Shouldn’t we have empathy for Addicts? I should have empathy for them but sometimes I can’t find it in me. I have known enough of them in family, friends and patients to say the hell with them. But then on the other hand they are people too. Many addicts are cunning, creative and manipulative liars. Its staggering to see the level of creative deception that some will do to get money. Mind boggling what lies, some will create to play out a kind person who is trying to help them. They should be playwrights in theatrical dramas or Who Done Its or Mystery Novels. Its hard to believe that someone using drugs with all their disorganized thought processes, can come up with the fantastic creative well prepared lies!
Have I been played out by an Addict?
The answer is YES, I HAVE. My ex girlfriend stole all my family air looms; jewelry, watches, precious gems and furs which totaled in over $100,000.00 loss if we were going to replace these. She even stole my 7 year old daughter’s jewelry and her Civil War Silver Dollars. She carefully and slowly over time methodically scraped us thin. To make a long story short, she was caught and confessed. Then was charged and pled guilty to take a lesser plea bargain agreement. Then I heard she had violated her probation to have more years tacked on. We never got the stolen items back because it was all pawned. The pawn broker who was found through a private detective had immediately gotten rid of the loot that he knew was stolen, and converted goods for cash. So NO I don’t have as much empathy for addicts, as I should. I don’t hate on them either. Because not all of them steal. But they do all lie and will turn your life into a living hell.
The ones who want to get clean and sober, do so.
Shouldn’t we have empathy for Addicts? The others, who get clean and some relapse, but I don’t know what the percentage is for those addicts who get off drugs versus staying off. Some statistics state that within the first year 40 to 60% of addicts relapse. The study compared itself diabetics who relapse using sugar products. I don’t think addiction relapse is quite the same as a diabetic eating milk chocolate. I have not seen to many diabetics turning tricks prostituting to get that Hershey Chocolate bar. I have not seen to many diabetics stealing goods to get money for the Hershey Bar.
Addiction is not a disease
Chalkboard with the word ADDICTION written with an eraser
Shouldn’t we have empathy for Addicts? In fact, I don’t see addiction as a disease period and point blank. How can so many people have a disease? I think addiction can lead to disease, but in itself is not a disease. Government wants to call it a disease to justify all the millions of dollars issued for Federal Grants. The detox and rehabs need addiction classified as a disease so that insurances and Medicaid can be billed for rendering treatment. Addicts lie, manipulate, commit crimes of assault, burglary, child abuse, robbery, motor vehicle theft, shoplifting, prostituting. How can these behaviors of addiction be called a disease?
I have concluded that many Drug detox and rehabs aren’t successful. I base this on my personal field experience during graduate school. I did a one year nursing case management project in Camden, New Jersey. I case managed 68 homeless addicts living in a “Tent City”. I sought to help them get services from providers for dental, medical, mental health and substance abuse. Two thirds of this population volunteered that they had been detox and rehab multiple times. I understand that I lack evidence to support my statement so let it go at that. The detox and rehabs costs a lot of money but fail to keep a lot those who attend treatment off drugs.
According to the Bureau of Justice more than 18% of those in state prisons and 17% incarcerated in federal prisons committed their crimes to get money for drugs. In addition to this 26% of violent crimes were committed by someone who was using drugs or alcohol at the time they committed the crime.
Crimes like robbery, theft, fraud, and even rape and murder are committed (in a large percentage) but those under the influence of drugs.
I don’t think that addicts turning to crime to fuel their habiits is anything particularly new. I do think that law enforcement is now paying attention to possible addiction as a motivator behind why a person commits a crime. I don’t still don’t see how addiction can be classified as a disease?
Opioid Subculture is Sustainable. Every 11 minutes someone is dying from an opioid overdose but none of that deters addicts from using. People have difficulty accepting that the Opioid addiction is a chronic relapsing disease. Those that are actively using opioids live within a sustainable subculture, which revolves around foraging for money to buy drugs, cigarettes and maybe some food. I can tell you with great certainty, that no opioid addict will enter into treatment until they are ready to do so. Many addicts have already tried multiple treatment modalities from Detox, Inpatient rehab, Intensive Outpatient, Methadone, Suboxone, Subutex and the Vivitrol Injection. Many have gotten sober and relapsed to go back to using opioids. Some who relapsed have returned to sobriety and others continued with the addiction.
The single biggest reason America is failing in its response to opioid epidemic:
Adapting To The Mainstream Life
Opioid Subculture is Sustainable. I like to refer to the social environment that we non-addicts live in as the mainstream life. In the mainstream, we go to our job, pay for our housing, bills and come home after work to take care of our children. To be successful in the mainstream lifestyle did not happen overnight and to stay stable within it requires us to practice diligence. Some of use may have a job, a trade or a profession with economic growth and advancement. We may have started at age 18 or later at 22 after attending college.
For most people who are getting clean and sober, they will experience varying degrees of difficulty navigating into the mainstream life. Its not impossible to enter into the mainstream and it is certainly doable, if they have some measure of support. I fervently believe a good support mentor is crucial to anyone coming away from addiction into recovery.
Maslow’s Hierarchy of Needs
Opioid Subculture is Sustainable. One of my greatest criticisms of drug rehabilitation is how do they negotiate to getting the basic needs met in the mainstream life? Where are they going to live? How is the rent and the basics going to be paid? How will they find a job? What if they have felony records and active warrants? In thinking about Maslow’s Hierarchy, beginning with Physiological Needs – a person will need suitable shelter, water, food, sleep and clothing. Safety needs – personal security, employment, resources, health and property. Love and Belonging – friendship, family, sexual intimacy.
Why Opioid Addicts Resist Getting Clean
If the recovering addict doesn’t have the support from family and friends, to assist with the basics, then how do they successful achieve the Physiological Needs? If they go live in the shelter, will this provide that person with a suitable atmosphere to stay clean? It is easy to see why so many opioid addicts fail at recovery and resist getting clean, when they know what works for them. They know that for the past years, they have been successful at foraging for money to buy drugs, cigarettes, food, while living as an urban survivalist. Society as a whole is talking about the Opioid Epidemic because we feel a sense of morality to fix it. The overdose deaths is the reason why society wants to address the Opioid Epidemic. The deaths are the reason why its called an Opioid Epidemic. We can learn the most from the ones who are successful at overcoming opioid addiction and remaining in recovery.
I believe that many opioid addicts accept their plight in life. They lack the family and friends to provide emotional support. This is the reason why most addicts are resistant to go into treatment. They know that entering into mainstream life will be an uphill battle or a vertical climb. Its easier to just stay put surviving and foraging within a sustainable drug subculture. Perhaps for some, the drug subculture offers them a feeling of safety with a predictable lifestyle.
Afghan Opium Production
Bumper Crop of Opioid Overdoses. Across the United States for opioid addicts there is a bumper crop of overdoses. An opioid overdose occurs every 11 minutes, which translates into 5 an hour, 120 a day, 840 a week, 3,600 a month and 43,200 a year.
These statistics are alarming to us, but they are not a deterrence to the addicts. The surgeon general advised that civilians should carry naloxone to resuscitate a victim. Here is the hard and fast truth about opioid addicts. No one can make them quit using opioids until they are ready to do. If they are locked up in the jail, by default they will get clean. If they are released, the vast majority will go right back to using opioids again.
The Addicts Lifestyle Is Sustainable
Bumper Crop of Opioid Overdoses. I hear people say that addicts have to hit rock bottom to realize that they need help and that may be true for some addicts. But I can tell you, the ones I have seen roaming around in Camden New Jersey and the Kensington Section of Philadelphia, look like rock bottom was last year. As non-addicts we look at an addicts life and find very hard to understand why they don’t want to quit using opioids and get clean? We think that their lifestyle is lousy but to them it is perfectly sustainable. In most cities, there are shelters, homeless kitchens and even locations to get free clothing and a coat. These people are true urban survivalist. Some live on the streets, but others live in tents under bridges or overpasses. Some are squatting in abandoned buildings. Females may meet up with a Pimp and live with that person. She might work the street or do online escort work. The pimp furnishes the drugs, food, cigarettes and housing. The men coming to pick up the girls to get it done in the car, or a motel. Some other addicts are shoplifting and then try to sell whatever was stolen. Others are panhandling for money on the street corner. Still others are burglarizing homes in suburbia and pawn off what was stolen.
It might seem very hard to believe that an addict’s lifestyle is completely sustainable because they live in their own subculture. They forage all day long to scope out the who, what, when, where and how they are going to get the money to buy a bag. Some help one another with a bag or half a bag of dope. They sell each other loosies (loose cigarettes). They don’t usually go anywhere because they are tethered to wherever they getting the drugs. Some do actually live in the private residences with their family. Some go see their children on the weekends.
Just because it is sustainable, opioids is a cruel addiction because the longer they are on the drug, the more they need. The longer they use it, the less pleasurable is the effect. Some addicts tell me that they don’t get high. They use to just feel right and I am not certain exactly what that means other then not feeling sick. If they do not use soon, they get stressed and irritable. A lot of addicts prefer the heroin cut with Fentanyl because its makes them very high.
Its a vicious cycle of hell because the more they use, the more the brain adapts to opioids and the more they need. So these people just keep on using opioids and performing the necessary steps to keep up with their addiction. I have often said that addicts are not lazy, because they have to work at their addiction much like we do a regular job. It takes a lot diligence to be a successful addict.
Opioid Addiction Can Make Some People Do Most Anything
Bumper Crop of Opioid Overdoses. If they cannot buy the drug, then they eventually experience the very worst flu of their life. The whole effect will come crashing inward with chills, shakes, cramps, irritability, depression, anxiety, vomiting, and diarrhea. People say they feel like their skin is crawling. An opioid withdrawal can happen like nothing they have ever experienced. I hate when I am sick with a flu virus, which causes nausea and vomiting. It is perfectly understandable why people become desperate and solely focused on getting right to avoid the opioid withdraw.
I had a girlfriend who was a Nurse. She was a beautiful, bright, energetic woman with a kind heart or so I thought. She lived with me and outwardly, I never knew at first she was an opioid addict. By the time, I found out it was to late, because she had stolen and pawned off every bit precious things I had. I did finally entrap her over the telephone. I told her that I had installed cameras and recorded her stealing things from my home. She fessed up and I still charged her. The police arrested her and the case went to pretrial mitigation. She went on felony probation. Yes, I ended the relationship.
I felt like if I did not charge my ex girlfriend, that she might not ever stop using opioids. Her family had said via email that she was on methadone. I later heard that she relapsed and violated probation, which added on more years. She stole in the vicinity of $80,000 of belongings from me and my 10 year old daughter. I am a single parent and some of the things that were left to my daughter by my wife who died from ALS and my Mom. It was really hurtful. When someone you love, does that to you its a real violation of ethical and moral trust. I was emotionally hurt for a long time. I was more sad about her stealing from us, then the loss of the things.
Disease Versus Choice
Bumper Crop of Opioid Overdoses. Did you know that the Addiction Treatment Business, is almost a $40 Billion Dollar a year business? That is how much money is coming into the addiction treatment centers in the United States. Now of course the addiction centers support that addiction is a disease. If it was not a disease, there would be no monetary reimbursements from insurance. Classifying addiction as a disease legitimizes billing out for the services rendered and the federal grants that go to the not-for-for profit centers. Regardless if addiction is a choice or a disease, one undeniable fact is that no one can make an addict quit using drugs until they are ready to get help. I am a Registered Nurse and I have worked with plenty of addicts. I am caught in the middle as to whether addiction is a choice or a disease. I really don’t know if it is a disease or a choice. I do know that addiction does lead to other diseases.
According to the National Institute of Drug Abuse “No matter how they ingest the drug, chronic heroin users experience a variety of medical complications, including insomnia and constipation. Lung complications (including various types of pneumonia and tuberculosis) may result from the poor health of the user as well as from heroin’s effect of depressing respiration. Many experience mental disorders, such as depression and antisocial personality disorder. Men often experience sexual dysfunction and women’s menstrual cycles often become irregular. There are also specific consequences associated with different routes of administration. For example, people who repeatedly snort heroin can damage the mucosal tissues in their noses as well as perforate the nasal septum (the tissue that separates the nasal passages).
Medical consequences of chronic injection use include scarred and/or collapsed veins, bacterial infections of the blood vessels and heart valves, abscesses (boils), and other soft-tissue infections. Many of the additives in street heroin may include substances that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. Immune reactions to these or other contaminants can cause arthritis or other rheumatologic problems.
What are the medical complications of chronic heroin use?
Addicts are Masters of Manipulation
An addict is a master of manipulation. If you ever confronted with the dilemma of whether you should help out an addict with money? My response is a resounding NO. Don’t ever give them money, even they threaten to let a group of men run a train on them for 20 dollars. The reason is because the asking for more money will not ever stop. Don’t enable an addict by giving them money. They are manipulative masters at trying to guilt you into believing they are going to kill themselves. If they threaten suicide, pick up the phone, dial 911 for the police. They will be taken by EMS to the local psychiatric crisis center for evaluation. Better to be safe then sorry. Someone at the psychiatric crisis unit may be be able to influence them to enter detox and rehab.
If you have a friend or loved one who is opioid addicted, chances are they might steal right out from underneath your nose to pawn off anything for money. You might have a daughter, sister, or girlfriend who is threatening to go prostitute on the street or become an escort. Let them go and don’t give them money. If you start giving money, then you are creating a perfect storm for the day that you are pull back the enabling. Your loved one or friend will become Michael Myers from the horror movie Halloween and rip you a new one with nasty and filthy language like you can’t believe.
If you are struggling with dealing with an Addict there is help available:
SAMHSA’s National Helpline – 1-800-662-HELP (4357)
Addiction is a chronic disorder where relapse is common for addicts who are in recovery. Every addiction case is separate and distinct. For some sobriety can occur within a few months and while others struggle for more then 20 years.
In the Vietnam war, there was a widespread epidemic of marines and soldiers who were addicted to heroin. The federal government fearing the worst that military personnel would be returning to the United States from war as addicted veterans, mandated that no one could return home without a clean urine drug screen. Those that failed the urine drug screen stayed in Vietnam until they were clean and had a negative urine drug screen. The Vietnam war is significant, because this was the first evidence that people addicted to heroin (opioids) could get clean and sober without drug treatment because none was offered.
Hold Their Feet To The Fire
Bumper Crop of Opioid Overdoses. Do you really want to struggle with an addicts addiction until it destroys your health and wellbeing? Don’t feel sorry for these people so much so that your own mental and physical health is affected. If they come asking for help, then by all means assist them if you can. If they are playing you out then send them out the door. If they refuse to leave, then call the police. Dealing with an addict can wreck your life. Don’t let their addiction destroy your mental and physical wellbeing.
As you have read earlier, the marines and soldiers in the Vietnam War overcame opioid addiction with no treatment. Fortunately today there is treatment available such as Methadone, Suboxone, Subutex, Vivitrol Injection, 5 to 7 day detox, inpatient rehabilitation and outpatient. Help is available if the person is committed to get clean and sober. A person with an opioid addiction must have a burning desire to get off the drugs.
Check out our website: www.HTRSD.ORG
Understanding Addiction: https://htrsd.org/courses/understanding-addiction-new/
Every 11 Minutes Another Overdose Death. How many people have to die from opioid overdoses, before there is political and social policy change? Every eleven minutes a new person has overdosed and died, which translates into over 5 an hour, 130 a day, 3,927 a month, 47,127 a year and those estimates are on the low side. Heroin and Cocaine is cut with Fentanyl, which is 50 times more potent then Heroin. Opioid epidemic has killed more people then gun violence and motor vehicle accidents. The Attorney General said over 2 million people are addicted to Pain Killers.
Every 11 Minutes Another Overdose Death. Thousands of families have lost and will lose members to opioid overdoses. Those people who are callous and lack empathy say its not their problem are correct that they didn’t cause it. Take in the consideration that the apathetic ones can be victimized from the extremes addicts will do to support their addiction; Murder, Assault, Prostitution, Burglary, Shoplifting, Robbery, Forgery, Credit Card Fraud, Receiving Stolen Property, Fencing, Conspiracy, Illegal possession of Firearms, Disorderly Conduct, Harassment, Extortion, Threat of Violence. Any innocent person can become a victim of any of these crimes, driven by an addict desperate to get money to buy drugs.
LET’S CUT THE BULLSHIT
Every 11 Minutes Another Overdose Death. How much more addiction research, studies, charts, graphs and statistics is needed before the Federal Government wakes to the UNDENIABLE FACT that thousands of people are dying from Opioid Overdoses and the War on Drugs is Lost?
We don’t need the news media telling us that Opioids Kills thousands of people. Tell it to the very small children in the elementary school, so they don’t fall victim. addiction researchers are tracking how many overdoses are fatal versus non-fatal and how is that going to stop overdoses? I have had it up to my back teeth hearing about community awareness and drug rehabilitation facilities touting their recovery success stories, because none of that is going to stop the overdoses unless the addict is in treatment. Do the government leaders understand that the opioid overdoses are those people that are not in inpatient drug treatment?
These opioid users are in the alley ways, sitting in cars, in the woods, behind a bush, in abandoned buildings, in a public restroom, in the public parks, under an overpass, homeless, in a tent, in a residence, a flop house and playgrounds shooting up, snorting and popping pills!
If the goal is to tell the nation that the U.S. has Opioid Epidemic then congrats!!!!
If the goal is to reduce the number of Opioid Overdoses then the United States needs a social and legal policy right now.
SAFE INJECTION SITES – ADDICTS DON’T QUIT USING UNTIL THEY ARE READY
Every 11 Minutes Another Overdose Death. These addicts are not going to quit using Opioids until they are ready to get treatment or they are dead from an overdose. I want to see something in boiler plated in law that will help STOP OVERDOSES! The only thing that is going to work to decrease Drug Overdoses is the implementation of the Safe Injection Sites. A place where the an addict can go the drug under the supervision of medical professionals. It has worked in other countries and it will work here in the United States.
Article in Favor of Safe Injection Sites: NJ Assemblywoman says safe injection sites could save lives
Article Against Safe Injection Sites: Safe injection site’ denounced as false solution to Philadelphia drug problem
Harms of Prostitution, Some Facts.
She Shouldn’t Have To Suck Dick. Many women who are addicted to opioids, mainly Heroin, support their addiction performing sex for money. The title is crude, but it gets the point across that some addicts sell their bodies to support addiction. Prostitution is said to be one of worlds oldest professions. I am certainly not bashing on prostitutes. It is a women’s decision to choose whatever she elects to do with her body. Not all of the prostitutes are addicts and this article is not about the non-addicted women who has chosen prostitution as their occupation. This article is about those addicted women who sell their body for money to support their addiction. It is my contention that women addicts, who prostitute to support their addiction are highly vulnerable for violence.
Tricking Ain’t Fun
Prostitute talking with a potential Trick
She Shouldn’t Have To Suck Dick. Prostitution is sometimes called “Tricking” and the client is known as a Date, John or Trick. In the United States, prostitutes can be found along the streets, in bars, casinos, motels or on the internet. As stated earlier, not all prostitutes are addicted to drugs. Some escorts advertise on the internet or can be found in bars, casinos and they may earn something in the vicinity of $150.00 to $500.00 per hour, which translates into $2,842-$7,104 a month. Then there are those escort women, who are highly paid can earn thousands of dollars for a single night. The average street prostitute earns $20.00 to $30.00 for oral sex and $40.00 to $60.00 for intercourse. They might earn more for staying with trick all night or for providing anal sex or other fetishes. Some prostitutes are independent and others have a pimp.
For the most part Tricking Ain’t Fun. Most men seek out to pay a prostitute for a no strings attached, physical release. Can you imagine what these women endure to earn money; it must be disgusting going down on a strange guy to perform oral sex in the front seat of his vehicle or in a motel room. The guy might be groping the woman’s backside or breast. One could only imagine the urine stench surrounding the penis after being tucked away in his pants.
For the uncircumcised penis, hopefully the man practices hygiene and cleans under the hood. I can’t imagine the disgust of oral sex coupled with that cheesy smegma oozing into her mouth along with the urine stench. Some prostitutes use condoms for oral sex while others do Bareback Blowjobs. Can you imagine how vile it must be with a stranger orgasming into her mouth and not to mention the possibility of infectious semen. Its all enough to make me gag and hurl! Its upsetting for me personally because our family lost a member to addiction and sex trafficking.
One would hope for vaginal and anal sex that condoms are used but who the hell knows! Most women who sell their bodies to support addiction hate doing it. Depending how big their habit is, and what are their earnings, is the deciding factor on how many dates they will do.
Not That Easy To Quit Using
What Not to Say to Someone With a Drug Addiction Hurtful Comments Can Trigger Drug Use
She Shouldn’t Have To Suck Dick. Unless you have had an addict in your life or worked with this population, it is very difficult to comprehend why they behave the way they do. You can drag them off to detox and rehab, but until they are ready to get clean and sober, the clinical treatment will be a costly waste of money. These people may not be willing to quit using heroin under the threat of incurring emotional, mental, physical harm to their health nor for social, and or legal reasons. Its really very difficult for the non-addict to come to terms with the reality that addicts will not get clean and sober until they are ready to do so.
OPIOID CRISIS: Drug courts have goal of rehabilitation
She Shouldn’t Have To Suck Dick. There is one forcible hand to push sobriety, that I have witnessed work successfully and that is Drug Court. The reason I say this is because, I know two women who I met during my graduate school Nursing Case Management Project in Camden, New Jersey. They got mixed up in felonies to support their addiction and were arrested by the police. Both of these women also did prostitution as well. The drug court process is meant to adjudicate the offender who is an addict into the justice system, but to offer a pretrial alternative of getting clean and sober. If they fail to get clean and sober, then they are remanded to go to the state prison to serve out the penalty for the felony. Drug court and all its processes is one very punitive system that holds the addict’s feet to the fire. If you want to learn more about Drug Court then access the link below.
Safe Injection Sites
Work toward Seattle’s safe injection site slows as court case continues
She Shouldn’t Have To Suck Dick. Safe Addiction Sites are locations where an addict can go and safely use heroin under the supervision of medical professionals.
According to the Department of Nursing at USC; the health risks of IV drug use are extreme — 130 people die from an overdose every day in the United States. External link The lifetime risk of dying from an opioid overdose is greater than that of a car collision: External link 1 in 96 versus 1 in 103.
The U.S. government has struggled to control the most recent. Other countries have decided to give people misusing intravenous drugs ownership over at least one aspect of their addiction: location.
People use opioids “wherever they can,” said Kathleen Woodruff External link DNP, ANP-BC, clinical assistant professor at USC Suzanne Dworak-Peck School of Social Work Department of Nursing. “The street, abandoned buildings … they will find a place to use.”
Supervised injection sites are also called safe injection facilities, overdose prevention centers and drug consumption rooms (DCRs). According to Woodruff, who has worked with high-need communities in Baltimore and specializes in HIV and substance misuse, supervised injection sites serve several purposes.
Aside from providing people who inject drugs with safe and medically supervised locations to use drugs, they provide critical services such as case management and medical, social and mental health care.
To read more about Safe Injection Sites, access the link below:
Supervised Injection Sites Are Coming to the United States. Here’s What You Should Know: https://nursing.usc.edu/blog/supervised-injection-sites/
Accredited Continued Nursing Education:
Safe Injection Sites Save Lives. Drugs are bought and sold on the street. Addicts find a spot to inject and many overdose. Drug paraphernalia is left on the streets, in playgrounds and the parks. Not surprisingly community leaders, politicians, law enforcement, healthcare and the public are scope locked on this opioid epidemic asking what in the hell is to be done? No one has the solution to stop it and the opioid epidemic continues.
Many Are Not Ready For Drug Rehab
Safe Injection Sites Save Lives. Its a simple fact that if the addict is not ready to get clean, then they most certainly are not going to be successful at drug detox and rehabilitation. Many of these drug rehabilitation centers leave a lot be desired in terms of their success versus attrition rates for addicts.
One of my greatest criticisms for drug rehabilitation centers, is they do a piss poor job case managing this population following the discharge from the facility. Many of these people don’t return to stable and structured living circumstances. They may have active warrants and most don’t have a job so earning money legitimately is out. They may have mental and physical illnesses that require intervention. I lost count how many addicts, I have met who have Hepatitis C.
Some callous people shrug their shoulders and don’t care that an addict dies of an overdose. In contrast, a lot of families have been devastated from love one’s dying from an opioid overdose. One of my closest friends and a nursing colleague lost her brother to a heroin overdose. Another friend and also a nursing colleague, 22 year old daughter died from heroin addiction and involved in sex trafficking. A close military friend is losing battle to heroin addiction everyday. Her the problem is multifold because she was injured in the military with a traumatic brain injury. A few years later her younger brother died from heart complications and the year after that her Mom passed away from sepsis. The culmination left her with a feeling of hopelessness and severe depression. She started using Percocet and got into heroin.
For the apathetic uncaring people who think that addicts are not worth saving, I can say with conviction that every soul is worth saving. I also will volunteer that unless you have dealt with addict or worked with this population, things are not as simple as they seem. For many people who are addicted to opioids, quitting heroin is like trying to exorcise the devil out of a possessed soul. Once that drug sinks its teeth into its victims, it has a hold on to them stronger then any vice.
Heroin is killing a lot people
Safe Injection Sites Save Lives. The reason community leaders, politicians, law enforcement, healthcare and the public are scope locked on this opioid epidemic is because opioids KILL people in greater numbers then that of motor vehicles. Those opioid addicts who are not ready to get clean are going to use. There is nothing under the threat of logic, reason, law, health, or religion that is going to stop a determined opioid addict from using. If they have no place safe to use the drug, then it will be done in the abandoned buildings, the parks, playgrounds, public bathrooms, a car, the woods or behind a bush. Then some will discard their paraphernalia on the ground.
Safe Injection Under Supervision
Science Supports Supervised Injection Sites. Why Don’t Politicians Agree?
Safe Injection Sites Save Lives. If leaders, would finally come to terms with the FACT the opioid addicts who are not ready for drug rehab are inevitably going to use and many of these people will die of overdoses. Then by logic of acceptance, they would agree that the Safe Injection Sites, would invariably save lives. The site would be staffed by medical professionals, social services and counseling. This would foster building relationships with addicts to address some of the issues that weigh heavily in driving them to keep using such as mental and physical illnesses, homelessness, unemployment, hopelessness and legal issues.
Supervised consumption services (SCS) are provided in legally sanctioned facilities that allow people to consume pre-obtained drugs under the supervision of trained staff and are designed to reduce the health and public order issues often associated with public drug consumption. They are also called overdose prevention centers, safe or supervised injection facilities (SIFs), and drug consumption rooms (DCRs).
Facility staff members do not directly assist in consumption or handle any drugs brought in by clients, but are present to provide sterile injection supplies, answer questions on safe injection practices, administer first aid if needed, and monitor for overdose. SCS staff also offer general medical advice and referrals to drug treatment, medical treatment, and other social support programs.
There are approximately 120 SCS currently operating in ten countries around the world (Australia, Canada, Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain and Switzerland) – but none in the U.S. SCSs can play a vital role as part of a larger public health approach to drug policy. They are intended to complement – not replace – existing prevention, harm reduction, and treatment interventions.
Supervised Consumption Services http://www.drugpolicy.org/issues/supervised-consumption-services
It is not enough for the police and emergency medical services to carry naloxone to counter a drug overdose. Naloxone is effective at saving those victims whose overdose is witnesses and 911 dispatches help. The Harm Reduction initiatives such as Needle Exchange helps with the prevention of reusing dirty syringes.
For the opioid epidemic and the overdoses to be comprehensively addressed will require the United States to change its legal and social policy, which currently prohibit illegal drug use. The implementation of Supervised consumption services (SCS) will significantly reduce overdoses, help to diminish the spread of infections, curb the criminal elements that accompany the drug trafficking. Until this occurs, there is no hope on the near horizon of stopping the opioid epidemic and significantly reducing the deaths from overdoses.
People who publicly masturbate. What is up with men who masturbate in public? Consider this, my wife and I are driving in my truck on a three lane interstate. We are in the far left lane and pass a vehicle in the middle one. My wife blurts out; hey that guy is jerking off and smiling! I exclaimed, what! Sure enough, I glance over to see his hand going up and down flogging himself.
I am thinking of myself why people do this sort of lude thing? In review of the explanations available online, there are a number of reasons why someone chooses to expose oneself or do a lude sex act publicly. Some reasons are they are angry at women and shocking and or humiliating gives a sense of power. The man gets aroused to maliciously create fear for the woman. The man hates himself and is addicted to his own shame. A man may expose himself to reassure his manhood is intact. I know it is common because we saw in the vehicle and a similar event happened to a girlfriend in college. Masturbating in public is exhibitionism, which is a mental disorder. It is illegal to publicly commit a sexual act and or expose one’s genitals. It is also an assault and sexual harassment, if a consent was not given.
Women being masturbated in public, isn’t as rare as you might think
People who publicly masturbate. According to the author of this article, he tweeted one woman’s experience of being masturbated at this morning, the response was overwhelming. A deluge of replies flooded in from women who had experienced the same thing. From grandmothers to girls who were six when it first happened, their reports came from London, Sydney, Frankfurt, Paris, Berlin, Barcelona, Brussels, Las Vegas, New York, San Francisco, Canada, Mexico, Ireland, Ukraine, Peru, and even Vatican City. Within two hours, over 400 women and girls had come forward with their own experiences of being masturbated at.
To read more about the article: https://www.theguardian.com/lifeandstyle/womens-blog/2014/jun/26/women-being-masturbated-at-in-public
People who publicly masturbate. For me, the whole public exhibitionism adversely affects my moral compass. Moreover with regards my wife’s experience, it just pisses me off that someone has no regard. But getting past the moral issue and the angry, I wonder if that kind of exhibitionism behavior could lead to an uncontrollable desire to commit sexual assault and or violence against women? The reason I ask this question, is because psychologist have said that pornography affects people differently. That there are some people who have a uncontrolled urge to seek even more provocative intense kinds of porn. Could that same rationale apply to some men who are public exhibitionist?
Read about Sexual Assault Victims: Role of the Nurse: https://htrsd.org/product/sexual-assault-victims-role-of-the-nurse/
Legalizing and Managing Opioid Addiction. Fentanyl is an ingredient that drug dealers add to Cocaine or Heroin to make the drugs more potent and it is the major contributor to lethal overdoses. Drug dealers can reduce their costs by adding Fentanyl as an ingredient. Fentanyl is a synthetic opioid painkiller for treating severe pain. To give you some idea of Fentanyl’s potency, it is 50 to 100 times stronger than morphine. Physicians prescribe fentanyl to patient populations with cancer pain as either transdermal patches or medicinal tablets.
National Forensic Laboratory Information System (NFLIS) showing that the majority of the Fentanyl related overdoses are occurring in the Eastern United States.
Legalizing and Managing Opioid Addiction. According to the Centers for Disease Control and Prevention (CDC), Fentanyl contributed to a 47% increase in lethal overdoses resulting in 70,000 deaths in 2017. The map above was from the National Forensic Laboratory Information System (NFLIS) showing that the majority of the Fentanyl related overdoses are occurring in the Eastern United States. The reason is that type of heroin sold in the eastern states is Powder, which mixes easily with the Fentanyl. In the contrast, states west of the Mississippi river sell Tar Heroin, which doesn’t easily mix with the heroin. To make matters even worst, the drug dealers making counterfeit prescription pills using Fentanyl. Fentanyl is easily obtainable from China, which is purchased online and shipped in the U.S. https://www.cdc.gov/drugoverdose/opioids/fentanyl.html
How to Manage the Opioid Drug Epidemic
The war on drugs began back when Richard Nixon was the U.S. President. The war on drugs is a lost cause, because for every law enforcement drug bust and seizure, there are multitudes of shipments of the Fentanyl coming in from China and Heroin coming in from Mexico.
The FBI website states that there are 33,000 violent street gangs, motorcycle gangs, and prison gangs are criminally active in the U.S. today. Many are sophisticated and well organized; all use violence to control neighborhoods and boost their illegal money-making activities, which include robbery, drug and gun trafficking, prostitution and human trafficking, and fraud. Many gang members continue to commit crimes even after being sent to jail. https://www.fbi.gov/investigate/violent-crime/gangs
Many of these gangs are also affiliated with the Mexican Drug Cartels. If are own country cannot stop the illegal importation of drugs, then we should hold the countries of China and Mexico accountable for drugs illegally entering into the United States.
Addicts end up in court, county jails and state prisons for drug related offenses. The Drug Rehabilitation Treatment Centers are collectively raking in a sum total of $35 Billion dollars. Treatment Centers have a very poor success rate among those discharged patients staying in recovery. When the addict/client is discharged from treatment centers there is no case management to bridge them to a better situation and monitor their recovery. Cities are discussing having Harm Reduction Centers, where addicts can go use opioids under supervision in case someone overdoses. Police Officers are issued naloxone to help save lives from overdoses. Paramedic and EMT’s are diverted from non-drug related medical emergencies to treat overdoses.
The Solution is Legalization
Prohibiting Alcohol during prohibition was largely unsuccessful. By comparison the Fentanyl and Heroin are in demand by the people who sell it and the addicts who use it. If the government is unable to cut off the source of the opioids, then why continue to waste resources on failed methodologies? The opioid usage should be legalized because outlawing keeps everything underground.
The legalization of opioid usage, offers a number of positive outcomes
- opioid dispending pharmacies regulate impurity, & potency of heroin
- offering Harm Reduction Centers, will decreases drug overdoses
- decreased incidence of Hepatitis A, B & C
- opportunity to effectively case manage addicted clients before, during and after drug treatment
- restore and foster community relations with law enforcement
- divert law enforcement to pursue other crimes unrelated to drugs
- open up the opportunity for better drug rehabilitation research
- reduced drug related street violence
Check out the accredited course: https://htrsd.org/product/understanding-addiction/
Drug waivers to join the military. Offering men and women who use drugs a second chance to join the military is a valuable alternative to turn their life around. Its a fact that changing one’s environment for the better greatly diminishes drug relapse. The person is getting an opportunity to accomplish something to proud of, which will help instill self respect. The opposite is deny them opportunities and they get farther long into drugs. Then eventually one day enters a Drug Treatment facility, which have a horrible success record contrary to what they actually report. Most of this population are on State Medicaid so the Taxpayers are eating the costs of these failed programs. The U.S. Army is using drug waivers to fill their ranks.
Army using drug waivers, bonuses to fill ranks
Under the gun to increase the size of the force, the Army is issuing more waivers for past drug use or bad conduct by recruits, and pouring an extra $200 million into bonuses this year to attract and retain soldiers.
According to data obtained by The Associated Press, nearly one-third of all the waivers granted by the Army in the first six months of this fiscal year were for conduct and drug problems, mainly involving marijuana use. That number is significantly higher than the other three military services, and represents a steady increase over the past three years.
French Foreign Legion
Drug waivers to join the military. You might be thinking am I nuts? The idea of taking people with a bad background into the military but this is not unheard of. The French Foreign Legion accepts men who are from any country in the world with criminal backgrounds except murder. The Legion has high standards and their training is grueling. The French Foreign Legion has fought gallantly in more combat engagements then most any other military force.
Americans struggle to meet the French Foreign Legion’s high bar
CAMP DE CARPIAGNE, France — For almost 200 years, the French Foreign Legion has prided itself on offering a haven for men yearning for adventure and a new start in life.
It was just what “Edward,” a 24-year-old Californian, was looking for after he was booted out of the U.S. Marine Corps in 2015 for a disciplinary infraction.
“I can’t go into too much detail about what I did, but I was young and very stupid, and that’s why I’m no longer in the Marines,” Edward said.
Edward — who has a new identity given to him by the Legion — is now an anti-tank missile operator in the 1st Foreign Cavalry Regiment based near Marseille on the Mediterranean coast.
He is one of what he says are “several dozen” Americans in the elite formation that is still the hard core of the French army. Though many Americans have served with distinction in the Legion’s many wars, their numbers have fallen in recent years.
Read more about Legion: https://www.stripes.com/news/europe/americans-struggle-to-meet-the-french-foreign-legion-s-high-bar-1.497591
Drug Treatment Centers Are Costing Taxpayers Billions
Drug waivers to join the military. The drug treatment business rakes is a $35 Billion business. Drug Treatment facilities are historically not to successful in that their population remaining in recovery. This brings up another problem, which is the bulk of those who are discharged from drug treatment centers return to the same pretreatment environment. Many have burned bridges with family and friends. I might sound heartless but the Addicted Population has sought treatment has been to multiple Inpatient and Outpatient Centers. They can’t pull it together to assimilate back into society so many go right back on drugs. If you have ever worked around Drug Addicts, they just can’t get right, unless they have a long process of managed recovery and assimilation back into society. They have to be managed properly for a very long time. But why should taxpayers keep footing the bill for drug treatment that is failing. If we are going to pay for something then it ought to be for program that will work. I think that drug addicts forgo their constitutional rights when they are scourge to society.
Treatment is Unnecessary For Recovery From Heroin
Drug waivers to join the military. In the Vietnam War many military personnel were hooked on drugs including Heroin. The government mandated that any military personnel returning home must pass an Urine Drug Screen first before boarding the plane. The ones that failed the Urine Drug Screen were kept in Vietnam until they passed the Urine Drug Screen. This is significant because it was proven that people could get clean and sober from drugs without treatment. Its a fact that changing one’s environment greatly reduces the chances that a recovering addict will relapse. But in our country, most of these addicts are discharged back into the same drug milieu.
Read About What We Can Learn from the Vietnam War and Heroin Addiction https://www.michaelshouse.com/blog/what-we-can-learn-from-the-vietnam-war-and-heroin-addiction/
A Heroin Addict’s Daily Routine. Most people have no unearthly idea the amount of discipline it takes to be a Heroin addict. Many of us might think that an active using Heroin Addict is lazy but they are certainly not! I have worked with enough heroin addicts to understand the amount discipline and tenacity that they exercise in their day-to-day activities.
The Discipline To Use Heroin
Most heroin addicts when they get up for the day, are confronted with the grim reality of being on E (Empty), which is not enough of the drug in their body to keep them from getting dope sick (flu like symptoms that only worsen). Dope sickness is worse then motion sickness. The addict can get so sick that they experience abdominal cramps, body aches, cold sweats, nausea, vomiting and diarrhea. The first order of the day is to get off E. If the addict has a bag of dope left over then they use. In most cases, the heroin addict is not to terrific at saving money, so they have to forge a head to acquire money.
Activities To Earn Money and Using Heroin
A Heroin Addict’s Daily Routine. Some addicts panhandle, shoplift (boosting), burglarize, rob, steal, or prostitute. Some may even work a legitimate job. It is my belief that women addicts are at the greatest risks of harm then their male counterparts. If the woman is a prostitute she might take a stroll down the red light district corridor to catch a date (John). If she gets a date, then she performs a sex act in exchange for money. Of course its not always that easy to go on sex date because some Johns are abusive and maybe even dangerous. After the date, she goes to the drug set to buy a bag of heroin. On the way to the drug set, she might have to evade law enforcement. There might be another addict waiting for that unsuspecting female on E to rob her of the just acquired money. After she gets bag of dope, then she has to find a place to use it. Some addicts duck into an abandoned building (Abando) or the woods. Heroin can be smoked, snorted or injected into a vein. Most addicts are Intravenous Drug Addicts (IVDA) and if they have been using for awhile then their venous access is very poor. It might take a few minutes or maybe an hour to access a vein to get a flashback in the syringe. If she blows the vein and drug enters the subcutaneous tissues, then it might cause a nasty and painful skin abscess to form. There is always the risks that the Heroin is cut with something like Fentanyl and she might overdose. A lot addicts prefer the Heroin cut with Fentanyl.
A Heroin Addict’s Daily Routine. Drug sets are controlled by different gangs and they are competing to get customers. There have been drug dealers will put out pure heroin or Fentanyl to spread the news that their brand is more potent. The word of the potency gets around on the street to the other addicts that a particular Drug Set has really good product because X number of people have keeled over from an overdose. If you think that most addicts would use good judgement and insight to avoid buying from that unscrupulous drug set, then you would be mistaken.
For the addict obtain the money is an endless repetitive cycle. A Heroin Addict might be characterized as many things but lazy they are not. Being addicted to Heroin is an awful drudgery. Heroin gives people an unforgiving addiction that is physically insufferable if the cravings are not satisfied and it is very difficult to quit.
VIDEO: Chasing the Dragon: The Life of an Opiate Addict
Continued Nursing Education: Understanding Addiction
Publicly Traded Addiction Treatment Understanding Addiction is a difficult realm to comprehend because each addict has their own reasons why they took up the drug use. There is no cookie cutter reason why people become addicts. Many of these addicts also have mental illnesses, with the symptoms masked over by the drug abuse. It is my contention that the drug treatment centers need to spend an inordinate amount of time weighing in on what was the cause of the addiction and structuring a clinical treatment plan to meet the patient’s needs. A poorly conceived clinical treatment plan will result in unfavorable outcomes and a high degree of recidivism. I believe that high degree relapse might be influenced by many factors:
- mental illnesses
- patient returning to the same environment as pretreatment
- associating with other active addicts
- past demons that remain unaddressed triggering use
- dysfunctional home settings
- child abuse
- domestic violence
- sexual assault
- sex trafficked
- bridges burned with family and or friends
- poor insight and judgement
- a discharge plan that was unrealistic
- unable to cope with being sober
- no case management follow up
- unwillingness to stay sober
- suicidal ideation
- poor coping skills
- poor life skills
- no employment
- learning diabilities
- undiagnosed developmental disabilities
Drug Treatment is a Multi Billion Dollar Business
Forbes Magazine has stated that the Drug Addiction Treatment is a $35 Billion Dollar Business https://www.forbes.com/sites/danmunro/2015/04/27/inside-the-35-billion-addiction-treatment-industry/#1c9c2e7517dc
Publicly Traded Addiction Treatment. Addiction Treatment is Profitable But is it Helping. $35 Billion Dollars is serious money and for that kind profit, one would hope the patient outcomes were exceedingly favorable. The recidivism for recovering addicts relapsing back on drugs is very high. These treatment centers have variable lengths of stay and much of that has to do with insurance approvals, degree of addiction, motivation and or some are ordered through the court. The treatment centers are from the basic ordinary inpatient unit to a high dollar swanky place like the Betty Ford Clinic. Singer musician Eric Clapton, a Addict now in recovery, is the founder of Crossroads Centre located on the island of Antigua. I think going to the island of Antigua for treatment would be highly favorable. The island would be totally positive and patients would likely tolerate the treatment woes better. https://crossroadsantigua.org/
Quitting Addiction Without Treatment
Publicly Traded Addiction Treatment. Some addicts have kicked their addiction without treatment. This was seen at the end of the Vietnam War when many military personnel were addicted to heroin and other drugs. The government fearing that the men would return home still addicted. The government mandated that all military personnel must first have a clean urine drug screen before returning home. Those that failed the urine drug screen were held in country until they could pass the urine drug screen. This was a significant finding, which verified that addicts could quit addiction without treatment.
Some Addicts Do Well With Outpatient Drug Treatment
Some opioid addicted patients do very well outpatient wise with methadone maintenance, prescriptions for Suboxone , Subutex or the intramuscular injection of Vivitrol. The addicts undergoing outpatient care also need a thorough intake assessment and clinical treatment plan. Some of the physicians dispensing Suboxone , Subutex and Vivitrol injection do so without much of a follow through clinical treatment plan to address the underlying issues. The reason is most likely they do not have the time to dedicate to this endeavor. These patients need to be referred to an outpatient counseling center.
Inpatient Drug Treatment is Necessary For Some
Publicly Traded Addiction Treatment. For many addicts who cannot quit on there own, some kind of Drug Treatment is no doubt necessary. According to the recent literature, only 17% of active addicts go for formalized treatment program. If a person does seek of the clinical treatment, then it should meet the patient’s needs. I am not entirely convinced that all drug treatment programs utilize individualized treatment plans of care. Apparently the success rates of staying clean post discharge are not optimum.
In contrast in acute care when a respiratory comes to the hospital emergency department for an exacerbation related to Chronic Obstructive Pulmonary Disease (COPD), there will be similar standards of care that all patients may receive (Mini Nebulizer, Steroids, Chest X-Ray). But if the COPD patient is not responding to the implemented care, then clinical treatment team make adjustments. The Segway here is that treatment facilities should manage patients individually. As discussed earlier many addicts have mental health issues, which are largely unaddressed while they are using a substance. As the person undergoes treatment and enters into drug recovery the mental health issues / symptoms might resurface. I think that more ought to be done to individualize the addicted patient’s plan of care if needed and also include mental health treatment.
There are Dual Diagnoses facilities that treat addiction and mental illness. Its real important during the admission process that a through intake assessment take place. As people progress through treatment new issues may surface and these need to be addressed.
Case Management For All
An important component of recovery should be an involved case management strategy while the patient is inpatient at treatment center and for those under the guise of outpatient care of methadone clinic or a physician. Whenever a patient is discharged from an inpatient and outpatient setting, there ought to be case management follow-up to check in on progress.
Accredited Continued Nursing Education Course Understanding Addiction here:
Johnson and Johnson Increased Opioid Addiction. State of Oklahoma Cleveland County Judge slammed the drug company Johnson & Johnson with a $572 million court for increasing the opioid epidemic through its greedy opioid drug sales. Johnson & Johnson has become a Drug Dealer earning huge profits while irresponsibly addicting the public to opioids. The company must be held accountable for instructing its drug sales representatives to provide erroneous information to physicians that the opioid addiction risks.
Drug Company Lied About Opioid Addiction
Johnson and Johnson Increased Opioid Addiction. Opioid manufacturers are facing thousands of lawsuits across the country for aggressively marketing drugs like OxyContin, Vicodin, and Percocet as non-addictive and safe for long-term use for chronic pain—even though the drugs are chemically very similar to heroin. https://www.commondreams.org/news/2019/08/26/about-damn-time-first-thousands-lawsuits-against-big-pharma-johnson-johnson-ordered
Was The Opioid Addiction A Planned Epidemic
The opioid addiction epidemic has reached mega proportions throughout the United States. Many people became addicted to the opioids prescribed by physicians for pain. There have numerous deaths from opioid over dosages. Many of those addicted to opioids turned to using heroin when their opioid prescriptions were discontinued. The irresponsibility of Johnson and Johnson executives is so obvious one must ask if the opioid epidemic was planned? Was Johnson & Johnson in cahoots with the Food & Drug Administration (FDA) to intentionally fuel addiction? Because now the Addiction Treatment is a $35 Billion Dollar business. Government already knew the seriousness of opioid addiction. During the end of the Vietnam War, thousands of military personnel were addicted to Heroin and other drugs. The U.S. Government fearing the military personnel might return home as drug addicts mandated negative urine drug screens prior to returning home. Those military personnel who failed the urine drug screens were held in country until they could pass the test. How could the Federal Drug Administration (FDA) not have known that Opioids sold by drug companies were not highly addictive?
Check out the CE Course: https://htrsd.org/product/understanding-addiction/
News Affects The Opioid Epidemic. Like many, maybe even most things, the public continues to get a large percentage of the information they receive on a trending subject from the news media. Leaving out personal social media interactions, that number even increases when you add online media to traditional media outlets.
So, it probably comes as no surprise that news coverage of the opioid epidemic affects people’s perceptions of exactly what the problems are, as well as whether it is a growing concern, and how well or effectively the problem is being addressed.
The Public Health Institute has performed an analysis of news coverage of the opioid epidemic in Northern California that sheds an interesting light on the question:
News Affects The Opioid Epidemic. The news in rural Northern California provides a window through which we can glimpse how the public—and policymakers—understand the critical epidemic of opioid abuse and overdose in the region. A new preliminary analysis from PHI’s Berkeley Media Studies Group (BMSG) found that the news reinforces that the opioid epidemic is severely affecting communities locally and nationally; that the epidemic drives local crime; and that communities are exploring fledgling prevention and recovery efforts.
Unlike previous responses to drug use, opioid addiction is routinely framed in the news as a public health issue as well as a criminal justice issue—but public health advocates and medical practitioners are currently absent from the coverage.
As the opioid epidemic worsens, it is critical to understand how the news is shaping people’s understanding of the issue and what can be done about it. In this report, supported by the California Public Health Department, PHI’s BMSG analyzes news coverage from Northern California outlets, provides insights into how the issue is framed, and suggests questions for additional research.
Read more at phi.org
Link to our course on Understanding Addiction
Hepatitis A Outbreak in Heroin Users. “You’re turning yellow.” Using of contaminated needles and other drug paraphernalia increase risk of Hepatitis A. Hepatitis A infections is the newest negative outcome of the opioid epidemic is emerging . The population is at risks for Hepatitis A particularly if they are injecting drugs like Heroin and reusing syringes and the other drug paraphernalia. These Intravenous Drug Abusers don’t think to throw out used syringes because they would have to buy new ones. There use to be nonprofit mobile van needle exchange that was available for addicts to bring safety disposal containers with old syringes. That was a good harm reduction methodology to discourage reusing old syringes and discarding them on the ground. Then there was talk about Syringe Dispensing machines. Now there is nothing here in the way of harm reduction in areas ravaged by addiction. The addicts are reusing syringes, discarding them on the ground and Hepatitis A has come to roost.
Maybe those who unilaterally make these horrible decisions to do away with the Harm Reduction strategies of a Needle Exchange Van or the Needle Dispensing Machines might realize that having them in place is actually better for Public Health.
The CDC recommends health departments ensure people who report drug use are vaccinated for hepatitis A, and consider programs to educate at-risk populations, as well as to provide vaccinations in places where at-risk populations may seek treatment. Health care providers should encourage patients who report drug use to be vaccinated for the disease.
Hepatitis A Outbreaks in Heroin Users, Just before the Fourth of July, Trenton Burrell began feeling run-down and achy. Soon he could barely muster the energy to walk from one room to another. A friend shared an alarming observation: “You’re turning yellow.”
Within days, the 40-year-old landed in the hospital, diagnosed with the highly contagious liver virus hepatitis A, which has infected more than 3,220 people in Ohio and killed at least 15.
Since 2016, the virus has spawned outbreaks in at least 29 states, starting with Michigan and California. It’s sickened more than 23,600 people, sent the majority to the hospital and killed more than 230. All but California’s and Utah’s outbreaks are ongoing, and experts expect to eventually see the virus seep into every state.
Read more at usatoday.com
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Prescription painkillers and the opioid crisis. Trying to get a clear understanding of the relationship between Prescription Painkillers and the Opioid Crisis has, for a long time, been a difficult journey in which consensus has been a circuitous, moving target. Theatlantic.com has taken a lengthy and clear-eyed look at the issue, from the earliest days of the dawning awareness that a new and devastating social ill of opioid addiction was proliferating, through today, where the long held professional opinions on the best way to treat opioid-using pain patients is undergoing profound reconsideration.
It a true deep dive on the subject, but if you take the time to read it, you will gain a fuller understanding of why it’s been so difficult for many to even begin to understand all the complex factors that must be integrated into efforts to alleviate suffering without exacerbating the challenges of the addiction rehabilitation process.
In the early days of the opioid crisis, public officials had reasons to blame it on all the pills. News stories featured people who, to the shock of their neighbors and loved ones, had died unexpectedly of a drug overdose. In an emergency, authorities do what they can with the tools at hand. In tightening controls on doctors who prescribed pain relievers, state and federal agencies were focusing on the aspect of the problem most subject to regulatory intervention.
To some degree, that strategy worked. According to the Centers for Disease Control and Prevention, overdose deaths declined by about 5 percent in 2018—a dip attributable almost exclusively to fewer deaths from oxycodone, hydrocodone, and other prescription opioids. (Fentanyl deaths are still climbing.) Now that the fever of the opioid crisis may be breaking, Americans can revisit some of the stories we have told ourselves about the role of prescription medication in the crisis.
By now, the outlines of the story are familiar: Opioid prescribing began to rise in the early 1990s, powered by two forces. One was a campaign by oncologists and pain specialists to correct the undertreatment of pain. The other was the introduction in 1996 of the potent time-release oxycodone medication Oxycontin, which the drug company Purdue Pharma vigorously marketed to doctors.
Read more at theatlantic.com
Link to our course on Understanding Addiction
Overview of the Opioid Crisis. The problems of opioid addiction, from both illicit drugs like heroin and prescription medications such as oxycodone has been with us for a very long time, and sadly, will remain a huge, costly, and ultimately deadly issue for the foreseeable future. But it is said that knowledge is power, and CNN.com has just published an excellent overview of the opioid crisis that is sure to open the eyes of even those who have a good working knowledge of the issue.
From the insightful overview of the opioid crisis, to a unique time line that begins in 1861, the article is well worth the time it takes to read:
Overview of the Opioid Crisis. Experts say the United States is in the throes of an opioid epidemic. In 2017, an estimated 1.7 million individuals in the United States suffered from substance use disorders related to prescription opioid pain relievers and 652,000 suffered from a heroin use disorder.
Opioids are drugs formulated to replicate the pain-educing properties of opium. They include both legal painkillers like morphine, oxycodone, or hydrocodone prescribed by doctors for acute or chronic pain, as well as illegal drugs like heroin or illicitly made fentanyl. The word “opioid” is derived from the word “opium.”
During 2017, there were more than 70,200 overdose deaths in the United States and 47,600 of those overdose deaths involved opioids. More than 130 people died every day from opioid-related drug overdoses in 2016 and 2017, according to the US Department of Health & Human Services (HHS).
Prescription opioid volumes peaked in 2011, with the equivalent of 240 billion milligrams of morphine prescribed, according to the market research firm, IQVIA Institute for Human Data Science. The volume declined to about 171 billion milligrams of morphine in 2017, a 29% drop.
read more at cnn.com
Link to our course on Understanding Addiction
Criminal intent and the opioid crisis. It’s not always the illegal drug traffickers and dealers who are the criminals in these cases. Sometimes it is the upstanding members of our community, like the pharmaceutical companies and distributors, physicians and the pharmacists who are the ones committing the crimes that lead to increased opioid abuse, addiction, overdose and death.
Of course, the opioid epidemic has many elements, and is a complex problem that will not be easy to eradicate nor resolve. Most communities and regions of the United States have been adversely impacted by opioid abuse, addiction, overdose and death. In the Appalachia region, a legitimate distributor of prescription drugs was recently indicted. Fox News has the story:
Criminal intent and the opioid crisis. An Ohio pharmaceutical distributor has been accused in a criminal indictment of scheming to flood parts of rural Appalachia with millions of painkillers, contributing to the opioid epidemic.
Miami-Luken was charged with conspiring to provide hydrocodone and oxycodone pills to more than 200 pharmacies in Ohio, West Virginia, Indiana and Tennessee, the Cincinnati Enquirer reported Thursday.
Read more at foxnews.com
In the State of Virginia, a physician was found guilty and sentenced to 40 years in prison for illegally prescribing more then 500,000 doses of opioids to patients in Virginia, Kentucky, Ohio, West Virginia and Tennessee.
Link to our course on Understanding Addiction
News reports that Drug overdose deaths are decreasing. Is that proof that the situation is actually getting better? The problem of drug addiction, and overdoses are complex social disparities occurring in America. The news is reporting that less people are being killed by drug overdoses, but I doubt the validity.
For example, the increased utilization of Narcan by police and other first responders in overdose situations may have lead to a reduction in the number of opioid drug users who die when the O.D., but that doesn’t necessarily indicate that the problem of drug addiction in the U.S. is getting better.
The L.A. Times has more on the reported numbers on overdose deaths:
U.S. overdose deaths last year likely fell for the first time in nearly three decades, preliminary statistics suggest.
Nearly 68,000 drug overdose deaths were reported throughout the country last year, according to provisional figures posted Wednesday by the Centers for Disease Control and Prevention. The number may go up as more investigations are completed, but the agency expects the final tally will not exceed 69,000.
Overdose deaths had been climbing each year since 1990, topping 70,000 in 2017.
Any leveling off — or decline — in overdose deaths is good news, but the overdose death rate is still about seven times higher than it was a generation ago.
“We’re still in a pretty sad situation that we need to address,” said Rebecca Haffajee, a behavioral health researcher at the University of Michigan who studies policies aimed at curbing opioid addiction.
Read more at latimes.com
Link to our course on Understanding Addiction
Chronic Pain Patients Are Becoming Orphans. Under the prevailing conditions of opioid regulation, chronic pain patients who are legitimately prescribed medication are finding that doctors are apprehensive write prescriptions. Its the rotten ones who over prescribed for profit and the continued misuse that has brought us where we are.
Opioid Paradox of Legitimacy Versus Addiction
This whole Opioid situation is a paradox.
In one house we have the legitimate chronic pain patients who are prescribed opioid medication. Physicians are reluctant to prescribe pain medication because big brother is coming down with regulation and scrutiny. If for some reason you change primary physicians and new doctor doesn’t know you, then it is possible might profile you as a drug seeker. If that happens, your jacked because the potential consequences.
In the other house are the opioid addicted patients. Here is the rub; this population can get into addiction treatment a lot easier then a chronic pain patient is able to receive a prescription for a legitimate opioid medication.
It’s Not a Good Situation
Chronic Pain Patients Are Becoming Orphans. People who take opioids for chronic pain have a harder time finding a doctor than non-opioid taking patients, a new study finds.
About 40 percent of primary care clinics refuse to take patients who regularly use Percocet, regardless of what type of health insurance they have, according to research published Friday in JAMA Network Open.
“Anecdotally, we were hearing about patients with chronic pain becoming ‘pain refugees,’ being abruptly tapered from their opioids or having their current physician stop refilling their prescription, leaving them to search for pain relief elsewhere,” Pooja Lagisetty, a researcher at the University of Michigan and study lead researcher, said in a news release. “These findings are concerning because it demonstrates just how difficult it may be for a patient with chronic pain searching for a primary care physician.”
read more at upi.com
Link to our course on Understanding Addiction
Where Children Live Determines The Threat Level. Child safety education is contingent on where they live and what are the most immediate threats. In the United States, the drug abuse is a threat. In the region of Ukraine’s Donetsk Oblast region, the risk to children are the landmines. In parts of Africa, the Nile Crocodiles pose a risk. The JAMA Pediatric Study concluded that teens are likely to use Heroin. Heroin is easier to obtain as opposed to the prescription opioids. Much of the heroin is cut with fentanyl thus making it more lethal resulting in overdoses.
Teen Opioid and Heroin Use
Where Children Live Determines The Threat Level. The Jama Pediatric study stated that as many as 13% of young people recreationally use prescription opioids and 11% of the users later moved on to heroin after high school graduation. If you think about the reality of young people using opioids and heroin its mind boggling to understand why? Prescription opioids and heroin are responsible for premature death among this age population.
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Early Childhood Drug Prevention
Heroin, Opioids, Landmines and Crocodiles. Our teens using prescription opioids and after high school graduation, moving on to heroin is staggering reality. It makes sense educate very early on drug prevention. Some may disagree that the younger impressionable children should be shielded from learning about the horrors of drugs.
Child Education is Relative To Whatever is the Threat
Elementary children living in war torn areas within the country of the Ukraine are educated where not to play and walk to avoid stepping on a landmine.
Heroin, Opioids, Landmines, and Crocodiles Are Relative Threats. Children are educated to avoid high risk areas indigenous to the Nile Crocodile, which is native to freshwater in Egypt in the North, through Central and East Africa, down to South Africa.
According to the National Institute of Health (NIH), the first 8 years of a child’s life are critically important to prevent substance abuse. The NIH states that a stable home environment, good caring parenting, optimum nutrition, play and being stimulated to learn are dyer to having success later in life to avoid substance abuse. But what if the child doesn’t have all these attributes in their life due to divorce, poor parenting etc.
Implementation of an early elementary drug prevention program would need to illicit help of trained professionals, parental involvement, community advocates and training teachers how educate on the subject matter.
A School Drug Prevention Program Must Include All Stakeholders
Where Children Live Determines The Threat Level. Join Together recommends that schools adopt proven prevention programs that are researched-based, involve parents and community, offer teacher training and support, and use interactive teaching methods. They also suggest that teachers have easy access to prevention materials, and such information be supplemented in after-school and extra-curricular activities. Ideally, schools should also offer opportunities where older students are trained to help teach younger students about alcohol and drug abuse. Finally, when teachers and administrators have substance abuse prevention education specified as part of their job, their performance should be included in their formal evaluations.
Understanding Addiction: https://htrsd.org/product/understanding-addiction/
Addicts Receiving Treatment Need To Be Accountable. Most drug addicts, except for the few are unemployed, uninsured and on Medicaid. Due to addicts not staying compliant and in recovery there is a lot discussion as to what treatment is the most effective. States with fewer social services will have less treatment options for the Medicaid patients. States with more social services will have a greater variety of treatment options. People addicted to opiates such as heroin, which fondly known as “dope” can elect to go for Methadone Treatment, or be prescribed Suboxone, Subutex or agree to the monthly Vivitrol Intramuscular Injection. Others go to detox and to rehab. Many people continue to stay in recovery after successfully complete detox and rehab. In contrast, there is large population that run into serious problems once treatment is completed. A lot these people return to using opioids. There are a wide variety emotional, psychosocial, and psychiatric reasons why some return to the using heroin.
Vietnam War Veterans Overcome Addiction
During the Vietnam war many military personnel were addicted to drugs and especially heroin. The federal government fearing a multitude of drug addicted veterans would home with the addiction, mandated that a clean urine drug was necessary before getting on the plane to the United States. Those that failed the urine drug screen were kept in the country of Vietnam until they passed. This is significant because it was the first proof that people are able to stop the addiction without treatment. Addicts Receiving Treatment Need To Be Accountable. https://jamesclear.com/heroin-habits
Methadone Treatment and Concurrent Heroin Use
Addicts Receiving Treatment Need To Be Accountable. If a person elects to start on Methadone, they come to the clinic to meet a Certified Alcohol & Drug Counselor (CADC) to discuss the program, their addiction and give a social history. Then the patient meets with the Clinic Doctor for a Health Assessment and Urine Drug Screen. The Clinic’s Methadone Starting Dose is 30 Milligrams. The Clinic Doctor increases the Methadone by 5 Milligrams daily from Monday through Friday. Over the weekend the dosage remains the same until Monday. The patients go to the Methadone Clinic for their Methadone dosage Monday through Saturday. The clinic is closed on Sunday, the patient given a take home bottle.
Patients report that the clinic CADCs, say that until the desired Methadone dosage is reached, they will experience cravings to use Opiates. It’s unofficially understood that the patient’s will continue using heroin while the methadone dosage is gradually increased. From a pharmacologic perspective, the medical logic would be that as the Methadone Dosage is increased, the patient would decrease their heroin usage. But a lot of the patients keep using their full compliment of heroin as they did prior to treatment. Heroin is a sneaky drug because it keeps binding and producing more receptors in the brain. Hence forth, there are always more receptors then there is Heroin which, explains why the habit increases. If addicts keep using the same amount of heroin as they did in pretreatment, then whatever is then the therapeutic effect of the Methadone will be delayed or not reached.
The same scenario of regression could play out with a noncompliant Insulin Dependent Diabetic Mellitus (IDDM) patients who are not mindful to keep their blood glucose regulated with a proper diet and medication regimen. Some IDDM end up admitted to the hospital for very high blood glucose levels and Diabetic Keto Acidosis. Then after discharge continue to be noncompliant.
What Are The Options To Foster Compliance
Addicts Receiving Treatment Need To Be Accountable. Its hard to say what addiction treatment works the best. Quite possibly, its not a cookie cutter explanation. What works for one person might not be effective for another. Some people kick the habit on their own without treatment like the Vietnam War military personnel. Others have gone to tried every treatment option and none of these helped them stay in recovery. If a person has been unsuccessful to stay in recovery after repetitive drug treatment options, then should insurances keep footing the bill? Maybe the person was not really ready to quit and was cornered by family to seek treatment. Perhaps there should be a specified waiting period between future treatment options. The fact is people may go to treatment for addiction, fail to stay in recovery and continue to repeat the process. The drug treatment is a $35 billion dollar business. If the person doesn’t have private health insurance, then the costs is paid by taxpayers. It would be unethical to deny addicts treatment for addiction because its a disease. Its termed a disease because health insurances are billed by treatment providers. There must limits on the frequency and number of times a person may seek drug treatment. Unless these addicts are found to be mentally incompetent, then they need to be held accountable for their compliance to remain in recovery.
The questions that I have about opiate addiction & recovery via drug rehab are:
- What is the percentage of recovering opiate addicts who stay clean & sober?
- What is the percentage of opiate addicts who were addicted to prescription pain medication who stay clean & sober?
- What is the percentage of opiate addicts who were addicted to heroin (aka dope) who stay clean & sober?
- Is there a clinical difference in treating opiate addiction of those addicted to prescription pain medication versus to heroin?
Every single week, I read someone’s post on Facebook or a blog about how they are trying to get into and/or stay in recovery from opiate addiction. The media reports ‘X’ number of arrests made for selling drugs or possessing drugs.
It’s insane to see so many people addicted to opiates! No doubt that Drug Rehabilitation & Treatment Programs are staying busy because opiate addiction is spreading like wild fire. There is no end in sight to deal with the Opiate Addiction issue. When I say no end, it means that more people are becoming addicted to opiates and I don’t see the addiction ending. In has been my professional nursing experience that once someone is hooked on heroin, then, sadly far too frequently, “it’s a wrap.” That same direct nursing experience tells me that very few heroin addicts who get clean stay that way.
Nearby my home, we have a methadone clinic that opens up at 5:30am and closes at 1:00pm, Monday through Saturday. Person after person, alone in their vehicles, and getting dosed. Some stay for groups and others leave to go home or to work. Then there are multiple livery vans transporting people to get dosed. Well, issues related to Methadone is a whole other discussion to be had another day, but the point is to underscore the prevalence of the addiction problem.
Back to the focus of this story: Clients attending these Drug Rehabilitation and Treatment Facilities ( Inpatient Drug Rehabilitation ) are not experiencing a high degree of success at staying clean & sober. I can say this with great conviction and evidenced based experience. How do I know? I have worked in the Emergency Department, Psychiatric & Addiction Care Facilities. I am also a Clinical Instructor, and I ran Homeless Health Link, LLC during the capstone course of my Master’s of Science in Nursing. I case managed the homeless addicted by linking them to services; medical, dental, behavioral health and addiction treatment. I did this for 9 months. I was nominated for the service excellence award at my university. Of 68 clients, 11 were compliant and now five years later 7 are still clean, sober & remain in recovery.
Changing How We Discharge Drug Rehab Clients
Hooray! The Client has completed Drug Rehabilitation and is going to discharged from a structured, stable clinical environment — most likely to an environment with no stability, no structure, and maybe unsafe circumstances.
Many Clients who have completed drug rehab are not experiencing a high degree of success at remaining in recovery because they return to the same social existence that they had prior to treatment – and that environment is the one within which the problem emerged in the first place.
Idle time to an addict is one of the biggest defeating elements. This population must have something constructive to do; be case managed for a number of months following discharge. A lot of these folks might not have suitable living circumstances. They need a JOB. But its not easy getting a job when you don’t have a cell phone, Internet access, transportation, clothes and a suitable place to live. Not to mention that many may have past criminal records and employers might be apprehensive about hiring them.
Its so ludicrous to Rehabilitate Clients and turn them out, on their own, to start over. No Job, No Permanent Housing, No basic amenities such as clothes, cell phone. No Case Management. I have seen it from a clinician standpoint:
Scenario: Larry age 26. At group the day prior to discharge, the counselor ask; Hey Larry what is your plan? I am going to live with my sister and her husband. Larry goes to his sister’s and maybe it works out. But maybe his brother-in-law doesn’t like Larry and they have an argument. Larry gets kicked out and he is back on the street. Larry says screw it and wants to get high. So he goes to the local pharmacy and boost (shoplifts) and gets busted by the camera. Police come and arrest Larry. Or maybe Larry gets away with shoplifting. He sells the merchandise for 20 dollars. He goes to cop two bags of dope and buys works (syringe, etc.).
Scenario: Amy age 24. Is discharged following a 30 days inpatient drug rehabilitation and returns to her Mom’s home. Mom is an alcoholic and her live in boyfriend is abusive. He also likes to try to have sex with Amy after her Mom passes out from drunkenness. Amy decides to bolt and goes over to her girlfriend Rachel’s place. Rachel still uses and she tricks on Broadway to support her habit. Rachel just had a date with a John and has scored 4 bags of dope. Amy is feeling herself at the edge and ask for taste. So she shoots up and feels a nice high. The high wears off and Rachel’s dope is gone and Amy wants to get high. Rachel and Amy go to Broadway to catch a date and score some more dope.
Holding Rehabilitation Facilities Accountable
For many clients, the victory of completing drug rehab is short lived because of similar scenarios to those described above. Drug rehabilitation facilities should be highly invested in how they prepare clients for discharge and how they case manage Clients after discharge. I believe these facilities must be held to the same standards of accountability that hospitals are held to with regards to discharge planning and avoiding readmissions for the same morbidity.
Hospitals have had to do a better job at keeping patients from being readmitted soon after discharge to avoid not being paid for an untimely admission that occurred, and addiction rehab facilities need to be held same or even higher level of accountability to ensure the Client doesn’t fail and go back on drugs. Addicts have problems by definition, and require a steady hand to help them stay compliant. As I said, they need a job and suitable, stable and safe housing. Many of these clients would stand a far better chance of staying in recovery if they went to a reputable halfway house or sober living facility as part of their discharge plan.
Opioid Addicts Life Is Hard. I have met a bunch of opioid addicts who were patients mostly hooked up on dope (Heroin). They have been through drug treatment for inpatient, outpatient, methadone clinic, prescribed Subutex, suboxone and some had the vivitrol intramuscular shot. Most of them are still using dope. I worked in the emergency departments , the psychiatric crisis unit and did 9 month case management project for graduate school. I don’t know exactly what exactly it is about dope, but most addicts can’t quit that drug. I hear people say well the person just has not hot rock bottom yet and are not ready. In the City of Camden, New Jersey some of those poor souls, that I have seen, sure as hell look like they hit rock bottom ten times! Some are emaciated, drawn in faces, eyes popping out with scars all over their arms, legs and even the neck. Scars from abscesses. One person told me it takes her well over hour to find and inject into her vein. Some of the women sell their bodies for money (tricking). Some women and men panhandle while others shoplift. Some go to nice neighborhoods to burglarize homes. Whatever is their poison is what they are going to do get money. They all smoke cigarettes and mostly its the brand Newport’s.
Opioid Addicts Life Is Hard. The level of commitment that opioid addicts dedicate to finding money, copping drugs, avoiding detection from law enforcement, go to an “abando” (abandoned house) or bushes, and then to try to find a vein. Others snort or smoke heroin. But most are (IVDA) Intravenous Drug Abusers. Heroin Addicts have pure dedication to doing everything to get that drug. The addicts repeat doing the same litany of steps several times a daily and everyday of the week. I don’t judge and I don’t hate on them. If addicts could get clean and dedicate themselves to any job or task, they would become very successful.
I began thus little eulogy stating that addicts who seek drug treatment may go for inpatient, outpatient, methadone clinic, prescribed Subutex, suboxone and some had the vivitrol intramuscular shot. Clearly some addicts who complete Rehabilitation do stay clean & sober. I have read about drug rehabilitation centers who state that they are 90% effective, and my sense is that is a rather lofty percentage. I am not entirely certain how these Rehabilitation Centers measure their successes nor what metrics they are using to make that claim.
If some drug rehabilitation outfits were truly at a 90% effective drug addiction treatment success rate, than I would surmise that entity’s methodology would be replicated and the center would receive notoriety comparable to a Nobel Peace Prize. I believe these questionable success rates may be more of a marketing tactic because Addiction Centers want to keep the beds full and make money. Now, there is nothing at all wrong with making money. But the question remains of how effective their treatment methodology really is in successfully treating addiction and hence the client staying clean & sober.
According to White, W (2018), “Despite decades of advancements in science, pharmacology, and technology, the continuum of evidence-based addiction treatment services remains largely unavailable to those in need. The addiction treatment system is hindered by fragmentation, outdated treatment philosophies, and a payment system that perpetuates antiquated care models and discourages the adoption of best practices in the field. The historical rise and development of the current addiction treatment system explains the evolution of a broken system, and sheds light on new solutions. The continued use of outdated treatment methods is harmful to patient health, and, in some cases, it’s even criminal. The treatment system fails to reach people until the latest stages of addiction, and is ill-equipped to provide care for people with low to moderate problem severity. Insurance denials, prior authorization requirements, and admission waiting lists create impossible hurdles. The system is plagued by high early dropout rates (40-60%), high rates of non-completion (more than 50%), and low rates (less than 50%) of successful linkage to long-term recovery support resources.” https://www.shatterproof.org/blog/time-now-radical-transformation-addiction-treatment
Opioid Addicts Life Is Hard. There really needs to be a strictly evidence based standard of care practices that are rooted in both science and medicine. Consumers need to be able ascertain if a given Rehabilitation method is implementing evidence based practice and can objectively demonstrate their outcomes. All Rehab Centers should have a score card system rating them for demonstrated outcomes, cataloged by a third-party recorder.
I see all these heroin addicts in Camden New Jersey and many have been using dope for years. I am not certain they are willing or wanting to quit. But there is a definite disconnect between the number of times that they have gone to drug rehab and the high success rate that some of rehabs claim.