Portland, Oregon Addiction Treatment
Covering 145 square miles and with a population of an estimated 639,863 people, Portland is the biggest city in Oregon State. Serving as a boundary between the East side and West side of Portland, OR, the Willamette River is one of the most notable natural features of Portland. The cityscape of Portland is defined and characterized by the bridges that join the two sides of Portland, an aspect that has made earned the name “Bridgetown.” Some of the bridges in Portland are historical monuments, mainly due to their age with some being older than 100 years.
Drug abuse and addiction is a huge problem in Portland, OR and the most common and widely abused drug is Heroin. Portland is the central distribution center for heroin in the state of Oregon according to various Portland law enforcement agencies. The agencies consider the drug heroin, to be the most significant threat in Portland and Oregon at large. According to data from the High-Intensity Drug Trafficking Area Program, seizures that are related to the abuse of Heroin have registered a rise of above 900%, and this is since the year 2007. The abuse and dependence on heroin in Portland have led to it being nicknamed ‘heroin city’. The heroin drug problem has been a massive problem in Portland since the 1990’s. Heroin is an incredibly addictive drug, and its dependence on in Portland, OR can be attributed to work-related stress and increased availability due to ease of trafficking.
The rate of unemployment in Oregon is currently estimated to be at 4%. The rate is relatively low compared to cities across the U.S, and nationally where it is about 4.1%. The average household income in Portland is $53,230. Educational attainment in Portland OR indicates that 50.5% of the population has a higher degree, a percentage that is higher compared to that of the state. 40.1% of the population has a diploma, much lower than the state at about 51%, and 9.5% is lacking a high school diploma, about a percentage lower than the Oregon state level which is at 10.61%.
Based on records by the Portland Police department, between 2/5/2018 and 2/11/2018, a six days period, there were 28 arrests. The charges varied from assault, criminal trespass, and acquisition of drugs by deception, forgery, and operating under the influence. The number of arrests is high given that the profile and seriousness of the offenses. The most common types of crime in Portland include; murder, forcible rape, robbery, and aggravated assault. The rate of property crime is relatively high, in Portland with a 62% likelihood of an individual suffering from such a criminal offense. The percentage of property crime in Portland is exceptionally high compared to that of the United States which is at 38%. Engagement in property crime is aimed at the theft of money and property.
Drug overdose is a significant problem nationally, and so it is in Portland, OR. According to statistics, there are 12.5 deaths registered per 100,000 people in Portland due to a drug overdose. The challenge of the overdose drugs in Portland is coupled with the fact that for a majority of the victims, the overdose is due to the abuse of multiple illegal and prescription drugs. The rate of drug abuse in Portland matches that of the State which ranked 4th nationally. The drug addiction problem in Portland city is evident in average annual admission in rehabilitation centers being an average of 8, 000 people. The drugs problem in the city is attributed to the location of Portland geographically as well as the system of transport that makes transportation and trafficking easy and convenient.
Most Commonly Abused
There are different types of drugs that are abused in Portland, OR. These include;
- Methamphetamine – there has been a rapid increase in the abuse of the drug in the recent past with dependence increasing by 600% in a six-year period, 2008-2014, according to data by the High-Intensity Drug Trafficking Area Program (HIDTA).
- Opioids and Benzodiazepine – the prescription opioids registered highest in the category of unintentional overdoses based on the HIDTA. A majority of abusers get opioids and other painkillers from close friends, others stole the drugs while others got them from physicians.
- Cocaine – According to the HIDTA, there has been a reduction in the dependence on Cocaine in Portland. The decline in the number of seizures due to abuse of the drug has reduced, though a section of the population continues to depend on the drug.
- Marijuana – while the use of marijuana is high in Portland, it has been legalized with use and dependence on recreational marijuana being higher than the average nationally.
The Need for Recovery
Heroin addiction treatment is manifested in different signs and symptoms. Understanding these encourages an addict, or their close family and relatives to seek treatment. The assessment conducted on heroin addiction, and that precedes treatment is also based on the detection of the signs and symptoms of addiction. These include;
- Poor hygiene.
- Lack of motivation.
- Dry mouth.
- Mood swings.
Addiction to heroin is also believed to be caused by various factors. These factors increase the likelihood of an individual becoming an addict. These include;
- The chemistry of the brain of a regular heroin user changes dramatically. The disruption of communication in the brain, by disabling neurotransmitters, gets inhibited, and dependence on heroin is the solution to the adverse effect is made up by regular use of the drug, causing addiction.
- An individual that has parents or grandparents that were abusers of heroin is likely to become addicted as well.
- Being in an environment that encourages drug use, especially close friends and peers could result in addiction as well.
Treatment for heroin addiction follows key steps including; an assessment, administered and conducted by a qualified physician, preparation for intake, intake in a treatment facility, undergoing detoxification, the provision of inpatient or outpatient treatment, aftercare, and sober living that ensures that an addict does not resume to drug use and dependence.
There are various instruments and methods used for the evaluation of the extent of heroin addiction. The instruments mainly work to assess the impact that the abuse has had on the addict, to ensure that the best treatment option is adopted. These include;
1. Addiction Severity Index
The Addiction Severity Index (ASI) assesses the problem of addiction by focusing on the impairments that heroin dependence has on the addict. The assessment evaluates the difficulties that addiction causes concerning the relationship with the friends, members of their families and co-workers. The medical consequences or conditions that can be associated with dependence on the drug are assessed through the ASI. The ASI also helps evaluate whether an addict could have suffered from sexually transmitted diseases due to irresponsible behavior as a result of addiction to heroin as well.
The Addiction Severity Index also explores the legal issues that an addict has encountered due to heroin abuse. Serious legal problems is an indicator of the extent of dependence on the drug by an addict. The addiction severity index also assesses the psychiatric disorders that have stemmed from the use and abuse of drugs, and this is based on mental disorders due to heroin addiction.
In the evaluation of the extent of addiction to heroin, the ASI reflects on the history of the family of an addict. The history of a family of a drug addict could provide valuable insight into the problem, and the primary factors that could have caused the addiction problem. The family history of an addict further helps determine whether relatives used or use heroin or other illicit drugs.
In the administration of the Addiction Severity Index, which is done by a psychiatrist, counselor or a physician, the distress levels across the different parameters is measured. The need for treatment is also outlined across every parameter assessed, and this is followed by the calculation of the composite score, per the different subsets assessed. The score is the foundation for the appropriate form of treatment that a heroin addict should get. The ASI is a precious tool in the assessment of the extent of addiction to heroin, and a basis for decision making on proper treatment.
2. Hair follicle and Urine Testing
The assessment of heroin abuse and addiction is also done through the testing of a hair follicle or urine sample. The tests are extremely reliable in the determination of the content, in almost exact amounts of drugs, abused by an addict. A hair follicle test is more reliable given that it provides drug abuse information on drugs that have been abused for several days, and in recent months. A hair follicle test is the most recommended in the assessment of heroin addiction though it is a little more expensive. Hair can be obtained from the armpits for drug addicts that are bald in this method of assessment.
In the case of urine testing, proper procedures must be followed to ensure that an addict provides the correct sample for testing. Tampering is highly likely from an individual that has access to the urine sample being tested hence the need for strict procedures to be followed and adhered to. Timing in the collection of a urine sample, ensuring that the sample is validated, and using proper techniques of collecting the specimen is done in testing for heroin addiction in urine samples is vital. The results from the hair follicle test and the Addiction Survey Index are compared and contrasted with the determination of the treatment procedure that needs adoption for the successful treatment of a heroin addict.
Pre-intake refers to that which precedes intake for treatment to formally begin in a rehabilitation center. Pre-intake serves as a preparation, mainly for the patient, by ensuring that the addict gets fully informed on how the treatment ought to be done. The following is done pre-enrolment in a treatment center;
- A treatment plan is proposed to the addict, based on their needs and per the results of the assessment conducted. The addict should be provided with options that they should consider or choose from, and guidance should be provided to ensure a most suitable option is selected.
- The reservation of a place in the selected rehabilitation center is done. The payment of any deposit that should be done before admission should be done at this stage as well.
- The date that the addict should report for treatment is provided or agreed upon between the addict and the chosen treatment center.
- The treatment center provides the addict with information on the necessary materials or personal belongings that they should bring with them during enrollment for treatment.
- The addict must prepare a list of medication they are using, and bring some of the medicine with them during intake.
- The notification of friends, relatives, workplaces, and mates, in the case of enrollment in an inpatient treatment facility, is done before admission.
- Some treatment centers provide transport to addicts, and an arrangement should be done if the addict does not have a reliable form of transport.
Intake happens on a specified date and after an addict prepares adequately and meets the requirements that are necessary for heroin addiction treatment. During intake, the following are the critical activities that are critical;
- Assessment by a physician
During intake, once an addict arrives at a treatment center, a doctor evaluates the physical needs of the addict. The mental needs are also assessed during intake. The assessments are of great value and significance in ensuring that the requirements are addressed through integration in the chosen treatment plan for a particular addict. The safety of others in a treatment center is also enhanced through the understanding of the mental state of an addict being admitted. The addict, during an assessment, should be warned to provide accurate and reliable information in the evaluation since it factors in the provision of proper care and treatment.
- Checklist of important items
Many items are required, mainly for use by the patient during treatment, especially in the inpatient settings. Some of these include a towel, soap, slippers, and comfortable footwear. The patient should also bring warm clothes, workout clothes and sleep clothing. A toothbrush, toothpaste, and toiletries that a patient needs should be brought along as well. These items must be checked during intake to ensure their availability as an assurance of comfort for the addict during their stay in a treatment center. The basic items must be adequate to cater for the personal needs of the addict for the period they are to stay in an inpatient treatment facility.
- Evaluation of medical history
The medical history of an addict should be obtained during intake as well. The information could provide insight into the recent psychiatric treatment that has been administered to the addict. The information would help in better decision making and ensure that the treatment options and plan integrates aspects that would work. The medical history is also expected to provide information on health issues and medication that could have been given to a patient, and that could provide an understanding of the heroin addiction problem. The allergies that an addict has and decisions on medications that should not be used due to the allergies is also learned from a comprehensive evaluation of the medical history of an addict.
- Personal Information
An addict must provide critical personal information during intake. The collation of the information is done through the filling of a form. The full names of the addict must be provided. The date of birth, gender, address, and contacts are also filled in the form. Information on the race, nationality, and others could also be requested based on the treatment center. Personal information ensures that proper record keeping is done. It could be used for reference in the future for treatment.
Treatment for heroin addiction begins at the stage of detoxification where the heroin-related toxins are removed from the body, ensuring that they do not continue causing harm and negative consequences to a user. Detoxification for heroin can be done naturally or through the medical technique.
Natural detoxification involves automatic or abrupt avoidance of the use of heroin. The body is expected to adjust and operate healthily, in the absence of the drug. A doctor must control sudden stoppage from the use of heroin results in various withdrawal symptoms and these. Mental issues, especially for addicts suffering from co-occurring disorders, is likely in natural detox, The symptoms that arise from natural detox and immediate stoppage of using heroin are;
- Lack of sleep
The withdrawal symptoms need close attention and management by a qualified professional. Relapse is highly likely if a patient is overwhelmed by the intensity of the symptoms of natural detox. Regular counsel and advice must be given to an addict to ensure that they do not relapse as well. Support from close family members and relatives is an important source of encouragement in natural detox, and for the management of withdrawal symptoms.
Withdrawal from heroin is undoubtedly an extremely challenging endeavor in the case of natural detox, and the avoidance of the suffering is done through medical detox. In medical detox, the flushing of heroin-related toxins is done using sedatives which could be strong or relatively weak. The discomfort of the withdrawal symptoms of heroin withdrawal is moderated tremendously through the use of medication. Methadone is one of the sedatives that are used, with doses being given on a gradual basis, to counter the harmful symptoms of withdrawal. Suboxone is also used in medical detox to calm heroin withdrawal symptoms.
The use of medical detox is recommended for heroin addiction treatment. The fact that withdrawal symptoms can be better managed makes medical detox the preferred and safer method. Relapse is also less likely in the case of medical detox, further making it the better option.
There are two treatment options in drug addiction treatment. The two have stark differences irrespective of the fact that the objective that they aim to achieve is the same. Inpatient and outpatient treatment methods are used in drug addiction treatment centers. More on Inpatient Vs. Outpatient
Inpatient treatment involves abandonment of the natural environment where one lives, home, and works, for treatment of addiction in a residential center. Some of the programs that are integrated into an inpatient treatment center include; ways of preventing relapse, individual and group therapy, and lectures that are informative to the addict. In the case of inpatient treatment;
- An addict gets enlightened more about their heroin addiction challenge.
- The particular needs of the addict are addressed to ensure successful overcoming of addiction.
- The heroin addict is protected from exposure and denied access to heroin access.
- The addict is prepared for ways of avoiding a relapse.
- An addict is helped to create support networks with fellow addicts undergoing treatment, and with the general society.
- The addict is enlightened on ways of improving their general health through proper diet as well as regular exercise.
- The addict gets to be monitored throughout their stay. Routine tests are conducted, and with improvement, an addict undergoing treatment is encouraged.
Inpatient treatment ensures that an addict has access to professionals that monitor the condition and progress regularly. The monitoring is vital in the prevention of relapse among heroin addicts. While it is a little more expensive compared to outpatient treatment, it is more efficient in ensuring that the goals of treatment to full recovery are achieved.
Treatment in a residential center is not possible for some heroin addicts, mainly those who are in the early stages of the addiction or those that cannot afford the costs. Outpatient treatment ensures that a heroin addict gets to recover from the problem and lives a healthy life through attendance for treatment during the day. Counselling is done, individually and in groups, on ways to avoid use and dependence on the drug. Ways of ensuring that an individual lives healthy are also proposed in outpatient treatment. The use of medication to control any withdrawal symptoms during treatment is done, and administration is done by a medical professional.
Aftercare in heroin addiction treatment is done to lower the likelihood of relapse after inpatient or outpatient treatment. It involves engagement in multiple well programmed activities. Aftercare in heroin addiction treatment involves;
- Therapy sessions, individually or in groups.
- The use of supplemental medication to help enhance the success of the treatment.
- An assessment of any co-occurring disorders.
- Counselling sessions with family or other groups of recovering addicts.
- Workforce training for the recovering addict.
- Enhanced management of heroin cravings.
Aftercare is supplemented with sober living to ensure the success of heroin addiction treatment. Sober living mainly involves avoidance of influences that are likely to lead a heroin user to relapse. Living sober after heroin addiction treatment also requires engagement in productive life and activities, where the mind of a treated addict is fully occupied. Attendance to therapy sessions and advisory groups on tips of living normally without dependence on drugs is an incentive that is valuable in sober living.