Verified by 
The numbers differ, depending on who you listen to, but the idea that we are losing 65 to 100 people each day in this country to fatal opiate overdoses is sad, stunning, and not surprising. How and why so many opiate addicts die is an on-going national conversation. The spectrum of use ranges from a legitimate pain patient, with a real knee, back, neck, or shoulder injury, who becomes addicted to medically-prescribed and supposedly supervised opiate pills, to the recreational drug user who shifts over to sniffing, snorting, or injecting heroin as a new way to get high, avoid the pain of life, and wrongly thinking he or she could self-manage the drug.
According to studies from the Centers for Disease Control, people who start using pill forms of opiate drugs are 40 times more likely to become heroin addicts later on. This shift to heroin is understandable: it’s cheaper to buy and easier to get than Vicodin, Hydrocodone, or Oxycodone, which can sell from $5 to $40 per pill on the street, depending upon the dosage and the availability. After “doctor shopping,” “borrowing” pills from friends or family members, or buying them on the street has failed, many pill addicts who are desperate to avoid the intense discomfort from opiate withdrawal will make the switch to powdered or black tar heroin.
And what was once a drug that started as the sticky goo of the opium poppy, then gets chemically altered into heroin, is fast being replaced by heroin mixed with the powerfully synthetic narcotic called fentanyl. To say this new derivative is a stone cold user-killer understates it by half. A dosage about the size of eight grains of sand can be fatal when ingested, injected, or inhaled, especially when mixed with the opiate addict’s other favorite: anti-anxiety or anti-depression drugs known as benzodiazapines.
Opiate cravers need to use (inject, smoke, or snort heroin or swallow a series of high-dose opiate pills) every four to six hours. Fentanyl users roll some deadly dice when they knowingly or unknowingly introduce this new scourge into their systems. A little goes a long way and when the local cops or the feds arrest fentanyl smugglers with kilos of the stuff, it’s in dosages enough to kill many thousands of people.
Today, it’s harder to smoke the fumes from the heated pills or crush the pills and snort them, mostly because the manufacturers, (under increased government pressure and scrutiny) have changed the physical design of many of these drugs. Smoking heroin or certain types of opiate pills is actually a bit faster way to get high than injecting the drug, as it goes rapidly from the lungs to the pleasure center in the brain.
Let’s do some Diacetyl Morphine or Heroin Math. Let’s say that the average longtime powdered-using heroin addict needs to inject about a gram (or one regular sugar pack size) of heroin per day. Using rough economics, that means a longtime addict has about a $100 per day heroin habit. Times that by seven days and we’re at about $700 per week, $3000 per month, and $36,000 per year, at a minimum. (Heroin addiction does not take weekends and holidays off.)
Illegal fences and the more shady pawn shops only pay 10 percent on the dollar for “allegedly” stolen stuff, so the average heroin user will have to steal $1000 worth of your and my possessions to get $100. This includes things they kipe out of our houses, cars, or workplaces, including cash, phones, tablets, laptops, PCs, purses, wallets, tools, guns, other prescription drugs, TVs, jewelry, and anything else they can walk out with, run off with, or drag down the street.
Keep in mind this person has probably already alienated his or her family and lost a series of jobs due to showing up wasted or getting high at work, or the related poor attendance heroin use causes, or fighting with bosses or co-workers, or stealing everything that wasn’t nailed down. No job means it’s time to steal, every day, because as the addicts like to say, “You Can’t Divorce the Horse.” Or, in more medically-accurate words, stopping heroin is hard without being in a supervised treatment facility.
Getting off heroin or other opiates, say rehab experts like Dr. Drew Pinsky (who has a fascinating history of opium and opiate abuse), is actually not as hard as quitting alcohol. Depending on their dosage use, heroin users can go into withdrawal without four to 12 hours from their last use. Going cold turkey, or dealing with the physical withdrawal from opiates, requires about a week to ten days, preferably under supervised medical treatment. It’s quite unpleasant, but survivable, like the flu times a thousand, with nausea, vomiting, diarrhea, muscle and bone aches, chills, and plenty of accompanying anxiety. The tough part, however, is not just the physical withdrawal, but the psychological withdrawal, which can take up to one to two years for the recovering addict to create new neural pathways that finally remove the urge to use.
Opiate addicts in recovery face lots of triggers that encourage their brains to want to start using again, including stress, relationship problems, drastic changes in their routines, being around other still-users who are not in recovery, and not surprisingly, being in physical pain. Opiate addicts cannot just take prescription pain pills for their injuries and go about their business. Normal pain relief is tough for them and can lead to relapses.
One miracle drug in the fight to stop opiate addicts from dying in our homes, workplaces, libraries, parks, and hospitals is Naloxone, or Narcan. This drug is either given as a nasal spray dosage to a downed person suspected of an opiate overdose or less commonly, as a small-needle injection into his or her thigh. It works within minutes and it brings the near-dead back to life. In high-overdose patient areas, paramedics will routinely give Narcan to young people they find unconscious without obvious signs of injury or cardiac arrest. Because Narcan, an opiate antagonist, is injected into the overdoser’s nose, it works rapidly, seeking out opiate molecules and destroying them. It’s literally a miracle drug, working for patients who looked dead but were revived.
The City of Philadelphia is currently debating the value of creating so-called “harm reduction” centers, which are buildings or mobile homes staffed with nurses or Physician’s Assistants who are there to monitor heroin addicts as they shoot up. They can provide clean needles, safe used needle disposal, and in the event of an addict’s accidental overdose, medical intervention using CPR and/or Narcan. Critics, and there are many, including the current US Attorney for the Philadelphia area, William McSwain (who recently spoke about his concerns on Fox News), say these types of facilities just encourage more drug use and they enable already-illegal behavior. Supporters suggest these addicts are going to use anyway, so why not get their needles and drug residue off the streets and shepherd them into a medically-supervised area where they can also get exposure to drug treatment programs and substance abuse recovery opportunities?
While this debate continues, the only real solution is going to have to be a concerted moon landing-equivalent effort to fight the current opiate problem in this country. This will have to include: more concerted efforts by the American Medical Association to re-educate doctors as to the dangers of providing haphazard and recurring opiate pill prescriptions to their at-risk patients; more work by the Food and Drug Administration and the Drug Enforcement Administration to put pressure on pharmaceutical companies to create and monitor products that don’t cause continued harm; and certainly, more access for addicts at every socio-economic level to get into affordable opiate treatment and substance abuse recovery programs.
