Heroin Epidemic Series: Treating heroin addiction goes straight to the heart

Heroin coverSOUTHERN DELAWARE — It’s no secret overcoming a heroin addiction is a difficult task.

Withdraw symptoms both physical and mental that accompany quitting the drug often lead to relapse. What’s more, former opioid abusers – as well as those with other substance addictions – are never completely “cured” of their cravings.

“I think the reason people continue to go back to heroin first of all is they are chasing that first high, because there’s no high like your first one and they’ll all tell you that,” said Certified Alcohol and Drug Counselor Jessica Neal, who is a therapist at and site coordinator of Crossroads of Delaware’s Milford office. “And within drug treatment, rehab and detox, you don’t figure out what’s driving their addiction. There’s something in here (their head). When we get people off drugs, in rehab facilities or detox, we need to take it a step farther and figure out why they started in the first place. If you don’t fix what’s in your heart, you’re going to go back to what numbs it.”

Fortunately, those seeking to rid themselves of opioid addiction can get help locally. As awareness of the heroin epidemic grows, so too has the spread of facilities to combat the drug’s hold.

Treatment methods vary, ranging from Narcotics Anonymous meetings to counseling and therapy all the way through clinics that dispense synthetic opioids such as methadone.

Many centers – such as Crossroads of Delaware, which focuses on juveniles – combine the two former options. The latter is only available through certain venues like Connections Community Support Programs, which has a center in Millsboro, or Kent Sussex Counseling Services in Georgetown.

Crossroads, amongst many things, conducts what it refers to as “day treatment” – clients don’t attend school and are educated at the facility and undergo intensive drug and alcohol treatment – and outpatient therapy, which assigns a patient to a therapist for 8-10 hours.

“We do stuff with NA and AA (Alcoholics Anonymous), behavior modification and just say ‘no,’” Ms. Neal said. “We’ll work on self-esteem and all kinds of stuff. While they’re here they do a lot of group sessions and then they’ll do individual sessions.

“Day treatment is during school hours. In outpatient I’ll do therapeutic intervention. Whatever it is they need, even if it’s just to talk about what happened during the day. Then our counselors help them with life skills. If they need help with homework we’ll do that or if they’re old enough to work we’ll help them with resumes and job searching. And we also conduct family sessions. We try to build back the bond between them (family members) that got lost due to their addiction.”

As difficult as overcoming the mental addiction to opioids is, not succumbing to relapse is also trying due to physical addiction.

Although not life-threatening, heroin withdraw can be immensely unpleasant.

“Heroin withdraw is awful,” Ms. Neal said. “It’s sickness, throwing up, shaking, sweating, nervousness… You can’t sit still or focus. You can’t do anything.”

Detoxification and therapy are the first lines of defense against abuse, but if an opioid addict continues to relapse they may be eligible to receive help in managing their addiction through synthetic substitutes.

Included in those substitutes is the more commonly known methadone, as well as drugs such as Buprenorphine, a semi-synthetic.
While classified as synthetic opioids, they differ from commonly abused drugs such as OxyContin. Methadone, an agonist, not only helps eliminate physical withdraw symptoms, it can diminish cravings for opiates and also blocks their effects.

“For one thing, it’s a long acting drug and you only have to take one dose a day,” said Connections President and CEO Cathy McKay. “The other thing methadone has is it does not produce any kind of euphoria and in fact it blocks you from being able to get high from other opioids. So, if you’re on methadone and you shoot-up heroin or take OxyContin, you don’t get the same feeling. That doesn’t mean people don’t do it, but you don’t get that same self-reinforcement.

“A lot of people say ‘well isn’t it all the same,’” Ms. McKay continued. “It’s really not. They’re not the same drugs and they don’t have the same impact. Methadone is pretty much the only longterm treatment for people who have not been successful with other methods. It’s a last resort and it should be. It should never be the first thing you try.”
Along with outpatient treatment, Connections also provides all of the health services in Delaware’s corrections system.

Unlike most states, Delaware’s penal system is completely run by the state.

“We don’t have any local jails,” Ms. McKay said. “In Delaware, everybody who is incarcerated, whether it’s pretrial or sentences, is in the same place. A lot of people who come into the system are being held for offenses related to substances, whether it’s for possession or crimes trying to procure those drugs. And a lot of people in the criminal justice system are coming in in withdraw. A big part of what we’re trying to do is to really look at how people get connected to services when they come out of correctional facilities. So, we operate services both inside the correctional facilities and in the community. That gives us the opportunity when someone is being released to talk about the alternative of going to treatment so they don’t relapse.”

Treating and ultimately eliminating opioid abuse is a daunting effort that might never be fully realized. Regardless of what options those fighting the epidemic choose to employ though, there is something nearly all agree upon; prevention is paramount to winning.

“One of the things we try to focus on at Crossroads is, we don’t want to start paying attention to them when they are passed-out with a needle in their arm,” Ms. Neal said. “When they’re abusing marijuana and alcohol, that’s when we need to get in there. I strongly believe have to intervene with education and prevention in the elementary schools. That’s the only way we’re going to make a dent.”

For more information regarding Crossroads of Delaware, call 302 491-4740. Connections Community Support Programs can be reached at 866 477-5345.

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