7 Of The Most Unknown Street Drugs Today

The war on illicit street drugs never ends 

As dangerous new drugs appear on the market while other, older drugs get “rebranded” under new names. While cocaine, LSD, heroin and amphetamines still cause problems, narcotics agents see dozens of new drugs appear each year. The Drug Enforcement Agency often quickly moves to restrict the most dangerous drugs as Schedule I drugs (a listing that includes cocaine and methamphetamines) under the United States Controlled Substances Act. But wily backyard chemists quickly tweak the chemical formula, and come up with a legal variation to market under a different slang term. Here are just a few examples of dangerous new recreational drugs, or variations of old ones, which have hit American streets in recent years.

7. Flakka

A variation on the “bath salts” fad, this drug resembles small white rocks, hence the alternate name, gravel. That’s a much more convenient term than its patented chemical name, alpha-pyrrolidinopentiophenone, or a-PVP. Flakka can be cut with anything from clonazepam — a muscle relaxer — to rat poison. Some local drug enforcement agencies report seeing a sharp rise in incidents involving this highly addictive stimulant; its use has become widespread in South Florida and there are numerous media reports of arrests in the Tri-Cities area of Tennessee and southwestern Virginia. As one user told a Tennessee TV station, “It’s like crack for my generation.” Use of flakka, which can be smoked, injected or snorted, induces hallucinations and paranoia; habitual use can result in kidney failure. As with so many other synthetic drugs today, where the DEA always seems one step behind clandestine chemists, in early 2014 the DEA issued an emergency ruling to designate a-PVP (flakka/gravel) a Schedule I controlled substance.

6. Kratom

Kratom is made from the leaf of a tree indigenous to Thailand, where it has been chewed or eaten for centuries. It has also been illegal in that country since the mid-20th century (that hasn’t stopped many Thais from making a trendy drink known as 4×100, using a mixture of boiled kratom leaves, cough syrup and Coca-Cola). Now, other countries, from Europe to Southeast Asia, are taking a closer look at this psychoactive plant that can act as either a stimulant or depressant, depending on the dosage. In the U.S., the Drug Enforcement Agency currently lists kratom as a “drug of concern,” as the herb is making inroads into the country, as a tea, powder or in capsule form. While some medical professionals worry that kratom is dangerously addictive, others point to possible benefits from the drug, including using it as a substitute to wean people from prescription painkillers and methamphetamines. There are even calls in Thailand to decriminalize the drug.

5. Spice

Spice can be found in many convenience stores and online, often marketed as a “legal and natural” marijuana alternative, and sold in packages marked “Not For Consumption.” But many people are smoking this, as the active ingredient is a variant of synthetic cannabinoid. Five active chemicals found in typical spice blends are listed as Schedule I substances by the DEA, though manufacturers continue to attempt to bypass these restrictions. Spice also goes by many other names, including Moon Rocks, Black Mamba, and K2. The National Institute on Drug Abuse says many spice blends are particularly dangerous because the ingredients are unknown. Although the DEA mentions no reported deaths by overdose, possible side effects of these drugs include paranoia and panic attacks.

4. “Vitamin K” or “Special K”

The “K” in its various street names comes from ketamine, originally developed 60 years ago as a veterinary anesthetic. It didn’t take long for this drug to find its way to the black market; by the 1970s, ketamine’s hallucinatory effects led to the development of angel dust, or PCP, two drugs that led to frightening cases of abuse and death. Ketamine can be consumed in many different forms: injected or poured into drinks as a liquid, or converted into powder and smoked or snorted. Popular today at raves and nightclubs, ketamine is also known as a “date rape drug” and is swiftly emerging as a drug of choice in the Far East as well as the UK. Although details of deaths and injuries from this drug are sketchy, there were reportedly 529 emergency room visits involving ketamine in the U.S. in 2009, according to the Drug Abuse Warning Network. Regular ketamine use has been linked to kidney and bladder damage.

3. Smiles

Similar to a street drug known as N-bomb, both smiles and N-bomb are derived from a psychedelic drug discovered in 2003 known as 25I-NBOMe. The difference in N-bomb vs. Smiles is the substitution of one iodine atom for a chlorine one. An interesting distinction for chemistry buffs, maybe, but users get a similar experience from the two drugs, with sometimes deadly results; at least five deaths in the U.S. had been linked to 25I-NBOMe (Smiles) as of mid-2013. Available in pill, liquid, or powder form, Smiles can cause hallucinations, seizures and panic attacks. And while you might think the street name for this drug comes because it makes users smile, the reality is more technical: “Smiles” is a play on the abbreviation for a common chemical term, “Simplified molecular-input line-entry system.”

2. Molly

A new and refined variant of Ecstasy (3/4-methylenedioxymethamphetamine) or MDMA, users frequently believe Molly is safer than that popular drug. The Drug Enforcement Agency, however, has listed it as a dangerous Schedule I controlled substance and use of Molly can — like Ecstasy — cause users to become confused and unable to regulate their body temperature, heart rate or breathing. At a Washington State music festival in 2013, the DEA reports one person died and 125 were hospitalized, some in intensive care, after taking Molly. The drug is extremely popular in many college towns, largely the result of its relatively low cost. The name Molly is short for “molecule.”

1 Acetyl Fentanyl

A new synthetic opioid drug five times more potent than heroin, acetyl fentanyl was never marketed for medical use. This drug first surfaced on the radar of law enforcement in 2013, after a Centers for Disease Control and Prevention advisory attributed 14 overdose deaths in Rhode Island to acetyl fentanyl use. Dozens of additional deaths have since been reported in Pennsylvania, Louisiana and North Carolina. The CDC advisory recommended that emergency rooms stock naloxone, an antidote to acetyl fentanyl and other opioid overdoses. An analog of fentanyl, new street drugs such as acetyl fentanyl are often missed by coroners and crime labs, simply because they aren’t looking for them.

One More: Krokodil

Many horrific krokodil stories surfaced in 2013, involving people who supposedly became addicted to this drug, even as the drug caused the flesh to literally rot off their body. Many critics wondered why anyone would take a drug, allegedly made with a mixture of codeine, gasoline and hydrochloric acid, that caused their skin to rot off in zombie-like fashion. As it turns out, there is hope for the human race after all; Krokodil is apparently an urban legend of drug use, unintentionally spread by even major national news outlets. Forbes.com did a great job debunking this urban legend.

Written on Listosaur: 7 Dangerous New Street Drugs

Counterfeit “Oxys” Containing Dangerous Fentanyl in Mississippi

Police in Gulfport Mississippi have issued a warning to the public (May 7, 2018) about counterfeit Oxycodone tablets that look like regular “oxys” but are actually made of the dangerous synthetic opioid fentanyl. Analysis in a DEA lab revealed the pills contained no oxycodone at all. Pills containing fentanyl carry a high risk of overdose and death, especially if users are unaware of their actual content and are likely to take too many.

Written By the National Institute on Drug Abuse at : Emerging Trends

Prescription Overdose Deaths in Florida Plunge After Tougher Measures, Report Says

Prescription drug overdose deaths in Florida fell sharply after the state began strengthening its prescribing laws and stepping up enforcement. Federal researchers said Tuesday that it was one of the first significant documented declines in the nation since the epidemic of prescription drug abuse took hold more than a decade ago.
The death rate from prescription drug overdoses in Florida fell by 23 percent from 2010 to 2012, according to a report by the Centers for Disease Control and Prevention, and by more than half in the same period for oxycodone, one of the most widely abused drugs and one that has been at the heart of the health crisis.
Florida began making legal and regulatory changes in 2010, for example requiring pain clinics to register with the state. At the same time, the authorities conducted statewide raids that resulted in drug seizures and the closing of pain clinics. Federal researchers who wrote the report said that the decline in deaths might not be exclusively attributable to the reduction in prescribing, but that the timing suggested it had been an important factor.
Dr. Thomas Frieden, director of the C.D.C., said the pattern provided a hopeful example of the effect that policy could have on one of this country’s most entrenched public health problems, one that takes the lives of more than 20,000 Americans a year.

“This tells us that policies and enforcement work,” Dr. Frieden said. “This is an epidemic that was caused largely by inappropriate prescribing, and it can be fixed to a significant extent by improving prescribing.”
With the decline, the rate of prescription drug deaths in Florida fell to 2007 levels, a significant achievement. Pain clinics had proliferated in Florida, and by 2010 the state was home to 98 of the 100 doctors nationally who dispensed the highest quantities of oxycodone directly from their offices, according to the report. In the six years before Florida changed its laws, deaths from drug overdoses surged by more than 60 percent.

Florida has reported that about 250 pain clinics had been closed by 2013, the C.D.C. said, and the 98 doctors who had prescribed high volumes of oxycodone dwindled to 13 in 2012. By 2013, there were none. The decline documented by the federal agency does not include a continued fall in deaths in the first half of 2013, the most recent reporting period for the state.

The national rate of prescription drug deaths has remained persistently high through 2011, the most recent year for which there is national data.
Dr. Nathaniel Katz, an adjunct assistant professor of anesthesia at Tufts University School of Medicine in Boston, whose company, Analgesic Solutions, develops treatments for pain, said Florida’s prescription drug monitoring program had made it much more difficult for patients to shop for doctors, a practice that raises the risk of overdose.

“Florida has finally shut down criminal prescribing, after years of flooding the market by unbridled prescribing,” he said.
Overdose deaths from illicit drugs like heroin and cocaine increased slightly in the period covered by the report, possibly a sign of people switching away from prescription drugs. Still, the increase did not offset the decline in Florida’s prescription drug deaths. For example, there were 668 fewer overdose deaths from opioid painkillers in 2012 than in 2010, compared with 60 more heroin deaths. In all, 108 people in Florida died of heroin overdoses in 2012, compared with 2,116 who died from prescription drug overdoses.
A few states have reported declines in overall drug deaths, but none as deep and sustained as Florida’s. In Washington State, a substantial decline in prescription opioid drug deaths was offset by a rise in fatal overdoses of illicit drugs. In Utah, a reduction in prescription opioid drug deaths was not sustained, and North Carolina’s decline, like Washington’s, was wiped out by a subsequent increase in fatalities from illegal drugs, said Dr. Leonard Paulozzi, one of the authors of the report.
In Florida, deaths declined for those drugs for which prescribing also dropped. Oxycodone prescribing fell by about a quarter, the report found, while morphine prescribing increased, as did deaths from it.
The sheer number of prescriptions has helped drive abuse in the United States. In 2012, more than 259 million prescriptions for pain pills were dispensed, federal researchers said, enough for every American adult to get a bottle of them. In a separate analysis on Tuesday, federal researchers found that most of the highest prescribing states were in the South. Doctors in Alabama, the highest prescribing state, wrote almost three times as many prescriptions per person as doctors in Hawaii, the lowest prescribing state.
The C.D.C. report noted that a 2010 formulation of oxycodone that made abusing it harder may have also contributed to the decline. But most of the decline in both prescribing and deaths happened after 2011, leading federal researchers to put less emphasis on that as a reason.

Written by the New York Times at: Overdose deaths drop dramatically after tougher laws

At NJ Hospitals, Ex-Users Urge Opioid Overdose Victims to Seek Treatment

“The first time I did heroin was in Brooklyn House of Detention,” recalls Eric McIntire, sitting in a windowless conference room at Barnabas Health Medical Group in West Orange, New Jersey. His two iPhones, which ring loudly and often, are on the table in front of him.

Eric McIntire today: recovery support specialist at RWJBarnabas Institute For Prevention & Recovery in Eatontown, NJ

A native of Tottenville, Staten Island, McIntire recalls candidly how in his teens and twenties he turned his mother’s quiet, dead-end block—“the white-picket-fence-type thing”—into a “high drug-traffic area with a lot of ridiculous activities going on.” A bullet once shattered his mother’s bedroom window, he says. Heroin helped McIntire come down from crack, and dealing drugs helped pay for both. “I thought I was the Scarface of the world,” he laughs. “Meanwhile I couldn’t make enough money to re-up.”
Stories like these come in handy for the gregarious 45-year-old father of three, now sober going on fifteen years. He’s the recovery support coordinator at RWJBarnabas Health Institute for Prevention and Recovery—part of New Jersey’s largest health and hospital system—and his job is to make a connection with opioid overdose patients and persuade them to get on the road to recovery. He supervises 60 other recovery specialists— each in recovery for at least four years—who are deployed at hospital emergency rooms in seven counties, trying to do the same thing.
When patients reach the ER due to an overdose, it’s a fateful moment. Traditionally, hospitals just stabilized such patients and discharged them, pigeonholing addiction as a behavioral disorder, not a medical one, and, therefore, not their concern.
But such patients’ prospects are dismal. Among those who shoot heroin, about half of overdose survivors will eventually die from another overdose, according to Adam Bisaga’s new book, Overcoming Opioid Addiction.
Though hospitals are powerless to force patients into drug treatment, and ideal treatment may not be geographically or financially available, some hospitals are now taking what steps they can. A growing number of systems now enlist the services of peer counselors, like McIntire. In 2016, the New Jersey Department of Health, inspired by a Rhode Island program called AnchorED, began offering counties $255,000 in grants to hire and train former addicts as recovery specialists. The program is now in 42 emergency rooms across all 21 New Jersey counties.
“We’re definitely in a moment,” says Suzanne Borys, an assistant director at New Jersey Mental Health and Addiction Services. In July 2016, the National Governors Association endorsed the use of peer counselors to try to cajole opioid users into recovery, and today there are such programs in Massachusetts, Ohio, and Delaware, too.
Taking advantage of the her state’s grants, Connie Greene, Vice President of the Institute for Prevention and Recovery at RWJBarnabas, incorporated recovery specialists into her system’s new Opioid Overdose Recovery Program. Two years earlier she’d noticed an increase in emergency room patients in Monmouth and Ocean Counties who’d been administered the anti-overdose drug Narcan. Emergency room staff expressed frustration with these patients, who were in withdrawal and often upset.
At that time, Greene recalls, “patients were given a brochure, which ended up in the garbage before the individual left the hospital.”
Sensitivity training for ER staff was also falling flat, she says, since doctors and nurses didn’t have time to develop a bedside connection.
Between 2014 and 2016, only one patient agreed to try a treatment program. “He got into detox but left the next day,” Greene recounts.
With the arrival of peer counselors, Greene says, the “magic” kicked in, and more patients could be reached.
McIntire meets patients lying in a hospital bed, less than an hour after they’ve been administered Narcan. In a sea of nurse scrubs and lab coats, he’s the guy in street clothes. Many patients are afraid. Two of the sentences he hears most often are, “Am I getting arrested?” and “When can I get out of here?”
“Another big one is, ‘You have no idea what I’m going through,’” McIntire adds. “And I’m like, ‘Oh no. I know exactly what you’re going through. Mind if I sit down for a couple minutes?’”
Some bedside scenarios are easier to navigate than others. Patients have spit at McIntire when he starts in with his “recovery bullshit,” he admits, and he’s seen people angrily rip IVs out of their arms, spurting blood. He says recovery specialists know to leave when a full-fledged argument seems inevitable. But they follow up regularly by phone for eight weeks, regardless of the patient’s bedside mood. Greene refers to the follow-up practice as “lovingly stalking.” Specialists make three calls or texts in the first week, including the morning after the overdose; three calls the second week, and two each for the next six.
McIntire’s team boasts a 95-percent “participation rate,” by which they mean that the patient engages in bedside conversation or followup telephone calls. Once the patient is cooperating to that degree, a clinical navigator, as they’re called, talks to the patient over the phone. Using criteria from the American Society of Addiction Medicine, the navigator recommends an individualized treatment plan, based on the patient’s interest in treatment, mental health, history, and living situation. Clinical navigators also assess patients’ financial needs and help them find programs with available spaces.
Among public health authorities there is a broad consensus that medication-assisted treatment (MAT) is the safest and most effective treatment for opioid addiction, running the least risk of relapse and subsequent fatal overdose. (Overdose after detox is particularly dangerous, because patients have lost their tolerance.) Ideally, MAT means long-term, often lifetime, treatment with either methadone, buprenorphine, or naltrexone, backed up with behavioral therapy and support groups.
But New Jersey hospital officials have found that the reality on the ground is challenging; such state-of-the-art programs are hard to come by, and patients and their families often don’t want them.
While medication-assisted treatment is the “gold standard,” Greene says, many patients still prefer inpatient detox. “Let’s just say the field is in a process of change,” she admits.
There’s a lingering stigma around MAT, according to Borys. “It’s one of the things we’ve been struggling with,” she says. “There’s a pervasive notion that detox is the answer. It’s been institutionalized.”
The program is too new to have yet compiled any recovery success metrics. New Jersey does keep track of patients’ decisions about what path to take after their initial bedside conversations with recovery specialists, though. Across the state, 22 percent of patients accepted either detox or medication-assisted treatment at bedside, according to Borys. Another 39 percent agreed to try a recovery group or meeting, she continues. Eighteen percent refused services altogether, although some of them later changed their mind during follow-up calls. Another 21 percent fell into a variety of other categories: patients who left the hospital without a formal discharge, or didn’t participate because they were incarcerated, or or didn’t participate because they were hospitalized long-term for an unrelated illness.
Meanwhile, overdose deaths continue to rise in New Jersey. According to the latest figures from the Centers for Disease Control and Prevention, 2,542 people fatally overdosed in the state during the 12-month period ending September 30, 2017—a 50.2 percent increase over the preceding 12-month stretch. (The 2017 figures are provisional, meaning they are likely underestimated.)
The year-over-year rise is the worst in the nation—striking for a state whose governor during that period, Chris Christie, was so associated with fighting the epidemic, and chaired the White House commission on combating the opioid crisis. One major factor is the influx of illicit fentanyl—the deadly synthetic opioid far stronger than heroin—which was associated with 818 overdose deaths in New Jersey in 2016, nearly double the 417 such deaths in 2015.
Against this tide, one of McIntire’s strategies is to invite patients to a peer-led recovery meeting, regardless of their recovery status. “Whether you’re in-and-out, you’re on medication, whatever,” he says. “Anybody’s welcome.”
He also gives out his phone number—to everyone. In addition to emergency room calls at all hours of the night, McIntire gets calls from former patients seeking help after a relapse.
“Once they’re in, they’re in,” he says. “They have my number. I’ll never change my number.”

Written By Emma Whitford at: Opioid Watch

Families Share Stories of Strength and Surviving a Loved One’s Addiction

Sharing an addiction story takes courage, not only for the addict but also for the family, friends, supporters and loved ones who have been affected by addiction. Alcohol and drug abuse can carry so much denial and stigma, that many times those who do or have used will not admit it, sometimes even to themselves. Families often bond and seclude themselves to avoid discussing the struggles they face, ashamed and afraid of potential consequences. However, surviving a loved one’s addiction, and better yet, bringing them into recovery is something to be celebrated.

Sharing Stories of Surviving a Loved One’s Addiction

So sharing these stories takes incredible courage, but stories of strength and survival have the potential to help others. Around the world, families are coming forward to speak out about surviving a loved one’s addiction.
Approximately 10% of the US population, age 12 and older, uses illicit substances or abuses prescription drugs. With so many millions of people affected by substance abuse, it’s time to start removing the stigma by sharing stories of surviving a loved one’s addiction and joining together to combat this national epidemic. No matter what stage of recovery your loved one is in, there are stories of survival to comfort you and strengthen family bonds.

Survival 1: Watching Someone Slip Away

Karen and James had been married for 12 years when he broke his leg in a skiing accident. James was away on a trip with a group of friends, fit men in their late 30’s and early 40’s, all of them. So the injury itself came as an unfortunate surprise, but little did they know it would be the beginning of a terrible change in their lives.
James needed surgery and the recovery was painful. To cope with the pain he started using a prescription opioid, OxyContin. At first, he took it exactly as prescribed, but then he started to take more.
For Karen, the hardest part was when she realized she didn’t recognize her husband anymore. He yelled at her and their two children. He lost his job but did not seem interested in getting another one. He seemed agitated all the time.
At first, she didn’t even know that he was abusing the pain pills until she realized how many empty bottles she had seen, and found one that had someone else’s name on it. “Watching someone change before your very eyes, someone you knew and loved for so long, that was the hardest part,” Karen says. “I think it was even harder on our son. Dad was a hero in his eyes, and then he was just… someone else.”
By the time James got help, he had been legally and illegally obtaining oxycodone, and sometimes resorting to heroin. So what is a family to do, in that situation, when you suspect someone might be using drugs, or abusing their medication?
“I think you should confront them,” Karen advises. In retrospect, she wished she had said something sooner. “Maybe it wouldn’t have changed a thing. Maybe I didn’t really want to admit what I suspected. But then again, sometimes I wonder if I would have gotten James back before he had gone so far.”

Advice for survival 1:

  • Confront the suspected addict.
  • Learn about enabling, and don’t do it.
  • Solicit help from other family members.
  • Stick together and show unconditional love.
  • Your support can make all the difference.

Survival 2: Waiting for “Rock Bottom”

Many of the families who have been through the process of surviving a loved one’s addiction talk about the hopelessness felt when watching a loved one hit what seems like “rock bottom,” only to watch them crash again. You may see them go to rehab, only to get out and use again, sometimes many times.
Maintaining and building family relationships under such circumstances can seem impossible. Just ask Nadine and Corinne Purdy, two sisters whose story of devotion under the stress of addiction was televised through an NBC Dateline special.
Nadine hit rock bottom more than once. She got help and stayed clean, only to spiral out of control again. She was homeless and even ended up in jail, while pregnant. For her, she had two guiding lights: a desire to be reunited with her children, and the unwavering support of her younger sister, Corinne.
Eventually, a true change occurred. “I like myself finally,” Nadine reports. “I really do. I never — from the time I was a child, I always wanted to get out of my own skin, and now I’m comfortable in it… I’m a walking example that there is a God because so many miracles happened in my life, and it’s all because I’m sober and I deal with life the right way.”

Advice for survival 2:

  • Patience, patience, and more patience. No one changes except by their own choice. You can encourage, even insist, but you cannot force a change.
  • Seek out support from friends or loved ones. When someone you love is an addict, you may feel like you need to hide it, but that can be isolating and lonely. You deserve your own support network.
  • Stage an intervention and draw the line in the sand that you will not cross, so you do not enable.

Survival 3: Rebuilding Relationships in Recovery

In a treatment program, addicts also learn about improving relationships with family and friends. Undoubtedly, those relationships get damaged while using or abusing drugs and alcohol. Survival at this stage, for the long-haul, often requires incredible strength, humility, and forgiveness.
For the addict: Learning to communicate and repair relationships can be an important step in recovery. Programs also often teach to make amends in some way, with those whose lives have been damaged as a result of your addiction. Suggestions include:
Sending updates and regular communication while in recovery.
Admitting wrongdoing, without any particular expectation of acceptance of those apologies, since everyone must learn to accept in their own way and on their own terms.
Making up damage, if at all possible, such as replacing the stolen money.
For James, after rehab, he realized that repairing his relationship with Karen and their two children would take time. He decided to set a “date night” with each of them once per month, so that he could show them each that he cared for them, as individuals. “In some ways,” Karen reports, “We are doing better than ever. We know we’ve lived through hell and come out alive.” Surviving a loved one’s addiction is never easy but is so rewarding.
For the loved one: Getting this sort of advice can create a sense of hope, but also one of expectation. But no two recovery stories are identical, and expectations can get in the way of reality.

Instead, consider these suggestions:

  • Communicate support
  • Do your best to forgive
  • Practice patience, it does take practice
  • Forgive yourself, which can often be the toughest part
  • Encourage, whenever possible, and try not to find fault or criticize or point out perceived wrongs

Surviving a Loved One’s Addiction Takes Working Together as a Family

Working together as a family, you can often restore bonds. It takes persistence, and more than a little patience and forgiveness on everyone’s part. It takes letting go of expectation, about who someone “should” be or what they “should” do, and instead allowing everyone the personal space and freedom to make mistakes and find their footing.
But above all else, surviving a loved one’s addiction takes strength. If you are ready to share your own story of strength and survival, comment below and let us know. We would love to hear from you.

Written by Serenity at: Families Share Stories of Strength and Surviving a Loved One’s Addiction

Women addicted to opioids turn to sex work in West Virginia

‘”If I went back out on the street, I would die,” said one former sex worker and recovering opioid addict.

HUNTINGTON, W.Va. — There was a time when Beth would have laughed if somebody had told her she would wind up selling herself on the streets.
She had loving parents. She had a high school degree. She was 19 and plotting her next move in life.

 

Then her old friend Amber handed her a little green pill.
“It was an Oxy 80,” Beth said, using the slang for an 80-milligram tablet of the opioid painkiller Oxycodone. “She said, ‘C’mon, just try it one time.’”
Five years later, Beth was walking a seedy stretch of Sixth Avenue in Huntington and Amber was watching her back while car after car slowed down to check them out.

“I was a little nervous, scared, but I got a pep talk” from Amber, Beth said as she recounted that first night. “She made it like it was fun. She convinced me there was a freedom in it. She said, ‘You’re making your own money.’”

By that point, Beth said she had already traded sex for drugs with several dealers.
(Beth, as well as Amber’s family, asked that they not be identified by their full names to protect their privacy.)
“I had been used to faking it, wearing a mask to survive,” Beth said. “I would pretend to absolutely adore somebody to get people to take care of me.”
But now she was so desperate for drugs she didn’t care how she got the money. And within minutes, a potential john pulled over.

“It was this guy who was well-known down there for picking up girls,” Beth said. “He slows down, gives me the head nod, makes a turn into the back alley.”
And she went to him.

‘We stand to lose a generation’

No place in America has been hit harder by the opioid epidemic than West Virginia. And no place in America was less prepared for the onslaught.
Already grappling with the loss of thousands of coal mining jobs, stagnant growth and an exodus of young people in search of opportunities elsewhere, the Mountain State was a sitting duck when Big Pharma began pumping prescription painkillers into the state.

The House Energy and Commerce Committee is now investigating the pharmaceutical companies and distributors who they say turned West Virginia into the epicenter of the crisis.

Last year, 909 people died in the state’s 55 counties, according to the West Virginia Health Statistics Center. Nationwide, opioids figured in two-thirds of the 63,632 fatal overdoses reported in 2016, according to the federal Centers for Disease Control and Prevention.
Some struggling small cities like Williamson (population 3,200) were swamped with an astounding 6,500 pills per person over a decade, creating a new generation of addicts and further fraying the already torn social fabric.
The epidemic also drove many desperate women, as well as some men, into the street for cash, lawmakers and police said.

“A lot of the addicts are from towns that went bankrupt when the coal industry collapsed,” said Matthew Perry, the Department of Homeland Security’s resident agent in charge, who investigates sex trafficking. “In some places, there just aren’t many other ways to make enough money to support a habit.”

While some women in West Virginia choose sex work, others are victims of sex trafficking, forced into prostitution against their will. Sex trafficking “is a crime of opportunity, and the pivot point for that opportunity is opioid addiction,” said Assistant U.S. Attorney Andrew Cogar.
“Pimps often hold out [the] promise of drugs in return for women engaging in prostitution,” he said. “We think that’s fueling a lot of the demand and supply.”
It’s hard to quantify just how pervasive a problem prostitution driven by opioid addiction is in West Virginia, a conservative state that gave President Donald Trump a landslide victory in 2016 (68 percent, to 26 percent for Hillary Clinton).

The FBI compiles annual crime statistics from law enforcement in all 50 states for its annual Uniform Crime Report. But for reasons that are unclear, West Virginia is one of the few states that do not report crimes that fit in the category of “prostitution/commercialized vice.”
“The State Police does aggregate prostitution arrest data, and I do not understand why it hasn’t been forwarded to the FBI,” Cogar said. “But I do know that data exists. And it’s troubling.”
NBC News has requested those figures from the West Virginia State Police.
Matt Meadows, a probation officer in Huntington, said he sees the steady stream of prostitution arrest reports and there is a sad refrain running through them.

“They go from prescription painkillers to heroin to prostitution,” he said. “It’s very common.”

The West Virginia Human Trafficking Task Force, which includes social workers and concerned lawmakers, is trying to figure out how big the problem has become. The group aims to raise awareness about sex trafficking and fight it by developing a network of service providers, victim advocates, agencies and religious organizations to support trafficking victims — and their children, who are straining the state’s foster care system.
“I don’t want to lose any women to human trafficking at all, but we stand to lose a generation if we don’t act more forcefully,” warned Barbara Fleischauer, a member of the West Virginia House of Delegates who sits on the task force.
Amber’s dad told NBC News he fears it may be too late for his daughter.

“I wish she would go to prison because then I’d know she was alive,” he said. “I know she’s having to be hooking and you hate that for your kid. But what can you do but cry and pray every night, and that doesn’t seem to be working.”

‘I had a sweet innocent face’

Now 28, Beth said she didn’t drink or smoke marijuana in high school. She was already living on her own and working as a waitress when she first crossed that line.
(Beth, like other sex workers quoted in this article, is being identified by an alias. Her story has been corroborated by the local police, newspaper accounts and interviews with her social workers.)
“I had stopped being friends with people because they were using that stuff, I was that good,” Beth said. “Then a friend I hadn’t seen since high school called me and needed a place to stay. She was really sick.”

That friend was Amber. And she was sick because she was trying to get off drugs.
“So I gave her a place to stay,” Beth said. “When she got better, she said she wanted to do it one last time before she quit forever and asked if I would be interested. I said sure.”
Years later, Beth said she doesn’t know why she agreed, why she let her defenses down.
“I tried it with her and it just took off from there,” she said. “My mom’s an alcoholic in recovery and my dad may have smoked weed back when he was a teenager. But nobody in my family had been involved in drugs.”

One Oxy 80 became another, then another and another.

“In my mind it helped me work better,” she said. “I had more energy. I felt more social. There was no hangover.”
But already her world was starting to tilt.
Beth had to kick Amber out because she stole. “But I had gotten involved with her people,” Beth said. “I had an apartment, I had a car, and they jumped on that.”

Before long, Beth was driving dealers around and getting a cut of the money and drugs.
“They used me as the face of their operation,” she said. “I had a sweet innocent face and had never been in trouble before.”
Things were going so well that she didn’t worry when the restaurant fired her for failing to show up for shifts.
“Then I met this older guy who used to take people down to Florida to the pill mills,” she said. “They asked if I wanted to drive and they would pay for the gas and the food and I would get drugs. It was 14 hours down and 14 hours back.”

After a couple of trips, Beth decided “to get clean” — the first of some two dozen attempts to get off drugs.
“I wound up getting on suboxone for 10 months,” she said, referring to an anti-opioid dependency drug. “I found a good job. Then I used one time and I lost my job.”
That was in 2011.
“The pills were so expensive and heroin is so huge in Huntington, so I started doing that,” she said. “I got to the point that I would sleep with the dealers for drugs.”

For the next three years, Beth said she was in and out of rehab. She lived with her mother for a time and then moved to Virginia to live with her grandmother.

“I started using again and wound up stealing from my grandmother,” she said. “I ran for a couple weeks before they caught me and I went to jail.”
When she got out, Beth said she tried to go home.
“I wound up back in Huntington with the first girl I used with,” she said. That was Amber.

‘One foot in prison’

Women with stories like Beth’s often end up in Cabell County drug court, which is presided over by Circuit Court Judge Gregory L. Howard in an annex across the street from the imposing county building in Huntington.

Howard takes what the probation officers call a “carrot-and-stick” approach with this especially vulnerable population.

The carrots are modest — colorful rubber wristbands and $10 gift certificates from Subway and Pizza Hut. And when the judge does apply punishment, he generally does so after first consulting the social workers who are trying to help these women get back on track.
There was no carrot for Nicole, the first woman who went before the judge at a recent hearing.

Her transgression? She missed a drug screening to make sure she was not using.
“I’m sorry, I overslept,” she said.
Howard, who has heard this excuse many times, shook his head. He upped the number of spot drug screenings Nicole is required to do from two to four times a week. And he ordered her to retake a six-week drug awareness course that meets on Saturdays.
“Do I have to do the course?” a visibly unhappy Nicole asked. “I have kids.”

“That’s why you can’t miss screenings,” the judge replied, his voice even.

Nicole made a face.
“I guess,” she said, slumping in her chair. “I will do it.”
“It’s not really optional,” Howard said.
Nicole already knew that.

“The bulk of the people we deal with already have one foot in prison,” probation officer Lauren Dodrill said. “They are mostly great people, but they have a drug problem.”

More than 1,300 adults and nearly 300 juveniles statewide in 2016 and 2017 have appeared in drug courts like the one Howard presides over, according to the state Supreme Court of Appeals.
To avoid incarceration, many agree to take part in state-approved alternatives like the Women’s Empowerment and Addiction Recovery program, which is based in Huntington and specially designed to help women break the cycle of drug dependency and, in many cases, escape the streets.

“Not using drugs is actually the easy part,” Dodrill said. “Changing behaviors, habits, that’s the hard part.”
Meadows, the Huntington probation officer, said the women they monitor “are not the stereotypical prostitute.”
“They have done things they are not proud of just to buy dope,” he said. “There is a lot of shame. But here they have a chance to reclaim their lives — they’re treated with a bit of dignity.”
And yet, barely half make it through the program, which typically takes a little over a year, he said.

That is why — ahead of the court hearing — Howard met with the probation officers and social workers to review the cases.
For someone like Nicole, who had been doing well, the decision was made to sanction her in a way that wouldn’t be so harsh as to potentially derail her recovery — but was strong enough to reinforce the message that missing drug screenings is not acceptable.
Nicole was followed by several women who were in court to collect carrots.
“You are doing better than we thought you would,” Howard told a beaming woman named Linda and invited her to come up and take one of the gift cards arrayed before him — her reward for making it past one of the major mileposts on her road to recovery. “I’m proud of you.”

“Oh, thank you,” Linda replied as the courtroom erupted in applause. “My kids love pizza.”
There were more kudos from the judge and cheers for several other women who collected wristbands and gift cards, including a young woman, Carly, who informed the judge she had just landed a job at a McDonald’s.

“They just took my sizes for my uniform,” she said.
All Carly needed now were shoes with nonslip soles. But rather than give her money — and perhaps endanger a person still wrestling with temptation — activist Necia Freeman volunteered to find a pair for her.

Because that is what Freeman does.
For half a dozen years, Freeman has been running a ministry through the Lewis Memorial Baptist Church called Brown Bag and Backpacks that provides sex workers with meals, a Gospel tract and a number they can call when they are ready to leave the life.
“The girls love Vienna sausages and Capri Sun drinks,” she said, adding that many of them rarely eat more than once a day. “We give them a pack of Pop-Tarts and soft snacks like yogurt because a lot of them have dental issues. And we give them spoons because we saw them trying to scoop yogurt out of the containers with their fingers.”

Hitting rock bottom

All the johns became a blur as Beth worked the streets. All she could think about was getting high.

“I had given up on myself,” she recalled. “I’d given up on the idea of having a normal life, of having a marriage, children, the white picket fence. Any ambition like that was just gone.”
All she wanted, needed, was another fix.
“You literally live from moment to moment,” she said. “You don’t want to be sober because that’s when reality sets in.”
Beth said she did things she would never have dreamed of doing sober, like trying to rob a CVS in September 2015 with a note that said she had a gun.

“I wound up doing some time for that,” she said. “I got clean in jail, got out, came back, and relapsed.”
When the drug dealers she relied on most began getting arrested, Beth said she took a friend’s advice and decamped for Lynchburg, Virginia. There she posted an online ad for men “looking for a ‘date’ and within five minutes there were five guys hitting me up.”

One encounter went really bad.
“There was a guy I met up with at a motel and we did some stuff and I passed out,” she said. “I woke up 45 minutes later and he had taken me to some trailer out in the country. He took my phone and chained me up. I had to drug him to get the chains off and get away.”

Beth said she didn’t dare report this to police. But it rattled her and she moved on to Roanoke, Virginia, where she tried again to get straight.
“I had dried out after an eight-month run,” she said. “I called my mom and told her I wanted to come home for Christmas.”
Warily, her mother agreed. Soon, Beth was on a Greyhound Bus home to West Virginia. Once there, she ran into an old friend who she “used to use with” who told her about a place for women like her in Charleston called Recovery Point.
“I looked at my mom and said this was the kind of place I need,” Beth said. “So I called, packed my bag, and have been here ever since.”

That was 14 months ago.

Path to sobriety

Recovery Point is a 92-bed long-term facility for women in Charleston that is supported by federal grants, donations and fundraising drives. It is in a low, gray industrial-style building, and many of the patients have walked in Beth’s shoes.
It is also a stone’s throw from some of the seediest streets in the West Virginia capital. And every time Marie, an employee of the center, drives by and sees “the girls” working the street, her heart breaks a little.
“I did it for six years,” said Marie, who is from a nearby state and was a college student when she got hooked on painkillers prescribed by her doctor.

Within weeks, Marie said, she graduated to heroin and soon started doing sex work to support her habit.
“You’ll do anything for the next high,” she said. “You’ll meet somebody who will act like some kind of Prince Charming, and they wind up selling you.”
Several stints in jail convinced her she needed to make a change.
“The last time I got paroled, it was to a long-term treatment program in Kentucky,” she said. “I was ready. I wanted a different life. I knew if I went back out on the street, I would die.”

Marie, who is 27 and asked not to be identified by her full name, got sober, finished school and landed a job at Recovery Point.

Now she helps recovering women transition from one phase of treatment to the next. Women start with the detox program, which takes three to seven days and introduces them to the Twelve Steps, the philosophy pioneered by Alcoholics Anonymous.
If they make it through the grueling first few days, they are assigned a bunk and a shelf for their belongings. They are required to attend daily drug awareness classes. And they are assigned a “72 hour buddy,” the first of several peers who help them adjust and get back on their feet.
Needless to say, no drugs or alcohol are allowed. Residents are also barred from using cellphones or driving cars. They must refrain from violence, making racial threats and having sex.
If they break any of those rules, they risk being tossed out.

“All of our girls, they do all the cooking, cleaning, yard work, maintenance,” Marie said. “They learn all those life skills while they are here.”
As they move up from one phase to the next, they are given more freedom — and more responsibility.
They are encouraged to find jobs on the outside once they’ve completed the program, but they have a strict curfew. In time, they are allowed to spend some nights away until they are ready to live on their own again.
At that point, some get tapped to be mentors for the newbies.

Marie said it takes from nine to 14 months for most patients to graduate, although some like Beth take longer.
Since the program started two-plus years ago, 18 women have completed it, and 16 of them are still sober, Marie said.
Eleven of the graduates are still at Recovery Point, working as staffers, she said. And they have now completed an apartment building behind the facility “where the girls can live.”
But many women don’t make it. And many arrive with a mindset forged by years on the street that everybody can be conned.

“They learn really quick that they can’t pull that stuff with me,” Marie said. “I know when they’re lying.”

‘I just want to be happy’

Beth’s days now begin at 6:30 a.m., when she wakes up in a dorm room crowded with bunk beds that she shares with 44 other women.
The rest of the day is structured around chores and meetings where the women sit in a circle and smoke cigarettes and share their stories and draw support from one another.

At 10:15 p.m., it’s lights out. And another day of sobriety is in the books.

Beth is close to completing Phase 1 of her recovery and preparing for the next phase, which will require her to get a job outside the protective cocoon she has been living in.
“The last time I held a job was back in 2012,” she said.
Beth said she has some short-term goals, like the 10th high school reunion this summer that she is thinking about attending. She also has a court date coming up for the attempted CVS robbery where she hopes the judge will take her rehab into consideration and expunge the arrest from her record.

Long term? “I just want to go back to school — I am a super nerd,” she said, adding that she doesn’t know what she would study, but that she finds the idea of being back in a classroom is comforting.
What she doesn’t see in her future right now is a man.
“I don’t crave a husband anymore,” she said. “I just want to be happy. I don’t want other people to go through what I went through. I don’t want people to feel like they can never be loved.”
But the past is always present for a recovering drug addict.

Last fall, Beth said she was doing her chores and found herself staring at an all-too-familiar face: Amber.
“We caught up some,” Beth said. “She told me this time she was going to get sober. She lasted three days and she was gone.”’

Written by CNN at: Women sell their body for drugs

 

 

How Science Has Revolutionized the Understanding of Drug Addiction

“For much of the past century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When scientists began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punishment rather than prevention and treatment. Today, thanks to science, our views and our responses to addiction and other substance use disorders have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of compulsive drug use, enabling us to respond effectively to the problem.
As a result of scientific research, we know that addiction is a disease that affects both the brain and behavior. We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease. Scientists use this knowledge to develop effective prevention and treatment approaches that reduce the toll drug abuse takes on individuals, families, and communities.

Despite these advances, many people today do not understand why people become addicted to drugs or how drugs change the brain to foster compulsive drug use. This booklet aims to fill that knowledge gap by providing scientific information about the disease of drug addiction, including the many harmful consequences of drug abuse and the basic approaches that have been developed to prevent and treat substance use disorders. At the National Institute on Drug Abuse (NIDA), we believe that increased understanding of the basics of addiction will empower people to make informed choices in their own lives, adopt science-based policies and programs that reduce drug abuse and addiction in their communities, and support scientific research that improves the Nation’s well-being.”
Nora D. Volkow, M.D.
Director
National Institute on Drug Abuse

Alcohol Poisining

Alcohol poisoning is a serious — and sometimes deadly — consequence of drinking large amounts of alcohol in a short period of time. Drinking too much too quickly can affect your breathing, heart rate, body temperature and gag reflex and potentially lead to a coma and death. Alcohol poisoning can also occur when adults or children accidentally or intentionally drink household products that contain alcohol. A person with alcohol poisoning needs immediate medical attention. If you suspect someone has alcohol poisoning, call for emergency medical help right away.

Symptoms

Alcohol poisoning signs and symptoms include:

  • Confusion
  • Vomiting
  • Seizures
  • Slow breathing (less than eight breaths a minute)
  • Irregular breathing (a gap of more than 10 seconds between breaths)
  • Blue-tinged skin or pale skin
  • Low body temperature (hypothermia)
  • Passing out (unconsciousness) and can’t be awakened

When to see a doctor

It’s not necessary to have all the above signs or symptoms before you seek medical help. A person with alcohol poisoning who is unconscious or can’t be awakened is at risk of dying.
Alcohol poisoning is an emergency
If you suspect that someone has alcohol poisoning — even if you don’t see the classic signs and symptoms — seek immediate medical care. Here’s what to do:
Call 911 or your local emergency number immediately. Never assume the person will sleep off alcohol poisoning.
Be prepared to provide information. If you know, be sure to tell hospital or emergency personnel the kind and amount of alcohol the person drank, and when.
Don’t leave an unconscious person alone. Because alcohol poisoning affects the way the gag reflex works, someone with alcohol poisoning may choke on his or her own vomit and not be able to breathe. While waiting for help, don’t try to make the person vomit because he or she could choke.
Help a person who is vomiting. Try to keep him or her sitting up. If the person must lie down, make sure to turn his or her head to the side — this helps prevent choking. Try to keep the person awake to prevent loss of consciousness.
Don’t be afraid to get help
It can be difficult to decide if you think someone is drunk enough to warrant medical intervention, but it’s best to err on the side of caution. You may worry about the consequences for yourself or your friend or loved one, particularly if you’re underage. But the consequences of not getting the right help in time can be far more serious.

Causes

Alcohol in the form of ethanol (ethyl alcohol) is found in alcoholic beverages, mouthwash, cooking extracts, some medications and certain household products. Ethyl alcohol poisoning generally results from drinking too many alcoholic beverages, especially in a short period of time.
Other forms of alcohol — including isopropyl alcohol (found in rubbing alcohol, lotions and some cleaning products) and methanol or ethylene glycol (a common ingredient in antifreeze, paints and solvents) — can cause other types of toxic poisoning that require emergency treatment.

Binge drinking

A major cause of alcohol poisoning is binge drinking — a pattern of heavy drinking when a male rapidly consumes five or more alcoholic drinks within two hours, or a female rapidly consumes at least four drinks within two hours. An alcohol binge can occur over hours or last up to several days.
You can consume a fatal dose before you pass out. Even when you’re unconscious or you’ve stopped drinking, alcohol continues to be released from your stomach and intestines into your bloodstream, and the level of alcohol in your body continues to rise.

How much is too much?

Unlike food, which can take hours to digest, alcohol is absorbed quickly by your body — long before most other nutrients. And it takes a lot more time for your body to get rid of the alcohol you’ve consumed. Most alcohol is processed (metabolized) by your liver.
The more you drink, especially in a short period of time, the greater your risk of alcohol poisoning.

One drink is defined as:

  • 12 ounces (355 milliliters) of regular beer (about 5 percent alcohol)
  • 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7 percent alcohol)
  • 5 ounces (148 milliliters) of wine (about 12 percent alcohol)
  • 1.5 ounces (44 milliliters) of 80-proof hard liquor (about 40 percent alcohol)

Mixed drinks may contain more than one serving of alcohol and take even longer to metabolize.
Risk factors

A number of factors can increase your risk of alcohol poisoning, including:

  • Your size and weight
  • Your overall health
  • Whether you’ve eaten recently
  • Whether you’re combining alcohol with other drugs
  • The percentage of alcohol in your drinks
  • The rate and amount of alcohol consumption
  • Your tolerance level

Complications

Severe complications can result from alcohol poisoning, including:

  • Choking. Alcohol may cause vomiting. Because it depresses your gag reflex, this increases the risk of choking on vomit if you’ve passed out.
  • Stopping breathing. Accidentally inhaling vomit into your lungs can lead to a dangerous or fatal interruption of breathing (asphyxiation).
  • Severe dehydration. Vomiting can result in severe dehydration, leading to dangerously low blood pressure and fast heart rate.
  • Seizures. Your blood sugar level may drop low enough to cause seizures.
  • Hypothermia. Your body temperature may drop so low that it leads to cardiac arrest.
  • Irregular heartbeat. Alcohol poisoning can cause the heart to beat irregularly or even stop.
  • Brain damage. Heavy drinking may cause irreversible brain damage.
  • Death. Any of the issues above can lead to death.

Prevention

To avoid alcohol poisoning:

Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger. When you do drink, enjoy your drink slowly.
Don’t drink on an empty stomach. Having some food in your stomach may slow alcohol absorption somewhat, although it won’t prevent alcohol poisoning if, for example, you’re binge drinking.
Communicate with your teens. Talk to your teenagers about the dangers of alcohol, including binge drinking. Evidence suggests that children who are warned about alcohol by their parents and who report close relationships with their parents are less likely to start drinking.
Store products safely. If you have small children, store alcohol-containing products, including cosmetics, mouthwashes and medications, out of their reach. Use child-proof bathroom and kitchen cabinets to prevent access to household cleaners. Keep toxic items in your garage or storage area safely out of reach. Consider keeping alcoholic beverages under lock and key.
Get follow-up care. If you or your teen has been treated for alcohol poisoning, be sure to ask about follow-up care. Meeting with a health professional, particularly an experienced chemical dependency professional, can help you prevent future binge drinking.”

-Written by Mayo Clinic at:

Alcohol Information

Why Some Opioids Users Don’t Fear a Fatal Overdose

“A couple years ago, when local news agencies reported a spike in overdose deaths related to fentanyl in St. Paul, Minnesota, clinicians at an outpatient treatment clinic in that city saw an immediate effect.
“A dozen of our patients disappeared,” says Dr. Marvin Seppala, chief medical officer of the Minnesota-based Hazelden Betty Ford Foundation. “They’d been in treatment from six weeks to two years and were sober.” The patients dropped out of the program to try fentanyl, a synthetic opiate painkiller that was new to the area. “Nobody in their right mind would want to get near fentanyl, which is 50 to 100 times more powerful than morphine and up to 50 times stronger than heroin,” he says. “Our patients heard about fentanyl and thought, ‘I want to try that.’ They wanted to recapture the euphoric high they hadn’t felt since they’d started using.”

Luckily, Seppala says, none of these patients died during their relapses. Still, the anecdote helps explain why the deadly opioid epidemic is getting worse; the grim fact is that some people with opioid use disorder are drawn to substances they know might kill them – and not because they’re suicidal. The pull helps explain the growing death toll the opioid crisis is exacting. Every day, more than 115 people in the United States die of an opioid overdose, according to the National Institute on Drug Abuse. More than 64,000 people died of drug overdose in the U.S. in 2016, and the lion’s share of those fatalities – more than 42,000 – involved opioids, a record number, according to the Centers for Disease Control and Prevention. Opioid overdoses in recent years have claimed the lives of acclaimed actor Philip Seymour Hoffman and the musicians Prince and Tom Petty. Opioids include heroin and prescription medications such as hyrdrocodone, oxycodone, oxymorphone, morphine, codeine and fentanyl. Lately, authorities have seen carfentanil – which is typically used to tranquilize elephants and other large animals – show up on the street. Carfentanil is about 100 times more potent than fentanyl and 10,000 times stronger than morphine, according to the Drug Enforcement Administration.

Luckily, Seppala says, none of these patients died during their relapses. Still, the anecdote helps explain why the deadly opioid epidemic is getting worse; the grim fact is that some people with opioid use disorder are drawn to substances they know might kill them – and not because they’re suicidal. The pull helps explain the growing death toll the opioid crisis is exacting. Every day, more than 115 people in the United States die of an opioid overdose, according to the National Institute on Drug Abuse. More than 64,000 people died of drug overdose in the U.S. in 2016, and the lion’s share of those fatalities – more than 42,000 – involved opioids, a record number, according to the Centers for Disease Control and Prevention. Opioid overdoses in recent years have claimed the lives of acclaimed actor Philip Seymour Hoffman and the musicians Prince and Tom Petty. Opioids include heroin and prescription medications such as hyrdrocodone, oxycodone, oxymorphone, morphine, codeine and fentanyl. Lately, authorities have seen carfentanil – which is typically used to tranquilize elephants and other large animals – show up on the street. Carfentanil is about 100 times more potent than fentanyl and 10,000 times stronger than morphine, according to the Drug Enforcement Administration. 
The grim fact is that for many people with opioid use disorder, the lethality of a particular batch of drugs isn’t a deterrent – it’s an attraction, says Howard Samuels, chief executive officer of The Hills Treatment Center in Los Angeles. Samuels, 60, speaks from experience: He’s been in recovery from heroin addiction for more than 30 years.
“When I was on the streets of New York, when we heard a brand of heroin was causing people to overdose and killing them, we wanted that brand of heroin so badly,” Samuels says. “We thought the people who were dying didn’t know how to shoot it [properly]. I thought [overdosing] won’t happen to me.” This mindset is illogical, but it makes sense to someone struggling with substance use disorder, because denial is a hallmark of addiction, Samuels says. “It’s all about denial and rationalization,” he says. “I was shooting heroin and thought I was still in control. It was absolutely crazy.”
The introduction of fentanyl and carfentanil as readily available street drugs has made using opioids much riskier than it was in the past. Fentanyl and carfentanil are sometimes sold on the street or are laced in other drugs, like heroin. Some opioid users know they’re buying drugs that contain fentanyl or carfentanil, and some don’t.
The lure of a high from either of those substances would have been too great for him to resist during his active addiction, Samuels says. “If I was shooting heroin today, I’d be dead, no question,” he says. This risk separates opioids from alcohol and other drugs that are misused, says Dr. Joseph Garbely, medical director at Caron Treatment Centers, which has facilities in Pennsylvania and Florida. For people who are in early recovery, for example, relapse is common – and when it comes to opioids, it can be deadly, Garbely says.

Between 40 and 60 percent of people who’ve been treated for substance use disorder, whether it’s for drugs or alcohol, relapse within a year, according to a 2014 study in the Journal of the American Medical Association. “If someone [who’s in early recovery] goes into a bar and grabs a drink, he or she won’t necessarily end up dead or in extreme circumstances,” Garbely says. “For an opioid user, a relapse could be an immediate course of death.”
In response to the opioid epidemic, health officials and parents are using a variety of strategies to try to keep people with opioid use disorder alive. For example, some parents have resorted to calling law enforcement authorities on their kids to have them arrested in the hope of preventing them from overdosing. Throughout the country, health officials are teaching traditional first responders, such as police, and nontraditional ones, like civilians, how to use naloxone to rescue people who have overdosed on opioids. Naloxone is a medication that blocks the effects of opioids and can reverse an overdose. 

People with opioid use disorder who are seeking to replicate their initial euphoric high aren’t the only ones at risk of overdosing, says Dr. Carla Marienfeld, an associate clinical professor in the psychiatry department at the University of California, San Diego. Some people put themselves at risk by ingesting opioids simply to avoid feeling terrible. For example, if someone’s used opioids for a year or more, his or her body has become accustomed to having the drug in its system. “Once your body is accustomed to high levels of opioids, it’s like a new set point,” Marienfeld says. “Some people who’ve been using opioids for a while need the drug in order to just feel normal.”
Most people who misuse opioids evolve from getting high to over time needing to use them to feel normal to ingesting their drug of choice to avoid terrible withdrawal symptoms when they’re trying to quit using, Marienfeld says. These symptoms can include nausea, vomiting or diarrhea; muscle pain; a rapid heart rate; tremors; fever and sweating; insomnia and agitation. The severity and duration depends on several variables, such as how long the individual has been using opioids and the level of his or her dependence. Typically, people who have been using drugs for longer periods of time will have more difficult withdrawal symptoms. For short-acting opioids, such as fentanyl and heroin, the main physical withdrawal occurs quickly, is very intense and typically passes within a day or two, Marienfeld says. Peak physical withdrawal symptoms typically last about a week, says Dr. Sidarth Wakhlu, an addiction psychiatrist with UT Southwestern’s Peter O’Donnell Jr. Brain Institute in Dallas. 
“My patients say, ‘I use enough drugs so I can feel normal,'” Wakhlu says. “Without drugs they’re miserable, they have no energy, they want to stay in bed all day and have intense cravings. [Using is] not about achieving a euphoria or getting high as they progress in their addiction.” The desire to avoid withdrawal continues the cycle of drug use, which patients know might lead to a potentially fatal overdose. “It doesn’t mean they’re suicidal or uninformed,” Wakhlu says. “It’s the nature of addiction. Addiction is powerful, cunning and baffling.”‘

-Written by Ruben Castaneda for U.S. News at: https://health.usnews.com/wellness/articles/2018-04-23/why-some-opioids-users-dont-fear-a-fatal-overdose

Opiate Detox is the worst, here’s what to expect

“One of the most challenging aspects of recovery from opiate addiction is the withdrawal process. Many of our patients want to know what to expect from the opiate withdrawal process. However, no two people have the same withdrawal experience. The timeline for opiate withdrawal depends on a variety of factors and differs between individuals. That is why effective treatments for opiate addiction cannot take a “one size fits all” approach. Understanding the common symptoms of opiate withdrawal can help you make informed decisions about your treatment.
Why Opiate Withdrawal Occurs
Opiate addiction does not develop overnight, and the same is true for recovery from the drug. Opiates — whether heroin or prescription painkillers — exert their effects by crossing the blood-brain barrier and acting on specific brain areas. The opiate molecules bind to particular receptors in the limbic system of the brain, which is responsible for processing rewards and emotional information. When these receptors are activated, the trigger the “rush” or euphoric sensations experienced by opiate users.
Over time, however, the brain becomes numbed to the effects of opiates. As the brain and body begin to expect frequent doses of the drug, they prepare a compensatory response. This is why it takes more and more of the drug to achieve the same effect. When the drug is no longer taken, and the body does not get its expected dose, the result is a collection of physical and psychological symptoms.
What to Expect from Opiate Withdrawal
Opiate withdrawal symptoms typically start within a few hours of the drug leaving the blood stream. They peak between 5 and 10 days. Most people have no residual symptoms after a few weeks, although some people have reported experiencing a post-acute withdrawal syndrome (PAWS) that lasts up to a few months. While PAWS has been commonly described by individuals in the recovery community, this disorder is not recognized by the Diagnostic and Statistical Manual of Mental Health Disorders or any other significant medical association. The severity and duration of the opiate withdrawal symptoms can depend on the length of opiate dependence, dosage, metabolism, the drug of abuse, the manner in which drugs are taken, and other factors.
Risks of Opiate Withdrawal
Going “cold turkey” can be dangerous for some opiate users. Patients run the risk of severe dehydration or elevated blood pressure. Furthermore, opiate withdrawal can cause heart irregularities that may be dangerous for patients with certain chronic medical conditions. Professional medical attention is suggested, to keep one safe during the opiate withdrawal process. For example, medical detox protocols help remove opiates from your system and safely manage withdrawal symptoms.
Perhaps one of the most prominent disadvantages of going “cold turkey”, is the high likelihood of relapse or due to the extreme discomfort, some might not even complete the withdrawal process. A professional medical detox is more likely to result in a positive, safe and effective manner to obtain an opiate-free life. The Waismann Method ® located exclusively in So. California has successfully treated thousands of patients and medically assisted them overcome the opiate withdrawal symptoms.
Opiate Withdrawal Timeline
There is absolutely no way to predict precisely how the opiate withdrawal process will affect you. The effects depend on your substance abuse history, medical background, metabolism and some other personal factors. However, the following timeline provides an overview of the typical course of a “short-acting” opiate withdrawal:
Withdrawal Days 1 and 2:
Most people begin to experience symptoms within the first day without opiates. Early symptoms may include aching in the joints, muscles, or bone. You may also experience abdominal cramping, sweating, nausea, or vomiting.
Withdrawal Days 3 and 4:
The body begins to adjust to an opiate-free state. Withdrawal symptoms typically peak between days 3 and 5. Many people describe their symptoms as feeling like a bad case of the flu. Common symptoms include:
Nausea and vomiting
Diarrhea
Excessive sweating
Runny nose
Excessive tear production
Insomnia
Tremors
Irregular heartbeat
Fluctuating body temperature
Muscle or joint aches
Abdominal cramps
During this phase, the body is focused on expelling toxins and re-balancing levels of endorphins the brain chemicals associated with feelings of pleasure. Because of the vomiting and diarrhea, people run the risk of severe dehydration. Breathing in stomach contents after vomiting is another risk. This is one of the most challenging times for an individual because so many simply cannot withstand the suffering and relapse. A medically supervised detox can prevent these and many other serious complications from arising.
Withdrawal Days 6 and 7:
By the one-week mark, most physical symptoms have subsided. However, you may feel physically weak and exhausted. At this point, the symptoms shift from being mostly physical to primarily psychological. Common symptoms include:
Anxiety
Drug cravings
Restlessness
Insomnia
Depression
Shame or regret
The psychological symptoms of opiate withdrawal can be just as challenging to manage as the physical symptoms. To promote healthy outcomes, it is important to be in a supportive environment and reach for an appropriate mental health provider. This is the time to learn new strategies to deal with frustration, manage damaging emotions, and self-harming behaviors. An individualized assessment and treatment of the root cause, is essential to maintain sobriety. No two profiles are the same, and emotional assistance should be based on each specific individual needs.
After day 7: Psychological symptoms and cravings may persist for up to a month or longer after stopping use. Continued psychological and social support eases this transition and raise the chance for an opiate-free life.
The Waismann Method® provides a safe, supportive environment in which to receive inpatient medical detox. Not only can the Waismann Method safely manage uncomfortable physical symptoms and prevent unnecessary complications, but the post-detox Domus Retreat allows an individualized and private continuum of care.”

-Written by Anesthesia Assisted Medical Opiate Detoxification, Inc at:https://www.opiates.com/opiate-withdrawal-timeline/