Many people believe that addiction, and certainly more “serious” drug use or abuse is limited to the inner city – people in gangs, homeless, chronically mentally ill. This is simply false. The recent death of famous actor Phillip Seymour Hoffman, and local McLean High School student Emilee Lonczak is opening the dialogue not just about heroin, but about addiction in general. Parents want to believe that in an area with so much affluence, their child is shielded from drugs. This is not so. Drugs and drug use and abuse do not discriminate with respect to race, socioeconomic status, or gender.
Now as a psychotherapist and earlier when I worked for Child Welfare, I have seen many examples of the impact of drugs on all kinds of people. I had an adolescent patient who attended an affluent high school. He was addicted to many drugs – ecstasy, marijuana, cocaine. He was doing relatively well in school. He was also savvy enough to be supplying some of the adults at the school with drugs in exchange for their altering his records, keeping his parents from knowing that he was barely attending school. There was also a case of a high school teacher who was addicted to crack. She had a baby who was born addicted to crack. Her boyfriend was a crack dealer, selling drugs to her students.
Each drug has its own set of specific characteristics, pathways of use (i.e. by injecting, smoking, or snorting) and means of impacting the brain and the central nervous system. Heroin, specifically, is a derivative of morphine. It appears as a white or brown powder or a black sticky substance, known as “black tar”. This used to be thought of as a hard core criminal drug or one that was trafficked in the prison systems. The face of heroin is changing. As more people are facing personal challenges, seeking pain management for chronic issues, such as unspecified back pain, or are in recovery from traumatic physical injury, etc., the desire or need to become “numb” physically and mentally is increased.
When individuals find themselves unable to gain the prescribed opiates, some turn to the easily accessible street form, heroin. Heroin can be injected, inhaled or smoked. All of these routes have an impact on the brain rapidly. The part of the brain that becomes flooded with the opiates involve the perception of pain and reward. These receptors are also located in the autonomic nervous system which controls all the processes critical for life – blood pressure, respiration, arousal. Overdoses frequently involve suppression of breathing, which can be fatal.
Heroin users report a “rush,” a feeling of euphoria, after injecting the drug. They also have a dry mouth, flushing of the skin and heaviness of extremities as well as clouded mental functioning. They often close their eyes and seem to come in and out of a conscious state. They tend to sway back and forth and can be difficult to understand. The “rush” is never as good as the first time. People become addicted because they are looking to replicate the feeling that they experienced the first time. This is known as “chasing the dragon.” Chasing the dragon, combined with an increased tolerance is another reason that people overdose. The higher the dose of the drug the higher the likelihood for death from decreased breathing.
As with any drug, users can develop a tolerance or a dependence on heroin. Tolerance occurs when more of the drug is needed to achieve the same intensity of effect. Dependence occurs when there is a continued need to use the drug to avoid withdrawal, which characterized by flu like symptoms – muscle and bone pain, restlessness, insomnia, diarrhea and vomiting.
As I previously referenced, the face of heroin use is changing. Heroin users used to be older inner city people. Now, heroin has made its way into the suburbs and into the hands of younger people. The average age of a heroin user is 21 years old. Big metropolitan areas have one day a week when the drug dealers offer free samples of heroin and other drugs; similar to the free samples at Costco. They count on people getting “hooked” and coming back for more. With many interstates highways converging in the major cities, it is also easy to traffick the drugs into and out of the city; making the drug more accessible to more people.
Common signs of Drug Abuse:
• Drop in attendance at work or school
• Unexplained need for money
• Financial issues
• Socially withdrawn
• Sudden mood swings
• Increased Irritability
• Lack of motivation
• Change in friends
• Changes in appetite
• Changes in sleep pattern
Drug use and addiction is a complex issue. There are often deep psychological underpinnings – depression, anxiety, relationship issues, abandonment issues, shame. If you or a loved one is struggling with substance use or abuse, there is help available. There are trained, local professionals who can help. You can find resources through your local Mental Health Association or locate a therapist on www.psychologytoday.com. There are Narcotics Anonymous (www.na.org) or Alcoholics Anonymous Meetings (www.aa.org) as well as SMART Meetings (www.smartrecovery.org) throughout the United States. Feel free to contact me for more information or referrals.
National Institute on Drug Abuse, 2014