Pubdate: Fri, 22 Nov 2013
Source: Advocate, The (Baton Rouge, LA)
Copyright: 2013 The Advocate, Capital City Press
Author: Louis Cataldie


The recent article citing the coroner's information on the heroin 
epidemic is alarming, and certainly in keeping with what I am seeing 
in the patients I treat. I am an addictionologist and provide 
detoxification services for two programs in the area. The surge in 
heroin use has continued over the past year. Many of my patients 
"graduated" to heroin because the price of pain pills, such as 
Roxicodon (roxies) has increased to $25 to $30 each. Suboxone costs 
$20 per tab, or strip, on the street. If you are using 6 "roxies" a 
day, that's close to $60,000 a year. My patients tell me heroin is 
cheaper and easily acquired if you are in the drug culture. I want to 
emphasize Louisiana is not the only place with a heroin problem. I 
also treat patients from out of state and their stories are the same. 
My younger opioid addicted patients, who are in their 20s (and 
younger), frequently report using heroin.

I am also seeing a surge in Hepatitis C as a direct consequence of 
intravenous drug use. Hepatitis C deaths have surpassed HIV deaths in 
number in the U.S. The Hepatitis C virus can have long-term 
consequences and is the leading cause for liver transplants in the 
U.S. and Europe. Most of the patients are unaware they have "Hep C" 
until we get the blood tests back. Subsequently, they continue to 
spread the virus unknowingly. This heroin epidemic is taking a heavy 
toll upon all of us.

The war on drugs is a failure. Alcohol Prohibition was a failure. We 
need to learn from past and current mistakes. Yes, let's arrest and 
prosecute the major drug dealers. But the key to stopping drugs is to 
decrease demand by decreasing the number of drug consumers. This 
requires a prevention and early intervention approach. We are 
fortunate to have I-CARE in the Baton Rouge School System to help 
with the prevention component, albeit we need more. I-CARE cannot 
carry the entire load by itself.

Family and community involvement are critical. The second step to 
prevention is early intervention. This means treating the addicts. 
This early intervention can be seen in "drug courts" and pretrial 
intervention. Clinically, accountability and consequences tend to 
promote involvement in addictions treatment. Our drug courts do a 
great job. I support incarceration for the major dealers, but I also 
support treatment for the addict who is caught with possession of 
paraphernalia or small amount of a drug for personal use. In order to 
embrace treatment, the addict needs consequences. In rehab treatment, 
we call a consequence a "handle." This handle is a tool to help us 
motivate the addict to do what needs to be done to recover. I have 
worked with the PTI and can attest to the fact that our district 
attorney, Hillar Moore, runs an effective and tight ship and he is 
good at furnishing handles.

Louis Cataldie


Baton Rouge
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