Essay on "Heroin Abuse"

Essay 5 pages (1569 words) Sources: 3 Style: APA

[EXCERPT] . . . .

Hardships of Breaking Heroin Addiction

In 1971, President Richard Nixon declared a war on drugs. Most targeted was heroin, because as young men who survived their tour in Viet Nam returned to the United States, many returned as heroin addicts. The addictions were acquired in Viet Nam, where there was what has been described as a free-for-all access to heroin, marijuana, and cocaine. When Nixon declared the war on drugs, he created the Drug Enforcement Agency (DEA), and instituted the drug schedule, which listed by classification drugs and prohibition of drugs that were deemed of a certain class. The schedule included marijuana and heroin on the same level of dangerous drug, which demonstrates how little we knew about heroin.

In addition to the fact that heroin addicts are our loved ones, our friends, and colleagues, we want to find effective treatments for this addiction because many drug related crimes and serious property crimes are committed by heroin addicts (Bean, Philip, and Nemitz, Teresa, 2004, p. 1). Heroin addicts run the risk of acquiring and transmitting serious diseases, HIV / AIDS by sharing needles, and the cost of these ailments is transferred to the taxpayer at different levels of care, or the physical deterioration of the addict. In countries like Canada and the UK, where there are socialized medicine programs, addiction and those conditions that acquired through addiction and sharing of needles has put a financial burden on the healthcare delivery systems that would be left more productive and accessible if heroin addiction could be cured.

The UK has one of the most developed and widespread treatment delivery systems for the treatment of heroin as compared to any other country in the world (p. 2). A separate and distinct government entity, the National Treatment Agency (NTA) was established to deal with addictions of heroin and other narcotics like cocaine, and problem drug users (p. 3). The mission of the agency is,.".. [t]o increase participation of problem drug misusers including prisoners in drug treatment programmes which have a positive impact on health and crime by 66% by 2005 and by 100% by 2008' (ibid.) (Bean and Nemitz, p. 3)." This was an aggressive agenda, and to date the data remains unavailable as to whether or not the UK accomplished this goal by the end of 2008; although it would be highly unlikely that they did given the numbers of celebrity heroin addicts in the papers over the past year.

The question as to what treatments work has not yet been answered, not even by the UK, whose own aggressive mandates would suggest that they had some sort of model or formula for success.

Yet behind the slogan that 'Treatment Works' lie a range of difficult questions, many are rarely asked and most produce no easy answers. First, there is a group of empirical questions, such as: with whom does treatment work? Can successful treatments be given over a single period, or do they require subsequent treatments even if the first was successful? Is a single type of treatment appropriate to all patients? Then there are questions about the principles of treatment: what are the aims of treatment? What should be the remit, and to whom should it be given? Finally there are questions about outcomes: does treatment need to be voluntarily undertaken to be effective (see Chapters 9, 10 and 11 of this volume)? And what outcome measures should be used, abstinence or controlled use? (p. 3)."

In the United States, where there is no socialized medicine, treatment rendered privately costs in the billions of dollars each for heroin alone (Waismann, Andre, 2000, p. 32). Treatment programs have made great strides in treatment approaches, and programs that once relied upon replacement drug therapy, like methadone programs, have begun going the wayside in lieu of new and innovative treatment approaches based on decades of research and treatment approaches (p. 32).

Throughout the years, patients' demands have been in direct opposition to the options for available treatment. Most patients desired freedom from the dependency, and tried abstinence without medical assistance. As a consequence, "cold turkey" became recognized as a valid treatment. When a no-treatment treatment became a workable idea, many experts were willing to apply therapeutic values to vomiting, pain, diarrhea, and other symptoms of withdrawal. Statements such as "no pain, no gain" became part of many physicians' vocabularies. The scientific community continues to ignore the need to challenge the existing perceptions of opiate dependency and treatment (p. 32)."

Treatment approaches today include former heroin addicts as counselors, therapists, and support people in the client's support who have a history of personal use and addiction (p. 32). This understanding of the addiction, and the role model of someone that has overcome that addiction, serve to inspire and encourage the clients towards sobriety (p. 32). These experts on the addiction quickly relate to the physical difficulties that the client experiences in going through detoxification from heroin. The cravings that the addict experiences in a post detox environment to use what has been described as the best high in the world, but the meanest addiction too are easily understood and even recognized by the more seasoned therapists. A former addict knows the full range of excuses, the deceit, and how it works to weave a web of intricate lies to hide the addiction, because, experts say, no one withdraws from heroin the first time without relapsing at some point in time (p. 32).

Early treatment therapists and experts refer to their selves as "anthropologists" in the pioneering of treatment approaches for heroin (Landry, Mim, 1994, p. xi). The subacute, or prolonged withdrawal from heroin, make it a difficult addiction to treat and from which to recover from (p. 18). The experience is a painful one, that puts the body through some of the worst physical torture a person can experience (p. 18). The severe nature of the physical withdrawals requires that it be done under the care and supervision of a clinical team, under the direct supervision of a medical physician who can deal with the physical side effects of the withdrawal, which can lead to cardiac arrest if not properly treated (p. 18). This is an addiction that grips the addict in a vice grip, and getting through the physical detoxification is just the first step in a long and bitter sweet recovery process that requires diligent adherence to the treatment regimen, and the support structures of treatment, family, and a complete reassessment of the patient's social life.

Often times heroin addiction is accompanied by alcohol, or marijuana, and this is a dual addiction, and one cannot be treated without the treating the other. A patient cannot be detoxed from heroin, but continue to use alcohol or marijuana. Likewise, the other side of dual diagnosis is the psychological indicators, which often accompany drug use and addiction (p. 276). Treatment is a complex process, and one of the problems that interferes with treatment today is that many insurance companies do not consider drug addiction, beyond detoxification, an illness that requires an inpatient course of care or treatment. In fact, it requires diligent treatment, and the way to help bring about a change in the patient's perspective socially, and to help the patient experience the redirection of activities of daily living (ADLs) is to provide services at an inpatient level of care to ensure program and treatment integrity (p. 232). Insurance company policies make treatment regimens of difficult cases like heroin addiction challenging beyond the detox stage, but the insurance companies are focused on cost, and will only authorize treatment without a physical side effect on an outpatient basis.

Even so, perhaps what has proven the best treatment of all is when the patient hits their rock bottom, and for reasons between them and their… READ MORE

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