Tag: heroin

  • Fentanyl Found In Startling Number Of Heroin Samples In Canada

    Fentanyl Found In Startling Number Of Heroin Samples In Canada

    “Something like 60% of the drugs that we check are not what people think they are,” said the author of a new drug-testing study.

    Drugs in Vancouver, Canada may be even more dangerous than normal, according to a new pilot project. 

    The project from the B.C. Centre on Substance Use (BCCSU) found that more than 80% of drugs sold as heroin in Vancouver do not actually contain heroin, but rather a dangerous synthetic opioid called fentanyl. 

    For the project, the BCCSU gave local users the opportunity to test their drugs for fentanyl as well as other substances. The study took place from November 2017 to April 2018 at two supervised-consumption sites in the Downtown Eastside part of Vancouver.

    In total, 1,714 samples were tested with fentanyl test strips and an infrared spectrometer. 

    The results, which the Globe and Mail reports will be published in September in the Drug and Alcohol Dependence journal, demonstrated that fentanyl was present in a great deal of local drugs, especially heroin. The project also found that types of drugs such as stimulants and hallucinogens are more likely to contain the substance they are sold as.

    The findings, according to co-author Mark Lysyshyn, give insight into how problematic the contamination of various drugs is locally. 

    “Something like 60% of the drugs that we check are not what people think they are,” Lysyshyn said on Tuesday, according to the Globe and Mail. “We’ve always had the idea that drugs could be something different, but right now [the contamination rate] is really high.”

    During the study, the Globe and Mail states, authors found that the majority of drug samples (58.7%) were expected to be opioids. They received 907 samples of what was thought to be heroin, but only 160 (17.6%) contained heroin. Of the total 907, 822 contained fentanyl. 

    Lysyshyn says the results aren’t necessarily indicative of the illegal drug market as a whole since the study was concentrated in downtown Vancouver. 

    He also added that the intention of the study was not to prove whether an illegal drug is safe, but instead to encourage those who use the drugs to seek out more information about what they are putting into their bodies. 

    “I don’t think the purpose of drug checking is to say, ‘These are safe; take them recklessly.’ That’s not what we’re trying to do,” he said, according to the Mail and Globe. “We’re saying, here’s a bit more information about these substances; they still could be risky. Because even if you find out there’s no fentanyl in your heroin, heroin causes overdoses, too. We don’t want people to forget all about the other harm-reduction advice that we’re giving; this is just additional information that we think could be helpful.”

    View the original article at thefix.com

  • Suboxone: A Tool for Recovery

    Suboxone: A Tool for Recovery

    With medication-assisted treatment (MAT), people with opioid addictions are given the chance to rebuild their lives—often from the ashes and debris of drug-induced destruction—without having to fight cravings and withdrawal.

    Suboxone is a prescription medication that treats opioid addiction. It contains buprenorphine and naloxone, active ingredients that are used to curb cravings and block the effects of opioids. Although a major player in addiction recovery today, and often referred to as the gold-standard of addiction care, many in the recovery community remain resistant and even wary, including a large portion of rehab facilities and many members of the 12-step community.

    How does Suboxone work? When an opioid like heroin hits your system, it causes a sense of euphoria, reduced levels of pain, and slowed breathing. The higher the dose, the more intense the effect. Buprenorphine and heroin are both considered opioids, but the way they bind with the opioid receptors in the brain differs. Heroin is a full agonist, meaning it activates the receptor completely and provides all of the desired effects. Buprenorphine is a long-acting partial agonist. While it still binds to the receptor, it is less activating than a full agonist, and there is a plateau level which means that additional doses will not create increased beneficial effects (although they may still cause increased adverse effects). In someone who has been addicted to opioids, buprenorphine will not cause feelings of euphoria—the sensation of being “high.” Naloxone is paired with the buprenorphine to discourage misuse; if Suboxone is injected, the presence of the naloxone may make the user extremely ill.

    Jail Physician and Addiction Specialist Dr. Jonathan Giftos, M.D. offers this analogy: “I describe opioid receptors as little ‘garages’ in the brain. Heroin (or any short-acting opioid) is like a car that parks in those garages. As the car pulls into the garage, the patient gets a positive opioid effect. As the car backs out of the garage, the patient experiences withdrawal symptoms. Buprenorphine works as a car that pulls into the same garage, providing a positive opioid effect—just enough to prevent withdrawal symptoms and reduce cravings, but unlike heroin, which backs out after a few hours causing withdrawal—buprenorphine pulls the parking brake and occupies garage for 24-36 hours. This causes the functional blockade of the opioid receptor, reducing illicit opioid use and risk of fatal overdose.”

    Critics and skeptics of medication-assisted treatment (MAT) believe that using Suboxone is essentially replacing one narcotic with another. While buprenorphine is technically considered a narcotic substance with addictive properties, there are important differences between using an opioid like heroin or oxycontin and physician-prescribed Suboxone. Similarities between using heroin and Suboxone are that you have to take the drug every day or you will experience withdrawal and likely become very ill. Aside from the physical dependency, which is without a doubt a burden, Suboxone offers people in recovery the opportunity to live a “normal” life, far removed from the drug culture lifestyle they may have been immersed in while using heroin.

    People are dying every day from heroin overdoses, especially now in the nightmarish age of fentanyl. People in recovery from opioid addiction are living, free from the risk of overdosing, on Suboxone. Suboxone is a harm reduction option that while initially raised some eyebrows is gaining more traction, and considered an obvious choice for treatment by addiction medicine professionals. While someone using heroin is tasked daily with coming up with money for their drugs, avoiding run-ins with police or authorities, meeting dealers and often participating in other criminal activity, someone using physician-prescribed Suboxone is not breaking the law. They are able to function normally and go to school or get a job, and they are often participating in other forms of ongoing treatment simultaneously. People are given the chance to rebuild their lives—often from the ashes and debris of drug-induced destruction—without having to fight cravings and withdrawal.

    There is a common misconception about Suboxone, and medication-assisted treatment in general, that it is a miracle medication that cures addiction. Because of this idea, many people use Suboxone and are disappointed when they relapse, quickly concluding that MAT doesn’t work for them. When visiting the website for the medication, it reads directly underneath “Important Safety Information” — “SUBOXONE® (buprenorphine and naloxone) Sublingual Film (CIII) is a prescription medicine indicated for treatment of opioid dependence and should be used as part of a complete treatment plan to include counseling and psychosocial support.”

    So, as prescribed, Suboxone is intended to be only part of a treatment plan. It is but one tool in a toolbox with many other important tools such as counseling or therapy, 12-step meetings, building a support system, nurturing an aspect of your life that gives you purpose, and practicing self-care. It is medication-assisted treatment, emphasis on the assisted.

    With that being said, the type of additional treatment or self-care a person participates in should fit their own individual needs and comfort level and not be forced on them. Like a wise therapist once said, “Everybody has the right to self-determination.” Twelve-step meetings, although free and available to everyone, are not the ideal treatment for many people struggling with addiction. Therapy is expensive. People using Suboxone or other MAT shouldn’t be confined to predetermined treatment plans that have little to do with an individual’s needs and more to do with stigma-imposed restrictions.

    It’s unlikely that you’ll find a person claiming that simply taking Suboxone instead of heroin every day saved their life. It is not the mere replacement of one substance for another that is saving lives and treating even the most hopeless of people who have opioid use disorder; it is the relentless pursuit of a new way of life, a pursuit which includes rigorous introspection and a complete change of environment, peers, and daily life. Through the process of therapy, 12-step, using a recovery app, or whatever treatment suits you best, a person can face their demons, learn healthy coping mechanisms, and build confidence without the constant instability of cravings and withdrawal. Suboxone is giving people a chance that they just didn’t have before.

    So why is there such a stigma tied to the life-saving medication? Much of it comes from misinformation and is carried over from its predecessor—the stigma of addiction. It is hard for people who have a pre-existing disdain for addiction in general to swallow the idea that another “narcotic” medication may be the best form of treatment. In addition to addiction-naive civilians or “normies” as 12-steppers might call them, many members of the Narcotics Anonymous community are not completely sold on Suboxone’s curative potential either. Some members of the 12-step community are accepting of MAT, but you just don’t know what you’re going to get. You may walk into a meeting and have a group that is completely open and supportive of a decision to go through the steps while on Suboxone, or you may walk into a meeting of old-timers who are adamant that total abstinence is crucial to your success in the program.

    Another reason people are unconvinced is the length of time Suboxone users may or may not stay on the medication. Again, there is a stigma that shames people who use Suboxone long-term even though studies have shown long-term medication-assisted treatment is more successful than using it only as a detox aid. If Suboxone is helping a person live a productive life in a healthy environment, without the risk of overdose, that person should have the right to do so for however long they need without the scrutinizing gaze of others. While their critics are tsk-tsking away, they may be getting their law degree or buying their first home.

    Suboxone is a vastly misunderstood and complex medication that has the potential to not only save the lives of people with opioid addictions, but also allow them to recover and rebuild lives that were once believed to be beyond repair.

    View the original article at thefix.com

  • Vancouver Sees Success in Peer-Supervised Injection Sites

    Vancouver Sees Success in Peer-Supervised Injection Sites

    The chief coroner of British Columbia estimates that without the safe injection sites and without opioid antidotes, the death count would be triple what it is.

    In Vancouver, Canada, individuals who wish to use injection drugs have the option of doing so in a safe environment, supervised by their peers.

    According to NPR, downtown Vancouver is home to the Vancouver Area Network of Drug Users (VANDU), a place that serves as a safe space for those using injection drugs. The location is equipped with various supplies like clean needles and sanitizing pads. On the wall, there is a poster highlighting the safest places on the body to inject. The site also provides treatment materials, if someone requests them.

    Hugh Lampkin, a site supervisor and vice president of VANDU, explained that the site’s injection room is an area where an attendant watches over individuals using drugs and administers overdose antidotes if necessary.

    The idea behind such sites, which are often peer-run, is harm reduction, Lampkin says. In other words, if people are going to use drugs, Lampkin and his colleagues would rather they do so in the safest manner possible to minimize the chance of overdose.

    Lampkin himself has a history of heroin use and discovered VANDU at a point when he was really struggling. VANDU hosted support groups and meetings, which Lampkin joined.

    “I was telling a bunch of strangers my life story, and it was something I’d never done before,” he told NPR. “After that just about everybody came up and either hugged me or shook my hand.”

    He says that in his experience, peer-run sites are preferred to sites run by authorities due to having fewer rules, no paperwork, and peer supervision.

    “If you put this up against another service provider where you have a PhD or a psychologist, I would put my money on a place like this.”

    According to Mark Lysyshyn, medical health officer at Vancouver Coastal Health, these sites and the people that run them are helping authorities when it comes to the opioid crisis.

    “These community agencies and groups of peers and associations of drug users, they’re the ones who are making the innovations. They’re telling us what to do,” he said. “They showed us how to create pop-up supervised injection sites. They know the community, they know where to put these things. So they’ve been able to solve a lot of problems.”

    Vancouver officials say that no one has died at any of the medical or peer-run sites. Chief coroner of British Columbia, Lisa Lapointe, tells NPR  that without such sites and without opioid antidotes, her office estimates the death count would be triple what it is.

    Though injection drug use is illegal in Vancouver, NPR says, the police support the injection sites and do not make arrests. On the other hand, the Drug Enforcement Administration (DEA) in the U.S. maintains that the sites host illegal activity and anyone involved with operating one could face legal consequences.

    View the original article at thefix.com

  • Dope Sick: Breaking Down Opioid Withdrawal

    Dope Sick: Breaking Down Opioid Withdrawal

    The strength it takes for a broken down, tormented person, feeling sick and hopeless every single day, to say, “No more” to their source of relief is something many people cannot even fathom.

    Dope sickness (from opioid withdrawal) or even just the fear of dope sickness can trigger a desperation and panic unlike any other. This fear, in large part, drives the addiction that has led to the opioid epidemic, which claimed 64,000 overdose deaths in 2016 and is now classified as a public health emergency. Or some say it’s the high that keeps opioid users chasing the dragon all the way to hospitals, jails, and institutions. Much like an abusive relationship that long overstays its welcome—often by years and even decades—it starts with love and butterflies but then transforms into a much darker animal, tethering a person in place not with love but with the fear of what happens when you leave it behind.

    How does someone know when their dose is wearing off and they need another fix? They’ll start to feel hot and cold at the same time, getting goose bumps and perspiring simultaneously; their eyes begin to water and they yawn repeatedly; they feel intense cravings coupled with severe anxiety, and their stomach starts to turn. These early onset symptoms of withdrawal work like an internal alarm in the brain, signaling to the nervous system that it desperately needs what is missing. These symptoms typically occur 6-12 hours after the last dose, and their intensity varies based on how often and how much of the drug the person is using. Opioid (painkillers such as oxycodone, vicodin, and codeine, as well as heroin) addiction is a progressive disease in which tolerance builds, so the required dose grows larger, and the withdrawal worsens. The deeper you are in the hole, the farther out you must climb.

    Once someone begins to experience the first stage symptoms of withdrawal, panic sets in. There is an overwhelming sense of impending doom because, as most seasoned junkies know, the only thing worse than the first stage of opioid withdrawal is the second. Muscle aches, pains, and spasms can cause a person to kick their legs and flop around like a fish out of water. Just as a fish longs for water to breathe again, the person in opioid withdrawal longs for a hit to end their agonizing race toward what feels like death. Vomiting, diarrhea, and severe stomach cramps keep them crawling to the bathroom, if they even make it, if they even have access. These physical symptoms are paired with deep depression, anxiety, and the torture of knowing that the hell could simply cease if they get their fix. And this typically goes on all 24 hours of each day that it lasts—typically just over a week—because insomnia prevents any relief that sleep would bring.

    It is the fear of that torment, which words can’t really do justice, that shackles people to a substance which indefinitely curses them with relief and pain. It is also that fear that compels them to lie, cheat, and steal. People who have become addicted to opioids wake up one day, deeper into their addiction then they’d ever anticipated, and look in the mirror only to see a stranger. They look at childhood photos of themselves and feel overcome with sadness, asking themselves, What happened? Their mothers do the same thing, looking at their baby’s photos and asking themselves where they went wrong. It’s difficult to separate the person from the addiction: although one entity does seem to overtake the other, that can be reversed and they are, in fact, two distinct realities.

    In most cases, a rotten egg is not born into this world destined to be a thief, robbing to feed their addiction. What once was a promising honor student, the girl next door, the boy working behind the deli counter, or the kid who loved fishing has now slowly, pushing the limits a bit farther each time, transformed into that thief overcome with fighting the terror of withdrawal. It’s as if they’ve sold their soul to the devil, stealing for it, lying to loved ones, to anyone, cheating people just to survive, just to feel well. When someone with an addiction hits rock bottom, and they hate themselves at this point, they think they’ve had enough and they want their soul back. But they can’t just stop. There’s a debt to pay.

    The strength it takes for a broken down, tormented person, feeling sick and hopeless every single day, desperate enough to do things they’d never imagine themselves capable of doing, to say, “No more,” is something many people cannot even fathom; it is standing up to the fear of the agony of withdrawal, of feeling like you’d gladly crawl out of your own skin if you could. For many people, it’s also facing the fear of life unaltered, buffer-less, possibly for the first time.

    There are different methods of withdrawing from opioids. Doctors sometimes offer benzodiazepines or clonidine, a blood pressure lowering drug, to temper the misery. There’s the good old fashion “cold turkey” which comes from the cold flashes and goosebumps you experience, or “kicking dope” which comes from kicking your legs around in weird spasms for over a week. And of course, we can’t have this discussion without mentioning the two big whoppers, Suboxone and methadone. These are known as medication assisted treatment (MAT), and they work wonders for many people. But one day you might want to get off of them, and that’s another opioid detox.

    Something worth mentioning about MAT is that if you take it long enough, you have the chance to rebuild a “normal” life. You can go to school, kickstart your career, do all the things that being a full-fledged junkie makes impossible. Stay on as long as you need; I even heard about one guy who got himself through law school on Suboxone. So there are upsides, incredible advantages really, but at the end of the day, after you’ve obtained your PhD, you still have to pay that debt.

    I once heard someone say, close your eyes and picture an addict. Whatever picture came into your mind, that’s the stigma of addiction. But there’s not just one static image, because addiction comes in layers. There’s the first layer, how it originated. Maybe a doctor prescribed Norcos for an ankle sprain and neglected to mention what you might be signing up for. According to drugfree.org, almost 80% of people who shoot up heroin started with the misuse of prescription medication. The next layer is when the drug takes over, and your identity—who you are—is now overwhelmed by the addiction, hiding your actual self somewhere beneath. And finally, hopefully, there’s the detox—the week or two of pure hell as the drug leaves your system and you start learning how to function without it.

    But when you do, finally, make it to the other side, however worn and broken down you may feel, it feels like the first day of the rest of your life. It’s a terrifying feeling, but you come out triumphant, and victorious.

    View the original article at thefix.com

  • Link Between Heroin Addiction And Narcolepsy Examined

    Link Between Heroin Addiction And Narcolepsy Examined

    Could opiates be the key to treating the chronic sleep disorder?

    Heroin could be the next big breakthrough in treating narcolepsy. 

    That’s one possibility raised in a paper published recently in the journal Science Translational Medicine, detailing new work probing the connection between addiction and the chronic sleep disorder.a

    When narcoleptics nod off or lose muscle control, it’s caused by a lack of hypocretin in the brain. But to probe the connection further between the wakefulness-controlling chemical and the sleep disorder linked to it, researchers started studying the brains of dead narcoleptics. In the process, they stumbled across one brain that stood out. 

    It had a lot more hypocretin-producing cells than the other brains – and then the researchers learned that person had been addicted to heroin. So the scientists decided to start looking at the brains of people who had struggled with opioid use disorder before their deaths.

    In the first four samples they studied, researchers found the opioid-addicted brains had an average of 54% more hypocretin-producing cells than regular brains. 

    “So it was natural to ask if opiates would reverse narcolepsy,” study co-author Jerry Siegel, a neuroscientist at the University of California Los Angeles, told Gizmodo.

    The next step, Siegel explained, was trying a study with mice. 

    Over a two-week period, researchers drugged up narcoleptic mice with regular doses of morphine. The experiment upped their hypocretin-making cells, and the effect lasted for a few weeks after scientists cut off the dosage. 

    Basically, the researchers said, the opiates wake up dormant cells that make the necessary chemical. 

    “Understanding why opiates ‘awaken’ these cells is a task for the future,” Siegel said. 

    But other scientists voiced reservations about the work. Even if opioids turn out to be an effective treatment in humans, there are practical limitations. 

    “No mother of a 15-year-old with narcolepsy would sign onto us giving them several doses of morphine a day,” sleep expert Thomas Scammell of Harvard Medical School told Gizmodo.

    Yet, the findings could herald new hope for addiction treatment. If opiates users have more neurons that make hypocretin, the researchers suggested, then maybe they need less. 

    “If chronic use of opioids is increasing hypocretin production—and the authors show that nicely—then that could amplify the rewarding aspects of these drugs, making addiction all that much worse,” Scammell said. “I think that’s actually the most interesting part of their research.”

    View the original article at thefix.com

  • So You Want to Write About Addicts

    So You Want to Write About Addicts

    At its best, addict lit satiates our quintessential human yearning for stories that may lead to salvation. We want warm fuzzies. We want sweet, sweet, redemption.

    We started each morning of residential treatment with burned muffins, a house meeting, and introductions.

    “My name is Tom and I’m a junkie here on vacation. My goal today is to lay in the sun and sample the delicious food in this all-inclusive resort.”

    Tom’s sarcasm made orange juice squirt out of my nose. Humor was an elixir for the boredom of early sobriety and monotony of the rehab center’s strict daily schedule.

    Our addiction counselor corrected Tom: “You need to take this more seriously. I need you to redo that and tell us your real goal for today.”

    The story that society tells about addiction is one of tragedy. When we talk about addicts, we talk about pain, drama, and heartbreak. Of course, addiction is all of these things, but it’s also a rich, multi-faceted story with humor and joy. When we let addiction define the entirety of a human being’s existence, we flatten people to one-dimensional caricatures.

    The story that society tells about my favorite tragic hero Kurt Cobain is a prime example; his sense of humor gets buried beneath his pain. The media glosses over parts of his personality, like how he wore pajamas on his wedding day and a puffy-sleeved, yellow dress to a heavy metal show on MTV. “The show is called Head Banger’s Ball, so I thought I’d wear a gown,” Cobain deadpanned. “But nobody got me a corsage.”

    Two weeks after Nirvana released Nevermind, they pranked the famous British show Top of the Pops. Wearing sunglasses and a smirk, Cobain infuriated producers and the audience when he dramatically sang “Smells Like Teen Spirit,” in a mopey style that evoked Morrissey from The Smiths.

    If you want to write about addiction, remember that two seemingly contradictory things can be true at the same time. Addicts can be both funny and tragic. Another example: Cobain’s original name for In Utero was I Hate Myself and Want To Die, but the record company opposed the title, fearing that fans wouldn’t understand the dark humor.

    While I love satire, I also understand why we don’t want to minimize the seriousness of addiction. Addicts suffer. Addicts bleed. Addicts, like Cobain, die too young.

    *

    I know a thing or two about almost dying.

    I recently discovered an old home movie of my ex Sam* and me. In the video, we were strung out like Christmas lights. Watching it made me feel like a voyeur in my own life.

    Thick tongued, I slur, “Let’s jaaammmm,” to my musician boyfriend. He pushes a tuft of blonde hair out of my face. My unruly David Bowie mullet always gets in the way.

    Sam’s strumming his acoustic guitar and singing “Needle and The Hay” by Elliot Smith, a classic junkie song.

    I’m taking the cure/ So I can be quiet whenever I want.

    He hands me a bass guitar, but I can’t hold it. My limbs go limp. Thunk. The maple-neck, cherry wood bass crashes to the floor.

    So leave me alone/ You ought to be proud that I’m getting good marks.

    The bass doesn’t break, but I do. I try to pick it up, but my body slumps into a question mark. I look like a bobble head doll, with glassy blue-green eyes. Doll eyes blinking open and shut. Opiate eyes. Open and shut. Haunting thing.

    Sam stops singing. “Are you okay? Tessa, did you take Klonopin this morning?”

    Shut. When my eyes roll in the back of my head, he grabs my shoulders and commands, “Wake up! Wake up!”

    “I’m fiiiinnnneeee,” I mumble as my pale skin turns blue.

    I wouldn’t be fine for years.

    *

    When I heard there was going to be an opioid overdose memorial, I was skeptical. When I saw that Showtime was releasing a new docuseries about the epidemic called The Trade, I was skeptical. When Andrew Sullivan christened a non-addict “Poet Laurette of the opioid epidemic,” in a New York Magazine essay, I was skeptical. But not surprised. Never surprised.

    I’m skeptical because I’ve been devouring books, essays, documentaries, and movies about the opioid epidemic for years, charting their predictable rhetoric, cliché story arcs, and stigmatizing portrayal of addicts: addicts as cautionary tales, signal fires, propellers for drama. We’re afraid to color outside these lines, to show the ways in which addicts contain multitudes.

    I wear skepticism like a shell. It feels safer than being vulnerable. My skepticism asks questions like: who has the right to tell the addict’s story? How can a writer dip their plume into the well of an addict’s pain without having been there herself? How can we do justice to addicts and the addiction story?

    If you want to write about addicts, you first need to familiarize yourself with the formula and conventions of the “addict lit” genre. The territory has been well-charted in recent books like Leslie Jamison’s The Recovering.

    Human beings are intrigued by conflict and drama. We are all complicit. I am, too. Even though I’ve been clean for multiple years and know that I shouldn’t be gawking, I do. Even though I feel like they exploit people’s pain for entertainment, I still watch shows like Intervention and Celebrity Rehab with Doctor Drew. These shows jolt us out of the doldrums of our own lives or, if we are addicts ourselves, they reassure us that we are not alone.

    We watch from a safe distance, with the luxury of returning to the comfort of our own cocoons. At its best, addict lit satiates our quintessential human yearning for stories that may lead to salvation. We want warm fuzzies. We want sweet, sweet, redemption.

    *

    If you want to write a story about the opioid epidemic, you must imagine how addicts hunger for stories that represent us, encourage empathy, and feel believable. We long for stories to be our anchors and buoys to keep us afloat. Unfortunately, some stories sink. We must study those too, as a lesson of what not to do.

    The Prescribed to Death Memorial is a dehumanizing failure. It features a wall of 22,000 faces carved on pills to pay tribute to those who overdosed in 2017. If I died of an overdose, I wouldn’t want my face carved on a pill.

    I’ve spent my whole life being carved out. Instead, I’d like to know what it feels like to be whole.

    When I heard about the docuseries The Trade, I quickly signed up for a free trial of Showtime and checked its Metacritic score: 84.

    Steve Greene of Indie Wire praises the series. The Trade “doesn’t purport to be a corrective or some magic key to unlocking the problem. But as a means for empathy and a way to understanding the human cost at each step of an international heroin trade, it does far more than hollow words and shallow promises.”

    Each episode shifts between three main story arcs: a Mexican drug cartel, law enforcement, and addicts and their families. It is technically well-made, with sharp cinematography and juxtapositions like masked members of the cartel guarding poppy fields in Mexico as children play in the street; a grieving mother and father at a memorial rally in Ohio flying signs that say, “Hope Not Dope.”

    But the series was predictable and flat. The addict’s story arc of The Trade is a simple five-part dramatic structure. In the exposition, we see white middle-class young adults are prescribed painkillers for a sports injury or surgery. As their physical dependence grows, they need more and more to manage their pain. At the climax, they switch to heroin because it’s cheaper and sometimes easier to find than painkillers. They fall deep into the well of addiction.

    Then they go to rehab or they don’t. Cut. End scene.

    Paste film critic Amy Glynn says it was “dangerous from a watchability perspective…Junkies don’t make good television because they are really, really damned boring. They are painfully uninteresting, because heroin turns most people into zombie reptiles who are deeply depressed and deeply depressing.”

    At first, I was taken aback by this quote. But Glynn has a point. If you want to write about the opioid epidemic, you might want to do more than rely on pain porn. The poetry of a needle plunging into the crook of a junkie’s arm, crimson swirling into the plunger. Junkies drifting through public streets like zombies.

    Glynn redeems herself: “Someone needs to start telling the rest of the story. Like now.”

    *

    If you want to write a story about addicts, you need to realize that it’s still a stigmatized condition. My friend had to leave a grief group because other parents said her son’s overdose death was his fault and not as sad as a child who died of cancer. It’s as though grief was some sort of competition of suffering and pain. But an entire super bowl stadium could be filled with dead bodies like her son. There were 64,000 overdose deaths in the US in 2016.

    If you want to write a story about addicts, you need to know that life-saving medication-assisted-treatments like Suboxone and methadone are still expensive and difficult to access. Unfortunately, many treatment centers are “abstinence-only,” meaning they don’t allow their patients to take Suboxone or methadone. For a more in-depth plunge into the world of harm reduction, read Tracey Helton, Tessie Castillo, or Maia Szalavitz.

    *

    In addition to these dire facts, we have to deal with our stories being appropriated and exploited. Enter the poet William Brewer, who has never used opioids or struggled with addiction himself. Brewer inhabits the voice of addicts in his poetry book, I Know Your Kind. The title derives from a Cormac McCarthy quote, but it’s very clear to me that Brewer doesn’t “know my kind.”

    I don’t want to be harsh on Brewer. Being from the polite Midwest where we’re supposed to avoid confrontation, I almost deleted this part. But Brewer’s words feel like a chisel mining people’s pain. I also feel it’s my responsibility as a recovering addict and writer to call it like I see it.

    Brewer writes lines like: “Tom’s hand on the table looked like warm bread. I crushed it with a hammer, then walked him to the E.R. to score pills” and “Who can stand another night stealing fistfuls of pills from our cancer-sick neighbors?”

    In a world where artists and writers are constantly being called out for cultural appropriation, I was surprised that nobody called Brewer out for appropriating the addict’s story for his own artistic gain. Brewer’s sole connection to the epidemic is that he was born and raised in Virginia, the state with the highest overdose death rate in the nation. In an interview with Virginia Public Radio, Brewer said when he visited over the holidays, he inquired about whereabouts of former classmates. “People replied, ‘They’re on the pills. We don’t really see them anymore.’”

    If you want to write about an addict, you should avoid infantilizing and dehumanizing addicts, along with the trope that addicts are all “lost and forsaken.” Some of the strongest, most courageous people I know are addicts. Active drug users like The People’s Harm Reduction Alliance in Seattle established needle exchanges, distributed the overdose reversal drug, naloxone, and are fighting to open supervised safe injection sites.

    *

    If you want to write a story about addiction, realize that most addicts struggle with whether or not they should publicly share this part of their identity. For a long time, I didn’t think I’d ever write about my addictions to alcohol, opiates, and benzos. I didn’t have the courage. Here in the Midwest, we keep the laundry to ourselves. We don’t air it out. When I wrote about my first struggle with alcoholism in 2011, my family warned me that it could impact my future job opportunities and dating. I knew they were just looking out for my “best interests.” But I insisted: my privacy, my mistakes, my choice. I hoped that sharing my addiction and vulnerability might be therapeutic for me and maybe even help others.

    If you ‘re going to write a story about addiction, realize how it’s affected by different identities. For example, I’m extremely lucky, because I have supportive friends and family. When I was broke and had nothing, they offered me food, shelter, and support. Also related to my privilege as a white, middle-class woman is that I don’t have a criminal record. Yes, my hospital records bother me, but they are protected by confidentiality laws.

    In a way, writing about my addiction felt like making these private records a public matter. I was hesitant. Brewer was also reluctant to write about the opioid epidemic, for different reasons. He said, “West Virginia is very rarely looked at in a positive light. And so here again is a situation where something really quite terrible is going on, but it became so clear that this thing wasn’t going to go away and was starting to seep into my daily life.”

    *

    Heroin doesn’t seep into most people’s daily lives. Heroin is a tsunami. Heroin drowns.

    *

    There may be value in writing beyond our own experience, as Brewer did. Representation is important and if we all followed the advice to only “write what we know,” things could get bland and boring. Artistic expression would suffer. But it’s a tightrope. It’s a practice in tremendous empathy, wanting to diversify representation, while also being respectful and staying in your lane.

    *

    If you want to write about addicts, you’d benefit from also depicting the humor of early recovery, a story that often falls outside the margins. When I was digging through my own videos and journals, I was of course humiliated by some of my own narcissism and self pity. But I was also surprised and heartened by the unexpected joys like my friendship with Tom at my first rehab.

    On my first day, I noticed him in the smoking tent, wearing bright red Converse, a beret, and long sleeves to hide his track marks. I noticed the way his brown eyes brimmed with both kindness and sadness as he deadpanned in meetings.

    “You guys are like The Wonder Twins of rehab,” staff said. Despite our 20-year age difference, we were inseparable.

    Tom bummed me Parliament menthols and lent me one of his ear buds, so we could listen to The Replacements, The Pixies or The Velvet Underground together. On weekends, we went to record stores, ate pizza, and he read my shitty poetry. We made beaded lizards and built crooked birdhouses bedazzled with feathers and glitter.

    One day in group, we had to watch a 1987 film called, The Cat Who Drank and Used Too Much.

    “Was I just daydreaming, or did you just say we are watching a movie starring a cat?” Tom asked.

    “Yes, it’s made for kids. Lost and Found Ministries recommended it as a good way for parents to explain addiction to their kids.”

    “Drunken cats, who knew?” I said.

    I later learned that the film was praised as an “audience favorite about a beer drinking, drug addicted cat,” when it was screened at the Oddball Film Festival in San Francisco.

    Our story begins in any town USA, a sleepy suburban neighborhood lined with rosebushes and plush green lawns. Cue sappy flute and piano elevator music with too much treble.

    The film opens as Pat the Cat is getting into a red car for his morning commute. We see Pat drinking alcohol from a pitcher and beginning to experiment with other things. A cigarette here, some prescription pills, a bit of coke there (powdered sugar).

    “He’d try anything, it was never enough. Then it was too much.” Pat crashes his car and almost loses everything, but then decides to go to rehab!

    “I’m not trying to be catty, but Pat seems to be pretty well-off to me,” Tom said.

    At the end of the movie, Pat has a cupcake to celebrate his sobriety. Ah, it seemed like only a few weeks!

    “If only it were that easy!” I said.

    “Sure, his life isn’t purr-fect, but it’s pretty close!”

    *

    What I’m trying to say is: If you want to write a story about an addict, we might not be perfect, but we can do better. Starting now.

    If you want to read stories about heroin or the opioid epidemic, I recommend starting with nonfiction. There is power in reading about people’s lived experiences.

    Of course there are also excellent and illuminating fictional books about the opioid/ heroin addiction. Check out this list by Kevin Pickard.

    View the original article at thefix.com

  • Is it Hard to Quit Heroin?

    Is it Hard to Quit Heroin?


    ARTICLE OVERVIEW: Coming off heroin can be very difficult. Many heroin addicts who have tried quitting on their own experienced severe complications which included frequent relapses and life threatening situations. But when coming off heroin under a doctor’s supervision and medical care, there is a way out!


    TABLE OF CONTENTS

    • Addictiveness
    • Heroin and Brain Changes
    • Dangers
    • Side Effects
    • Safety Suggestions

    Read further to discover what make heroin so to quit and learn HOW TO and HOW NOT to try quitting. Feel free to use the section at the end for all your questions and/or personal experiences with stopping heroin.


    How Addictive Is Heroin?

    Heroin is one of the most addictive opioids. You can get addicted to heroin even from a single dose! In fact, the Drug Enforcement Administration (DEA) enforces the classification of heroin in the group of Schedule I drugs. This means that heroin is NOT used for medical purposes and has a HIGH potential for abuse.

    The addictive potential of heroin comes from:

    1. The speed with which this drug produces dopamine.
    2. The intensity of dopamine effects.

    Heroin crosses the blood brain barrier 100 times faster than morphine. It has very high activity on opioid receptors, which results in intense dopamine effects. Many users reported physical dependence upon heroin after only a few days of regular use.

    Brain Changes on Heroin

    Each time people consider trying heroin they wonder why getting high on this drug makes stopping so difficult? The answer to this question lies in the way heroin affects the brain.

    When heroin enters the brain, it transforms into morphine. Morphine binds to the opioid receptors in the brain responsible for recognizing and regulating pain and reward. Furthermore, this action causes a sense of euphoria that makes users experience extreme sense of power, pleasure and joy, almost like they are on the top of the world and can do everything. Heroin users describe this state as a feeling of happiness and having a different reality. Unfortunately, this empowerment last very shortly.

    Further, scientists found that the use of heroin affects 3 (three) opioid receptors in the brain: the mu, kappa, and delta receptors.

    1. Mu opioid receptors (MOR) bond with heroin to produce effects such as: pleasure, acute pain relief, physical dependence and addiction.
    2. Kappa opioid receptors (KOR) bond with heroin to produce effects such as: trance-like states, physical dependence, and addiction.
    3. Delta opioid receptors (DOR) bond with heroin to produce effects such as: relief from persistent pain, reduced gastrointestinal motility and modulation of mood.

    When heroin wears off, the overwhelming feel-good feelings go away and all that is left is the longing for the initial euphoric state. The mini explosions of pleasure induced by heroin combined with the psychological bliss and beauty vanish very quickly.

    When the body adapts to the presence of heroin, the new chemical reality brings strong cravings and urges to continue taking it until users reach the point where they no longer feel pleasure from heroin so when they make an attempt to suddenly stop, they are hit by extremely uncomfortable withdrawal symptoms.

    What Makes Stopping Heroin Dangerous?

    Quitting cocaine cold turkey, without a doctor’s clearance or medical supervision, lowering doses abruptly… all make stopping harmful! Here is why each of these methods is NOT recommended.

    1. Cold turkey heroin detox causes severe withdrawal symptoms.

    Going cold turkey off heroin can expose you to serious and severe withdrawal symptoms, including:

    • Cold flashes
    • Diarrhea
    • Insomnia
    • Muscle and bone aches
    • Restlessness

    Additionally, cold turkey, as a quitting method increases your chances of relapse. Instead, going through all of this, it’s best to seek medical advice on how to stop taking heroin safely. Medical aid during heroin withdrawal is consisted of tapering regimens or replacement therapies to lowers the dosage of heroin in your system over a period of time. This way, your body will not experience such intensive and uncomfortable withdrawal symptoms.

    2. Stopping heroin without medical supervision can lead to complications.

    Quitting heroin without professional counseling is unsafe and can be very uncomfortable. In fact, quitting heroin at home is rarely recommended, and advised only if you get clearance from your doctor. Why?

    Getting heroin out of your life is not only a physical journey, in requires behavioral changes, as well. In other words, once you quit heroin you will need to learn how to live without this powerful drug.

    Choosing to stop using heroin without medical supervision can result in unnecessary pain and suffering. Plus, it will simply lead you back to using. This is why you should not consider trying this method. Instead, doctors and addiction professionals are trained to not only teach you how to manage the strong heroin cravings but to help you develop coping skills and a support system to stay quit,

    3. Lowering doses of heroin suddenly and abruptly provokes relapse.

    This type of heroin cessation causes severe withdrawal symptoms and provokes relapse. Instead, plan your stopping thoroughly. Talk to a medical professional, or check in at an addiction treatment facility and let be supervised. This will significantly increase the chances of successful recovery.

    Quitting Heroin Side Effects

    People who’ve used heroin chronically for a longer period of time develop dependence, which makes it difficult to quit due to withdrawal symptoms.

    The common physical withdrawal symptoms include:

    • Bone pain.
    • Cold flashes.
    • Goose bumps
    • Diarrhea.
    • Insomnia.
    • Nausea and vomiting.

    The more serious withdrawal symptoms include:

    • Hallucinations.
    • Painful abdominal cramping.
    • Severe body tremors.
    • Severe diarrhea.
    • Severe nausea.
    • Suicidal thoughts.
    • Vomiting.

    Safety Suggestions

    Despite all odds and difficulties, when deciding to end your heroin addiction, there are safer and more comfortable ways of quitting such as:

    1. Quitting heroin under medical supervision gives you a better chance at recovery.

    Heroin withdrawal includes using prescription meds. Pharmacological treatment for heroin addiction includes:

    • Methadone to prevent withdrawal symptoms.
    • Buprenorphine to reduce cravings and physical symptoms like vomiting and muscle aches.
    • Naltrexone to reduce heroin cravings by blocking receptors in the brain that react to heroin. This medication is designed to occupy the nerve receptors so that you basically trick the brain into thinking it no longer needs heroin.

    2. Tapering (coming off heroin slowly) make withdrawal less painful.

    Tapering includes a gradual reduction of heroin doses over an extended period of time. Tapering off heroin should be done in accordance with a doctor’s suggestions. Your doctor will prescribe meds that will ease the withdrawal discomfort and design a unique tapering plan tailored to your individual needs.

    During most detox periods, doctors will test you before and after you quit for drug presence. Based on this, you’ll create a tapering plan, and your doctor should be at your disposal 24/7 in case of emergencies.

    3. Heroin detox clinic supervision helps support you emotionally.

    Heroin detox clinics provides a safe space to manage withdrawal symptoms. This is one of the highly recommended options for long-term success. Heroin withdrawal can sometimes bring complications and fatal injuries in case you try detoxing on your own such as becoming severely dehydrated.

    Is rapid detox appropriate for quitting heroin?

    No, rapid detox is not recommended when coming off heroin. Rapid detox is a procedure where you will be basically put under, as if for surgery, and your body will be rapidly flushed of heroin. This is a relatively new procedure and therefore is not yet covered by insurance companies, so the cost is quite expensive, plus the risks are high and therefore it is NOT recommended as an option for stopping heroin!

    4. Inpatient heroin treatment for long term success.

    Residential treatment centers for heroin addiction require living at a rehabilitation facility for a specified amount of time min 28 days up to 6 (six) months or longer. Your length of stay at the inpatient drug rehab facility will depend on the extent of your heroin addiction issue. During your residential stay you will start with detox and withdrawal shortly after being enrolled.

    Because heroin is a strong drug, you make a tapering plan together with your addiction specialist. You will also receive ongoing psychological counseling that will help you to deal with the underlying causes of your addiction. Another advantage of inpatient treatment for heroin addiction is the opportunity to attend group therapy sessions. This type of therapy will provide you with the opportunity to meet others who have already gone through heroin detox and have successfully started down the path to recovery.

    Your Questions

    Expect certain difficulties and discomfort during heroin detox, but don’t give up! If you still have questions about quitting heroin difficulties, please leave them in the designated section below. We try to answer all legitimate inquiries personally and promptly. In case we don’t know the answer to a question, we will gladly refer you to professionals who can help.

    Reference Sources: DEA: DRUG SCHEDULING
    Teen Health: Is Heroin A Depressant Or Stimulant?
    Rehab International: Fact and Fiction
    Quora: How does it feel to be high on heroin?
    Beach House Rehab: Heroin and the Brain: What Everyone Should Know about the Drug’s Scary, Long-Term Side Effects 
    How To Kick Heroin: How Heroin Works
    Teen Drug Abuse: The Dangers of Quitting Opiates Cold Turkey
    Element’s Behavioral Health: Dangerous Detox: Doing It At Home Could Be Deadly
    NIH: What are the treatments for heroin addiction?

    View the original article at drug.addictionblog.org