What you need to know about heroin addiction and treatment options

Cory Monteith 2010 GLAAD Media Awards

Cory Monteith, star of popular TV show, Glee, was found dead at 31 years old of heroin and alcohol overdose. The actor had been open about his struggles with drug addiction, and said he went to rehab when he was 19 after his family intervened. Monteith checked himself into a rehab facility in March, and thanked his supporters on Twitter when he completed his treatment a month later.

Monteith’s death has shed light on the rise in heroin use among a population that parents and other adults find puzzling. Young, affluent, white heroin users seems to contradict the portrayal of opiate drug users of previous decades being poor and from the inner city.

On Thursday July 18, 2013, the Today show reported on the changing face of heroin users. NBC News contributor Brian Alexander reported 90% of Heroin users are White. He also said that Heroin’s popularity is linked to the rise of use of prescription pain medication to get high. Pain medication that has a similar effect to heroin is more expensive and harder to obtain making heroin a convenient choice for those looking for a narcotic drug.

Heroin can be injected, snorted, or smoked. Typically, a heroin abuser may inject up to four times a day. Parents who are concerned about their child’s drug abuse should be looking for changes in peer groups, isolation from friends, work and  activities, missing personal items, money issues, needle marks and tracks and drug paraphernalia. Heroin use includes a variety of accessories, including needles and syringes, scales, coffee grinders, small plastic bags, etc. The user will try to hide the true purpose of these items, but taken together there is usually little question about their true purpose.

Treatment tends to be more effective when heroin abuse is identified early. There are a variety of medical and behavioral treatments for heroin use. Methadone, a synthetic opiate, is a pharmacological treatment for heroin that blocks the effects of heroin and eliminates withdrawal symptoms. Buprenorphine is newer to the array of medications now available for treating addiction to heroin and other opiates. This medication is different from methadone in that it offers less risk of addiction and can be prescribed in the privacy of a doctor’s office. Buprenorphine/naloxone (Suboxone) is a combination drug product formulated to minimize abuse.

Detoxification is a step in the heroin treatment process. Typically detoxification programs aim to achieve safe withdrawal from opiates by minimizing the severity of withdrawal symptoms and other medical complications. The primary objective of detoxification is to relieve withdrawal symptoms while patients adjust to a drug-free state.  Withdrawal symptoms from opiate drugs may be nausea, vomiting, diarehea, goose bumps, abdominal cramping, sweating, insomnia, tearfulness, agitation, anxiety and muscle aches.

Detoxification, alone is not sufficient for drug treatment, but is a useful step only when it leads into long-term treatment that is either drug-free (residential or outpatient) or uses medications as part of the treatment. The National Institute of Health and the National Library of Medicine report best documented drug-free treatments are the therapeutic community residential programs lasting three to six months.

As with other mental illness, although behavioral and pharmacologic treatments can be extremely useful when utilized independently, research shows that integrating both types of treatments is the most effective approach. There are many effective behavioral treatments available for heroin addiction. These can include residential and outpatient approaches. The best outcomes are when a match is made with the best treatment approach to meet the particular needs of the patient. New behavioral therapies, such as contingency management therapy and cognitive-behavioral interventions, have shown promise as treatments for heroin addiction, specifically when applied in concert with pharmacotherapies.

If you are concerned about a family members drug abuse you may value from speaking to a therapist. A trained professional can make referrals to appropriate treatment facilities for your family member. Expert clinicians can also help you manage anxiety, fear, sadness, and anger associated with a child’s drug abuse and set appropriate boundaries to help your family member achieve sobriety and create safety in your home.

Carrie Krawiec is a Licensed Marriage and Family Therapist at Birmingham Maple Clinic in Troy, MI  (www.birminghammaple.com) and Executive Director of Michigan Association for Marriage and Family Therapy (www.michiganfamilytherapy.org). 

Photo credit: Wikipedia Commons

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