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Just the Facts Ma'am (Or Addressing the Elephant in the Room)

Most people here in North Carolina know that there is an opioid epidemic in our nation and it is particularly bad in our state, with a 584% rise of heroin related deaths. Of the top 25 worst cities in the US for opioid abuse, Wilmington is ranked as the number one, Hickory is 5th, Jacksonville 12th and Fayetteville 18th. Wilmington is ranked 4th, Fayetteville 15th and Hickory 16th of the top 25 US cities for the worst prescription opioid abuse problems as well. Many know a friend of a friend that overdosed and/or died and some are unfortunate enough to have had this epidemic hit MUCH closer to home.

In my last post I stated that I have never known any kid with aspirations to be an addict. Addiction is torment and the heart of the Father is to see His children in peace, in health, and to know His heart and His love for them. His heart is for redemption and so it is my heart as well and to see those that are tormented by this addiction to find complete freedom. But to fight a battle you need to know your enemy.

Drug overdose is the leading cause of accidental death in the US (prescription drug overdose accounts for 52%). Many people taking an opioid class drug as a prescription for pain management such as oxycodone, hydrocodone, codeine, morphine, fentanyl or others find themselves addicted. 3 out of 4 new heroin users have previously abused prescription opioids. Prescription pain reliever overdose deaths among men increased by 237% from 1999 to 2010 compared to more than 400% in women during that same time period. According to the CDC, heroin related deaths have more than quadrupled since 2010. 62% of all overdoses are opioid related.

Kiss goodbye the Hollywood induced images of a “junkie” – in a big city, leaning against a brick wall in a garbage strewn dark alley with a needle in their arm. Heroin no longer has a “typical user”. Use has increased across the board with the biggest increases among women, young adults and those in higher income brackets. It is often inhaled or smoked. Besides the costs in lives, the monetary costs to the US yearly is $20.4 billion a year.

Both the CDC and the DEA report that possible factors in the huge rise in use of heroin may be due to the rise in availability and high purity as well as the relatively low price when compared to prescription opioids. Here in North Carolina, many of the overdose deaths may have been due to fentanyl. Fentanyl is a synthetic opioid that is much stronger than heroin and can cause even long time users to overdose. It is added to heroin or sold as heroin.

From the DEA website: • Heroin today is much higher in purity and lower in price. Between the 1980s and 1990s, the purity of the heroin brought into the United States increased significantly. In 1981, the average retail-level purity of heroin was 10 percent. By 1999, that had increased to an average of 40 percent. (During the same time, the price per gram pure decreased greatly. In 1981, the average price per gram of pure heroin was $3,260 in 2012 U.S. dollars (USD) at the retail-level; by 1999, that price had decreased to $622 (2012 USD). (Since that time, heroin prices have remained low and heroin purity levels, while fluctuating, have remained elevated.

What are the effects of heroin? Heroin is converted by the brain into morphine and creates in the user a surge of pleasure/euphoria. The initial rush usually causes the skin to flush, dry mouth and a heavy feeling in the extremities. It may also cause nausea, vomiting and severe itching. For several hours following use, users will usually be drowsy and mentally foggy. Breathing and heart function slows which can be life threatening, causing coma or death.

Long term consequences: (From the National Institute on Drug Abuse)

Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations. Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence, the body adapts to the presence of the drug and withdrawal symptoms occur if use is reduced abruptly. Withdrawal may occur within a few hours after the last time the drug is taken. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and leg movements. Major withdrawal symptoms peak between 24–48 hours after the last dose of heroin and subside after about a week. However, some people have shown persistent withdrawal signs for many months. Finally, repeated heroin use often results in addiction—a chronic relapsing disease that goes beyond physical dependence and is characterized by uncontrollable drug-seeking no matter the consequences. Heroin is extremely addictive no matter how it is administered, although routes of administration that allow it to reach the brain the fastest (i.e., injection and smoking) increase the risk of addiction. Once a person becomes addicted to heroin, seeking and using the drug becomes their primary purpose in life.

What can be done?

First off, I ask everyone to start praying! The affects of opioid abuse are so tormenting, and the problem so large that we need His direction and intervention. Those under the power of this addiction need to experience the power of His love in a mighty way to be set free.

We need to be sure that ALL first responders have Narcan, (Naloxone), which can be given to someone that is overdosing to reverse the process and save their life.

Here is Guilford County we have three options for opiate detox available to the uninsured, none of which are actual IN Guilford county. Because the other two options are in Burlington and Chapel Hill, we try to take people to Arca (Winston-Salem) which provides a medically supervised detox for opioid users. Although they do a great job, it is not enough for the severity of the issue. Arca has 24 beds for detox and serves 37 counties! Wait times can be a big problem, as they simply do not have enough space to accommodate the need. I understand that the financial cost of providing detox and rehab is immense, but our options are to continue on as we have and allow more and more people to die, provide a road to rehab or to step up law enforcement and incarcerations. Statistics show (see my last post), that it is far more costly to incarcerate than it is to rehabilitate. One leads to a person actually having a shot at living a fulfilling life, the other leads to the probability of return to use after incarceration and further incarceration, it makes no sense.

Another issue I have seen repeatedly is those seeking help - they may truly want the help but are incredibly afraid of the detox process itself. Many have tried to “cold turkey” themselves or were lucky enough to get into a treatment facility and the withdrawal symptoms lasted longer than the detox. (detox for heroin in NC is typically 3 days while intense withdrawal can last weeks). Industry standards for medically assisted opioid detox is 7 days. Imagine having the flu, fever, cold sweats, hot flashes, runny nose, intense pain in muscles and bones, nausea, vomiting, terrible diarrhea and all while not being able to sleep. Now imagine feeling that way and being expected to sit in recovery classes while these symptoms are still intense? It is hard enough to detox off of these drugs, we need to give people a fighting chance! If I hear one more time, “If they want it bad enough…” I just may scream! Again, no one sets out in life to be an addict. It is broken places of the heart that lead them down this path, if we are to be more effective in helping people find freedom we have to do something different! If we can get them through the initial detox without them seeing it as hopeless and returning to using, then perhaps more will make it through to find out just where those broken places of the heart are and be able to face them and find healing. I fully believe that if the issues that LED to the addiction are identified, brought to the Light and healed, freedom can come and relapse is far less likely.

Along with providing a greater availability to treatment, we need to educate and work on ways to prevent the problem from continuing to grow.

Please pray with me to see God bring healing and restoration to those suffering under this torment!




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