Monday, June 24, 2019

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Drug Treatment in Syracuse, New York

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Syracuse, New York has a large amount of drug-related arrests yearly. Though on its surface that comment may imply an issue out of control, in fact both Syracuse and the state of New York have been among the most proactive states in the county in terms of combating addiction issues with educational programs, strong law enforcement, and therapeutic programs.

The largest issue, consistent with present statewide (and national) trends, is that the abuse of prescription opioids is not only a problem for those who use, but also with the children of those who use who steal the medication to sell on the street, or otherwise trade for pot or    alcohol – preferred substances for their own personal usage. 

Heroin remains a strong concern. Meth also remains a clear and present danger, as it’s been since the turn of the millennium, but treatment admissions for meth are substantially lower than they were a decade ago. Cocaine use is also below the national average, according to many recent statistics, though the drug is still accessible in the area. Crack is negligible compared to pre-2000 usage.

Caucasian and Mexican drug traffickers continue to take advantage of the myriad of transportation systems in Syracuse and the surrounding areas, and as such the state’s ensuing drug problems continue to evolve. Trafficking crosses lines between most state-wide cities and major boroughs.

Based in part on recent statistics and studies, our outlook for Central New York’s Syracuse is this:

  • Drug traffickers will continue to pivot and take advantage of the opioid epidemic;
  • Stronger synthetic heroin will increase production;
  • Opioid abuse will increase pending still-further efforts;
  • Pot and Alcohol use will remain consistent, especially popular among young people;
  • Cocaine may continue to decrease, but will remain readily-accessible;
  • A year-to-year increase of treatment center admissions, regardless of drug, as education continues to hold and users seek treatment early; and
  • Conversely, a lessening of certain physical abuses.

For yourself, your friends and/or your family, we advise that you continue to be aware of your community’s substance issues, and suggest that you join in Syracuse’s efforts to curb drug abuse.

ABOUT THE CITY

Syracuse is the county seat of Onondaga County, with a current population estimated at just under 147,000. The last official number was stated in the 2010 Census, which was then 145,252. It is the 5th-largest city in New York in terms of residency, after New York City, Buffalo, Rochester, and Yonkers. The total area of Syracuse is 25.61 square miles, of which .56 miles is water. The city is considered the economic and educational hub of Central New York.

In 2010, Forbes rated Syracuse #4 in its list of the Top 10 U.S. places to raise a family.

Racial makeup is primarily Caucasian, at 57%, and African American, at 30%. Asian is the next-highest racial group, at 6%. Native American, and Pacific Islander round out the rest, and Hispanic or Latino of any race comprises nearly 9% of the populace. In 2017, the city’s median income for a household with a family was under $43,000, below the state average. In the 2010 Census, males earned an average income of $39,537, versus $33,983 for women of equal jobs or job roles.

Syracuse ranks #50 for cities in the Unites States in terms of high transit ridership. Mass transit of all forms is highly-available, and favored. The economy of the city has had its difficulties, due primarily to the exodus of industrial jobs. University Hill is Syracuse’s fastest-growing neighborhood, of 26 identified as within the city, and is fueled my its neighboring college and medical center. Arts and related culture are strongest in the city’s downtown area.

Syracuse shares a similar drug culture with much of the state, which is considered a High Intensity Drug Trafficking Area (HIDTA).  Pot and alcohol are most popular with young people, college-aged and below. For those older, prescription opiates are the city’s largest problem. Treatment admissions for cocaine typically shows poly-use, or more than one drug in the system at the time of admittance. Heroin use is growing in conjunction with usage in the rest of the state, especially as misuse of painkillers fails, after time, to deliver its desired effect on the part of the user.   

Any examination of Syracuse’s drug problem, however, should include statewide statistics for perspective.

SYRACUSE CITYWIDE DRUG ISSUES

From 2013-2017, Central New Yorkers seeking treatment for substance abuse has more than doubled. In 2017, medical personnel have been called 551 times from one Central New York poison control center alone for patients who were extremely ill as a result of opiate misuse.

These numbers represent a year-to-year increase in CNY’s opioid and heroin abuse statistics.

However, positive news also beckons. From the first quarter of 2017 to year’s end, Onondaga County’s drug deaths dropped notably from prior levels in the same period, by nearly two-thirds. There have been few explanations that have proven acceptable to authorities and educators; however, the decrease has been notable.

2018 may be continuing the trend, based on the numbers from the first quarter in progress. So far, nine of ten opioid-related deaths this year have been due to Fentanyl, which is sold to addicts as authentic heroin. Illicit Fentanyl, mirroring the ingredients of a popular hospital opioid, has become an evolving issue.

One unique program being looked at is the implementation of supervised drug use facilities, where people with addictions, especially opioid addictions, can use drugs under the eye of a medical physician. If approved, Syracuse would be only the third U.S. (or Canadian) city to work with such programs, behind Ithaca – also in New York – and Vancouver, Canada.

The three drugs most commonly used within Syracuse medical centers to curb opioid drug addiction are Suboxone (a combination of buprenorphine and naloxone), methadone, and Vivitrol (naltrexone).

Though the message is mixed in terms of city-wide trends, 2017 arrest headlines bring us quickly back to certain sad realities: Operation Bricktown Busts 52 in Heroin and Cocaine Ring; 12 Arrested After 114 Bags of Heroin, Marijuana, and Guns Found in Syracuse Drug Bust; 7 Busted on Drug-Conspiracy Charges; New Arrests in Marijuana Trafficking Charges; and Recovery of Xanax and Other Drugs Lead to Castle Court Arrests.

Clearly, though progress is indicated, there is still plenty of work ahead.

STATEWIDE DRUG ISSUES

The following bullet points elucidate some general information about New York States’ most notable current drug issues:

  • New York State has a population of over 18,000,000, a statistic that has proven to cast a favored net for drug traffickers to ply their trade;
  • In 2017, 11 of every 100,000 state residents passed away from overdoses related to the blanket “all opioids”;
  • In the same calendar year, 5.5 of every 100,000 state residents passed away from overdoses directly related to heroin;
  • Also in the same calendar year, 7 of every 100,000 residents passed away from overdoses due directly from over-the-counter opioid pain killers;
  • The number of drug overdose deaths in the state have nearly tripled since 1999;
  • The majority of overdose deaths are from misuse of prescription opiates, which outnumber the deaths from heroin and cocaine combined;
  • Annual drug overdose deaths exceed annual deaths from motor vehicle accidents;
  • Sales of prescription painkillers have quadrupled since 1999;
  • New York drug trafficking organizations (DTOs) are run primarily by individuals from the following countries or regions: Afghanistan, Pakistan, Nigeria, Puerto Rico, Columbia, Mexico, Russia, Dominican Republic, Jamaica, Israel, Vietnam, China, Asian immigrants from Canada, and organized crime from Italy.
  • Cocaine abuse is consistent year-to-year, due to the wealth in much of the state.

New York State is multi-faceted as it regards infrastructure, nature, and economy. Central New York’s large cities, such as Syracuse, are central to drug traffickers. Accessible transportation to and from the various cities creates an equal access of drug availability.

PRE-INTAKE RESOURCES

Pre-intake is the process whereby a concerned user believes they may have a problem, and they begin the process of seeking help. Ask yourself the following questions: “How long have I been using?” “Do I believe I have a problem?” “Do I think others who know me believe I have a substance-related problem?” “Does it matter to me?” “Have others confronted me with questions related to substance abuse?” “Do I use alone, or in hiding?” “Have I ever substituted one drug for another, thinking one particular drug was the problem?” “Do I find the thought of running out of drugs scary?” “Have I ever been in a jail, a hospital, or a drug rehabilitation center because of any using in the past?” “Is this what I want with my life?”

If you find your answers to the following questions alarming, we suggest that you follow up with other, more positive questions: “What are my life’s goals?” “Where do I want to be in my life one year from now?” “Where do I want to be in my life five years from now?” “Where do I want to be in my life ten years from now?”

If like many users you cannot answer such goal-related questions, try this: “Where do I want to be tomorrow?” If your answer to this question is dark, or bleak, and related to depression, it’s time to seek treatment. Similarly, if your answer is something positive, the very fact that you have come to this point and have begun researching options also means it’s time to seek treatment.

If you do, your tomorrow may be exactly what you want it to be.

A brief disclaimer: As with any other self-diagnostic tool, questions such as these are exploratory only. You must speak to a trained and licensed professional for any true diagnosis. Still, answering these questions can be extremely useful, and insightful. Remember, if you are under the influence as you answer, you may not be the best arbiter of your responses. If, however, you can be truthful with your responses, the results of your subsequent efforts can be invaluable.

INTAKE SERVICES

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.

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.

We’ve spoken about the power of commitment on these pages before. There will be an element in your treatment of letting go of any defiance and trusting others. Trust usually comes in time.

As we said, intake is but a step in a larger process.

DETOXIFICATION SERVICES

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:

  1. Poly-drug abuse;
  2. Pre-existing medical or mental health conditions;
  3. Your level of dependence;
  4. Genetics
  5. Previous trauma;
  6. 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.

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.

More on Inpatient Vs. Outpatient

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 a structured 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.

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. Requirements and rules are strict, and they usually include:

  • No drugs or alcohol on the premises;
  • No violence;
  • No overnight or sleepover guests, not even family;
  • Commitment to random drug testing;
  • Involvement in a community-related program;
  • Acceptance by a peer group;
  • Acceptance of advice from treatment professionals;
  • Respect for the rules of the house;
  • Following all directions;
  • No swearing;
  • No stealing;
  • No sexual activity between residents;
  • Honesty;
  • As part of a recovering community, if you see or hear any resident breaking the rules of the community, they must be reported immediately to appropriate staff;
  • Anyone on prescribed medication must inform the house manager upon admittance;
  • Residents must attend all sober house meetings;
  • Residents must submit to drug and/or alcohol tests upon request;
  • Rooms must be clean at all times;
  • Chores must be completed without argument;
  • Curfew must be respected.

Many of the above rules are enforced with a Zero Tolerance Policy. Meaning, if any of these rules are broken even once, you risk being kicked out of your sober living home. If you had experienced structure during your prior treatment to this point, you should be in good shape.