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MADCP Presentation Abuse and Prevention Methods Opiates / Heroin Raj Mehta M.S.W. serenityhelp.com

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MADCP Presentation Abuse and Prevention Methods Raj Mehta M.S.W. www.serenityhelp.com Licensed by the State of Michigan to kill addiction onsite. I help people and smash addiction on a daily basis. I wrote the Underground Recovery Book to help addicts and their families. Some people say, I never should have messed with drugs, I say, addiction should have never messed with me!

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MADCP Presentation Abuse and Prevention Methods Raj Mehta M.S.W. www.serenityhelp.com Serenity Therapy Center 745 Barclay Circle Rochester Hills, Michigan What is a disease? Symptoms + ?

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MADCP Presentation Raj Mehta M.S.W. What is a disease? Symptoms + Treatable The Flu = Physical Symptoms Addiction = Physical Symptoms Mental Symptoms Social Symptoms Legal Symptoms Financial Symptoms Spiritual Symptoms

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SO WHAT IS ADDICTION ANYWAY? The main symptom of addiction? The inability to get high successfully! No, this is not a challenge to the person using drugs. Addicts use drugs to change how they feel Recovery = Change! An active change in attitudes, ideas and behaviors The drunken horse thief? An allergy reaction

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Models of Addiction UNDERSTANDING MODELS OF ADDICTION Paradigm: An example; a model; a lens through which to view something; a pattern. Everyone has their own perspective when describing something complicated. When 3 blind men attempt to explain an elephant after touching it, the result is confusing. One touches the foot and says, It is large and round like a tree stump. Another touches the tail and says, it is like a snake. Another touches the face and says, It is like a giant. They are all telling the truth from their perspective. However, they only understand a part of the animal. 1. Moral / Spiritual Model -If you really wanted to stop you would. Youre self-indulgent -This is a vice like cheating on your wife or gambling- Its a choice -Solution Find your morals, Find God you lost your way 2. Psychiatric / Psychological Model -Early life traumas cause addiction -Psychic cause, not enough love, abusive family - Solution Go back to the past and solve / treat the psychological trauma 3. Environmental Model -Social learning. Bad people showed you how to get high -Its the problem of peer pressure and poor surroundings -Its these people, that area, easy access to drugs -Solution Geographic cure, social cure; leave that place and those people alone and you will stop using 4. Existential Model -Conceptual Model relating to the unique experience of human existence -Condition: People with no sense of purpose or destiny are prone to anxiety, addiction, laziness, insecurity, and fear of death -Solution Discover your purpose or destiny on this earth and you will live a life of meaning and purpose. Those fulfilling their sense of purpose have no use for intoxicants 5. Disease Model -Genetic / Psychological pre-disposition -Symptoms just like a disease: Mental, Physical, Legal, and Social consequences -Insurance billable model, AMA model, removes blame, and its treatable -Solution Stop the cause of the disease (using), the symptoms (consequences) will go away

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Roger Bannister and the four-minute mile Today substance abuse treatment methods and relapse rates are stuck in a four-minute mile scenario. We can do better and do better consistently. Remember, before AA no one thought that chronic alcoholics could be helped. And before NA, no one thought that chronic drug addicts could be helped. Whatever you think the recovery rate is for an addict, it is time to re-think it as being 100%. Now we need to pave the way for change in substance abuse treatment and stop business as usual thinking! ADDICTS WHO ARE TOLD THEY WILL GET SOBERWILL LIKELY GET SOBER! According to Miller & Rollnick (2002) The effect that believing that one is receiving an effective treatment is so strong that placebo (rather than no medication) is the standard against which new medications must be tested. This phenomenon is not restricted to a patients beliefs. The counselor, doctor, or teacher also holds beliefs about a persons ability to change, and these beliefs can become self-fulfilling prophecies. In one study conducted in three different alcohol treatment programs, patients identified to staff as having high potential for recovery (but who in fact had been chosen at random) were significantly more likely to be sober and working a year after discharge. Perceived prognosis influences real outcomes. Motivational Interviewing Therapy Miller and Rollnick 2 nd Edition page 6

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Stages of Change= 1.Precontemplative 2.Contemplative 3.Preperation 4.Action 5.Maintenance *Relapse Addicts and Non-Addicts feel Ambivalent about using drugs= They love the way the drugs make them feel-- they hate the consequences

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Abuse and Prevention Methods Opiates / Heroin In the beginning people are motivated by consequences to change, then they are motivated by rewards, finally the motivation should be values / morals. 1.Consequences 2.Rewards 3.Values / Morals External Motivators Internal Motivators

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The Gladiator Concept Raj Mehta M.S.W. WHO WERE THE GLADIATORS? The Romans captured and recruited gladiators from all over the world. Every tribe, culture, and country contributed gladiators for the fight. In addition, women gladiators were also recruited and known to bravely engage in contests to the death. Most often, gladiators were slaves who were selected or requested an opportunity to train and live better lives. They realized that by training with other gladiators and experts they would be able to hone their skills and become better warriors. They attended special gladiator schools were they lived, trained to exhaustion, and reached their full potential as warriors. If they fought well and won often enough, they could win their freedom. TODAY? Todays recovery warriors are like ancient gladiators. Addiction enslaves people from all cultures, tribes, and countriestaking away their freedom. Often, these addicts have lost contact with family and friendsmany have also lost hope. Accordingly, many addicts are even slain and disabled by addiction. Those addicts who yearn to be free turn to treatment centers, other addicts, and experts to get help. If they train hard and learn well, they can earn their freedom. Remember not all prison walls are made of brick and mortar. To face and fight addiction is to be valiant. Freedom from active addiction is a glorious thing. Welcome to Gladiator School for Recovery! Fortune Favors The Bold! Sell sobriety

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What to do? 1.Get family involved / Employment 2.Get change talk going 3.Use the Socratic method 4.SSRIs (PROZAC) / Acupuncture 5.Get them involved in positive activities 6.Written relapse prevention plan 7.Focus on relapse prevention 8.Find the traction points / Change social network 9.Vitamin C for extended and acute withdrawal 10.Dont ignore their concerns 11.Vivitrol and Naltrexone (blockers) 12.Move them on to the next change level People in active addiction utilize: Deny, Distract, Delay, Divide

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What to watch for? 1.Inability to delay gratification 2.Lack of future orientation 3.Shortened time horizons 4.Insensitivity to future consequences 5.Are they Criminals? 6.Who is an ally? 7.Medications (non-mind altering) 8.What are they taking? 9.Find out which model of addiction they relate to the most Always respect addiction, because addiction has no respect for you

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Whats Important? 1.Family Involvement lowers attrition rates 2.25% of people who try heroin one time, become completely addicted. 3.There has been a 100% increase in heroin use in the past five years. Every never I ever said, came true. Anonymous heroin addict.

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SOCIETY AND COST 80 mg oxycontin = $80 $1 per mg = Oxy 1000 mg = 1gm 1gm oxycontin = $1,000 28.34 gm = 1oz 1 oz of oxycontin = $28,340 Heroin per ounce NY (DEA) = $5,000 Cocaine per ounce (DEA) = $1,200 Methamphetamine per ounce (DEA) = $1,400 Oxycontin per ounce = $28,340 Gold per ounce = $1,200

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The History of Heroin 1800's Patent medicines and opium preparations such as Dover's Powder were readily available without restrictions. Indeed, laudanum (opium mixed with alcohol) was cheaper than beer or wine and readily within the means of the lowest-paid worker. As a result, throughout the first half of the 19th century, the incidence of opium dependence appears to have increased steadily in England, Europe and the United States. 1853 The hypodermic needle was invented. 1874 English researcher, C.R. Wright first synthesizes heroin, or diacetylmorphine, by boiling morphine over a stove. 1898 The Bayer Company introduced heroin as a substitute for morphine.

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The History of Heroin 1903 Heroin addiction rises to alarming rates. 1905 U.S. Congress bans opium. 1914 Passage of the Harrison Narcotics Act which aims to curb drug (especially cocaine but also heroin) abuse and addiction. It requires doctors, pharmacists and others who prescribed narcotics to register and pay a tax. 1924 The Heroin Act made manufacture and possession of heroin illegal. 1925 There were over 200,000 American heroin addicts

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How Does Heroin Work? In 1972 brain researchers from Johns Hopkins University made a puzzling discovery that would illuminate scientists' understanding of drug addiction. They found that the human brain's neurons had specific receptor sites for opiate drugs: opium, heroin, codeine and morphine. But then there was the obvious question. Why would nature put in our brains a receptor for a plant? They soon figured out that the active ingredient in all these opiates - morphine - had a chemical structure similar to endorphins, a class of chemicals present in the brain. Endorphins are feel-good chemicals naturally-manufactured in the brain when the body experiences pain or stress. They are called the natural opiates of the body.

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How Does Heroin Work? When endorphins do their work, the person feels good, high, or euphoric, and feels relief from pain [analgesia]. Logically, endorphin levels go up when a person exercises, goes into labor, or is stressed out. Although they seem to be triggered by stress, endorphins can do more than relieve pain, they actually make us feel good. Like an evil twin, the morphine molecule locks onto the endorphin-receptor sites on nerve endings in the brain and begins the succession of events that leads to euphoria or analgesia. This imposter is more powerful than the body's own endorphins. Since we are all pleasure-seeking animals, the motivation to self-administer such a drug is easy to understand. The drawback, of course, is addiction.

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The History of Heroin 1930's The majority of illegal heroin smuggled into the U.S. comes from China and is refined in Shanghai and Tietsin. 1948-1972 Corsican and French gangsters dominate the U.S. heroin market through their connection with Mafia drug distributors. (French Connection) 1972 Heroin exportation from Southeast Asia's Golden Triangle, controlled by Shan warlord, Khun Sa,becomes a major source for raw opium and heroin in the profitable drug trade. Mid-1970's Saigon falls. The heroin epidemic subsides. The search for a new source of raw opium yields Mexico's Sierra Madre. "Mexican Mud" would temporarily replace "China White" heroin until 1978. The Golden Triangle overlaps the mountains of four countries of Southeast Asia: Myanmar (Burma), Vietnam, Laos, and Thailand. Southeast Asia MyanmarBurma VietnamLaos Thailand

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The History of Heroin 1992 Colombia's drug lords begin introducing a high-grade form of heroin into the United States. 1992 - Present Afghanistan is the Worlds largest producer of opium / heroin @ 93% However the U.S. has only two major suppliers and very little Afghan heroin is found or sold in the U.S. Mexico = Supplies heroin west of the Mississippi purity = 24.7% Columbia = Provides heroin east of the Mississippi purity = 56.4% Mexican Tar Afghan heroin lab

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Abuse and Prevention Methods Opiates / Heroin Illegal drugs are cheaper and even more plentiful than ever before. A lot of organizations have direct and indirect interests, in keeping illegal drug availability as is. Quoting a Mexican sociologist, Americans are quite happy with their current level of illegal drug consumption. Status quo exists because many groups work against change.

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