heroin addiction & recovery 101 · understanding heroin addiction & recovery 101 a personal...
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Heroin Addiction& Recovery 101One man's understanding
of the opium invasion
by Ron CalhounCopyright 2016
All rights reserved. No part ofthis publication may be reproduced,distributed, or transmitted in anyform or by any means, includingphotocopying, recording, or otherelectronic or mechanical methods,without the prior writtenpermission of the publisher, exceptin the case of brief quotationsembodied in critical reviews andcertain other noncommercial usespermitted by copyright law.
Copyright © 2016by Ron Calhoun
Ron CalhounHeroin Doesn't CarePO Box 675Independence, KY 41051
HeroinDoesntCare.org
This eBook is providedat no cost to you. Butplease, understand, it
isn’t free.The information in thiseBook has been paid forby thousands of brokenhearts and millions of
fallen tears fromcountless parents,
spouses and loved oneswho have loss someoneto a opium overdose.
While the content ispriceless, it came at a
tremendous price.
Understanding Heroin Addiction & Recovery 101
From injury to addiction – Dave was afirefighter with a major municipality. He
had "never ever tried pot.” Once in awhile,
he would have a beer. He was married,
had children, and loved being a
professional firefighter. Then he had an
accident. At the scene of a fire, he fell two
stories.
After several months of recuperation, he
was ready to return to his job. When Dave
had left the hospital he had been given a
prescription for an opiumbased pain
reliever. But there was a problem. Dave
developed a terrible flulike illness after he
stopped taking the pain pills. He returned
to his doctor who explained that he must
have become addicted to the prescription
medication.
But that couldn’t be possible. Dave had
been careful to follow the doctor’s orders
and take the physician ordered medication
exactly as instructed. But now his
Understanding Heroin Addiction & Recovery 101
doctor said there was nothing he could do
to help him.
In short, Dave has an accident related
injury, he took medication according to the
doctors instructions, became addicted to
the medication, and his doctor addressed
Dave’s addiction by telling him there was
nothing he, the doctor, could do. Some
months later Dave was arrested for
breaking into a house to get drugs.
Understand, Dave never took pills to get
high. First, he took them to dull the pain.
Next, he took the pills to avoid the pain of
withdrawing.
Dave is just one of thousands who have
become addicted to an opiumbased
prescription while following doctors orders.
Dave had nevereven tried pot
Understanding Heroin Addiction & Recovery 101
Prescriptions pain pillsA few years ago there were two types of
people who were being prescribed
opioidbased pain pills. (Opioidbased
means the basic ingredient is opium, which
is what heroin is made from) The first
group was people with legitimate illnesses
or injuries. The second were people who
misused the medications to get high and
either got prescriptions at multiple doctors
or pill mills.
Over time, many of the people with
legitimate illnesses accidentally became
addicted to the medication. Those
accidentally addicted to opioidbased pain
pills were still getting them from their
doctors even tho the pain was gone. But
that would change.
Realizing there was a problem states
enacted laws to monitor doctors who
prescribed opioidbased medications.
Understanding Heroin Addiction & Recovery 101
Abusers could no longer get prescriptions
from multiple doctors and quarterly blood
test proved the patients were taking the
pills and not selling them. Prescriptions
became harder to get.
In Kentucky the monitoring program is
called KASPER, which stands forKentucky All Schedule Prescription
Electronic Reporting.
As control of prescriptions tightened those
who had accidentally become addicted
along with those who purposely misused
the pills now had to find some other way to
maintain their addiction. Many were now
faced with buying pills on the black market
aka the street.
Mexican cartels jumped in and used this
opportunity to set up more elaborate heroin
distribution methods throughout the United
States. So we had two problems, first
prescriptions drug abuse, which lead to the
second problem, heroin abuse.
Understanding Heroin Addiction & Recovery 101
Side note: morepeople die from
prescriptionspain pills than
heroin.
Understanding Heroin Addiction & Recovery 101
AddictionAccidental and deliberate users werenow purchasing pills and heroin on thestreet.Opium (heroin) users don’t necessarily
become addicted from only one use.
Before becoming an addict your body
builds up a tolerance to the drug. At some
point, the user may experience flulike
conditions known as dope sick. Even users
who use only small amounts and only use
occasionally can build up a need for the
drug to avoid becoming dope sick. It
becomes necessary to use the drug so
they can feel normal.
At this point, when the drug is needed to
feel normal, the user is now an addict. Why
do I say that? Because stopping the use of
the drug will cause severe withdrawal, flu
like, dope sick conditions, therefore, they
will continue using the drug in order not to
go through withdraw.
Understanding Heroin Addiction & Recovery 101
The difference in the level of usage to feel
normal, or get high increases over time
with use. The user’s body builds up a
tolerance and will need more of the drug to
maintain the desired effect.
A problem arises because the level
needed to die from an overdose, is not
much higher than the amount needed for
the desired result (feeling normal or getting
high). We will call the amount needed for
an overdose the ceiling.
The difference from desired results to the
ceiling decreases over time so that user is
getting increasingly close to the overdose
ceiling.
People overdose from one of two ways.
For example, the victim passes out, lies on
their back, exasperates and chokes. But
the most common way is the victim has hit
the ceiling and the body becomes so
relaxed that the brain forgets to tell
Understanding Heroin Addiction & Recovery 101
the body to take a breath. An overdose
may last a number of hours because the
victim may still breath occasionally. Given
enough time, however, the body will die.
...the mostcommon way (tooverdose) is thevictim has hit
the ceiling andthe body
becomes sorelaxed that thebrain forgets totell the body totake a breath
Understanding Heroin Addiction & Recovery 101
Treatment and Recovery
Addicts need this narcotic to feel normal.
Not having the drug in their system causes
withdraw. The first step in recovery is to
cleanse the drug from the user's body by a
process known as detox.
Recovery starts with detox. But howhard is it to get into a detox?
According to aUniversity of Kentucky study:• For every 100 people who want to quit
and call for help, we only have help of any
kind for 24. Most are put on a waiting, but
76% will never get help.
• We can only help 24 of every 100 whobeg for help
• In Greater Cincinnati, it is estimated we
can only help 1 person out of 9 or 11%.
89% never make it off the waiting list.
Understanding Heroin Addiction & Recovery 101
A personal storyIn 2014 I attended an awareness event at
a park in Kenton County, Kentucky. A
young woman, mother of a twoyearold
daughter, came to the event and asks for
help. She explained that she had been
using pills and started using heroin. She
explained that she was not using a needle,
“yet.” She had gone to the local emergency
room (ER) and asks for addiction treatment
fearing, without treatment, she would soon
start injecting.
The ER told her, “You’re not bad enough.”
Where she ask what “bad enough” meant
they explained she wasn’t experiencing an
overdose at the time. She ask if they would
help her if she was overdosing and they
explaining they could keep her for three
hours and then she would have to leave.
The ER told her,
“You’re not bad enough.”
Understanding Heroin Addiction & Recovery 101
So now she has come to this addiction
awareness event to ask for help. Six
different awareness groups sprung into
action. People pulled out cell phones,
started calling detox centers. In the three
counties that make up “Northern Kentucky”
there is only one detox center, Droege
House. Droege House has a total of eleven
detox beds. Eight for men, three for
women, they had no openings.
The advocates kept calling. Fifteen
minutes later and still no detox bed. But
the young mother was assured an opening
would be found. Thirty minutes, calls were
now being made to other parts of the state.
Fortyfive minutes, they were now calling
Tennessee and still no room.
...they were nowcalling Tennesseeand still no room.
Understanding Heroin Addiction & Recovery 101
One of the advocates started to tell the
young lady that they were still trying. And
then it happened. The young lady who had
arrived at the event with a hopeless heart
with tears in her eyes was gone. She had
come to the event, begged for help, had
six groups trying to find her help, and she
had simply lost hope and walked away.
She had been told over, and over there
was no help to be found. She gave up.
Everythingstarts with
detox.
Understanding Heroin Addiction & Recovery 101
But what happens if you're one of thelucky one who gets into a detox center?
Even if the user can get into detox they
are still in danger. It is important to
understand after a successful detox the
users body has lowered its tolerance to
heroin. The overdose ceiling has also been
lowered now to an unknown level.
Therefore, if the person reuses any
amount they can die from an overdose.
After a user detoxes and the body has
reset it’s tolerance level (ceiling) the
desire to use the drug is still present.
Just like cigarette smokers who have daily
activities, which causes triggers to smoke.
Opium users also have daily triggers and a
psychological desire to continue using the
drug.
After detox the overdoseceiling is lower, but the
desire to use is still present
Understanding Heroin Addiction & Recovery 101
Time is needed to recoveryThe users body and brain must be given
enough time to recovery. The users mind
must be given enough time to heal and
learn how to respond to these triggers.
NOTE: A couple of days of detox and 30days of treatment is not enough time forsomeone to learn how to respond totriggers.
A recommended pathway to recovery is to
start with detox (7 to 10 days), after which
the client should be directed to a program
that teaches life skills perhaps a residential
program and/or the working of a 12 step
program. Detoxed clients should be
allowed to use Suboxone or Vivitrol for
longterm care. Suboxone and Vivitrolboth suppress the desires and cravingsof addiction, however Vivitrol blocks opioid
receptors in the brain so that users cannot
get “high” for approximately a 28 to 30 day
period. Either medication should only be
used under the direction of a doctor.
Understanding Heroin Addiction & Recovery 101
MedicationAssisted Treatment (MAT)and Behavioral Therapy
Suboxone and Vivitrol are two forms of
medicationassisted treatment. Doctor
supervised medicationassisted treatment
(MAT) gives the client’s brain time to heal
and time to unlearn triggers. Theimportance of time cannot be overstated.
How long should a person be on MAT?The answer is, as long as their doctor
believes it is needed. For some it may be
two weeks, others two years, and still a
few may have to take medication for the
rest of their life. The goal is, under the
supervision of a doctor, when the doctor
and client believe they are ready, they
should be able to gradually wing the client
off of the medication.
One challenge facing clients during this
period is living in the same conditions they
Understanding Heroin Addiction & Recovery 101
lived in before recovery. Daily triggers for
example, if clients have to go back to the
same neighborhood, in the same family, or
the same drug filled surroundings as
before, recovery is jeopardized. Therefore,
sober living facilities, for example, Oxford
House, allow clients to fully rehab and
reintegrate back into a successful
recovery.
When helping someone recovering from an
opium addiction, think long term.
Next, how soberliving facilitiesallow clients to
have needed time
Understanding Heroin Addiction & Recovery 101
Sober living facilities allow clients tolive in a house, have jobs and takeresponsibility for their lives.
Clients are expected to pay rent, contribute
to the purchase of food and maintenance
of the house. The house is expected to be
selfsustaining.
It has been learned that one of the triggers
of relapse is a client trying to deal with the
normal stresses of life. Paying bills, raising
kids, dealing with the death of a loved one
are enough to send many people into
experiences of depression or anxiety.
Recovering addicts are people too. They
have normal everyday problems, for which
they use to selfmedicate. Sober living
facilities allow clients to gradually take on
those responsibilities and those anxieties
and learn how to cope with them without
selfmedication. How long should you
“work a program?” The answer, as long as
you plan on being alive. Recovery is a
lifelong process.
Understanding Heroin Addiction & Recovery 101
The Transtheoretical Model
Stages of Recovery
Two wellknown alcoholism researchers,
reverse engineered the stages of
changing behavior. The researchers, Drs.
Prochaska and Diclemente started withpeople who had successfully recovered
from addiction and had been in recovery
for ten to twenty years. They started with
people who had succeeded and looked at
what had worked.
Drs. Prochaska andDiclemente started
with people who hadsuccessfully recoveredfrom addiction and had
been in recovery forten to twenty years.
Understanding Heroin Addiction & Recovery 101
The Transtheoretical Model
Stages of Recovery
They published the findings in 1983. The
model is called The Transtheoretical
Model (TTM).
The model has been updated over the
years. On the following page is a
breakdown of how I understand the model
and what it means in easy to understand
English.
Is this the ONLY model of recovery. No,
but it's a great place to start.
• Stages 1: Denial• Stages 2: Interruption• Stages 3: Acceptance• Stages 4: Determination• Stages 5: Action• Stages 6: Maintenance
Understanding Heroin Addiction & Recovery 101
Stages of Recovery• Stages 1: Precontemplation (Not Ready, Denial)No intention to take action.
• Stages 2: Interruption (Distraction, Wakeup call)
lost a job, lost family, overdose, arrested or others
problem – Dr. Jeremy Engel calls this, the Distraction
stage.
• Stages 3: Contemplation/Acceptance (GettingReady) They are starting to understand they have a
problem. They are “on the fence.”
• Stages 4: Preparation/Determination (Ready,decision time) This stage is still not recovery. It’s
thinking about and planning for recovery. They are
determined to commit to a plan of action.
• Stages 5: Action/Implementing the plan – Theyhave a plan and more importantly they are modifying
behavior. Finding a Detox is generally part of
your preparation while starting detox is part of Action.
They have started on the road to recovery. They are
working a plan and changing behaviors. They may
make a public commitment. They are “building a new
pattern of behavior”, which will take time.
• Stages 6: Maintenance – Person has been able to“sustain” new actions for at least six months. They
have a support system that helps them prevent
relapse. New, better behaviors are a part of their life.
Understanding Heroin Addiction & Recovery 101
Relapse is not a stage of
recovery in TTM but is seen as
a return to an old behavior.
You don’t need to go back to
the first stage because of a
relapse you can start at the
action stage. Also, going back
to the action stage is a good
way to strengthen maintenance.
Understanding Heroin
Addiction & Recovery 101
by
Ron Calhoun, Founder
Heroin Doesn't Care
Understanding Heroin Addiction & Recovery 101
Resources andWebsites
HeroinDoesntCare.orghttp://www.samhsa.gov/
Opioid Treatment Program Directoryhttp://dpt2.samhsa.gov/treatment/directory.aspx
MedicationAssisted Treatment (MAT)http://www.samhsa.gov/medicationassistedtreatment
SAMHSA.gov is the single most
important website and resource you
and I have.
Go to the SAMHSA.gov website & bookmark the page
Recommended reading
Dreamland: The True Tale ofAmerica's Opiate Epidemic
Book by Sam Quinones
Google Search:
"purdue pharma doj settlement"
About the author
Ron Calhoun
Ron Calhoun is a videographer from Independence, Ky wherehe lives with his wife Donna. He was a professional entertainermost of his adult life but came off the road and started college atthe age of 52.
"They told me I was a non-traditional student, which for thefirst three months I thought meant I showed up and paidattention."
He double majored in public relations and electronic media withminors in journalism and sports marketing.
He is currently in production of a documentary web serierscovering opium addiction and recovery. He is the founder ofHeroin Doesn't Care, a nonprofit electronic media creator.
He has twice been presented the Chair's Award from NorthernKentucky University Department of Communication, College ofInfomatics, received a Blue Chip Media Award for ProfessionalDocumentary, and commissioned a Kentucky Colonel by thegovernor of Kentucky.
www.HeroinDoesntCare.Org/blog