The front lines of fighting addiction
© by Barbara Anderson

The Salem News
Thursday, October 1, 2015


International Overdose Awareness Day was last month. I’ve wanted to write about the opioid crisis, especially since our new governor has made it a priority, but have very little awareness of the subject except for what I read in the newspapers. I know I’ve used some opiates after surgery, at least I assume that’s what made my recoveries from lower back surgery, a hysterectomy, lung surgery and a head injury pain-free. Grateful, I recovered from the surgery, stopped taking pain meds, have no connections with addiction so little awareness of what causes the problem.

So I decided to wait until my son, a licensed drug and alcohol counselor (age 51), came from Northern Nevada to visit and then interview him.

Barbara: What is the difference between my experience and whatever makes some people opioid addicts?



Barbara's son Lance

Lance: Well, I work with teenagers and adults who struggle with addiction to all kinds of substances, but lately opioid dependence has increased tremendously. Many of the clients I work with start out by abusing opiate pain pills such as Vicodin, OxyContin or Percocet. Many patients also get hooked on pain pills because of surgery or some other kind of medical issue. So I suspect many of them were not made aware of the addictive nature of these drugs or were just looking for a quick high without thinking of the consequences.

In my view, many of these drugs have been overprescribed, creating an avenue toward serious addiction. Recently many states have cracked down on overprescribing by doctors, tightening up the supply and increasing the price on the street. In Nevada, one OxyContin pill can sell for as much as $80.

The problem with these drugs is that they build tolerance, so patients who continue to take them will have to increase the amount they use to avoid withdrawal symptoms. These are so painful that addicts are desperate to avoid them, so they switch to heroin, which is cheaper and more readily available than illicit prescription drugs. They can get a balloon of heroin (about the size of a pill) for about $10, but again, tolerance increases quickly, so that an addict may develop a habit costing $100 a day or more. Heroin addicts often start out smoking or snorting the drug, but may switch to IV use simply because it is more economical.

The drug cartels have increased the flow of highly processed heroin to the U.S. to meet the new demand. They have become more sophisticated in transporting the drug throughout the U.S. and marketing it to users, even offering free samples to get buyers hooked.

Barbara: What is Nevada doing that may be helpful as the country tries to deal with the problem?

Lance: First of all, access to prescription medications must continue to be tightened up except for patients who really need it, hopefully for the short term. In Nevada, a new law requires doctors to utilize a database to make sure that patients aren’t getting multiple prescriptions from different doctors.

Nevada doctors are also required by this law to undergo training in the dangers of prescription drug abuse. More people have died in recent years from opioid overdose than from car accidents. A public health approach is needed to educate doctors so that they in turn can educate their patients and offer other alternatives, such as physical therapy or lifestyle based interventions (diet, exercise, meditation, yoga, etc.), whenever possible. Lastly, the law allows first responders to use Narcan, a drug that reverses overdose.

Many of my clients are referred by the courts, and are compelled to enter therapy in order to avoid incarceration. Drug court programs balance accountability, including random chemical testing, with mandated treatment participation. Treatment may include medical referral for medications to help clients to abstain from drugs or alcohol. This “carrot-and-stick” approach provides motivational enhancement to help clients get sober.

But treatment programs often are expensive and/or have long delays to access treatment. In my view, we need to invest in building accessible treatment programs close to where people live, to help them to get clean early and avoid the legal system entirely. We need to double down on education and intervention in the schools, to prevent or address substance use before it becomes chronic.

Barbara: A law has been proposed in Massachusetts to test students in the schools. Does Nevada do this?

Lance: No, this is generally considered a violation of privacy when it is applied to all students, who must attend school but may not choose to participate. However, young people who are suspended for having drugs in school can reduce that suspension by agreeing to undergo assessment and counseling/education. Students involved in voluntary school activities are also tested randomly and for cause.

Barbara: What can parents do to help their children avoid becoming addicted to drugs? I know (now) that you did your share of experimenting growing up here in Marblehead in the ‘70s and ‘80s; I can tell you that I didn’t really notice anything but the drinking, which was familiar to me as a problem during my generation’s youth.

Lance: You were firm about the drinking, wouldn’t sign for me to get my driver’s license; I eventually outgrew that phase. I had you convinced that the pot plants on my windowsill were herbs for cooking, that the red eyes were caused by allergies. Parents should keep their prescription drugs locked away.

There was an excellent program in the Marblehead schools called Beyond Boundaries, part of Project Adventure, which is still based in Beverly. This got me addicted to the great outdoors, to rock climbing, then working in similar programs with teenagers out West, which led to my being a juvenile probation officer and now, into my present career of drug and alcohol counseling.

This kind of program is called strength-based intervention, and is the best way to lure kids away from drugs and into a productive, happy lifetime.

Nevada also has alternative education programs, but instead of calling them, say, “recovery high school,” we call our similar program “ASPIRE: All Students Pursuing Integrity, Responsibility and Education.”

Barbara: I’m feeling much more aware, and I hope readers can see why I am proud of my son.

Barbara Anderson of Marblehead is a weekly columnist for the Salem News and Eagle-Tribune Publishing Company.

The comments made and opinions expressed in her columns are those of Barbara Anderson
and do not necessarily reflect those of Citizens for Limited Taxation.

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