Saturday, February 16, 2019

Rochester

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Drug Treatment in Rochester, New York

Rochester, New York is a beautiful area in upstate New York with a crime and drug problem that is surprisingly higher than most U.S. cities of similar sizes.

The area has been hit particularly hard by heroin, meth and opiates of late, mirroring national trends. Pot and alcohol use is higher than the national levels; cocaine is flat – neither increasing nor decreasing to any notable level – while crack has all but faded as a primary issue.

Rochester officials and educational organizations have agreed to step up various programs to fight the city’s ongoing drug scourge. We plan on revisiting this city in the future to check out its progress.

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On a recent public Reddit thread, an unnamed addict from Rochester wrote the following: I’m a heroin addict who is from Rochester, and it is insanely easy to cop heroin in this city. The whole area between Clifford and Norton and Conkey and Jospeh are infested with drug dealers, especially, as the video mentions, North Clinton. The Valero on North Clinton was a joke: it was literally like a drive-in market for drugs of all kinds. You drive in and before you can even try to get gas someone will come up to you and offer heroin, coke, weed, whatever… Drive down the side-streets and people will whistle at your car, yell out “Boy boy, girl girl” (heroin, coke). It’s insane out there.

As could be derived by the above words, Rochester, New York appears to be a haven for drug abuse. Treatment center admissions for meth and prescription opioids are higher than the national average, as is admissions for cocaine, while both pot and alcohol abuse are consistent with said average.

No drug in this area falls below the national line, in terms of misuse and treatment admissions.

The first of two real-life thread responses to the original poster is as follows: “Most people I know don’t have any real disposable money. It (heroin) destroys their families’ savings and nothing really comes from it … Their rates of permanent recovery are not very high.”

Reprinting these words in full, assuming their veracity, affords us a rare opportunity to explore perspectives as it regards Rochester substance abuse issues, from users themselves. We have balanced the thread against several newspaper and online articles, all of which support the words herein. To that end, we wanted to reprint this comment as well: “This is why Ill never get behind the whole ‘legalizing all drugs’ movement. There is no way to responsibly use heroin and there were hundreds of people there with their lives completely torn apart. People will use heroin regardless of whether it’s legal or not, and I think that this video especially shows how futile the war on drugs has been. The illegality of heroin also makes the substance much more dangerous than it needs to be. Not only does black market heroin drastically differ in potency from dealer to dealer when its heroin alone, but some dealers also put in fentanyl to increase their profits, which makes their product dangerously strong and is the main reason for the explosion of ODs in Buffalo and surrounding areas. Also, the impurities in black market heroin make it much easier to get abscesses and other nasty health issues than if they were using a pure product. If addicts could access medical grade heroin, then the strength could be consistent, it would be much cleaner and healthier, and counseling could be offered.”

As if in a further response, indeed, the following headline was nationally released on January 30, of 2018: “Feds: Dangerous Drug Dealers had Massive Operation in Rochester.” The article goes on to explain that a “multi-agency investigation” culminated in drug raids that yielded more than $630,000 in cash, six assault rifles, two kilos of cocaine, and unspecified amounts of heroin and fentanyl.

On a daily basis, it seems, Rochester is in a constant battle against substance abuse-related issues.

Rochester, New York, is the seat of Monroe County and the third-most populated New York city behind New York City proper, and Buffalo. Interestingly, in 2010 Forbes Magazine listed Rochester as #3 of all U.S. cities to raise a family, citing its economy and quality of its public schools, among other factors. Two years later, Kiplinger ranked the city as #5 in the U.S. for the same reasons.

The most recent U.S. census (2010) listed Rochester’s population as over 210,000, and its racial makeup as the following: 43.7% Caucasian, 41.7% African American, 0.5% American Indian and Alaska Native, 3.1% Asian, 6.6% from “Some Other Race,” and 4.4% from “Two or More Races.” Percentages are said to be consistent to now, in 2018. Median income for a household with a family today is well below the national average, at just over $40,000.

Another statistic that has, unfortunately, remained consistent is that of crime. As with many cities of this size with a commensurate drug problem, crime is well above the national average. In 2012, as a glaring example, Rochester suffered 2,061 violent crimes, compared to a national average rate of 553.5 violent crimes in cities with populations larger than 100,000. Also in 2012, the city saw 827 personal crime incidents and 11,054 property crime incidents. As the records were explored, nearly 35% of these crimes were found to have had a drug connection. By 2017, the numbers lessened a bit, but not to any notable degree.

Many have offered theories as to why such a well-kept and culturally-rich city has been so plagued by drugs and alcohol over the years. The issue with trying to accurately answer that question will likely be, despite best efforts, little more than an educated guess.

When The Recover presents those issues, our focus is on the user. Together, we can only move ahead. The following will hopefully inspire you to seek help, if for you or a loved one.

SIGNS OF ABUSE

If you believe any of these signs are present in either yourself or someone with whom you are close, please seek help for the proper party:

  • Changes in personality or mood swings;
  • Confusion;
  • Incoherence;
  • Poor personal hygiene, or lack of personal hygiene altogether;
  • Increased Secrecy;
  • Notable weight loss without diet;
  • Loss of appetite;
  • Self-isolation or increased anti-social behaviors;
  • Loss of interest in formerly-enjoyed activities;
  • Poor school or work performance;
  • Loss of money;
  • Presence of drug paraphernalia.

We cannot state strongly enough that help is always out there. Similarly, we need to stress the importance of taking advantage of that help now, as opposed to later.

COMMON ISSUES RELATED TO ADDICTION

Addiction has numerous dangerous and potentially damaging consequences, including:

  • A depressed immune system: People who are addicted to a drug are more likely to receive a transmittable condition, such as HIV or Hepatitis C, either through harmful sex or by sharing needles.
  • Self-destructive tendencies: Individuals who are addicted to drugs and alcohol die sooner than those with no addictions.
  • Other health issues:  Drug addiction can result in a variety of both temporary and long-lasting psychological and physical illnesses, depending on the type of substance that is used.
  • Accidents:  Individuals who are addicted to drugs are more likely to drive or engage in other risky activities while drunk or under the influence of drugs, both illegal and prescribed.
  • Problems in the home: Most often addicts experience problems with relationships at home and with friends.
  • Financial issues: Addicts often experience financial difficulties due to their lifestyle, which frequently leads to debt or dishonest behaviors.
  • Legal problems: Legal issues are common for the addict such as arrest, domestic, and warrants.
  • Suicide: Addicts have a considerably higher degree of suicides than those not addicted.
  • School and employment issues: As addiction leads to a lack of motivation. School and work take a back seat to the addiction.

THE MULTIPLE STAGES OF ABUSE

Your treatment will begin with a determination as to where you are in your addiction. The initial stage of substance usage is experimental. If the high or other desired effect is attained, recreational use usually follows. For those who choose to experiment with either alcohol or drugs, and said desired effect is not attained, the majority go no further or perhaps try once more following their first use.

Most, however, do attain their high, which leads to the problem.

Continued use is the second state, and tolerance is the third, as the user will look for bigger fixes as old tolerances no longer apply. Abuse is the fourth stage, followed by addiction. 

Among the steps that must be taken to support the struggles of an addict, while breaking him or her away from their addiction, include: removing the addict from their negative environment (including the company of dealers and fellow abusers) and placing them within a therapeutic community, the necessity of entering a rehab program and participating in psychological and emotional counseling (and sometimes physical rehab), and how to spot triggers so as to hedge against relapsing.

PRE-INTAKE RESOURCES

Pre-intake is the earliest stage of your treatment plan following a decision to get help. Once the decision is made, further decisions regarding resources for intake services and detoxification (withdrawal) aspects usually follow.

Sometimes, a person can begin treatment without the need to detox. A user may be sober during the period of seeking help. In this regard, detox may be attended as part of an overall treatment plan, although withdrawal from a particular substance may not be formally necessary.

To determine the extent and nature of one’s addiction, pre-intake questions may include the following:

  1. “How long have you been using?”
  2. “Do you believe you have a problem?”
  3. “Do you think others who know you believe you have a substance-related problem?”
  4. “Have others confronted you with questions related to substance abuse?”
  5. “Do you ever use alone?”
  6. “Have you ever substituted one drug for another, thinking one particular drug was the problem?”
  7. “Does the thought of running out of drugs terrify you?”
  8. “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.

INTAKE SERVICES

You will need to prepare the following for intake, based on an application you must complete prior to services being rendered:

  • A list of your prescription medications, if any;
  • Days and times you take your prescription medications, if any;
  • An authorization of medical care;
  • A list of allergies or other medical issues;
  • A waiver of responsibility.

Some applications ask for more than the above. A physician or treatment center representative will then review your application for the proper steps, and treatment.

One of the greatest benefits of a well-thought treatment plan is that every day will bring a new step in your treatment, and each step will lead to another. During this process, you may well learn of the stringency and urgency of structure, especially if your problem is too large for outpatient therapy, and in-patient will be your next step. The structure you learn and the discipline you will attain will help you immensely during one of the advanced stages of your formal treatment process: the sober house.

Conversely, one of the more difficult aspects of the intake process is one of trust. We all know that a user does not always trust easily. If you fall into this category, we need to reinforce to you that your treatment team is there for you. They will spend the time working with you and for you. In as much as you can, speak to them openly. If you believe a given treatment as administered by a professional is disagreeable to you, you need to make that known to them.

DETOXIFICATION SERVICES

There are as many stages of treatment as there are stages of actual drug abuse. Especially if you have an immediate need for a medically-supervised withdrawal treatment, among the first and most important stage in your treatment plan is the decision to enter into a detoxification program.

Detox addresses the physical hold of an addiction. The length of a detox program will vary based on several factors, including the nature of the addiction, and of the addict’s personality. Regarding the former, chemical dependency frequently occurs that must be medically handled, as your brain has become fully dependent on further use of the substance in order to function. This is a medical issue that will frequently require medication to handle.

During the early phases on detoxification, withdrawal will occur which can be a painful process. Your system will be cleaned of the drug, and your brain will learn to operate as it once did. Certain withdrawal symptoms can be life-threatening, which punctuates the importance of full and systemic treatment.

Factors that can influence the longevity of the detox aspect of your treatment program include: What is worse for you, the withdrawal process or the grip of the drug itself? Multi-drug abuse. Pre-existing medical or mental health conditions. Your level of dependence. Genetics. Commitment. Strength of the drug from which you are withdrawing. Fear. Intent following the withdrawal process. Previous trauma. Environment (both that of your home life and the environment of your support system).

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

What is withdrawal? How long does it last?

INPATIENT TREATMENT SERVICES

Post-withdrawal, the process of your ongoing recovery can be either inpatient, or outpatient. Inpatient treatment is appropriate for more severe cases, and the generally more flexible outpatient treatment is geared towards those with a more moderate addiction (though addiction is still addiction) and a stronger support system in their home environment.

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

Most inpatient therapies, regardless of option will last 5-10 days. They can last longer based on the severity of the problem, and the patient’s physical and mental fitness.

Among its services, a PHP will most frequently incorporate intensive one on one therapy in its treatment program. The reason for this is most PHP admissions are due to disturbances in behavior from the drug being abused, or for those who experience otherwise increased symptomatology. In a PHP, the patient is often isolated and of no risk to other patients.

PHPs and RTCs are highly-structured treatment options. PHPs are the most structured options of all. If you have little structure in your home environment, both of these invaluable choices will likely take some time getting used to. That said, the importance to your overall treatment plan cannot be understated.

Note: Substance use disorder treatment is listed as one of the 10 Most Essential Health Benefits of the Affordable Care Act, meaning that your care is covered if you have health insurance. If you do not have insurance, many treatment centers offer financial aid.

Always ask when you speak to a treatment advisor if this is a concern, as inpatient treatment is more expensive than outpatient.

How do I pay with insurance?

OUTPATIENT TREATMENT RESOURCES

Outpatient treatment is often preferred when one has substantial duties in their outside environment, such as school or family. In fact, family and friend group therapy is often included in this option, which is quite flexible in its scheduling. Outpatient treatment has proven to be very effective for those with underlying causes for their addiction, such as eating disorders, to grasp the root of their substance-related issues in a more relaxed setting among familiar support systems.

As an outpatient, you are not enmeshed in as structured an environment, you live at home and you are not under constant supervision.

However, outpatient treatment is no less important or helpful than inpatient treatment. Though the scheduling of your appointments may be flexible, you still need to commit to the time. If you miss one appointment, you will likely miss another.

Ask yourself if you are responsible enough for an outpatient program. If you are, and you maintain your treatment, the rewards can be innumerable.

Both inpatient and outpatient treatment are comprehensive approaches to wellness. You will face

temptations in both but as long as you remain responsible, you will also learn specific strategies as to how to deal with them. It is up to you to take advantage of those lessons.

Should I choose inpatient or outpatient?

AFTERCARE AND SOBER LIVING RESOURCES

Sober living may be the final step in your formal treatment plan before returning home, but treatment never really ends. Sober living houses provide the interim environment between rehab and mainstreaming back to your natural environment. The reason for the initial formation of sober houses was simple: a person in recovery frequently needed a safe and supportive place to stay, during the vulnerability of early recovery, prior to returning home.

Sober houses are also highly-structured, and most residents are referred to a sober living environment from a rehab center. If you had experienced structure during your prior treatment to this point, you should be in good shape.

What happens after discharge?

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