9781422279663

Preventing and Treating Addiction

Chronic Pain and Prescription Painkillers The Dangers of Drug Abuse The Heroin Crisis Preventing and Treating Addiction Who Is Using Opioids and Opiates?

Preventing and Treating Addiction

Xina M. Uhl

Mason Crest Philadelphia

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Printed and bound in the United States of America. CPSIA Compliance Information: Batch #OPO2017. For further information, contact Mason Crest at 1-866-MCP-Book. First printing 1 3 5 7 9 8 6 4 2 Library of Congress Cataloging-in-Publication Data

on file at the Library of Congress ISBN: 978-1-4222-3826-4 (hc)

ISBN: 978-1-4222-7966-3 (ebook) Includes bibliographical references and index. ISBN 978-1-4222-3337-5 (hc) ISBN 978-1-4222-8622-7 (ebook)

1. Southwestern States—Juvenile literature. 2. Arizona—Juvenile literature. 3. California—Juvenile literature. 4. Nevada—Juvenile literature. I. Title. F785.7.L37 2015 979—dc23 2014050200

O PIOIDS AND O PIATES : T HE S ILENT E PIDEMIC series ISBN: 978-1-4222-3822-6

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Table of Contents 1: The Scope of the Problem ......................................7 2: What’s What with Opioids ....................................13 3: When It Becomes a Problem ................................21 4: Preventing Problems ............................................31 5: In Treatment ..........................................................41 6: Helping an Addict ................................................51 Series Glossary of Key Terms....................................58 Further Reading ........................................................59 Internet Resources ....................................................60 Index ..........................................................................62 Photo Credits/About the Author..............................64

Words to understand: These words with their easy-to-understand definitions will increase the reader’s understanding of the text while building vocabulary skills.

Sidebars: This boxed material within the main text allows readers to build knowledge, gain insights, explore possibilities, and broaden their perspectives by weaving together additional information to provide realistic and holistic perspectives. Educational Videos: Readers can view videos by scanning our QR codes, providing them with additional educational content to supplement the text. Examples include news cover- age, moments in history, speeches, iconic sports moments and much more!

Text-dependent questions: These questions send the reader back to the text for more careful attention to the evidence presented there.

Research projects: Readers are pointed toward areas of further inquiry connected to each chapter. Suggestions are provided for projects that encourage deeper research and analysis. Series glossary of key terms: This back-of-the-book glossary contains terminology used throughout this series. Words found here increase the reader’s ability to read and comprehend higher-level books and articles in this field.

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Words to Understand in This Chapter

opioid— a natural or synthetic drug used for the relief of pain. overdose— to take a lethal or toxic amount of a drug. sobriety— the state of being free from drugs or alcohol.

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A 2017 study performed by researchers from Indiana University and the University of Virginia found that there is a direct relation- ship between the rising unemployment in an area and an increase in opioid addiction.

The Scope of the Problem

N ineteen year old Sean O’Conner became a heroin addict in high school. He was living with his aunt, uncle, and cousins--and stealing from them and their neighbors, too. He needed the money for his next fix. One night, he went to a friend’s birthday party. He was anxious to get his next fix. As he waited he got drunk. When he shot up at last, he began to have seizures. The man who sold him his fix propped him up against a tree and went back inside his house, leaving O’Conner where he was. Luckily, a neighbor saw him outside and called the police. He woke up in an ambu- lance after medical personnel administered a shot of the drug naloxone to reverse the effects of a heroin overdose . They told him that he had nearly choked on his tongue because of the seizures he had been having.

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Preventing and Treating Addiction

O’Conner entered rehab. His mother told him, "Go and get better or you're done, no more family." At first O’Conner was resentful and uncooperative, but then he realized the benefits of getting clean. Things would improve with his family, and he could get his high school diplo- ma. He knew it would be a long road to sobriety , but he decid- ed to go for it. Drugs at the Doctor’s Office B eing a doctor is a hard job. Their schooling is long and expensive. Their internships and residencies often require long hours and tough decisions. Not only is it stressful to deal with patients’ life and death diseases and injuries, but it’s also tough to deal with their insur- ance companies. Doctors commit suicide at twice the rate of the gen- eral population. But that’s not the only problem they have. Drug abuse is also rampant. Up to 10 percent of the general population is addict- ed to drugs and alcohol. This number climbs to 15 percent for doctors. This is due, in part, to physicians’ easy access to prescription medicine. A 2013 study published in the Journal of Addiction Medicine reported that 69 percent of doctors had abused prescription medications. The reason for this abuse was to relieve stress and either physical or emo- tional pain. When doctors descend into addiction they often head to rehab. There, for once, the percentages work for them. Studies report that they succeed at rehab programs between 70 and 80 percent, a rate that is quite high when compared with other that of others who attend rehab programs.

The Scope of the Problem 9

O’Conner is not alone in surviving an overdose. Many aren’t so lucky, though.

Hard Numbers The Centers for Disease Control (CDC) has issued an alert about the epidemic of drug overdose deaths in the United States. More than six out of ten overdose deaths involve an opi- oid . Opioid overdoses have quadrupled since 1999. From 2000 to 2015 that figure equaled more than 500,000 deaths. That works out to a figure of 91 Americans dying each day from opi- oid overdoses. More than a thousand people a day are treated in emergency rooms because of misuse of prescription opioids. In 2014 alone, drug overdoses claimed 47,055 lives. This is more than deaths caused by motor vehicle accidents (35,398) and firearms (33,599). Experts from Columbia University pre- dict that the overdose deaths will continue to rise at least through 2017. Clearly, something terrible is happening in the homes, schools, and workplaces of America. The opioid overdose epi- demic has been fueled by an increase in the sales of prescrip- tion opioids for pain. They accounted for more than 183,000 deaths between 1999-2015. The prescription opioids most commonly abused are methadone, oxycodone (such as brand name OxyContin), and hydrocodone (such as brand name Vicodin). States with double-digit percentage increases in pre- scription opioid overdoses from 2014 to 2015 are: Massachusetts, New York, North Carolina, Ohio, and Tennessee. No state has escaped the scourge of opioid overdose deaths, though.

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Preventing and Treating Addiction

Did You Know?

Among patients not suffering from cancer, 1 in 4 people who receive prescription opioids struggle with addiction.

A Lethal Path Many, if not most, opioid addicts start their road to addiction in the doctor’s office, and the path they take is a familiar one. After a period of regular usage, it takes more opioids to achieve the same high as previously. A person’s tolerance for the drug has increased. They must take more of the drug more frequent- ly than before or suffer difficult withdrawal physical and emo- tional symptoms. These include headaches, trembling, chills, bone and muscle pain, insomnia, diarrhea, vomiting, night- mares, hallucinations, and depression. All of this is accompa- nied by an intense craving for the drug. Opioid use is about more than just experiencing the initial euphoria after adminis- tration. Now it is about avoiding withdrawal, too.

Educational Video

Scan here to see a beauty-pageant winner talk about growing up in a family of addicts.

The Scope of the Problem 11

Addiction leads users to try to obtain more prescription pills from their doctor’s office, or from multiple doctor’s offices at once. Addicts frequently transition to buying opioids like heroin off the street. The cost becomes too high to sustain. Addicts begin to steal from family, friends, or neighbors. They may turn to prostitution or trade sex for drugs. Many are arrested, and ordered into drug treatment programs, or rehab. Often, individuals relapse, or begin to use opioids again. Rehab can be a revolving door. The most sobering statistic on addic- tion is that 90 percent of them start in a person’s teen years. Yet despite these grim numbers, there is hope to prevent further addictions and successfully treat already addicted indi- viduals. Even the most desperate abusers have found help.

Text-Dependent Questions

1. What has happened to the opioid overdose rate since 1999? 2. How do most opioid addicts begin their addiction? 3. What withdrawal symptoms do opioid addicts experience when they stop using drugs?

Research Project

Visit the National Institute on Drug Abuse’s Emerging Trends and Alerts webpage at https://www.drugabuse.gov/drugs-abuse/emerging-trends-alerts. Scroll down to the alerts, located in boxes with an exclamation point icon in the corner. Choose one of the alerts and write a one-page essay summariz- ing the issue.

Words to Understand in This Chapter

euphoria— to take a lethal or toxic amount of a drug. narcotic— a natural or synthetic drug used for the relief of pain. pharmaceutical— drugs taken as medicine. stupor— a condition in which a person has dulled senses, difficulty moving, and generally is nearly unconscious.

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Oxycodone is one of many popular opoid painkilling drugs. According to a national survey, in the past year almost 18 percent of high school students abused an opioid painkiller by taking it without a doctor’s prescription.

What’s What With Opioids T he original opioid is the opium poppy, which contains a narcotic drug known as opium. Opium is the basis for some of medicine’s most powerful painkillers. By itself, opium was used to relieve pain for thousands of years. Beginning in the 19th century, morphine was derived from opium. Other derivatives followed, like codeine. Semisynthetic opioids are created in labs from natural opioids. Examples are hydromorphone, hydrocodone, oxycodone (brand name OxyContin) and heroin. Fully synthetic opioids are completely man-made and include fentanyl, pethidine, levorphanol, methadone, tramadol, and dextropropoxyphene. Opioid drugs work by binding themselves to opioid recep- tors in the brain, spinal cord, and other areas. Chemically, they

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Preventing and Treating Addiction

resemble endorphins, or opioids that our bodies make natural- ly in order to relieve pain. Opioid drugs are able to reduce feel- ings of pain by reducing the sending of the brain’s pain mes- sages. Effects of Opioids How quickly opioids affect a person has to do with how they consume it. Taking opioids in pill or tablet form causes them to travel through the digestive system. The drug is absorbed slow- ly because of this. Smoking causes quicker absorption of the

An Afghan farmer holds the seed pod of an opium poppy. Juice from the seed pod can be refined into pain-killing opiates like morphine and codeine. A separate class of drugs, called opioids, are synthetic compounds that mimic the effects of opiates. These drugs include substances that are currently illegal in the United States because they have no medicinal value, such as heroin, as well as drugs that are prescribed as painkillers such as hydrocodone and oxycodone.