Friday, April 26, 2019

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Addiction and Drug Abuse Treatment in Gainesville, Florida

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Gainesville, an expansive city in Alachua County, Florida, has a population of 131,59, with 52,367 students from the University of Florida. Regarding campus students, writers for the Herald Tribune, Josh Salman and Emily Le Coz, claim that, although studies show college-aged adults in both east and west Gainesville “use drugs at identical rates, it’s in east Gainesville where police make the majority of drug busts”. Assessing the Herald-Tribune’s “per capita analysis of arrest records by the state,” the authors’ explained that,“College-aged blacks off campus are nine times more likely to be arrested for drugs than their white peers at UF”. These discrepancies in drug arrests, have likely skewed the complete picture of the number of drug occurrences among Gainesville residents, but still the 2016 Medical Examiner Commission, reveals a high percentage of drug offenses and deaths. For instance in 2015, oxycodone caused 25 deaths in the district, slightly increasing to 28 in 2016. Likewise, Hydrocodone deaths increased from 13 in 2015, to 14 in 2016; fentanyl also jumped by one, with 13 deaths in 2016.

When compared to other counties, however, Bruce Goldberger, director of UF Health Forensic Medicine and UF Department of Pathology, Immunology and Laboratory Medicine, says that Alachua County “hasn’t had the explosion of fentanyl use others have”. Goldberger claims that fentanyl prevails more in neighboring districts to the east and south of them, adding “You go to Sarasota and Manatee, and they have had hundreds of fentanyl or fentanyl-analogue deaths”. Cindy Swirko, writer for the Gainsville Sun, reports that Alachua County’s Fire Rescuer, Jeff Taylor,  maintains that although they have not “seen the large increases in fentanyl overdoses and heroin overdoses, like neighbors down south,” their district “typically runs two-to-three years behind the folks down there”. Although this doesn’t guarantee an eventual expansion of drugs, Taylor confirms that officials use statistics from others counties as indicators. Statewide, opioids have surged: total drug deaths grew by 22 percent, and opioid deaths increased 35 percent. Thus, it’s important for district officials to be on guard and take action on the issue.

Solving the Opioid Crises in Alachua County

According to Meredith Sheldon, reporter for WUFT.org, “Alachua County is one of the first Florida counties to sue pharmaceutical makers and distributors as a result of the opioid epidemic”. This last February, county officials, with the help of attorney, Joseph Ciaccio, “Filed a complaint in circuit civil court naming more than a dozen defendants, from manufacturers to individual doctors”. Supposedly, the defendants spent millions of dollars inaccurately marketing opioids as long-term, safe and non-addictive drugs. Sheldon claims that Alchua has taken legal action as a precautionary step—“The District 8 medical examiner’s office, headquartered in Gainesville and covering six counties, saw a total of 96 deaths from opioids like heroin, fentanyl, methadone and others in 2016, according to the report”. Like Jeff Taylor, Alachua County Attorney, Sylvia Torres, notes that although their district has not experienced the degree to which other areas have had with opioids, action must be taken, or else more occurrences of opioid use will eventually wind up in their community.

On a small-scale, the most effective way to avoid this increase altogether, is for the addict or abuser to seek out help through a rehab treatment program. First though, it’s important to understand addiction, withdrawal-symptoms, and the recovery process as a whole, therefore, here’s what you need to know…

What is Heroin Addiction?

According to heroin.net “Of all the substance abuse problems in the world, heroin addiction remains the one with the most serious ramifications”. Among the numerous health implications caused by this drug, there are specific risks associated with solely heroin addiction. Furthermore, this disease does not discriminate based on gender, socio-economic status, or age— although it’s clearly a problem in Florida, nationally, heroin addicts make up a comprehensive cross-section of dependent users. Varying in reasons why one develops an addiction to heroin, factors can range from teens trying to cope with self-image issues, and “fitting in,” to adults self-medicating to nge to wean off this drug; meanwhile it’s consuming a person’s life, while slowly destroying relationships, physical and mental health, and anything positive. Potential health risks includes overdose, liver failure, heart failure, etc; problems with IV heroin may also cause death, and also disturbingly, individuals who use or share dirty needles when shooting heroin may likely develop HIV (AIDS), hepatitis or other serious illnesses.

For those seeking heroin addiction help, it’s highly recommended to go through a drug treatment program. Not only does a drug rehab for heroin addiction assist in cleansing the user’s system of harmful opiate toxins, but this sort of program educates them on how to make positive choices moving forward, and how to avoid “triggers,” and abstain from temptation. Among these benefits, heroin drug rehab centers usually offers aftercare programs, which helps the recovering addict learn how to re-enter into and maintain a healthy lifestyle. Treatment programs significantly improves the chances of staying permanently “clean”. Additionally, they offer many recourses, from local Alcoholic Anonymous meetings, to therapists within the county; however, we’ll discuss this in depth a little later.

Symptoms of Heroin Addiction

According to the National Institute on Drug Abuse, common short-term effects of heroin addiction may include: severe itching, nausea (vomiting), flushed skin, an initial euphoric rush, long-lasting drowsiness, heaviness of limbs, slowed heart rate (following rush), and clouded thinking. Uncommon, but possible reactions to this drug may occur (due to “adulterated” heroin; or added chemicals), such as: tremors, palpitations, anxiety, shortness of breath, headache, and/or chest pain.

What is Opioid Addiction?

Basically, opioid addiction means to abuse pain medication (like opium, codeine and fentanyl, or hydrocodone, hydromorphone, and methadone; several prescription cough medicines also contain opioids). Yes, heroin is an illicit opioid, but because most get prescribed legally by a doctor or psychiatrist for reasons such as, injuries, surgeries, toothaches, chronic conditions (eg cancer), it’s important to note the dangers of legal forms; Since these tablets ease pain signals from the body to the brain, many consumers exceed the recommended amount and frequency in order to lessen discomfort, while elevating pleasure. Opioids can boost health considerably when used correctly, but unfortunately, more and more people have used painkillers improperly, causing significant damage. Some opioid addicts obtain prescriptions illegally on the street, or by “doctor shopping,”—a practice that involves visiting various doctors in order to receive multiple prescription substances. Addiction develops as the user increasingly relies on misusing the drug(s), in order to feel exhilaration. Gradually, the brain actually alters and rewires itself, thus a powerful urge to use the drug grows stronger.

Symptoms of Opioid Addiction

Signs and symptoms of substance abuse manifest physically, behaviorally, and psychology. One major sign includes the inability to stop using the substance altogether, or by not being able to take the recommended amount. Other distinct signs of opioid abuse include: drowsiness, nausea (vomiting), shallow or slow breathing rate, mood swings, irritability, sleeping more/less, poor coordination, physical agitation, constipation, poor decision making, neglecting responsibilities, slurred speech, euphoria (high feeling), lack of motivation, depression and/or anxiety attacks.

Symptoms of Opiate Withdrawal

As reported by National Library of Medicine, early symptoms of opiate withdrawal (when one is coming “off the drug”) may include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Possible late symptoms involve:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

Note: These symptoms generally start within 12 hours of last heroin usage.

Heroin and Other Opioid Treatment

Treatments for opioid addiction vary; for example, there’s behavioral and pharmacological plans available; specific medication helps restore balance to brain function and behavior. Although the National Institute on Drug Abuse states that these treatment options can work well when utilized alone, “Research shows that for some people, integrating both types of treatments is the most effective approach”.

Detoxing Off Opiates

Pharmacological Treatment of drug addiction heightens “retention in treatment programs and decreases drug use, infectious disease transmission, and criminal activity” (NIDA). Since medications ease craving and other physical symptoms during withdrawal, they work especially well when detoxing off drugs. Detoxification consists of cleansing the body of chemical toxins by remaining sober anywhere from five to ten days, before entering treatment. Most rehab centers offer medically supervised rehab programs, which helps the patient either stay away from pills altogether, or makes sure that the individual uses recovering medication (developed to treat opioid addiction) appropriately. According to National Institute on Drug Abuse, “A particular medication is used based on a patient’s specific medical needs and other factors”—Three types include: “(1) agonists, which activate opioid receptors; (2) partial agonists, which also activate opioid receptors but produce a smaller response; and (3) antagonists, which block the receptor and interfere with the rewarding effects of opioids”. Effective medications for detoxing off heroin and other opioids are: Methadone, Buprenorphine, and Naltrexone. Detoxing makes up the first step in recovery, so it’s important to undergo effective behavioral treatment as well.

What is withdrawal? How long does it last?

Overview: Addiction Treatment

Outpatient or residential impatient settings work best for recovering heroin addicts and opioid users. Through approaches such as cognitive-behavioral therapy (actively changing behaviors to promote improved feelings and emotions), and contingency management (an incentive-based intervention), rehab centers use expert strategies in treating drug addiction. Notably, once the patient’s accepted into the program, the doctor or therapist assesses the individual in order to match them with a specialized treatment plan. Shortly after, there’s the intake process: the patient meets individually, with a counselor or therapist, a doctor, and/or a psychologist, and establishes comfortable relationships. This step may slightly restructure the initial plan, due to observations from various team members and further communication. Additionally, it’s worth noting that the intake process usually involves some form of payment and/or a financial plan.

Inpatient  Treatment

Inpatient, or residential treatment centers (RTC), operate as highly structured evidence-based programs;  Many facilities include a heroin (or opioid) detox center, as well as weekly schedules for each individual, which keeps them actively productive. Rehab groups, such as Alcoholics Anonymous, 12-step model of recovery frequently conduct meetings. Additionally, inpatient rehabs offer emotional process groups for those requiring CBT, and/or dialectical behavior therapy (DBT). Other meetings may include spiritual gatherings with prayer, art therapy, and further specialized topics. Conveniently, inpatient treatment centers have workshops on planning for work-return, which encourages the patient to anticipate and strategize ways to succeed financially after graduation. For individuals who recently received hospital-care, or who need considerable structure, or more stability than outpatient programs, RTC works especially well. Average length of stay is typically three to six months, and “residential-based,” means there’s no returning home each night.

Outpatient Treatment

Outpatient treatment programs includes: Partial hospitalization drug rehab programs (PHP), and intensive outpatient programs for substance abuse (IOP). These rehab centers differ from RTC in that they run shorter, and the patients go home in the evenings. PHP, also known as “day rehab,” delivers the patient with the intensity of RTC, but for six hours a day, five days a week. Using many of the same tools and resources, PHP can be just as effective; individuals receive group-therapy, counseling, medical assessment, etc. Due to cost-reduction and flexibility, many drug and alcohol rehab centers now offer this style of treatment. Correspondingly, IOP has many similar services, but it goes for three hours a day, three days a week. Similar to PHP, this option suits those who’ve completed an inpatient program, like RTC, or for individuals that require an outpatient setting (due to professional or personal reasons). Typically, IOP focuses on group therapy, while using one-on-one counseling less often. Length of attendance differs from person to person, depending on their emotional and psychological progress, and well-being.

Should I choose inpatient or outpatient?

Aftercare

Immediate, and continuous follow-up treatment for substance abuse, should occur after the completion of one of these rehab programs. Addiction aftercare programs aim to encourage recovery maintenance, by enhancing skills to prevent relapse, retaining a fulfilled life through healthy relationships, and giving a sense of purpose. Longstanding substance abuse can de-normalize cognitive-function and altar parts of the brain long after rehab, therefore continuing treatment is extremely important. Beyond physical impact, several long-term psychological changes may affect thoughts, feelings, and behaviors (as another consequence to prior intoxication). Therefore, its essential that aftercare proceeds.

Sober Living

Another idea to consider is living in a sober living home— a group home for addicts, that allows one to come and go as they please, as long as they follow curfew-rules and do chores. Before moving in, the recovering-addict should find a 12-step sponsor (a family member, a friend, or an acquaintance, that will support, listen, and hold you accountable). Once, enlisted, residents in these homes must remain sober, and willingly support one another. Thus, this environment encourages sobriety and helps addicts adjust to a non-substance/non-alcoholic life. Many sober living homes include volunteer opportunities and therapeutic meetings, such as feeding the homeless at soup-kitchens, as well as, Alcoholic-Anonymous (12-Step) gatherings, and job-search tools. Before moving in, each individual must complete the detox process.

Not every recovering-addict needs to move into a sober living home, but, like the above resources and programs listed, it’s worth considering. Many members agree that there’s strength in numbers, when trying to get help; and it’s comforting to know that most other members can relate, as they too suffered from addiction. Still, if a patient recovered with a different program, and can confidently live on their own without feeling the urge to take drugs or drink, than that’s great too. Though the road to recovery differs for each person, the end result should look the same: the recoverer achieves a healthier, safer, and sober lifestyle.

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