Wednesday, June 26, 2019

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Substance Prevalence in Boise

With an estimated population of 664,422, Boise is the capital and most inhabited city in Idaho. Located southwest, on the Boise River, Boise serves as the county seat for Ada County. While many residents and tourists visit the parks, music venues, restaurants and museums, several others take part in destructive activities—from excessive alcohol consumption to heroin and prescription drug abuse, substance addiction has increased throughout the district.

If you live in Boise, and have fallen victim to substance abuse don’t hesitate to seek treatment. There are enormous resources in at your disposal.
Boise Recovery, The Recover

A Rise in Heroin Addiction Near Boise

Compared to previous decades, the number of arrests and deaths from heroin has risen sharply (IdahoNews). Officers around the Treasure Valley area (southwestern Idaho), have recently made many heroin-related arrests. Tracy Basterrechea, chief deputy of the Meridian Police Department, said, “I can tell you that just in the last few days we’ve had three heroin arrests” (IdahoNews). Almost doubling each year, the Boise Police Department busted 10 people for heroin possession in 2013, 25 in 2014, and 43 arrests were made in 2015. Statewide, heroin-related charges increased by nearly 800 percent from 2014 to 2015. Police believe that the rise in heroin use has resulted from doctors cracking down on the amount of pain killer prescriptions they hand out.

Opioids Continue to Cause Overdose Deaths

According to the Centers for Disease Control and Prevention (2017), 13 of 44 Idaho’s counties have a high percentage of opioids prescribed per person, which includes: Boundary, Shoshone, Nez Perce, Washington, Gem, Valley, Lemhi, Butte, Twin Falls, Cassia, Oneida, Bear Lake, and Caribou. Notably, Ada County did not make the list, likely due to improved restrictions and regulations for doctors—but still, the CDC, states that from 2012 to 2016 Ada County, “Had significantly more drug-overdose deaths with opioid drug(s) specified on the death certificate than any other Idaho county (154 deaths)”. Though Ada County has responded with stricter opioid laws, it’s staggering overdose deaths indicates that residents continue to obtain medications through other streams (eg the “black market,” or “doctor shopping”).

Alcohol-Related Crime Reports in Boise

Although the number of DUI offenses slightly decreased from 1,177 in 2015 to 1,014 in 2016, drunk driving still remains high in Boise (BPD Crime Report). Comparatively, charges for drunkenss increased from 108 in 2015 to 129 in 2016 (a 19.4 percent change). Liquor law violations, however, decreased from 365 in 2015 to 279 in 2016. As a whole, Idaho ranks as the 11th worst state for DUI problems. Both the CDC and MADD report that Idaho saw a staggering 32.1 percent increase in DUI’s. Likewise, Ada County had 349 alcohol-related crashes in 2016 (with 13 fatalities and 213 injuries).

            Idaho law states that a blood alcohol content (BAC) of 0.08 percent or above counts as impaired driving (0.02 percent for drivers under 21, and 0.04 percent for operators of commercial vehicles). The Idaho Transportation Department claims that even a BAC of 0.05 percent significantly effects reflex time and depth perception. For the first DUI offense, penalties include: a misdemeanor violation, up to 6 moths in jail, a possible fine of $1,000, and license suspension for 90 to 180 days. From then on, each additional DUI charge faces severer consequences, and for good reason: “Over 39% of Idaho’s fatal collisions are caused by people driving under the influence of alcohol and/or other drugs” (the Idaho Transportation Department). Therefore, it’s important to plan ahead: choose a designated driver, call an Uber or Lyft driver, or spend the night at the current location—just don’t get behind the wheel.

What is Heroin Addiction?

Heroin is an illegal and extremely addictive substance that, “Derives from opium from the poppy plant before it is refined to morphine, then further chemically modified to become heroin”. Heroin gets sold and used in various forms including “white or brown powder, a black sticky substance (tar heroin), and solid black chunks”. These different forms makes it possible to snort, smoke, or inject heroin directly into a muscle or vein. Any way heroin gets consumed, the drug produces its strong effect quickly. Feelings users typically feel while intoxicated, includes: a surge of pleasurable feelings called a “rush,” a relaxing, warm state, a heaviness and slowness in the arms and legs, and an increased sense of confidence and well-being.

Signs and Symptoms of Heroin Addiction

Depending on the volume, frequency, and how long heroin has been used, signs and symptoms will vary. Immediate negative symptoms usually involve: nausea, vomiting, itching, and dry mouth. Delayed symptoms follow the immediate effects of heroin, in which the body begins to slow down and becomes less alert and active. These symptoms include: slowed breathing, having a fuzzy mental state, drowsiness and sleepiness, slowed heart rate, and “nodding,” alternating between periods of being awake and asleep. Signs of long-term use may involve: heart problems, collapsed veins from repeated injections, needle marks and bruising, skin problems like infections and abscesses, and disease in organs, such as liver and kidneys.

Effects of Heroin Abuse

Social consequences of heroin addiction generally causes troubled relationships, being fired from work, financial struggles, and legal issues. Long-term health effects often result, such as: damage to the septum and nose tissues from snorting, heightened risk of infectious diseases, persistent mental health issues like depression, and reproductive issues. Additionally, pregnant women that use the drug, increase the risk of miscarriage, premature labor, and neonatal abstinence syndrome (NAS), in which the baby is born dependent on the substance and undergoes withdrawals symptoms. Then there’s the strong chance of overdosing, which may lead to sudden death. Related effects include: significantly slower breathing, depressed heart rate, unconsciousness, permanent brain damage, and coma.

Heroin Withdrawal Symptoms

Once the substance passes through the body, the user will go though several withdrawal symptoms, including: 

  • Trouble sleeping
  • Agitation and edginess.
  • Bone and muscle pain
  • Coldness
  • Nausea, sickness
  • Involuntary kicking movements
  • Intense cravings for more heroin

What is Opioid Addiction?

The opioid family of narcotics, which includes codeine as well as extremely potent medications such as oxycodone and morphine, has many legitimate medical uses. However, “Because of the way opioids affect the brain, these substances do have the potential of becoming addictive”. Opioids stimulate areas of the brain that are connected to reward, which creates a “high” feeling. Unlike heroin, many opioids get legally prescribed to patients to relieve mental or physical pain, but the amount and frequency can easily get abused. Addicted individuals may consume too many pills to feel a euphoric state, and sometimes users will grind painkiller tablets and snort them. Even if the doctor restricts the number of prescriptions per patient, he or she may seek other doctors and/or obtain it on the black market.

Signs and Symptoms of Opioid Abuse

Addiction occurs when dependence interferes with daily life. Though opioid use may interfere with the individual’s social, mental, occupational and psychical well-being, the opioid drug produces uncontrollable cravings and inability to stop. Several symptoms include:

                     Mood/Psychological

  • Increased general anxiety
  • Euphoria/Heightened self-esteem
  • Psychosis
  • Irritability
  • Lowered motivation
  • Depression

   Physical

  • Increased energy/Alertness
  • Constricted blood vessels
  • Increased heart rate
  • Stronger sexual arousal
  • Decreased appetite
  • Problems sleeping
  • Physical agitation
  • Hyper-vigilance

Effects of Opioid Abuse

Some of the side effects of opioid use include: fatigue, constipation, confusion, nausea, bronchospasm, breathlessness, a sense of elation, depressed heart rate/difficulty breathing, strong dependence, chest pain, and death.

Opioid Withdrawal Symptoms

Once the individual stops using opioids, common withdrawal effects involve:

  • Chills/Cold sweats
  • Nausea/Vomiting
  • Stomach pain/Diarrhea
  • Physical and psychological cravings
  • Trouble sleeping
  • Anxiety
  • Agitation
  • Shaking or quivering
  • Pain in bones
  • Muscle tension
  • Enlarged pupils

How to Diagnose Alcoholism

One should consider the following when figuring out whether or not an individual has alcohol addiction:

  • alcohol consumption interferes with work, school, family, and/or other responsibilities
  • Consumption continues despite the negative impact it’s having on one’s relationships
  • Risky behavior results after drinking, such as driving, fighting, or having unprotected sex
  • Needing more alcohol over time to achieve the desired intoxication state

Withdrawal Symptoms From Alcohol

The American Addiction Centers breaks alcohol withdrawal down into three stages. Stage 1 begins 8 hours after the last drink, and involves: anxiety, insomnia, nausea, and abdominal pain. Stage 2 occurs 24 to 72 hours after the last drink, and includes: high blood pressure, increased body temperature, unusual heart rate, and confusion. Finally, stage 3 arises around 72 hours after the last drink, which involves: hallucinations, fever, seizures, and agitation. Since alcoholism usually has underlying mental and psychological factors associated, its important to receive proper treatment after or during withdrawal.

Steps to Full Recovery

  1. Detox

            In order to begin a recovery program, the patient must detox— this means, ridding of all toxins in the body’s system by staying clean for at least five to ten days. Usually, rehab programs reject those who aren’t fully detoxed. However, many centers have medically supervised detox programs for those whom struggle to abstain from substance and alcohol-consumption. Detoxing without further therapy, though, will inevitably lead to relapse. Therefore, detoxing is just the first step in a series of phases for full recovery.

  1. Assessment

            For rehabs dealing with any major addiction—heroin, cocaine, alcohol, other opiates, etc—assessments must take place before accepting a patient. Assessments typically come in the form of questionaries, self-evaluations, and/or a physical exam. By answering questions and recording health-data, the assessor can accurately determine whether an addiction is fully present, to what extent, whether or not it pairs with co-occurring condition(s), and how to treat the specific, individual. Usually doctors, nurses, social workers, and therapists carry out these assessments. Though assessment strategies may differ from rehab to rehab, all locations carry out comprehensive analyses’.

  1. Intake

            During the intake process, the patient will meet individually with a counselor or therapist, a doctor, and/or a psychologist. Establishing these relationships with the staff helps them communicate with each other to collaboratively develop a methodical treatment plan. Typically, documented notes describing medical and mental health history, will be reviewed from the session(s), and specialized screenings and physical exams might also take place. Additionally, the patient will be asked about major events or certain instances that might have triggered the addiction. Important to note—the intake process usually involves some form of payment and/or a financial plan, and fortunately, many facilities offer a number of payment and insurance options. 

  1. Inpatient Treatment

             Residential treatment centers (RTC), are highly structured, and evidence-based programs that typically follow the 12-step model of recovery (Alcoholics Anonymous). Additionally, inpatient rehabs offer emotional process groups—e.g. CBT (for obsessive thoughts and compulsions), DBT (for stabilizing moods), and work-return planning, etc. RTC works especially well for individuals who have recently received hospital-care, or who need more structure, and stability than outpatient care. Average length of stay is typically three to six months, and is usually all residential-based (no returning home each night).  

  1. Outpatient Treatment

            Partial hospitalization drug rehab programs (PHP), and intensive outpatient programs for substance abuse (IOP), differ from RTC in that patients go home in the evenings. PHP, also referred to as “day rehab,” provides 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.

            Intensive outpatient programs for substance abuse (IOP), offers the same services, but goes for three hours a day, three days a week. Typically, 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). Additionally, IOP focuses on group therapy, while using one-on-one counseling less often. Length of stay differs from person to person, depending on the individual’s emotional and psychological progress. 

  1. AfterCare 

            Immediate, and continuous follow-up treatment for substance abuse, should occur after the completion of an initial rehab program. Addiction aftercare programs aim to encourage recovery maintenance, and helps develop ways to prevent relapse, to achieve a fulfilled life with healthy relationships and 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.

Consider a Sober Living Home

            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 complete standard 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 be willing to support others. 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 planning. Before moving in, each individual must complete the detox process (refer back to step 1 on how to do this).