Many people who struggle with substance use may feel awkward calling it an addiction. There is still a lot of stigma behind that word, and it may not feel accurate based on how you used drugs. Maybe you were a binge drinker or “only partied a few times a week.” Substance use disorder doesn't care how much you used or what you used. The words are more nuanced than that. The term means anyone who uses illicit substances, drinks to get drunk, or misuses substances, usually to their own detriment.

Are You Using Substances To Get High Or Drunk?

A person with a substance use disorder uses street drugs, alcohol, prescription pills, or other substances to get high. For example, a person whose drug of choice is alcohol may drink only to get drunk.

Substance use disorder is a term to describe anyone who has an unhealthy or dependent relationship with alcohol, illicit drugs, or prescription drugs. Illegal drugs are marijuana, heroin, cocaine, or any other drug you can buy on the street. People who drink to get drunk typically have an unhealthy relationship with alcohol. A person who misuses substances may be taking a legal prescription, but more than prescribed because they are trying to get more of a side effect such as euphoria.

People with substance use disorders often use drugs impulsively and obsess over their drug use. Addiction can cause cycles of heavy drug use, followed by pain and regret, that lead to more use. Nobody chooses to have a substance use disorder, but you can decide to get help when you realize you may have a problem.

Accepting That You May Have Substance Use Disorder

Using drugs or alcohol is an unhealthy coping skill that can keep you from living life to your full potential. If you find that your alcohol or substance use interferes with your quality of life, you probably have a substance use disorder. Many drugs are highly addictive, including alcohol. Addiction can cause many negative consequences in your life, such as financial problems, relationship issues, and even trouble with the law.

Admitting you need help is the first step toward recovery. Take an honest look at your life right now. Are you happy with it? Are you accomplishing the things you want? Are your relationships being hindered by your substance use? Have you lost anything due to the substances you use? Are you lacking money, relationships, or self-respect? Addiction can cause a lot of harm.

You don’t have to be a “fall-down drunk” or live on the streets to have a problem with alcohol or drugs. If you’re unhappy and having trouble quitting substances, you may have a problem with them.

We now know that substance use disorder is a disease of the brain. It’s not a moral failing or something you need to be locked away for. Instead, there is now treatment that can help you reclaim your life. You’re worth the work!

Getting Help for Addiction

If you or somebody you love has a problem with drugs, we’re here to help. You can reclaim your life and get started on the path to healing and wellness. Get in touch with your questions at 619-363-4767. All calls are confidential.

Many people take prescription medications under the supervision of their doctors. However, some drugs that are prescribed have the potential for abuse. In addition, people who take these medications may not be aware of their addictive nature until it is too late. People with opioid use disorder, for example, often don’t realize the extent of their addiction until they try to stop using opioids and suffer severe withdrawal symptoms.

Legally obtained prescriptions are one of the most commonly abused drugs in America. While most drugs are meant to improve our quality of life or our health, some also have side effects that can cause misuse and lead to a substance use disorder.

What Prescription Drugs Are Addictive?

Any drug that can alter your state of mind, cause euphoria, or other pleasurable side effects can be addictive.

Who Abuses Prescription Drugs?

People of all ages have the potential to abuse prescription medications.

When a drug is addictive, there is always a potential for misuse when a doctor prescribes it. For example, it’s common for a person using an opioid for pain relief to take an extra pill or take their next dose early to get more of a euphoric feeling.

Sometimes, though, a person who misuses prescription drugs may not have been prescribed them. For example, adolescents who experiment with drugs might take medication from their mother or grandfather’s pill bottle when they are not looking. This scenario is why it is so important to properly dispose of opioids and other prescription drugs if you’re not using them.

Symptoms of Prescription Drug Misuse

People who are abusing substances will often change their behavior. For example, they may be more secretive or less talkative. In addition, young people who are using drugs will sometimes change their friend circle. They may have trouble getting to work on time, have financial issues, or even get in trouble with the law.

If a person is misusing prescription drugs, they may also display the following behavior:

Each drug, however, has its own side effects. For example, a person who is misusing Adderall may stay up all night for days, while a person who is on opioids may appear to be sleeping all the time.

You can learn more about prescription drug abuse on this blog and recognize the symptoms of addiction. In addition, information on specific prescription drugs can help you learn about the signs of misuse and the dangers or side effects.

Getting Help for Addiction

If you or somebody you love need help with a substance use problem, we’re here to guide you. Learn more about our programs and how we can help you get on the road to recovery by calling us at 619-363-4767.



Have you or somebody you love started to drink too much during the pandemic? You’re not alone. Almost every adult generation has seen an increase in substance since the beginning of the coronavirus pandemic. And for many people, that means drinking too much has become a coping method. The term “pandemic drinking” has become a casual euphemism for this dangerous behavior.

Fathers, mothers, sons, and daughters are all living in a new world. The COVID-19 pandemic has affected people and families from every walk of life. Even when we have a reliable vaccine or treatment, we will probably still be coping with the aftereffects. Hopefully, people who have a problem with pandemic drinking can get the help they need.

Why Are People Pandemic Drinking?

The era of COVID-19 is a lonely time for many people, primarily because, as humans, our mental health relies on being social. It can be hard to connect or reach out to others when you’re home alone and struggling. You may think it’s easier to drink than to talk about your feelings. However, alcohol addiction can take over your life. You may find yourself drinking during the day or having to drink more or harder liquor to get the buzz you crave.

Alcohol is a common “escape” for people who are depressed, anxious, or lonely. Nobody binge-drinks or drinks until they blackout because they’re happy in life.

Many people think that drinking more heavily can help them cope with stress, sleep problems, boredom, and loneliness. But this is simply an escape that can have dire consequences.

Consequences of Regular Alcohol Abuse

People who drink too much right now may have struggled with their alcohol use in the past. You may have consumed a lot of beer in college or when you were going through a difficult time. No matter what the reason is that you’re drinking it, alcohol is not a safe coping mechanism. It has long-term health consequences, contributes to many social ills, and can cause intense withdrawal effects.

Some withdrawal effects from heavy alcoholism cause life-threatening consequences, such as hallucinations, heart palpitations, or seizures.

Alcohol abuse doesn’t fix any problems, but it can introduce new ones to your life. You don’t have to hit bottom to get help. Even during a pandemic, there are programs ready and willing to help you reclaim your life.

Getting Help for Alcohol or Substance Abuse

While drinking is seen as a more acceptable addiction, it is still a dangerous addiction that can cause significant problems in your life. It inhibits your ability to make good, rational decisions. Some people get DUI’s or even commit acts of rage or violence when they drink too much.

Abusing alcohol also makes you more likely to overdose on other drugs you use.

Getting Help for Alcohol or Substance Abuse

If you’re drinking too much during the pandemic or need help with substance use, there’s never been a better time to reach out. We’re here for you to help you start a new journey and reclaim your life. We can help you navigate your options and start charting your course to recovery and healing. Give us a call at 619-363-4767 to learn more about how we can help.


Drinking can cause a lot of problems for people, especially the drinker. Long-term drinking makes the drinker at still at risk for a myriad of issues, including mental health disorders and specific conditions and diseases. One particularly severe health problem that an alcoholic might have is “wet brain,” a slang term for Wernicke-Korsakoff Syndrome. The syndrome is a dangerous disorder caused by alcoholism. A severe thiamine deficiency causes it.

Alcohol Abuse Causes Nutritional Deficiencies

Thiamine (vitamin B1) deficiency is common among people who chronically abuse alcohol. People who have been drinking heavily for an extended period of time don’t always have the best diet. Pair this with the fact that alcohol prevents thiamine absorption, and there are several health problems that a drinker can be susceptible to.

Not every person who has a thiamine deficiency gets wet brain. But a large number of people who chronically abuse alcohol have nutritional deficiencies that can lead to blood diseases, dementia, and other serious health problems.

Understanding “Wet Brain”

The term “wet brain” has been around a long time. It’s a term that’s used to describe Wernicke-Korsakoff Syndrome and a collection of symptoms caused by thiamine deficiency.

Symptoms in the early stage of the disease include a loss of appetite, fatigue, and irritability. These symptoms are all familiar to doctors and, in general, can signal a variety of conditions. A person with an alcohol use disorder may have multiple deficiencies.

Another, more evident and alarming symptom of wet brain is problems with motor coordination. A person with this condition may have slow reaction times even if they haven’t been drinking.

Thiamine is an essential vitamin to the body. When the brain is starved of it, it causes brain damage, which can lead to dementia. This means that a person may seem psychotic or have delusions. They may have significant lapses in the memory.

Curing Wet Brain

Because wet brain is brain damage, it cannot be cured. Some symptoms can be treated, but brain damage is usually severe. Treatment for a vitamin deficiency can be treated with injections or an IV. If treated immediately, the damage can be minimized.

Getting Help for Alcohol Addiction

Do you or somebody you love have a problem with drinking or drugs? Help is available. You’re not alone. No one has to be vulnerable to this disorder! Recovery from alcohol addiction is possible. We offer a safe, comforting, safe environment to get and stay sober.

Learn more about our detox services at 619-363-4767.

Addiction (also known as substance use disorder) is a devious and sometimes confusing disease. However, many signs and symptoms may alert loved ones to the fact that a person is in trouble with their drug or alcohol use. Drug-seeking behavior, financial issues, and drama with relationships and even the law are signs that something is wrong. People who are addicted to drugs may have different symptoms, depending on the drug they use. People can become addicted to any mind-altering substance. However, some drugs are more addictive than others. These are important to know because “hitting bottom” or experiencing negative consequences can snowball quickly for the drug user as they begin to need more of the drug.


  1. Heroin: Heroin is one of the most addictive drugs and one of the most dangerous. It’s been used in many years all over the world as a narcotic, derived from the poppy plant. As an opiate, heroin quickly affects the brain, eliminating any pain signals and giving the user an intense euphoric high. Users rapidly also develop a tolerance to the drug, making them need more amounts to get the same rush they first experienced when getting high. When a person who uses heroin problems tries to cease using, they experience intense withdrawal symptoms. Often they choose to use again because these symptoms are so unpleasant or painful.


  1. Opioids: Similar to heroin, opioids are fueling an addiction crisis across the Unit4ed States due to lax prescribing and regulation. Opioids such as Oxycontin, Percocet, and Vicoden are all highly addictive drugs. They operate in the same way as heroin, with the difference being that they’re pharmaceutical drugs. They are made in a lab, not from the poppy plant, but they work the same way. Withdrawal is a considerable issue that stops people from getting help for this addiction, and group sitting in a waiting room looking seriouspeople often resort to heroin when they can’t get their drug of choice.


  1. Crack cocaine: Crack cocaine spurred a crisis of addiction, drug wars and mass incarceration throughout primarily inner-city communities in the 1990’s. Many stereotypes still surround this drug, and a lot of stigmas encompass its use. However, crack is incredibly similar (just more potent) to its more “designer” counterpart, cocaine. Crack is considered more addictive than cocaine because it’s more powerful, and its high is short-lived. Many people who use crack are unable to quit because of its powerful high. It gives users euphoria and more energy, making them jittery as well as high. The intense lasts about 15 minutes. People who become addicted to crack crash from that high and seek it again immediately, without realizing that they are quickly becoming addicted to the drug.


  1. Methamphetamine: This drug is also an “upper” with a high that can last for hours and cause the user to stay awake for hours or days. The high stimulates almost ten times as much of dopamine as is normal, causing extreme euphoria, adrenaline and sometimes paranoia too. The brain chemistry is immediately effected when a person has used meth. With the extreme high comes an extreme crash – making the user feel depressed and lethargic almost immediately after they “come down”. The withdrawal effects of meth are dangerous and can include nausea, vomiting, tremors, fever, seizures and hallucinations.


Many other drugs are addictive out there, but these are some of the most dangerous and, unfortunately, popular among addicted persons. Help is available no matter how bad you feel your addiction is! Recovery is possible.

If you or somebody you know thinks they have a problem with drugs, help is available. Please give us a call at 619-363-4767.

Ohio codifies recovery residence principles in groundbreaking legislation | Addiction Professional Magazine

Many States believe the a Sober Living Environment (SLE) is a great place go on day 31 of ones recovery journey. The treatment plan is being extended to an Intensive Outpatient Program (IOP) but the person is not ready, willing or able to go home or start a new living sitution just yet. This is where we help. If the community could would embrace the fact these homes (most anyway, FYI, I am all-in for inspections and regulations from industry groups like NARR , just not government agencies) serve a vital role in the Treatment Plan for a person living a life in recovery. Ohio is setting a great standard that California should look closely at...

you David, it was truly a manifesto of sorts. I can say that I have been relentlessly
pursued by the call centers and bed brokers over the last couple of years. Continuing
to refuse this “easy money” hurts in a way that I have not felt in the business
world before. I have been a sales person all my life (I'm pretty old too!!!) in
various industries so I am used to receiving and paying commissions for
bringing in revenue. The revenue was always attached to a product or service
with a measureable and desired outcome. Like insurance to protect my car when I
run into an immoveable object or new clothes to cover up the extra 10lbs I put
on over the last 6mos. The services for SUD and OUD (Substance Use Disorder /
Opiate Use Disorder) or Mental Health fitness are not a measurable service upon
usage like new pants, but rather a wellness program that some people need
yesterday and others that won't find for a number of years in the future. One thing
that we in Recovery agree on is that without these "services" death
is sure to follow. This puts us in a league many of us have had to learn to
embrace through our own recovery or Professional Studies and internships.


So, the
feeling that comes over me is empathy, a sense of urgency, even fear in some
cases that the person I am speaking with on the other end of the phone may
experience a life changing event in which I am now a part of…This puts my
selling experience up-side-down. This is why I actually refer
this caller to my network rather than simply tell them they don’t fit in my box
and move on. Be it another RTC, an IOP level of care, a therapists or coach
with a Sober Living companion, or to the community shelter. This NO CHARGE
referral may not be reciprocated in kind, and no one ever promised me my sales
experience would suffice, but I did make the promise to help in any way I
when I spoke to them on the phone that day…



Why Pay Per Leads, Call Centers, Patient Brokers and Fixing Dollar Signs to Clients are Horrible Ideas

Most of us got into the chemical dependency field to help people, and with the best of intentions. In order to do so we have to have people to help of course, and it seems that the process of generating new admissions is difficult at best and terrifying at worst. I get it, and particularly for those of us in the for-profit segment of the profession we rely on a lot of activity at the front end to ensure the success of our programs.
Traditionally we have looked to organic marketing efforts to generate inquiries. Good old fashioned boots on the the ground relationship marketing. It requires that we get out of our chairs and go meet people, tour programs, look folks in the eye listen to them talk about their program and they about ours. In doing so we develop a "book" of people we can work with, that will refer to us and we learn enough about then to make appropriate referrals ourselves.
In recent years SEO, adwords, pay per click - digital marketing - has risen dramatically. Initially at least this augmented the outreach efforts of our business development folks however as the years rolled by, algorithms changed, competition became more sophisticated and the depth of the pockets grew, not everyone could play in this space. It became the geography of large programs with vast budgets and all others be damned.
We are a resourceful lot, creative, and we tend to adapt as needed. Some of us ignored the direction of our moral compass and began to pay for referrals ($12,500 is to top price I have heard for a paid referral), utilize "patient brokers", commoditize the human life we sought to serve. And some of us too began to rely on call centers to provide us leads. It all amounts to the same thing - affixing a dollar sign to the forehead of each human we come into contact with and thereby inserting the concept of profitability ahead of help into the equation. They necessarily have a value proposition associated with them in this case - we paid for them and now how are we going to get paid back?
So with this in mind, I'd like to make a case as to why this is not only a bad idea, but is potentially ruinous to our profession:
  1. The first point of contact MUST be with a facility that can either help or refer a client to a place that can. When the window opens in which a person is willing to get help, it typically only opens a short distance and for a brief period of time. Adding iterations of contact, either in phone transfers or brokering a client to a facility serves only to lengthen the time before a person receives the help they are dying for. In the worst of it, this person is caught in a phone tree from which they eventually fall or jump, or they're tied up with someone trying to sell them to the highest bidder.
  2. Everyone calling a facility for help is in some sort of crisis. If you have ever worked the admissions line at a treatment facility you know the truth of this. Mom is on the other end of the line, desperately looking for help for her child, terrified she'll be making funeral arrangements before she sees them again. Husband calling for wife, child for parent, coming apart at the seems with grief. Or the addict themselves, beaten into a state of momentary surrender and you're the one that is going to reel them in. If you have not been exposed to this, trained for it and prepared to take on this responsibility you have no business answering the phone.
  3. We are unable to make referrals. We have an unwritten mandate to get out in the field, meet each other, collaborate with each other, learn what each other does in order to ensure the person in need is getting to the place best suited to help them. Not everyone that comes into contact with your admissions department is going to be a good fit for your program and so you are obligated to send them elsewhere. If you are not out in the field learning about the services others provide, you can't make good referrals and this is a failure for the caller and for the profession. You're cheating everyone.
  4. We're giving in to profiteering. Call centers and patient brokers do not care about the people who are seeking help. I don't care what they say. They care simply about turning this vulnerable population into cash flow. Period. They are not providing a service to the client - who is best served finding help direct - they are providing a service to themselves.
  5. It amounts to human trafficking. When we buy and sell people we are trafficking in human life. There's no nicer way to explain it. The person in need is reduced to a number, a dollar sign, not a compilation of causes, conditions and needs that require a host of clinical services. This is a human being - think of your child, sibling, parent, anyone you love deeply and care for beyond articulation. And then ask how much they're worth. How much would you sell them for. Or buy them for.
Now, notice I did not bring up the legality of any of this. Some of it is, some isn't - I think we have a higher authority to answer to however. That authority is the intrinsic value of a human life, a life often unable to save itself. As care givers we pledged first and foremost to stand in the gap with this human, to shoulder some of the struggle and light the way out of the darkness. We can't do that with one hand on their backs and the other on their wallet. There's no other medical field that's engaged in this manner; we're not treating cancer patients this way, those with diabetes or MS. So why should we treat addicts this way?
For the record, I make my living and take care of my family working for for-profit entities in this profession so I don't want to come off as holier than thou. And I think it's ok to make a living in this field provided the needs of the client are well ahead of the financial gain. It's been my experience that with the client as the first and foremost priority the rest of it works out. I've talked to enough others that feel this same way to know I am not the exception.
With all this being said, I'd like to draw your attention to the state of the profession as it stands at present. Never before - at least to my knowledge - have we been under greater scrutiny. The massive gouging that has taken place with urine drug screens has resulted in criminal investigation and prosecution; the manner in which clients get to treatment and are provided services is under the microscope of multiple insurance companies, so much so that reimbursements are being significantly delayed, reduced or denied outright. Communities are railing against us setting up programs within them, city government is getting involved in limitation or elimination of treatment facilities and sober living homes. The very foundation of the work we do is being challenged, called into question, and the proliferation of bad actors and bad action is only growing. It does not take much consideration to realize the likely outcome unless we make a serious and significant change in our behavior.
Finally, and this is a bitter pill to swallow - we did it to ourselves. When the good intention many of us had gave way to greed, when the bar of bad behavior lowered rather than raised, when we decided that human life was negotiable for our own profit we pulled the gun and shot ourselves in our collective foot. Now it's time to staunch the bleeding and contribute to the healing or we'll all be looking at amputation.



DEXTOX from Drugs and Alcohol can be a comfortable

Treatment of Addictive Disorders in the 21st Century

By Phillip Milgram, MD, Medical Director @ Present Moments Recovery

Recent advances and experience with the treatment of physical, chemical and habitual dependence, and with attempts to individualize treatment and engage unwilling or biased participants in traditional 12-step programs demand a discussion of how treatment can be more successful currently, than in the past.

“Treatment” consists of the gamut of use and abuse to identification, intervention, detoxification, introduction into rehabilitation, dedication to recovery, lifestyle changes, sober living, intensive outpatient and ongoing individual and group therapies. Predictors of successful recovery include rigorous self honesty, willingness to change, accepting direction, cleaning your side of the street, identifying and dealing with past issues so you can let go of them, social networking, admission of one’s faults to another human being, seeking authenticity and assisting others. As one who has personally found a new way to live in the 12-steps, I know to the deepest introspection; that to each of these contributors to successful program of recovery I can respond with “Yes, and by the way; AA has that”. As a treatment professional for 25+ years and with 28 years of dedicated personal recovery and a commitment to addiction treatment as my personal cause; I would like to discuss some recent discoveries that can serve to increase the success of recovery treatment.

The detox with Nicotinamide Adenine Dinucleotide (NAD) is a game changer. I believe that therapeutic use of NAD will prove to be one of the greatest discoveries in medicine since Fleming invented penicillin. As an experienced Detox MD, and a member of “Like-Minded Docs” I have managed hundreds of patients with traditional “white knuckle” detox, and now personally observed almost 100 detoxes with NAD infusion therapy. NAD is a game changer. If you respond with the common 12-step old-timer response “there is nothing really new. They are just promoting already known concepts to make it sound new, softer and easier”: you are partially right, and partially wrong. If you are staunchly in that belief, you are just ignorant. The intent of this article is partially to attempt to enlighten you to an absolutely better detox: NAD. The part of the statement that is true, is that NAD, or Coenzyme 1; part of Vitamin B3; that is present in every living cell of your body and responsible for many intracellular, extracellular and nervous system health was what Bill W. and his doctors discovered in the 1930’s. The problem was that, for reasons we won’t discuss here, they used the entire Niacin molecule, and not the pure NAD portion. The pure NAD, only recently available from a limited manufacturing process and administered with concomitant nutritional protocols with care for purity and stability of the pure NAD molecule; results in an incredible benefit for the detoxification process.

In summary: *(Adapted, in part from “The NAD Story—The Big Picture”, by James Watson MD)

  1. Alcohol metabolism causes NAD+ deficiency 
  2. NAD affects the reward circuits in the brain (nucleus accumbens and ventral tegmental area) common to all addictions that involve endogenous brain opioids, GABA and Dopamine 
  3. NAD affects the stress circuits in the brain, which are responsible for the discomfort known as withdrawal 
  4. These stress circuits play into the high occurrence of mental disease, specifically anxiety/depression and the various range of Bipolar Disorders 
  5. NAD plays a role in treating the “neuroadaptive” responses in the brain that cause tolerance, sensitization and withdrawal 
  6. NAD, through a separate action on brain chemicals known as “Sirtuins” allow the brain to remain “happy” and further reduce withdrawal symptoms 
  7. NAD has a profound effect in opiate abuse patients due to epigenetic factors and gene expression. 
  8. NAD causes a level of clear thinking (mental clarity), brain rejuvenation and a sense of peace that conduces to hope and a sense of “yes, I can recover” 
  9. The use of NAD, combined with nutritional supplementation protocols we have developed, reduces the need for standard detox medications, which have their own deleterious effects. 
  10. The NAD significantly reduces cravings over standard detox; almost like the patient had never been exposed to the alcohol or drug—truly miraculous to observe personally. 

This discussion is not the platform for a scientific explanation. And there are many more ways that NAD has been shown to enhance the detox experience. But I have simplified some of these proven scientific discoveries to display that there is real science to what we see in using NAD in clinical detox situation. When I personally saw this, I was so impressed that I have dedicated my life to helping recovering alcoholics and addicts acquire NAD treatment. One of the things I most like is that; the infusions are administered over several days. So I have a captive audience, with a clear brain, to drop a little recovery on them, and hopefully ruin their drinking or using forever, like Johnny Appleseed, except dropping mustard seeds. My favorite thing to do, is to talk with alcoholics and addicts, especially those new in recovery, about the disease and treatment of addiction. My clinic is NAD MD, Inc. and my website is

I am not saying that NAD is a “cure”, but in my experience NAD is absolutely the best first step in recovery. You still need a program of recovery, guided to the appropriate level of care for that individual, a plan, ongoing therapy, counseling and other techniques to find a new way of living and a lifestyle change, learning to place sobriety as the first priority. We have found that various techniques, such as NLP, and various psychological techniques have a much improved impact on a clear NAD brain. Also nurturing nurses and alternative physical methods such as yoga, stretching, massage, acupuncture, equine therapy, and other techniques create a detox experience that gets the newly recovering patient into a new path, a path to health and self-nurturing different from their previous deterioration into abuse, hopelessness and despair.

With the increasing prevalence of alcoholism and drug addiction in our society, and the informational technology seeming to enhance self-centeredness, isolation, self-directed crazy decisions, and disdain for traditional treatment, we have employed easier ways to enter recovery; such as letting a person live according to their conscience, or a sense of doing the right thing for the right reason and letting go of expectations or control. This is increasingly difficult with Millenials and Generation X patients.

As some of my friends and mentors would say: “Phil, it’s just the same thing packaged in a way for marketing purposes.” This does not pertain to NAD, as NAD will be shown to be one of the greatest advances in alcohol and drug treatment. But as far as rehabilitation, we must fashion recovery into a pill the newly recovering person can swallow, to accommodate those who are reticent to trust anything but their own self-determination and control; a characteristic of most of us already exhibit in early recovery.


Drug overdoses won't stop rising — and that's not even the worst part

written by...Harrison Jacobs of the Business Insider
The number of deaths from drug overdoses reached a new high in 2014, totaling 47,055 people, according to a CDC report released on Tuesday.
The rise in overdose deaths is being driven largely by a dramatic rise in the use of opiates, including prescription drugs such as Oxycontin and illicit opiates such as heroin.
Opioids were involved in more than 60% of the deaths from overdoses, according to the study.
The numbers released by the US Centers for Disease Control and Prevention (CDC) are hardly surprising. Opioid use has been rising for nearly 20 years.
According to Dr. Ted Cicero, a professor of psychiatry at Washington University in St. Louis and an opiate-use researcher, opioid prescriptions started skyrocketing in the mid-1990s as pharmaceutical companies introduced powerful new painkillers such as MS Contin and Oxycontin and medical groups began calling pain the "fifth vital sign" that doctors should attend to.
"There was a big push saying we had a big problem with the undertreatment of pain," Cicero told Business Insider. "Opioid prescriptions skyrocketed from the early '90s until about 2010."
Prescription opioids introduced a whole new segment of the population to opiates, either directly through prescriptions or through those same drugs being diverted to illicit uses. Both legitimate pain clinics and "pill mills," shady establishments whose sole purpose was to prescribe legal opioids without asking too many questions, thrived in this environment.
According to Grant Smith, deputy director of national affairs at the Drug Policy Alliance, when the prescription-painkiller crisis became apparent, state, local, and federal law enforcement launched crackdowns on prescribers and patients that used prescription opioids. Pill mills and pain clinics shut down and physicians became scared of overprescribing. The supply of prescription painkillers was curbed and prices on the drugs started rising.
While many might have hoped that the crackdown would be the end of the problem, it simply changed its trajectory. With a vast new population addicted to opiates, many users turned to heroin to feed their addiction.
"From a public-health perspective, things are worse now. Before people were misusing pharmaceutical drugs. Now they've shifted to heroin," Smith told Business Insider.
cicero study heroin painkillersWashington University School of Medicine in St. Louis
Between 2007 and 2013, the number of users of heroin in the US nearly doubled, according to Insight Crime.
The idea that the crackdown on painkillers led to the rise in heroin use appears to be backed up by the numbers.
Cicero and his team recently concluded a study surveying the drug use of more than 15,000 patients with opioid dependence entering non-methadone-maintenance treatment programs between 2008 and 2014. The study found a near-direct correlation between drops in users taking solely prescription opioids and a rise in users taking only heroin and those taking both substances.
Many users are simply using whatever is available at the time.
When the team conducted interviews with a group of 129 patients that reported using prescription opioids before turning to heroin, 73% cited heroin's accessibility and cheaper price compared to prescription opioids as their primary reason for using heroin.
"It has become a natural progression for may people taking opiates to move to heroin over a period of time," says Cicero.
The CDC found similarly:
Drug overdose deaths involving heroin continued to climb sharply, with heroin overdoses more than tripling in four years. This increase mirrors large increases in heroin use across the country and has been shown to be closely tied to opioid pain reliever misuse and dependence.
Past misuse of prescription opioids is the strongest risk factor for heroin initiation and use, specifically among persons who report past-year dependence or abuse ...
The heroin issue has not gone unnoticed. During a speech in October, US President Barack Obama announced a wide range of steps to combat the heroin crisis, including increasing access to drug treatment and expanding the training of doctors who prescribe prescription painkillers. In August, the administration announced a plan to connect drug-enforcement officers with public-health workers to track down heroin supplies, as well as tightening prescribing rules around certain opioids.
Despite the increased attention, Cicero doesn't see the problem subsiding anytime soon.
"At some point, heroin use will peak and then start to drop off, but for the foreseeable future, heroin is going to be a big problem," he said.
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