The most recent national survey on drug use and health indi­cates that the number of current heroin users (those who have used within the past 30 days) increased from approximately 136,000 in 2005 to 338,000 in 2006.

The survey also reported that in 2006, approximately 2.5 million people (ages 12 and older) first used pre­scribed medication for non-medical reasons. Of these, 84% used pain relievers. Also, according to the study, first-time users of pain killers increased from 573,000 in 1990 to 2.5 million in 2000.

The annual costs for this major health concern in the US alone are in the billions of dollars. Contributing to these staggering costs for this medico-social illness are lost productivity, familial disrup­tions and crime. This ongoing pub­lic health concern includes several forms of opiate. Heroin and opioid prescription pain killers are the two most commonly abused opium-derived substances.

Addicts vs. Dependents

Both of these categories of opi­ates play the most rapidly growing drug dependent portion of US soci­ety. Heroin use has been increasing at alarming rates. Addicts generally pertain to the stereotypical individ­ual who is ultimately stigmatized as using the drug of their own volition due to some form of weakness or defect. Dependents by contrast, are those individuals who generally find themselves using opiate-based medi­cations due to: chronic pain from surgery, traumatic accidents with chronic injuries, cancer, sickle cell anemia, intense migraines and other medical/surgical conditions needing regular analgesia (pain relief).

Such dependent patients, who can and do occur from all areas of the population, find themselves in the same situation as the drug addicted patient. Substance abuse experts consider prescription pain­killers to be the new gateway drug. Even the best intentions can lead people down the life-threatening path of opiate dependency.

Prescription drug addiction knows no bounds. The addictive power of these prescription pain meds are so powerful that it impacts teenagers and the elderly, middle class families as well as executives, professionals and celebrities. While some people will continue abus­ing opiate pain relievers long-term, others will graduate to using other drugs from the opiate family such as heroin or morphine.

An estimated ten percent of pre­scribing physicians themselves are dependent on the very drugs that they prescribe. Opiate dependency is a physical illness involving a cen­tral nervous system disorder caused by long term opiate intake.

For more than a century or more, this dependency was simply ignored medically, politically and socially. The judicial and penal system kept tabs on the criminal aspects and even that left much to be questioned. Resultantly, a helpless-hopeless attitude developed by the powers who could intervene and much that could have been done was simply not done. The con­sequences of this and other systemic apathy had far reaching negatives.

As a whole, dependant patients were relegated to “drug-addict-crim­inal-outcast-defective loser status”. This meant that “leper-labeling” with convenient dismissal readily occurred and still does. The patients themselves gave up and assumed the roles thereof and so did all elements of society-social, medical and politi­cal, leaving decades and generations to ongoing strife and predictable disasters.

What Are Opioids?

There are literally dozens of either naturally occurring or syn­thesized opiates or opioids available. These substances are both naturally occurring in nature either in normal brains as endorphins or enkeplalins which are nerve cell chemicals to suppress pain, diminish anxiety and serve to modulate physical stress and also as harvested from opium poppies as chemicals to soothe many ills. The earliest recorded use of the opium poppy for these areas was about 6,000 years ago. Alcohol is the only substance that outranks opiates as man’s oldest and most common persistent drug of choice for abuse.

Some common synthesized opiates are:

o Meperdine (Dermerol)

o Propoxyphene (Darvon)

o Hydrecodone (Vicodin)

o Hydromorphone (Dilaudid)

o Oxycodone (Oxycontin)

o Percodan) and

o Diacetylmorphine (Heroin).

The more common naturally occurring opiates are:

o Morphine and

o Codeine derivatives of the poppy plant.

The German pharmaceutical company Bayer first developed the new derivative of morphine in 1898 (morphine had been developed 93 years earlier also in Germany from opium as an infectable way to use opium in order to bypass the uncomfortable gastrointestinal side effects of the ingested compound), and introduced Heroin as the brand name of this new drug.

Patients with opiate dependence are usually aware that their use of these controlled and dangerous sub­stances are very likely to cause toler­ance (more and more of the same compound will be needed for the same effects), withdrawal (abrupt cessation will yield a physically uncomfortable, although seldomly a fatal reaction lasting upwards of one week or more) and most impor­tantly, they’re armed with the prior awareness that the ongoing use/ abuse of these substances will very likely do them serious and often permanent (as in fatal) harm and yet they continue, insistently, to abuse them anyway. These are the three cornerstones of any addiction, but even more glaringly with opi­ate dependency. Intravenous abuse in particular may lead to infections with potentially fatal results and overdose that is unintentional, is all too common and may also be potentially fatal. Overall health is routinely ignored and criminal activity is commonly a means to obtain the drug as well as to avoid withdrawal and its consequences.

Treatment of opiate addiction/dependency is a challenge. Denial, poor insight, refusal to recog­nize lost realities through minimization, lying, cheating and stealing all are part of this.

Friends, family and coworkers will often attempt to shore up these serious gaps. The addiction is a chronic disease that defies a sustain­able, affordable cure. Recovery- as starkly contrasted from recovering-if and when it occurs, is always frag­ile and precarious. Lapse or relapse is a constant predator.

Individuals who abuse opi­ates, including prescription drugs will almost invariably develop a dependency or even an addiction. Unfortunately, this will lead to nerve damage in the brain, a severely altered sensorium and cognition, all of which may proceed to more extensive and permanent negative results. Recognizing the signs of opiate addiction and dependency and understanding these deleterious consequences will hopefully provide hope and motivation to patients and families to seek effective treatments before the cascading negative seque­lae of loss, pain, and even death, grabs hold for good.

The fact that opiate addiction/ dependency can now be effectiv-ely treated with medications like Suboxone (buprenorphine), accom­panied by appropriate psychothera­pies, is hope for restoring patients to their most optimal level of function and health.

Please contact our office directly at (609) 484-0770 to schedule an evaluation for our comprehensive program utiliz­ing both modalities simultane­ously and confidentially. Being alone in all this is scary and unnecessary.

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