Tag Archives: heroin addiction

Bacterial Infection Hidden Epidemic, Taking Lives in Opioid Crisis

The current opioid crisis is responsible for producing a new epidemic among teens and young adults. It’s a potentially-fatal bacterial heart infection called endocarditis.

This condition is most commonly seen in older adults. Now doctors are seeing it in much younger patients more often due to opioid drug use.

What is Endocarditis and How is is Related to Opioid Abuse?

Endocarditis is a bacterial infection of the inner lining of the heart chamber and its valves. The condition occurs when bacteria are enter the body, then are spread through the bloodstream until they attach themselves to damaged parts of the heart. It is spreading through the use of shared needles by IV drug drug users.

The clump of bacteria grows over time, and the infection can be life-threatening if it isn’t treated, according to Dr. Sarah Wakeman, the Medical Director of the Substance Use Disorder Initiative and the Addiction Consult Team at Massachusetts General Hospital.

How Infection is Spread

In a doctor’s office, clinic or hospital setting, a health care worker will swab a patient’s skin with a disinfectant to kill bacteria before administering an injection. The purpose of this step is to avoid pushing bacteria from the skin into the body with the needle. Opioid drug users who are using needles may not be taking this step, which has led to the increase in endocarditis cases.

Endocarditis Treatment Not Enough for Opioid Use Disorder Patients

Endocarditis can be treated using intravenous antibiotics over a long time. If the damage to the heart valves is severe, surgery may be recommended to replace them.

If the patient is also injecting opioids, such as heroin, treating the infection is only treating half of the problem. The opioid use disorder is still present, and the patient will go right back to using once if he doesn’t get appropriate help for the addiction.

According to a 2016 Tufts University study, hospital admissions for endocarditis due to injectable drug use increased from 3,578 in 2000 to 8,530 in 2013. The study also found that a large number of these cases involved young people aged 15-24.

opioid epidemic

Addiction Expert Explains Three Main Groups of Opioid Epidemic

For the average person reading news stories or listening to the situation being discussed on the air, it seems as though the situation is mainly about young people who have moved from a prescription opioid dependency to a heroin addiction and that fentanyl is causing many of the overdose deaths. Popular news stories imply that efforts to stop people from becoming addicted to prescription drugs have not helped, but only made the issue worse.

This is one part of the opioid crisis but it isn’t the full story. As Andrew Kolodny, the co-director of opioid policy research at Brandeis University Heller School for Social Policy and Management pointed out, there are three opioid epidemics impacting North America.

The Three Opioid Epidemics in North America

1. Longtime Addicts

This, according to Kolodny, is the smallest group. Most of them are between the ages of 50-70 and started using heroin in the 1970s and 1980s. They lost a number of their friends to addiction. Fentanyl is responsible for killing off people in this group, due to the heroin supply being “laced” with this powerful pain reliever.

2. Young Rural and Suburban Users

The second group is the middle one, and is between 20-40 years of age. This is the group that gets most of the press coverage. They are people who are being found dead of an overdose, often with needles still in stuck in their arm.

In many instances, the road to addiction starts out with prescription opioids. The person may have started taking medications prescribed for someone else. They may have originally been prescribed the pain medication, but started using it more often than as directed. When their supply ran out, they turned to buying pills on the street.

At some point the cravings for pills increased. The cost was high and heroin could satisfy the cravings at a cheaper price. Switching from pills to heroin wasn’t anything new, according to Kolodny. Again, when dealers started adding fentanyl to their heroin supply around 2011 because it was a cheap filler, the number of overdose victims skyrocketed.

3. Middle-Aged and Senior Adults

The largest group, which has remained mostly under the popular press’ radar, is made up of people in their mid-40s through to their 80s. Their deaths due to opioid abuse are under-reported.

People in this age group may have been taking pain medications prescribed by their primary care doctors for several years. When they pass away from heart disease or another cause, no one wants to think of their long-term opioid use as being a contributing factor. Families also don’t think to ask whether their loved one may not have been using their opioid medication appropriately, whether there was an interaction with other medications (over the counter or herbal supplements included). They wouldn’t ask whether alcohol use and opioids may have been an issue.

The fact there are three sub-groups among this epidemic is why the number of overdose deaths have continued to rise. This isn’t a typical substance abuse problem, as the number of lives lost have actually reduced the average life expectancy in America.

To solve this problem Kolodny suggests investing money in building a new treatment system at an estimated cost of $60 billion. Although there are a ton of addiction programs doing great things, the system as a whole isn’t slowing the number of deaths, so more must be done.

Heroin Affecting Newborns in Record Numbers

One of the most dangerous things about heroin is that it can impede a mother’s instinct to protect her child. This is most evident in the number of children being born addicted to heroin. This addiction occurs when mothers continue to use the drug while pregnant, causing their babies to be born dependent on the opiate, and needing to go through excruciating withdrawal symptoms in their first days of life. The number of infants born addicted to opiates continues to rise, as the heroin epidemic rages on in rural and urban communities.

While this problem is occurring throughout the country, it appears that rural areas are seeing a higher percentage of these tragedies than in cities. This may be because there is less access to quality treatment in rural areas, or drug education is not as evolved as it is in the cities. According to a University of Michigan study, heroin addicted babies increased four times in cities, while rural areas reported an increase of seven times. The results were published in the journal JAMA Pediatrics.

One reason why it is so difficult for expectant mothers to cease heroin use when they find out they are pregnant is because of the painful withdrawal symptoms they have to go through. Heroin addicts who stop using the drug experience insomnia, body aches, vomiting, paranoia, anxiety, depression, flu-like symptoms and intense cravings. These symptoms are so extreme that many in the medical profession strongly advocate for medical assistance when it comes to withdrawing from heroin. And while these are extreme symptoms for an adult, they are even more intense for an infant. Medical staff has to monitor the child constantly and watch as the baby goes through a withdrawal that most adults avoid at all costs.

“In the worst-case scenario, some of these babies die, and there’s a higher rate of mortality in this population. Later in life, there may possibly be issues with attention, but more research is really needed to understand the long-term effects,” explained Dr. Nicole Villapiano of University of Michigan Mott Children’s Hospital. Most babies who are born addicted to heroin exhibit increased irritability, tremors, inability or lack of desire to consume food, seizures and respiratory distress.

However, there are very few treatments approved for opiate-addicted mothers because of the potential damage caused to the unborn child during withdrawal. Unfortunately, the most common treatment includes putting the mothers on buprenorphine or methadone – both of which are synthetic opioids and can still cause the baby to have to go through agony after birth.

Researchers hope that this study will not only educate people on the dangers of using heroin while pregnant, but will also shed a light on the necessity of increasing education and prevention efforts in rural areas of the country. It also expresses a need for better treatment methods for mothers so that their newborns do not have to go through withdrawal.

The Evolving Face of Heroin Addiction

young manIt is becoming more and more clear to investigators and the public that heroin abuse has moved from seedy back alleys of major cities and into homes in quiet, little neighborhoods. No longer is the average heroin user a middle aged man. Instead, a typical heroin user is the average teen or young adult. Scores of overdoses are happening in communities where parents never thought heroin could touch.

Unfortunately, in many cases, the heroin problems that are destroying many of these lives are being kept quiet. People feel ashamed when instead they should be speaking up and asking for help. It is too big of a problem to keep silent, and parents fighting to save their sons and daughters from heroin or any other drug need to know that there are resources that can help. They also help shed light on the pervasiveness of the problems and can help prevent more tragedies by sharing their experiences with other parents.

Experts caution that heroin is cheap and widely available. These reasons are helping to fuel the heroin surge throughout the country. They also point out that many teenagers and adults don’t start off abusing heroin. They oftentimes start by taking prescription painkillers and then moving to heroin because the drug is cheaper and provides a similar high.

This past weekend a huge rally was held at the National Mall in Washington, D.C. called Unite to Face Addiction. Many thousands of people attended the event, which featured many speakers and performers including notable politicians, legendary musicians and people who have lost family members to addiction.

According to Donald McFarland, the communications direct for Facing Addiction, “That’s why we’re in Washington, D.C., because it is a national health-care crisis. The truth of the matter is, ‘just say no’ didn’t work and the war on drugs failed.”

Facing Addiction is a new non-profit organization that is trying to unify many groups and messages into wielding more power by acting together. Every effort helps.

Approach to Heroin Addiction Changing in Some States

addictAs it becomes more apparent that heroin addiction is taking many states by storm, the way state governments approach handling the fight against this dangerous drug has never been more important. It has brought more issues to the table and forced some legislators to consider things they wouldn’t have previously.

In the past, more of a hard line approach has been taken when it comes to drugs and addiction in many areas. Incarcerating people caught with small amounts of drugs, or caught with drug paraphernalia has always been commonplace, but now opinions are changing. Some people are starting to speak out against these practices and pointing out that this does not help addicts, and in some cases actually escalates substance abuse issues.

One of the major differences that is being expressed is the need for states to have Good Samaritan Laws. These laws allow other addicts to call emergency services and the police if one of their companions goes into a drug overdose. In the past, addicts had to worry that they would be arrested for possession or being under the influence of an illicit substance.. With more and more law enforcement agencies and other first responders starting to carry doses of Naloxone (a drug that can reverse the effects of an opiate overdose), Good Samaritan laws are more important than ever before.

Another topic that is being discussed is the idea for needle exchanges programs and other harm reduction strategies. Needle exchanges are facilities that are set up to take old, used needles from addicts and supply the addicts with clean needles. This controversial practice has gained more attention now that many are seeing this as a forum for getting addicts into treatment and minimizing the diseases that get passed from one addict to another because of needle sharing.

“This is about saving lives. Since 1971, we’ve engaged in this war and we’ve learned a lot of painful lessons. They don’t do us much good if we don’t do something different to attack this problem,” explained Kentucky State Rep. John Tilley about changing the plans of attack on the heroin problem.

Heroin Deaths Spanning Multiple Ethnicities

heroindeathsA new study came out indicating that Caucasians aged 18-44 were the largest group of people dying from heroin-related causes. This report is a surprise to many, as heroin used to be a drug used almost exclusively by African American and Mexican men just over a decade ago. In the last several years heroin has gained popularity with the younger crowd and has made its way into every race. Heroin is now a drug that is easily accessible by everyone and most common amongst those in the suburbs.

The Centers for Disease Control and Prevention (CDC) focused on heroin related deaths from 2002 – 2011. They found that in 2002 the highest group of heroin related deaths was among African Americans, aged 45-65 years old. By 2011, Caucasians had surpassed the African American group by more than double.

Researchers have indicated that the increase in painkillers being prescribed may be part of the reason why so many more people are becoming addicted to heroin and subsequently dying from heroin related deaths. Young adults are oftentimes either prescribed narcotic painkillers or obtain them from other people who are prescribed the powerful drug. Once addicted to the pills, addicts often resort to using heroin. Heroin is cheaper and becoming easier to obtain than prescription pain medication.

States all over the country are looking into how they can put a stop to the heroin epidemic that is sweeping through the nation. Many public officials are pointing their fingers at the medical community. Law enforcement and those in government are calling for more strict guidelines when prescribing narcotic painkillers. Many states have instituted a prescription monitoring program that will notify law enforcement and physicians if a person is attempting to obtain more than one prescription for narcotics. This allows doctors to keep an eye on their patients and reduce the risk of over-prescribing.

The medical community and municipalities are fighting back as well. There are several lawsuits being filed against multiple pharmaceutical companies. The lawsuits allege that the drug companies were not forthright with the side effects of many of the painkillers and that salespeople and other representatives failed to fully explain the powerful addictive nature of some of these medications.