Category Archives: Addiction

Addiction to heroin is a powerful obstacle to overcome. The resources listed below will provide educational material for you and your loved one struggling from the affliction.

What Is Methadone

This medication is used to treat opiate substance use disorder. It’s also used to treat severe chronic pain in patients who need 24/7 pain relief. This medicine is prescribed by a doctor and dispensed to patients at a medication-assisted clinic. The drug can only be dispensed at a SAMHSA-certified opioid treatment program.

This drug is used in medication-assisted recovery programs to wean patients off of other opiates such as heroin, fentanyl, and morphine. It’s also used to maintain those with an opiate addiction on a stable dose of medication.

History of Methadone

German scientists at I.G. Farbenindustrie AG were working in 1937 to develop an easy-to-produce synthetic opiate to supplement Germany’s diminished opium supply. In 1941, they developed a synthetic formulation. They called it Hoechst 10820 or Polamidon.

Polamidon was marketed in 1943 and used by the German army during World War II. After the war ended, the Allies confiscated all information about Hoechst 10820. A U.S. study later reported that although the drug was potentially addictive, it produced less sedation and respiratory depression than morphine. It also had the potential to be marketed as a commercial drug.

In 1947, the American Medical Association named this drug methadone. It was introduced in the U.S. that same year by Eli Lilly and Company as a painkiller named Dolophine. Although the drug is an effective analgesic and pain reliever, it’s primarily used to treat opioid addiction. Dolophine literally means “an end to pain.”

When Was This Drug First Used for Opioid Treatment?

This medication was developed by German physicians Gustav Ehrhart and Max Bockmühl between 1937 and 1939. In the United States, it was approved for use in 1947. Initially, it was used to treat chronic, extreme pain. More recently, it’s been used as a treatment for those addicted to heroin and other opioid painkillers.

This drug has been designated as an Essential Medicine by the World Health Organization. It’s considered an effective and safe medicine, and it comes in tablet, powder and liquid form.

In the 1950s, treatment for heroin addiction usually meant going cold turkey while in prison. Over the next few decades, maintenance treatment was introduced as a more effective and humane treatment for opiate addiction. Heroin addiction was beginning to be seen as a medical problem that required treatment rather than as a moral failing.

Those with a substance use disorder can substitute this medicine for heroin and other opiates that may be dangerous to get and expensive to purchase. You don’t have to buy street drugs or doctor-shop to get a steady supply of prescription painkillers.

Instead of the erratic dosing experienced by those who use street drugs, this medicine can be dispensed daily with no variation in the dose. Rather than producing a “high” like other opiates, this medication simply keeps the withdrawal symptoms at bay so that you can attend to other matters and get on with your life.

Treatment works best when paired with a comprehensive medication-assisted recovery program. These programs typically include social support, education, counseling, and group therapy. Attendance at support group meetings like Narcotics Anonymous may be required.

How Does This Program Work?

This medication changes the way the brain processes pain. It reduces opiate withdrawal symptoms while blocking the sensation of “getting high.” The drug is taken once a day, and the effects can last from four to 24 hours. The dose is determined by the prescribing physician based on the patient’s history.

The more opiates you’ve been using, the higher your dosage will be. The dose can be raised or lowered at any time depending on the needs of the patient and the judgment of the physician. After a patient has been in the program for a while and stabilized on a reasonable dose, he or she may be allowed to take doses home for daily ingestion between clinic visits.

How Long Does Treatment Last?

The majority of treatment professionals agree that the most effective treatment lasts for at least one year, but some patients take this medicine for longer. If a patient wants to try life methadone-free, he or she should gradually taper off under the supervision of a doctor to minimize withdrawal symptoms and to maximize the possibility of success.

What Are the Side Effects?

Most side effects of this medication are well-tolerated. However, there are some symptoms that shouldn’t be ignored. Call for emergency services if any of the following symptoms appear:

  • Breathing difficulties
  • Chest pain
  • Pounding or rapid heartbeat
  • Confusion
  • Hallucinations
  • Feeling dizzy or faint
  • Hives or rashes
  • Swelling of the tongue, lips, face or throat

Some individuals experience other adverse side effects of this medicine. The most common are listed below:

  • Intolerance to heat
  • Flushing
  • Constipation
  • Sweating and perspiration
  • Constricted pupils
  • Sedation
  • Dry mouth
  • Vomiting and nausea
  • Low blood pressure
  • Dizziness
  • Itchiness
  • Missed menstrual periods
  • Decreased libido
  • Impotence
  • Inability to achieve orgasm

What Are the Withdrawal Symptoms?

Withdrawal symptoms with this medication take longer to ease off than the withdrawal symptoms of other opiate drugs. However, these symptoms can be greatly reduced with a gradual detox. The most common withdrawal symptoms associated with this medication include the following:

  • Sensitivity to light
  • Tearing eyes
  • Dilated pupils
  • Runny nose
  • Dizziness
  • Yawning
  • Sneezing
  • Intolerance to cold
  • Sweating
  • Nausea and vomiting
  • Hyperventilation
  • High blood pressure
  • Chills
  • Fever
  • Weakness
  • Hypersensitivity to pain
  • Restlessness, agitation, and nervousness
  • Tremors
  • Rapid heartbeat
  • Sore joints or legs
  • Thoughts of suicide
  • Possible relapse
  • Visual and auditory hallucinations
  • Chronic insomnia
  • Depression
  • Anxiety and panic attacks

Addiction to opiates is thought to cause tooth decay due to the common side effect of a dry mouth. This symptom is exacerbated by the fact that many of those with a substance use disorder neglect oral hygiene and regular dental exams. Curiously enough, methadone seems to have a beneficial effect on reproductive health.

U.S. FDA Black Box Warning

The following risks are outlined in the Food and Drug Administration’s black box warning included with this drug:

  • Opioid withdrawal symptoms can be present in children of pregnant women.
  • This drug can be addictive.
  • Accidental lethal overdose is possible.
  • This medicine can be risky when taken with alcohol or benzodiazepines.

What Are the Overdose Symptoms?

The symptoms below have been observed in people who have overdosed on this drug:

  • Pinpoint pupils
  • Sedation and unresponsiveness
  • Limp muscles
  • Nausea and vomiting
  • Slow and shallow breathing
  • Cool, clammy and damp skin
  • Unconsciousness and coma

Although deaths related to this medication can occur, most result from mixing it with other drugs, particularly CNS depressants.

Opiate overdose can be treated with an opioid antagonist like naloxone or naltrexone. Administering an opiate antagonist is tricky. Too little will be ineffective, and too much could activate a sudden detox with severe withdrawal symptoms. Naloxone is the preferred treatment because it has a short half-life. If you administer too much and the patient goes into withdrawal, the effects will be short-lived.

Naloxone leaves the body quickly, so multiple dosing may be necessary to keep the patient out of an overdose. This is especially true with methadone. It stays in the body for a long time, and its effects can last for up to 24 hours. When the antagonist wears off, the person returns to a state of overdose and another dose must be given.

Does This Drug Produce Tolerance and Dependence?

The more of an opiate you ingest, the more your tolerance builds. Although tolerance to the pain-killing effects of this medication may build slowly, tolerance to the euphoric effect develops quickly. On the other hand, tolerance to sedation, constipation and respiratory depression may not develop at all.

Who Qualifies for Methadone Treatment Coverage?

Although brand-name formulations can be expensive, generic tablets are relatively cheap. Treatment at an outpatient clinic may be covered by private insurance or by Medicare or Medicaid. When prescribed for pain and dispensed at a pharmacy, the cost of this medicine is covered under Medicare Part D.

Part D Medicare does not, however, cover this medication when it’s dispensed in a clinic and used for medication-assisted recovery of opioid dependence. Eligibility for medication-assisted recovery with methadone is usually contingent on participation in a substance use disorder treatment program. Veterans in the Veteran’s Administration health care system may be eligible for medication-assisted recovery.

What Are Medication-Assisted Recovery Programs?

Medication-assisted recovery programs are clinics that dispense methadone, naltrexone, buprenorphine, and Suboxone. These drugs can help you to quit heroin and other opiates and are provided as part of treatment. This treatment is designed for patients who are now dependent on opiates or who have been dependent on them at some point in the past.

Overall, people who participate in medication-assisted recovery programs may be more successful in quitting heroin than those who do not. People who quit heroin without methadone are more likely to relapse. They also have a higher risk of an overdose after a period of abstinence or lower daily doses.

Methadone is considered a Schedule II opioid painkiller that’s used for pain management as well as opioid substance use disorder. This medicine treats pain and reduces heroin withdrawal symptoms. It’s particularly effective because of its long-acting properties. When the drug is taken in the morning, its effects can last all day.

Patients must report to the clinic daily to receive their dose. Because many clinics are closed on Sunday, however, take-home medication for one day is often provided. Patients may be required to undergo drug testing. They may also be required to attend substance use disorder groups and outside support meetings through organizations like Narcotics Anonymous.

With daily treatment, patients are relieved of opioid withdrawal symptoms as well as the feeling of being “high.” They are able to regain some stability in their lives and to learn new ways of living. All the time and energy that used to be spent finding and using drugs is now free. That energy can be channeled into recovery activities, checking out employment opportunities and spending quality time with friends and family.

How Can I Tell if I’m Addicted?

You know you’re addicted to opiates if you get unpleasant withdrawal symptoms whenever you try to quit. If you’ve been using heroin regularly for six or more months, you may be addicted.

Patients who take methadone may be more successful in quitting heroin than those who don’t. Opiates are highly addictive, and if you’re hooked, your body needs these drugs to function properly. Tapering off gradually under a doctor’s supervision is highly recommended. Going “cold turkey” can produce such intolerable side effects that you set yourself up for a relapse.

People who quit heroin while participating in a drug-assisted treatment program are less likely to relapse. If you’ve been clean for a while, your tolerance will be lower. You could be at risk for an accidental overdose if you resume using.

Methadone maintenance is not a cure for heroin addiction. Rather, it allows you to stabilize yourself and your life so that you can attend to the business of living. A methadone detox at some point in the future may be pursued.

If you want to quit heroin or any other opiate drug, don’t do it alone. Speak with your doctor and if necessary, get help. Many of those with a substance use disorder have quit using heroin and then entered drug rehab for addiction treatment. They now live clean, drug-free lives in recovery without having to use opiates.

How Heroin Kills You

The U.S. is facing a dangerous health crisis. Rates of heroin use and overdoses haven’t been so high since the 1970s. In 2017, more than 70,000 Americans died as a result of a drug overdose. Approximately 47,600 of those deaths were opioid-related fatalities, and 15,482 were heroin overdoses. Even these high statistics may not tell the whole story because they don’t count the deaths of people in states who don’t specify the drug on the death certificate after an overdose. Nor do the statistics take into account the drug users who died from exposure to the cold because they were too high to go indoors in below-zero temperatures or the individuals who committed suicide while they were on drugs.

It’s easy to think of heroin and other drugs as only affecting marginalized populations in poor neighborhoods with gangs and drug dealers. In reality, heroin use and overdoses affect all strata of American society from blue-collar employees to wealthiest celebrities. Even if you don’t believe that heroin overdoses directly impact your life, you’re at an increased likelihood of being indirectly affected by the heroin epidemic going on in the country. Communities with high levels of drug addiction tend to have the less educational achievement and more crime. Long-term heroin users at risk of an overdose not only do harm to themselves but to their friends and family as well.

How People Get Hooked on Heroin

Heroin is an opioid derived from morphine. The populations most susceptible to death from a heroin overdose are long-term users who suffer from a heroin addiction.

The initial decision to use heroin may not be a behavioral flaw. Heroin addiction is a sickness in which the brain becomes dependent on increasing levels of the drug to function even as it causes neurological breakdown and other physical symptoms. Sometimes, heroin addiction can spring from the overzealous prescription of painkillers. Heroin bought off the street is much cheaper than prescription drugs, so prescription pill addicts may turn to heroin to continue to get the high they felt before. Another reason for continued heroin use is to stave off the physically devastating side effects of withdrawal from the drug.

People addicted to heroin may have difficulty stopping their drug use and relapse often because heroin affects the dopamine receptors in the brain. Dopamine is a special chemical that makes pleasurable feelings radiate through the body. In short, heroin makes the user feel good. However, continued heroin use dulls the ability of the dopamine receptors to experience the same amount of pleasure from the drug. Over time, the user requires more and more heroin to get the same high. Eventually, the addicted individual consumes more heroin than their body can handle, oftentimes resulting in death. Many factors affect heroin addiction such as the individual’s environment, genetic makeup and whether they started drug use at an early age.

Heroin overdoses indirectly affect other individuals, especially children, and teenagers. Children who grow up observing heroin addiction and who have relatives who have overdosed on heroin are more likely to use the drug themselves. Starting any kind of drug use at an early age affects critical decision-making skills, learning, and judgment. Younger drug users are less likely to decline heroin when it’s offered and more likely to move on to heroin from a gateway drug like marijuana.

Indicators of a Heroin Addiction

As the common prerequisite for heroin overdose is an addiction to the drug, it’s beneficial to know the signs and symptoms of a heroin addict. Some symptoms are common among addicts, such as manipulation, lying, stealing, avoidance of family and friends and unexplained disappearances. Other symptoms include long sleeves to hide track marks from repeated injections, missing belts or shoelaces, trails of white powder, burnt spoons and missing prescription medications. If you notice valuable items in your house going missing at the same time, your loved one might be selling them for heroin. Belts and shoelaces go missing because the addict uses them to tie their arm and prep a vein for injection. Spoons get burnt when an addict puts the heroin in the spoon and slowly burns it with a flame to ready the substance for intravenous ingestion. If you see any of these signs, do your best to obtain and carry naloxone with you so that you can save your loved one from overdosing should that occur.

Signs of a Heroin Overdose

It’s important to know the signs of an overdose so that you can help the affected person. The U.S. Surgeon General has recommended that relatives of known heroin addicts carry naloxone, an anti-overdose drug that can save lives.

Heroin can be ingested in multiple ways. It can be taken orally or injected under the skin or into muscles. Smoking and injecting heroin are the most dangerous methods because the drug enters the bloodstream more quickly and the effect is felt almost immediately. Sometimes, it may be difficult to know the root cause of a heroin addict’s death. Repeated injections can lead to deadly communicable diseases like HIV and hepatitis. Advanced cardiovascular disease can result in pulmonary embolisms and instant death.

It’s very important not to confuse signs of an overdose with signs of heroin withdrawal. Administering naloxone during heroin withdrawal can be deadly. Signs of withdrawal include agitation, insomnia, sweating, muscle pain and a craving for the drugs. This means that a friend or relative in withdrawal will be complaining of pain, awake for hours and hours on end, and exerting his or her best efforts to find more heroin to use.

In contrast, signs of overdosing are drastically different. Someone about to die from too much heroin intake will have difficulty breathing and take shallow breaths. This means that brain stem function is decreasing. The pupils will become very small, a condition is known as pinpoint pupils. The mouth becomes so dry that the tongue becomes discolored. The pulse becomes weaker and weaker, and as the body is deprived of oxygen, the skin and lips begin to turn blue. In some cases, the individual could enter a comatose state before death. If you see an individual exhibiting these symptoms such as gasping for air with a discolored tongue, bluish lips and pinpoint pupils, you should administer naloxone. It could save their life.

What Happens to the Body During a Heroin Overdose?

Heroin’s route upon its entrance into the body’s bloodstream takes it right to the individual’s brain. In the brain, it is converted into morphine and binds to the brain’s mu-opioid receptors. Mu-opioid receptors are located in the cerebrum, cerebellum and brain stem. The binding of morphine to the cerebral and cerebellar receptors is what causes slurred speech, slowed movement, delayed reactions and outbursts of uncontrolled violence from poor impulse control. However, when there is too much heroin, the converted morphine binds to the receptors in the brain stem. The brain stem is responsible for automatic breathing. When the brain stem is compromised, the individual enters into a state of severe respiratory depression and ceases to breathe. Respiratory arrest can lead to cardiac arrest. That’s how heroin kills you.

Intervening Factors in Deaths From a Heroin Overdose

Knowing how heroin kills you may help save you or someone else from an overdose. Unfortunately, naloxone may not always work. Sometimes, heroin overdose is the secondary cause of death, not the primary one. Many heroin users are abusing other drugs such as cocaine, methamphetamine or prescription drugs.

Another intervening factor is a reluctance to seek medical help and attention. Even if you were doing drugs or committing illegal activity while your friend or relative was overdosing, don’t use that as an excuse to avoid calling the authorities. Many states now have Good Samaritan fatal overdose protection laws. These laws are a special form of legislation that allows individuals to call police and ambulance services without being subject to arrest or imprisonment. Statistics show that one of the most common reasons for failing to call 911 is fear of arrest by the police.

How You Can Help Prevent Heroin Overdose-Related Fatalities

Carrying naloxone and learning how to inject it is the quickest and surest way to help someone suffering from a heroin overdose. If you don’t have naloxone and you believe that someone is overdosing or entering respiratory distress, call 911 immediately. Explain the symptoms to the 911 operator in detail. Be sure to tell the 911 operator the victim’s weight, age, the amount of heroin they took if you can, and when they took it. An ambulance will come and take the affected person to the emergency room.

People who don’t regularly use drugs might not know what heroin actually looks like. Drug addicts can be manipulative and try to convince their loved ones that they’re not actually doing heroin. One of the ways that heroin kills you and the people close to you is through ignorance. Heroin is a white, brown or cream-colored powder that is cut with sugar or powdered milk to make it more palatable than its purer form, which is quite bitter. As powdered heroin looks very similar to powdered sugar or crushed candy, it’s important to keep very small children away from the presence of heroin users and out of users’ homes. For children, the oral ingestion of heroin, even in small quantities, can lead to a fatal overdose. The darker form of heroin, known as “black tar,” is the type of heroin that’s injected.

At the emergency room, try to be a supportive presence. Overdosing can be a scary experience, not just for the person witnessing but for the person going through it as well. Emergency room doctors will probably run diagnostic tests like CAT scans, blood tests, and ECGs. Treatment options include intravenous fluids, naloxone and breathing support with oxygen therapy. Feel free to ask the doctors and nurses questions about follow-up care and treatment at home. If treated quickly, patients can be discharged after 24 to 48 hours in the hospital. Longer hospital stays occur when the heroin has caused significant organ damage. Some hospitals have programs in which the drug user can go from the hospital directly to a private rehab facility if they have health insurance. While overdosing can be scary, it just might be the “rock bottom” situation that an addict needs to push them into getting help for good.

Another way you can help is by getting educated. Familiarize yourself with the symptoms of heroin use, withdrawal from the drug and overdosing. Support your loved ones in their fight against addiction. You can’t fight their battles for them, but you can encourage them to go to inpatient or outpatient rehab and get clean. Let them know that they’re not alone in their fight and that getting clean is possible. Through proper care in the right treatment center, your loved one can kick their heroin habit and become sober.

Drugged Driving Statistics

Driving under the influence is one of the most preventable crimes in the United States. Especially in the age of ride-hailing services and apps, it’s easy to avoid drugged or drunk driving, yet statistics from the Bureau of Transportation report that three people are killed in alcohol-related crashes every two hours. In the same survey, the Bureau cites that in 2010, 4 million American adults said they’d driven drunk at least once.

Many people are aware of the effects that alcohol and illicit drugs can have on the human body, but many legal and doctor-prescribed drugs also affect a person’s driving ability, making accidents far more likely to occur. If there is any intoxicant present in a person’s body, they are considered to be driving under the influence. Not only is it illegal to drive high or drunk, possibly resulting in getting a DUI citation or arrest, but it’s also incredibly dangerous. Drugged driving can bring harm to more than just the user, and the ramifications of doing so can have an impact on many people’s lives.

What Is Drugged Driving?

Drugged driving is driving under the influence of any intoxicant whatsoever. Alcohol and marijuana use are two of the leading causes of DUIs in the United States, but drugged driving is not limited just to these two substances. Illegal drugs like heroin, methamphetamine, LSD and cocaine significantly impair someone’s ability to drive, and prescribed pharmaceuticals of any sort can do the same. Even some store-bought or over-the-counter medications can alter a person’s consciousness enough to turn driving into a more dangerous activity.

Most people know the moral and legal consequences of drunk driving, but they may be unaware that even medication prescribed by a doctor can result in an accident or DUI if misused. It’s wise to ask your doctor if a medication that he or she prescribes to you will affect your ability to drive, and, if so, how long after taking it you have to wait before you can operate a vehicle.

Drugged or drunk driving is a common occurrence in some people’s lives. Many believe that just one drink or one hit of pot won’t affect their driving ability, but even a small amount of alcohol or drugs in the body can be enough to alter someone’s motor abilities and reaction times. Statistics from a 2013 – 2014 Governors Highway Safety Association roadside survey indicate that nearly 22 percent of all weekend drivers were under the influence of alcohol or drugs. This number could be much higher, however, as it’s substantially more challenging to test drivers for drug use than for alcohol in roadside conditions.

How Many Accidents Are Caused by Drugged Driving Each Year?

In 2016, 20.7 million drivers drove under the influence of some substance, and 11.8 million of them were under the influence of something other than alcohol. Every year, millions of people are arrested for drugged driving. A survey by the GHSA reported that 44 percent of drivers involved in fatal traffic accidents were under the influence of alcohol or drugs. Not all of these drugs were considered illicit; over-the-counter drugs and doctor-prescribed pharmaceuticals were also accounted for in these statistics.

State law enforcement agencies are having a challenging time adjusting to changing marijuana laws. Though still illegal on a federal level, many states have legalized pot for medicinal or recreational use. With marijuana use increasingly becoming legalized throughout the United States, the rate of drugged driving accidents each year has increased. From 2007 to 2014, states saw a 48 percent increase in drivers testing positive for THC, the psychoactive compound contained in marijuana.

How Do Drugs and Alcohol Affect a Driver?

Every drug, including alcohol, affects a person’s ability to drive a vehicle, but not every intoxicating substance goes about this in the same way. Each substance changes various aspects of the brain and other bodily systems, making driving dangerous because of the possibility to react differently than while sober.

Alcohol, for instance, affects drivers’ central nervous systems by limiting activity in the brain’s neocortex and cerebellum. These parts of the brain are responsible for high-level decision making, coordination, and motor skills. Alcohol greatly reduces these systems’ ability to function, resulting in blurred or doubled vision, slurred speech, impaired balance and the possibility of blacking out, to name a few symptoms.

Marijuana affects different parts of the brain that respond to the plant’s cannabinoids. Memory loss, paranoia, hallucinations and a loss of coordination are some symptoms of pot use that may cause a driver to weave in and out of lanes, not respond to traffic lights or signs, or briefly lose consciousness, all of which can be incredibly dangerous when operating a vehicle.

Opiates, a widespread class of medication that has both prescribed varieties, i.e., Oxycodone, Oxycontin, Dilaudid and Vicodin, as well as illicit forms like heroin and fentanyl, affect a person’s brain differently than alcohol and marijuana. However, symptoms like memory loss and incredibly marked drowsiness can cause a driver’s abilities to become significantly impaired. Other illegal drugs like methamphetamine or cocaine can cause a person to become agitated, aggressive and reckless, to name only some of their effects. A driver under the influence of these or any other illicit drugs can cause injury or death to themselves or others.

Many people who drive drunk have other intoxicants in their systems. These substances can combine to create an even stronger effect on the user, so anyone driving intoxicated is substantially more likely to cause a potentially fatal accident.

Who Are the Most at Risk for Drugged Driving?

Anyone who drinks or uses any form of drugs and then chooses to drive is at risk of getting into a severe accident. However, men are much more likely than women to be involved in an accident involving drugs or alcohol. In 2010, men committed four out of every five DUIs, and 32 percent of these belonged to males between the ages of 21 and 34.

Another group that’s more at risk than others is those who engage in drug or alcohol use on a regular basis. People who binge drink, which is having more than five drinks in a setting for men or four drinks for women, are more likely to find themselves behind the wheel of a car more often, resulting in a much higher rate of accidents. This group was responsible for over 80 percent of drunk driving accidents in 2010.

Teens are especially susceptible to drugged driving. Their lack of experience with driving as well as with drug and alcohol use results in a particularly deadly combination. Teens exhibit less regard for speed limits and safe driving habits than adults, and drugs and alcohol can especially exacerbate this behavior. Car crashes are the leading cause of death for teens between the ages of 16 and 19. According to a 2016 survey by the Center for Behavioral Health Statistics and Quality, 12 percent of high school seniors reported driving under the influence of marijuana while 9 percent said they’d driven drunk.

Some people believe that they have a high tolerance for liquor or drugs and therefore are better suited to drive a car inebriated. This belief, however, is not true. Any amount of alcohol or drugs in a person’s system can result in a DUI or arrest by the police. The legal blood alcohol content, or BAC, limit in most states is .08  although a police officer can arrest anyone who’s showing signs of intoxication even if their BAC is below that percentage.

What Are the Penalties for Drugged Driving?

The most significant penalty that can occur because of drugged or drunk driving is causing death to yourself or others. Vehicles of any sort can turn into deadly weapons if operated by a driver who’s drunk or high. It’s for this reason that every state has strict laws regarding DUIs and DWIs.

Sixteen states have zero tolerance laws making it illegal for any measurable amount of a drug to be present in a driver’s system while operating a vehicle. Seven states have “per se” laws that make it illegal for any measurable amount of drugs to be in a person’s body outside the legal limits. States are also making more specific regulations regarding the parameters and legality of marijuana use.

Penalties for breaking these laws can be strict. Citations, arrests, jail or prison time, hefty fines, DUI classes, and rehab are just some of the punishments a person convicted of drugged driving can expect if they are pulled over or involved in an accident.

How Can Drugged Driving Be Prevented?

There are many ways to prevent drugged driving. The simplest and by far the most effective way is to never get behind the wheel when you’re under the influence of any substance whatsoever. If you’ve had anything to drink or you’ve consumed any intoxicant, find a designated driver to take you home. A ride-hailing or taxi service can take you where you need to go without you having to drive at all. If you’re in addiction recovery, it’s strongly suggested that you avoid going to places or events where alcohol and drugs are readily available.

It’s also important to not let anyone you know drive drunk or high. If you see a friend about to drive in this state, and if you’re not under the influence of anything, offer to take them where they need to go or get a taxi for them. Even if you’re not intoxicated, it’s important to pay attention to the road when you’re driving, especially on popular drinking days like the weekends and holidays. Always be sure to wear your seat belt.

Despite alcohol being legal to purchase by anyone over 21, the legal status of most drugs varies considerably. Marijuana is legal in only some states and still illegal on the federal level. Doctor-prescribed drugs, especially opiates, are highly controlled and illegal to use without a prescription. Illicit drugs, which include but are not limited to heroin, cocaine, fentanyl, LSD, inhalants, and methamphetamine, are entirely illegal no matter the state. Using these drugs can result in DUIs, injuries or fatal accidents.

Drugs and alcohol can significantly inhibit your ability to drive. With many states legalizing marijuana use, and with more and more people using it, drivers need to be aware of the risks that can come from drugged driving. With more ways available to people to travel without driving under the influence, drugged driving is more avoidable now than it ever has been.

Medications to Reverse Heroin Overdose

Heroin is a highly addictive illegal opioid derived from morphine. Used to produce feelings of euphoria, the drug takes a toll on individuals, their families, and society. It contributes to crime and violence, and it creates problems in work and educational settings. One study estimates that heroin use costs at least $51,000 for each user annually, which equates to $51 billion for the entire United States.

The Centers for Disease Control and Prevention says almost 500,000 people in the U.S. reported using heroin in 2017. That same year, 15,000 people died from drug overdoses involving heroin, a death rate that was five times higher in 2017 than in 2010. The states with the highest percentages of heroin deaths were California, Illinois, and Virginia.

There are medications that can help those struggling with both heroin use and overdose.

How Is a Heroin Overdose Treated?

Heroin can be deadly. A large dosage depresses breathing and heart rate so much that a person cannot survive without medical intervention. When help arrives in time, there are medical treatments that can reverse or stop an overdose. They include:

Polyethylene glycol can sometimes be used to flush an overdose of heroin from the body. Although it is usually prescribed as a laxative for severe constipation, it can also flush opioids that have not been metabolized from the system. It may not work in large doses, however.

Naloxone is an old medication that has become more popular in recent years because of the opioid and heroin addiction crisis. It is a mainstay in emergency rooms where it is used to stop a heroin overdose. It is also given to first responders and police officers to give to people who have taken too much heroin. Individuals and families are also trained to administer the medication if a loved one takes an overdose.

Naloxone works by binding to the same receptors in the brain as opioids. Because it binds more quickly than heroin, it stops the body from reacting to the heroin, ending the deadly effects of the overdose. It may not work when an individual has taken a massive amount of heroin.

It also leaves the body faster than heroin, meaning the heroin can stay in the system after the naloxone is metabolized. If this happens, the overdose may return. That is why it is important to call for emergency medical help after administering the naloxone.

Studies are being done to see if naloxone can also be used to treat heroin abuse and addiction. Although more research is needed, it may be helpful as a therapy for tapering people off an opioid addiction. Its ability to stop heroin’s effects in the brain could potentially help with withdrawal symptoms and cravings.

Nalmefene is routinely used to stop or reverse the effects of alcohol poisoning. Because it binds to the same receptors in the brain that heroin does, it can treat heroin overdoses. Studies suggest that it can also quickly reverse the effects of heroin overdose. It may, in fact, be more effective for treating overdoses than naloxone, but it has only been approved for use in hospitals. It does not work for symptoms of cocaine withdrawal.

Buprenorphine, known by its brand name as Suboxone, is prescribed to help with withdrawal symptoms and cravings. Patients can take the drug at home to decrease the risk of a heroin overdose.

Are There Safe Natural Alternatives?

A controversial alternative called kratom is an herbal supplement derived from the same botanical family as coffee and gardenia. It comes from tropical evergreen trees in Southeast Asia. Its leaves can be smoked, chewed, as well as made into a tea, extract, or capsule. Its effects can be felt at low doses, and euphoria occurs at higher doses. Kratom has been used for hundreds of years but has been made illegal in some Asian countries. It is also illegal in some states in the U.S.

In the past, kratom has been used in the U.S. to relieve pain and reduce opiate withdrawal, but its effectiveness and safety have been questioned. In 2018, the FDA said that it has no scientific evidence of its use for medical reasons. The FDA also says that kratom should not be used as an alternative treatment for opioid addiction.

In 2018, the U.S. Centers for Disease Control and Prevention (CDC) reported an outbreak of kratom-linked salmonella infections in 20 states. No deaths were reported, but 11 people were hospitalized. The supplement had been consumed in teas, pills, and powder. Officials were not able to find the source of the tainted kratom. The supplement may also have dangerous pesticide residue and unsafe additives.

How Is Heroin Addiction Treated?

Substance use disorder is a chronic condition, but medications can be prescribed to reduce cravings and withdrawal symptoms, making it easier for users to stay sober. Each person’s treatment is tailored to individual needs and takes into consideration other illnesses and health issues that occur at the same time as the addiction. Treatments for heroin use disorder may include medications, behavioral therapy, or a combination of the two.

Studies show that treating heroin use disorder with medication helps to keep people in a treatment program. It also helps to decrease drug use, reduce criminal activity, and lessen the risk of transmitting infectious diseases like hepatitis and HIV.

People who give up heroin often have severe withdrawal symptoms that include nausea, diarrhea, and vomiting. Medications can ease the detox process and make relapse less likely.

Behavioral therapy may take place in outpatient or residential environments. To reinforce and encourage sobriety, treatments may rely on reward systems or cognitive-behavioral therapy, which teaches ways of coping with stress and dealing with relapse.

Some programs also use the 12-step system or other kinds of support groups to encourage patients and give them an opportunity to share their feelings. Every treatment should be tailored to fit the specific needs of an individual patient.

What Drugs Are Used to Treat Heroin Addiction?

Medications used to treat heroin and other opioid use disorders use the same opioid receptors as the drug that causes the addiction, but they are safer and less likely to lead to behavioral problems than the opioid. Three kinds of medications are used to treat addictions. They include:

  • Agonists

Agonists activate opioid receptors.

  • Partial agonists

Partial agonists activate opioid receptors, but they create a smaller response.

  • Antagonists

Antagonists block the opioid receptors, but they also change the reward effects of the addictive drug.

The type of medication used to treat a specific patient depends on their individual needs. Treatment centers use three types of drugs:

Methadone

Methadone is sold under the brand names Dolophine or Methadose. It is an opioid agonist that is taken by mouth so that it reaches the brain slowly to lower the risk of a high. It has been used since the 1960s to treat heroin addicts, and it can be effective for individuals not helped by other medications. Methadone must be administered through an approved daily treatment plan.

Methadone also has the following benefits:

  • It is not likely to cause an overdose.
  • Methadone maintenance gives the patient an opportunity to stay stable long enough to make constructive changes.
  • Doses are only required once a day or less.
  • It cuts down on health problems, such as injection-related infections and vein problems.
  • Methadone is more affordable than heroin.

The Alcohol and Drug Abuse Foundation says that methadone treatment is more effective if it is part of a comprehensive program. These types of programs combine methadone maintenance with counseling, support groups, and alternative therapies.

Buprenorphine

Buprenorphine is sold under the brand name Subutex. Buprenorphine helps to relieve heroin cravings but does not produce the highs or side effects of other opioids. It is taken sublingually, or orally, and contains an antagonist called naloxone that keeps an addict from getting high if they inject the buprenorphine. If a heroin user injects Subutex, the naloxone causes withdrawal symptoms not caused when the drug is taken by mouth.

Buprenorphine has the following benefits:

  • It is less likely to cause physical dependence or euphoria.
  • It has a mild withdrawal when compared to heroin.
  • It lessens cravings and has a lower risk of abuse.
  • It suppresses opioid withdrawal symptoms.
  • It cuts down on illegal opioid use.
  • It blocks the effects of other opioids.

Buprenorphine, approved by the FDA in 2002, was the first drug that could be prescribed by certified doctors through the Drug Addiction Treatment Act. This made it possible for patients to take medication without visiting a treatment center. Buprenorphine availability has given many people the opportunity to get the treatment they need.

In 2016, the law was expanded with the Comprehensive Addiction and Recovery Act, or CARA, to include eligible physician assistants and nurse practitioners. There are two FDA-approved generic forms of the drug, making it more affordable and more widely available for the people who need it. In 2016, the FDA approved a buprenorphine implant that lasts six months and an injection that is taken once a month.

Naltrexone

Naltrexone is an opioid antagonist licensed under the brand name Vivitrol. It prevents the effects of heroin, does not sedate, is not addictive, and does not cause physical dependence. However, it is sometimes not effective because patients have trouble following the treatment. An injectable long-acting version of the medication came out in 2010, allowing patients to be treated monthly rather than through daily doses.

Naltrexone has the following benefits:

  • It can be prescribed by any health care provider with a license to write prescriptions.
  • It reduces cravings.
  • It decreases reaction to drug-conditioned cues.
  • There is less risk of withdrawal than with opioids.

What Happens After Treatment for Addiction or Overdose?

Individuals who have a long-term problem with heroin, or those who overdose on the drug, recover more quickly and experience fewer relapses when they undergo treatment in a residential facility. Trained caregivers and medical professionals can monitor the use of prescribed medications and daily activities, but the stay also gives people a chance to take a break from the stress and temptations they face in their daily lives. Therapy usually includes medication, counseling, and information that offer support, encouragement, and skills for avoiding relapse and returning to a normal lifestyle.

If you or someone you love has a problem with heroin, there is help available. Heroin addiction is a chronic condition that requires lifetime maintenance, but the rate of relapse is similar to that of medical conditions like type 2 diabetes. Recovery requires commitment and lifestyle changes, but it is worth the effort.

America’s Heroin Epidemic

How does taking opioids make someone feel? We usually avoid asking this question when discussing recreational drug use because nobody wants to encourage drug experimentation, let alone drug addiction. When the topic is addressed, it’s easy for people to assume that only weak-minded, reckless people turn to drugs.

Sadly, not many people are prepared to understand that drug addiction, particularly heroin and opioid addiction, has risen to epidemic proportions. America’s heroin epidemic affects all of us. It could be your significant other, your neighbor or even your child. No one ever thinks that it can happen to them or someone they love. However, heroin addiction doesn’t discriminate.

Dating back to the 1990s, pharmaceutical companies claimed that patients taking certain opioid medications would not become addicted. As such, health care providers began prescribing opioids for everything from sprained ankles to post-partum pain control. With this increased rate of opioid prescriptions, it slowly became clear that these types of medications were highly addictive and often led to substance abuse issues. As addiction levels rise, so does the need to understand that opioids, legally or illegally, led the U.S. to its current heroin epidemic.

The U.S. Centers for Disease Control and Prevention, or CDC, estimates that the economic burden brought about by prescription opioid and heroin use comes in at $78.5 billion. This figure includes addiction treatment, the cost of health care, legal expenses and lost productivity.

Understanding the Epidemic

The opioid epidemic has been described as the deadliest drug crisis in American history. According to the CDC, more than 115 people die from opioid overdoses every day.

People used to think that only unemployed people from broken homes turned to heroin to escape reality. No longer is opioid use limited to low-income areas; it has transcended into all geographic areas, affecting people of all ages and ethnicities. Now, the faces of heroin addiction include veterans who cannot find work after leaving the military, moms who needed pain relief after giving birth and even people who had oral surgery.

Many people who become addicted to heroin do not have a prior history of substance misuse. Substance use disorder is not linear or predictable. Some people who were introduced to drugs through prescription pain relievers end up on heroin. Health care officials say that the ever-increasing abuse of prescribed painkillers leads users to the street when they no longer can obtain the drug legally. Unfortunately, because heroin is so addictive, it leads to increased drug-seeking behavior.

Those who misuse the drug and become addicted look for a stronger and possibly cheaper high. Heroin is both, but it is also deadly. It can be laced with other drugs that cause death. Deaths from heroin overdose doubled between 2010 and 2012. The death toll also increased dramatically in 2014 when heroin mixed with fentanyl became more common. Fentanyl, when combined with heroin, is lethal. Users can die within seconds of ingestion.

Although the issue is multifaceted, drug makers and physicians play a key role in this epidemic. After all, if there were no pharmaceutical opioids, physicians wouldn’t be able to prescribe them. That is not to say that they are responsible for another person’s substance use disorder, but the snowballing effect of prescription drug use and not being able to gain access to them has led many Americans to heroin.

Veterans and Heroin Use

Veterans have also been affected by America’s opioid epidemic. Untreated chronic pain has led many veterans to seek out pain relief on the street. After being discharged from their service, some veterans find themselves unemployed and homeless. Depression and the need to escape create the perfect backdrop for substance use disorders. According to the VA, it is estimated that 68,000 veterans are currently struggling with opioid use disorders, and when they can no longer gain access to prescription pain medication legally, they may turn to heroin.

Heroin’s Effects

Heroin can be snorted, injected or swallowed. The speed at which heroin reaches the brain depends on the method taken. Users who inject heroin can feel its high within seven to eight seconds. Astonishingly, not all first-time users experience the feeling of euphoria we hear about. Since heroin slows down the digestive tract, some users may become nauseated and vomit.

Many users report that the high they experience is similar to the feeling after a satisfying sexual encounter, only much more intense. It is this sensation that drives users back to the drug. The brain cells that are affected by heroin eventually become damaged, causing the inability to feel pleasure without heroin. In turn, these cells create the intense craving heroin users have. Unfortunately, the more that individuals take the drug, the larger amounts they need to achieve a high. Often, users become convinced that they can’t function normally without the drug.

Symptoms of Heroin Addiction

It is not surprising that an estimated 23 percent of all people who try heroin will become dependent. The brain’s receptors change almost immediately upon use, leading to an inexplicable high within minutes. Since heroin produces a downer effect, using it produces an almost instantaneous feeling of relaxation and euphoria. Similar to other kinds of opiates, heroin prohibits the brain’s ability to feel pain.

Initially, heroin users can hide the signs of their habit. Over time, family members and co-workers may start to notice the signs of drug use, which include cycles of alertness followed by falling asleep, constricted pupils, rapid behavioral changes and shortness of breath.

The above red flags are not unique to heroin. There are more definitive signs that a heroin user exhibits and these typically include possession of paraphernalia used to prepare the drug. In addition, behavioral changes become more evident as drug users sink further into the substance abuse cycle. Individuals may lie to cover up their addiction and avoid making eye contact. Speech may be incoherent. Performance at work and school may decline, resulting in unemployment or expulsion.

Long-Term Effects of Heroin Use

When someone continues to use heroin despite the deadly consequences, they can develop all kinds of health issues as follows:

Central nervous system

Heroin’s impact on a user’s brain is profound. The receptors that produce chemical signals for happiness and pleasure shrink. People who use heroin for long periods of time also show deterioration of white matter on CT scans of the brain. As such, their ability to make sound decisions and regulate their behavior is altered.

Respiratory system

Like other opiates, heroin slows respiratory function. People who use heroin may breathe much slower and shallower when they are high. If someone uses too much, they may stop breathing. The risk of cardiac arrest is one of the major health risks of heroin. Although it can occur the first time someone uses heroin, chronic users usually need to take higher doses to feel the same effect, which increases the risk of respiratory failure.

Cardiovascular system

Large doses of heroin can cause sudden death. Long-term heroin users also face a slew of other cardiovascular issues including vein damage. With each injection, the damage is done to the veins and arteries that lead to the heart. In turn, infection and abscesses can occur. According to the CDC, approximately 32 percent of heroin users in New York City suffer from a drug-induced abscess.

Digestive system

Heroin can also negatively impact the user’s digestive tract. Its sedative properties slow the movement of food and water, causing constipation and bloating. Users may not disclose these symptoms nor seek treatment, putting them at greater risk for developing intestinal blockages.

What’s Being Done

The FDA believes a multidisciplinary approach to treatment would help bridge the gap between substance use disorders and treatment. Stricter limitation of the frequency and the number of opioid prescriptions would force people to look for alternative ways of pain management, including cognitive therapy, occupational therapy, and physical therapy.

The CDC has also partnered with many states to combat both opioid addiction and heroin use. By educating the public and setting up safe zones for those who are suffering from addiction, the hope is that users will go to those safe zones to inject or use as opposed to getting high on the street.

The Opioid Crisis Response Act of 2018 marks a breakthrough in the fight against the heroin epidemic in the U.S. Federal action is intended to make people more aware of the crisis and provide resources for those who want to get clean. However, one the largest hindrances to this bill being passed are funding. If the legislation is successful, some pharmaceutical companies could be bankrupt, thus making treatment of other chronic medical conditions more difficult.

Getting Treatment

Behavioral and pharmacological treatment can be effective for heroin users. Comprehensive treatment allows users to remain abstinent and restore a level of normalcy into their lives.

Heroin users must complete a detoxification program prior to entering a long-term treatment program. During detoxification, patients may be given medications to reduce the intensity of withdrawal symptoms, which can include pain, diarrhea, nausea, and vomiting. Even though the detoxification period is not a treatment for the addiction itself, it is an effective first step.

After detox, many users manage their cravings with medication. Several medications have been approved for the treatment of heroin addiction. Since they work on the same receptors as heroin in the brain, they are considered safe and effective. They satisfy cravings while blocking opioid receptors in the brain; even if a user relapses and takes heroin, they would not experience a high, which can help them on their road to recovery.

The most common medication used for recovery is methadone. Taken orally, it is slow-acting and prevents withdrawal symptoms. If the user is not at an inpatient facility, the medication is usually dispensed through an approved outpatient treatment center on a daily basis.

Buprenorphine has also been approved for the treatment of heroin addiction. This medication is only available through certified physicians. However, it also eliminates the need for daily trips to a methadone clinic. Generic options are available, making it a more affordable treatment option.

Getting treatment for any substance use disorder may be frightening and, for some, embarrassing. People with long-standing emotional problems or chronic pain are usually at a higher risk of developing substance use disorders. However, that should never dissuade anyone from asking for help. The good news is that heroin addiction is treatable. The first step is asking for help and admitting that there is a problem. Both inpatient and intensive outpatient treatments are available for those in need.

How Long Does Heroin Stay In Your System?

What Is Heroin?

Heroin is a controlled substance in the United States, and the USDA classifies it as a Class-1 highly addictive drug. It is a plant-based but heavily manufactured and altered opioid drug derived from the poppy flower. Heroin is processed and cut with other substances before it gets to the consumer. Users of the drug typically smoke, snort or inject it intravenously. The immediate effects are feelings of euphoria and sedation.

Health Impacts of Heroin in Your System

Opiate addiction is a significant problem around the world and in recent years, opioid abuse has been on the climb, leading to numerous cases of overdose. These types of drugs have a negative impact on energy levels and sex drive as well as the weight and functions of major organs such as the liver and kidneys.

Most significant, however, is the effect of opiates on brain function. As this drug is used for its effects on brain chemistry, it can cause changes to the way your brain operates and how it sends and receives signals.

In fact, the biggest danger of heroin abuse results from the drug’s ability to block or alter signals in your brain that control important bodily functions. Emergencies from opioid abuse often stem from breathing difficulties associated with overdose. The reason for this is that heroin can change the chemistry of the brain stem and cause depressed breathing.

Parts of your brain control the basic functions of your body, such as breathing and the beating of your heart, so that you don’t have to think about it. Heroin can alter and interrupt these signals that are telling your body to do what it needs to do to survive.

Drug Testing in the USA

In the United States, drug testing is used in many different types of situations. This is a common reason people may ask how long drugs will stay in your system. Many employers require pre-hire drug testing, and some also perform random drug tests on their employees.

Types of Tests

There are several ways to test for opiates and other drugs in the human body. Depending on the type of test performed, heroin can show up on the tests results whether a person has used recently or been abstinent for some time. Here’s a closer look at some of the tests currently in use:

Blood

Blood tests are one of the best ways to test for substances in the body, such as prescription or illegal drugs. This is not the most common type of drug test used, however. Blood testing is sometimes used by law enforcement, but it’s most commonly utilized in emergency medicine. In fact, blood testing is rarely used for legal issues and more often for medical diagnostic purposes.

The invasive nature of this test has raised constitutional issues. Of course, blood testing involves taking blood from a person’s body, and this requires either consent or due process of law, including a court order. While blood tests are great for medical purposes to determine what is going on in the body right now, they are not ideal for detecting prior opioid use because opiates may not be picked up in the bloodstream if it’s only been a few hours after use.

Urine

The most common type of drug test used in the United States is the urinalysis test. This is the preferred method for employment testing and probation and parole testing. This is because it is a fast and reliable form of testing that is also far cheaper to perform than blood and hair tests. Additionally, there are fewer legal and constitutional concerns when using urinalysis.

Hair

Hair testing is not especially common, but it does have a significant history of use in the U.S., primarily in the court systems. This method does have one benefit over other methods: While blood and urine tests have a more limited time frame to work in, hair testing can detect drugs months after their use.

Saliva

Testing of oral fluid is another somewhat common testing method for illegal and prescription drugs. This method involves using a cheek swab to collect a sample of saliva and other oral fluids. The test works much the same as a blood or urine test and detects the same content as other forms of testing.

The issue with saliva testing is that it can be a less reliable method due to medical conditions or drug side effects that may cause dry mouth. If a good sample can’t be collected, then the test will fail. In certain instances, the very drug being tested for can cause side effects that will negate the saliva test. This type of test isn’t typically the first choice when it comes to heroin detection.

Understanding Half-life

In science, half-life refers to the time it takes for a substance to be reduced by half, either by decay or through elimination within the human body. In medicine, half-life is used in formulas to determine proper doses and duration for treatment. For example, an antibiotic would have to be administered at a certain dose and frequency to ensure that antibodies remain present long enough to effectively fight the bacteria or infection.

The half-life of a drug determines how long the substance will be present and detectable in your body. If you are not a chemistry person, the concept can seem confusing, but it is fairly simple. Essentially, different substances take longer to clear from your body than others.

On one hand, there is the time it takes for the substance to be cleared to the extent that you no longer feel the effects of the drug, and on the other hand, the time it takes for it to not be detectable by tests. As an example, you could take a medication for pain and at the end of its half-life, you may feel your pain return and no longer feel the effects of the drug. However, a blood test would still show the presence of pain medication.

Variables to How Long Heroin Will Stay in Your System

 

When people ask how long a particular drug will remain in their system, it is not a simple answer that is the same for everyone. The best answer is always going to be a range because not all people are the same and not all drug mixtures are the same. Below are some of the many factors to take into consideration when asking how long a drug will be detectable in your system.

Age

Your age has a lot to do with your metabolism and the way your body processes substances you take in. An older person with a slower metabolism may show the presence of a drug longer than a younger person with a fast metabolism. Additionally, a person who has not yet reached full maturity may process the drug at a different rate than an adult. This is one reason that addiction in youth is of particular concern.

Weight

It stands to reason that weight would be a factor in the half-life of heroin and other drugs. Doses for medication are often based on weight. The reason for this is that the dose may need to be larger to have the intended effect on a larger person while a smaller person may get stronger effects from a drug at a smaller dose.

Body Fat

Body fat plays a role in how your body metabolizes what you put into it and how it breaks substances down. Excessive body fat impacts circulation, digestion, and liver and kidney function.

Hydration

Hydration plays a key role in removing toxins from your body. Good hydration is very effective in reducing the duration of time that drugs can be detected in urine. Using water to clean the urine is so effective that many people will drink large quantities of water in an attempt to pass a drug test. However, many tests will count clear urine as an automatic fail on the assumption that the subject was trying to falsify the results.

Drug Quality

This is one of the biggest variables in determining both the effect of the drug and how long it remains in your system. The fact that heroin is an illegal drug means that supplies are not checked for quality or held to an FDA standard. When using black market products, there is little way to know the purity and strength of the drug itself.

As drugs like cocaine and heroin are cut with other substances, the actual volume of the drug can vary. Think of it in the same way as proof in alcohol terminology. A 4% ABV will have a different effect on your body than a 90% grain alcohol. Similarly, heroin of low purity will break down in your body faster than a higher concentration.

Health Factors

One individual may process heroin in a different way depending on personal health issues. A diabetic, for example, will break things down in the body in different ways and at different rates. A person with blood and circulation issues may also take longer to clear the drug from their body.

Use History

The effect of a particular drug can have a lot to do with a person’s history of use. Consider that a dose for a first-time user may have a much stronger impact than the same dose for someone who has dealt with addiction for many years. One component of drug abuse is the perceived need for more and more as time goes on. Unfortunately, this is what leads to many overdoses.

While a lifelong user may process the drug differently, the bigger issue is their likely increased dosage. If a person is consuming higher and higher amounts to try and get a certain high, the volume in their body will likely take longer to process through the system.

How Long Does Heroin Stay in Your System?

Taking all of the above into account, we are talking about a drug with a very short half-life. In most cases, it will be undetectable in urine after only a couple of days. Blood and saliva tests are especially poor testing methods for heroin. In fact, testing blood and oral fluids may yield a negative result within only five to six hours of taking the drug. The most effective test available for detecting drug use over time is hair follicle testing, which has been reported to detect heroin in the body for up to three months after the last use.

So, when considering how long the drug stays in your system, the answer really depends on the test. You can think of two days and up to three months as the two extremes. However, most tests will only be able to detect heroin in your system for a period of two to seven days.

Heroin Withdrawal Symptoms & Detox

heroin withdrawalAbuse of heroin is a real and pressing problem in the United States. According to the National Institute on Drug Abuse, the number of people reported to abuse heroin has been on the rise since 2007. It’s reached 948 thousand Americans in 2016, and the heroin abuse epidemic shows no signs of slowing down.

It’s what can be expected, considering that the opioid abuse crisis in the U.S. is also in full swing. However, that doesn’t mean that nothing can be done. To be able to recognize the signs and symptoms of heroin abuse and help people around you, you should know what heroin withdrawal looks like and how it manifests. Here’s everything you need to know about heroin withdrawal and abuse:

Why People Turn to Heroin

Heroin is classified as a Schedule I drug which has no medical purpose or application, but is highly addictive and has a lot of potential for abuse. Similarly to prescription opioids, heroin suppresses some central nervous system functions like heart rate, respiration, temperature regulation, and blood pressure. Acting on opioid receptors in our brain; the heroin also causes a rush of pleasure much like when prescription opioids are abused.

However, heroin is a cheaper alternative to prescription opioids such as Vicodin, OxyContin, and others. They might be a gateway into drug abuse, as they’re prescription medications whose use doesn’t carry such a stigma as the use of street drugs do, but many prescription opioid abusers eventually turn to heroin. It’s usually easier to obtain since prescription painkillers are becoming harder to attain. According to CNN, once measures have been taken to make prescription opioids harder to abuse, the use of heroin almost doubled.

Heroin Withdrawal

As with other opioids, the symptoms of heroin withdrawal peak at one to three days after the last dose, but they can start as early as 6 or 12 hours after it. After one week, the symptoms begin to subside, but then the post-acute withdrawal syndrome follows. The symptoms that characterize the post-acute withdrawal stage are mostly psychological or emotional, but they can last years as the brain chemistry is returning to its normal state.

When it comes to acute heroin withdrawal symptoms, they can be very severe, depending on the amount of drug that’s been taken and how often. Some of the symptoms include:

  • Sweating
  • Shaking
  • Agitation and nervousness,
  • Nausea and abdominal pain
  • Drug cravings
  • Depression
  • Muscle spasms

Once withdrawal occurs, heroin addicts may use medical detox to soothe them, which is medication and therapy that helps alleviate the severity of the withdrawal symptoms. However, more often than not the solution for withdrawal is to wait until the symptoms abate.

The Range of Heroin Withdrawal Symptoms

Not everyone experiences the same withdrawal symptoms — there is a range of them based on how dependent the brain is to heroin. It means that the length of the abuse of heroin, the way in which it was abused, the doses that were taken, and the frequency in which they were taken, all affect the severity of withdrawal. As the abuse of heroin causes intoxicating effects like euphoria, the withdrawal symptoms will often cause the user to experience the opposite. Slowed heart rate will become rapid during withdrawal, and elation and sedation will turn into anxiety and a lower mood in most cases.

Mild withdrawal symptoms generally happen to those people who haven’t spent the past few months or years abusing heroin frequently and in massive doses. They include:

  • Yawning
  • A runny nose and tearing
  • Chills and sweats
  • Nausea and abdominal cramps.

Any of the milder symptoms above may coincide with moderate withdrawal symptoms depending on how much and how often heroin was abused. These include:

  • Diarrhea
  • Vomiting
  • Trouble concentrating
  • Agitation
  • Restlessness
  • Goosebumps
  • Fatigue
  • Tremors

The most severe heroin withdrawal symptoms may consist of a few that are life-threatening if there are certain complications. Severe heroin withdrawal symptoms include:

  • Depression
  • Difficulty feeling pleasure
  • Drug cravings
  • Insomnia
  • Anxiety
  • Hypertension
  • Rapid heart rate
  • Impaired respiration
  • Muscle spasms

Owing to some complications that these symptoms can cause and how dangerous it is to quit heroin outright, it’s usually advised to go through medical detox where the user has proper support of both medical and mental health experts who can keep the users safe through the process of quitting heroin.

How Does Medical Detox Work?

Detox can help manage the withdrawal symptoms by incorporating medications and therapy to help lessen the brain’s immediate dependence on heroin. Since it is a short-acting drug that starts affecting the user fast but also leaves the bloodstream quickly, it’s crucial to start detox before heroin exits the user’s system completely. Withdrawal can begin as soon as 6-12 hours since the last dose, but it usually takes heroin anywhere between 5-10 days to entirely leave the system, depending on how addicted the user is.

As part of medical detox, it’s also essential to monitor the user’s vital signs that might be affected by heroin withdrawal. These are primarily heart rate and breathing, but also temperature levels and blood pressure. During withdrawal and detox, it’s imperative to keep those who are going through it safe from withdrawal-related harm.

Some of the medications used during detox may include symptom-specific remedies to battle nausea, depression, and convulsions. In some cases, heroin can be replaced with a longer-acting opioid such as buprenorphine, naltrexone or methadone. Buprenorphine is the one used most often, as it has the lowest abuse potential and it can help suppress drug craving symptoms which helps those going through post-acute withdrawal syndrome to stay clean.

Even though heroin withdrawal is usually not life-threatening, it’s still extremely uncomfortable and dangerous to go through. Abruptly quitting heroin is not advisable, and those who want to stop and stay off the drugs should seek professional medical help. A detox is a viable option, and buprenorphine therapy can be very beneficial if administered correctly. Those addicted to heroin don’t have to walk the road to recovery alone.

Opioids & Heroin Epidemic

opioid and heroin epidemicThe opioid epidemic is a serious problem in America today. In the late 1990s and early 2000s, prescription opioid drugs were touted as low-risk solutions for chronic pain and other conditions. Thousands upon thousands of people all across the country were led to assume that opioid drugs were relatively safe solutions to temporary or chronic pain, and these days, almost everyone in America knows somebody whose life has been negatively affected by these dangerous drugs.

As the use of prescription opioid drugs became more and more widespread, another equally destructive problem continued to simmer in the background: heroin abuse. In recent years, these two disparate issues have combined into a maelstrom that is ravaging the country. By learning more about the origins of the opioid epidemic, you can insulate yourself against the dangers that this mounting trend poses.

What Are Opioids?

Opioids are a class of drugs that block pain by directly interacting with pain circuits in the brain. In addition to reducing the sensation of pain, these drugs also produce a euphoric high that quickly becomes addictive. When opioid drugs are used in their prescribed concentrations, they can be effective short-term tools for fighting pain, but abusing these drugs quickly results in addiction.

The original opioid was opium, which was used in the ancient world for analgesic and recreational purposes. Opium is extracted from the bud of the poppy flower, and it is also known as the “milk of the poppy.” While opium itself isn’t widely used in the West anymore, every type of synthetic opioid is in some way derived from the substance. For instance, morphine was one of the first isolate opioids to be extracted from opium, and it is still widely used in medical settings today.

Morphine is much more powerful than normal opium, and the first signs of opioid abuse in America began with cases of morphine addiction in the mid-20th century. However, another synthetic opioid known as oxycodone rapidly supplanted morphine as the go-to drug for cases of pain that were moderate to severe. Today, oxycodone is widely known by its brand names OxyContin and Percocet, and it is one of the main drivers of the opioid epidemic.

As medical drugs like morphine and oxycodone gained popularity in the mainstream, another type of opioid steadily crept into American homes from the shadows. Known as heroin, this morphine derivative is of much lower quality than other types of opioid drugs, and since it is made by criminal drug gangs, there is no way for end users to guarantee that their supply is safe. This drug is usually cut with cheaper substances, and long-term users often inject it into their bodies with needles that may or may not be safe.

Heroin powder is white in its pure form, but most types of street heroin are brown due to additives. An even more insidious type of this drug is also available to street users: black tar heroin. It is either gummy or hard as a rock and derives its name from its black color. This type of heroin is the cheapest, but it is also more likely to be filled with pollutants than any other form of this street drug.

In recent years, however, a street drug that’s even more dangerous than heroin has made its debut. While fentanyl is used in hospitals under extreme circumstances, this drug is also manufactured in China and other countries and smuggled into the United States for illicit use. If fentanyl were just another opioid like oxycodone or morphine, it would be easier to lump this drug into the existing opioid crisis. However, fentanyl is a synthetic opioid that is much stronger than others traditionally manufactured in the pharmaceutical industry.

The Centers for Disease Control and Prevention (CDC) has estimated that fentanyl is 50 to 100 times stronger than morphine. As an abused substance, fentanyl had its debut as an incredibly potent designer drug that was mainly used by wealthy coastal elites. As prices of fentanyl have dropped, however, it has been much more widely used.

These days, it’s common to find fentanyl included in bags of street heroin. Many users are unaware of the presence of this drug in their supply, and they may choose to use their regular dose immediately upon receiving a new bag of drugs that has fentanyl in it. The results of this choice can be disastrous. Because fentanyl is so much stronger than normal heroin, it’s far easier to overdose on heroin that has been spiked with this highly potent synthetic drug.

What Is Fueling the Epidemic?

There are a number of factors that are contributing to the ongoing prevalence of the opioid epidemic in the United States. It’s possible to trace the origins of this pressing social issue back to earlier days of heroin abuse in the United States. During the waning decades of the 20th century, heroin became more and more popular throughout the country. When opium production spiked in Afghanistan in the years following 9/11, this problem only became worse.

Today, it appears that a significant amount of heroin is still coming into the U.S. from foreign countries. While cocaine and marijuana seizures on the country’s borders have decreased in recent years, heroin seizures have increased in some areas. Additionally, although there is no statistical information yet available on fentanyl seizures along the border, a U.S. citizen was recently arrested while attempting to smuggle nearly 11,500 fentanyl pills across the San Ysidro Port of Entry. Fentanyl is so powerful that a batch of pills of that size could easily poison a sizeable town.

Despite the fact that fentanyl poses such a danger to users, companies in China and other countries continue to produce this drug. In many cases, these companies often sell fentanyl directly to American citizens over the dark web. In other situations, fentanyl is smuggled into the country for illicit use. However, increased awareness of the dangers of this drug is minimizing the domestic market for fentanyl.

Historically, one of the biggest impediments to halting the opioid crisis has been domestic opioid manufacturers. For instance, the manufacturers of OxyContin, Purdue Pharma, once claimed in their official materials that their prescription opioids were safer than morphine and other types of opioid drugs. These types of misguided marketing campaigns led many doctors to believe that some opioids were safer than others. In many parts of the country, prescriptions for these drugs increased. For example, in the state of West Virginia, 110 opioid prescriptions were written for every 100 people in 2013 at the height of the opioid crisis. While certainly not all of these prescriptions were illegitimate, the sheer number of pills being prescribed made the drugs much more widely available for use.

The rise of prescription painkillers has even had a bleed-over effect into heroin abuse. According to the National Institute on Drug Abuse (NIDA), using prescription opioid drugs increases the likelihood that you will use heroin. This phenomenon is partially fueled by the fact that this drug is generally cheaper than prescription opioids, and it’s easy to find a supply of heroin even when your doctor refuses to prescribe you any more opioids.

To briefly recap, here are the most prominent reasons why the opioid crisis is still a significant problem in the United States:

  • Medical: Doctors have prescribed much higher doses of opioids than are safe for extended periods of time.
  • Smuggling: Many tons of opioids have come over the U.S. border in recent decades. These drugs continue to be smuggled into the country.
  • Plentiful supply: The dangers of opioids are becoming better known, but these drugs are still widely produced and prescribed.
  • Prescription and illicit overlap: Since both heroin and prescription opioid drugs are widely available, it’s easy for addicts to remain addicted.

What Is Being Done

In recent years, greater attention has been paid to the problems that have arisen from increased opioid drug use in the United States. The Trump Administration declared that the opioid epidemic is a Public Health Emergency in 2017. This declaration has brought more attention to the blight of opioid drugs in American communities, and members of the Trump administration have begun coordinating with local officials around the country. Alongside the highest office in the land, policymakers and medical professionals across the United States are leading a national conversation focused on how to best combat this issue in local communities that each face their own unique problems.

The greater emphasis on border security has also helped decrease the supply of opioids entering our country illegally. While keeping illicit opioids from passing through our points of entry will ultimately require the help of other nations, every border seizure of heroin or fentanyl is another batch of drugs that won’t make it into the hands of Americans who suffer from opioid addiction. The incoming Obrador administration in Mexico has promised to work with the U.S. government to fight the power of the cartels in Central and South America. In addition, better diplomatic relations with China will inevitably lead to decreased fentanyl production.

An increased public awareness of the danger that opioids pose has been the most effective measure in curbing the spread of this epidemic. While stopping the drug supply is one half of the equation when it comes to stamping out the opioid menace, education is another critical part of this initiative. An informed populace will be less likely to make decisions that are harmful, and adults who have been educated regarding the dangers of opioids will pass their knowledge down to their children. In decades past, Americans were largely unaware of the dangers that opioids posed to themselves and their communities. However, the American people have woken up to the problem and many are actively working to find a solution.

Increased prevalence of abuse-deterrent formulations (ADFs) in prescription pills has made it harder for people to abuse drugs like OxyContin and Percocet. However, ADFs aren’t present in the majority of prescription opioids, and they aren’t present in any illicit drugs like fentanyl or heroin.

If more people become aware of the dangers of opioid drugs, and if fewer opioids are made available to the populace, this fire will naturally extinguish itself. In the raging blaze that is opioid addiction, the drugs themselves are the wood and ignorance about the dangers of opiates is the oxygen. When starved of these vital components, any fire has no choice but to go out. By surrounding this problem from all sides, we are making the gradual destruction of this danger to our well-being a guaranteed inevitability.

Effects of Heroin on the Brain

inhaling heroin how it effects the brainThere’s a new and disturbing trend among heroin users that involves inhaling heroin instead of injecting, sniffing or snorting it. “Chasing the dragon” is what this method of heroin ingestion is called. It involves heating heroin in a pipe and inhaling the fumes.

Chasing the dragon has become a popular way to use heroin because it protects users from the hazards of injection. For example, shooting up, which is another name for injecting, can cause skin abscesses. Sharing needles with other users can facilitate the spread of infectious diseases like AIDS and hepatitis.

Hazards of Chasing the Dragon

Chasing the dragon has been identified as a new threat to health according to a recent study about the effects of heroin on brain function published in JAMA Neurology. According to researchers, inhalation does offer protection against the hazards of shooting up. However, it can also cause dementia, coma, irreversible brain damage and death.

One of the lead researchers, neurologist Ciro Ramos-Estebanez of the University Hospitals Cleveland Medical Center in Ohio, learned in 2015 of an unusual side effect in a woman who had been inhaling heroin.

The woman had fallen into a coma caused by hydrocephalus. That’s an excessive buildup of spinal fluid in the brain. The hydrocephalus was caused by chronic inflammation of the brain, and the inflammation was caused by regular heroin inhalation. Although the woman recovered from her coma following emergency surgery to remove the trapped spinal fluid, she suffered from side effects of heroin on brain function. Her symptoms included permanent cognitive impairment.

Hydrocephalus Connected to Heroin Use: A New Phenomenon?

This was the first case of hydrocephalus that had ever been reported in connection with heroin inhalation. Because hydrocephalus is not recognized by health professionals as a side effect of heroin, Dr. Ramos-Estebanez decided to explore the issue further and to identify the reasons behind it.

Dr. Ramos-Estebanez and his team examined over 30 case studies. The reports included two incidents that had involved patients at their own hospital. Based on this study, the team came to some interesting conclusions regarding the inhalation of heroin.

Although there’s little official information about the frequency of heroin inhalation, the information available indicates that inhalation is more common than most health professionals realize. This method of ingestion is currently on the rise, and it’s quickly becoming the most popular way to use.

More than two-thirds of heroin users in India and Norway admit that they regularly inhale heroin. Available information also suggests that inhalation is becoming popular among teenagers in large urban areas east of the Mississippi. In 2014, 21 percent of all heroin-related inpatient hospital visits by teenagers between 12 and 19 years old were due to heroin inhalation. This method of drug ingestion appears to have become a global phenomenon, and it’s currently reaching epidemic proportions in the eastern United States.

Side Effects of Heroin Inhalation

The side effects of heroin inhalation range from mild to severe. There can be mild memory loss and long-term cognitive impairment at one end of the continuum. The worst-case scenario at the other end can involve killing off cells and creating spongy holes in the brain’s white matter. White matter consists of connective tissue through which brain cells communicate. Damaged white matter is associated with seizures, progressive dementia, trouble speaking, coma and death.

A Potent and Toxic High

There is growing concern that chasing the dragon will make heroin more accessible because needles and other drug paraphernalia are no longer a part of getting high; all users need is a pipe. Users also report that the intensity of the high from inhaling is much greater than with snorting or sniffing. That could account for greater interest in heroin by those who previously did not use it and increased consumption of heroin by those who do use it.

The JAMA researchers hypothesized that heating heroin to the high temperature required for inhalation changes it into a chemical that easily crosses the blood-brain barrier and reaches the brain immediately. This barrier normally screens out harmful substances. However, vaporized heroin crosses the blood-brain barrier so quickly that there’s no chance for it to be metabolized by the body into a less harmful substance before it enters the brain. The faster heroin enters the brain, the greater the high and the more addictive the drug becomes. The result is a seductively potent high that’s directly harmful to the brain.

Inhaling Heroin: An Emerging Public Health Problem

Based on the results of the study, Ramos-Estebanez said that medical professionals who treat heroin users should be aware of the practice of heroin inhalation and of the risks involved. Ramos-Estebanez calls heroin inhalation “an emerging public health problem.” However, he believes that lives can be saved if the symptoms are recognized early. In fact, researchers have already identified drugs that could prevent catastrophic brain damage if they are administered early on.

Risks Associated With Long-term Heroin Use

Regardless of the method of ingestion, the long-term effects of heroin on brain function can be catastrophic. The most notable effects are long-term changes in hormonal levels and shifts in the brain’s neuron system. These changes are not easily reversed and can cause discomfort for those trying to kick the habit. The white matter of the brain is damaged regardless of how the drug is ingested, and this damage affects decision-making, behavioral regulation and the ability to cope with stress.

Heroin quickly creates high levels of tolerance. That means the dose must be increased regularly. Heroin also causes severe physical dependence, and withdrawal symptoms occur rapidly if drug use is reduced or stopped. Within hours after the last dose, withdrawal symptoms kick in. They can include diarrhea, vomiting, repetitive movements of the legs, muscle and bone pain, restlessness, insomnia and an acute sensitivity to cold. Symptoms are most intense during the first 48 hours. In a best-case scenario, the symptoms ease off after that.

The faster heroin reaches the brain, the more intense the high and the greater the risk of developing heroin use disorder. A heroin use disorder can range from mild to severe, and the most severe form is addiction. With this chronic condition, users cannot get clean or stay clean on their own. The craving for drugs causes the user to do whatever is necessary to get heroin regardless of the consequences. Getting and using the drug consume a user’s entire life, and heroin ingestion continues even when the use of the drug causes serious and life-threatening health problems.

Subjective Effects of Heroin When Smoked, Injected, Snorted or Sniffed

Heroin converts to morphine in the brain and quickly binds to opioid receptors to produce a pleasurable sensation called a rush. The rush can be accompanied by a pleasantly warm flush, heavy extremities and a dry mouth. Depending on the dose, there may be “nodding out.” That occurs when a user vacillates between a conscious and a semi-conscious state.

Users may also experience vomiting, nausea and extreme itching. The initial rush is usually followed by slowed-down breathing and a decreased heart rate. If enough of the drug has been ingested, slowed-down breathing can lead to coma, permanent brain damage and death.

Physical Effects of Heroin on the Brain

Heroin slows down breathing by impacting neurochemical activity in the brain stem. The brain stem controls automatic body functions like heart rate, blood pressure and breathing. Heroin also impacts the limbic system, which governs emotional states, sleep and pleasure. Heroin is a pain reliever, and that pain relief is delivered via the spinal cord.

Brain Damage Caused by Heroin and Methadone

Methadone is a synthetic drug used to treat those with heroin use disorder. Patients visit a clinic and are dispensed a dose of methadone powder mixed with juice that keeps withdrawal symptoms at bay for 24 hours. Methadone maintenance, as it’s called, is thought to be safer than heroin because it’s ingested orally and administered in a clinic, and it involves neither injections nor inhalation.

Researchers in a study at the University of Edinburgh published their results in the Journal of Neuropathology and Applied Neurobiology. The study examined the effects of heroin on brain function  in 34 heroin and methadone users who had died at an average age of 26 years. Their brains were compared to the brains of 16 young adults who were not drug users but who had died young.

The researchers found that opioid users’ brains were up to three times more likely to have sustained brain damage when compared to the brains of those who did not use drugs. The drug users’ brains were similar to the brains of older people, and they had brain damage similar to that found in patients with Alzheimer’s disease. The researchers called this effect the premature aging of the brain.

The brains of deceased heroin and methadone users had damaged nerve cells in brain areas associated with memory, learning and emotional well-being compared to the brains of those who did not use heroin or methadone.

Drug users’ brains were similar to the brains of people experiencing early Alzheimer’s disease. Their brains showed “significantly higher levels of two key proteins associated with brain damage.” Heroin and methadone have also been linked to low-grade brain inflammation.

Brain Damage and Cellular Death

The researchers found that a key brain protein called Tau, which facilitates communication between brain cells, had become insoluble in certain cells. That, in turn, caused nerve cell damage and even cellular death in certain areas of the brain.

There was also an accumulated level of amyloid precursor protein. This suggested that there had been a disruption of protein transport in the brain at a cellular level. Protein buildup can cause serious nerve cell damage and death in key parts of the brain that are essential for healthy functioning.

Other Effects of Heroin on the Brain

Neurotransmitters in the brain that regulate pain, pleasurable feelings and hormonal release are all affected by heroin, methadone and morphine. Opioid drugs increase pleasure and reduce pain. These drugs stimulate the brain’s reward centers, which, in turn, creates a craving for more drugs. In healthy brains, these centers are stimulated by naturally occurring neurotransmitters. With drugs, the presence of these naturally occurring neurotransmitters is reduced or limited. That creates a dependence on drugs to provide normal levels of stimulation.

Heroin Inhalation and Asthma

Inhaling heroin can be dangerous for those with asthma. Three asthmatic patients in Britain required mechanical ventilation soon after inhaling heroin. Two patients died due to acute severe asthma after inhaling heroin. Two asthmatic patients refused to stop inhaling heroin despite the health risks.

Heroin Inhalation Thought by Users to Decrease Risk of Infectious Diseases Caused by Injection

Half of all U.S. heroin users live in New York, New Jersey and Connecticut. Up to 80 percent of users in clinics report that they no longer inject heroin. One-third of those who enter drug rehabilitation for heroin use disorder say they’re snorting, sniffing and inhaling heroin to guard against infectious diseases like AIDS.

Treatment for Heroin Use

Treatment for heroin use disorder generally involves an inpatient stay in a medical detox facility during which users are gradually weaned from the drug. After the patient is stabilized, he or she may participate in treatment modalities like education, individual and group counseling and medication.

Most recovering heroin users are encouraged to attend support group meetings like Narcotics Anonymous. Recovery also involves developing the ability to deal with the urge to use and learning techniques to reduce the effects of triggers that could lead to a relapse.

Some treatment programs even use devices to help curb withdrawal symptoms. In 2017, the FDA approved the use of an electronic stimulation device. Known as the NSS-2 Bridge, the device is placed behind the ear and helps to reduce withdrawal symptoms by sending electrical pulses to stimulate certain key nerves in the brain.

It’s entirely possible to recover from a heroin use disorder, but it’s best not to do it by yourself. There is plenty of help available that can take you from a medically supervised detox to residency in a sober house. Treatment options include both inpatient and outpatient programs that can be long- or short-term depending on your needs.

Substance Abuse & the Elderly: A Growing Issue

Senior-Alcohol-AbuseBe prejudiced for a moment. In your mind, picture a drug addict. Picture a jobless, alcoholic man with a Xanax addiction who lives alone and can barely afford to pay his utility bills. He’s so out of touch with modern society that he doesn’t have a computer, and rarely does he receive visitors. Now you should have an image of this man in your mind. Regardless of any other feature, did you expect him to be 78 years old?

This man is not real, but the problem of substance abuse among the elderly is very real. More than 2.5 million elderly people have a substance abuse problem in this country. It is, in fact, “one of the fastest growing health problems facing the country.” However, for reasons we will explore, “our awareness, understanding and response to this health care problem is inadequate,” according to the National Council on Alcoholism and Drug Dependence.

Nearly 10% of hospital visits among the elderly are caused by substance abuse. The same goes for 14% of their trips to the emergency room and for 20% of their psychiatric hospital admissions. Widowers aged 75 and over have the highest alcoholism rate in the nation. Half of nursing home residents battle alcoholism. High rates of prescription pill abuse and misuse are common among the elderly.

There are some evidence-based reasons for why the elderly face their own substance abuse epidemic, as well as some implicit causes for why this is so. Also, some factors only serve to worsen the issue, such as living alone or the fact that doctors are less likely to refer the elderly to substance abuse recovery programs.

Reasons, Causes, and Contributing Factors

Many reasons exist, both physical and psychological, for why the elderly may turn to drugs or alcohol. The majority of these reasons are unique to the elderly age group. Certain life situations can cause the elderly to self-medicate. Another cause for elderly substance abuse regards the lifestyle of their particular generation, the baby-boomers. Also, especially regarding prescription drugs, the elderly face an over-saturation of medicine as an age group. Over one half of the elderly currently take three or more different prescription pills a day.

Let it be noted that there are essentially two types of elderly substance abusers, those who had begun abusing early and continue to in old age, and those who start abusing in old age. People over 65 who have abused drugs and/or alcohol throughout their lives are nicknamed ‘hardy survivors,’ and those who begin later in life are nicknamed ‘late onset’ substance abusers. Obviously the hardy survivors are more at risk than the late onset abusers, but substance abuse remains as deep a problem for one as it does for the other.

Reasons why the elderly may turn to substance abuse:

  • Depression due to the children being grown and gone
  • Loss of identity and/or financial hardship due to no longer working
  • Feelings of dependence due to the need for assisted-living
  • Friends are fewer and further away
  • Physical and/or mental health problems
  • Death of a longtime partner or loved one
  • Physical pains of aging, including loss of mobility
  • Boredom

These are reasons why an elderly person might continue to abuse (hardy survivors) or start to abuse (late onset) drugs and/or alcohol. People move away, jobs must be left, health is deteriorating, and loneliness occurs more often than ever. There are also more increasingly complicated factors that contribute to this growing problem.

Medically speaking, substance abuse in the elderly can be difficult for doctors to recognize and diagnose. According to the Center for Substance Abuse Treatment, “Diagnosis [of substance abuse] may be difficult because symptoms of substance abuse in older individuals sometimes mimic symptoms of other medical and behavioral disorders common among this population, such as diabetes, dementia, and depression.” If the substance abuse goes unrecognized, no treatment gets provided.

Another medical contribution to the problem stems from research done in 1982. The researchers found there was a “decline in encounter time for patients 65 years of age and older compared with those 45 through 64 years of age.” If people over sixty-five with substance abuse problems are not being diagnosed as such, and are also not being seen by doctors as long as others, it’s almost no wonder this is a growing problem.

Lastly, today’s elderly people consider substance abuse very much a private matter, and may feel great shame which leads to reclusion. The Center for Substance Abuse Treatment explains that due to this possible shame, the elderly are much less likely to seek professional help on their own. The same actually goes for the friends and family of the elderly, especially for their children. “Many relatives of older individuals with substance use disorders, particularly their adult children, are also ashamed of the problem and choose not to address it.”

The Baby-Boom Generation

If you were born between 1946 and 1964, you are considered a ‘baby-boomer.’ The baby boom was a spike in the birth rate that occurred after World War II. There were 76 million children born in America during this time, and the birth rate reached levels unseen since the 1920s. These baby-boomers, according to the Partnership for Drug-Free Kids, “had much higher rates of illicit drug use as teenagers and young adults than people born in earlier years.”

Statistics suggest that baby-boomers continued patterns of substance abuse with them through time. Approximately 3 million baby-boomers have a diagnosable substance abuse problem. Up to 25% of them binge drink alcohol, with nearly 10% of them alcoholics. Alcohol is the most commonly abused substance among the baby-boomers, and among the elderly, but is by no means the sole substance of choice.

For the first time ever, both the accidental drug overdose rate and the opioid abuse hospitalization rate are higher for baby-boomers than for those currently aged 25 – 44. According to The Wall Street Journal, between 1990 and 2010 “the rate of death by accidental drug overdose for people between ages 45 and 64 increased eleven-fold.” Annually, a drug abuse survey is conducted by the U.S. Dept. of Health and Human Services. In 2012, the survey showed that less than 20% of those aged 65 and over had ever used illicit drugs, but for those aged 64 and under, nearly half had used them.

What this all means is that baby-boomers as a generation contribute greatly to the present issue of elderly substance abuse. This notion was summarized well by Dr. Wilson Compton, deputy director of the National Institute on Drug Abuse: “As the baby boomers have aged and brought their habits with them into middle age, and now into older adult groups, we are seeing marked increases in overdose deaths.”

The baby-boomers are not the only ones to blame. A large portion of current baby-boomers do not even qualify as elderly. On the same token, there are members of the elderly who abuse substances but are not baby-boomers. One might argue that the biggest contributor to elderly substance abuse outside of the baby-boomers is prescription pill abuse and misuse.

 

Prescription Pills and the Elderly

prescription pillsThe elderly consume almost one-third of prescription pills in America, yet only make up 13% of the population. Putting that into real numbers, approximately 4 billion prescriptions are written each year in our country, which has a population of 319 million. Essentially this means that the 41.5 million elderly people in this country receive 1.2 billion prescriptions per year. That’s 29 prescriptions a year for every single elderly person in America. Granted, not all of the prescriptions written for the elderly are abused for recreational purposes. However, let’s take this further…

Studies have shown up to 23% of all prescriptions given to the elderly are benzodiazepines. This class of drugs is known to be sedative, hypnotic (sleep-inducing), and muscle-relaxant. The most common benzodiazepine is Valium. Well over 10 million people report abusing Valium per year, making it the third most abused tranquilizer in the US. The number of hospital visits involving benzodiazepines increased six-fold between 1999 and 2011.

Abusing prescription pills isn’t the only way they can be damaging to the elderly. Misuse of a legal drug occurs when the medical directions are not followed. Misuse could mean taking too many pills at once, and could also mean taking the right amount of pills but too frequently. Misuse can be committed voluntarily or by accident. According to the Center for Applied Research Solutions, the elderly “are particularly vulnerable to prescription drug misuse.” You may recall from previously in this text that the elderly are seen for less time by doctors than any other age group. This may be resulting in the elderly being misinformed on the pills they have. This and several other factors make prescription pill abuse and misuse (as well as other illicit drug/alcohol abuse) especially dangerous for the elderly.

Substance Abuse is More Dangerous for the Elderly

As we age, our minds and bodies tend to fail us slowly. Because of this, the dangers elderly people face when abusing substances are greater than they are for other demographics. Specific dangers exist for those over 65 who engage in drug and/or alcohol abuse.

  • The elderly are much less likely to be referred to a specialist by family, friends, or medical professionals.
  • Substance abuse is not often detected among the elderly. This is due to living alone more commonly than others, being less willing to share this information with others, or because the effects of aging are similar to those of substance abuse.
  • Older people take multiple medications at once more often than other people do. This is rather dangerous because of possible adverse effects from misuse or from mixing these drugs with alcohol.
  • It is all too easy for an addicted elderly person to assume they are too far gone to change, that they don’t have enough reason to quit.
  • Tolerance decreases with age. This means what might have been a normal amount to an elderly person at one time could actually cause overdose.
  • Enzymes in the liver that process alcohol decrease in volume as people get older. This means alcohol abuse among the elderly can cause liver diseases more rapidly.
  • Intoxication often leads to falling down or making other poor decisions, which can be sufficiently more dangerous for an elderly person.
  • Less responsibility and fewer commitments means less holding back from abusing among the elderly. Job loss and parenting are not concerns for them.
  • Due to natural aging processes, the elderly are simply much more affected by substance abuse than those under 65.

In Conclusion

Unfortunately, it is predicted that the number of elderly people with substance abuse issues is rising. Part of this is population-based, since those aged 65-70 are the part of the populous growing the fastest. However, a large part of this remains due to a lack of knowledge. Elderly substance abuse is known as a ‘hidden dilemma.’

Said best by the US National Library of Medicine, substance abuse among the elderly will only cease when further means of prevention are instilled into the medical community. The quote:

“Studies have shown that intentional abuse of prescription drugs is increasing among all age groups. As the number of persons 65 years of age and older skyrockets with the aging of the baby boomers, experts predict that prescription drug abuse among the elderly also will rise significantly. Efforts to increase awareness of drug abuse among elderly patients, caregivers, and health care practitioners, as well as research into how best to prevent and treat the elderly drug abuser, will be necessary to thwart what could become a significant public health problem.”