Why are people dying to get high?
Approx 30-60 seconds after injecting or inhaling heroin, users feel a surge of warmth, emanating from the lower spinal region - a "rush" of sensation that slithers through the CNS. Immediately, an overriding sense of wellbeing envelops the user. Within seconds of use, both the rate and depth of respiration sharply decrease. The rate of breathing can fall to two to four breaths a minute. As respiratory rates decline, blood pressure begins to drop, body temp plummets and the epidermis becomes cold and clammy, eventually turning blue-grey. Seizures may occur and respiratory failure can occur. The brainstem drowns in the drug and the signals to breathe, sent to the diaphragm and lungs, drown with it. Nothing glamorous here.
People are overdosing for two reasons. One, the heroin coming in from Colombia and Mexico is more pure than ever before. In 1980, average purity was four percent; now it is in the range of 70 percent pure. There is evidence that some blocks of heroin are up to 90 percent pure. Increase in purity can be attributed to more sophisticated production and marketing ploys used by retailers.
People are also getting poisoned with low-quality heroin now cut with a number of additives such as fentanyl quinine, milk sugar, starch, powdered milk, and even talcum powder. The problem is, to the consumer, both products look the same so they never know what they are getting.
The End Result
It is not uncommon for the user to experience imprisonment, violence, social condemnation, physical disfigurement, dangerous STDs, Hepatitis C, and other diseases as a result of recapturing this feeling of bliss. Heroin users may ultimately chase the "bliss" to the gates of insanity or death.
Analogous to my own personal powerlessness over my heroin addiction, I am also beginning to feel powerless over the current heroin epidemic. The local government will hold hearings and discussions and dictate policy that will hopefully assist communities in understanding the nature of the problem and, perhaps more importantly, offer solutions. Meanwhile, the law enforcement will continue to incarcerate the drug users.
Why All the Fuss? The CDC released their research findings on heroin. To summarize:
- Drug poisoning is the number one cause of injury-related death in the US with 44,000 in 2013.
- From 2000-2013, the number of deaths involving heroin nearly quadrupled. Most of the increase occurred after 2010.
- The number of drug-poisoning deaths involving heroin were nearly four times higher for men than women.
- From 2000-2013, drug-poisoning deaths involving heroin increased nationwide with the greatest increase here in the Midwest.
- Those aged 25-44 had the highest rate of heroin-related drug poisoning.
- During the 14-year period, there was an average of six percent per year -- after 2010, it spiked to 37 percent.
What Are We Doing About It?
In response to the opioid crisis, Hazelden Betty Ford Foundation has developed one of the most comprehensive opioid specific treatment protocols I have seen to date. Hazelden in Chicago has developed one of the first outpatient opioid-specific treatment groups that supports both medically assisted treatment along with traditional abstinence-based treatment adjunct to 12-step facilitation. Additionally, Sen. Kirk's anti-heroin task force is working hard to put a nasal spray version of Naloxone in the hands of all first responders, but it's not yet passed by the FDA.
What More Can We Be Doing?
I am working directly with families and those addicted to heroin. I am in contact with some of the top leaders addressing this issue including those conducting research, advocating for recovery and those helping to reduce supply and demand of heroin, as well as those developing cutting-edge treatments. This is where all of you the savvy readers come in. I am doing my part, but "I" alone am not enough. This is a "We Problem" and a "We Solution." We need to join forces and create a treatment product that is more compelling than heroin. We are all in our pods doing extraordinary work, doing the best we can, but we need to be coordinating our resources in an effort to share and exchange best practices across disciplines. Please share ideas of what is working or has not worked for you. Together, we can design and implement a more efficient, strengths-based, individualized, cost-effective, comprehensive treatment protocol that additionally takes into consideration the context of the family in recovery.