Pubdate: Thu, 09 Jun 2005
Source: Wakefield Observer (MA)
Copyright: 2005 Community Newspaper Company
Contact:  http://www2.townonline.com/wakefield/
Details: http://www.mapinc.org/media/3791
Author: Lisa Guerriero
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

KICKING THE HABIT

Nausea. Diarrhea. Chills And Sweats, Aches And Pains.

Health care professionals say quitting opiates takes a toll on addicts. 
"It  can be pretty intense," said Dr. Lawrence Fuhrman, a substance abuse 
counselor  at Riverside Outpatient Center in Wakefield. Riverside, which 
treats patients  from Wakefield, Stoneham, Reading, Melrose and other 
communities, provides  non-residential treatment for various types of 
substance abuse. Larry  Berkowitz, Riverside's executive director, said in 
the last few years there has been a marked increase in OxyContin and heroin 
abuse - while OxyContin is a  prescription painkiller, both drugs are 
classified as opiates. Berkowitz  said high school students and people in 
their 20s are suffering from opiate  abuse throughout Riverside's coverage 
area, and that "absolutely" includes  Wakefield.

OxyContin  tablets are prescribed to people suffering from severe pain, and 
are covered  with a time release coating.

When abusers remove the coating, the drug gives an  intense high. Many 
users crush the tablets and sniff or swallow the powder,  providing a 
quicker and more intense high. Getting  clean Riverside  isn't the only 
place to see an increase in opiate abuse, especially among young people.

Local police, Essex and Middlesex district attorneys and state and federal 
lawmakers have encountered the same problem and are taking steps 
to  prevent abuse and reduce its prevalence. There are  several approaches 
to treating opiate addiction, Furhman said. Many  addicts attend one-on-one 
substance abuse counseling, sometimes in conjunction with group therapy 
meetings, similar to Alcoholics Anonymous. Some abusers start  by entering 
detoxification, a live-in program that lasts from one week to 30  days, but 
experts recommend continuing with outpatient treatment - because  opiate 
dependency is often tough to kick. "Most  heroin addicts have an incredibly 
hard time staying abstinent; they have a lot  of relapses," said Fuhrman, 
adding that OxyContin habits are just as tough to  kick.

Patients  are sometimes prescribed an interim drug, either methadone or 
Suboxone tablets,  to help them quit. The drugs help an addict function as 
a normal person without  escalating dependency, while counseling continues.

Only a doctor who is  certified can prescribe methadone or Suboxone - most 
abuse counselors  cannot.

Both drugs  ease the symptoms of withdrawal and reduce cravings, relieving 
some patients who  otherwise relapse repeatedly. Methadone clinics have 
historically been  controversial, while Suboxone hit the market only a few 
years ago. Suboxone  treatment has proved effective for some patients and 
isn't as difficult or  uncomfortable to quit, Fuhrman said. It is helpful 
for some addicts who want to  avoid the "stigma" of visiting a clinic or 
detox program - a certified physician can prescribe it at a private 
practice. State Sen.  Richard R. Tisei, R-Wakefield, said the healing 
process can be long and costly  for families.

He serves on the Joint Committee on Mental Health and Substance Abuse, and 
one of the committee's recommendations is to increase the accessibility of 
both private and public-funded treatment. Getting 'jammed' Tisei 
also  favors voluntary drug testing at schools, which would require a 
parent's  permission.

"I think  would be great deterrent," he said. Fuhrman  said his young 
patients, who have included Wakefield residents, "think they're  using 
(opiates) recreationally," and then get hooked. Woburn's  Center for Health 
Resources devotes a regular therapy group to opiate recovery, and it is 
open to people of all ages. As a  counselor at Riverside, Fuhrman tries to 
show his patients the "skills and  lifestyle changes they need in order to 
stay clean." It isn't  uncommon for young people to make the leap from 
OxyContin to heroin, which  delivers a similar high at a cheaper price.

OCs, Oxys or jams, as they are  sometimes called on the black market, cost 
about $80 per pill, and addicts often  need one or two a day to get 
"jammed." Heroin, in  comparison, is cheap these days, according to 
Wakefield Police Chief Rick Smith  - $3 to $5 per bag.

Heroin can  be snorted, like OxyContin pills, and Fuhrman said he doesn't 
see many young  people using needles to inject drugs these days. "That's 
one  area where public education has made a difference," Fuhrman said. 
Chewing or  sniffing an opiate instead of injecting it may be better in 
some ways, but it  "doesn't help with the addiction," he said. Smith 
said  OxyContin and heroin have both caused overdoses in the suburbs north 
of Boston,  and young people add additional risk when they drink alcohol 
while high on  opiates.

Heroin's powder form is especially dangerous because it is difficult 
to  gauge the amount being consumed.

Middlesex  District Attorney Martha Coakley recently told a task force of 
lawmakers that 76  people overdosed on prescription drugs in her county 
last year - and that  doesn't include heroin overdoses or incidents that go 
unreported.
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MAP posted-by: Jay Bergstrom