Wednesday, June 26, 2019

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Drugs and Treatment in Salem, Oregon

Salem, Oregon. The capital of the state of Oregon and the home to universities such as Willamette and Corban. Around 160,000 people call Salem their home and find life in the city with a river that runs through it to be somewhat rainy, but overall quite pleasant. It is a little under an hour driving time from Portland and yet due to its geographic location is often slightly colder than its sister city. The city is overwhelmingly Caucasian with the next biggest group being the growing Latino population. The Latino population currently makes up about 14% of the population in contrast to the 83% White population and the very small 1.3% African American population. The Native American population calls in with a 1.5% hold on the overall population.

Employers include the State of Oregon and food companies such as Kettle Potato Chips. There are eighteen neighborhoods, multiple independent areas, and an array of festivals and cultural events throughout the year. Salem is truly a happening place to be. Unfortunately, not all of the happenings are positive ones, as seen by the overdose rates in previous years.

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

Drugs

The population of Oregon has a major problem with heroin and opioids. In fact, the Center for Disease Control stated that it was one of the top ten states in America with the worst problems with these two substances. Although Portland is the main drug hub for the state, Salem’s close proximity has made it a part of that picture as well. Research shows that most of the users are young men and women who experiment recreationally with prescription pills such as addictive painkillers. They often are not well educated on the long term consequences and effects of these drugs. When they find they still have that strong need for the drug and are unable to obtain the prescriptions they started with, mainly will switch to heroin because it gives them a similar high. Therein lies the root of the problem throughout the state and yet it extends far beyond that. A study done several years ago revealed that when the escalation first started the largest number of people dying from overdoses were actually women in their forties and fifties who used heroin, most likely after transitioning from opioids.

Risk Factors

Many of the identifiable risk factors for an individual to become a substance abuser can be directly linked to environment during childhood. Parenting style, particularly styles in which there is a general lack thereof parenting, or an overt absence of love and care being shown by the parents is one element that can lead to trouble down the road. If a parent is doing drugs a child is also more likely to get hooked on drugs and continue that habit into adulthood. In addition to love and nurturing, the amount of  discipline laid upon the child makes a difference as well. Clear, enforced rules and the ability to see consequences is a helpful deterrent that molds an individual for their choices down the road. Other struggles including high stress and broken home life, issues in school either academically or socially, and general lack of acceptance play a role as well.     

However, there are other factors that can also be attributed to the city on the whole. The ability to obtain drugs locally with ease is an important piece of abuse as is knowing people involved in the drug scene or having friends who are using and abusing. Being in an area in which a lot of drugs move through makes them easier to obtain and often means there are more people in the area who do not put as strong of a stigma on drug usage.  Areas that are on a drug trade route tend to have an abundance of drugs circulating that are then offered at lower costs locally. Furthermore, drugs now occur in many different forms, such as meth being put into candy that looks appealing to children, all of which changes the stigma and often allures first time users who may be completely unsuspecting.

Many researchers believe that genetic factors play a huge role in addiction as well and argue that it can be a disease, with certain individuals more prone to becoming hooked on a substance after trying it due to the wiring of their brain and the chemicals within. This goes hand in hand with the concept of using drugs to self-medicate for co-occurring conditions such as anxiety or depression. Other researchers argue that the age at which drugs are first tried and the drug that was tried correlates to how strong the abuse is later in life. If a young person takes a few extra doses of cold medicine and continues to take it when they are no longer sick, does this always turn into lifelong addiction or simply a passing phase? This is one of the questions that continues to be explored.

Lastly, economics plays a role in drug use and abuse. Not to say that many affluent families are immune to addiction (in fact, these families tend to be where prescription pill abuse and alcoholism are most rampant) but for youth in low income areas who look around and see no options for escape, selling drugs often appears to be a viable option to make a living. Thinking that occurs along those lines in relation to the perceived “benefits” of drugs is often witnessed during critical transition periods in a young person’s life, whether it be starting school, sports, moving, their first relationship, etc.

Signs of Drug Abuse and Addiction

Perhaps the most common identifier of substance abuse is the overall change in each aspect of a person’s life. Individuals who are using are often noted for having bloodshot eyes or dark circles under their eyes. They may have gained weight or they may have lost weight, depending on the weight they started at. They may complain of insomnia or be unable to wake up and stay awake for any length of time once they fall asleep . Other physical transitions are seen in ongoing “illness” which although it may appear as flu-like it is in reality the effects of withdrawal from a substance that the body has become used to having in its system and thinks it “needs.” Friends and family often observe they seem more reckless and have general disregard for rules or warnings. Often these same individuals distance themselves from previous friends and family and start spending time at locations that may be foreign to them with people they never previously mentioned. Sometimes the change in behavior is more secretive and is noted by being more reserved whereas other times it may be more overt with objects being stolen and money being obtained at all costs so that they can pay for more drugs.       

With the rise of prescription drug abuse, doctors have ironically become abused in this cycle as well. Many addicts will doctor shop, or go to several different physicians to obtain painkillers or narcotics for the same issue, simply so they can have the extra pills to use. If a loved one is taking pills after the initial issue has subsided, or borrowing pills not prescribed for them, these too may be signs of an underlying addiction.

Experimentation to Addiction

When initial exposure to illicit substances occurs, most often one of two scenarios plays out. The first scenario is that the individual shown the substance says no and leaves the situation, or at least has strong enough feelings against drugs to decline. Sadly, this is a less common scenario and is becoming increasingly rare. The second scenario is that the person knows drugs can be harmful but they are curious what drugs are like and decide it won’t hurt anything to try just a few. Just a little. Just enough to know what it feels like. With this decision comes the perceived belief they will try it tonight and never have to see it again if they don’t like it or decide they do not wish to see it again. However, this is the stage where addiction gets its early reach on the brain. After experimentation comes the phase of social use where peers are using and the individual only uses in the company of others, either as a way to fit in, enjoy the party more, or just relax. When this stage escalates and becomes increasingly common it often manifests itself as binge drinking or heavy usage. This step transitions into addiction, the chemical long term change or disease that is related to a psychological and physiological dependence.

Recovery

Due to the large numbers of individuals battling addiction within the state, there are numerous options when it comes to recovery. Whether an individual is seeking private or government rehab services, has insurance or is without, is admitting themselves or being admitted by a court order, there is something for everyone and many of the options are located within Salem city limits. However, if none of the Salem options satisfy, Portland has tons of options for receiving help in both  inpatient and outpatient services as well.

Assessment

When beginning to investigate rehab, a variety of words will appear in the literature about options and in personal conversations with representatives. Assessment is often the starting place after having self-identified or being identified as potentially needing rehab. While assessment varies based on the facility and their approach, as a general rule several individuals with unique focus areas (i.e. social worker, psychologist, nurse, etc.) will work together to understand each potential clients’ circumstances. The client will provide information via questionnaires and conversation, as well as often being asked for a urine and hair sample. This process serves to help the treatment center better understand whether the client is dealing with an actual addiction to said substance, and if so what the depth of their addiction may be. Furthermore, it allows specialists the opportunity to see if there are co-occurring conditions, be they psychological or environmental, at the time of admission. Whatever conditions are discovered provide better insight into the addiction itself and are also often able to be simultaneously treated.          

Pre-Intake

During this phase of interaction with the potential treatment center, the service provider works with the client to map out what a treatment plan would look like, and seeks to name the ways in which life will change for that individual once they enter into rehab. In doing so, they are able to identify potential barriers to the treatment process, as well as struggles that may be specific to that individual. Since the life of an addict is often surrounded by a web of uncertainty, it can be invaluable to have the stability provided in a plan of treatment. However, even in its positive form, it is still a tough transition, and working with the facility to find the best program and fit is vital.                                                               

Intake

While a client may learn some about a facility during the pre-intake, it remains very important for the client to find the rehab facility that best fits their needs and liking. Not only does the initial impression need to be positive, but the ongoing climate of the facility needs to be good enough to ensure retention and a level of change occurring in the patient so that they do not simply leave the program. Since rehabilitation as an overall process differs from detox in its focus on lifestyle and thought pattern change and overall transformation, the intake process is more of a partnership with the rehab facility, whether it is self-initiated or proposed by a family member or close friend. Paperwork, urine samples, and breathalyzer all generally occur during this stage. 

Detoxification

Detox can be a step in a rehabilitation center, and it can be a separate process completely, depending on the approach of the providers. In its most basic form however, detox is the withdrawal and cleansing of the body from the drug. It can be a very difficult process as the body craves the drug and has repeated visceral reactions to not having said drug that often resemble the symptoms of having the flu. However, this experience is made much more pleasant by the trained stuff able to assist the patient during the process. Centers are able to help monitor the physical process and do their best to aid in the transition for the client.

The Treatment Process

One of the main benefits of inpatient treatment, or treatment within a facility that offers around the clock care and trained staff to assist with all aspects of the transition, is that the friend groups, stress points, and triggers to use are temporarily removed as one is isolated from the outside world. RTC tends to be focused on individuals who have been struggling with addiction for an extended period of time or who may have been battling another co-occurring issue. PHP (partial hospitalization) allows for the freedom of not needing to stay the night, and yet having more intensive care during the daytime hours than at normal outpatient treatment. The third option, IOP, focuses more on illnesses such as eating disorders and depression, while also treating addiction in a subtle way so that the client is able to go about their work or family life in as normal a routine as possible.

When an addict has a community supporting them and the means to start replenishing the life they diminished during their drug use, outpatient treatment is often a good option. This format often requires meeting with a therapist during the week who specializes in addiction counseling, and following their advice along with the advice of a medical provider.

Whatever route an individual decides to follow when seeking help, it is vital that an aftercare plan is in place for the time period when the initial treatment has ended. Even after returning to society or passing benchmarks for sobriety, triggers such as lifestyle changes may still lead to a relapse. Having an aftercare plan in place helps ensure the recovery will truly be long lasting. Aftercare plans in which individuals “check in” and receive remedial work/information are very common. However, for individuals needing more than occasional realignment, options such as sober living communities exist, where people trying to stay clean live and work together and follow a set of house standards and rules. There are many different options, particularly in major cities surrounding areas like Salem. These options include those that are faith based and those that are non faith based.

Regardless of the route, recovery is worth the effort. Not only does it benefit the individual, but it also helps the entire community. Lower rates of addiction mean many benefits for the community at large, including less strain on insurance, hospitals, and emergency rooms. They also mean lower rates of violent crime and better family situations. Local law enforcement are able to save time on drug arrests and focus more on preventing violent crimes and keeping the community safe. Tax dollars are saved by the millions. Furthermore, there would be lower rates of HIV and Hepatitis C and that kind of transferable disease with lower rates of drug use. Prostitution rates might decline as well. For Salem to continue to be the thriving, bustling city that it is, and to continue to grow and develop in healthy, holistic ways, it needs to fight to reclaim its youth and young adults. Previous drug education programs have since become outdated and are not as effective as they once were in the 1980’s and 1990’s. While drug researchers across the country work to develop new solutions and law enforcement officials work to find new ways to save lives and prevent crime, the one truth that has surfaced continues to that recovery benefits everyone. The possibilities related to recovery and renewal are endless. The United States of America, and specifically Salem, as a society needs recovery as much as individuals struggling with addiction need it.