Tuesday, February 19, 2019

Dallas

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Drugs and Treatment in Dallas, Texas

The City

Dallas, Texas. The home of President John F. Kennedy’s assassination, the Nasher Sculpture Center, and the Dallas World Aquarium. This western metropolis is modern and commercial, full of culture and country; both reminiscent of agricultural country and patriotic country, a love of state and nation with architecture that mirrors all of the above. Yet also surprisingly diverse, with almost as much of the population (42 % ) identifying as Hispanic or Latino, as there are individuals who identify as Caucasian (50.7%). Within the Latino community, most of the folks came from Mexico, with a very small percentage having originated in Puerto Rico and Cuba. In addition, the African American community maintains a strong presence (24%) and the Asian community holds out with around 3%. Interestingly, the area is host to a large number of Russian speaking men and women, mainly of whom are women married to American men. Paired with folks with lives that began in Asian and African countries, this Texas City is truly a melting pot of cultures.                                                

In terms of gender the population is split 50/50 with male and female being of equal proportions. Dallas is well known for having an  immense number of residents who identify as LGBTQ (Lesbian, Gay, Bisexual, Transgender, and Queer) and the Oak Lawn and Bishop Arts communities are gathering places for groups with common leanings. Within each of these racial and sexual categories, the average age is 31 years old. The median income is $40,000 for a resident of Dallas and average housing prices for the city market are $129,600.           

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The racial makeup of the city is largely segregated into geographic regions that create cultural hubs where businesses and authentic foods circulate and allow immigrants to thrive with a taste of their homeland. A southwest portion of Dallas known as Oak Cliff is inhabited mainly by Mexican residents, as is the East and West side (Hispanic predominantly) and the area known as Garland. A mixed race area where African American and Hispanic residents reside together is found in Pleasant Grove, with the North part of Dallas being another region where all races reside together.  

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

The Drug Culture and Trafficking

Heroin has been on the rise since the late nineties in Dallas and surrounding areas. Although it started out as being mainly men getting into trouble and having physical issues from using the drugs, there are now many women who use as well. Also in previous years was a trend of African American men having the highest rate of heroin use. In current times in Dallas, ecstasy has been the drug of choice when it comes to the club drug category. Ecstasy is also known as MDMA and is said to be produced primarily in European Countries such as the Netherlands or Belgium. However, this may change in the future as news points to the Monterrey area of Mexico as trying to develop production of MDMA in hopes of emerging as the leader in that field. Many of the users of ecstasy are young African-Americans between the ages of eighteen and twenty-four. When it comes to drugs like meth and opioids, there is a high rate of people who commit violent crimes while high or shortly after using. For example, with all drugs there is a correlation to the number of homicide rates; rates are said to be twice what they were when drug use rates were lower in most of Texas. Indeed, violence is intertwined with drugs in all aspects; from production, distribution, to usage.

In the past year, a crime ring bust led the local law enforcement on a path with a Mexican Cartel at the end. This discovery of drug trafficking carried out under the guise of a used car operation is evidence of the work of the Jalisco New Generation Cartel of Mexico actively running drugs in Dallas city limits. Located in the Oak Cliff area, the members of this ring not only had drug sales occurring from the car lot, but they also had several labs where they were crystallizing meth and preparing illegal substances for sale. Gallons of liquid meth and kilograms of actual meth that would bring around 7 million dollars on the street were confiscated from the residence as well as over thirty vehicles from the auto sales lot. The vehicles were seized because police believed that the money from the drug sales was being used to purchase vehicles that could then be resold on the lot. Upon further research, it was discovered that this cartel was formed after breaking off from El Chapo and the larger Sinaloa Cartel and has been in existence since 2010; most likely running drugs for half as long in the Dallas area.The used car lot had been actively engaging in illegal activities since 2016.

Other cartels have also been active in the Dallas area, and most of them have Latino roots. La Sinaloa has a presence, as well as the La Familia cartel and the Los Zetas Cartel. The Ndrangheta mafia, an Italian group, has been running drugs in the area also and is an outlier amongst the Latino groups.

Los Zetas cartel has been repeatedly found to be the cartel that had both a high level of sophistication when it came to equipment with complex technology. However, they have also  been found to be the most merciless and violent of all the cartels and therefore remain an ongoing threat. While violence with cartels is nothing new, the Zetas employ more unusual tactics, stooping to carrying out crimes such as beheading rivals or individuals who crossed them wrong simply to make a point that they are not to be messed with. Zetas are known not only for their drug trafficking but also double in sister scenes such as sex trafficking and gun running. They are even larger and more involved in the American scene than their infamous La Sinaloa counterparts. Mexican authorities arrested one leader of the Zetas known as “Z-43” in Mexico city the first week in February. He had also been wanted by the United States of America and the United States Government had posted a five million dollar reward for his capture because of the vast amounts of cocaine and meth that he was responsible for moving into the country.

Intelligence and law enforcement groups tracking these movements have found that while Mexican groups have the main hold on the area, there are also a few Colombian and Dominican groups operating throughout Dallas and the wider Texas stretch. In addition, there has been evidence that drug cartels who run the east coast are targeting Dallas as a potential business prospect in terms of a distribution center. They seem to believe that they could obtain and store their cocaine cheaper in Dallas and then move it throughout the east coast effectively with a greater profit margin, and idea obviously appealing to anyone money hungry.

State Laws

Jane Maxwell, a drug researcher at the University of Texas-Austin (quoted on The Fix) made the statement that one of the largest problems with drugs that has led to the continuing cycle of abuse and addiction is the idea of what she terms “generational forgetting” where young people do not have the full education to understand how harmful the drug can be and they haven’t seen the way it has negatively affected others in the past.      While her sentiment paves a way for long term change by means of education about experimenting with drugs, methods continue to be tried to combat the present state of abuse.

One such method was put into effect by the Texas Legislature to provide Naloxone, a non-addictive drug that stops the opioid receptors in users brains to prevent the effects of an overdose. It made Naloxone available throughout the state, in stock at Walgreens, and available to people upon request without having the need for a prescription.

Types of Drugs

There are several types of drugs that have surfaced specifically in the Dallas area in the last few years that were previously not as present in the local substance abuse scene. One of these surfaced in 2012 and is a type of heroin that is mixed with over the counter cold medications. The heroin used in the mix is black tar, and the treasured ingredient from the cold medications is acetaminophen leading to a concoction that is referred to as “cheese heroin” on the street. It has not been seen in many regions aside from North Texas and yet within North Texas many youth have been impacted by the mixture. Overdose off of it has been common with individuals as young as fourteen and fifteen years old. The appeal of the drug for younger audiences is seen especially in the way it is administered, as it is a substance to be snorted rather than injected.

The year 2016 in the city of Dallas also saw an increase in use and overdose of two synthetic substances known as K2 and Spice. Even though these drugs are have been put on a ban list, government officials have not been able to regulate them well enough to make them difficult to obtain. Easy access and difficult detection make them preferable for many individuals seeking the satisfaction of a high. Years ago, these substances were considered legal and were largely undetectable in the system. Despite the normalcy of them, they still have medical consequences that are not well-known because the recipe for the drugs is always a little different when they are concocted.   

K2 is also known as Black Mamba, and has many other aliases. It resembles marijuana in its chemical composition but has not been proven to have any of the medical benefit that marijuana is believed to have. It can be rolled into a cigar or cigarette to smoke or can be mixed into herbal tea.

Offenses and Recovery

For someone living in Dallas, Texas there are signs of hope in the recovery process. Many folks receiving care choose to do so within Dallas County or the actual city limits of Dallas itself. Contrary to popular image of harsh punishment and lack of concern for people charged with criminal offenses, leaders of some advocacy programs have argued that Dallas is really ahead of its time in reform of its treatment of drug offenses through means such as a drug court. It is now believed that there are over one hundred and thirty such drug courts scattered across the state of Texas. Judges are known to work with the system and try and place folks into rehab, doing all that they are able to support recovery and help offenders piece their lives together again.                               

Another benefit from the system came in 2009 when the Texas State Legislature passed the bill to support Medicaid Substance Use Disorder Benefit. The coverage has also been expanded to benefit children as well as adults. The concern for children escalated when a drug seizure led to the discovery of mass produced lollipops that were shaped like superheros and contained meth. Mexican and Texas meth labs are targeting families all the way around, from children to adults with their products. People are also starting to use heroin at younger ages throughout the state of Texas and the country, perhaps in relation to these marketing techniques geared at making drugs appealing to all age groups, and especially appealing to folks who do not understand the lasting effects of the drug.  Of course, underage drinking continues to be an issue for adolescents and young adults that can lead to lasting brain damage and many other detrimental situations, ranging from emotional, physical, and social to psychological. When studied on college campuses where much recreational and binge drinking occurs, young adults repeatedly mentioned that it was college and that everyone drank during college. This sentiment points to the larger idea that one must not have to worry about alcohol poisoning or long term addiction and alcoholism because the context in which these actions are occurring adds a level of normalcy to it. Normalcy that stems from a group mentality of acceptance, when the consequences generally only appear on an individual basis (with the exception of car accidents, pregnancies, and crimes against another). With the heroin use, lack of education, and increased drug use on the whole, more individuals are contracting diseases such as HIV or Hepatitis C. This Medicaid benefit is vital as it helps ensure that people with limited means can access help for their addiction for themselves and their children. With this aid benefit they can then start the process of recovery.     

In the state of Texas on the whole, drug possession is taken very seriously. The maximum sentence for possession of controlled drugs is at least ten years and can go up to but not exceed ninety-nine years. In addition, the fine for such maximum possession can range up to two hundred and fifty thousand dollars. Manufacturing drugs has the almost the same penalty, with a few added years as the minimum range is fifteen years. For possession of marijuana a sentence can start with one hundred and eighty days in jail and range up to more than five years depending on the amount of marijuana present and how serious law enforcement considered the situation to be. For example, more than four hundred grams of a substance can lead to life imprisonment and a fine that can go up to a maximum of two hundred and fifty thousand dollars. There is also a separate category of charges that describe the penalties for the offenses dealing with selling drugs or alcohol to a minor. 

For on the ground real time enforcement, the DEA has two sectors: DEA Mobile Enforcement Teams, and DEA Regional Enforcement Teams. The mobile teams alone have carried out over eighteen thousand arrests through their deployments to specific locations. They focus their work on preventing and stopping violent crime in cities that is related to drug use and traffic. Furthermore, there is a DEA office for the division actually located within Dallas city limits, giving them first hand knowledge of what is going on around the city.

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 their 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

Detoxification 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.

What is withdrawal? How long does it last?

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.

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, less strain on insurance, hospitals, and emergency rooms. They also mean lower rates of violent crime and better family situations. Much of the money from the drug trade currently goes back into Mexico and the countries of origin of the cartels that run the drug scene. That money spent by those purchasing the drugs could go to benefit our economy in other ways. Not only would that money flow have an impact, but expenses would be cut in other areas as well. For example, there has been a noticeable increase in Dallas area car crashes. This escalation can be mapped and shown to be in correlation with the rise of drug and alcohol abuse as both impair driving capabilities even for the most seasoned of motor vehicle operators. When under the influence of mind altering substances, everyone is more likely to have a wreck (they impact your vision too!) It is said that traffic accidents in the past six years have cost an average of around six and a half billion dollars, which is all money that taxpayers are providing. 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. The possibilities related to recovery and renewal are endless. The United States of America, and specifically Dallas, as a society need recovery as much as individuals struggling with addiction need it.

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