Pubdate: Mon, 28 Apr 2014
Source: Day, The (New London,CT)
Copyright: 2014 The Day Publishing Co.
Contact:  http://www.theday.com/
Details: http://www.mapinc.org/media/293
Author: Judy Benson
Page: A1
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)

Deadly Addiction

DOCTORS SAY HEROIN TREATMENT IS AVAILABLE

Addiction in Region Is Worse Than Ever, They Say

After more than 20 years in psychiatry, Dr. Rajesh Parekh is
witnessing a new and disturbing trend among patients who come for help
with drug addiction.

"Twenty years ago I would see an adolescent a few times a year," said
Parekh, attending psychiatrist at the Care Plus outpatient program in
Groton, part of Natchaug Hospital. "Now it's a few times a month."

The reason? Too many teenagers are abusing prescription opiate
painkillers like Percocet, getting addicted, then turning to heroin.

"Heroin is cheaper and it stops the painful withdrawal symptoms (from
prescription opiates)," said Parekh. "But I try to tell them, whatever
pain you had when you started, the pain of heroin is much worse."

Despite the long and well-known history of its dangers, heroin has
seen a recent resurgence in popularity and with it, the ruined lives
and physical damage that go with the addiction. Oftentimes, addicts
come to Parekh after ending up in the hospital emergency department
because of an overdose. During an overdose, breathing muscles became
paralyzed and "respiratory depression" sets in.

"For some it can be a wake-up call," he said.

Dr. Martin Maloney of Coastal Behavioral Health in New London said
that in his 20 years as a psychiatrist, he's never seen the heroin
problem worse than it is now. It's a cheap, easily accessible
substitute that people are turning to after getting addicted to
prescription painkillers after surgery, he said.

"People are spending $ 400 to $1,000 a week on heroin, and end up
dealing drugs, stealing or turning to prostitution to support it," he
said. "It destroys people's lives. Drugs are so prevalent, and there's
this nonchalant attitude about it."

Heroin is one of the most powerful addictions because of the unique
way the drug interacts with the brain, Parekh explained. When the drug
enters the body, either through the nose or by injection, it couples
onto specific opiate receptors in the brain and - initially - relieves
pain and produces pleasure.

"But as you constantly expose your body tissues, you create more
receptors so you need more and more to get the same effect," he said.
"Your tolerance builds."

As the addiction deepens, the body "starts fighting back" anytime
there's an interruption in the heroin supply. Withdrawal symptoms
become overwhelming.

"The autonomic nervous system gets excited," Parekh said. "You'll get
muscle spasms, sweating, the blood pressure elevates, the pulse goes
up, the piloerector muscles (the ones that cause goose bumps and hair
standing on end) get agitated, you get diarrhea, abdominal cramping.
There's so much pain."

Addicts end up doing almost anything to stop the pain. At this point,
using heroin brings no pleasure, but "just stops the discomfort of not
using it," he said.

"Maintaining their drug use becomes their lifestyle," he said. "They
end up stealing from stores, their own family, taking other people's
medications. They spend all their time trying to cop the drugs. It
becomes their job."

He's seen patients who've lost families and jobs and ended up homeless
and struggling with depression on top of their addiction.

"You give up everything, and for what?"

The good news, according to Parekh and Maloney, is that there are
effective treatments to help people break their addiction. Both
psychiatrists are prescribing Suboxone, an antidote that came into
wider use about five years ago, in combination with group and
individual therapy.

"Within a week on Suboxone, people have no more cravings," said
Maloney, who received his federal license enabling him to prescribe
the drug six months ago. "People who are vested in getting better and
whose families are vested in them getting better do very well.
Suboxone is a lifeline."

A daily dose of Suboxone costs about $ 10. An initial appointment with
a private practice psychiatrist can cost $150 to $200, and follow-up
evaluations run $75 to $150, Parekh said. But patients who balk at the
cost need only be reminded how much they had been spending on heroin,
Parekh said.

In addition to prescribing Suboxone, and having patients submit to
regular urine tests to ensure they are taking the drug rather than
diverting it for street sale, his office runs two Suboxone support
groups. One of the keys to success for patients, he said, is that they
erase all their cell phone and computer contacts with heroin suppliers
and friends who are users.

"Once they see a name, it can be a trigger," he said. "I tell them
they have to stay away from people and places and things that can be
triggers. I have people who've been in treatment for six months to one
year to four years."

Overall, both psychiatrists want the public to know that there is help
available to beat heroin addiction.

"I want people to know about treatment," Parekh said.
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MAP posted-by: Matt