Heroin-Linked Deaths Surge 39 Percent, CDC Finds

Overdose deaths linked to heroin jumped 39 percent in 2013 from the year before, according to data released Monday by the Centers for Disease Control and Prevention.

The CDC said 8,257 people died of heroin-related deaths in 2013, compared with 5,925 deaths in 2012. The number of overdose deaths overall increased to 43,982 from 41,340.

Many more Americans die from prescription opioids. But the rise in fatal heroin overdoses came as users of prescription painkillers switched to the cheaper, illicit street drug. The heroin deaths contributed to an overall 6 percent jump in drug overdose deaths in 2013 from 2012.

“These troubling statistics illustrate a grim reality: that drug, and particularly opioid abuse, represents a growing public health crisis,” Attorney General Eric Holder said in a statement.

As states cracked down on the illicit use of prescription painkillers in the 2000s, many users shifted to heroin, which sells for a fraction of the cost. The February 2014 death of actor Philip Seymour Hoffman from a mix of heroin, cocaine, and other drugs dramatized the shift. Deaths from heroin are often also associated with other drugs.

Despite Hoffman’s death and the broad political reaction it sparked, data on heroin abuse has been hard to find. The National Survey on Drug Use and Health found that the number of people who had used heroin in the past year rose from 2012 to 2013, but the number who had used heroin in the past month dropped.

Michael Botticelli, the acting White House drug czar, said the rising overdose deaths underscored the need for a “comprehensive solution” to the nation’s drug problem that includes prevention, education and law enforcement. Both Botticelli and Holder have increasingly emphasized the need for local police to carry naloxone, a drug that can reverse opioid overdoses.

The World Health Organization estimated earlier this month that better distribution of naloxone in the U.S. could save as many as 20,000 lives every year.

Meghan Ralston, the harm-reduction manager for the Drug Policy Alliance, a nonprofit group that aims to end the war on drugs, applauded the increased distribution of naloxone to police. She said she hopes community nonprofits are not left behind.

“Community-based naloxone distribution programs continue to struggle mightily to be able to afford to do this lifesaving work, while police departments have access to a much larger pot of money,” Ralston said.

States like New York and Maine have increased the number of law enforcement agents tasked with drug enforcement while they have expanded naloxone access. Ralston criticized the increased enforcement.

“These tactics are really just the same old, same old,” said Ralston, who had not been able to examine the CDC data in depth. “Any increase in the number of heroin-involved deaths argues loudly in favor of reforms that help save lives and reduce mortality.”

DEA Issues Alert on Fentanyl-Laced Heroin as Overdose Deaths Surge Nationwide

The Drug Enforcement Administration (DEA) has issued a nationwide alert in response to a surge in overdose deaths from heroin laced with the narcotic drug fentanyl, the most potent opioid available for medical use.

“Drug incidents and overdoses related to fentanyl are occurring at an alarming rate throughout the United States and represent a significant threat to public health and safety,” DEA Administrator Michele M. Leonhart said in a statement. “Often laced in heroin, fentanyl and fentanyl analogues produced in illicit clandestine labs are up to 100 times more powerful than morphine and 30-50 times more powerful than heroin.”

Fentanyl is potentially lethal, even at very low levels, according to the DEA.

Last year, Philadelphia officials announced at least 28 people died after using heroin laced with fentanyl in March and April. Earlier in 2014, law enforcement officials said heroin laced with fentanyl was suspected in at least 50 fatal overdoses in Pennsylvania, Maryland and Michigan.

Seizures of illegal drugs containing fentanyl more than tripled between 2013 and 2014, according to USA Today. The National Forensic Laboratory Information System, which collects data from police labs, received 3,344 fentanyl submissions last year, up from 942 the previous year.

Between 2005 and 2007, more than 1,000 U.S. deaths were attributed to fentanyl, many of them in Chicago, Detroit and Philadelphia. The source of the drug was traced to a single lab in Mexico. The surge of deaths ended when the lab was identified and dismantled, the DEA said.

DOES AA WORK THE SAME FOR YOUNG ADULTS AS IT DOES FOR OLDER ADULTS?

Involvement in Alcoholics Anonymous (AA) is known to be beneficial for adults, however, less is known about the effects and ways in which AA helps young adults recover from substance use disorder (SUD). Arguably, young adults face more recovery challenges than their older adult counterparts for several reasons. They are more likely to be exposed to alcohol and drug cues in social situations because the prevalence of substance use during this life stage is the highest of any developmental period. Additionally, those under 30 tend to be less interested in spirituality and religion, therefore, the spiritual focus of AA might be less appealing compared to older individuals. Compared to adults, those under 30 face different psychosocial stressors, too, including a more transient lifestyle, sexual and romantic challenges, and financial stressors.
The researchers examined whether young adults (18-29 yrs) benefit from AA attendance as much and in the same ways as those over age 30. The authors tested six different potential mediators of AA’s effects which were chosen because they were found to be mediators in previous AA studies with adults. They asked whether AA helped people recover via its ability to: increase individuals’ confidence in their ability to abstain in high risk social contexts, and when experiencing negative affect; to increase spiritual/religious practices; decrease depression symptoms; and, increase the number of pro-abstainers and decrease the number of pro-drinkers in individuals’ social networks. Data was from a 12-week outpatient treatment trial called Project MATCH, where participants were individuals with alcohol use disorder (N=1726). Participants in Project MATCH received either cognitive behavioral therapy (CBT), motivational enhancement therapy (MET) or 12-step facilitation therapy at one of nine outpatient clinics around the US. The authors compared young adults 18-29 yrs (n=266) with adults over 30 (n=1460) at 3-, 9- and 15-month follow-up points on two outcomes: percentage of days abstinent (PDA) and the number of drinks per drinking day (DDD).
At baseline, the young adult group was found to have less clinical severity (e.g. higher PDA, fewer DDD, and a lower number of prior alcohol treatments), lower religiousness and a stronger pro-drinking network compared to the older group. Both groups were found to benefit equally from AA attendance, however, the six mediators explained more of the effect that AA attendance has on PDA and DDD for those over 30 than young adults. This suggests that there are additional mediators for the relationship between AA attendance and the outcomes for those under 30, however, this study did not examine what those mediators may be.
Confidence in the ability to abstain in social situations and pro-drinking social networks were found to explain the effect of AA attendance on drinking outcomes for the young adult group. The indirect effects explained more of the drinking outcome variance in the older group even when accounting for similar attendance rates between the groups, therefore suggesting that there are additional pathways for the younger group that were not tested in this study. The authors speculate that other potential pathways include that AA attendance increases abstinence motivation for young adults, increased feelings of hope and belonging through membership, or a feeling of empowerment by attending meetings.
In Context
Young adults (18-29 years old) carry a disproportionate share of the SUD-related burden. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), more than 16% of young adults meet past-year criteria for an alcohol use disorder, about 1.5 times that of middle aged adults and twice that of older adults. AA attendance has been found to be equally beneficial for individuals over and under the age of 30. This is very good news, however, AA attendance seems to help these age groups in different ways. Another way of saying this is that these age groups use AA in different ways. AA attendance in older adults boosts the number of pro-abstinent members in their social network, whereas while younger adults, who are attending AA at a similar rate and who are also adding pro-abstinent members to their social network, are adding sober new social network members not from AA. Finding where those new pro-abstinent social network members are being added from is key, and more research is needed to further examine this. A barrier for some individuals under the age of 30 may be the lack of similar-aged peers in recovery and this is something that AA and other mutual-help groups have worked to overcome by holding youth focused meetings. AA and other mutual-help organizations (MHOs) are a low-cost resource for individuals in recovery. Additionally, some MHOs have meetings that are geared towards young adults. Developing pro-abstinent relationships for young adults may help to aid in recovery, though AA does not appear to help with this.

Four Obstacles to getting Heroin Treatment

Treatment facilities are packed. Jam packed. Inpatient rehab? It is expensive. Insurance companies? They are refusing coverage. Addicts are looking to get clean from heroin, a tiring uphill battle. And it seems like we will never be able to help every single person who wants it.

Here are the 4 obstacles to getting heroin treatment and getting sober (at least the biggest ones):

Withdrawal: Withdrawal is most opiate users worst nightmare. Especially heroin users. Heroin addicts will begin to crazy racing thoughts, their bones will hurt, they will begin to sweat, and it will start to feel like the world is going to end. Hot and then cold, cold and then hot. The withdrawal itself doesn’t kill, but it can cause many addicts to just to give up and go back to using heroin. With a now lowered tolerance, many overdose, and then a few die. Withdrawal is tough. And we get it. It is one of the biggest obstacles to getting sober. But withdrawal can be overcome and there is a higher chance of making it through it if you have the help from a facility. That is if you can find a bed, which brings us to our second obstacle.

Lack of beds: The number of people using heroin the United States has nearly doubled from 2007 to 2012 to some 669,000 people and more people are now seeking treatment for their problem. But of the 23.1 million Americans who needed treatment for drugs and/or alcohol in 2012, only 2.5 million people received help from a facility. There just aren’t enough beds at treatment facilities, or there aren’t enough facilities in general. There are about 12,000 addiction treatment programs nationwide, according to the nonprofit Treatment Research Institute in Philadelphia. Of those, only 10% are residential facilities, and about 80% are outpatient programs. The other 10%? They are methadone clinics. So let’s say you do manage to find a bed, how are you going to pay for it? Here is obstacle number 3.

The Constant Battle with the Insurance Company: While most insurance policies state that they allow coverage up to 30 days in a residential treatment center, nobody actually gets those 30 days and if they do, there is usually a high deductible that has to be paid somehow. The average duration in residential care? It is usually 11 to 14 days. So let’s say you want to pay out of pocket? What is it going to run you? Well, here is obstacle number four.

The Cost: If you are paying out of pocket, a 30 day inpatient stay could cost you ONLY 5,000 dollars. But the average cost is usually around 30,000 dollars. The cost of a heroin detox only is usually around 3,000 dollars and that is for 3 to 5 days of care. Most clinics require payment up front if insurance can’t be used.

Luckily there are numerous ways around these obstacles and we know the roads to take. Nothing has to stand in the way of you getting help for yourself or your loved one. All of these obstacles are surmountable even though they are there. If you need treatment for yourself or a loved one, get expert help and advice. No one has to wait to get help because of these obstacles,so don’t.

Pot is Out, Heroin is In

A GLOBAL TRADING SYSTEM: POT IS SO LAST YEAR, POPPIES ARE IN

Sierra Madre? Sierra Madre refers to one of many mountain ranges in Mexico, Central America, and the United States. So what does that have to do with anything.

With the wholesale price of marijuana falling, partially because of the decriminalization of the drug in certain parts of the US, Mexican drug farmers have begun to turn away from cannabis and have started filling their fields with, you guessed it, poppies. Poppies are heroin in its very first, au naturale form. Mexican heroin has been flooding the north as US authorities with perfect timing. The flood of heroin, came right as the prescription drug epidemic came to a screeching halt, following tightened control on synthetic opiates such as Vicodin and OxyContin. As the pills became harder to get and more costly, Mexican drug trafficking organizations have tapped into the new markets for heroin in places such as Winchester, VA., and Brattleboro, VT., where, until recently, needle use for street narcotics was unknown.

So yeah. The farmers are smart. The famers in the fabled “Golden Triangle,” of Mexico’s Sinaloa state, which has produced some of the countries biggest and most infamous gangsters, as well as their biggest marijuana harvests, say they have stopped growing pot because the price has collapsed in the past 5 years. It has gone from 100 dollars per kilo to less than 25. It just isn’t lucrative anymore, nor is it worth it.

So as any good business does, they tap into the consciousness of their consumers. Growers are now sowing their plots with opium poppies and large-scale heroin operations are turning up in places were they have never been seen before.
Let’s go back to December really quick: Police in Honduras found their first poppy farm in the country, raiding a sophisticated mountain greenhouse as big as a soccer field. That same week, soldiers and police in Guatemala came under attack by farmers armed with clubs and gas bombs, as they moved in to destroy 160 acres of poppy.

Along the border with Mexico, US authorities have seized 2,162 kilos of heroin. That is up from 367 kilos in 2007. So as the needle habit in the US makes a comeback, the Mexican farmers are more than happy to tap into a money making machine, known as your heroin addiction.

Although prescription painkillers remain more widely abused and account for far more fatal overdoses, heroin has been “moving all over the country and popping up in areas you didn’t see before,” said Carl Pike, a senior official in the Special Operations Division of the Drug Enforcement Administration. With its low price and easy portability, heroin has reached beyond New York, Chicago and other places where it has long been available. Rural areas of New England, Appalachia and the Midwest are being hit especially hard, with cities such as Portland, Maine; St. Louis;and Oklahoma City struggling to cope with a new generation of addicts. Pike and other DEA officials say the spread is the result of a shrewd marketing strategy developed by Mexican traffickers. They have targeted areas with the worst prescription pill abuse, sending heroin pushers to “set up right outside the methadone clinics,” one DEA agent said.

But can you blame them?

While Columbia is historically known as being the biggest source of heroin, Mexican output has surpassed it recently. Together the two, account for 90% of the heroin in the United States. As seizures of cocaine and marijuana along the border have fallen over the past several years, flows of methamphetamine and heroin have soared, federal statistics show.Mexico’s Sinaloa drug cartel continues to be the biggest provider of heroin to the United States, controlling as much as half of the North American market. Sinaloa boss Joaquín “El Chapo” (Shorty) Guzmán grew up here in the mountains outside the municipal seat of Badiraguato, and his organization remains the dominant criminal power along the western border and west coast of Mexico.

This area though, all it knows is how to grow potent drug making plants. The entire region is a giant drug farm and has been for decades. “There’s no other way to make a living here,” said Silla, who has brought up his sons in the business, as his father did before him. Feeling confident after several years of good harvests, Silla and other families here planted more poppies than ever this year, but their radiant purple, red and white flowers were spotted by aerial surveillance last month. Mexican soldiers in pickups came roaring up the creek bed soon after and tore out the crop, chopping up irrigation hoses and searching homes for guns and cash.

A kilo of the raw, sticky opium sap that is used to make heroin sells wholesale for $1,500 in the northern Sierra Madre, nearly double its 2012 price, according to growers. With fertilizer and favorable weather, a well-tended poppy field can yield eight kilos of sap per acre, nearly enough to make a kilo of raw heroin. It’s a much better cut than the whole marijuana game.

The increased demand for heroin in the United States appears to be keeping wholesale prices high, even with abundant supply. The Mexican mountain folk in hamlets such as this one do not think of themselves as drug producers. They also plant corn, beans and other subsistence crops but say they could never earn a living from their small food plots. And they just can’t compete with the American marijuana growers. And with more and more of the American marijuana market being flooded with potent and cheaper pot, Mexican trafficking groups have reorganized.

When a product starts losing value, you diversify. It’s true of any farmer as well as business man. And that’s how they see it.

If anything, it just goes to show that the legalization of a drug does have an effect on cartel and gang involvement. Just not the one we were hoping for.

Frequent Marijuana Use in Teens and Young Adults Affects Brain Development

Using marijuana at least once a week can lead to cognitive decline, poor attention and memory and decreased IQ in teens and young adults, according to researchers at the American Psychological Association annual meeting.

Krista Lisdahl, Director of the Brain Imaging and Neuropsychology Lab at the University of Wisconsin-Milwaukee, noted that 6.5 percent of high school seniors reported smoking marijuana daily, up from 2.4 percent in 1993. Among young adults ages 18 to 25, almost one-third said they had used marijuana in the last month, Lisdahl noted in a news release. She said a 2012 study found people who have become addicted to marijuana can lose an average of six IQ points by adulthood.

“It needs to be emphasized that regular cannabis use, defined here as once a week, is not safe and may result in addiction and neurocognitive damage, especially in youth,” Lisdahl wrote in a study she so-authored in the journal Current Addiction Reports.

Lisdahl noted that brain imaging studies of regular marijuana users have shown significant changes in their brain structure, especially among teenagers. USA Today reports Lisdahl said abnormalities in the brain’s gray matter, which is associated with intelligence, have been found in 16- to 19-year-olds who increased their marijuana use in the past year.

A study of more than 17,000 teenagers in Montana, co-authored by Bettina Friese of the Pacific Institute for Research and Evaluation in California, found people’s acceptance of legalized medical marijuana use appears to have an effect on teens’ perception of the drug’s risks. The study found marijuana smoking was more common in counties where larger numbers of people had voted to legalize medical marijuana in 2004. “People don’t perceive it as a very harmful substance, and these community norms translate to teens,” Friese said. “From the teen study, they do reference legalization: ‘If it was that bad a drug, they wouldn’t be trying to legalize it.’ “