Monday, June 24, 2019

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Substance Abuse and Rehab in Camden, New Jersey

Camden, New Jersey may be small for a city with roughly 76,000 people, but that hasn’t prevented the area from far exceeding the national average in terms of deaths caused by heroin. With close access to the ocean and other seaports, New Jersey has become a major pipeline for hard drugs. Today, its citizens continue to suffer the effects.

Camden is especially vulnerable to the lure of heroin abuse and alcoholism. Nearly 40% of its inhabitants live at or below the poverty line. Due to the drug trade, Camden ranks near the top of the list in violent crimes as well. In 2015, Camden was ranked America’s most dangerous city above other cities like Detroit and Chicago that get the majority of the press. Nonetheless, the homicide and violent crime rates in Camden continually rank at the very top of all major US cities.

The national average for homicide rate is .37 per 100 people. Camden has never ranked under 2 per 100 since the FBI began recording crime statistics in 1980.

Budgetary cuts have plagued Camden’s police force who routinely finds themselves too overwhelmed to manage the massive amounts of criminal activity that take place in the city. Homelessness, prostitution, robbery, assault, homicide, and drug trafficking make for a situation in which law enforcement finds itself spread too thin to accommodate all of the needs of the area’s problems.

Drug Abuse In Camden By The Numbers

Heroin and other opiates accounted for nearly half of Camden’s rehab admissions over the past 3 years. Alcohol found itself a close second. While both of these drugs have vastly different addiction profiles, and one is legal while the other isn’t, neither is safe, and folks that find themselves losing control of their habit will at one time or another find themselves in a rehab center.

The majority of these people will be white, between the ages of 25-44, and male. But it’s important to note that neither heroin abuse nor alcoholism discriminate in terms of age, race, or gender. Those that are under 18 find themselves in rehab clinics as well as those that are over the age of 55.

The majority of these individuals are either on unemployment or not in the labor force at the time of their admission. Many of them are referred to a rehab treatment facility through the criminal justice system, and many are on probation or parole. Some were referred through the drug court system with around 23% of addiction patients being self-referrals.

Camden County accounts for nearly 56% of all New Jersey’s addiction treatment services. While it’s true that Camden City has certain pressures that its residents face, the numbers for the area are far too high. Heroin overdoses exceed the national average by over 300%, and Camden County suffers the majority of those.

While heroin deaths have been reduced by the availability of drugs like Narcan to police officers and emergency health professionals, the number of people dying from avoidable deaths is far in excess of America’s other major cities.

Understanding Heroin and Opioid Addiction

A lot of times, you’ll hear stories about how cigarettes are more addictive than heroin or that it’s more difficult to kick a nicotine habit than it is a heroin habit. This only tells part of the story. The degree to which a drug like heroin takes over a user’s life is far greater than nicotine. In addition, nicotine is socially acceptable while in most cases, heroin isn’t.

Consider also that individuals that are high on heroin can’t function at all while they’re on the drug. They simply curl up in bed somewhere and enter a vegetative, albeit comfortable, state. After the high has ended, the only thing they can think about is procuring more of the substance, and they’re willing to do just about anything to make that happen

It’s also important to recognize that many of these individuals got their start on heroin through the legal use of prescription opioids. Drugs like Lortab or Oxycontin have an incredibly high addiction profile. Individuals that were legally prescribed these drugs after an accident or a surgery find themselves unable to stop taking them. When their prescription has run out, they look to the street in order to find more. What they’re sold is often heroin.

What Is Heroin?

Heroin is a synthetic form of morphine also known as diamorphine. The drug hones the naturally euphoric effects of the opioid class. It activates the pleasure center of the brain by releasing copious amounts of dopamine all at once. Users say the high is the best experience of their life. But as they take more and more of the drug, they begin to form a tolerance. The tolerance ensures that the more of the drug they take, the less pleasurable it will be. Over time, a user will need to take more and more of the drug in order to achieve the same effect. On a long enough timescale, they will end up taking too much.

Heroin is designed to work much more quickly in the body than other opioids. Within 10 seconds of injection, the user feels an immediate high. There is an immediate sense of euphoria that is followed by several hours of peaceful tranquility.

But the withdrawal begins almost immediately after the drug has worn off. The human brain is designed with opioid receptors that regulate our pain and reward response. Heroin over activates the pleasure and reward response. But after the drug is gone what the user feels is intensely unpleasant.

As much as heroin is involved with the pleasure and reward system, the body ends up growing used to the effect it has. Over time, the ability to feel pleasure without the drug is replaced with nothing other than the fear and pain of being without it. Even those who have managed to beat back the physical addiction and outlast the withdrawal symptoms report a feel of deadness inside. This is known as anhedonia and roughly means an inability to experience joy

Heroin users must relearn and reprogram the reward center of their brain. It can take up to a year before the chemical processes that are involved in a normally functioning dopamine system are stabilized again.

Addiction Treatment and Rehab

Assessment and Pre-Intake

The first part of the process will involve being assessed by a doctor. Intake nurses will give an incoming patient a full physical in order to determine the extent to which a user’s habit has damaged their body. It often happens that heroin addicts suffer from numerous other complications that were caused either directly or indirectly by their drug abuse. It will help the doctor tailor their treatment of the addiction in a safe way and being able to catch any complications before they occur

A family history will be taken for the same reason. The doctor will need to know about any genetic ailments that run in your family in order to anticipate complications that may occur. The will also need to have a patient history on file. Any surgeries or medical issues an incoming patient has had will help avoid complications during treatment and detox.

A patient will also be given a survey and a mental health evaluation to determine the extent of the psychiatric and brain-related damage the drug has caused.

Detox

The first part of a recovering heroin addict’s journey is detox. It is often described as the most painful part of the process, but medical science has found ways of reducing the physical withdrawal symptoms by using drugs like suboxone and methadone. Drugs such as these help wean a heroin addict off the drug in a safely controlled environment. That’s why it’s imperative that a heroin addict seek inpatient services during this period

It’s nearly impossible to kick a heroin habit cold turkey, and there are numerous dangers involved with trying to do so. A patient needs to be looked after by a medical staff while they’re going through detox, and medical intervention can make the process infinitely less painful.

Nonetheless, detox does not feel good.

Post-Acute Treatment: After Detox

Generally, inpatient programs last 28 days. But studies have shown that longer inpatient programs have higher rates of success. That’s due in large part to the difficulty in managing the post-acute phase of heroin addiction.

Post-acute heroin addicts typically feel a sense of emptiness, profound depression, and a feeling of deadness that is related to their brain chemistry being thrown off balance by the drug. Almost all drugs that individuals find themselves in rehab for, mess with the brain’s dopamine channel. The dopamine system is involved with pleasure and reward. When a drug overstimulates one center of the brain, the brain must relearn how to produce dopamine on its own.

There’s no way for a doctor to help an addict through this part of the problem. Antidepressants can be prescribed which may help mitigate the effects somewhat, but the brain must relearn to produce dopamine in a healthy, natural way on its own. That means no chemical support.

It’s during this period that most addicts relapse. The emptiness they feel without the drug cannot be easily put into words. Hence why 3-month rehab programs are more successful than 28-day programs. They help the addict navigate the many stressors that will draw them back to their addiction.

Other Options for Post-Acute Treatment

Aside from extended inpatient treatment, which is often costly and may not be covered by some health insurance plans, a person in recovery has other good options available to them. 28-day programs can be successful given that a recovering addict has a safe place to go back to. Obviously, the temptation to use during this period is incredibly strong. It’s therefore imperative that an addict is not subjected to persons, places, or stressors that will entice them back into their old habits.

Partial Hospitalization Programs

Partial Hospitalization is a midway point between outpatient services and inpatient services. A recovering addict is expected to spend their day in the hospital where they will attend group meetings and meet with a counselor and other medical staff. They will also receive tox screens to make sure that they are not using in their off time

PHP is great for those who have a sober living environment to go back to when they’re released from the hospital. It also helps regiment them on a schedule that will help them find employment when they’ve completed their program.

Intensive Outpatient Programs

For those that have a solid home life, a regular job, and are highly motivated to quit abusing drugs, Intensive Outpatient Programs offer them the right avenue to do so. Meetings with health officials and counselors can happen around a patient’s schedule. It’s ideal for those that have a life waiting for them at home.

The key to making this work, however, is managing the daily stressors that inspire a person to use. Many of these individuals found themselves with an opioid habit due to prolonged prescription use that was suddenly cut off. They managed their addiction for a while but found their lives becoming unmanageable and wanted to clean their bodies of the substance.

There’s an awful lot of individuals that fit that profile all across the United States.

Continued Care after the Completion of Rehab

Regardless of what drug a user finds themselves in rehab for, even if that drug is alcohol, the journey of recovery never really ends. The urge to use will remain a powerful motivator throughout the remainder of their lives, and having a plan in place for stressors and triggers that drove them to use in the past will be a paramount concern for the success of their recovery.

12 Step Programs are a big part of this process for many individuals, not just in the early stages, but throughout the remainder of their lives. They often find themselves needing a community that is willing to provide a supportive environment. Places like AA and NA can do just that. They help them talk through their addiction and work on ways to make amends with their past. They also form friendships that last a lifetime and make connections in the community.

For a recovering addict, the road is never easy. But commitment and support from the community make the journey gratifying.