Addiction

Ocean County Heroin Deaths

Donna Weaver wrote an article for The Press of Atlantic City entitled “Ocean County surge in heroin deaths spurs action to prevent tragedies“. She noted that Ocean County, NJ is on track to double the number of drug-related deaths on record for 2012. Already this year there are 54 deaths on record (53 at the time of that article). In just one 8 day span during April, 9 people died of heroin overdoses in Ocean County.

I've been actively involved in some of the prevention and awareness efforts in Ocean and Monmouth counties. There are many rumors of “bad” heroin coming out of Philadelphia, being sold in Atlantic City area. There are stories of “good” and “bad” heroin, with some people wishing it were simply a problem of identifying the bad stuff from the good stuff. But this issue is much more complicated than that. All heroin is “bad stuff”. No matter who you are, your heroin dealer is not the most trustworthy source of safe, reliable medications.

The “heroin problem” in Ocean and Monmouth and other counties in New Jersey is part of a broader drug problem, involving prescription drugs prescribed by doctors. I added a comment to that article:

The surge in heroin-related deaths in Ocean County is not an isolated event. The rise in prescription drug misuse and the abuse in New Jersey over the past several years is now feeding into a heroin trade, as the prescription opiates and opioids (pain killers) become harder to obtain legally.

I’m a drug detox professional with Sunrise Detox in Morris County, and I collaborate with substance abuse treatment centers throughout New Jersey. I participate in the Ocean County Center for Prevention’s Prescription Drug Misuse working group (part of the DART Coalition). Sunrise Detox is opening a drug detox facility in Toms River later this year, to meet the growing demand for prescription drug, alcohol, and increasingly heroin addiction in Ocean and Monmouth counties.

Drug users, parents, loved ones, and community leaders need to recognize the strong connection between opioid prescription drugs (painkillers like oxycodone) and heroin. In many ways, heroin is a cheaper and more accessible form of the same drug, but heroin brings in additional risks associated with illicit manufacturing, irregular purity, and unknown dosing, all of which increasingly brings tragedy to NJ families who previously thought they were “only” dealing with a pill problem.

It is essential that we raise awareness of the signs of drug addiction epidemic in New Jersey, and help people get into treatment as early as possible. Currently medical intervention is restricted to those already too far along the addiction pathway. We need changes to the laws to enable medical assessments and early treatments for those showing signs of serious dependency, before they are tragically addicted to the most dangerous street drugs like heroin.

At Sunrise Detox we treat New Jersey residents who come to us with substance abuse issues that have gone out of control. Not all of the problems are recreational drug use. Many of them started as innocent prescription drug use. Pain killer use sometimes leads to mis-use and then abuse. The powerful prescription opioid medications are addicting, and act the same way in the body as heroin does, creating a cycle of addiction that is uncontrollable. For many, the only solution is to get medical assistance (medical drug detox) as soon as possible, and then the support and counseling needed to repair damaged lives, relationships, and expectations.

 

“Prescription Drug Abuse: Society’s Newest Epidemic” Ira Levy On the Air Friday June 21 12:00 Noon

Ira Levy will be helping to educate and inform as he participates in a discussion of the prescription drug abuse epidemic

Ira Levy of Sunrise Detox in Ft. Lauderdale, Florida will join Dr. Lisa Stewart of VoiceAmerica for a radio show about the prescription drug abuse epidemic in America.

Ira Levy will be a guest on a special episode of Voice America's Health and Wellness program this Friday, June 21, at noon. Ira will provide insights into what is being called the “new epidemic” of prescription drug abuse and addiction.

Over the past several years prescription drug abuse (especially misuse of opioid pain killer medicines) has surged beyond anyone's expectations. Addiction to these drugs is one of the leading causes of preventable death in America.

Sunrise Detox treats thousands of patients every year for substance abuse, and prescription drugs compete with alcohol for the top substance abuse issue month after month. While government administrators and drug enforcement agents often spout statistics about crime and bad people doing drugs, Ira will show how regular everyday good people are suffering the consequences of addiction. Addictive substances now follow everyday events like minor injuries, doctor's orders, and everyday life challenges.

Drug addiction is no longer a problem for only “drug addicts”. Powerful opioid pain killers show up in almost everyone's medicine cabinet these days.

  • “Prescription Drug Abuse – Society’s Newest Epidemic” featuring Ira Levy of Sunrise Detox
  • Hosted by Dr. Lisa Stewart
  • June 21, 2013 at 12 noon Eastern time or via Podcast published after the show

From the studio:

Most people have had pain medication prescribed to them by a physician at some point in their lives. The recovery from knee and back surgery, for example, can be long and painful. What are the dangers of taking these prescribed pain medications? How can we avoid the damage caused by addiction to these medications that are supposed to be helping us? What can both doctors and patients do to become more aware of the dangers? Join Dr. Lisa Stewart as she talks with Ira Levy, an addictions specialist, about this national epidemic. Learn important information about the addiction cycle as it pertains to pain medication, and preventative measures that can be taken on an individual level to avoid the nightmare of physical and psychological addiction. Treatment options and specific strategies for this population of addicts will also be discussed.

 

1,000 New Jersey Residents are in Substance Abuse Treatment, Every Day

In New Jersey on any given day, nearly 1,000 people are in a clinic or hospital receiving substance abuse treatment. Most have entered a detox program (Sunrise Detox in Stirling services over 100 individuals every month) for what is typically a week to ten days of medically-supervised treatment. The initial detox is needed to stabilize them medically, so they can prepare for rehab or another treatment plan. The rest are in hospitals, also receiving detox before further treatment.

People are often surprised by the high numbers. Nearly 1,000 moms, dads, workers, professionals… one thousand New Jersey residents every day, getting treatment for a drug or alcohol addiction. Nearly half (42%) are in for heroin and prescription pain killers (heroin is an opiate, and many painkillers are synthetic opiates known as opioids, also highly addicting). Over 30% of the rest are in for alcohol abuse (dependency).

These data are from 2010. The trend lines for both alcohol and opiate abuse have increased dramatically since then, so today's numbers are likely to be even higher.

Marijuana In Recovery — Why Not?

“If caffeine and nicotine are accepted in the program, and they are both mood-altering substances, how come weed isn't? Pretty soon doctors will be able to prescribe it. They already can prescribe it in some states.”

Most drugs are useful and manageable when properly prescribed and used, but history has made it clear that such is often not the case. Doctors can prescribe Oxycontin, and you can buy beer at the gas station. However, legality has absolutely nothing to do with addiction. (And it has never been shown that doctors are the best source of ideas for staying sober, except in the very rare cases when they are specifically trained to treat addiction.)

The First Step reads, “We admitted we were powerless over (alcohol) (our addictions) – that our lives had become unmanageable.” It doesn't say and that our lives had become unmanageable. Our lives were unmanageable because we were powerless over a drug.

There are many different kinds of mood-altering substances. Some are clearly problems, some less so, some aren't problems at all, and some are problematic over such long periods that we tend to think they're not major issues. Nicotine is an excellent example. Tobacco products are the number-one preventable cause of death in the world, yet the next cigarette, cigar, chew or dip isn't likely to be the one that kills us – as far as we can know. Obviously there is, at some point, a level of exposure that makes the difference, but we can't see it and it's easy to ignore.

Denial, as they say, is not just a river in Africa. And, for the record, many treatment centers no longer permit nicotine use during treatment and strongly encourage newcomers to quit smoking. Their position is that an addiction is an addiction, and that we are either ready to be clean or we are not. While nicotine may be an “outside issue” in AA, it certainly isn't in NA, but in both cases the fellowships take the position that the drugs with the most serious immediate effects need to take priority, and experience has shown that to be the case. No fellowship that I know of, however, has ever stated that they believe nicotine to be harmless.

Caffeine, in anything like reasonable quantities (200-250 mg. a day, not five energy drinks), is unlikely to make our lives unmanageable. Small quantities, in fact, are now believed to be good for us, especially if gotten from brewed coffee.

Drugs like alcohol, opioids, barbiturates, benzodiazepines and – yes – weed, are a different story. All have been shown, in repeated scientific studies that have been published in reputable scientific journals for the review of any expert who wishes to challenge them, to have both short-term and long-term effects that can negatively affect both users and the people around them.

Marijuana works on the same pathways in the brain as other drugs of abuse. As long as those pathways are kept active, the brain cannot make the repairs that allow long-term recovery to be successful. From that standpoint alone, there is no place for marijuana in recovery.  Nicotine works in a slightly different way, and does not seem to impair recovery as much.  However, recent research has indicated that it may have more undesirable effects than has been believed.

From an overall point of view, consider that the purpose of recovery is to learn to live a healthy, productive life without the crutch of drugs – to face life on life's terms, to learn to live, love and prosper in a healthy way, and fit into the rest of society.

There are many things that can block that progress, from eating disorders to sexual obsessions, shopping, gaming and any other activity that can be used – to excess – to keep us from having to deal with life.  When we depart from our purpose of living life on life's terms, and need to use things outside ourselves to make us feel good, we are not truly in recovery.  The exception, obviously, are medications such as antidepressants, which do not affect the brain in the same way as drugs of abuse.

Sobriety is about getting sober. Either you're on board that flight, or you're not.

Complete Honesty In Step 4 Is Difficult The First Time

This is going to offend some folks, and that’s the point.

Over the years, I’ve spoken with alcoholics and other addicts who have done three and four 4th Steps, and (presumably) a 5th and 6th along with them. I’ve also talked with others who have adamantly stated that they did their 4th Step, cleaned house, and that’s it, that The Book doesn’t say anything about doing it more than once, and The Book is the way they work their program.

Without wanting to seem confrontational, that’s pure b.s. Honesty in Step 4, especially, is nearly impossible in early recovery and The Book doesn't say we shouldn't repeat it, either.  When Bill Wilson wrote the book Alcoholics Anonymous three-quarters of a century ago, there was a boatload of things that he left out simply because no one had thought of them yet. Bill followed up the Big Book with several others that expanded on his thinking, but some folks seem to believe that all essential knowledge about addiction reached its peak in 1938-39. And, let’s be honest, the basic texts of virtually all the other fellowships rely so heavily on the Big Book that they’re practically interchangeable except for the adjectives and a few nouns, so it’s easy to carry that thinking over to those fellowships as well.

Fast-forward 70-odd years, and we know incomparably more about alcoholism and other addictions than Bill ever thought of. For example, there’s a superb article in last week’s edition of The Fix, CBT and the 12 Steps Have a Lot in Common, that compares the Twelve Steps to Cognitive-Behavioral Therapy (CBT).  It establishes in one more way the validity of the Steps as they compare to modern knowledge and theory, and also confirms (once again) Bill Wilson's brilliance.

I recommend the article, but it’s not the point of this one. The real point is that in the first stages of sobriety we aren't able to face and/or talk about all of our issues. Our fragile self-image, just beginning to emerge from the shame of our primary addiction(s), can’t take any more battering, and we’re extremely likely to sweep a lot of stuff back under the pantry door instead of finishing the job of cleaning the kitchen. We aren't able to be completely honest with ourselves, let alone with someone we've known for only a few months, no matter how sincerely we try.

So how can we trust a process we went through in the first few months of our recovery, and truly believe that we've done a good job with that initial inventory? The answer is our old demon, denial. We want to believe that we’re finally okay, and we are afraid to face the facts that mean we are not, that ignore issues that we've failed to address, and that are still screwing up our lives.

My drug of choice was alcohol (not that I didn’t sample many others over 20+ years of active substance addiction) and I was also addicted to some prescription drugs. Fortunately, circumstances in my life precluded easy access to illegal drugs, or undoubtedly I would have been hooked on some of those too. In any case, booze brought me to my knees, and that and the surrounding issues are what I dealt with during my step work. There was enough chaos connected with alcohol that it was easy to ignore some other things that were, in their way, creating dysfunction just as powerful if much less obvious. I’m still working on some of those, many years after that initial step work.

Nicotine, shopping, sex, codependency, gambling, energy drinks, eating disorders of any kind, hoarding, collecting carried to ridiculous extremes, video games (again, to excess), over-exercising — anything that will allow us to distract ourselves and that will give us that brief rush of feel-good brain chemicals — are disorders of our brains’ reward response. They make us feel better, while allowing us to ignore for a bit the normal problems of life that we haven’t learned to face. The trouble is, the good feelings don’t last and we’re so confused we don’t know or remember how to look for them in places less harmful.  Our unhealthy attempts to avoid the normal unpleasantries and pain of life simply increase, along with our dysfunction, until we are in some way forced to contemplate change.

So I put it to you this way, my fellow addicts: If we think we have nothing to deal with but our substance abuse, the chances are we’re fooling ourselves. Until we become willing to revisit Steps 4, 5 and 6, whether in the rooms or with a good therapist who understands addiction, we may be hopping through life on one lame leg, thinking we're just fine. And that kind of movement through life is not only uncomfortable, it also makes us far more likely to fall under a bus.

Keep Celebrity Worship Out of AA (And the other groups)

I have been sighted coming and going from thousands of AA meetings. The difference…is that nobody knows who I am and nobody cares. This has been very much to my advantage.

I”ve written about this before, and will again.  No one is more aware of this problem than people who work in treatment centers — except, of course, for the victims of the publicity themselves.  We see well-known faces come and go quite often. When we see them again, we have to wonder how much of their relapse was due to being hounded by people who can't mind their own business. Personally, I wonder just how much effect the lack of consideration from other recovering people might have. Do we give celebreties the same shot at sobriety in the rooms as we would anyone else, and how do we think we'd feel if the shoe was on the other foot?

A good article that should make us all think.

Read more: Keep Celebrity Worship Out of AA

Sugar Addiction In Recovery

After we get clean and sober, many of us discover that we are still addicted to sugar: in our coffee, in our snacks, in our desserts and elsewhere. Sugar addiction is common, in and out of recovery. Our bodies have a natural attraction to sweet things. We need sugars and other carbohydrates in our diets, and we are pre-programmed to like them because they are good for us (in the right quantities). They are easily burned by the body for energy. In fact, every cell in our bodies are fueled by glucose, a form of sugar.

READ THE LABEL! This one's not bad

READ THE LABEL!
This one's not bad

The problem with our modern lifestyle, however, is too much of one good thing and not enough of another. We get far too much of the wrong kind of sugar in our diet, and we don’t exercise enough to burn it up. Our metabolism, however, makes adjustments in order to insure that we have energy when we need it, so unburned sugars are converted to fat, which is sort of our bodies’ gas tank. Our lack of exercise insures that this fuel supply, too, remains mostly untouched, and so we gain weight.

As we put on weight, through too many calories and too little exercise, our bodies fall victim to a variety of health issues connected with excessive weight, including heart and arterial deterioration, pre-diabetes and diabetes, and several other metabolic diseases.

Our taste for sugar and the problems associated with it — along with poor eating habits in general — make maintaining a healthy lifestyle difficult. Food manufacturers and most cooks know that mediocre food can be made more palatable by adding sugars, and they do so in abundance. The great majority of the calories we get from sugars in our diet come from foods that, if questioned, we wouldn’t even identify as sweets! That’s because we become accustomed to sweet flavors, and don’t even notice them unless they are missing. Careful perusal of the labels on packaged foods will amaze!

Those of us addicted to sugar didn’t ask for it, any more than we asked to become addicted to alcoholor other drugs. For many of us, given too many sweets as kids, it became part of our lives when our brains were still developing. So if we have a “problem” with sweets, the first thing is to forgive ourselves and not beat ourselves up. Sugar is highly addictive to some of us, especially recovering alcoholics, and substitute addictions are common. Combined with any previous histories with sweets, it would be fairly amazing if we weren’t having some problems. Remember that you are on your side, you’re not the enemy!

For those with sugar addiction issues, we recommend finding a meeting of Food Addicts Anonymous or Overeaters Anonymous. FAA tends to fit best for sugar addicts, as their approach to controlling intake is more specific than that of OA. Overeaters Anonymous is a great program. Don’t get the idea that we’re saying one is better than the other. It’s just that FAA’s focus fits best when we are considering foods as an addiction.

Second, we try immediately to address substituting something else for the sugar when we have cravings for alcohol, other drugs — or sugar. Peanut butter and whole grain crackers are good, as they have protein and fats that help assuage hunger and that will not cause blood sugar swings that affect appetite.

We need to watch how we eat in general, and avoid getting hungry. We eat small, well-balanced meals and between-meal snacks of whole grain breads, proteins, beans, nuts,

Good Sugar!

Good Sugar!

bananas and so forth. If we balance things properly, we can probably get by eating less than we are now, because we’ll avoid getting really famished, which brings on the urge to binge.

We need to avoid white flour whenever possible. There are great similarities between it and sugar as far as the body is concerned, and it will only prolong and increase cravings. We try to stick with fruits and high-protein snacks, and we check ingredients carefully for their sugar content.

It is most important that we see a doctor for a checkup and lab work. There are metabolic issues that can affect cravings for both sugar and alcohol. If there, they need to be addressed.

Baaaaad Sugar! BAD!

Baaaaad Sugar! BAD!

We also avoid dieting — like the plague. Weight control is about developing new eating habits for a lifetime. Diets are reverse binges. They teach us nothing about proper eating, and do nothing to develop the lifetime habits that are necessary if we are to maintain good nutrition and healthy weight. Because they are regimens of deprivation, it is extremely likely (if not inevitable) that we will return to our old eating habits, gain the weight back, and enter a dieting and eating cycle that can only defeat us and cause us to decide that our efforts are useless.

As with any other addiction, we are likely to fall off the wagon and into the sugar bowl occasionally in the beginning. We are going to be learning how to manage our eating in a whole new way. Relapse is a symptom of addiction, and it’s going to happen in this case because it’s impossible to eat perfectly regardless of how hard we try. If we “slip,” we can be thankful that it isn’t as deadly as drinking or drugging would be, and decide that we will do better. We don’t think of ourselves as weak, or strong. It’s about powerlessness. It’s also about reality. We can’t expect to be perfect. If we make mistakes, we immediately return to our program. We can’t abstain from food, so if we slip, we just decide to do better. We try to be good to ourselves.

Buddhists talk about “skillful” and “unskillful” behavior. In recovery, we want to become more skillful in our ways of living. When we’re learning, we’re apt to make occasional mistakes. That’s human, not weakness. Keep moving toward skillful. Forget perfection — that way lies more addiction.