Horror stories of opiate addiction: 'Terrible form of chemical slavery'

News-DemocratApril 4, 2014 

AP GRAPHIC

"Rachel" was a young mother in an unhappy marriage who had no idea her stress headaches would lead to a decade-long struggle with addiction.

Representatives from Wellspring Resources shared Rachel's story during the second meeting of the Madison County heroin task force Friday, as a way of illustrating the most common pathway to addiction and the resources available to treat it.

Rachel had two children and struggled with depression and stress, which caused serious headaches. She asked her doctor for advice, and he prescribed Vicodin, which is an opiate-based prescription painkiller.

Before long, Rachel found that whenever she didn't take Vicodin, she felt sick. So she called her doctor again.

He told her she was abusing the Vicodin and hung up on her. A week later, a letter arrived stating he would no longer treat her.

Jessica Park, of Wellspring Resources, said that at least half of the heroin addicts they treat started just like Rachel: using a medication prescribed by a doctor. Addiction to an opiate-based drug can set in as little as two weeks, she said. "We are talking about our family members, our neighbors and friends," Park said.

Addiction occurs when the brain develops specific opiate receptors that can only be filled by drugs derived from opium, such as heroin. When those receptors are not filled, the person suffers from chills, tremors, irritability, insomnia, nausea and diarrhea, sweating, weakness, wracking abdominal pain -- what Park described as "having the flu times a thousand."

"You cannot get out of bed, you cannot move," she said.

Worse, the withdrawal begins only a few hours after the last heroin dose. Addicts can no longer achieve the euphoria it originally created, but are only staving off withdrawal.

"It's a terrible form of chemical slavery," Park said. "They are constantly looking for the next fix to ward off the withdrawal. It's no longer about getting high; it's about being able to function at all."

Rachel quickly moved from Vicodin to any painkiller she could get. She did things she had never imagined: lied and stole from family members, including stealing her mother's pills as her mother was recovering from surgery. She tried to enter a rehabilitation facility, but was sent home because she was "only" on pills. Other doctors refused to treat her.

By the time she came to Wellspring, they said, Rachel was taking 50 to 55 pills a day, including Vicodin, Percocet or any other painkiller she could find.

Rachel was treated with a methadone series, which Park said is only one component of modern opiate treatment. Methadone itself is a long-acting, synthetic narcotic, but works differently on the brain. Instead of filling those opiate receptors, Park said, it covers up the receptors. It does not get the patient high and does not increase tolerance, but it prevents withdrawal.

A dose lasts 24 to 36 hours, while heroin requires a dose every four hours or so. "Methadone allows people to live a normal life, hold down a job and focus on their families," Park said. "We view methadone as a tool to help them achieve recovery."

But it isn't a magic solution; there are multiple components to heroin treatment. Park said Wellspring focuses on the individual and group therapy and other support services that help addicts build their recovery, and all those services are also available to clients that cannot pay for methadone.

"Our philosophy is that we meet the client where they are," Park said. "We get them physiologically stable with the methadone, and then help them get stable with the rest of their lives. They're not committing crimes or risky sexual behaviors, reducing their risks, help them obtain employment and improve their parenting skills."

Methadone costs $90 to $120 a week, and an addict might be on it for a long time. Park said health insurance generally covers methadone for pain management, but not to treat addiction. At some point, the goal is to wean the addict off methadone in a medically-supervised procedure, but that can take years.

That's Rachel's goal now, after 10 years in treatment. She earned her GED and a bachelor's degree in education, and aims to graduate from Wellspring's program. While Park and fellow Wellspring employee Kelly Medlin shared Rachel's story anonymously, they said Rachel believes it's worth sharing her story if it helps one person seek help.

Wellspring used to have a years-long waiting list to get into the program, which is why they've moved to an "open access" model where evaluations can be offered as soon as someone walks in the door.

At Chestnut Health, which treats 450 drug clients, they saw heroin and prescription opiate addiction begin to increase in 2009-2010. "Then heroin left prescription opiates in the dust," said Julie Brugger of Chestnut. Since then, heroin continues to trend upward, now surpassing all other substances as the primary drug addiction.

"That is frankly frightening, because of the risk of overdose and other risk behaviors specific to heroin," Brugger said.

Chestnut uses another medication-assisted treatment: suboxone, which is sometimes covered by insurance. Without health coverage, a three-day detoxification treatment could cost as much as $3,000, Brugger said. But the county health department is helping people sign up for health coverage via Affordable Care Act exchanges and for Medicaid, she said.

"There are a lot of people who aren't sure where to go to access help," Brugger said. "It's about recognizing where the help is available and making the call to come in. ... We're the people who never give up. We are always here and we will always help you."

The heroin task force was put together by Sheriff Bob Hertz and Madison County State's Attorney Tom Gibbons after three heroin-related deaths took place in one night earlier this year. The first task force meeting focused on the problem in Madison County with a focus on law enforcement, but Gibbons said he knew enforcement alone can't solve the problem. He hopes to bring in doctors, recovering addicts, families, more treatment providers and others to focus on "all pieces to this puzzle" in search of solutions.

"We're going to keep doing this," Gibbons said. "There are a lot of parts to this story that need to be told."

Contact reporter Elizabeth Donald at edonald@bnd.com or 618-239-2507.

Contact reporter Elizabeth Donald at edonald@bnd.com or 618-239-2507.

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