Dr. Henry Paul, MD

Psychiatrist, Author and Educator

WHY SHOULD I CARE ABOUT A DRUG ADDICT?

April 15th, 2016

Addiction is similar to other diseases, such as heart disease. Both disrupt the normal, healthy functioning of the underlying organ, have serious harmful consequences, are preventable, treatable, and if left untreated, can last a lifetime. Source: From the laboratories of Drs. N. Volkow and H. Schelbert.

Last week I posted a blog about Narcan™ (naloxone), an opiate antidote that saves lives! It was brought to my attention this week that a local community coalition spreading the word about opiate and heroin addiction was offering a free Narcan training, and I was surprised by some of the online conversation about it.

33645761_sSome of the comments were about “letting the addicts die” because they (the addict) had made a choice to use drugs. Others were debating whether-or-not addiction is a disease. What these comments tell me is that there is a lot of confusion out there amongst adults about opiate addiction (including heroin, which is an opiate). So, I thought I would dry to address some of the confusion here.

First, drug addiction is a disease that develops over time as a result of the initially voluntary behavior of using drugs. While the full causes are not known drug addiction does take on a life of its own. Addiction ends up affecting a host of functions of a person’s body and mind.

In June of 2015, TIME magazine had a cover story, “Why America Can’t Kick Its Painkiller Problem.” The story makes the case that these addictions no longer start in the dark alleys with drug dealers, but rather start in doctors’ offices with everyday people seeking relief for their pain. These painkillers, known as opioids, are used to treat everything from migraine headaches to back pain, to sports injuries, to severe pelvic pain to chronic Lyme disease.

Here’s a little excerpt from the article that gives a pretty clear picture. “The longer patients stay on the drugs, which are chemically related to heroin and trigger a similar biological response, including euphoria, the higher the chances users will become addicted. When doctors, regulators and law-enforcement officials try to curb access, addicted patients buy the pills on the black market, where they are plentiful. And when those supplies run short, people who would never have dreamed of shooting up, like suburban moms and middle-class professionals, seek respite from the pain of withdrawal with the more potent method of dissolving and injecting the pills’ contents, or going straight to heroin.” (Massimo Calabresi, TIME)

This opiate epidemic is leading elected officials and the medical community to a point where we have to rethink pain management in this country. Law enforcement is on the treatment side. Yes, believe-it-or-not getting arrested leads to the beginning of treatment for many. What we need to do, and what was evident to me by reading some of the comments online, is that we have to put much more effort into awareness and prevention.

LINKS
Drugs, Brains, and Behavior: The Science of Addiction – this booklet explains scientific information about addiction that is easily understandable. Here is a link to a PDF you can download.

Why America Can’t Kick Its Painkiller Problem – You do need a TIME subscription to read this article.

How Science Has Revolutionized the Understanding of Drug Addiction

Easy to Read Drug Facts from the NIDA

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription.

YES, IT CAN HAPPEN IN YOUR FAMILY!

March 9th, 2016

22616601_sThe hardest part about the heroin epidemic in this country is getting those who think “not in my family” to understand that it happens to ANY family. It happens to high school and college athletes – the “good kids” — and it occurs in higher numbers in our adult population over age 50. Why? Because painkillers are prescribed to injured athletes and adults with injuries and chronic pain, and painkillers are a gateway drug to heroin.

Let’s focus today on adolescent athletes and how an injury can lead to addiction. A 2013 study published in the American Journal of Public Health found that young athletes are 50 percent more likely to abuse painkillers. Just yesterday CBS News ran a story about college high school wrestler Robert King who was prescribed the painkiller Percocet for his broken foot and who just a few years later found himself addicted to heroin.

According to CBS, “King’s story is not an uncommon one. As the heroin epidemic continues to rage throughout the country, high school athletes are falling victim to addiction in alarming numbers.”

I have written blogs about painkiller and heroin addiction for the past year and the need in this country for more awareness, and I applaud families who are opening up about their loved one’s addiction. Now, even in obituaries families are candidly disclosing the cause of death as a drug addiction. Families are not trying to scare anyone. On the contrary, they are helping to promote awareness that just may save a life.

In the CBS story, Jack Riley, Deputy Administrator of the Drug Enforcement Administration (DEA), emphasized that addiction cuts across every demographic group. He told CBS, “Heroin never discriminates, and athletes are no different. This dangerous drug has become a powerful weapon of mass destruction for drug addicts, some of whom are athletes who first became addicted to painkillers while rehabilitating from sports injury.”

So what should parents do? Most important is to educate yourself about the growing painkiller and heroin epidemic. If your school or community is offering drug awareness education forums — go! Encourage your friends to go with you too. Learn about Narcan™ (naloxone) an opiate antidote. Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin. Many local communities are training first responders and school staff in the use of Narcan.

Trust your instincts. If you think something is off with your teen, you’re probably right. Ask questions and get answers. If you have a child on pain medication, ask the doctor about it. In the end, remember this is an epidemic in this country so do what you can do to prevent it from spreading to your family. Knowledge is power – always a good place to start!

LINKS

The surprising path from student athlete to heroin addict  CBS

You can make a difference in the growing heroin epidemic. Blog by Dr. Henry Paul

He died of a Heroin overdose! Blog by Dr. Henry Paul

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription.

 

STOP THE DELAY! RELEASE NEW PAINKILLER PRESCRIPTION GUIDELINES

January 1st, 2016

“In 2013, health care providers wrote 207 million prescriptions for opioid painkillers, almost quadruple the number written in 1999.” Senator Joe Manchin, Beckley (WV)Register-Herald

Yesterday in my blog I talked about the need for the Affordable Care Act, also known as Obamacare, to include medication-assisted drugs to help those in treatment for opioid addiction. There is a movement afoot to make this happen, and I support it. Today, I want to talk about the letter that Senator Joe Manchin (D-WV) sent this month to HHS Secretary Sylvia Burwell urging her to support the release of the CDC’s guidelines for prescribing opioids.

24026286_sAccording to Manchin, this report has been delayed due to pressure from outside groups and objections from the Food and Drug Administration (FDA). Manchin told the Beckley (WV) Register-Herald, “At a recent meeting, the FDA’s Director of the Division of Anesthesia, Analgesia and Addiction Products, Sharon Hertz, was one of the strongest voices against the guidelines,” Manchin wrote, adding, “While the President of the United States, the Department of Health and Human Services, and every other agency of the federal government has been actively working to save lives and stop this epidemic, the FDA is working against these efforts and further endangering the public.”

Opioids are prescribed for pain management, but they are dangerous. Opioid addiction is a medical condition characterized by the overuse and abuse of opioids (i.e. morphine, heroin, codeine, oxycodone, hydrocodone, etc.). When abused, all of these classes of drugs directly or indirectly cause a pleasurable increase of dopamine in the brain’s reward pathway. Addiction happens when a person seeks to experience repeatedly that rewarding or “high” feeling.

34841088_sThe over-prescribing of opioids is the main problem. Many of these drugs are given for longer than 30 days – the time it takes to become addicted. Also, these drugs are often prescribed to teenagers recovering from sports injuries. Painkillers are the beginning of the addiction that leads to heroin. Why? Because heroin is cheaper. According to the CDC, in 2013, 207 million prescriptions were written for prescription opioid pain medications. Those are a lot of prescriptions. With the misleading information presented early on to doctors, there has been a lot of confusion and second-guessing about the use of these drugs and the potential risks.

I join Senator Manchin in urging Burwell “to stand behind the CDC in pushing for the strongest possible set of recommendations to help end prescription opioid abuse and overdose deaths.” It’s true that the horse is already out of the gate and that the epidemic is in full swing, but we can turn this around, and we have to start somewhere. These new guidelines regulating opioid prescribing, along with the medication-assisted drugs are good first steps.

LINKS
The Neurobiology of Opioid Dependence: Implications for Treatment
DrugFacts: Prescription and Over-the-Counter Medications
Manchin decries delay of CDC guidelines for prescribing opioids
The Monster of Accidental Opioid Addiction

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

TREATING OPIOD ADDICTION UNDER OBAMACARE

December 31st, 2015

There has been a movement afoot by physicians, social workers, and consumer advocacy groups to require all healthcare plans on the federal exchange to cover medications that are used to treat people addicted to painkillers.

19508350_sThe federal government has declared opioid addiction a “public health crisis,” and the Centers for Disease Control and Prevention (CDC) reported that more than 28,600 people died in 2014 due to overdoses from prescription painkillers, other opioids, and heroin. From Congress right down to local government officials everyone is trying to find solutions to handle the growing opioid and heroin epidemic. To turn this around is going to take a lot of education, compassion and better treatment options for those addicted, and support and guidance for those family members, friends, and loved ones who are trying to help.

It certainly would be a wise choice to cover the cost of the medication-assisted treatment. For so many addicts relapse is more common than you’d think. To begin with, it is hard to get into a treatment program due to the lack of inpatient and outpatient treatment programs, and if you do get into a program, once you’re through the cost of staying drug-free can become a burden too.

Drug addiction treatment has been shown to reduce associated health and social costs by far more than the cost of the treatment itself. According to Drugabuse.gov, the average cost for one full year of methadone maintenance treatment is approximate $4,700 per patient (2012 statistic). That is a lot less than incarcerating someone at a cost of nearly $24000 a year. And let’s face it, many of those addicted to painkillers are never going to get the necessary treatment in prison to deal with their addiction and turn their lives around. Jails are not, and never will be, appropriate treatment centers for addicts. I don’t believe that prison is an alternative to a drug treatment program. We need more treatment centers, more programs and more money to fight this epidemic. Call your elected officials and let them know that you want medication-assisted drugs covered under the healthcare bill.

LINKS
Opioid addiction treatment argued as ‘essential’ insurance benefit
Is drug addiction treatment worth its cost?
Drug Overdose Deaths by State, US 2013 and 2014

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

HE DIED OF A HEROIN OVERDOSE!

July 20th, 2015

A growing number of obituaries of people who have died of heroin overdoses refer to their addiction, The New York Times reports. In the past, these obituaries tended to say a person died “unexpectedly” or “at home.”  Partnership for Drug-Free KidsMore Obituaries Refer to Addiction as Heroin Overdoses Increase”

26559211_sHeroin again! I have written blogs about painkiller and heroin addiction for the past year and the need in this country for more awareness. Now I applaud families who are opening up about their loved one’s addiction, particularly in obituaries. In the past, obituaries referred to overdose deaths as an “undisclosed” or “sudden” illness. Now families are candidly disclosing the cause of death as a drug addiction. Families are not trying to scare anyone. On the contrary, they are helping to promote awareness that just may save a life.
“This is part of a trend toward a greater degree of acceptance and destigmatization about issues pertaining to mental illness, including addiction,” said Dr. Jeffrey A. Lieberman, Chairman of Psychiatry at the Columbia University College of Physicians and Surgeons, in the Partnership for Drug-Free Kids article.

He added, “If a family chooses to do this, they can have a cathartic experience that facilitates the grieving process. When the person was alive, they may have been enabling, and they couldn’t acknowledge it. But this allows them to begin that process of coming to terms with the fallibility of the family member and their own limitations in not having been able to deal with it while the person was alive.”

I found a comment posted by “Charlie” to the Partnership for Drug-Free Kids article said it best, “No one plans on being addicted. They think they are stronger than that. Heroin messes up how your brain processes things. It messes up your entire system. These are people that made a bad decision once or maybe twice and the addiction took hold of them.”

The news media is reminding us every day that we have a serious painkiller and heroin epidemic in this country. All teenagers will be exposed to drugs and alcohol at some point. Studies show that about 65 percent of teenagers try marijuana in high school, but for many children drug experimentation begins even earlier, in grade, middle or junior high school. Parents need to understand that alcohol and marijuana are gateway drugs. What I am concerned about is that there are still so many parents and teens that don’t understand the dangers. Teenagers are known for risky behavior. It is part of their development. Many teens don’t think about the cause and effect correlation of drugs and alcohol with the greater likelihood of becoming involved in criminal activity, suffering from suicidal tendencies, or facing other life-threatening dangers such as death from overdose.

We need to work together to do a better job at keeping our at-risk population safe from drug addiction. It really is a matter of life and death. For more information on addiction you can visit:

YOU CAN MAKE A DIFFERENCE IN THE GROWING HEROIN EPIDEMIC

HEROIN AGAIN!

Why heroin is spreading in America’s suburbs — The drug has followed prescription painkillers into new neighborhoods, forcing police and parents to confront an unexpected problem. By Kristina Lindborg, March 2014, cover story.

Nice coalition.  Look for coalitions in your area.  Powertotheparent.org

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

HEROIN AGAIN!

March 19th, 2015

“New York City is now the “nation’s most significant” heroin hub,” according to city Special Narcotics Prosecutor Bridget Brennan. NY Post, 3/16/15, NY is now heroin central: narcotics prosecutor

35442181_sI have been writing about heroin now for over a year in my blog, and the heroin situation just continues to get worse. Heroin is an epidemic that has taken America by storm. I cannot impress enough on parents that they need to educate themselves about the dangers of prescription painkillers and the rising use of heroin. These threats are particularly dangerous to our teenagers and young adults.

Here are some facts on Heroin from the DEA’s Prevention4teens:

  • Narcotics (such as heroin, morphine, OxyContin, etc.) are used to dull the senses and reduce pain. Narcotics can be made from opium (from the opium poppy) or created in a laboratory (synthetic and semi-synthetic narcotics).”
  • Heroin is a narcotic which can be injected, smoked or snorted. It comes from the opium poppy grown in Southeast Asia (Thailand, Laos and Myanmar— Burma); Southwest Asia (Afghanistan and Pakistan), Mexico and Colombia. It comes in several forms, the main ones being “black tar” from Mexico (found primarily in the western United States) and white heroin from Colombia (primarily sold on the East Coast). In the past, heroin was mainly injected. Because of the high purity of the Colombian heroin, many users now snort or smoke heroin. All of the methods of use can lead to addiction, and the use of intravenous needles can result in the transmission of HIV.
  • Heroin Effects: Euphoria, drowsiness, respiratory depression, constricted pupils, and nausea.
    • Overdose Effects: Slow and shallow breathing, clammy skin, convulsions, coma, and possible death.
    • CSA Schedule: Heroin has no legitimate medical use: Schedule I.
    • Street Names: Horse, Smack, Black Tar, Chiva, and Negra (black tar).
  • Denial Can Make the Problem Worse:  Some parents may be afraid to confront the realities of drug use, so they may deny the truth, even to themselves. You may have heard some adults say: “My kid doesn’t use drugs.” “It’s not a problem for our family.” “I used drugs and survived.” “Drug use is a normal part of growing up.” “We’ll never solve the drug problem.” “Alcohol is more dangerous than marijuana.”

I recommend that you attend a forum at your local high school or a community coalition awareness forum to learn more about the substance and heroin abuse in your community. Many local coalitions are forming around the country to educate the public, parents and teens about the dangers of heroin and the painkillers that often are the “gateway” drug to it.

Some of the latest newspaper stories about the heroin epidemic:
Schumer Moves to Reverse President’s Cut in Critical Drug Trafficking Program
Man accused of stashing heroin in daughter’s diaper
4-year-old hands out heroin at daycare
Cops seize $2.5M worth of heroin in Bronx raid
Schumer slams Obama’s proposed cuts to anti-drug program

Disclaimer

This blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

YOU CAN MAKE A DIFFERENCE IN THE GROWING HEROIN EPIDEMIC

March 2nd, 2015

“What we’re seeing now is the pendulum swing from the legislation that was developed around prescription medications,” said Mark Gilmore, senior investigator with the Putnam County sheriff’s office. “The e-prescription program went into effect and cut off the supply line of falsified prescriptions. And that,” he said, “has made addicts turn to a quick, cheap fix in the form of heroin.” Senator Murphy pitches plan to combat heroin. Amanda Purcell, Poughkeepsie Journal, 2/27/2015

hdFor the past year, I have been blogging about the growing heroin epidemic in the United States. This growth is in large part due to the “gateway drugs” known as painkillers.

Elected officials in New York State have turned up the heat on the heroin epidemic (and it is an epidemic!) by forming coalitions and doing community education and outreach. Through awareness campaigns targeted at educating parents about the drug dangers facing their children, and at educating the children and the community at large, it is believed that we can fight this growing epidemic.

Heroin does not discriminate. From the wealthy to the poor, the cities to the suburbs, and the college campuses to the streets – heroin is big a problem.

Senator Terence Murphy (40th District) representing the New York City suburb communities in Westchester, Putnam and Dutchess counties said in a recent interview with the Poughkeepsie Journal (the Gannett daily newspaper) that, “I campaigned on this. I’m three weeks into my tenure here and I want to get out of the gate swinging,” Murphy said. The article went on to say, “Statewide, there were 89,000 heroin and prescription painkiller treatment admissions in 2013, 25,000 more than in 2004, according to Gov. Andrew Cuomo’s office. Locally, treatment facilities are full, or near to full, and recently, federal, county and local law enforcement arrested 21 and seized $1 million worth of the drug.”

After one of the biggest heroin drug busts in Westchester County in January, Westchester County Police Commissioner George Longworth said during a press conference announcing the arrests, “Some people may think that heroin is only an inner-city problem, but it’s not, Heroin is being sold on tree-lined streets. It is being used by — and sold by — young people who live in comfortable homes and circumstances. No community is immune.”

Senator Murphy is taking his message on the road saying that he intends to hold a forum every two to three weeks in his district. He held his first last week. If you have the opportunity to go to Senator Murphy’s forum or a forum in your district or  at the local high school – GO! The more ALL of us understand this epidemic the better equipped we will be to stop it.

The specifics of Murphy’s plan include:

  • Sponsoring legislation to require insurance companies to cover drug treatment and rehab up to ninety days;
  • Using drug seizure proceeds to provide funding for NARCAN, a potentially life-saving overdose treatment, to all first responders;
  • To help with prevention, state funding for school resource officers (Police SROs) and Drug Abuse Resistance Education (DARE) in all area schools by restoring the Gap Elimination Adjustment school aid cuts made by Senate Democrats in 2010;
  • Forming an federal-interstate-local joint, inter-agency law enforcement counter-narcotics proliferation task force and removing legal barriers to data sharing, aspects of which are already underway;
  • A state grant program for a local narcotics units to provide stepped up enforcement against drug distributors;
  • Increasing penalties for major narcotics traffickers; and
  • Restoring funding cuts enacted by Senate Democrats to the NYS Office of Alcoholism and Substance Abuse Services (OASAS) to fund peer recovery advocate, addiction services and treatment programs.

Ten years ago, most people never knew a person who died from a heroin overdose. Today, most people know of someone – a friend of a friend, the girl up the road, the son of a friend at work, their niece, son, brother or sister – and the list goes on. More awareness outreach and more money for law enforcement are needed to combat the “heroin epidemic” on the streets. Find out how you can help in your community. We all can make a difference.

Previous blogs on heroin:

GOVERNOR CUOMO RECOGNIZES THE HEROIN EPIDEMIC AND IS DOING SOMETHING ABOUT IT

THE GROWING HEROIN PROBLEM IN AMERICA

Disclaimer
This blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

A SURGE IN BIRTHS OF DRUG-DEPENDENT BABIES

June 19th, 2014

“No one who hears it ever forgets the sound.

When newborn babies begin to withdraw from powerful drugs, they shriek at a high, telltale pitch. Cut off from the substances they ingested through their mothers, they convulse, projectile vomit or writhe from skin-scorching diarrhea.

Their tiny bodies shudder violently. They cannot be consoled.”  

Quote from USA TODAY, June 2015, “Drug dependent babies challenge doctors, politicians”    Shelley DuBois and Tony Gonzalez, The Tennessean

The state of Tennessee has been monitoring a growing epidemic since the beginning of 2013 – a surge in births of drug-dependent babies. The state is dealing with a pain medication epidemic that is claiming the tiniest victims – newborn babies! Last year, 921 babies were born addicted in the state and now, Tennessee is fighting back by cracking down on what is known as “doctor shopping” — a trend that is all about finding a doctor that will prescribe pain medications. For an addict this means they can get multiple prescriptions to fuel their habit.

With Tennessee’s 2012 Prescription Safety Act things have changed for the better. The new database system flags people who try to get drugs from four or more sources. This amped up state prescription database requires doctors and pharmacists to use it when doling out pain meds. What a great idea! Why didn’t we think of this sooner?

As we have seen over-and-over for the past six months abuse of, and addiction to, Opioids (prescription painkillers) has skyrocketed leading to a heroin epidemic, and now, an epidemic of drug-dependent babies. Babies born addicted have to go through an excruciating drug withdrawal, known as neonatal abstinence syndrome (NAS). These babies can have seizures, brain damage and in later years school difficulties and behavior problems.

The complicated issue here is that the mothers are victims, too. Many are prescribed these addictive medications by a doctor to treat their pain. These women not only become addicted to the pain medications, but they also become pregnant. Once pregnant they become fearful of discussing their addiction with their doctor, family or friends. What needs to be understood is that there are two victims who need treatment – mother and child. This is a very heart-wrenching time for both and so compassion and understanding are necessary. Also, necessary are laws that make women feel safe so they can seek help for their addiction, and not fear losing their babies.

If you suspect that a friend or loved one is addicted to pain medications and pregnant you should talk about it with them, suggest they speak with their doctor, not be judgmental and help them to find the correct treatment.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

GOVERNOR CUOMO RECOGNIZES THE HEROIN EPIDEMIC AND IS DOING SOMETHING ABOUT IT

June 16th, 2014

“I’ll be the first to say to you: New York State has a problem with heroin addiction, and it is a growing problem,” Mr. Cuomo said on Wednesday in a speech announcing the move, his first major address on heroin. “In the ’70s we had a heroin epidemic. This is worse than what we went through before.” The New York Times

17463078_sI was glad to see New York Governor Andrew Cuomo address the heroin problem in the State. As I have been talking about in my blog, this is much more than an epidemic — It is a crisis! And, not just in New York State, but across the country. It is the result of many things, but much of the increase in heroin use among suburban teens and a growing number of adults coincides with a sharp rise in the use of prescription painkiller pills, which are quite similar to heroin.

According to the NY Times article, “the announcement comes as the resurgent abuse of heroin has been discussed intensively in Albany. For weeks, lawmakers have been meeting treatment providers, insurance companies and families who have lost relatives to overdoses to discuss heroin addiction and the opioid pill abuse that serves as a frequent gateway to heroin.”

Back in my April blog, I addressed the news stories that were coming out about young adults and teens struggling with heroin addiction, and the shock and awe that families felt when they suddenly realized that they had a loved one who was using. At that time, Vermont, Governor Peter Shumlin devoted his entire State of the State message to the heroin addiction. So I can say that I have seen this coming — the drugs are no longer just in the cities, but they are now in our suburbs, rural communities and high schools across the country. That is scary!

I am glad to see that the Governor’s legislation involves new officers being added to drug units around the state. It is a good start. I believe that Governor Cuomo’s efforts are a good start and can make a difference, but we ALL have to be vigilant, too. We must work together! The most important thing is for everyone, particularly parents and the healthcare community, to understand and recognize the symptoms of addiction, and to seek help if you suspect there is a problem. Here are some things that you need to know about heroin addiction:

  • Know the symptoms. These can include a change in personality, lying, stealing of money or medication, sudden drop in grades, depression, pinpoint pupils and signs of intoxication.
  • The first thing is to seek professional help. Treatment for heroin addiction, in addition to detoxification, sometimes includes the use of methadone, which is not intoxicating or sedating, but suppresses narcotic withdrawal. Methadone also relieves the craving for heroin. LAAM is a synthetic opiate that is used to treat heroin addiction.
  • Detoxification is necessary for most addicts. This is usually done in a residential center but sometimes in an out-patient facility.
  • Behavioral therapy is often effective, involving contingency-management therapy and cognitive-behavioral therapy. As with other drugs, 12-step programs can help reinforce the decision to stop using heroin once the addict has navigated the difficult straits of withdrawal.
  • Psychotherapy along with certain psychiatric drugs is also common and useful to control urges and yearnings, as well as to help with the many common underlying psychiatric disorders of addicts, especially mood disorders.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

THE GROWING HEROIN PROBLEM IN AMERICA

April 4th, 2014

As a psychiatrist with over thirty years of treating children, teens and adults, I have seen all kinds of drug addiction. From club drugs like ecstasy, Special K, Molly, and crystal meth to marijuana, cocaine, beer, booze, LSD, and yes, heroin, I have seen these drugs destroy lives.

Just in the past two weeks there have been news reports about teens dying of a heroin overdose in quaint towns like New Milford, CT., that had eight opioid-related overdose deaths last year, four of which involved heroin. This got the attention of the residents and officials in this Litchfield County town who had to face the sad reality that this was an unexpected epidemic that they never saw coming.

How bad is it? Well, in January, Vermont, Governor Peter Shumlin devoted his entire State of the State message to the heroin addiction. “In every corner of our state, heroin and opiate drug addiction threatens us,” he said. Law enforcement authorities in Massachusetts recently reported that 185 people have died of heroin overdoses in just the past four months – which didn’t include numbers from the state’s three largest cities. Nationwide, according to the Federal Substance Abuse and Mental Health Services Administration (SAMHSA), heroin use among persons age 12 and older nearly doubled between 2007 and 2012.

Much of the increase in heroin use among suburban teens and a growing number of adults coincided with a sharp rise in the use of prescription painkiller pills, which are essentially identical to heroin. These painkillers, or opioids, are prescribed for things such as sports injuries, dental procedures, or chronic pain. In a disturbing number of cases, research is showing, they are leading to overdependence and often to addiction to the pills themselves, which can then lead to heroin use.

So what should you do if you suspect a loved one, friend or your child is using heroin?

  • The first thing is to seek professional help. Treatment for heroin addiction includes the use of methadone, which is not intoxicating or sedating, but suppresses narcotic withdrawal. Methadone also relieves the craving for heroin. LAAM is a synthetic opiate that is used to treat heroin addiction.
  • Detoxification is necessary for many addicts. This is usually done in a residential center but sometimes in an out-patient facility.
  • Behavioral therapy is often effective, involving contingency-management therapy and cognitive-behavioral therapy. As with other drugs, 12-step programs can help reinforce the decision to stop using heroin once the addict has navigated the difficult straits of withdrawal.

Users of opioid drugs like heroin have a much higher relapse rate than other drugs. However, many people never relapse and if they do they get better again. One last piece of good news is that there is now FDA approval for a drug that can be administered in the home for addicts who overdose and stop breathing. It is an old drug, naloxone, now available in a new and easy to use home form.   More on this from USA Today.

More links:

Two Families, One Fate by Dennis J. O’Malley,  News-Times, March 2014

The horrific toll of America’s Heroin epidemic by Ian Pannell, BBC News, Chicago.  March 2014.

Why heroin is spreading in America’s suburbs — The drug has followed prescription painkillers into new neighborhoods, forcing police and parents to confront an unexpected problem.  By Kristina Lindborg, March 2014, cover story.

DISCLAIMER

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.