Heroin resurfacing in Central Texas

AUSTIN (KXAN) - Just a few years ago, Donna was a kindergarten teacher and a mom-to-be, with a life that included affluence and comfort.

The Austinite’s journey to rehab for a heroin addiction was a nightmare she says cost her nearly everything: Her job, her friends, much of her life.

"You're talking to the girl who shot heroin in the parking lot at the country club," Donna said.

Local police say that heroin, rampant decades ago and then again in the late 90s, is "resurfacing" here as more young people are using, Austin police Sgt. Richard Stresing said. And from students to country club members to housewives, as overdoses and rehab check-ins rise and the heroin gets cheaper and more dangerous, no one is safe from its grasp, authorities said.

"Our narcotics units are seeing I-35 being used as a major corridor," he said. "Drugs are coming into major cities, and Austin is one of them. Then it becomes a pinwheel effect. It goes into Austin, and then out to other small communities. Black tar heroin can be linked to Texas Syndicate and Mexican Mafia locally; the supply comes from drug cartels in Mexico."

The last place Donna thought she would ever be was at the door of Austin Recovery, a local drug rehab and treatment center. But a spine injury, which happened during the birth of her child, lead to an addiction to pain killers. From there, it turned into a heroin addiction.

"It really just spiraled out of control," Donna said. "It took me to places I never thought I would go. Everything I ever said I would never do, I did freely and willingly."

But two months ago, there she was: One of a growing number of Central Texans recently seeking help for addictions and overdoses.

"[We are] definitely seeing professionals, and even housewives," said Austin Recovery chemical dependency counselor Angela Vickrey.

KXAN Austin News was able to talk to some local recovering heroin addicts. To respect their anonymity, only their first names will be used.

Austin Recovery has seen a 15 percent increase in heroin addicts since February, particularly people who switched from pain killers and already the city has reported some 16 heroin overdoses in 2009. That's a higher number than usual, attributed by authorities to an especially strong variety coming from international gangs.

When the heroin is stronger, a user may take a hit that's normal for them and wind up dying of an overdose in an emergency room.

It's a cycle that happens often, and is not unheard of in Texas. In Plano in the mid-90s, teens started dying inexplicably of heroin overdoses in what health officials were calling a sudden epidemic of drug use and addiction. Dozens of young people died in the Dallas-Fort Worth and Plano areas before authorities were able to trace the alarming trend back to a drug ring that had specifically targeted Plano to peddle its wares - mainly for its high population of affluent people who could afford the drug and low number of things for teens to do with their time.

In Central Texas, the dangerous heroin nearly killed Kelli, another recovering addict who found herself near death not too long ago.

"The ambulance driver was screaming at me 'Lady, lady you're dying, we have to know what you've done,' " Kelli said.

With only two weeks clean, Kelli faces a long and dangerous road. The longer the drug stays out of her body, the more susceptible she is to death from overdose if she relapses - particularly with a dangerously strong variety on the streets right now.

But Kelli is determined and optimistic, and she wants to help other addicts by sharing her story.

"The people who were dying the week before I came in here, the ones who died here in Austin, they didn't die in vain," Kelli said. "Because I am a life saved."

Austin Recovery chemical dependency counselors said what commonly starts as a Vicodin or Oxycontin habit can quickly morph into a heroin addiction. Especially with Oxycontin at $80 a pill and heroin just $10 a balloon, which contains several doses.

"Usually they turn to heroin," Vickrey said. "It is very cost effective."

It seems that even drug addicts are affected by a recession. But, one of the worst parts of being addicted is not being able to compromise on your usage, recovering addicts said.

"It becomes the most important thing in your life," said Donna. "It does not matter who you are, what your last name is, how much money you have.”

Still, there is a way out.

"There's hope, there's recovery," Kelli said. "There's a 1,000 before us and 1,000 behind us, but there's still hope."

Below is a compilation of facts, signs and treatment options for heroin use:

Here are some heroin facts:

First synthesized from morphine in 1874, heroin was not extensively used in medicine until the early 1900s. Commercial production of the new pain remedy was first started in 1898. It initially received widespread acceptance from the medical profession, and physicians remained unaware of its addiction potential for years.

The first comprehensive control of heroin occurred with the Harrison Narcotic Act of 1914. Today, heroin is an illicit substance having no medical utility in the United States.

Heroin can be injected, smoked or sniffed/snorted. Injection is the most efficient way to administer low-purity heroin. The availability of high-purity heroin, however, and the fear of infection by sharing needles has made snorting and smoking the drug more common. National Institute on Drug Abuse researchers have confirmed that all forms of heroin administration are addictive

With 560,000 people using heroin in the last year, according to information from the National Survey on Drug Use and Health, there is a chance that you know someone who is using it.

 

Signs of heroin use

There are many signs that someone may be involved in heroin substance abuse. One of the most common signs includes dramatic changes in one's life.

Here are some symptoms or clues that are key indicators of possible heroin use:

• Unkempt appearance/hygiene issues
• Missing cash/valuables, stealing/borrowing money
• Change in performance, academic or otherwise
• Drug paraphernalia
• Apathy and/or lethargy
• Possession of unexplained valuables
• Runny nose
• Lying/deception
• Change in friends
• Little or no motivation
• Incurring unusually large miles on the odometer of car
• Ignores consequences of chosen behaviors
• Withdrawal from usual friends, activities, or interests
• Eyes appear "lost" or have faraway look
• Excess or sudden sleep
• Slurred speech
• Loss of interest in usual, healthy activities
• No interest in future plans
• Broken commitments
• Hostility towards others
• Unexplained absences at work, school or family events
• Poor self-image
• Running away
• Difficulty in maintaining employment

Questions to ask yourself when you suspect a person is using drugs:

1. Are the person's grades suddenly dropping?
2. Is the quality of work assignments becoming progressively worse?
3. Does the person's performance in sports or music suffer?
4. When someone suddenly becomes worse at something he or she is good at, this can be a sign of heroin substance abuse. Additionally, someone using heroin may stop showing up on time or at all.

 

Heroin Treatment Options

A variety of effective treatments are available for heroin addiction.

Treatment tends to be more effective when heroin abuse is identified early. The treatments that follow vary depending on the individual, but methadone, a synthetic opiate that blocks the effects of heroin and eliminates withdrawal symptoms, has a proven record of success for people addicted to heroin.

Other pharmaceutical approaches, like levo-alpha-acetyl-methadol and buprenorphine, and many behavioral therapies also are used for treating heroin addiction.

 

Detoxification

The primary objective of detoxification is to relieve withdrawal symptoms while patients adjust to a drug-free state.

Not in itself a treatment for addiction, detoxification is a useful step only when it leads into long-term treatment that is either drug-free (residential or outpatient) or uses medications as part of the treatment.

The best documented drug-free treatments are the therapeutic community residential programs lasting at least three to six months.

 

Methadone Programs

Methadone treatment has been used effectively and safely to treat opioid addiction for more than 30 years.

Properly prescribed methadone is not intoxicating or sedating, and its effects do not interfere with ordinary activities such as driving a car. The medication is taken orally and it suppresses narcotic withdrawal for 24 to 36 hours. Patients are able to perceive pain and have emotional reactions.

Most important, methadone relieves the craving associated with heroin addiction; craving is a major reason for relapse. Among methadone patients, it has been found that normal street doses of heroin are ineffective at producing euphoria, thus making the use of heroin more easily extinguishable.

Methadone's effects last for about 24 hours, four to six times as long as those of heroin - so people in treatment need to take it only once a day. Also, methadone is medically safe even when used continuously for 10 years or more.

Combined with behavioral therapies or counseling and other supportive services, methadone enables patients to stop using heroin (and other opiates) and return to more stable and productive lives.

Methadone dosages must be carefully monitored in patients who are receiving antiviral therapy for HIV infection, to avoid potential medication interactions.

 

LAAM and Other Medications

LAAM, like methadone, is a synthetic opiate that can be used to treat heroin addiction.

LAAM can block the effects of heroin for up to 72 hours with minimal side effects when taken orally.

In 1993 the Food and Drug Administration approved the use of LAAM for treating patients addicted to heroin. Its long duration of action permits dosing just three times per week, thereby eliminating the need for daily dosing and take-home doses for weekends. LAAM will be increasingly available in clinics that already dispense methadone.

Naloxone and naltrexone are medications that also block the effects of morphine, heroin, and other opiates. As antagonists, they are especially useful as antidotes. Naltrexone has long-lasting effects, ranging from 1 to 3 days, depending on the dose.

Naltrexone blocks the pleasurable effects of heroin and is useful in treating some highly motivated individuals. Naltrexone has also been found to be successful in preventing relapse by former opiate addicts released from prison on probation.

Another medication to treat heroin addiction is buprenorphine. Buprenorphine is a particularly attractive treatment because, compared to other medications, such as methadone, it causes weaker opiate effects and is less likely to cause overdose problems.

 

Behavioral Therapies

Although behavioral and pharmacologic treatments can be extremely useful when employed alone, science has taught us that integrating both types of treatments will ultimately be the most effective approach.

There are many effective behavioral treatments available for heroin addiction. These can include residential and outpatient approaches.

An important task is to match the best treatment approach to meet the particular needs of the patient. Moreover, several new behavioral therapies, such as contingency management therapy and cognitive-behavioral interventions, show particular promise as treatments for heroin addiction. Contingency management therapy uses a voucher-based system, where patients earn 'points' based on negative drug tests, which they can exchange for items that encourage healthy living.

Cognitive-behavioral interventions are designed to help modify the patient's thinking, expectancies, and behaviors and to increase skills in coping with various life stressors.