Friday, April 26, 2019

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SUBSTANCE ABUSE AND TREATMENT IN LINCOLN, NEBRASKA

The state of Nebraska has been identified by the U.S. Department of Justice as a High Intensity Drug Trafficking Area (HIDTA). However, on a statistical basis, such trafficking and subsequent abuses fall on the lower end of the HIDTA spectrum, below the national average. In a 2016 study by the Nebraska Department of Health and Human Services, the city of Lincoln was listed as a region rife with nightlife and activities for the young, and a drug outlook consistent with the state proper.

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

Nebraska is a HITDA region and a particularly strong drug trafficking stronghold, especially when it comes to Fentanyl and other opiates. Lincoln is strong in alcohol and pot abuse, and less so with heroin and cocaine though the latter two drugs are not anathema to the city’s dealers.

Prescription opiate usage continues to evolve. Fatal car crashes in the city of Lincoln are approximately 50% alcohol, or marijuana-related to a lesser extent, per 2017 statistics.

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 of the centers previously mentioned will accept Medicaid and Medicare, or cash. Many will also 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.

ABOUT THE CITY

Lincoln is the county seat of Lancaster County, and the capital of the state. Lincoln’s area is an expanse of 93.46 square miles, with a 2016 population of 280,364 according to the Census. Said population is expected to exceed 300,000 by mid-2018 according to most official estimates. The city is considered the cultural hub of the Lincoln Metropolitan and Lincoln-Beatrice Statistical Area.

Downtown Lincoln, a center of arts and commerce, has seen substantial residential growth over the last decade, mainly in the south and the east. Housing has increased to the degree of demand exceeding supply. Lincoln is the second most populated city in the state, and in 2013 was named one of the Top Ten Most Welcoming Cities in America by www.WelcomingAmerica.org.

The racial makeup of the city is presently estimated at (rounded) 90% Caucasian, 5% African American, and 3.8% Hispanic, with the remainder listed as Other Races. Gender makeup is even, at approximately 50% each of males and females.

Lincoln is considered a mid-sized city. Primary industries are manufacturing and service, not unlike many other mid-sized U.S. regions. Craft brewery is a fast-growing industry, and healthcare-related jobs are particularly strong. Overall, wages have increased approximately 10% from full-time 2015 levels.

The economy is strong, and shows no signs of slowing.

A PROBLEM AMONG NEBRASKA TEENS AND YOUNG ADULTS

According to a NDHHS report, while approximately one-third of all U.S. high school students were said to have used an illegal drug within the year, in Lincoln that figure is closer to one-fourth. In the state of Nebraska, one of every five high school students admitted to drinking alcohol in the past month. While 20% nationally said they smoked pot during the same month, 11.7% of  Nebraska high school students admitted to usage within the same period.

In 2010, the National Drug & Alcohol Facts Week (January 25-29) was initiated in Lincoln, promising to SHATTER THE MYTHS (an NDAFW trademark) about alcohol and drug abuse. The idea for the event remains the same today: to balance the realities of abuse against the myths, by introducing the students to experts with real life related experiences, as opposed to attaining their knowledge solely from efforts as portrayed in the arts, from friends, or the internet.

According to David DeVries, MS, at the time the epidemiology surveillance coordinator for the Division of Behavioral Health, parents must always be the first line of defense when it comes to preventing substance abuse among their children.

“Children are listening,” DeVries said, “and they are heavily influenced when parents communicate their expectations in relation to use of alcohol and drugs. Surveys have shown over and over that parents are the number one influence on a child’s decision to not use alcohol and drugs. As important to influencing their children is the amount of time parents spend actively involved in their children’s lives.”

In a 2014 NDHHS-commissioned epidemiological profile, DeVries shared information on other substance abuse issues, including casual drinking and binge drinking, drinking and driving, depression and suicide. Some of his shared public findings were the following, which primarily focused on the state proper:

  • Binge drinking exceeded the national average, according to the Behavioral Risk Factor Surveillance System (BRFSS). In 2014, 20.3 percent of Nebraska adults reported binge drinking within the last month. Nebraska high school students, however, reported lower binge drinking rates than their national counterparts, 13.6 percent compared to 20.8 percent.
  • Alcohol use (including binge drinking) and cigarette smoking among Nebraska high school students declined steadily since the 1990s. In 1991, 53.4 percent students reported drinking alcohol within the last 30 days. That number decreased to 22.1 percent in 2013. Binge drinking, reported at 36.9 percent in 1991, fell to 13.6 percent in 2013. Cigarette smoking dropped from 29.2 percent in 1991 to 10.9 percent in 2013.
  • In 2013, nearly seven percent of high school students in Nebraska reported driving after drinking within the past month.
  • In 2014, Nebraska adults were more likely than adults nationally to report that they had operated a motor vehicle while alcohol-impaired over the past 30 days (2.5 percent to 1.7 percent).

Note: The above statistics were reprinted from a publicly-available profile. 2017 statistics followed the above trends, and 2018 appears poised to do the same.

During the first half of the decade, the number of Nebraska teens and adults admitting themselves to treatment for depression issues increased substantially. Suicide became the 10th highest cause of death in the state, and the city of Lincoln correlated with that figure. In 2013, one of every 15 Lincoln residents reported at least one major episode of depression – the same percentage as the Nebraska proper. That same year, 220 Nebraskan deaths were caused by suicide. In 2017, the city of Lincoln saw the same percentage of depressive episodes, though the state’s suicide deaths increased to 231.

A MAJOR OPIOID ISSUE

Lincoln deaths by suicide are reported, though figures are inconsistent. However, depression-related treatment center admissions are considered high in comparison to the state average. The city of Lincoln is presently dealing with an ongoing prescription drugs and opioid issue, particularly Fentanyl. Initially, the synthetic opioid was considered a transient drug, one trafficked from Nebraska en route to other states. However, both in Lincoln and also widely in the state, Fentanyl has been responsible for an increasing number of fatalities. Versions of the painkiller are readily available on the streets, and have proven to be seductive to young people.

As a measure, Fentanyl is 50-100 times the strength of morphine.

In 2017, three men were found dead with Fentanyl in their system. Others have contacted authorities, fearing an overdose. Like several other cities both in and out of the state, many first-responders carry the antidote Narcan, which has been used on a regular basis to reverse the effects of heroin, and opioids. In 2017, Nebraska crime labs saw a three-fold increase of fatalities related to Fentanyl or Fentanyl variants, as compared to the prior year. Heroin is not as widely used in Lincoln, though Narcan has the same antidote-effects. Many Lincoln authorities expressed surprise at 2017’s suddenly increased Fentanyl use due to its expense. Though the cost per kilogram has dropped from as much as $20,000 in 2016, to $3500 in 2017, the price is still out of range of many prospective users. But the usage continues to grow. Many dealers tell their buyers to keep an ice bucket nearby, in the event of an overdose.

State laws are increasingly aggressive in its battle against the opioid, much as they were with Lincoln’s synthetic marijuana (a mind-altering drug, not cannabis), until producers of K2 and other synth variants attempted to outmaneuver the laws by altering the drugs’ chemical contents.

Other than the opiate problem, Lincoln’s drug of choice is marijuana. Arrests related to driving under the influence of pot is nearly equal to the country-wide average of those who drive under the influence of alcohol.

As always, help is out there if you need it.

The Treatment Process

PRE-INTAKE RESOURCES

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.

Kudos to you for checking such online resources to begin with. That’s certainly a proactive start. 

A quick note: Even if you don’t believe you are addicted, but are concerned that your usage is growing, help is out there.  You do not have to be on the far side of addiction to reach out to various resources on The Recover. In the same spirit, if you are drawn to use, but have not yet, The Recover provides resources available to you as well. It is never too early, nor is it ever too late. These are tools that have been formed for reason, and they are there for you.

INTAKE SERVICES

Many addicts, or users with a problem whose usage is not yet defined as an addiction, make the mistake of not taking the first step towards sobriety as it regards intake. If you need help in making an informed decision as to what treatment method is right for you, we cannot encourage you strongly enough to, again, speak to family and/or friends who have been there before. Sometimes, a user has a difficult time making such decisions with a clear head.

And once more, if you know of no one who has been through these issues before, please contact one of the centers as listed on this page.

Also, we encourage you to ask yourself a few questions: 1) What is holding you back from getting help? 2) Do you believe you have a support system? If so, do you feel comfortable contacting them and speaking about your problem? If not, would you feel more comfortable contacting a professional? And 4) Do you believe you are capable of making an informed decision as to your treatment? If yes, you are well-advised to take advantage of one or more of the resources here. If no, you are strongly advised to contact one of the phone numbers listed here, and discuss your reservations.

Again, they are there to 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.

If you have come this far, kudos to you. You have taken a major step towards reclaiming your life, and your potential.

DETOX SERVICES

The concept and practice of detox is typically broken down into three distinct phases: Evaluation, Stabilization, and Transition to Inpatient Drug Rehab.

Evaluation: As overseen by a doctor, who will determine what drugs are presently being used, how long has the patient been using, and how much and how frequently the patient uses.

Stabilization: As expounded on the site, stabilization differs patient to patient, based on specific substance being abused. This is the end result of the withdrawal phase.

Transition to Inpatient Drug Rehab: Many addicts believe that once they complete withdrawal, they are finished with their treatment. That is a dangerous belief, as withdrawal only releases the immediate physical hold of the substance.

Communication is key. Some users are resistant to treatment, most especially when in a treatment center against their will. In this instance, your communication with your specialists will be at risk. Remember, they are there to help you. You have the freedom to ask questions, and the right to receive answers.

That is one of the great benefits of treatment, a better understanding of your illness.

What is withdrawal? How long does it last?

INPATIENT TREATMENT RESOURCES

Inpatient treatment is frequently misunderstood, as there are several options available to the user under that umbrella title. Many people believe the term to refer to only hospital treatment. Or, only highly-restrictive treatment. In reality, it is neither.

Inpatient treatment can either be 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), and an RTC (residential).

Though you may be the best determinant of the degree of inpatient recovery resources best suited to your needs, frequently one may need the help of family or friends to help you more clearly identify the treatment options that are most prudent for your needs. From there, only your personal commitment will determine your success.

PHPs and RTCs are amazing resources for those with more severe or difficult abuse issues. Both options are highly-structured, especially the former. The importance of structure cannot be understated. You will have a time for medicinal treatment, a time for personal or group therapy, a time to rest, a time for activities …

Frequently, a user has little structure outside of the treatment center. The user is more interested in the high than by scheduling their day via their clock. The structure of PHP treatment, particularly, may be a challenge for some. But, if you allow the treatment to take its course, the end-result can exceed your most optimistic hopes.

So ask yourself: “Do I do well in a structured environment?” “Am I functional in a structured environment, or will I have a better chance to succeed with something less restrictive? As ever, a user if not always the best determinant as to treatment. If a user is high while making the decision, that will be in no one’s best interests. It’s time to commit, with as free a sense of mind as possible.

We will talk more about the level of commitment in a moment.

Should I choose inpatient or outpatient?

OUTPATIENT TREATMENT RESOURCES

Outpatient treatment is a comprehensive approach to wellness, and no less impactful than inpatient services. Please research the importance of outpatient treatment resources on The Recover, or speak to loved ones who have been through the process. Recovery is an ongoing process, which requires a substantive lifestyle change to avoid the ever-present threat of a relapse.

Let’s discuss a bit further. Outpatient treatment allows the patient a certain level of responsibility to remain clean while outside of the treatment center. You will face temptations but will have also learned specific strategies as to how to deal with them. It is up to you to take advantage of those lessons. There is a certain degree of trust on the part of the outpatient treatment administrators that the user will remain clean, and at the same time outpatient treatment allows for the user to remain productive on the outside while still receiving help. If you work, you can schedule your outpatient appointments or check-ins after hours.

One very important point, though, under this or any treatment circumstance: The entirely of your treatment is a commitment. Outpatient or not, if you miss one appointment you will likely miss another. That is a recipe for failure. What you allow, you encourage.

Never allow an excuse to fail. More precisely, let’s say it as it is: There are countless reasons why one would fail, in this or any other environment. Laziness, rigidity, intimidation …

There are fewer reasons to succeed: Yourself, first of all, then your loved ones (your collective of family and friends). Which means more to you? The pain of the commitment to get well, or the pleasure of using? If you answer the latter question as your affirmative, consider those loved ones who care about you, and worry about you.

On that note, let us elaborate upon the concept of commitment for a moment. Some users resent the term, thinking many of those who do not use, or who are not otherwise plagued by addiction, tend to believe commitment is that much easier than it truly is. How can a user commit to anything at all, one may ask, much less treatment if said user is overwhelmed by their addiction?

It is very difficult. Really, it is. But you can do this. You can reclaim your life, as none of us are defined by our addictions.

More on Inpatient Vs. Outpatient

AFTERCARE AND SOBER LIVING RESOURCES

Not all sober houses or aftercare facilities are created equal. However, you will frequently be surrounded by others in a supportive and understanding environment, others who have undergone similar difficulties. Sober houses most frequently prove to the addict – which as you see here is a message on repeat – that you are not alone.

There have been several popular television shows on various networks over the last decade that have dramatized the sober living experience. We suggest that you watch with caution, as several of these shows contain scripted elements that do not necessarily give a positive view of what could be  a positive experience. Further, several participants in these shows have passed away from their addictions. This is the toughest reality of all.

Be aware, always, and train yourself to remain focused even during this end-phase of your treatment.

We’ve seen users looking forward to attending sober houses for all the wrong reasons. The sober house experience is an often integral part of your overall treatment. But, it can be as abused as the substances for which you have been admitted.

You will live among others in a place away from your home. A sober care facility will actually be your new home until you leave. Others can influence you, so be careful. Sober living can be a hugely beneficial and beautiful experience, but you must remember, you are still in treatment.  

What happens after discharge?

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