In the article below (originally found HERE), David Kerr of the Recovery Advisory Group notes that heroin addiction is on a quick rise in small cities and towns citing a video from the New York Times talking about the potency of the drug and the rise of overdoses.

Suneal Menzies, Executive Director of ARCA, commented that:

“The greater St. Louis area is seeing a similar trend. Many of the ‘smaller’ communities within 35 miles of downtown St. Louis (Belleville and other southern IL cities, small pockets around the St. Charles / Lake St. Louis area, Webster Groves, to name a few) are being targeted as ‘hubs’ for dealers. They are aware that they will be one of the few if not the only one selling a highly abusable and addictive substance in areas where cost is often not an obstacle. This is why it so important that we offer long-term, comprehensive treatment solutions through ARCA’s Inpatient Residential Programs, Outpatient Programs and the Transitional Living Programs. We are able to combat the rise of heroin addictions and save lives in the process. Vivitrol is one of the medications we use to fight the disease of addiction and have seen great successes with our patients. It is important for those addicted to know that all hope is not lost and that we can help with their transition back to leading a normal, healthy life. “

Heroin Addiction Accelerating in New England with Deadly Consequences

According to a report in the New York Times dated July 18, 2013 there is a “sharp rise” in heroin addiction even in smaller towns in New England. Here is what Katharine Q. Seelye of the Times reported:

“Heroin, which has long flourished in the nation’s big urban centers, has been making an alarming comeback in the smaller cities and towns of New England.”

As a result of a high and broadening demand by users in the US, “China White” and many other “brands” of high potency heroin are flowing into the United States. It’s the simple equation of supply and demand and it starts with the high demand for heroin, particularly by youth, right here in the US. The potency of the recent street heroin is what makes it attractive but the consequences of its use have been deadly! Overdoses are far more common now and the rise in deaths should be alarming to parents, schools and to our nation!

Click on the link to view an alarming video from the Times story: VIDEO LINK

We can’t arrest our way out of this epidemic. There aren’t enough jail cells and even if there were, without treatment, the addiction continues immediately after release and sometimes in jail and in prison. The business of heroin trade is so lucrative that the money can buy nearly everything needed to continue the supply of heroin right into the arms of desperately waiting addicts ready to suffer the severe pain of the withdrawal syndrome without their next fix!

Yes the billions of dollars from the escalating worldwide heroin trade can buy nearly everything; everything that is except treatment. That’s up to our government and the response has not been overwhelming. The irony is that even with the huge glut of heroin addicts needing help, there are some programs with empty treatment beds! Just because an addict needs help doesn’t mean that he/she wants help. New Jersey’s system of drug and alcohol prevention and treatment will understand that there often must be an element of coercion in order to see that addicts who are in and out of hospitals and jails at great cost to society, are instead ushered into long term mandated treatment at far less cost.

The growing numbers of chronic heroin addicts need to be met head on. These addicts are powerless over their disease and will find and steal money to avoid the pain of withdrawal. This disease can turn college scholars into street junkies. Addicts will continue to increase their dose until they are stopped by an external force, i.e. a parent, police, school teacher, family member, an OD or death. Until this happens, the disease will continue to rage in their brains and their bodies and relapse is almost guaranteed. The growing number of reported OD’s and deaths are even more alarming as is the fast growing billion dollar drug industry. Anyone in touch with the facts of the heroin epidemic will agree with the above. The question is what to do about it?

I have seen and understand this monster of addiction all too well over the 45 years of my work with addicts. As a Parole Officer in the 1960’s when there were almost no treatment programs, there was a heroin epidemic that was ignored until it reached the white suburbs. At that point, money began to flow from government for prevention and treatment programs. The demographics of today’s heroin epidemic seem to mirror that which occurred in the late 1960’s and there’s now a call for action.

Here are my recommendations:

  1. The State, the drug treatment programs and the referring sources must work together to assure that all funded treatment beds are full at all times. At the same time, there must be no waiting lists for treatment.
  2. Since the vast majority of addicts prefer heroin over jail or treatment, we must also assure that out of control heroin addicts get to long term treatment and stay there for the required duration, whether they like it or not.*
  3. The Drug Court model needs to be greatly expanded and possibly modified to accommodate the growing numbers of illegal heroin addicts needing (but possibly not wanting) treatment, from all socioeconomic groups. When it’s determined that an addict has been in and out of hospitals and jails and prisons and treatment programs, the court or probation or DYFS or welfare or other state and/or county authorities must coordinate their response and provide the mandated option of treatment. These authorities must assure that there are regular urine tests taken a minimum of three times per week to assure that the addict does not continue using in jail, prison or in treatment. The latest data on OD’s and heroin deaths calls for this stepped up response.
  4. There must be a dramatic increase in all modalities of treatment, outpatient and residential to accommodate the new potential for court mandated heroin addicts sent for help.
  5. Heroin use is illegal and very dangerous since the FDA doesn’t stamp each glassine envelope of dope with their sign of approval. What’s in a bag of dope? No one knows. Heroin abuse has extreme consequences as we have seen by the recent reports of increased use, overdose and death.
  6. We cannot continue to ignore this epidemic by failing to provide a system of help that has an element of legal but pre-adjudication coercion for the unwilling chronic heroin addict to enroll in an expanded treatment network. The reported facts on the recent deadly illegal heroin epidemic call for a quick but measured response and I believe the above six points may be the place to start. According to one of the National Institute on Drug Abuses’ 13 Principles of Effective Treatment:

*NIDA’s point #10. Treatment does not need to be voluntary to be effective. Sanctions or enticements in the family, employment setting, or criminal justice system can significantly increase treatment entry, retention, and success.

 

Here are the 13 Principles of Effective Treatment published by NIDA in 1999:

  1. No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each patient’s problems and needs is critical.
  2. Treatment needs to be readily available. Treatment applicants can be lost if treatment is not immediately available or readily accessible.
  3. Effective treatment attends to multiple needs of the individual, not just his or her drug use. Treatment must address the individual’s drug use and associated medical, psychological, social, vocational, and legal problems.
  4. Treatment needs to be flexible and to provide ongoing assessments of patient needs, which may change during the course of treatment.
  5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness. The time depends on an individual’s needs. For most patients, the threshold of significant improvement is reached at about 3 months in treatment. Additional treatment can produce further progress. Programs should include strategies to prevent patients from leaving treatment prematurely.
  6. Individual and/or group counseling and other behavioral therapies are critical components of effective treatment for addiction. In therapy, patients address motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding nondrug-using activities, and improve problem-solving abilities. Behavioral therapy also facilitates interpersonal relationships.
  7. Medications are an important element of treatment for many patients,especially when combined with counseling and other behavioral therapies. Methadone and levo-alpha-acetylmethadol (LAAM) help persons addicted to opiates stabilize their lives and reduce their drug use. Naltrexone is effective for some opiate addicts and some patients with co-occurring alcohol dependence. Nicotine patches or gum, or an oral medication, such as bupropion, can help persons addicted to nicotine.
  8. Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.Because these disorders often occur in the same individual, patients presenting for one condition should be assessed and treated for the other.
  9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Medical detoxification manages the acute physical symptoms of withdrawal. For some individuals it is a precursor to effective drug addiction treatment.
  10. Treatment does not need to be voluntary to be effective. Sanctions or enticements in the family, employment setting, or criminal justice system can significantly increase treatment entry, retention, and success.
  11. Possible drug use during treatment must be monitored continuously.Monitoring a patient’s drug and alcohol use during treatment, such as through urinalysis, can help the patient withstand urges to use drugs. Such monitoring also can provide early evidence of drug use so that treatment can be adjusted.
  12. Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counseling to help patients modify or change behaviors that place them or others at risk of infection. Counseling can help patients avoid high-risk behavior and help people who are already infected manage their illness.
  13. Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug use can occur during or after successful treatment episodes. Participation in self-help support programs during and following treatment often helps maintain abstinence.
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