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Friday, September 26, 2014

Heroin Addiction

     Over the last few years, the number of heroin-related deaths has increased dramatically. Like most problems facing a community, the reasons for this increase are complex. Although there are many factors that contribute to drug use and addiction, there is only one factor that is necessary for heroin addiction, and that is using it one time (warning: graphic image below).

It has been shown to us once again that
it really does take a village to raise a child. Given the
risk factors for drug abuse, community intervention
is necessary, and this program seems to work best:

 There are many factors that contribute to teen heroin use.
Here are the significant factors:

1.    Heroin is completely 100% addictive after one use (people don't understand addiction - see end of post for a easy-to-understand description). Today, heroin is much more potent than it used to be. Like other drugs, including marijuana, the potency, or addictive potential has increased substantially. It changes the chemistry of the brain so that all the brain cares about is getting more of the drug. Our behavior is controlled by both the mind and the brain, but when the brain is addicted, the mind loses control.
2.    Heroin is being sold using many different names (see list of names toward end of post), so many careless teens are not aware of what drug they are trying or what their friends are asking them to try. Also, there are credible anecdotes of marijuana being tainted or laced with heroin. Heroin is actually cheaper than marijuana, so it is easier for drug dealers to give it out and use it as an adulterant in other drugs.
3.    If the teen's parents were or are drug users, then they might be more comfortable taking risks with drug use.
4.    If the parents use corporal punishment, drug use is a possible consequence. In fact, this is a significant factor for many types of anti-social behavior, with drug use being just one of them. It is probably worse for kids who are slapped in the face, hit, pushed, or punched. The effects of corporal punishment are worse for white male children.
5.    If you have chronic pain from a sports related or other injury and your doctor prescribed you Vicodin, Oxycontin, or another opiate-based pain killer, then you use the drug as prescribed.**
6.    If you are male, then you may be more likely to take risks like using drugs.
7.    If you are female, then you may develop addiction quicker because of hormonal differences compared to men.
8.    If you have life stress like divorce, death of a parent, trauma, or other stress.
9.    If you have chronic and moderate to severe Depression and Anxiety, or other mental health problems, then you might be more likely to try drugs in order to cope with bad feelings that you should probably get professional help for instead (not necessarily from a psychiatrist who may just prescribe other drugs).
10. If you spend time with other teens who use marijuana, prescription drugs, or other drugs, then you may become too comfortable with drugs or feel (admit it) pressure to use drugs to fit in when they ask (tell) you to use them.
11. If you are nice or have an inability to say "no" to your friends, then you may be more likely to give in to them when they ask you or tell you that you should use drugs.
12. If you believe the false idea that drugs are okay, even in in "moderation," then you may be more willing to try them when asked. You should know that states are making marijuana legal NOT because it's safe or okay, but in order to increase tax revenue and to spend less on law enforcement!
13. If you are in a very low or very high socio-economic class, then you may be more likely to engage in anti-social behaviors, like shoplifting, vandalism, misbehavior at school, getting tattoos, piercings, weird haircuts, dressing in black all the time, and using drugs. This may be because you're angry for being neglected due to your parents never being around, or due to them being basically replaced by a permanent nanny.
14. If you don't feel connected to people or lack family involvement in your life, then you may be more likely to use drugs to cope with feeling alienated, lonely, sad, and hopeless.
15. If your parents are permissive and have careless parental attitudes about drugs and drug use, for example, "It's just marijuana." Many heroin users start with marijuana, (even if they identify opiate-based pain killers or benzodiazepines as what they tried before heroin).
No matter all these risk factors, the most important thing to remember is that you can NEVER become addicted to drugs if you don't use them!

People who have used Vicodin, Percoset, or Oxycontin 
never imagined that they would end up like the man
in this photo who may still tell be telling 
himself that he's "in control."
Doctors need to prescribe responsibly.

Marijuana appears to cause anatomical changes in the brain of teenagers who use it just once a week or more


Stories like the one in the link below, on the Oprah Winfrey Network (OWN) about heroin addiction fail to give people a clear idea of the real risk factors for addiction.    
The teen in this video blames her addiction on something in her that needed to be "filled." Aside from being incredibly vague, misinterpreting the meaning of feelings is a common problem among teens. Teen athletes often have too many demands placed on them, too little sleep, and although they are sometimes "popular," they often don't get enough quality time with their parents, family, and friends. Also, anecdotes like the one above leave out vital information. For example, were the parents drug users, or was the teen abused or neglected, or did she have other risk factors? 

A significant risk factor is the availability of prescription opiates. These types of prescriptions are insidious because people trust their doctor. However,  your doctor hasn't conducted any of their own research on opiates for pain, so they have to trust the pharmaceutical reps who visit them and provide them with free lunches, free samples, and "speaking fees."

Doctors continue to unnecessarily prescribe
opiate-based drugs to naive moms, dads, and teens 
in the southern suburbs at alarming rates. 

These drugs sit in the homes of troubled kids who have no idea how addictive they are. Teens don't understand addiction. They think it's a one-time risk. They think that they have more control over their behavior than they really do. They don't realize that heroin is completely and 100% addictive after just one use. So if they start taking Oxycontin, it's an easy leap to heroin on the street, since the heroin is one tenth of the price and easier to get than the prescription drugs.

The producer of Oxycontin (laboratory created heroin) is Purdue Pharma. They conducted an intense marketing campaign in the late 1990s, successfully convincing thousands of primary care doctors that Oxycontin was a "wonder drug" for curing chronic pain, even though it had been around since 1917. 

They gave out free samples or "trials" of the drug for even up to a month (sound familiar?). Part of opiate drug marketing was to scare doctors into prescribing pain killers - "You could get sued or reported to the licensing board for not treating pain with the best available painkillers," was among the kinds of statements that were made to doctors. 

Many doctors were getting paid by the pharmaceutical corporations to promote their painkillers. You can see what doctors continue to get paid by visiting this website:

The indirect relationship between pharmaceutical corporations and Mexican drug gangs is disturbing. Eighty percent of heroin addicts use prescription "pain killers" like Oxycontin (oxycodone and Percocet) before they start using heroin. Oxycontin is the synthetic form of heroin that the US FDA needlessly allows to be sold to consumers. It's highly addictive, but very profitable for corporations; it is the 15th most commonly sold drug in America. Drug dealers from Mexico have been sophisticated in their ability to promote drug addiction, imitating pharmaceutical corporations (or is it the other way around?) by handing out "free samples" of drugs, lying about the type of drug by giving it a different name ("No this ain't heroin, this is cheese," (
see list of names for heroin toward end of post) is no different from when a drug company names addictive amphetamine salts with a friendlier name: Adderall, or Oxycodone: Percocet).

Preventing drug use is no easy task because many teens have several or more risk factors present in their life. But there are factors that protect teens from using drugs to begin with. Building up protective factors can help reduce the negative impact of risk factors. For example, teaching impulse control to young boys can help them take fewer risks when they are older. In addition,, replacing corporal punishment with more effective and appropriate discipline methods can reduce anti-social behaviors and increase pro-social behaviors.
The role that schools play in drug prevention should be commensurate
with the number of children they supervise and the number of hours
that they provide supervision = a very large role to play.

Many teens have the perception that more kids are using drugs than really are. Of course, teens are prone to making over-generalizations. Studies of older teens (college students) shows the same mis-perception, for example, that more students drink alcohol than not; but, the fact is that most teens and most college students do not drink alcohol, and the ones who do drink alcohol are not drinking on a regular basis. For example, 70% of teens will try alcohol before the age of 18, but less than 10% will engage in problem drinking, and about 7% of that 70% will go on to become dependent on alcohol.

Where does this mis-perception come from? To begin with, the number of teens using drugs has increased. However, the percentage of teens using drugs has actually stayed about the same since 1999, but has decreased since 1977. Another contributor is the increasing popularity of musicians who promote drug use, especially to younger teens and children: Miley Cyrus and Lady Gaga, most hip-hop artists, and nearly all "rappers" (although Lady Gaga later publicly stated that she regretted using marijuana). When teens hear music that promotes drug use and see poorly written headlines that "more Americans in favor of legalizing marijuana," they will assume that marijuana is safe and that more people are using it. Of course, marijuana is not safe, especially for teens, but it is the most commonly used drug by teens. Illegitimate organizations like NORML have been promoting marijuana since at least the 1980's, and they have spread lots of false propaganda about marijuana's safety and history.

The consequences of permissive drug attitudes is that many teens who try marijuana become addicted, go on to other drugs and end up with ruined lives; many teens will develop panic disorder, agoraphobia, or anxiety; some teens will develop ADHD and a general loss of motivation, under-perform or drop out; some teens will remain unemployed or under-employed throughout their 20s; some teens will develop schizophrenia or bipolar disorder.

Community intervention can occur at organizations like schools, Girl Scouts and Boy Scouts, churches, and park districts. An additional path to intervention involves improving DARE programs, since they have not been effective at reducing drug use, despite their popularity. Several major scientific studies funded by the US government have shown that DARE programs do educate children and teens about drugs, but this education does not prevent drug use or addiction.

However, a new program called REAL seems to work substantially better than DARE because it involves teaching kids to behave in ways that deter drug use. REAL is an acronym for: Refuse, Explain, Avoid, Leave. This reminds kids to first say, "no," second, to explain why they're saying no, "I don't want to use drugs so don't bother me with that," third, to avoid kids who are using drugs, and last, to leave situations where drugs are present. Practicing these verbal behaviors in role-plays with other kids helps kids behave that way in real life; they don't get caught off-guard, and they're prepared, well-rehearsed, and confident.

Take time to review the risk factors so that you can intervene when necessary. Keep in mind that most teens will not use drugs, but many will try them. Ask your school to implement the REAL program along with DARE. Role-playing with your own kids can help. Avoid keeping opiate-based painkillers at home, and keep them locked up if you must. Learn about the signs and symptoms of common mental health problems, like anxiety and depression, and get professional help from a licensed mental health specialist (social worker, counselor, or psychologist). Don't let permissive attitudes toward drugs get past you unchecked. Make sure your kids know that you don't approve of drug use, including marijuana.

** Opiate-based pain medications are addictive regardless of whether or not you are using them for pain management. Opiate-based pain medications (list of many below), are psychoactive. This means that the brain will adapt to them and eventually become dependent on them. 

What is addiction? Addiction is also called "dependence."

1. Addiction is when one part of your brain forces you to do whatever it can to make you get the drug.

2. Addiction is when your brain believes that you need the drug in order to live, like food, water, or air (dependence). It will push you to use the drug with increasing
intensity and frequency; this is because your brain is adapting to the drug and more is needed in order to achieve the same result as well as to satisfy the withdrawal problems. To understand addiction, see how long you can go without air before you brain makes you take a breath - that's what it means to be addicted.

3. Addiction is a process; it is like making a pile of sand. Every grain counts toward the pile, but by the time you see the problem, it’s too late – that’s why it’s best not to start using addictive drugs.

4. Most people do not want to be addicted to a drug, lose everything that was important to them, and then die from drug use. The reason people end up losing everything and dying is because the brain eventually overcomes the "will" or mind of the person, so that the person can no longer talk back to their addiction - in other words, they sadly "become one" with their addiction. 

5. Some drugs – like heroin - lead to a body and brain addiction. Others – like cocaine - cause a brain addiction with no physical addiction. Brain addiction is also called a "psychological" addiction. However, the term “psychological addiction” implies that "it's all in your head," or "in your control." But the term “brain addiction” emphasizes the lack of self-control and the anatomical and physiological changes in the brain.

 Additional readings:

Heroin has many names on the street but it's all the same thing. Some names are based on the appearance or packaging of the drug:
Big bag
Black Eagle
Black Tar
Black Pearl
Blue bag
Blue star
Brick gum
Brown Crystal
Brown Tape
Brown Sugar
Brown Rhine
Golden Girl
Nickel deck
Orange Line
Red Rock
Red Eagle
Red Chicken
Spider Blue
White Stuff
White Nurse
White Junk
White Stuff
White Nurse
White Junk
Some names are based on the origin of the drug or where it supposedly came from:
Chinese Red
Mexican Mud
Mexican Horse
Colombian White
Some names are used to describe the real or alleged affect of the drug: 
Birdie power
Blue heads
Brain Damage
Dead on Arrival
Hard Stuff
Hard Candy
Hell Dust
Holy Terror
Joy Flakes
Nice and Easy
Rush Hour
Sweet Dreams
Some names are of famous people who really or allegedly used heroin. Also, you'll notice several begin with the letter "H" which is to imply heroin:
Aunt Hazel
Al Capone
Bart Simpson
Big Harry
Dr. Feelgood
The Witch
The Beast
Other names based on the letter "H" for heroin:
Big H
Bin Laden
Capital H
Galloping Horse
Good Horse
Good H
H Caps
Finally, some names are based on deception, to try to hide the fact that they are talking about heroin earshot from other people:
Big Doodig
Bombs Away
Bull Dog
Chiba or Chiva
Dog food
Ferry Dust
Little Boy
Marge Simpson
Number 3, 4 or 8
Old Steve
Reindeer Dust
White followed by any name
Witch hazel

Mental Health Advice Disclaimer: The information included in this post and blog are for educational purposes only. It is not intended nor implied to be a substitute for professional mental health treatment or medical advice. The reader should always consult his or her mental health provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a mental health or medical condition or treatment plan. Reading the information on this website does not create a therapist-patient relationship.

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