Drug Abuse and Rehabilitation in Simi Valley, California
Ventura County is nestled on the south-western coast of California making it a ripe target for drug trafficking. Simi Valley rests in the eastern part of the county – about a 30-minute drive outside of Los Angeles.
While Simi Valley has been ranked the 18th most conservative city in the country (twice), that has not kept it from being hit just as hard as other American cities by the opioid epidemic that seems to be claiming an increasing number of lives.
While opioid overdoses appear to have tapered a bit statistically in the last couple of years, deaths due to both prescription opioids and street-grade heroin still outpace other California cities. A number of those deaths are not attributable to illegal drugs at all, but rather prescription pain management medications that are being prescribed by doctors.
The risk of abusing these substances is very high, despite the fact that they’re legally available by prescription, and the risk of overdosage remains a constant threat with opioids of any kind. Both doctors and pharmaceutical companies are becoming more aware of the impact that these drugs are having and the death toll that they’re leaving. This has inspired California to set up a dashboard to track the number of opioid-related deaths in the state.
The data shows a clear trend toward deaths caused by prescription opioid abuse. While this is not uncommon on the national level, it’s important to understand that these are all individuals that were prescribed opioids for chronic or acute pain management and found themselves in the thrall of opioid addiction.
Throughout this article, we’ll provide valuable information for those that find themselves addicted to opioids of one kind or another and the people who are closest to them. The purpose of this article is to inform readers about both opioid addiction and discuss the ways in which opioid addiction is treated.
What are Opioids?
Opioids are a class of narcotic pain relievers that act on the opioid receptors in the brain. They are designed to dull the perception of pain but have a number of side effects, not the least of which is that they’re habit forming. Technically speaking, opioids consist of a variety of synthetically produced opiate derivatives. Nowadays, the terms opioid and opiate are used pretty much interchangeably.
Opioids come in 4 different classes. Those include:
- Endogenous opioids or opioids that occur naturally in the body. Example: endorphins.
- Opium alkaloids that are derived from opioids. These were once known as opiates. Example: codeine and morphine.
- Semi-synthetic opioids that have a similar chemical structure to opium alkaloids. Example: heroin and oxycodone.
- Fully-synthetic opioids that are not chemically related to alkaloids. Example: methadone.
Opioids have a number of effects on the brain and body. Their effects differ mainly in scope. For example, heroin produces a rather strong euphoric effect, while something like codeine may have a more subtle effect. Both of these drugs are highly addictive.
Opioids bond to opioid receptors in the brain and produce a relaxing effect, numb pain, and slow breathing. When an individual dies of an opioid overdose, it’s because their breathing has been depressed to the point of stopping altogether. They are completely unaware of what is happening. If someone who is nearby calls an ambulance, the overdose can be reversed. Drugs like naloxone reverse overdoses by acting as opioid-antagonists. They nullify the impact that opioids have on the body.
Heroin is a synthetic opioid derived from morphine. It is either sold in a black tar variety or as a white or brownish powder. Black tar heroin is produced in Mexico and smuggled over the southwestern border and across the US. Since black tar heroin is less pure than heroin sold as a powder, it is generally injected by users.
The process of injection does a great deal of violence to the body, including collapsing veins and passing infections to the heart. Pure heroin can be snorted or smoked but is generally more available on the East Coast than the West. In both cases, the drug naturally hones in on the euphoric effects that opioids have on the user. In the process, it produces a flood of the neurotransmitter dopamine which is involved in reward and pleasure. The user experiences an incredible high followed by a period of relaxation and tranquility.
But like all opioids, the drug exacts a heavy toll for the fleeting pleasure that it gives.
Fentanyl is a prescription opioid that is now being mass-produced in Mexico for recreational use. It is considered highly profitable because it’s much more powerful than even heroin. A kilo of fentanyl powder can produce anywhere from 30 to 50 times the number of doses that a kilo of heroin can. While the drug has become a big hit on the black market, it’s also leaving a growing number of bodies in its wake.
The drug is powerful enough that only a couple milligrams will produce a fatal dosage for most people. In addition, it’s impossible for emergency medical personnel to know if an individual overdosing on heroin or fentanyl. The amount of naloxone it takes to reverse a fentanyl overdose is greater than that of a heroin overdose.
The Black Market for Prescription Opioids
Due in large part to the ease at which individuals can now procure prescriptions for habit-forming and potentially fatal drugs, a black market formed around their distribution. Deceptive marketing by drug companies and doctors that wanted to meet their patients’ needs produced much of what we today refer to as the “opioid epidemic”. In the last 20 years, the rates of fatal overdoses have doubled alongside every other possible negative statistic you can associate with opioid abuse. This epidemic was in no small part caused by pharmaceutical companies and the over-prescription of pain medication to treat everyday problems.
For instance, it would be unheard of to have an opioid prescribed for a dental visit in Europe or Asia. Acute, but temporary, pain is seldom treated this way. Opioids are reserved for chronic unmanageable pain that reduces the quality of an individual’s life. Cancer patients, for instance, are often are prescribed opioids because the potential benefit of relieving their pain outweighs many of the negative side effects.
But often times, chronic pain is not the only reason opioids are prescribed. Patients that are suffering from acute, but temporary, pain are given opioids over the course of a week, month, or a couple months in order to manage the pain. These patients either mismanage the medication or through no fault of their own, become hooked on the substance. At this point, it becomes an easy option to take to the streets and procure more.
Indeed, the vast majority of those that overdose on opioids do so from prescription painkillers and not street-grade narcotics. In most cases, the overdoses are accidental. They take their pain medication to help them sleep, they stop breathing, and they never wake up.
To top it off, there are those that will shop for pain doctors and fake symptoms in order to sell the pain pills on the street for major profits. Insurance companies are generally more than willing to cover the opioids. In other countries they are far more reluctant.
While health care officials and legislators are addressing the issue as best they can, the numbers remain grim. Accidental death due to opioid overdose remains far too high, and higher in Ventura County than most other California communities.
The Long-Term Side Effects of Opioid Abuse
Chronic opioid use and abuse take a remarkable toll on the human brain and body. On top of running the risk of respiratory failure, those who use opioids chronically suffer from a host of side effects, including dependency. Given a long enough time scale, the abuse of opioids becomes the user’s sole reason for being. The addiction is that strong.
While the habitual opioid user chases the pleasurable feeling that opioids give them, the feeling they seek diminishes with each dose. Users end up developing a tolerance to the drug. The more they take, the less potent the drug is, forcing them to find stronger opioids and to ingest them in increasingly dangerous ways.
Once the addiction has established itself, it becomes very difficult to break. Not only do opioids provide the user with pleasure, they also punish them when they don’t take the drug. Over time, it becomes more about chasing away the pain of withdrawal than experiencing the pleasure of the drug.
A user can begin to experience withdrawal symptoms within 48 hours of their last dose. The stronger the opioid, the sooner withdrawal sets in. The effects are incredibly unpleasant. Early symptoms include:
- Muscle aches
- Increased tearing of the eyes
- Runny nose
- Persistent sweating
Later, those going through withdrawal will experience:
- Abdominal cramps
- Dilated pupils
In extreme cases, hallucinations, paranoia and psychosis can occur.
Opioids also take their toll on the brain’s chemistry. As opioids bind to the opioid receptors in the brain, they produce dopamine which is involved in the reward circuit. After opioid use has stopped, and the physical withdrawal is gone, the psychological dependence on the drug to produce dopamine has its turn at tormenting the addict.
Users often feel an intense sense of depression and emptiness. A feeling like they can’t experience pleasure, happiness, or joy. They feel anxiety and agitation. They will often lash out for no reason. This is largely because without the introduction of more opioids into their body, their brains are no longer producing dopamine correctly. The longer their addiction has lasted, the longer the amount of time it will take before the brain can reset itself and begin operating normally. Most of those in recovery report that this process takes around a year. In some cases it can last up to 3 years.
Opioid Addiction Treatment and Recovery
Drug addiction treatment is a long-term commitment to one’s own goals, life, and sobriety. It does not happen overnight, and it is not an easy process. Nonetheless, there are a number of good rehab clinics that have shown a great deal of success with those properly motivated to kick their habit. Help is available to those who want it. But it takes work.
The process is as follows:
- Drug assessment
- Post-acute care
- Sobriety Maintenance
In this section, we’ll outline the process from start to finish. This will help those that are seeking out treatment to understand what the process looks like, what their options are, and what to expect. If you have a loved one in treatment, this can be beneficial for you as well.
The majority of individuals that find themselves in rehab in Simi Valley are there to kick an opioid habit. Drug assessments are designed to take into account the drug that the individual was abusing and how they abused it. Different forms of ingestion can cause different types of damage to the body. For those that found themselves with a pill dependence, gastrointestinal issues are not uncommon. For those who graduated to needles, a whole host of other problems can arise.
Doctors need to know everything that they can about the patient prior to intake. This will allow them to anticipate any complications should they occur. The process of detox from opioids takes a physical toll on the body, even when doctors can administer helper drugs that mitigate the worst symptoms.
Doctors will take a full patient history that details any surgeries that they’ve had, and congenital diseases that may impact their recovery. Often patients that find themselves in rehab for opioid withdrawal suffered something in the past that caused them to be prescribed the drug in the first place. Doctors will want to know what that is.
In addition, the doctor will be interested in knowing how long the patient has been abusing the drug for, and what, if any, mental health diagnoses they have.
This is the first step in recovery, and it’s often the most difficult. By now the patient will have accepted the fact that they have a problem for which they need help. Not all of those who suffer from opioid addiction ever make it this far.
Detox may sound like the scariest and most difficult part of the process. It is by no means easy. The patient will need to endure some discomfort in order to get the drugs completely out of their system. While doctors can prescribe drugs like methadone with a suboxone taper to help dull some of the discomfort of opioid withdrawal, it will nonetheless be uncomfortable. For those with serious long-term addictions, inpatient care is recommended during this process, though other options are available.
Inpatient programs, however, have proven to be the most effective. The longer the inpatient program lasts, the more effective it has proven itself to be. Inpatient programs are geared toward overseeing the individual patient while they are at their most vulnerable. Patients will also be given the opportunity to talk about their symptoms and share their stories with those in a position to empathize. Most importantly, they will have medical oversight to ensure that if complications arise, there is a medical team there to deal with it.
Inpatient programs, especially for opioid addicts, are always the best option.
One controversial option is known as rapid detox. Patients are sedated for the period of three days to a week and are administered the anti-opioid drug naloxone in order to flush their system. When they wake up, they may or may not still be going through withdrawal. It’s impossible to gauge how long an individual patient’s detox period will last, so it’s impossible for doctors to know if the patient will be completely cleansed in the duration of time it takes to flush their system.
In addition, some patients have shown extremely negative adverse reactions to the procedure. Some have died. For those that think that this path might be for them, it will be important to have a full physical workup to ensure that the procedure is safe for you.
It is also important to bear in mind that when a patient wakes up from rapid detox, they are by no means cured. They may have lingering withdrawal side effects, and will still crave the drug. Recovery and detox are not synonymous. Detox is just one step in the process. Continued sobriety depends on keeping up with treatment in its entirety. There is no “quick fix” for recovery.
Because of the impact that opioids have on the brain’s chemistry, the post-acute phase of opioid recovery is often the most difficult. Those in recovery will report a profound sense of depression that feels as though it will never end. Those who care about them may find their behavior upsetting. They may show a lack of interest in the things they once enjoyed, appear withdrawn, sullen, or distant. It’s important for loved ones to realize that this is temporary and part of the process.
Doctors may, at this stage, prescribe antidepressants or anti-anxiety medications to help them through the process. They may also give them something to help them sleep, as insomnia may be a major issue at this phase. They will still be craving the drugs even though there is no trace of the drug in their system. This is the reason why treatment doesn’t end after detox.
Patients have multiple options for treatment. Extended inpatient programs are designed to help patients through this stage of the recovery process. Outpatient treatment is more frequently selected. Patients will be expected to pass tox screens and keep up with their appointments. They will also be taught coping mechanisms that will help them manage cravings. For those that need to find housing or apply for disability and food stamps, social workers can help them apply for those programs as well.
Continued Sobriety and Maintenance
Most of those who have been through opioid addiction will tell you that there isn’t a day that goes by where they don’t consider using. Nonetheless, these folks have a choice. Those who are in the thrall of opioid addiction don’t. Recovery really means restoring your free will and your ability to choose to you. As difficult as this may seem to those in the early stages of recovery, recovery happens every day.
12 Step Programs and community support are vitally important to this process. Many lives are saved by individuals helping those who were once in a similar spot as themselves. Connections are established in the community. Lives are rebuilt and restored.
It may seem like a difficult journey, and it is. It is also worth it. If you need help, please reach out.