Pubdate: Sat, 15 Jul 2006 Source: Times Leader (Wilkes-Barre, PA) Copyright: 2006 The Times Leader Contact: http://www.timesleader.com/ Details: http://www.mapinc.org/media/933 Author: Rory Sweeney Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) THE ANATOMY OF AN ADDICTION It's not hard to understand how something that reduces pain, induces euphoria and reinforces its own consumption could be addicting. And that's just the problem with opiates, a group of drugs that convert into morphine in the brain and attach to receptors controlling those three very basic sensations. "I don't know of any other drug that can do that," said Dr. Joan Coffin, a King's College psychology professor and neuroscientist. "People experience a dreamlike state. That's why a person who is addicted to an opiate is unaware of the horrendous surroundings they find themselves in." There are many opiates, natural and synthetic, and many of them are used legally every day. Aside from legal status, the group is mainly differentiated by efficacy, or potency, which ranges from low, such as codeine, to medium, such as OxyContin, to high, including pure morphine and heroin. Fentanyl, an extremely high-efficacy opiate linked to more than 100 deaths in the country in the past several months, has been estimated at roughly 100 times more potent than morphine. "If you want to encourage someone to be a regular user (of a drug), throw a little of this in," Coffin said. That's exactly what heroin producers are doing, cutting amounts of clandestinely made fentanyl into batches of the yellowish, powdery, illegal drug. However, dealers aren't telling users how much was added, or even that any was added, and it's that lack of communication that's killing their customers. An amount of fentanyl equal to five or six grains of salt can cause a fatal reaction in an adult by depressing the breathing center in the brain's medulla and creating a breathing suppression that leads to asphyxiation. Since both heroin and fentanyl convert to morphine in the brain, a user's regular dose intrinsically becomes an overdose. "Heroin use has always been there, but people who use it know how to manage it, unless somebody changes the concentrations and composition of the drug," said Luzerne County Coroner Dr. John Consalvo, who has become alarmed by a recent rash of overdose deaths linked to the fentanyl/heroin blend. "I don't know that people who are buying really know that this is going to happen to you," Coffin said, adding she has heard stories of users dying from a fentanyl overdose before the next addict was able to shoot up. It's improbable that addicts will snap out of the addiction on their own, either. The drugs create such illogical reasoning in the minds of users that they often flock to highly potent batches of drugs rather than avoiding them, in hopes of achieving a high so effective it borders on death. "We're talking about ... drugs that reward down on the level where the brain simply has the purpose of survival," said Ed Pane, the president and chief executive officer of Serento Gardens, a Hazleton drug and alcohol rehabilitation center. "Without external intervention, (rehabilitation) ain't gonna happen." - --- MAP posted-by: Beth Wehrman