Based on current treatment admission statistics and recorded deaths, the state of Alabama leads the nation in both prescription drug and heroin abuse. This is a difficult place to begin this article; however, by identifying the state’s largest narcotics abuse issues in the beginning, we will from here explore the reasons thereof and the methods used by cities such as Birmingham to curb this great scourge.
Birmingham is the county seat of Jefferson County and Alabama’s most populated city. Its current population is estimated at close to 215,000, which represents nearly 25% of the state’s residents.
The city is historic primarily due to its role in the civil rights movement of the 1950s and 60s. The Ku Klux Klan was omnipresent in that era and, as many of its members worked in the mining industry, access to dynamite was plentiful. Angered with various race-related social progressions, the KKK bombed the houses of numerous black families in the area. Upon the arrival of Dr. Martin Luther King, non-violent protests were common, but the protestors were fought with tear gas, attack dogs, arrests and general police repression. In September of 1963, Birmingham’s 16th Street Baptist Church was bombed by the Klan. National outrage was substantial, which led to desegregation laws and the passage of the Civil Rights Act of 1964.
In terms of religion, Birmingham maintains the second highest percentage of Christians of all United States cities, and the largest number of Protestants.
Birmingham ranked #20 in 2017 for all U.S. cities as it regards country-wide crime. From 2017 to the present, the city’s crime rate is 85 per one thousand residents. Many of the crimes are drug-related. Poverty is a near-equal factor, as 31% of all Birmingham residents live below the poverty line. Currently, the city ranks as the third most violent city in the U.S.
Steel production and processing remain Birmingham’s primary industry. The city is a hub for the arts, as museums and arts-related cultural centers are common. Public transportation by both rail and bus are readily-accessible, and public highways plentiful.
Birmingham, Alabama, as with most of the state proper, is facing an outlook where heroin use is in the midst of a great epidemic. Prescription opioid use and abuse is the other ongoing issue, primarily with the city’s older population, and like heroin well above the national average in terms of treatment center admissions, and sole-cause deaths.
Signs are that opioid abuse will grow year-to-year for the immediate future, unfortunately leading the way for national trends.
Jefferson County is a HITDA region and as such a particularly strong drug trafficking stronghold, especially when it comes to the aforementioned heroin and opiates. The county is also very strong in alcohol and pot use. Violent crime is frequently drug-related, as the beginnings of statewide turf wars have been seeded in efforts to attain a larger share of the county’s growing and evolving drug culture.
The incontrovertible truth of the addict is such that most any drug can be had for a price. Whatever one needs, or craves … or wants, an addict will find. As mentioned earlier, help is a phone call or treatment center visit away. Always do your own research to find what is best for you, and use the above resource listings as a base. Many will work with you in terms of financial assistance. Do your diligence first, and then pick up the phone.
As ever, true recovery begins with the acknowledgment that you have an issue, and then seeking help for that issue. If you do not find the answers you are looking for, please feel free to drop us a line and tell us how we can help.
Drug Trends within Birmingham
The historic nature and natural beauty of Birmingham, however, are undercut with regular headlines such as the following: 2014 Heroin Admissions Up 140% in Jefferson County.
Indeed, within that calendar year, 123 deaths were confirmed by county authorities as directly related to heroin overdoses with the drug as the main cause of the overdose, as opposed to part of a larger cocktail. By the time of the writing of this newspaper article, at least 18 more heroin-related deaths were reported to the authorities, though these incidents were awaiting final word on toxicology.
Heroin is widely considered a “euphoric drug” in Birmingham that is seductive most especially among young people (20s-40s) for reasons associated with “euphoria” and “partying.” As quoted by U.S. Attorney Joyce Vance, “When Birmingham police go out into these areas where there is high violent crime, they’re falling all over heroin.” The article goes on to state that the blame for the abuse lies in the “availability, purity and the pursuit of a higher high.” 88% of 2014 heroin deaths in Jefferson County were of white men and women with an average age of 36. In 2017, both figures increased by close to 10%.
Law enforcement and educational centers have mobilized to work together and implement programs intended to fight the ongoing abuse. For older men and women, prescription opioids remain Birmingham’s largest issue. The cycle is near-unfashionable, as more older men and women die on an average every year from prescription opiates, than the young people losing their lives to heroin. Further, many of the young people steal their parents’ opiates to sell or trade in support of their own heroin habits.
Jefferson County has been recognized by the U.S. Department of Justice as a High Intensity Drug Trafficking Area (HIDTA), and as with most of the rest of the HIDTA regions in the U.S., the problems are parallel. DTOs (Drug Trafficking Organizations) utilize every form of available transportation in the county to deal in their wares.
Prior to the heroin and opioid epidemics, Jefferson County confronted turf wars related to crack cocaine a decade earlier. While cocaine is still somewhat prevalent in the county, the trading in and usage of crack has largely dissipated in favor of heroin and opiates. The area’s greatest present concern is with the expansion of the above markets, which brings with it rival distribution groups and further violence for control of the volatile marketplace.
Otherwise, pot remains popular in Birmingham, and on par with treatment admissions for alcohol abuse. Pot is used more frequently with young people, while alcohol is consistent among users regardless of age.
Birmingham in the News
To further illustrate the issue of Birmingham’s widespread drug culture, the following are other authentic headlines – from both newspapers and the internet – from the calendar year 2017:
1. 1.3 Kilos of Heroin, 120 Pounds of Marijuana Seized in Drug Raid;
2. $415,000 Worth of Cocaine, Heroin, Opioids Seized from Home of Trussville Man;
3. Eight Arrested in Birmingham Drug Bust; Six Arrested in Drug Raid of Birmingham Public Housing Neighborhood;
4. Alabama Man Indicted in $30 Million Drug Bust; and
5. Birmingham man charged with drug trafficking after authorities find 44 grams of heroin.
Sadly, there are hundreds more.
For those of you who have come to The Recover with the intent of trying to find some help for your own drug issue, or you are interested in helping a loved one, you have certainly come to the right place. The following will list some tried and true resources that will likely be of benefit.
Process of Obtaining Treatment
To determine the extent and nature of one’s addiction, pre-intake questions may include the following:
- “How long have you been using?”
- “Do you believe you have a problem?“
- “Do you think others who know you believe you have a substance-related problem?”
- “Have others confronted you with questions related to substance abuse?”
- “Do you ever use alone?”
- “Have you ever substituted one drug for another, thinking one particular drug was the problem?”
- “Does the thought of running out of drugs terrify you?”
- “Have you ever been in a jail, a hospital, or a drug rehabilitation center because of your using?”
You can find pre-intake sample applications online. In this case, as with any other self-diagnostic tool, the questions as asked are exploratory only. You must speak to a trained and licensed professional for any true diagnosis. Still, such online tools such as a pre-intake questionnaire can be extremely useful. If you can honestly answer those questions, you may be validated, or you may dislike your responses. If you were drawn to the tool, likely both will apply. Regardless, consider your results, and then take necessary action.
There are pros and cons with online resources such as these, particularly when it comes to completely basing your treatment decisions on your own responses. That would be a negative, as remember, such questions are guidelines only without a trained professional to analyze your answers. Regardless of whether such questions are based on true-life examples of treatment center queries (they usually are), you may not be the best arbiter of your responses. Most especially if you are under the influence of any drug, or alcoholic drink. On the positive side, if you can be truthful with your answers, such online questions will certainly provide a glimpse into your condition, and the need for help.
During the intake application process, you will be required to list your prescription medications and days and times taken (if “none,” you check “none”), an authorization of medical care, a list of allergies or other medical issues, and a waiver of responsibility. Some applications ask more. A physician or treatment center representative will then review your application for the proper steps, and treatment.
One of the greatest benefits of a well-thought treatment plan is that every day will bring a new step in your treatment, and each step will lead to another. During this process, you may well learn of the stringency and urgency of structure, especially if your problem is too large for outpatient therapy, and in-patient will be your next step. The structure you learn and the discipline you will attain will help you immensely during one of the advanced stages of your formal treatment process: the sober house.
Conversely, one of the more difficult aspects of the intake process is one of trust. We all know that a user does not always trust easily. If you fall into this category, we need to reinforce to you that your treatment team is there for you. They will spend the time working with you and for you. In as much as you can, speak to them openly. If you believe a given treatment as administered by a professional is disagreeable to you, you need to make that known to them.
Intake is but a step in a larger process.
There are as many stages of treatment as there are stages of actual drug abuse. Among the first and most important stage in your treatment plan is the decision to enter into a detoxification program.
Detox addresses the physical hold of an addiction. The length of a detox program will vary based on several factors, including the nature of the addiction, and of the addict’s personality. Regarding the former, chemical dependency frequently occurs that must be medically handled, as your brain has become fully dependent on further use of the substance in order to function. This is a medical issue that will frequently require medication to handle.
During the early phases on detoxification, withdrawal will occur which can be a painful process. Your system will be cleaned of the drug, and your brain will learn to operate as it once did. Certain withdrawal symptoms can be life-threatening, which punctuates the importance of full and systemic treatment.
Factors that can influence the longevity of the detox aspect of your treatment program include:
What is worse for you, the withdrawal process or the grip of the drug itself?
- Multi-drug abuse;
- Pre-existing medical or mental health conditions;
- Your level of dependence;
- Strength of the drug from which you are withdrawing;
- Intent following the withdrawal process;
- Previous trauma;
- Environment (both that of your home life and the environment of your support system).
The concept and practice of detox is typically broken down into three distinct phases: Evaluation, Stabilization, and Transition to Inpatient Drug Rehabilitation.
Inpatient Treatment Programs
Post-withdrawal, the process of your ongoing recovery can be either inpatient, or outpatient. Inpatient treatment is appropriate for more severe cases, and the generally more flexible outpatient treatment is geared towards those with a more moderate addiction (though addiction is still addiction) and a stronger support system in their home environment.
Inpatient treatment can either be a PHP (a partial hospitalization providing a highly-structured environment, with typically active treatment of 30 hours per week), the less-intensive IOP (intensive outpatient treatment plan, which requires up to three hours daily over 3-5 days, for a total of nine hours weekly; therapy is usually included, but the patient can live either at their own home or a halfway house during the process), or an RTC (residential).
Most inpatient therapies, regardless of option will last 5-10 days. They can last longer based on the severity of the problem, and the patient’s physical and mental fitness.
Among its services, a PHP will most frequently incorporate intensive one on one therapy in its treatment program. The reason for this is most PHP admissions are due to disturbances in behavior from the drug being abused, or for those who experience otherwise increased symptomatology. In a PHP, the patient is often isolated and of no risk to other patients.
PHPs and RTCs are highly-structured treatment options. PHPs are the most structured options of all. If you have little structure in your home environment, both of these invaluable choices will likely take some time getting used to. That said, the importance to your overall treatment plan cannot be understated.
Note: Substance use disorder treatment is listed as one of the 10 Most Essential Health Benefits of the Affordable Care Act, meaning that your care is covered if you have health insurance. If you do not have insurance, many treatment centers offer financial aid.
Always ask when you speak to a treatment advisor if this is a concern, as inpatient treatment is more expensive than outpatient.
Outpatient Treatment Resources
Outpatient treatment is often preferred when one has substantial duties in their outside environment, such as school or family. In fact, family and friend group therapy is often included in this option, which is quite flexible in its scheduling. Outpatient treatment has proven to be very effective for those with underlying causes for their addiction, such as eating disorders, to grasp the root of their substance-related issues in a more relaxed setting among familiar support systems.
As an outpatient, you are not enmeshed in as structured an environment, you live at home and you are not under constant supervision.
However, outpatient treatment is no less important or helpful than inpatient treatment. Though the scheduling of your appointments may be flexible, you still need to commit to the time. If you miss one appointment, you will likely miss another.
Ask yourself if you are responsible enough for an outpatient program. If you are, and you maintain your treatment, the rewards can be innumerable.
Both inpatient and outpatient treatment are comprehensive approaches to wellness. You will face temptations in both but as long as you remain responsible, you will also learn specific strategies as to how to deal with them. It is up to you to take advantage of those lessons.
Aftercare and Sober Living Resources
Sober living may be the final step in your formal treatment plan before returning home, but treatment never really ends. Sober living houses provide the interim environment between rehab and mainstreaming back to your natural environment. The reason for the initial formation of sober houses was simple: a person in recovery frequently needed a safe and supportive place to stay, during the vulnerability of early recovery, prior to returning home.
Sober houses are also highly-structured, and most residents are referred to a sober living environment from a rehab center. Requirements and rules are strict, and they usually include:
- No drugs or alcohol on the premises;
- No violence;
- No overnight or sleepover guests, not even family;
- Commitment to random drug testing;
- Involvement in a community-related program;
- Acceptance by a peer group;
- Acceptance of advice from treatment professionals;
- Respect for the rules of the house;
- Following all directions;
- No swearing;
- No stealing;
- No sexual activity between residents;
- Curfew must be respected.
Many of the above rules are enforced with a Zero Tolerance Policy. Meaning, if any of these rules are broken even once, you risk being kicked out of your sober living home. If you had experienced structure during your prior treatment to this point, you should be in good shape.
A benefit of many sober houses is that staff frequently are former addicts themselves. This is a benefit for two primary reasons: 1) They understand the struggle, and 2) They are living examples of former addicts who have successfully completed treatment and are now giving back. Some of these former addicts work on salary, and some happily volunteer their time.
Sober houses are most successful when utilized (in conjunction with a formal treatment plan) for a designated period of time. Do not expect all residents to attain equal success during this stage. You will likely come to know your peers through intensive group counseling. You will also undergo one-on-one therapy, but in the group setting you will notice your peers’ various stages of recovery. You will form opinions but always remind yourself that you are there for reason.
And that reason is to take care of you.