Addictions and Solutions in Columbia, South Carolina
Columbia is the capital and second largest city in South Carolina, the Palmetto State. The city resides in Richland County and extends into Lexington County. With a population of 134,309, Columbia is full of art, music, opera and theater. Hot spots like The Columbia Marionette Theatre, a thirty-foot stage that provides different sized puppets and The Lexington County Museum, a building with 36 historic structures dating back to the Civil War keeps the city full of tourists.
Columbia has multiple ongoing initiatives, such as redeveloping areas like Bull Street and aiding victims of tragedy and natural disaster in other areas. According to one local newspaper, most fast food chains throughout the state are host to drug deals each day, and more people lose their lives to overdoses (generally heroin and opioids in SC) than they do to automobile accidents.
Due to its large population, Columbia is also filled with crime. In fact, the city scored a 2 out of 100, with 100 being the safest. It is believed that the crime rate is also due to drug use, specifically opioids. Opioids consist of heroin, synthetic drugs like fentanyl and prescription pain medication like Vicodin, hydrocodone, oxycodone, methadone and Buprenorphine, etc. Prescription opioids are often nicknamed Percs, Vikes, OC, Hillbilly Heroin, Happy Pills, and Oxy.
Recently, federal authorities seized almost 30 pounds of drugs, 16 pounds of methamphetamine, nine pounds of heroin and three pounds of fentanyl in the Midlands, centered in Columbia. Opioid addiction is being battled across the United States and in 2016, 42,000 people died from opioid overdose, 40 percent of them caused by prescription opioids. In 2017, 66,324 died from a drug overdose. For the state of South Carolina, there were 550 opioid overdose deaths in 2016, surpassing the number of homicides. In 2016, almost 5,000,000 prescription opioids were prescribed to patients in South Carolina. With a population of 5.02 million that is essentially, one prescription per person in the state. Orangeburg, two counties south of Richland County has a population of 89,000 and 85,000 opioid prescriptions were prescribed for the same year. Next door neighbor, Calhoun County has a population of 14,800 and saw a lower number of prescription opioids at 1,700.
One of the reasons for the high level of drug use and addiction in Columbia is simply the transportation options within the city. The airport offers flights directly to New York and to Houston. Paired with personal aircraft and seaports such as Charleston that greet drugs from international waters, there is much trafficking of illicit substances. Youth gangs both those with ties to the well-known gangs like the Bloods and the Crips based out of Los Angeles and other groups such as the Insane Gangster Disciples distribute cocaine, heroin, and even marijuana across the state and throughout the city. Club drug levels are increasing in terms of usage in the city and state, and cocaine usage is high in other parts of the state where crack cocaine is easier to obtain.
Columbia does partake in the statewide program that asks doctors to check and see if a person has been prescribed a painkiller by another doctor prior to giving it to them. In some cases, this helps as it prevents people from doctor shopping in order to obtain enough pills to feed their addiction. However, the prevalence of pills on the street and pills that are stolen from homes makes it easy to obtain the substance regardless of whether a person actually sees a doctor or not.
The overdoses in Columbia point to opioids and heroin being the drug of choice throughout the state. Prevention and general awareness has been greatly increased through the discussion of people’s personal stories; especially stories offered up by those who have lost a loved one to the addiction battle.
What South Carolina is Doing About its Drug Problem
The Department of Alcohol and Other Drug Abuse Services, The S.C. House Opioid Abuse Prevention Study Committee and The Governor’s Office have worked together in an effort to design a campaign that targets opioid abuse called “Just Plain Killers”. Just Plain Killers is about education and spreading awareness to show that resources are available.
The South Carolina House Opioid Abuse Prevention Study Committee has recommended that prescriptions be limited since it is known that addiction starts with an opioid prescription. Research shows that addiction has come from emergency room or post-surgery prescription. Physicians must examine their practices of prescribing and use the South Carolina Reporting and Identification Prescription Tracking System (SCRIPTS) before they have prescribed a patient with opioids. This ensures that their patient is not already taking a medication which could result in a dangerous and fatal overdose.
The opioid crisis has been recognized by the federal government as a nationwide pandemic. The South Caroline Legislature and federal government has appropriated funding to not only treat patients who have an opioid addiction but to prevent others from developing one. Funding has been made available for services and life-saving medications like Naloxone, which reverses an overdose. In 2016, this medication was administered 6,400 times by emergency personal in South Carolina. The funding also provides Medication Assisted Treatment options like Methadone, Buprenorphine and Naltrexone which along with counseling treatment can help a patient avoid a severe withdrawal while also blocking the affects of opioids.
People Helping Other People
People Helping Other People
The movement of ending the war on opioids doesn’t start with people understanding that addiction is a disease, it starts with people helping people. It is possible for anyone out there to become addicted to opioids off one prescription that was prescribed after a surgery. Some people become addicted after having dental surgery, it wasn’t because that person went looking for the drugs. Having said that, once a person becomes addicted, they do going looking for the drugs. This isn’t a person who should be judged by society. This is a person who needs help.
Here are some ways that people can help other people:
- As mentioned above, Just Plain Killers is about educating and spreading awareness. There are plenty of websites online who are devoted to helping to educate people and spread awareness about harmful drugs like opioids, methamphetamines, cocaine, crack, etc. Knowledge holds a lot of power all on its own when it comes to the war against drugs.
- Education children is a pathway toward success. A young mind is maturing daily and during the teen years, the brain is maturing sections in the brain that cause poor decision making. It’s important to start early and educate children on the dangers of drugs. Many teens believe that taking opioid prescription drugs are safe since they are prescribed by a doctor.
- Know the Signs and Symptoms of Drug Abuse and Addiction
- Drug cravings
- Withdrawal symptoms
- Poor judgement
- Financial trouble
- Neglects responsibilities
- Becomes isolated
- Has “new” friends that share the same signs
- Glazed or blood-shot eyes
- Runny nose
- Changes in demeanor and personality
- Mood swings
- Changes to personal hygiene and/or grooming
- Poor sleeping or sleeping too much
- Changes in eating
- Loss of interest in favorite activities
- Injection tracks on arm
- Spread Awareness
- There are many ways to spread awareness. With social media being such a viral platform of positive trends for healthy and green living, it can also be used to spread drug awareness. Social media in itself has an addiction factor but when spreading positive messages, maybe that’s not such a bad thing. Negative influences however, can lead to a drug problem.
- Clear Out the Medicine Cabinet
- If a prescription is no longer needed, it’s time to toss it. The trashcan and the toilet are no place for unwanted pills. They can be easily found as people dig through the trash looking for them and flushing them down the toilet contaminates the water supply. Instead, there are many drop boxes located in South Carolina to drop off unwanted prescriptions.
- Lock Up Meds
- For those taking medication, it’s important to keep them locked up. Children and teens will rummage through medicine cabinets to find pain pills like Vicodin or Percocet. Friends and family members addicted to opioids will also look around for them as well. Locking them up allows medication to stay in safe hands and away from those addicted to it.
- Look for Alternative
- This last tip is for patients who currently have prescription opioids and uses them sensibly. However, talking with a doctor about other alternatives would be the best thing to do to move from taking opioids because they are so highly addictive. There are healthier ways to find pain treatment.
- Encourage Help
- Education and awareness are two of the best approaches to winning the fight against drug addiction. Seeking assistance is another great way. People should be encouraged to seek treatment for their addiction. Those who have already been to rehab can help to encourage friends to either go to rehab or to a support group with them. People need to be encouraged to get help, not judged.
How to Help Someone Who is Addicted to Drugs
- Open and honestly tell that person that you believe they have an addiction to drugs.
- “I’ve been concerned about you lately because you haven’t seemed like yourself.”- This is generally a good opening sentence to use. It’s not judgmental and it may encourage someone who is addicted to drugs to talk.
- Using guilt phrases like “do it for the kids”, “If you really loved me” or “don’t you even care about your life” will not lead to an open line of communication and could in fact, lead to an even stronger addiction.
- Try to stay away from words that can be taken negatively
- Addict (implies that one is unwilling to help themselves)
- Abuse (casts a harsher light that what is fair or necessary)
- Problem (very negative, addiction is more than just a problem)
- Habit (implies one has lack of willpower)
- Junkie (implies one is worthless)
- Clean or Dirty (implies one is dirty or even filthy)
- Habit (denies the medical nature of the condition)
- Persian poet Hafiz said “What we speak is the house we live in.” Positivity and understanding will go further than negativity and judgement. Positive words to use:
- Harmful use
- Risky use
- Alcohol and drug use
- Medication assisted treatment
- Misuse of drugs
- Substance Dependence
- Addiction free
- Addictive disorder or disease
- Encourage professional help because addiction is a very complex illness and drug rehabilitation can provide a great foundation for one to rebuild their life on.
- Encourage alternative activities instead of drug use such as playing sports or exercising, both can boost serotonin in the body which gives off a natural high.
- Join a support group. While you are trying to help a friend, family member or co-worker, joining a support group can help maintain positive energy throughout the process. It can also be a great way to express some negativity such as being agitated or stressed, things that cannot been shown to the person you are trying to support.
- Educate yourself about drug use and drug rehabilitation. There are many people who are addicted to drugs who do not want to go to rehab due to fear. By educating oneself about everything that goes into rehab, it can help to alleviate some of those fears.
How can families and friends help someone needing treatment?
Risk Factors for Drug/Alcohol Addiction
Many of the identifiable risk factors for an individual to become a substance abuser can be directly linked to environment during childhood. Parenting style, particularly styles in which there is a general lack thereof parenting, or an overt absence of love and care being shown by the parents is one element that can lead to trouble down the road. If a parent is doing drugs a child is also more likely to get hooked on drugs and continue that habit into adulthood. In addition to love and nurturing, the amount of discipline laid upon the child makes a difference as well. Clear, enforced rules and the ability to see consequences is a helpful deterrent that molds an individual for their choices down the road. Other struggles including high stress and broken home life, issues in school either academically or socially, and general lack of acceptance play a role as well.
However, there are other factors that can also be attributed to the city on the whole. The ability to obtain drugs locally with ease is an important piece of abuse as is knowing people involved in the drug scene or having friends who are using and abusing. Being in an area in which a lot of drugs move through makes them easier to obtain and often means there are more people in the area who do not put as strong of a stigma on drug usage. Areas that are on a drug trade route tend to have an abundance of drugs circulating that are then offered at lower costs locally. Furthermore, drugs now occur in many different forms, such as meth being put into candy that looks appealing to children, all of which changes the stigma and often allures first time users who may be completely unsuspecting.
Many researchers believe that genetic factors play a huge role in addiction as well and argue that it can be a disease, with certain individuals more prone to becoming hooked on a substance after trying it due to the wiring of their brain and the chemicals within. This goes hand in hand with the concept of using drugs to self-medicate for co-occurring conditions such as anxiety or depression. Other researchers argue that the age at which drugs are first tried and the drug that was tried correlates to how strong the abuse is later in life. If a young person takes a few extra doses of cold medicine and continues to take it when they are no longer sick, does this always turn into lifelong addiction or simply a passing phase? This is one of the questions that continues to be explored.
Lastly, economics plays a role in drug use and abuse. Not to say that many affluent families are immune to addiction (in fact, these families tend to be where prescription pill abuse and alcoholism are most rampant) but for youth in low income areas who look around and see no options for escape, selling drugs often appears to be a viable option to make a living. Thinking that occurs along those lines in relation to the perceived “benefits” of drugs is often witnessed during critical transition periods in a young person’s life, whether it be starting school, sports, moving, their first relationship, etc.
Signs of Drug Abuse and Addiction
Perhaps the most common identifier of substance abuse is the overall change in each aspect of a person’s life. Individuals who are using are often noted for having bloodshot eyes or dark circles under their eyes. They may have gained weight or they may have lost weight, depending on the weight they started at. They may complain of insomnia or be unable to wake up and stay awake for any length of time once they fall asleep . Other physical transitions are seen in ongoing “illness” which although it may appear as flu-like it is in reality the effects of withdrawal from a substance that the body has become used to having in its system and thinks it “needs.” Friends and family often observe they seem more reckless and have general disregard for rules or warnings. Often these same individuals distance themselves from previous friends and family and start spending time at locations that may be foreign to them with people they never previously mentioned. Sometimes the change in behavior is more secretive and is noted by being more reserved whereas other times it may be more overt with objects being stolen and money being obtained at all costs so that they can pay for more drugs.
With the rise of prescription drug abuse, doctors have ironically become abused in this cycle as well. Many addicts will doctor shop, or go to several different physicians to obtain painkillers or narcotics for the same issue, simply so they can have the extra pills to use. If a loved one is taking pills after the initial issue has subsided, or borrowing pills not prescribed for them, these too may be signs of an underlying addiction.
Experimentation to Addiction
When initial exposure to illicit substances occurs, most often one of two scenarios plays out. The first scenario is that the individual shown the substance says no and leaves the situation, or at least has strong enough feelings against drugs to decline. Sadly, this is a less common scenario and is becoming increasingly rare. The second scenario is that the person knows drugs can be harmful but they are curious what drugs are like and decide it won’t hurt anything to try just a few. Just a little. Just enough to know what it feels like. With this decision comes the perceived belief they will try it tonight and never have to see it again if they don’t like it or decide they do not wish to see it again. However, this is the stage where addiction gets its early reach on the brain. After experimentation comes the phase of social use where peers are using and the individual only uses in the company of others, either as a way to fit in, enjoy the party more, or just relax. When this stage escalates and becomes increasingly common it often manifests itself as binge drinking or heavy usage. This step transitions into addiction, the chemical long term change or disease that is related to a psychological and physiological dependence.
Due to the large numbers of individuals battling addiction within the state, there are numerous options when it comes to recovery. Whether an individual is seeking private or government rehab services, has insurance or is without, is admitting themselves or being admitted by a court order, there is something for everyone and many of the options are located within Salem city limits. However, if none of the Columbia options satisfy, other areas in the state have options for receiving help in both inpatient and outpatient services as well.
The Treatment Process
One of the main benefits of inpatient treatment, or treatment within a facility that offers around the clock care and trained staff to assist with all aspects of the transition, is that the friend groups, stress points, and triggers to use are temporarily removed as one is isolated from the outside world. RTC tends to be focused on individuals who have been struggling with addiction for an extended period of time or who may have been battling another co-occurring issue. PHP (partial hospitalization) allows for the freedom of not needing to stay the night, and yet having more intensive care during the daytime hours than at normal outpatient treatment. The third option, IOP, focuses more on illnesses such as eating disorders and depression, while also treating addiction in a subtle way so that the client is able to go about their work or family life in as normal a routine as possible.
When an addict has a community supporting them and the means to start replenishing the life they diminished during their drug use, outpatient treatment is often a good option. This format often requires meeting with a therapist during the week who specializes in addiction counseling, and following their advice along with the advice of a medical provider.
Whatever route an individual decides to follow when seeking help, it is vital that an aftercare plan is in place for the time period when the initial treatment has ended. Even after returning to society or passing benchmarks for sobriety, triggers such as lifestyle changes may still lead to a relapse. Having an aftercare plan in place helps ensure the recovery will truly be long lasting. Aftercare plans in which individuals “check in” and receive remedial work/information are very common. However, for individuals needing more than occasional realignment, options such as sober living communities exist, where people trying to stay clean live and work together and follow a set of house standards and rules. There are many different options, particularly in major cities like Columbia. These options include those that are faith based and those that are non faith based.
Regardless of the route, recovery is worth the effort. Not only does it benefit the individual, but it also helps the entire community. Lower rates of addiction mean many benefits for the community at large, including less strain on insurance, hospitals, and emergency rooms. They also mean lower rates of violent crime and better family situations. Local law enforcement are able to save time on drug arrests and focus more on preventing violent crimes and keeping the community safe. Tax dollars are saved by the millions. Furthermore, there would be lower rates of HIV and Hepatitis C and that kind of transferable disease with lower rates of drug use. Prostitution rates might decline as well. For Columbia to continue to be the thriving, bustling city that it is, and to continue to grow and develop in healthy, holistic ways, it needs to fight to reclaim its youth and young adults. Previous drug education programs have since become outdated and are not as effective as they once were in the 1980’s and 1990’s. While drug researchers across the country work to develop new solutions and law enforcement officials work to find new ways to save lives and prevent crime, the one truth that has surfaced continues to that recovery benefits everyone. The possibilities related to recovery and renewal are endless. The United States of America, and specifically Columbia, as a society needs recovery as much as individuals struggling with addiction need it.
Drug Rehabilitation 101
An assessment, also known as a pre-intake is the first step in drug rehabilitation. Here are some things that will be covered:
- General information about patient
- Date of Birth
- Phone number
- Drug information about patient
- What type drugs in the patient taking?
- When did the patient last use drugs?
- Was alcohol also used in combination with the drugs?
- Mental health information about patient
- Does the patient have any mental health disorders?
- Are there any signs of anxiety or depression?
- Is the patient having suicidal thoughts?
- Social environment of the patient
- Does the patient have a healthy support system?
- Is the patient married or single?
- Does the patient have children?
- Does the patient still live at home with the parents?
All the information gathered during the assessment will be used to help doctors and staff know what sort of treatment would be best for the patient. It’s important to provide accurate information so the best diagnosis can be made. Without providing the correct information, a wrong diagnosis can be made causing the risk for relapse to increase.
When beginning to investigate rehab, a variety of words will appear in the literature about options and in personal conversations with representatives. Assessment is often the starting place after having self-identified or being identified as potentially needing rehab. While assessment varies based on the facility and their approach, as a general rule several individuals with unique focus areas (i.e. social worker, psychologist, nurse, etc.) will work together to understand each potential clients’ circumstances. The client will provide information via questionnaires and conversation, as well as often being asked for a urine and hair sample. This process serves to help the treatment center better understand whether the client is dealing with an actual addiction to said substance, and if so what the depth of their addiction may be. Furthermore, it allows specialists the opportunity to see if their are co-occurring conditions, be they psychological or environmental, at the time of admission. Whatever conditions are discovered provide better insight into the addiction itself and are also often able to be simultaneously treated.
During this phase of interaction with the potential treatment center, the service provider works with the client to map out what a treatment plan would look like, and seeks to name the ways in which life will change for that individual once they enter into rehab. In doing so, they are able to identify potential barriers to the treatment process, as well as struggles that may be specific to that individual. Since the life of an addict is often surrounded by a web of uncertainty, it can be invaluable to have the stability provided in a plan of treatment. However, even in its positive form, it is still a tough transition, and working with the facility to find the best program and fit is vital.
While a client may learn some about a facility during the pre-intake, it remains very important for the client to find the rehab facility that best fits their needs and liking. Not only does the initial impression need to be positive, but the ongoing climate of the facility needs to be good enough to ensure retention and a level of change occurring in the patient so that they do not simply leave the program. Since rehabilitation as an overall process differs from detox in its focus on lifestyle and thought pattern change and overall transformation, the intake process is more of a partnership with the rehab facility, whether it is self-initiated or proposed by a family member or close friend. Paperwork, urine samples, and breathalyzer all generally occur during this stage.
An intake is very similar to an assessment and many rehab facilities tend to snowball the two together. The intake step dives much deeper into the patient’s history with questions about the patient’s family. Here is what the intake looks like:
- In-depth questions about history
- Drug (past and present use)
- Family medical
- Family mental
- Family environment
- A physical exam so the doctor can make sure a patient will be able to withstand detox. Things the doctor will check:
- For liver problems
- Small pupils
- A fast heartbeat
- For needle marks (tracks from injecting drugs)
- For slurred speech
- For nose or lung problems (from snorting drugs)
- Vital signs
- Lab tests will also be administered.
- A urine test to see what type of drugs are in the system
- In some cases, more tests may be taken.
- Patient will receive a list of items that are not permitted in the facility. This includes:
- Revealing clothing
- Over-the-counter medication
- Bed linens/pillows
- Financial arrangements will also be made at this time.
Detox can be a step in a rehabilitation center, and it can be a separate process completely, depending on the approach of the providers. In its most basic form however, detox is the withdrawal and cleansing of the body from the drug. It can be a very difficult process as the body craves the drug and has repeated visceral reactions to not having said drug that often resemble the symptoms of having the flu. However, this experience is made much more pleasant by the trained stuff able to assist the patient during the process. Centers are able to help monitor the physical process and do their best to aid in the transition for the client.
Detox is one of the times in rehab that patients feel the most uneasy about during the entire rehab process. This is due to withdrawal symptoms. The body needs to be cleansed and it can take anywhere from 5-7 days for this process to be completed. By cleansing the body, it has a better chance of recovery. Here are some withdrawal symptoms:
- Drug cravings
- Fast heartrate
- Muscle pain/tension
Symptoms usually start to occur at 6-12 hours for short-acting opioids and 30 hours for long-acting opioids. The peak at the 72-hour mark.
Detox can be very overwhelming for a patient, if this happens then a doctor will most likely describe a medication to help with drug cravings so that the symptoms will die down.
What is withdrawal? How long does it last?
Inpatient treatment, also called RTC (Residential Treatment Center) is a program used to help patients to learn more about their addiction. Learning about one’s addiction can have a huge impact on how effective the treatment is for the future. The program usually lasts about 28 days. However, there are situations where a patient is recommended for a longer stay of 30, 60 or 90 days. For patients who continue to relapse the moment they leave rehab, it may be recommended that they stay for 4-6 months to get treatment. RTC incorporates several different types of therapy into a patient’s daily life. Here is what RTC looks like:
- Cognitive Behavior Therapy
- CBT, a form of psychotherapy allows patients to get a better understanding of their own thoughts. This type of therapy works by modifying dysfunctional emotions, thoughts and behaviors. It focuses on solutions and encourages patients to challenge their distorted thinking. Distorted thoughts are things we tell ourselves even though we know they aren’t true. These thoughts stem from different things in life but one common factor among them is depression.
- Patients are offered other types of therapy as well such as art, acupuncture, meditation, yoga and music therapy. These are helpful for the body and the mind. Not only do they all relieve stress, but they also provide a patient with something positive to do while in rehab.
- Group therapy-While in RTC, patients will need to attend group therapy sessions. Within these sessions, it is important to express who one is feeling and what changes they have seen since entering the rehab. In many cases, patients have met a friend in rehab and a close bond is made between them while enduring rehab together.
Outpatient therapy is different than inpatient because it takes place outside the facility. When a patient leaves the RTC program, they also leave rehab. For some patients this can be very hard to do and some patients relapse because the pressure is too much. Luckily, there are sober living homes that can help patients to adjust slowly back into regular life. RTC builds a ton of structure and without that structure, things can get very scary. Outpatient therapy helps to maintain some of that structure. Here is what outpatient therapy looks like:
- Partial Hospitalization Program (PHP)
- A program that takes place in a facility for 6 hours a day, 5-7 days a week.
- It is designed to help patients make a transition from life inside the facility to life outside of it.
- Individual and group therapy are focus points for PHP
- PHP teaches about trigger points and what can be done to help avoid them such as coping skills.
- Intensive Outpatient Program (IOP)
- A program that takes place in a facility for 3 hours a day, 3 days a week.
- It’s designed to help patients further make their transition while using group therapy as a focus point.
- The setting that IOP provides is one very similar to support groups, which becomes a huge part of a patient’s life once they have completed both inpatient and outpatient treatment.
Aftercare starts to occur the moment a person leaves rehab but is taught during RTC. Aftercare is the ability to take care of oneself outside of rehab without relapsing. There are several ways to do this:
- Support groups
- These groups are supportive and encouraging. It is important to sign up for one and attend it regularly. Support groups have people who are going through the same battles together and it gives them all an outlet to express their concerns, fears, strengths and even, their new-found freedom from addiction.
- Eating right and getting fit
- Eating plenty of fruits and vegetables with minerals and vitamins in them can help maintain a positive mind frame while also making a person feel great.
- Taking vitamins daily can also be helpful
- Learning a fitness regimen not only keeps a person busy, it fills a person with energy and even, a natural high.
- Take supplements that can help boost energy and mood as well. There are many different types out there.
- Take time to meditate. This is one of the best things to do. It helps to destress and really get in touch with our own feelings and emotions before they take over us.
- Stay busy
- When a person has time to be idle for too long, anxiety and depression can start to set in. From there, thoughts of drug use can be tempting. It’s important to stay busy
- Learn a new sport: Basketball, football, tennis, etc.
- Take some classes: cooking, language, marital arts, etc.
- It truly doesn’t matter what one tries to incorporate into their life as long as it is positive and isn’t drugs.
There you have it, the process of drug rehabilitation. It’s not as intimidating as it seems and can be a very rewarding experience for someone who is facing addiction which is many people in America. Raising awareness and educating people is only the beginning, convincing people to go to rehab and then to stay on the straight path is the solution to the drug crisis that the United States is facing.
If you or someone that you know abuses drugs or has a drug addiction, get help.
What happens after discharge?