Wednesday, February 20, 2019

Millville

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Rehabilitation in Millville, New Jersey

Millville is nestled in Cumberland County on the southern tip of the state of New Jersey. Its population of roughly 28 thousand residents are spread densely throughout the area with 633 individuals per square mile. The median household income for the small city is roughly $46,000, while the median price for a residential property is nearly three times that at more than $126,000.

Millville has a history that predates America itself, tracing its roots back to the colonial area. But the recent decade has found the small city struggling economically with unemployment and job growth a major issue. Millville was designated an Urban Enterprise Zone to help facilitate growth and investment in the area, but the UEZ designation is likely to lapse when it runs out in 2019. With it will go lower tax rates and greater incentive for private industries to invest in Millville.

Alongside economic troubles, Millville has a violent crime rate that is nearly four times greater than the rest of New Jersey, and a murder rate that is nearly three times greater than that of the rest of the United States.

Many of these crimes are related either directly or indirectly to the drug trade. As an oceanside state, New Jersey has many ports that make it a prime place for trafficking.

In many ways, Millville isn’t all that different from many major American cities that have suffered a decline in the post-industrial era. Millville isn’t all that different from other American cities that have suffered a major rise in heroin and opioid abuse either.

Drug Abuse in Millville by the Numbers

The vast majority of individuals that found themselves in treatment programs were there for either heroin or another opioid. Opioids accounted for 47% of all Cumberland County rehab patients with so-called “soft” drugs like marijuana and alcohol combining to make up 45%. Heroin itself accounted for 42% of addiction-treatment patients. New Jersey’s heroin problem has reached epic proportions.

Economic indicators play a key role in this trend with the majority of Millville and Cumberland County residents that find themselves in treatment either being unemployed or not in the labor force. But 26% of those referred to treatment did have paying jobs. Only 4% were students.

33% of all individuals that were in a drug rehab program were compelled to be there by the criminal justice system. New Jersey employs a drug court program that allows those with cases pending in the criminal justice system to have their cases expunged on the condition that they meet their treatment goals. This system is designed to save lives instead of ruining them with jail time and criminal records. If those with charges pending meet their treatment requirements, their records can be expunged.

Understanding Heroin Addiction

Heroin is not among the sorts of drugs that an individual can manage in a healthy way. Individuals do not unwind after a long day at work by spiking their veins. Heroin completely overtakes a person’s life and becomes their sole source of motivation. It is the reason they wake up in the morning. It is the only thing on their agenda.

This is largely why you find many heroin addicts working the streets or becoming beggars. It’s the simplest and fastest way to their next fix. While many people may be under the misguided impression that heroin only impacts poorer communities, that is no longer true. Heroin has found its way into wealthy suburbs and urban centers alike. The majority of those seeking treatment (53% in Cumberland County) are white and male. They generally find themselves referred to treatment programs by the criminal justice system.

While it may be tempting to blame these individuals for poor life choices, there are a growing number of folks that find themselves addicted to heroin who once held decent jobs. Due to injury or surgery, they found themselves being prescribed opioids for pain management. After their prescription ran out, they ended up suffering withdrawal symptoms. Folks like these end up looking to the streets in order to manage an addiction that began through legal means.

This has become a major problem all across America and Cumberland County is no different. The majority of those who seek treatment for drug problems are between the ages of 35 and 44. They are not, in other words, wayward youngsters. Many of them are individuals who were put in a very difficult position and ended up overwhelming them.

How Heroin Works in the Body and Brain

Heroin is an extremely potent synthetic opioid. Opioids work on opioid receptors in the brain. The opioid receptors are responsible for regulating pain and are involved in the reward system. The euphoric effect that the drug causes is much more pronounced than other opioids. There is literally no therapeutic value in producing an effect like this in the brain. Heroin causes a flood of dopamine to be unleashed giving the user an instantaneous high that is followed by hours of peaceful tranquility.

When the drug has worn off, however, withdrawal begins almost immediately. To put it in the mildest possible terms, the feeling is uncomfortable. The longer an individual uses heroin, the quicker and harder the withdrawal hits them. Meanwhile, the user begins developing a tolerance to the pleasurable effects of heroin. This causes them to need more and more of the drug, the longer they’ve taken it. For this reason, overdoses are common.

Heroin and Dopamine

Dopamine is the neurotransmitter that is responsible for pleasure and reward. The feeling you get when you ace a test or get a promotion at work is dopamine doing its job. Heroin artificially stimulates this process. In so doing, it takes the place of the motivation and hard work that individuals need to exert in order to achieve success in their life. Heroin itself becomes the only thing worth striving for.

When addicts are admitted to rehab to detox, the physical addiction takes only around a week to kick. It’s what heroin has done to their brain chemistry that will cause the majority of relapses. The brain can no longer produce dopamine on its own. Long-time users that are in the post-acute (shortly after detox) phase of heroin addiction recovery often find themselves suffering through a profound sense of emptiness and depression. This is known to psychiatrists as anhedonia, or the inability to experience joy.

There is no way for a doctor to jumpstart the dopamine system to behave naturally again. It often takes up to a year of sobriety before the brain’s natural chemistry behaves the way it’s meant to. The first few months of heroin recovery are therefore hellish. The rate of relapse is very high.

Heroin Addiction Treatment and Recovery

Heroin addicts face an uphill battle on the road to recovery. Nonetheless, millions of people have successfully completed the process and find their lives restored and their prospects brightened. They settle down. They go back to work. They meet a partner who they can build a life with. But while in the thrall of heroin addiction, none of the above will take precedence over procuring more of the drug.

That’s why medical intervention in the process of kicking a heroin habit is necessary. There is almost no way that an addict can resist the urge to use no matter how desperately they want to.

Step 1: Assessment and Pre-Intake

Assessment is the first step on the road to recovery. The patient will need to undergo a full physical before intake. This process is necessary because the process of detoxing can take an extreme physical toll on the body, and the doctor will need to determine the extent of the damage that the addiction has caused.

For instance, many heroin addicts come into rehab with severe respiratory infections, collapsed veins, and infections in their skin. Some also have infections in their hearts from intravenous drug use or have contracted venereal diseases such as Hepatitis C from sharing needles. A doctor will need to know about these conditions in order to reduce the risk of complications during treatment. It may also be necessary to treat an addict for those conditions as well.

Medical staff will also want to take a patient history and a family history. A patient will be asked to fill out a questionnaire that details the extent and duration of their drug use. A mental health evaluation is usually taken to determine if there are other co-occurring psychiatric disorders alongside the patient’s addiction disorder.

Step 2: Detox

Heroin detox can be an incredibly painful and difficult period. Luckily, medical staff can mitigate some of the worst symptoms through the use of helper drugs like suboxone and methadone. The drugs effectively take the edge off the painful process of detoxing one’s body from heroin addiction. Administering these medications under the supervision of a doctor allows the patient to be weaned off heroin slowly, so that the full force of withdrawal does not hit them all at once.

Nonetheless, the process of detox is painful. Many opt for inpatient treatment during this period. Others opt for outpatient. For obvious reasons, inpatient treatment has proven much more effective. 28-day rehab programs offer enough time for a recovering addict to get the drug completely out of their body.

It will still, however, be a few months until their body has adjusted to life without the drug.

Step 3: Post-Acute Care

The majority of heroin addicts that relapse do so during this phase. That is because their brains have not gotten used to living life without heroin. As stated earlier, heroin over stimulates the dopamine channel of the brain. Dopamine is involved in pleasure and reward. The brain can no longer produce dopamine on its own. It needs to relearn how to do that. This will lead to a prolonged period of depression, and a feeling of emptiness and joylessness.

For obvious reasons, special care needs to be taken during this period to ensure that the recovering addict does not relapse. Many do, which ends up restarting the process of recovery from scratch all over again.

During this period, those in recovery are taught ways of managing their cravings, stressors, and the things that drive them to use. 12 step programs and meetings become very important to their recovery, as do meetings with mental health providers and recovery specialists.

Inpatient or Outpatient: Which is Best for Your Recovery?

Inpatient programs offer the most restrictive environments. There are generally 28-day and 3-month inpatient programs. Inpatient programs typically have the highest rate of success, with 3-month inpatient programs showing the best results in terms of relapse.

That being said, not everyone’s insurance will cover 3-month inpatient programs, and for others, it may be too expensive. Outpatient programs or partial hospitalization programs can be successful when the individual in recovery has an environment to return to where they won’t be tempted to use. There are a number of clean and sober living environments in Cumberland County that cater to all levels of care. Individuals in these programs can eventually work their way up to an independent living arrangement.

For those that have a home to go back to where they won’t be tempted to use, an intensive outpatient program may be the appropriate choice. Many folks that face addiction have jobs and families to return to. For these folks, a less restrictive arrangement makes sense. They still need to meet with health care providers that will make sure they are sticking to their treatment plan and not using, but getting back into the swing of their lives often takes their mind off their cravings.

Leading A Drug-Free Life

Most addicts will tell you that the process of recovery never really ends and that there is no such thing as a “former” addict. The lure of addiction is something that they have to battle each and every day. This is why they find it immensely helpful to involve themselves in 12 step programs. They give one another a community of individuals that understand what it’s like to have gone through addiction and reach the other side.

Recovery is not a destination, but an ongoing journey. It empowers each addict to have a conscious choice not to use. It doesn’t mean that the temptation won’t be there or there won’t be mistakes on the way. But having a community of people there to support you makes sticking to the process easier. 

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