THE GROWING HEROIN PROBLEM IN AMERICA by Dr. Henry Paul, MD

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.