12 Step programs or group therapy options. Having community support is vitally important to those in recovery.
Though the process is difficult, help is out there for those who need it. Lives can be and are rebuilt every day, regardless of the user’s drug of choice. The important thing to remember is that the process gets easier over time, and the brain is an incredibly resilient organ. If given the opportunity, the chemical damage done by these drugs can be reversed.