Detox

Fentanyl Contaminated Heroin Alerts

Someone is manufacturing Fentanyl, a very powerful opioid chemical, and selling it as heroin. Over 100 times as powerful as morphine, a dose of Fentanyl can kill you. Hundreds have died already, since last summer.

The Fentanyl-contaminated heroin is believed to be the cause of dozens of deaths this past month in Maryland, Pennsylvania, New Jersey, New York, and Long Island.

Drugs collected at scenes of overdose deaths are labeled in different ways. There are reports of wax folds stamped “bud Light”, “Theraflu”, “24K”, “Bud Ice”, “Tax Time”, “ObamaCare”, and others. Changing a label is as easy as rubber-stamping a wax fold. You should not expect to recognize the poisonous heroin by the label.

Investigators working on 22 deaths in Pennsylvania and 5 in Nassau County suspect a deadly mix previously known as “China White” may be the cause. Investigators know that the manufacture and distribution is intentional. Fentanyl is not distributed as a powder legally. Someone is purposefully and illegally manufacturing and distributing the deadly combination.

If you are addicted to heroin and cannot stop yourself from taking life-threatening risks associated with street heroin, especially in times of tainted or poisoned batches like those circulated widely right now, please call for help.

Everyone must choose to get help with addiction, and this is a perfect time to enter medical detox for opiate addiction. Sunrise Detox offers comfortable, medical detox and preparation for rehab in Stirling New Jersey (in Morris County, convenient to New York) and starting this month, in Toms River (along the Jersey Shore, convenient to Philadelphia and most of New Jersey). Start with a phone call to find out what options are available to you: 888-443-3869

Alert from long Island about Fentanyl-contaminated heroin killing people.

Alert from long Island about Fentanyl-contaminated heroin killing people.

From Nassau County on Long Island:

OFFICE OF THE MEDICAL EXAMINER
COUNTY OF NASSAU
CONTAMINATED HEROIN ALERT

The Nassau County Medical Examiner’s Office is investigating several deaths initially assumed to be linked to the abuse of heroin, but in fact were found to have involved the potent narcotic fentanyl. Evidence associated with two of these cases has been analyzed by the Forensic Toxicology Laboratory and has been determined to contain fentanyl in combination with the banned antipyretic metamizole. Specifically these glassine packets are stamped as “24K” in red ink.

Fentanyl is a synthetic narcotic analgesic of extremely high potency. Fentanyl is approximately 100 times more potent than morphine, the active ingredient of heroin. Clinically fentanyl is used for the treatment of severe pain or for the induction of anesthesia. Severe respiratory depression may occur with the use of fentanyl. Metamizole is an analgesic and antipyretic that is similar in use to ibuprofen. Metamizole has been banned for use in the US since 1977 due to the potential for the development of agranulocytosis.

The Nassau County Medical Examiner is reporting that glassine packets marked as “24K” that is presumably being distributed as heroin, in fact contains the extremely potent narcotic analgesic fentanyl. The Nassau County Medical Examiner is disseminating this information for situational awareness purposes only.

Laced Heroin on Long Island: http://www.newsday.com/long-island/nassau/laced-heroin-linked-to-5-overdose-deaths-in-nassau-1.6920119

Four arrested bringing heroin from Newark to Ocean County http://www.nj.com/essex/index.ssf/2014/01/four_arrested_in_plot_to_traffick_drugs_from_newark_to_ocean_county.html#incart_river

Fentanyl-laced heroin kills in PA http://www.cnn.com/2014/01/30/justice/pennsylvania-heroin-deaths/ and http://www.cnn.com/2014/01/27/health/pennsylvania-drug-deaths/index.html

Maryland deaths from Fentanyl-laced heroin http://www.afro.com/sections/news/baltimore/story.htm?storyid=81334

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.

 

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.

Caffeine In Early Recovery

coffeeOccasionally someone asks if they should give up coffee when they get clean and sober, since caffeine is “just another drug.”

Although some treatment centers recommend going caffeine-free, and some replace “regular” with decaffeinated, it’s beginning to seem more and more like that isn’t necessarily a good idea. If something isn’t making our lives unmanageable, it can usually wait until we’ve been in recovery for awhile.

In any case, there is a broad range of beneficial effects from consumption of caffeine, including increases in the levels of neurotransmitters such as norepinephrine, acetylcholine, dopamine, serotonin, epinephrine and glutamate. Many of the symptoms of withdrawal and post-acute withdrawal are associated with low levels of these chemicals, so there is good reason to think that the benefits of drinking coffee in early recovery may offset the disadvantages, which include shakiness and insomnia, among others.

Recent research has also shown that the antioxidants in coffee, along with the antioxidant effects of caffeine itself, benefit long-term coffee-drinkers by destroying free radicals in the body that are associated with heart disease and Alzheimer's.

Please keep in mind that we are referring to reasonable levels of consumption. More than 300 mg. of caffeine (one Starbucks Pike Place brewed) within three or four hours can cause anxiety, and even one cup of brewed coffee can cause elevated blood pressure in those who aren't used to drinking caffeinated beverages. As is true of most things not used in moderation, it is pretty obvious that sucking down too much joe won’t do us a lot of good, but a couple of cups of fresh-brewed coffee won’t be likely to do most of us any damage, either.

Clients’ Questions About Recovery

From time to time we post a few of our clients’ more interesting questions about recovery.

Why do I have to continue this detox?  I am ready to go home.

We are glad that you are feeling better, but that is because you are on powerful medication.  You need further monitoring, until you are off the meds and able to manage without them.

As far as going home is concerned, it is our hope that you will decide to go to treatment instead.  It has been our experience that clients who go back to the old people, places and things don’t do well unless they have a firm foundation of knowledge, some recovery, and are able to take full advantage of available supports. Familiar situations and faces can set off powerful cravings in people who are unprepared.

How do I deal with my baby and wife leaving me because of my addiction?

As we gain sobriety and work on a program of recovery, we learn to deal with problems like this one, and many others as well.

There are only two possible ways of handling this matter.  Either you go back out and use again, continuing the old ways of solving problems that didn’t work so well, or you get clean and sober.

Option number one will certainly be easier, but will accomplish nothing except your eventual death.  It certainly will not help you regain your family and self respect, and will simply add more pain to everyone’s lives.

On the other hand, if you get humble, follow suggestions, and do the things that you need to do for yourself, you have a chance at sobriety.  If you are able to remain sober, you will at some point at least be able to have a relationship with your child, and might actually be able to get the family back together.  Seems to us that the choice is pretty clear.

I would like to know how I get a sponsor.

We find sponsors by going to a lot of meetings, listening carefully to a lot of people, and finding out who is happy, productive, and working a good program of recovery.  Some folks choose “cool” sponsors.  The smart ones look beyond the surface and try to figure out if that person has what it takes to weather the long haul, and whether they can pass it on to others.

Our blogger Bill W. has two full posts devoted to choosing a sponsor, here and here.

How long should you be clean before you can actually go around social events with alcohol?

It seems to us that the issue isn’t so much how long as it is how well prepared we are.  We need to have enough sobriety that thoughts of drinking have pretty much disappeared, along with the nostalgia when we see a beer commercial or drive past a bar.  Beyond that, we need to consider the situation: will it be a gathering when we would have participated heartily and gotten blasted — perhaps a family party or shooting pool with our old buddies — or will it be a situation with less powerful triggers.

Finally, we need to be prepared, and we need to take someone sober with us.  Again, Bill W. has a post here that covers the matter.  Check out his archives for more answers to questions about recovery.

Have a great weekend!

Things Clients Say In Detox — Denial On The Hoof

We thought we would list some of the things that we hear clients say.  You can substitute any drug for any other drug in any statement or comment.  Denial ain’t just a river in Africa, remember?

I don't even know why I'm here.  I'm not an addict.

You're here for some reason.  You didn't just walk in to see what it was like.  Some major problem in your life got you through the doors.  You may as well hang out for a while and see if we can help you with the problem — whatever it is.

Marijuana isn’t addictive, because there’s no withdrawal.

It is true that years ago there was no noticeable withdrawal from marijuana use, but in those days cannabis had only about 1/10th the active ingredients that today’s hybridized varieties have.  Even then, chronic users often had trouble quitting.

Today, there is acute withdrawal that involves irritability, sleeping difficulties, mood swings, loss of appetite and other issues.  We also know that there is a post-acute withdrawal syndrome (PAWS) that  includes depression and cognitive disorders, and that can last for many months.

I'll stop drinking, but I'm still going to smoke a blunt now and then.

Recovery requires abstaining from all mood-altering drugs.  We cannot pick and choose.  All drugs work on our reward system.  Addiction occurs when the reward system loses the ability to make us feel good without the extra stimulation of drugs.  If we continue to stimulate the reward system so that it cannot return to normal, then we will continue to have cravings.

I only drink wine or beer.

All ethyl alcohol (ethanol) affects the human body the same way, and one six-ounce glass of wine, one 12 ounce beer, and one shot of 80 proof liquor all contain roughly the same amount of alcohol.

I only drink on weekends.

It is not important when we drink.  What matters is how much, and why.  If we are waking up with a hangover, which is really alcohol withdrawal, we are drinking enough to cause changes in our brains, even if we only do it two or three days out of the week.  And are we really remaining totally abstinent the rest of the week, or are we having a couple to “relax” each evening?  If that is the case, why do we need alcohol to relax?

I only use (pick a drug) occasionally, so I won’t become addicted.

There are millions of addicts who have found out the hard way that, despite their denial, the occasions tend to get closer and closer together until they have merged, so that we need the drug to be comfortable.  When we are more comfortable under the influence of drugs than we are without them, we are well on the way to addiction.

Alcohol doesn’t bother me; I can drink all my buddies under the table.

Increasing tolerance for alcohol or any other drug is the first sign of addiction.  If we can drink, snort, swallow or shoot more than we used to be able to handle, we’re in trouble.

“I can take it or leave it.”  (I just choose to take it.)

Put it down and don’t touch it for two weeks.  Let us know how that works for you.  Try it again.  Learn anything about denial?

I only have a couple of drinks at home, just to relax.

There is nothing wrong with that, unless we cannot relax without the drinks.  In that case we need to do some hard thinking.  We also we need to look at what we consider a “couple of drinks.”  A standard drink is one shot of 80-proof liquor, one six-ounce glass of wine, or one 12-ounce beer.  “Topping off” is cheating.  So is filling an iced-tea glass with ice and booze and calling it “a drink.”

My whole family drinks like me.

Alcoholism has a strong hereditary component, as do some other addictions.  Need we go on?

The bottom line is this: If drugs, including alcohol, are causing problems in our lives, whether they be hangovers, missing work, “discussions” with our spouses or partners, DUI’s, or any other issues, then they are a problem.  There are no two ways about it.  Either they cause problems or they don’t.  Then the big question becomes why we are continuing to do something that continues to cause us problems.

Now that is a good question — a very good question.

Could The Sandy Hook Tragedy Have Been Avoided?

We at Sunrise wish to express our heartfelt sorrow and sympathy to the families and friends of the victims, and to the community of Newtown. Tragedies like this defy expression, and only time can lessen the pain. Along with the rest of the world, we try our best to convey our shock, sadness, prayers and good wishes to all.

There are lessons to be learned from tragedy.  We do not know if Adam Lanza's path could have been changed at some point by the observation of an alert practitioner, or if the freedoms inherent in our way of life would have permitted any sort of intervention, but it is possible.  We do not know if he was a substance abuser or addict.  Nonetheless, these events should stand as a reminder to all addiction professionals that we need to remain alert for the co-occurring conditions that so frequently accompany our specialty.