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Heroin Addiction

Heroin Addiction

Heroin use is escalating, especially with its low price and availability on the street. According to the National Institute on Drug Abuse (NIDA), heroin addiction has steadily risen in the U.S. since 2007, with 669,000 individuals reporting use in 2012. The increases seem to be largely driven by the 18-25 year old age group, though numbers of first-time users has also increased almost twofold since 2006.

Narconon reports that there are 16 million opium and heroin addicts globally. In addition to the constant risk of overdose, heroin can cause damage to many organs in the human body, particularly the heart and lungs. In fact, often it is not the overdose that kills, but the fluid in the lungs. Treatment for heroin addiction is vital, and with the drug’s prevalence, there are many places to go for help.

Expert

Archie Boone
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Heroin use is escalating, especially with its low price and availability on the street. According to the National Institute on Drug Abuse (NIDA), heroin addiction has steadily risen in the U.S. since 2007, with 669,000 individuals reporting use in 2012. The increases seem to be largely driven by the 18-25 year old age group, though numbers of first-time users has also increased almost twofold since 2006.

Narconon reports that there are 16 million opium and heroin addicts globally. In addition to the constant risk of overdose, heroin can cause damage to many organs in the human body, particularly the heart and lungs. In fact, often it is not the overdose that kills, but the fluid in the lungs. Treatment for heroin addiction is vital, and with the drug’s prevalence, there are many places to go for help.

What Is Heroin Addiction?

There are numerous, often complex definitions of heroin addiction, but the short version is that heroin addicts feel a compulsion to use the dangerous drug despite its negative impact on their bodies and minds. Most also tend to increase their use over time, needing more and more of the substance to reach and maintain their high. While the symptoms of heroin use and addiction are specific, one of the most telling signs is the possession of injection supplies, reports Webmd.com. These items may include a spoon or bottle in which to cook the substance, a syringe, a tourniquet or towel to find a vein, cotton and matches. Physical signs include the following:

  • Euphoria
  • Drowsiness
  • Impaired mental functioning
  • Slowed respiration
  • Constricted pupils and bloodshot eyes

According to the Hazelden Betty Ford Foundation, the following signs may indicate a person has a heroin addiction and has not had the drug recently:

  • Restlessness
  • Diarrhea
  • Vomiting
  • Chilled feelings
  • Leg movements

How to Help Heroin Addicts

Heroin addiction is a nightmare for many families in the United States and around the world. It’s strong addictive qualities and adverse health impacts necessitate quality treatment and rehabilitation. It’s a very challenging and emotional experience to confront the heroin user, but it is critical.

What Does a Heroin Addict Look Like?

In addition to the signs and symptoms of heroin addiction, heroin addicts tend to exhibit certain behaviors and characteristics.

  • Is your loved one losing weight rapidly or exhibiting other changes in appearance?
  • Has his or her hygiene deteriorated?
  • Do you spy needle or “track” marks on his or her body? Note that not all heroin addicts may try to hide marks under clothing or inject the drug in more discrete areas of the body.
  • Is your loved one being secretive and/or disappearing for long periods of time?
  • Have you found signs of financial issues?
  • Does your loved one lack motivation?

If these behaviors describe your loved one–especially if they are coupled with any other signs and symptoms–it may be time for an intervention.

How to Talk to Someone About Their Heroin Addiction

Drugfree.org makes some good recommendations for taking the first steps in confronting your loved one whom you suspect is using heroin. Every situation is different, but many of these steps are necessary for a good start for a person’s road to recovery. First and foremost, remember that this is a long journey. Prepare this person and yourself for a marathon, not a sprint.

Never begin the discussion when the person is under the influence of heroin or any other substance. This can cause more intense reactions, even irrationality or violence, due to impaired impulses.

Make sure you have enough time and privacy to have a two-way dialogue. You need to be able to state your concerns and have the person respond with his or her view of the situation. You also don’t want to make the person feel the he or she is being lectured or attacked.

If your friend or loved one refuses to accept there is a problem, ask them to talk again at a later point.

Be specific with the signs, symptoms and behaviors you have seen that warrant this discussion. Continue to emphasize your concern for the person’s well-being.

Emphasize the reason you are approaching your family member or friend is because you care for him or her and you are concerned.

Stay focused on what you have observed rather than speculating, exploring motives or appearing judgmental. You want to stay focused on the main points.

Don’t expect any immediate changes. This may be the first time the person is hearing this or even thinking about it. Remember, this is the first step in a long process but it is so very important.

What is an Intervention?

When a loved one or friend is struggling with an addiction, it may seem overwhelming. Confronting a heroin addict is a lot for one person to handle, so it may be best to gather a team of people for the task. Often the person can be in denial so it may be effective to have a professional join in this process that is called an intervention.

For optimal success, the Mayo Clinic recommends some specific steps in the intervention:

Create a plan with loved ones and a qualified professional ideally so that you have the best chance for guiding the addict toward treatment. Interventions can be highly emotional situations in which the addict may become volatile, so the help of an addiction or mental health counselor, psychologist, social worker or professional interventionist may be warranted.

Acquire information on the severity of the heroin addiction and treatment programs to help him or her. The next logical step would be to start making arrangements for treatment.

Gather the intervention team, set a date and location. Team members should work on consistent messaging that will be delivered to the addict, and all team members are on the same page regarding the structured plan to be presented. It is important to keep your loved one who is the addict unaware of intervention planning until the actual event occurs.

Prearrange consequences if the addict doesn’t welcome treatment. For example, you may decide to ask your loved one to move out your home if he or she doesn’t accept treatment. However, make sure these are consequences you will follow through with.

Be prepared with what you are going to say. You may want to write a script or have notes with you describing how the addict caused problems or exhibited challenging behaviors. Discuss how it affected you while still expressing loving care and optimism about how treatment can help.

Stage the intervention with each member of the team expressing their concerns and feelings. The addict cannot argue with facts and your emotional response to it. Once the treatment option is presented, each team member needs to be prepared to state what consequences will happen if the treatment plan is not accepted.

Follow up is necessary as treatment is not the end of the road to recovery. Family members and friends can help an addict refrain from relapse by helping change activities and environments that led to the addiction. Encouraging healthy behaviors and knowing what to do if relapse occurs are also vital.

How to Find Help for Heroin Addiction

While states have mental health and addiction agencies, the Substance Abuse and Mental Health Services Administration is the federal clearinghouse for substance abuse and mental health information. On the SAMHSA website is a treatment locator which works in all fifty states, as well as links to support groups such as Nar-Anon and Narcotics Anonymous.

As part of National Recovery Month in September, SAMHSA also houses links to stories of recovery on its website. These true stories from actual survivors are intended to give hope to struggling addicts and their loved ones.

What is Heroin Addiction Treatment Like?

As with all substance abuse treatment programs, heroin is no different and should begin with an initial assessment. Both the person being treated and his family and/or friends may be consulted. It is important for loved ones to be completely honest to give a complete picture to assessment professionals. This first clinical assessment is necessary to devise the most effective treatment plan for an individual. Assessment will continue throughout treatment to monitor progress and to make any adjustments that are needed. More details can be found in a guide for families published by the Substance Abuse and Mental Health Services Administration (SAMHSA), What is Substance Abuse Treatment?. Free through the organization’s website, it offers simple descriptions of what to expect if you have a loved one that is entering treatment.

  • Detox: Withdrawing from Heroin
  • Visiting Someone in Rehab
  • Addiction Therapy: Participating in Treatment
  • With heroin and other opiates, often a medically supervised detoxification will be needed especially if your loved one is using large amounts of the drug. This could be performed in a hospital setting or a specialized inpatient treatment facility. SAMHSA also points out that in some instances, the detox may take place on an outpatient basis; however, it is important for a loved one to be there with the person to monitor and care for his or her well-being. The process can take several days to over a week. This first step is a very important one before the actual treatment begins.

    Once the detoxification is complete, there are multiple treatment options that have been shown to be effective including both behavioral and pharmacological. Each avenue has shown effectiveness, but the National Institute on Drug Abuse reports that integration of the two approaches has shown the best treatment results. Typical medications used in heroin treatment include Methadone, Buprenorphine and Naltrexone. Behavioral therapies include contingency management and cognitive-behavioral therapy.

  • With changes in insurance, inpatient treatment is not as common these days as residential which can offer programs lasting one month or longer. Often there are phases and levels of treatment with different requirements for contact with family, friends, even work and school. According to SAMHSA, this allows for the person to become immersed in the setting and focused on treatment. As your loved one progresses through treatment, these restrictions may be minimized but it is important to listen to treatment professionals and abide by the requirements they lay out in the treatment plan to obtain the best possible outcome.

  • Family involvement in treatment is an integral part of success for your loved one. It will also help you understand addiction as a disease and ways you can be supportive. There are various ways to participate. It could be through group meetings, lectures, discussions or other activities, but the most intensive format would be through family or couple’s counseling.

    It’s important for all involved in family and couple’s counseling to be very open and honest. It is important for the addict to understand how his or her actions have affected others; and, it is vital that you know what progress your loved is making and how you can support him or her along a journey that is still only beginning. It is also important to know signs to look for that may indicate a relapse and what steps you may need to take in the future.

Life After Heroin Rehab Programs

Heroin is a highly addictive drug and the rates for relapse are varied, yet higher than some other substances. Typically, the longer a person stays in treatment and follow-up, the greater chance he or she has in remaining off heroin. Many programs recommend that individuals stay in follow up care for at least a year.

Follow-up care eases the transition back to “typical” life. Once a person returns to his or her former way of life, there are old triggers that may be present and temptations and cravings my return. That is why it is critical to have a support system and professional that can still be accessed to help your loved one and you deal with these challenges. Sometimes an intermediate step to “typical life” might be a halfway house or transitional housing. These heroin-free living environments allow your loved one to be in a setting with others who are recovering and who can form a supportive setting. It’s often a need extra step to assure a more successful outcome.

Heroin recovery is a long process, but these staggered levels of care and treatment have shown the best success rates. It’s important to think about the entire process and long-term planning rather than relying on any quick fixes. Relapse can occur, and it is important to realize this is not total defeat, it is part of a long and ongoing road to recovery. With realistic expectations and goals, heroin addicts and their families will have the most success.

Find Personal Support

Treatment is tough, not just for your loved one but for you also. It’s important to take time for yourself, get plenty of rest, eat right, exercise and find your own sources of support, whether it be friends, family or a faith community. You may also decide that family or couple’s counseling is not quite enough, or after it has ended, you may be at a loss. The good news is there are support groups for loved ones as well as recovering heroin addicts:

  • Al-anon and Alateen (www.al-anon.org) were originally founded for family members of those with a alcoholism, but the groups have also opened their doors to family members of those with drug dependencies.
  • Nar-anon (www.nar-anon.org) was specifically formed for family members of drug users.
  • Co-dependents Anonymous (www.coda.org) is another group that may be helpful.

Q&A With a Heroin Addiction Expert

About Archie Boone
About Archie Boone

As Partnerships for Success Coordinator, Archie educates and leads youth and young adults in various youth initiatives for Norfolk, Virginia’s Community Services Board including youth surveying, data entry, field promotion, research, provision of input for targeted media campaigns, participation in special events and service as a coalition requirement. Archie Boone endeavors to ensure the City of Norfolk’s reach towards young citizens has an impact and certainly that their voices be heard. Archie coordinates volunteer and interpersonal networks where invaluable hours of service have aided Norfolk’s residents impacted by poverty, educational deficits, substance use disorder, mental illness and suicide.

  • Q. Are there any new trends you are seeing in heroin addiction? 

    The most alarming trends I am seeing in heroin addiction are: low perception of risk/harm among parents of youth and young adults; denial about addiction among young adult abusers, especially those entering the penal system for drug related charges; finally increased number of fatal overdoses caused by the combination of substances such as fentanyl and carfentanil.

  • Q. Can you discuss any treatment options that have shown particularly good success rates in treating heroin and other opiate addictions?

    From my public health perspective, the most significant tertiary prevention effort has been the promotion and use of Narcan (naloxone). It is an emergency medicine that prevents overdose death from prescription painkillers and heroin. Naloxone is available without prescription to friends and family members of people struggling with addiction, in addiction to learning how to recognize the opioid overdose and how to administer naloxone. Residents of Norfolk can register for REVIVE! Training by visiting www.Norfolk.gov/NPC. Virginians may access this resource by searching REVIVE! Training at www.DBHDS.virginia.gov.

  • Q. Are there particular challenges to treating a heroin addiction versus another type of addiction?

    The face of opioid addiction has changed over the past 20 years, making it particularly challenging to treat disparate populations: white males, ages 18-24; white females, 30 and under; men and women ages 44-54. With the help of epidemiologists, law enforcement agents, and friends/family members of fatal overdose victims, we are beginning to understand the lifestyles of people struggling with addictions across these given populations. Now coalitions and agencies are sharing data to drive community cause to change legislation in favor of improving treatment for heroin (substance-use disorder) addiction, as well as alternatives to conventional treatment. To meet the rising demand for substance abuse services, on October 27, 2017, the City of Norfolk posted a bid seeking medication distribution services to provide stock Buprenorphine and Buprenorphine/Naloxone combination agents for the Norfolk Community Services Board Opioid Treatment Program.

  • Q. What are the top three pieces of advice you give families and friends of people struggling with a heroin addiction?

    3. Addiction is a disease/sickness, not a choose or decision to be a junky. 
    2. People are people, not addicts. People struggle with addictions.
    1. Save a life. Carry Naloxone.

  • Q. What are some innovative ways you are tackling heroin addiction in Norfolk/Hampton Roads?

    Norfolk is one of 12 Virginia recipients of the SAMSHA Strategic Prevention Framework Partnerships for Success grant. This is a 5-year renewable grant to reduce prescription opioid and heroin use in Norfolk for youth and young adults ages 12-25.

    In 2015, Norfolk Community Services Board entered into a partnership with Norfolk Prevention Network to launch a concerted effort to build a working coalition, whose aim is to find solutions and begin to eradicate barriers within the City of Norfolk as it relates to poverty, drug misuse and abuse, and mental health promotion. This collaboration needed representation and input from young adults ages 18-26; a completed community needs assessment revealed this demographic was to be a population of impact. This project was made successful with the participation of young adults who are Norfolk residents. Their true passion for being an instrument of change in their communities fueled initiatives to raise awareness at festivals, games, and social gatherings to administer Youth Risky Behavior Surveys and 30-day drug use questionnaires.  

    A grant award from the Virginia Department of Behavioral Health and Development Services for the Norfolk Community Services Board  was accepted to implement the Virginia Opioid Prevention, Treatment and Recovery Program: to fill in the gap that current strategic prevention grant does not cover and for building a coalition for reduction of opioid deaths;  to establish peer recovery services to the residents in the cities of Portsmouth, Norfolk and Virginia Beach to provide support, education and linkage to treatment to individuals in these communities with an opioid use disorder; to implement programs for individuals with a diagnosis of opioid use disorder who do not have financial resources to access medically assisted treatment.