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Substance Abuse Treatment
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Portland, United States (Oregon)
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Drug Rehab in Oregon
Oregon Substance Abuse Treatment Centers offer help for those suffering from addictions.
Which Drugs Represent the Greatest Threat
While every state has its fair share of drug problems, drug problems tend to be unique to each individual state. For Oregonians, the drugs of choice are heroin and methamphetamine, with crystal meth identified as the single greatest threat to Oregonians in 2018 by the vast majority of law enforcement officer. These are two of the most dangerous drugs in terms of the physical toll on the body. They are also quite caustic to the psyche as well.
According to law enforcement, both crystal meth and heroin are being smuggled into the state from the cartel pipeline that leads from Mexico to Oregon and up into Canada. Both Idaho and Oregon have become major sites for drug trafficking. While drug officers have ranked crystal meth as the greatest threat to the region, but heroin and other opioids continue to rank a close second.
In addition, the same prescription opioid problem that has destroyed lives all across the United States has taken a foothold in Oregon as well. Doctor shopping and getting phony prescriptions have resulted in an unprecedented amount of prescription opioids on the black market and many of the individuals that find themselves in Oregon rehabs are there for otherwise legally prescribed drugs.
While the Oregon legislature and Federal officials continue to search for ways to curb the flood of opioid based prescriptions from hooking hundreds of thousands of Americans each year, the problem continues to grow worse, even as more and more doctors are being indicted on criminal charges.
Due to these factors, it’s likely that drug use in Oregon will rise in the coming years as it has every year for the past few years.
Drug Abuse by the Numbers
According to numbers collected by Oregon’s state government, on average 322 people die each year due to accidental overdose. What these numbers fail to account for is the damage that those who don’t not only due to their own bodies, but the lives of those around them.
Surprisingly, the majority of individuals that die from accidental overdoses are male, white, and between the ages of 45 and 54.
In addition, Oregonians ranked higher than the national average in alcohol abuse (59% to 52%) as well as the non-medical use of pain relievers (5.72% to 4.57%). Oregonians also ranked higher in dependence and abuse statistics than the national average (9.24% to 8.27%).
2.7% of Oregonians reported having an unmet need for substance abuse care for illicit drugs while 7.2% said they had an unmet need for substance abuse care for alcoholism.
As of 2012, heroin and other opioids remained the number one cause of Oregonians finding themselves in rehab clinics, but methamphetamines make up a growing number of those in need of substance abuse care.
The physical and psychological toll of both of these drugs is among the worst, with abusers often finding themselves with permanent psychiatric disabilities because of them.
Understanding Crystal Methamphetamine Addiction
What is Crystal Methamphetamine?
Crystal methamphetamine is classified as a stimulant, but it’s one of the most potent and addictive stimulants ever made for recreational drug use. Users can get addicted to it very easily. It can be smoked, snorted, injected, or simply eaten. It gives the user a manic high that lasts much longer than crack or cocaine.
The drug generally comes in a powder, but can also come in a pill as well. It’s sometimes called ice or glass because it looks like fragments of broken glass.
Chemically, crystal meth is similar to drugs like Ritalin or Adderall that are used to treat ADHD. Users become more alert and active, and often feel manic. In other words, it makes you feel really good.
Signs and Symptoms of Chronic Meth Usage
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Individuals that have developed a chronic meth habit often display the following symptoms:
Rapid weight loss (meth suppresses the appetite)
Skin sores and abscess
Disrupted sleep patterns
User may be appear hot or sweaty much of the time
User may appear to have a lot of energy or to be manic followed by periods of sleeping for days.
Methamphetamines Tied to Heart Conditions
But this good feeling also comes at a very high cost. Not only will crystal meth increase your heart rate, but it also increases your blood pressure and body temperature. It also makes it very difficult to fall asleep. Short term negative side effects can include anxiety, paranoia, and hallucinations due to going an extended period of time without sleeping.
In addition, the damage methamphetamines wreak on an individual’s body will affect them for the rest of their lives. Former meth users are at an increased risk of heart problems due to the overstimulation of the heart muscle during use. On top of that, methamphetamines cause a constriction of the blood vessels that, in turn, require the heart to work harder in order to transport blood through the system. The organs that these blood vessels supply can also be damaged.
Much of the damage done by extended methamphetamine use cannot be undone.
Methamphetamines and Addiction
Methamphetamine is among the most addictive substances known to man. The dependency formed to the drug is often immediate, with users often taking more than they had initially intended to take. This is similar to the effect of crack or cocaine. Once the initial high is gone, depression, agitation, and anxiety follows. All a user wants is more of the drug.
For this reason, many health officials consider methamphetamine the most dangerous drug widely available on the black market right now. It’s very easy to form a dependency on it, and the effect is has on the user often leads to violent, confused, paranoid behavior that destroys not only the user’s life but those of others.
Methamphetamine and Psychosis
Psychosis is psychiatric disorder that happens when an individual experiences both hallucinations and delusions. These delusions can either be of the paranoid kind, as when someone is out to get you, or the grandeur kind, when an individual believes they are specially chosen for some greater purpose. Individuals who believe these things aren’t living in the same reality as everyone else, and may at times believe that the other people they are interacting with are a threat to them. Sometimes they believe these people aren’t real at all.
Those that are having a psychotic episode are a threat to both themselves, and the other people around them. While heroin addicts have a tendency to curl up in a bed somewhere, those on methamphetamine have a tendency to be wired to explode.
Most of the big headlines that you’ll find in a newspaper about individuals that do something crazy are going to involve some drug of the stimulant variety.
Amphetamine psychosis generally happens to those that have been using the drug for an extended period of time. They may believe that they are the target of a government conspiracy or that the television is sending messages directly to them. The individuals on TV might be talking to them, or when they hear a song on the radio, subliminal messages are instructing them to carry out some task.
In other words, chronic meth users lose touch with reality and exhibit many of the same symptoms that those that suffer from schizophrenia do.
How Does Methamphetamine Cause Psychosis?
According to psychiatric researchers, psychosis is caused by an imbalance of dopamine to certain parts of the brain. Antipsychotic drugs are aimed at preventing the dispensing of dopamine to those parts of the brain. Amphetamines on the other hand, increase the amount of dopamine to the brain. This is not, in fact, dissimilar to how alcohol or marijuana operate. The major difference is the speed and scale at which a user may become psychotic.
This also plays a role in the addictive properties of methamphetamine. Since users who take the drug are releasing a lot of dopamine all at the same time, the brain becomes dependant on the drug in order to produce dopamine. This can have long lasting psychiatric side effects that go well beyond merely craving the drug. The brain chemistry that is unbalanced during this process may never be able to be fully restored.
Furthermore, unlike marijuana and alcohol, amphetamine psychosis is likely to occur, and happens in the majority of long time users. Users may begin to feel the effects of it within only a few months of abusing the drug.
On the other hand, marijuana and alcohol tend only to make conditions that are already a problem worse. So folks that are suffering from schizophrenia or bipolar disorder may find their psychiatric conditions worsened by these drugs, while a drug like meth can actually be the lone cause of these symptoms.
Methamphetamine by the Numbers
While opioids remain a problem all across the United States, Oregon has a major issue with meth. Law enforcement officers have made it more difficult to get over-the-counter medications that are used to make crystal meth, but that has only forced the drug trade to find other means of making and distributing the product. Those that watched Breaking Bad know that there are at least two different ways of manufacturing the drug.
While this has slowed the rate at which meth is produced, it’s also given more control of the market to the drug cartels. Thus, the West Coast pipeline that runs through Mexico also goes through Oregon where the drug is plentiful.
For Oregon law enforcement, this creates a unique problem. A majority of law enforcement agencies listed crystal meth as the number one drug threat in their jurisdiction, as it’s more likely to contribute to violent crime than any other drug out there. Law enforcement officials have also stated that the problem is growing, as cartels have found more ways to smuggle methamphetamines into Oregon. This has resulted in the drug being widely available in the state.
Over the past five years, treatment admissions for methamphetamine have risen nearly 12%, with more people being arrested on meth for aberrant behavior more than any other drug. Since 2010, the amount of methamphetamines seized by police has tripled, with the amount of deaths caused by the drug three times greater than what they were in 2001.
With law enforcement scrambling to do the best they can to prevent the drugs from reaching Oregon streets, the problem appears only to be getting worse.
Long-Term Effects of Methamphetamine Abuse
Chronic meth users, like most drug abusers, develop a tolerance to the drug over time. Because of the manner in which the drug affects the dopamine channel of their brain, many find it difficult to experience any pleasure without the drug. Its addiction profile is extremely high.
Users often suffer from a host of other psychiatric disorders including:
Aggression and violent tendencies
Psychotic symptoms are characterized by both delusions and hallucinations. Hallucinations are when an individual sees, hears, feels, or tastes something that isn’t there. A delusion is a false belief about themselves that they have no ability to distinguish from reality.
Delusions are characterized by a feeling of being singled out or special. Many people who experience delusions believe that they have the ability to read minds or hear other people’s thoughts. They believe that popular media like television or radio are speaking directly to them, or that they are at the center of a government conspiracy and that there are surveillance devices everywhere. They may believe that random people that they meet actually mean them harm, or were planted by the government to try to drive them insane. Delusions can be terrifying
Delusions can also be exciting and make life interesting. They are also, therefore, remarkably seductive. Most people would rather believe that they had special powers or were important enough to be the subject of a conspiracy. The loss of the delusion robs of them or their sense of self and a narrative in which they are the star of the show. Delusions further the grip of the drug.
These symptoms can last for years after an individual has quit taking methamphetamines, and even after symptoms have diminished, a stressful event can trigger another psychotic break.
In other words, long-time abusers may be stuck with serious mental illness for the rest of their lives. In cases where individuals make a full recovery, it may take over a year to restore the normal functioning of their brain. Some aren’t so lucky.
That being said, much of the damage caused to the brain by methamphetamine after periods of prolonged abstinence is reversible.
Physiological Problems Caused by Prolonged Meth Use
The use of methamphetamine over an extended period of time is also associated with an increased risk of cardiovascular problems. Users are putting themselves at increased risk for stroke or heart attack and exhibit serious problems with their blood vessels. Some individuals experience complete heart failure as a result of methamphetamine addiction.
Suffice it to day, meth over taxes the heart. That feeling you get when you’re scared or excited is felt throughout a meth high. It causes the blood pressure to increase and the heart to beat faster. It also causes a constriction of the blood vessels that make it more difficult for heart to pump blood through your body. This leaves users at increased risk for heart attacks or strokes. It also leaves users with increased inflammation of the heart.
While it takes a great deal of meth taken over a long period of time in order to produce these kinds of effects in the human body, as stated earlier, users require the use of more and more meth the more that they use it. Unchecked addiction thus makes heart problems inevitable.
It’s no secret that meth users aren’t the most enticing people to gaze upon. Meth causes a number of physiological responses, and one area that gets hit very hard is a user’s dental hygiene.
“Meth mouth” is that name given to the condition that chronic abuse of methamphetamine causes to a user’s teeth. Users often suffer from rampant tooth decay and gum diseases that destroys the enamel in their teeth, which causes them to crack and fall out. It’s important to note that the same thing that meth does to a person’s teeth, it’s also doing to a person’s bones.
According to one study, 96% of meth users had untreated cavities, while 58% had untreated tooth decay. 31% of those had 6 or more missing teeth.
In many cases, the teeth that are damaged by prolonged meth abuse cannot be salvaged and have to be removed. This, in turn, can lead to more health problems down the road, including heart problems. So on top of meth physically damaging a user’s heart, it also causes dental problems that have been shown to lead to severe heart conditions.
Individuals that abuse meth over extended periods of times will notice that their skin begins developing more pimples than normal. This is because meth raises the heartbeat and body temperature. The hotter your body gets, the more a person sweats. The more they sweat, the more oil that is produced. That, in turn, causes severe acne. The effect can be quite startling, and over time, will cause scarring.
In addition, meth users tend to form large sores from the pimples that form there. Doctors have dubbed this condition “meth mites” because meth users have a tendency to hallucinate that insects are underneath their skin. They obsessively pick at the pimples and acne that does form there making the problem much worse. Because meth constricts the blood flow to the skin, these and other sores can take a very long time to heal.
Another way that meth can damage your skin has to do with the damage that it causes it blood vessels. The lack of blood flow to the skin can make a person’s face look gray and leathery. This is why those that use meth for extended periods of time appear to be rapidly aging.
Osteoporosis is a condition that is characterized by bone loss. As you age, your body’s bone mass decreases. Eventually your body loses more bone than it makes. That are several health conditions that can accelerate the pace at which osteoporosis occurs, and the use of methamphetamines happens to be one of them.
One study showed that the relative bone mass density in 46 men who were chronic meth users was lower than what would be expected for other men of the same age.
Osteoporosis causes the bones to become more brittle, break easier, and heal slower. It’s another way in which meth accelerates the aging process.
Collateral Damage from Constricted Blood Vessels
All of the organs in your body require a healthy flow of blood in order to heal and nourish themselves. Thus, there isn’t an organ in the body that crystal meth doesn’t destroy, and that includes the eyes.
Retinal vasculitis is a condition that long-time meth users often suffer from. The disease is characterized by inflammation to blood vessels going to the eye. Severe cases of retinal vasculitis can cause blindness.
Other Physiological Issues
Depending on the manner in which the drug is ingested by the user, it can cause other problems as well. If meth is smoked, it can cause severe damage to the lungs. If it is injected, it’s likely the veins will be compromised. For those that snort it, damage to the nasal cavity is likely.
In addition, meth, like most stimulants, acts as an appetite suppressant. Therefore, it goes without saying that the majority of users are not getting a healthy, balanced diet. This negatively impacts their health across the board as well.
Part of treating meth users who have been on the drug for a long time, is managing the severe physiological problems that the drug has caused them. But in many cases, the psychiatric problems are just as bad, if not worse.
Who Uses Meth?
While Oregon isn’t alone in its meth problems, the state has seen increased usage over the past 5 years. This is largely due to the fact that it’s very easy to find in the state, although it’s becoming an increasingly difficult problem all across the country. Studies have shown that the rate of methamphetamine abuse is rising everywhere. But in a state like Oregon that is one stop along the cartel pipeline, the problem has become exaggerated.
Studies have shown that the majority of those that become chronic meth users are:
Between the ages of 18 and 23
College students and blue collar workers
Women seem to be particularly vulnerable to meth addiction due in large part to the fact that the drug is just about the most efficient, if unhealthy, weight loss regimen known to man.
That being said, meth addicts come from every demographic. They can be black or white, urban, suburban, or rural. Honor students may become meth addicts because the drug makes it easier to pull an all-nighter, study up before a big test, or complete an important paper. Athletes may become users because the drug make it easier for them to push themselves and work out.
The drug makes a person more alert, focused, and it gives them an almost endless supply of energy. For that reason, methamphetamine is popular even among successful professionals.
Treatment for Methamphetamine Abuse
While drugs like cocaine or methamphetamine don’t have the severe withdrawal syndromes associated with them that heroin and other opioids do, they nonetheless have the highest rates of relapse.
One of the major reasons for this is the intense depression that takes place after meth use has stopped. As a drug, meth throws off an individual’s brain chemistry and the chemicals that are involved with the experience of pleasure and reward can no longer function on their own without the drug. This causes a condition known as anhedonia. It roughly means “an inability to experience joy or pleasure”.
Over time, a user’s brain chemistry can, in many cases, be restored, but this will take 14 months of abstinence from the drug. Since most drug treatment programs can’t offer intensive care for that period of time, the relapse rate for a drug like meth is very high.
Unlike heroin, there is no physical addiction, so there is no drug out there that can help an addict wean themselves off of meth. But the psychological lure of meth is so strong that this often proves more of a curse than a blessing. That being said, the patient still needs to undergo a long course of detoxification.
Medications for Meth Addiction
For long-time meth abusers the psychological and psychiatric damage that the drug does to the brain must be restored. That may include the use of several different psycho-pharmaceutical medications including antidepressants and antipsychotics. These can include SSRI medications to treat the anxiety and depression that those who are detoxing from meth often suffer. For those that have displayed psychotic symptoms, a course of antipsychotic drugs may be necessary to bring the patient back in touch with reality.
These medications are used solely for the purpose of treating the psychiatric conditions that long-term meth abuse has caused the patient.
No drugs currently exist on the market to inhibit the desire for methamphetamines or other stimulants. There is, however, a lot of research being done in this area. The aim of these medications is to blunt the craving users of the drug often feel after quitting.
Behavioral Therapies for Meth Addiction
Since there is no physical addiction, the only methods that have proven successful over the long term for meth addicts have been psychotherapeutic behavioral therapies. The rehabilitation period will require the user to be abstinent for over 14 months before the brain’s natural chemistry has been restored. That period is fraught with obstacles.
One model that has shown success for meth addicts is known as the Matrix Model. The Matrix Model employs a cross-disciplinary approach that includes behavioral therapy, 12 step programs, individual counseling, drug testing, and encouraging activities that do not include drug abuse. Part of the process is involving family members in the healing. The Matrix Model has proven effective at treating meth addiction.
The Matrix Model includes the use of motivational incentives in the treatment process (MIEDAR). This model uses a reward system for periods of sobriety and teaches addicts that it’s possible to live a rewarding life without the use of meth. The MIEDAR system operates on the assumption that reward trumps punishment in the mind of most addicts, and has proven itself to be a very effective way to reduce drug-seeking behavior.
The goal of meth rehabilitation is to restore the proper functioning of the reward center of the brain that was damaged during the period of prolonged meth abuse.
Understanding Heroin Addiction
Heroin is among the most addictive substances known to man and Oregon is no stranger to the heroin and opioid epidemic that has gripped the rest of the country. While law enforcement officials may list methamphetamine as the number one cause for concern, if you asked any emergency room doctor or rehabilitation clinic they would still tell you that the vast majority of their patients are there because of opioids.
The opioid epidemic that has destroyed so many lives across America has been a problem in Oregon for longer. While statistics are showing that the use of opioids in the state has not grown with the national average, opioid addiction still accounts for more deaths and more overdoses than any other drug.
The number of lives lost due to opioid overdoses has been decreased greatly because of drugs like naloxone that act as opioid antagonists. These drugs can stop overdoses as they are happening and have saved numerous lives throughout the past decade. If not for drugs like naloxone and their widespread administration, thousands and not hundreds of lives would be lost each year.
The physical dependency that the drug causes in users makes medical intervention in the process an absolute must. Users will find it nearly impossible to resist the urge to begin using heroin once they begin to withdraw from an opioid. Much of the first month of rehab is thus geared toward managing the painful withdrawal syndrome that results from prolonged use of the drug.
Street Heroin and Prescription Drug Abuse
The craze in prescribing prescription opioids for pain relief has resulted in a massive shift in the demographics of typical opioid and even heroin addicts. Many of those that find themselves with severe heroin habits began by being prescribed prescription painkillers. No longer is the image of a disaffected twentysomething the stereotype that defines the typical heroin user. Today, we find many working class folks and professionals who began using heroin after they had a major surgery. Hence why these two seemingly different problems have grown together.
What is Heroin?
Heroin is also known as diamorphine. It is derived from morphine, and used widely for recreational purposes due to its euphoric effects.
There are two different kinds of heroin. One is known as “black tar” because that’s precisely what it looks like. Heroin is naturally a white or brownish powder. Black tar heroin is processed in Mexico quite cheaply, and the color reflects the numerous impurities that the crude processing method has left behind.
Heroin that is sold as a white powder can be smoked, snorted, or injected. Black tar is generally diluted and injected.
What are Prescription Opioids?
Prescription opioids are a true gateway drug for heroin. Many individuals that were legally prescribed opioids by a doctor following a surgery find themselves hooked the drug. While there are currently many measures underway to curb the prescription to heroin abuse pipeline, many individuals still find themselves going from leading perfectly healthy lives to having a debilitating substance abuse problem due to carelessly prescribed pain medication.
Drugs like lortab and oxycontin can also be purchased from careless doctors by phony patients, and then sold on the black market to individuals for recreational use. Teenagers often get their first dose of opiates from their parent’s medicine cabinets. The problem is rampant.
While these drugs may not produce the same level of euphoria as heroin does, they are no less addictive.
Heroin Statistics in Oregon
Prescription opioids used for non-medical purposes and heroin together make up 48% of deaths caused by substance abuse in the state of Oregon. By contrast, methamphetamine and other stimulants account for only 9% of accidental overdoses. The next highest is alcohol which accounts for around 16% of substance related deaths.
Of those that used opioids for non-medical purposes, 54% said that they got the drug for free from a friend or relative, while roughly 20% said that they were able to procure the drug from a careless doctor.
Meth and other stimulants may be getting all the headlines, but opioids remain the number one killer of Oregonians. Oregon has repeatedly posted numbers for heroin and opioid abuse that exceed the national average.
Long-Term Effects of Heroin Abuse
The Physiological Effects of Heroin Abuse
Like many drugs that stimulate the pleasure center of the brain, heroin and other opioids produce serious imbalances to an individual’s brain chemistry that are not always reversible. Studies have also shown that there is a deterioration of the brain’s white matter due to chronic abuse, and this, in turn, can cause difficulty with decision making and the ability to regulate behavior.
As an individual takes more and more opioids, they acquire a tolerance to the drug which causes them to need more and more of it. With an opioid as potent as heroin, withdrawal can take place 24-48 hours after the last dose was taken. The worst of the withdrawal will end after the first week, but some individuals have reported withdrawal symptoms for months after their last dose.
Heroin users also suffer from side effects like constipation, nausea, insomnia, and confusion. As a respiratory depressant, heroin addicts may suddenly stop breathing under the influence of the substance, and several deaths due to heroin happen this way. Lung diseases like pneumonia are not uncommon for heroin addicts.
In addition, heroin has an addiction profile like no other. Even drugs like meth and cocaine don’t come close to conditioning the sort of purposeful commitment to securing more of the drug than heroin does. This is largely due to the fact that it makes you feel incredibly awful after the drug has worn off. Over time, heroin addiction is no more about seeking out a pleasurable feeling. It becomes about avoiding a terrible one.
Individuals in the thrall of heroin addiction often suffer from an almost uncontrollable urge to do anything in their power to procure more of the substance. In so doing, they develop antisocial tendencies and will manipulate and exploit people simply to get more of the drug. Heroin addicts often have to battle depression, especially those in the early and middle stages of kicking the habit.
No method of ingesting heroin is safe, but those that inject it tend to have a unique set of complications from repeated use of their veins. Heroin addicts often find themselves with collapsed veins and numerous infections that find their way throughout their circulatory system and even into their heart. It’s important for doctors to assess the physical toll their addiction has taken on their bodies while administering treatment.
Risk of overdose is high for heroin addicts, and it’s especially difficult because the user themselves will not generally be aware of the situation. Many addicts have died choking on their own vomit while they were high on heroin.
The Mental Health Effects on Heroin Abuse
Every human brain has opioid receptors. The opioid system itself is responsible for regulating the pain response and is involved with the reward system as well. While all opioids act the same way in the human brain, heroin is synthetically produced to hone the euphoric effects of the drug. That makes it work much faster and tends also to make it much more powerful. Within 10 seconds of injecting the drug, the user will begin to feel the powerful effects of heroin coursing through their veins. The user feels instant euphoria followed by several hours of tranquility and peacefulness.
It’s important to note here that there is another way to achieve a very similar effect, if less intense: by exercising. When an individual exercises for extended periods of time, their brain produces endorphins. These endorphins bind with opioid receptors in the brain and produce what is known as a “runner’s high”. This is one of the reasons why those that are coming out of a period of opioid addiction are encouraged to exercise. It fights the post-detox depression and rewires the reward center of the brain, disengaging it from the drug and relinking it with a healthy activity.
The motivation circuit that governs human action becomes completely controlled by the desire to procure more heroin. There will be no experience that can remotely compare with the feeling that the drug gives its users. All actions are aimed toward getting more of it. Heroin’s hold on the reward system of the brain, which should be motivating us to succeed in our personal and professional lives, is absolute.
Our bodies are remarkably adaptive. The brain responds and adapts to what using heroin does to it quickly. Eventually, taking the same amount of the drug produces a less stimulating effect. The user thus needs more and more of the drug in order to get the same impact. That’s what’s known as “chasing the dragon”. Of course, the faster you run, the further away it gets.
For as much as heroin rewards the user for using it, it also punishes them with impunity. Withdrawal begins almost immediately after the drug has worn off, and the only thing that a heroin addict can think about is getting more of the drug. This happens despite the fact that they will likely not reach the same high they did last time. The desire to do so becomes an exercise in futility.
Heroin over stimulates the pleasure center of the brain until it’s replaced by nothing but pain and want.
Damaging the Brain Structure
Researchers have noted that heroin disrupts the white matter of the brain. The white matter is involved in transmitting impulses from one part of the brain to the other. Scientists have also noted that heroin decreases the gray matter density in the frontal cortex. That’s the area of the brain that controls our senses, speech, and decision making processes.
In addition to disrupting brain pathways and decreasing brain density, heroin has chemical effects on the brain that must be restored after the user has stopped taking the drug. Specifically, when a user takes heroin, they are flooding their brain with dopamine, which is the neurotransmitter responsible for pleasure and reward. In the absence of the drug, the user has no means by which to produce the drug naturally. What follows is severe depression until the user’s brain chemistry can be restored.
In every instance, the longer an individual uses heroin, the greater the damage to the brain.
Detoxing from the Drug is Just the Beginning of Recovery
Heroin essentially destroys any other motive toward pleasure or gratification. It destroys any motivation to achieve success beyond procuring the drug. While others are getting promotions and welcoming their new children into the world, heroin addicts live for the next fix. It’s an uncomplicated kind of existence, but as time goes on, it becomes less and less fulfilling. Leading a normal human life should be just the opposite.
Heroin actually punishes far more than it rewards.
Former addicts describe the feeling of heroin withdrawal as:
Hopelessness and depression that feels as if it will never end
Emptiness and despair
Restlessness and insomnia
Feelings of dread, panic, and anxiety that feels like it will never end
As close to hell as you can get on earth
Heroin renders a user’s brain unable to regulate its own chemistry. While this can be restored in time, it’s an uphill battle for long-time users. Heroin conditions its addicts into the belief that being off the drug is a hellish state of desolation and despair. The risk of relapse is thus very high, even for users that have broken the physical thrall of the drug.
The Persistence of Long-Term Effects
Heroin addicts deal with the lure of the drug for the rest of their lives. Our brains naturally dismiss unpleasant experiences while romanticizing the pleasurable ones. The trauma of detoxing is thus less persistent in the memory as the highs of the drug. The risk of relapse will remain throughout the user’s life.
The brain is resilient, but it takes a long time to fully heal. Brain dysfunction can last up to 3 years after the user has stopped taking the drug. In addition, the craving never fully goes away, and can be easily triggered by external stimuli and especially stress.
This last fact is key because successful former addicts manage to become aware of what stressors trigger cravings, and can manage those stressors without using. The user’s brain will never be the same, but with commitment to their recovery, they can lead healthy, happy lives again.
Who Uses Heroin?
While the largest demographic of heroin users are males between the ages 21 and 29, there isn’t a demographic that heroin abuse doesn’t touch. This is due in large part to the fact that prescription opioids are a gateway for a number of users that were legally prescribed medication for pain management.
In the early 2000’s the typical user was between the ages of 35 and 49, but in the last 20 years heroin was made much more accessible on the streets of major Oregon cities like Portland, which currently acts as the central hub of the drug trade in the state.
In the last few years, rural admissions to drug treatment facilities for heroin alone has increased by 300%. In urban communities the number has risen 35%. Nonetheless, easy access to the drug has worsened its impact on the Oregon’s population.
Deaths caused by heroin however, have decreased in Oregon and elsewhere due in large part to widespread use of the anti-overdose drug naloxone.
Heroin Addiction Treatment and Recovery
The first step in the process for any addict is a drug assessment. The assessment is designed to determine the extent of the user’s abuse and the physical toll that it has taken on their bodies. It’s also designed to determine their attitude toward their drug abuse. A medical history of themselves and their families is taken. This helps their care team anticipate any complications they may result as an effect of their treatment.
Intake and Detox
This is the first step in an ongoing process that for most addicts never really ends. Beating heroin addiction requires a lifelong commitment as the snare that the drug lays for the user never really fades. The damage caused by the drug can be mitigated to a large extent. Brain chemistry can restored. White and gray matter can be returned to their proper levels. But the psychological desire for the drug can last a lifetime. Detox is the first step in recovery.
Opioids are renowned for painful and miserable detox. Healthcare providers can lesson the painful withdrawal syndrome by using drugs like suboxone or methadone to blunt the physical cravings that the drug causes, and the other painful side effects of not being on the drug.
Symptoms of opioid withdrawal include:
Tearing of the eyes
Agitation and restlessness
Inability to concentrate
Aches and chills
Rapid heart beat
To some extent, drugs like methadone can help an addict through the early phases of withdrawal. They lessen the extent of the physical and psychological pain that the drug assaults its users with, but they can’t get rid of it entirely. Most addicts that kick the habit say that the period of detox is the most painful thing they ever experience.
For this reason, inpatient treatment during the detox phase for heroin addicts is crucial to the recovery process.
Post-Acute Treatment for Opioid Addiction
The period directly after detox is known as the post-acute phase. During this phase addicts are still quite vulnerable. Most relapses occur during the first couple of months after detox has completed. This is due to the psychological after effects of no longer being on the drug. Even with the physical addiction kicked, the psychological addiction remains strong enough to cause the majority of relapses.
Users in the post-acute phase report feelings of:
High blood pressure
Continued craving for the drug
This is because the reward center of their brain is no longer working properly. Achievements, successes, and enjoyment that would be experienced by an average person, cannot be felt by an individual in the second stage of recovery. Eventually, this chemical damage can be restored, but it won’t be fully restored until one year after full abstinence.
Treatment Options for Post-Acute Patients
There are a number of treatment options for post acute patients. These include inpatient options, partial hospitalization, and intensive outpatient programs.
Inpatient options are generally the most successful since the likelihood of a relapse is very high during the post-acute period. Inpatient treatment programs that last 3 months have shown higher rates of success than 28 day programs. While 28 day programs are good for weaning patients off the physical addiction, three month programs have shown success weaning patients off both the physical and psychological aspects of the addiction. They also allow addicts a completely safe place in which access to their drug of choice is highly improbable.
Outpatient programs can be successful for those there are committed to their recovery and have ties to a community in which their desire for the drug won’t be encouraged or tolerated. Folks that have jobs and families to go back to often choose outpatient programs because they are eager to get back to their lives. Individuals that have no place to go, however, often find that the loneliness and isolation that follows their period of addiction drives them back to people and places where drug addiction is the binding element of group.
Partial hospitalization lies somewhere in between. During the day, the patient will find themselves receiving treatment, attending meetings, and having one-on-one and group therapy sessions to track their progress and ensure that they are still on the road to recovery. Tox screens will be periodically administered. It’s ideal for patients that are in a supported living situation and have a clean and sober living environment to go back to.
Psychotherapeutic Methods for Treating Heroin and Opioid Addiction
There is no “one size fits all” solution to treating heroin addiction. The most successful methods draw from a number of different schools of thought on the subject, and understand that the road to recovery is different for each recovering addict.
That being said, every addict will face the urge to use again, so learning how to manage the cravings becomes a key part of the process to maintaining their sobriety and rebuilding their lives.
What ends up happening is that recovering addicts achieve a new equilibrium in their lives. Good things happen, and so do bad things. Certain bad things will cause an urge to use. Certain good things might also cause an urge to use. These are known as stressors or triggers. CBT (Cognitive Behavioral Therapy) has proven remarkably successful for managing triggers to drug use.
The theory behind CBT is that our thoughts influence our beliefs, our actions, and our behaviors. In fact, each of these influence the other. We can therefore manage all of these by managing one of them. By controlling and managing our thoughts, we can manage our behavior. And becoming aware of our triggers is the first step in this process.
This further involves changing the meaning that we ascribe to certain events that may cause an addict to relapse. Given enough time, stress in unavoidable. An addict will face thousands of reasons to justify a relapse throughout the course of their lives. It’s imperative that they supplant the urge to do so with an urge to do something else.
12 Step Programs and Sober Living Environments
The role that community plays in recovery cannot be understated, and many in recovery have found 12 step programs immensely helpful. 12 step programs emphasize the role of meeting with other people who have gone through addiction and are going through the process of recovery. Individuals in different stages of their recovery support one another and share their stories. They reward one another by acknowledging how long it’s been since they’ve used. Lifelong friendships are built in the process. Those who relapse have a support structure in place that prevents their addiction from taking over their lives again.
Sober living environments are ideal for those that have just gotten out of an intensive inpatient program and have no other place to go. Many addicts find that they’ve burned a lot of bridges with family and friends. Many times even supportive loved ones are afraid of what a recovering addict might do if they relapse and feel as though they cannot provide the right environment for recovery. Sober living houses and communities, many of which are subsidized by the government, can offer addicts a place to live and recover together.
Crime and Addiction
The connection between drugs and crime is difficult to ignore. Users of drugs like methamphetamine lose the capacity to make rational decisions and behave impulsively, aggressively, and violently.. They often lose touch with reality and can’t tell what’s real and what isn’t. They have false beliefs about themselves and the world around them. They feel threatened and become aggressive. They lash out in ways that seem bizarre to others.
Minor or even legal drugs like alcohol or marijuana have proven responsible for a number of car accidents many of which can turn fatal. Individuals under the influence of alcohol often behave aggressively and impulsively. They pick fights in public places. They end up in jail for assault or disorderly conduct.
Drug abuse may seem on the surface like a victimless crime, but addicts often make choices that not only negatively impact themselves, but others as well. Theft, robbery, homicide, child abuse, sexual assault, and domestic violence can all be correlated highly with drug abuse or alcoholism.
Beyond that, drug abuse and the need to procure more of drug condition users to do horrible things to other people that they would never think of doing under different circumstances. This includes armed robbery, battery, and even murder to get enough money to pay for their next fix.
As stated earlier, drugs like heroin make an addict remarkably single-minded. They live for the drug and they’re often willing to hurt others for it too. But even legal drugs like alcohol can cause people to behave in ways they would otherwise find repulsive. This includes putting not only their own lives but the lives of others in danger. It includes putting the needs of their addiction above the needs of their own family.
The most popular crime that a drug addict commits is driving under the influence. But often drugs and alcohol can be a primary factor in child abuse and neglect. Parents that should be watching their children are more interested in finding their next high. Their children become a secondary consideration. Alcoholics often are emotionally withdrawn or prone to fits of anger. Their children suffer as a result. Children that grow up in these households have a difficult time forming healthy relationships later in life. They’ve had no good example on which to form a basis for comparison.
Laws Regarding the Possession of Hard Drugs in Oregon
In a widely publicized decision, the State of Oregon reduced the charge of possessing many harmful drugs like heroin and methamphetamine to a misdemeanor. This law went into effect in August of 2017 and was applauded by many as a progressive approach to treating drug addiction. It doesn’t mean that those that are found to be in possession of hard drugs like meth or heroin are completely off the hook for being caught with the drug. It simply means that they’re unlikely to be sent to prison, or face draconian minimum sentencing charges for merely being in possession of hard drugs. This benefits both drug users and taxpayers.
Oregon, like many states across the US, wants to take a rehabilitative approach to managing individuals that are caught in possession of illegal narcotics.
There are, however, caveats.
The penalties for being caught with enough drugs to traffick have not changed. Possession with intent to sell remains a felony in the state of Oregon.
By changing drug laws to reclassify possession as a misdemeanor, Oregon joins a number of other states that have sought to improve the quality of the lives for addicts. Instead of throwing them in prison, where drugs remain rampant, Oregon health officials seek to push a treatment agenda that will see more lives saved and rebuilt in the wake of an ever-growing problem.
The law is part of an initiative to reduce the racial and economic divide that finds more black and poverty stricken communities filling prisons across the state. It also means that many addicts will find the help they need instead of having their lives further destroyed by their addiction.
Oregon’s Drug Court Program
Oregon has a drug court program for nonviolent drug offenders. It’s aim is to give those that have drug dependency issues a chance to kick the habit and get their lives going in the right direction. Drug offenders that are high-risk are often high-need as well. The program is aimed at preventing violent crime before it happens.
Much of Oregon’s crime rate is directly linked to drugs one way or the other. Whether it is addicts attempting robbery in order to pay for their next fix, or if it’s tied to the drug trade, drugs encompass a major chunk of the state’s crime rate.
The sense behind the drug court program is to prevent a major crime before it happens. This entails mandatory counseling, mandatory tox screens, ongoing judicial oversight, and a system of incentives and sanctions to help drug offenders and addicts from making a choice that will destroy their lives or somebody else’s life forever.
What If Your Loved One Finds Themselves in Oregon’s Drug Court Program
Drug court is not the same as being charged by a prosecutor. That form of justice is about penalizing an individual for breaking the law. Drug court is a form of restorative justice also known as collaborative law. Prosecutors and defense attorneys work together with other key figures to create a solution that is best for the defendant.
It’s key aim is to restore the individual to their full potential. Here, the criminal justice system works hand in hand with health care providers. Those in drug court are offered incentives for clean tox screens, and meeting their treatment goals. It bears mentioning, however, that cases in which an individual is non-compliant can be remanded to a criminal court. There, an individual can and would be prosecuted under the law, and could be responsible for serving a jail sentence. But an individual who completes drug court can have the charges against them removed.
The adult drug court team is composed of a number of individuals whose primary aim is to see that the individual maintains their sobriety and reaches their treatment goals. This can include going to meetings, counseling, psychiatric appointments, and of course, maintaining their sobriety throughout the process.
The drug court team is composed of the judge, the prosecutor, the defense attorney, the treatment provider, a court coordinator, probation and law enforcement officers, and a case manager. In some instances there will need to be a child welfare officer and a housing specialist as well.
Collaborative law is a special form of legal practice that is gaining widespread popularity across the country. It’s still based on an adversarial system, with competing parties imposing a system of checks and balances, but the ultimate goal is to help find a mutual solution that benefits all parties. Key to the process of collaborative law is a written agreement that all parties sign. This includes the prosecutor, the defense attorney, and the defendant. Failure to uphold this agreement results in a dissolution of the process. A case in which the agreement is not upheld by the defendant would thus be remanded to a criminal court.
The job of the treatment providers is to keep the court informed as to the compliance and progress of the defendant. A defendant who passes their tox screens and goes to their scheduled appointments, is a defendant that is upholding their end of the agreement.
If you or your loved one find themselves in a drug court, it’s imperative that as a defendant, they comply with the treatment requirements.
Oregon and Marijuana Legalization
While many have applauded the legalization and decriminalization of marijuana in Oregon and elsewhere, marijuana is still a drug. It may have less serious side effects than a drug like heroin or methamphetamine, but there are consequences to long term abuse, much the same way as there is with alcohol.
Consider that marijuana also affects the dopamine channel. In this regard it is similar to both heroin and meth. Many individuals that suffer from conditions like bipolar disorder or schizophrenia already suffer from abnormalities to the dopamine channel. In fact, antipsychotics are designed precisely to limit the amount of dopamine in the brain and this reduces many of the symptoms of psychosis.
While it’s unlikely that marijuana can cause psychotic symptoms in someone who is not already predisposed to them, it will affect the mental health of someone who suffers from issues with their dopamine. It thus becomes important for those that do suffer from these kinds of mental illnesses to steer clear of pot, which is less easy than it sounds, especially for longtime users.
Marijuana and Addiction
While there are people out there that will try to convince you that marijuana is not addictive, and that’s true in the physical sense, there are many individuals that find it difficult to stop smoking, even when it’s in their best interest that they do. For instance, if it comes down to spending money on an important bill that needs to be paid or a bag of weed, these folks would not think twice about buying the bag of weed first and letting the important bill lapse.
Just like any drug, marijuana use can reach the point of being addictive and it makes sense for those that are prone to addictive behavior to be very careful about smoking pot, just as they would about drinking alcohol.
The Role of Mental Health and Psychiatric Treatment in Drug Abuse
Before being admitted to any drug treatment or rehabilitation program in Smyrna there are a few steps you have to go through – one of which is the pre-intake process. This entails filling up a simple form.
You will also be handed out a slip that lists out the necessary documents and items that you will need through your program. Your eligibility as well as readiness for medication assisted treatment for drug abuse will also be assessed as a part of the pre-intake.
The Role the Family Plays in Addiction and Recovery
Many individuals that are reading this now have a family member that is struggling with addiction. As difficult as this is to hear, there is a fine line between support and enabling. Many family members find it necessary to cut ties with addicts while they’re using. Addicts are unstable, completely self-interested, manipulative, unpredictable, and dangerous. Being around them puts you and other family members at risk. You can be willing to take that risk under certain controlled circumstances, but providing them with room and board, or a comfortable place to get high only enables their addiction while putting yourself in jeopardy.
It’s important for addicts to realize that the person that they’ve become is a threat to not only themselves but others as well. The shred of humanity that is still reachable needs to make a conscious choice to turn their life around. Many times, this will require hitting rock bottom. That can include a near fatal overdose or a run in with the law in which they are forced into treatment. Support during this phase is vital, but it’s also likely that your loved one will at some point relapse. Addicts that are forced into recovery are more likely to relapse. Those that have made a conscious choice to kick the habit may still relapse at some point.
Codependency and Addiction
Question: What do most addicts claim is their number one trigger or stressor for wanting to abuse drugs?
If you guessed relationships, then you are correct. This is why romantic relationships are discouraged in the first year of recovery. Much of the learned behaviors that we take into relationships are analogous to an addict’s relationship to their drug of choice.
According to Psychology Today there are 6 questions that a person should ask themselves to determine if their relationships is codependent. Those are:
Does your sense of purpose involve making extreme sacrifices to satisfy your partner’s needs?
Is it difficult to say no when your partner makes demands on your time and energy?
Do you cover your partner’s problems with drugs, alcohol, or the law?
Do you constantly worry about others’ opinions of you?
Do you feel trapped in your relationship?
Do you keep quiet to avoid arguments?
Drug addicts make extreme sacrifices in order to satisfy their needs. They find it difficult to say no when their addiction makes demands of them. They feel trapped, but there doesn’t seem to be any way out. They make excuses for their drug abuse and pretend it isn’t as bad as it really is.
The overlap is, frankly, astounding. Codependency is a kind of relationship addiction. It doesn’t feel good, necessarily. Maybe it once did. Eventually it becomes more about avoiding the pain or fear of being without the person than the pleasure a person takes in their company.
Addicts must be very careful about the kinds of individuals they become involved with, and they must learn to consider both their partner’s and their own needs as being equally vital to the relationship.
The Role of Family in Recovery
No one is to blame for an addict’s choices beyond themselves. Ultimately, they are both responsible for the choices and mending the damage those choices caused. But in the process, it may be necessary for loved ones of the addict, and especially parents, to take a long hard look at their own choices as well. This isn’t to assign blame to any person, but the thrall of codependence is no less absolute than the thrall of any other kind of addiction. It is therefore necessary to understand what is and is not going to help your loved one through the process.
Most parents want to love and support their children, especially when their child is in a difficult place. That does not necessarily mean giving their children what they want. In fact, what’s best for the addict is very seldom going to be what they want.
The family member of an addict must be willing to put in the effort to identify behaviors that actually enable their loved one.
Consider for instance that addicts are in need of a lot of support, be it emotional, financial, or in terms of room and board. The addict may lean on family for emotional support, but parents and loved ones must be very careful about giving their addict financial support, because they run the risk of returning to the same lifestyle.
Addicts are not shy about scheming or using people in order to get their drug supply. On the one hand, they can’t help themselves. But a family member that plays into that cannot make the same claim. It’s important for addicts to find their own way, and mostly, this means keeping up with their treatment.
Family should carefully consider whether or not to take a recovering addict into their home, especially when there are clean and sober living situations that might better serve their needs in the short term. The end goal is for the addict to be self-sufficient. That means finding work, returning to school, securing independent housing, and being able to care for themselves. Family members that interrupt that process by giving them an easy out make it easier for them return to their old lifestyle. It’s important to remember, that support does not mean giving an addict what they want.
For a concerned family member that has read all the way through this document, the consequences of addiction may seem dire, and they are. Nonetheless, there is a role for hope. Most individuals that do suffer from major addiction at one time in their lives make significant recoveries. They find others to share their stories with and help individuals like themselves that are struggling with their own addiction. Support and understanding are necessary, and recognize that your loved one is not the same person they were under the influence of the drug is also vital to their recovery.
Seeing their potential will help them see it in themselves. In the end, this is the best you can do.