In response to the dramatic increase in fatal opiate overdoses in Cherokee County, Price Counseling has initiated a new Extended Outpatient Treatment Program. This extended ASAM Level One program will operate in the mornings on Monday, Wednesday and Friday from 9 a.m. to 12 p.m.. An evening schedule is also available: Monday, Tuesday and Thursday from 5 p.m. to 8 p.m. Services will be provided by licensed clinical professionals at our office located at 2920 Marietta Highway Building 122, Canton, Georgia.
We will offer MRT(Moral Reconation) therapy for patients with substance abuse issues who have already been through the detoxification process or who are no longer in need of detox. We accept patients ages 18-70. We will not bill insurance for this program, however we will provide patients with forms necessary to file insurance to be reimbursed for expenses.
Call 770-479-5501 for more information. Grace Price has been providing substance abuse services in this community since 1981!! We can help!!! Call 770-479-5501.
In Cherokee County, just far enough north of Atlanta (40 miles), those of us who are on the front line of the war on addiction have noticed a staggering upswing in opiate overdoses. In 2009, I started counting about one per month , but now we are averaging one fatal overdose from opiates (Heroin, Fentanyl, Oxycontin, etc) every other day!!! Can I repeat that?! In our county, we are seeing a person suffer a FATAL overdose from opiates every other day!!! We have been talking about this crisis in my alcohol and drug treatment groups for three years. I have written articles on the increase of opiate pain medication abuse and addiction. But, last Tuesday night was the kicker! I had about 15 people in my Tuesday night 7pm meeting. I’m sure that I was presenting a life changing group topic and we were having a lively discussion. Somehow, between who had warrants out in other counties and who had abused their cat’s tranquilizers, we got to talking about Narcan. Narcan is a life saving drug. Period. When a person overdoses from opiates, they stop breathing. This drug, like it or not, reverses the effects of the overdose on the spot. The drug goes into the brain and knocks the opiates out of the opiate receptors. Think of it like a muffin pan which represents your opiate receptors hidden in the center of your brain. An opiate comes in and plops in the muffin pan cup which gets you high! Well, pieces of cheese knock the muffins out of the pan and replace the receptor with a hunk of cheese, there fore reversing the effects of the muffin/opiate. (we did a role play demonstration of this in group today and muffins and chunks of cheese were flying. Within about three minutes of having a shot or a spray of Narcan up the nose, the person comes to. The reversal is very similar to the scene in the movie “ Pulp Fiction” where the woman sits up after being shot in the chest with a hyperdermic filled with speed. But we don’t shoot them in the chest. The drug saves the person’s life, and it throws the patient right into major opiate withdrawal. They throw up, shiver, shake and hurt, but they live. Last year, the Holly Springs Police Department was the first police department in the nation to carry and to administer Narcan. (Go Holly Springs PD!). Fire departments, EMTs and paramedics have been using Narcan but it was new for police. Other departments have followed suit. This kind of story may not make the evening news, but it is incredible. We are beginning to see more and more cases of this type of rescue. Well, back to my Tuesday night group. We were talking about Narcan and one person said “I have been Narcanned”. (I’m not sure if that is proper English, but when you are talking to junkies…) Another person said “I have been “Narcanned” and then a third. Are you kidding me? In my fairly small Tuesday night group, in my fairly large office, THREE participants have overdosed on Heroin and been brought back to life by NARCAN. What the @#$%^@#$%!
After I picked myself up off of the carpeted group room floor, I really looked at these guys. They were all heavy drugs users. They were all on probation. They had battled with this addiction for years and they did not stop after the Narcan incident. WHAT? You shoot Heroin or what you think is Heroin; you get to the line between life and death, get lucky enough to have emergency personnel arrive, get hit with a rather new drug and you start breathing again. And you didn’t see that as a sign from GOD to stop using??? One of the guys talked more about the unexpected side effects of overdosing and coming back to life. He has had a tremendous amount of memory loss. It took him a year to function normally again. Who would have thought? There are side effects of overdose? You mean I don’t come right back to where I started, smoking a cigarette and working on my 1982 Camaro? Apparently not.
Then I heard a story about a man in Fulton County who has been Narcanned 7 times. I am not sure that is true, but if you hear it at the beauty shop, the ball park or alcohol and drug group…….it is the gospel truth!! In my book. That seems crazy to me. So, what are we saving? I know that was antagonistic…I know. But now that we have this wonderful medical tool that we are using to save lives, maybe we need some more policies to go with it? Like a fast track into treatment? Like an ambulance ride to the nearest hospital?
I was stunned to hear those drastic stories last week. And I don’t know why I say that? I should not be stunned by anything anymore. We definitely need more information spread about opiates, overdose potential and side effects and Narcan. Some junkies will not be changed by education, but some will. Every human being is worth being saved, but the person has to be invested in their recovery or their life, at least a little bit! Otherwise, what exactly are we saving?
I just returned from the biggest conference of my career. 25 years of Drug Court Programs. Believe it or not, we are all celebrating 25 years of Drug Court Programs. Some readers might not– even after 25 years—even know what a Drug Court means. I certainly have to explain this concept to many of my Midwestern family. The wave of the judicial future is Accountability Court Programs. Cherokee County got on board with this wave of the future 9 years ago when the Cherokee County DUI/Drug Court was initiated. Since that time, two other accountability court programs have been developed in our county alone, The Misdemeanor Drug Court Program and The Felony Drug Court program.
Several members of the Cherokee County DUI/Drug court team have just returned from the 25th annual convention of such drug courts, with a mere 6-8000 others. It is actually quite an interesting conference. One is able to meet other therapists like myself from Wisconsin, Maine, Montana and more!! Programs are done differently across the country. Each program has 10 best practices that we adhere to, but the thousands of programs are as different a high heel or a rain boot. So, during the sessions, or while trapped in a shuttle or even in an elevator, we are able to compare notes about what works and what doesn’t work.
This was my ninth national conference. One of the major themes this year was HEROIN. One could be in a workshop, in the ladies room or in the hot tub and someone would ask “You guys seeing much Heroin?’ I never heard many “no” answers. Clients have either hopscotched over from pain pills, which very quickly get out of control financially, to HEROIN which is much cheaper. Or they start with Heroin first use. Of course, you have that pesky title of being a junkie, when you shoot Heroin. I learned that the Heroin in the 1970s was only 1 percent pure, so people had to shoot it. You couldn’t get a high if you snorted that Heroin. In 2014, Heroin is 8 times as potent, so you can snort it or shoot it or perhaps use Heroin in other more creative, more deadly ways. In this county alone, we are seeing a drastic increase in accidental Heroin overdoses. In fact, there was one while the team was in California.
Another theme of this conference was synthetic drugs. Synthetic drugs are manufactured to resemble illegal drugs. The brain is tricked into the high, but the person could buy the drug at a specialty shop and possibly pass a standard drug screen. Alas, there are some drawbacks. Researchers outlined the newest ones for use, including “spice”, “bath salts”, “crocodile”, “smiles” and “robo tripping”. The concern is that these designer drug cooks change their recipe as soon as one becomes illegal, so they are constantly changing. Next, several states have had deadly overdoses, homicides and suicides associated with designer drugs. Side effects include psychosis, paranoia and extreme anxiety.
The latest research indicates that the frontal lobe of the brain is not developed by age 21 as we were taught last year, but by age 25. So, the decision making brain cells are still “goo” when kids are in high school and college. Then, throw some marijuana and booze on top of that brain!
Last, a great deal of emphasis was placed on trauma and recovery. Some people use substances just for fun, but more research is focusing on abusers that experience a horrible trauma and may be inclined to turn to substance abuse for help. These could be people who’s lives were functional and started abusing only after experiencing the traumatic incident. I feel that through my professional experience, adults who have had at least one unresolved trauma as a child are more likely to have difficulty in resolving adult trauma. There seems to be a tow rope attaching the two. Examples given frequently were soldiers returning from combat duty drinking or using drugs as a band aid of sorts.
There were a hundred workshops or so over the three day conference. Tracts for prosecutors, counselors, judges and police officers were specialized. Once again, the four day conference was a huge learning event for this counselor. I have already used topics I learned last Friday in group settings this week. You can never break the chain!
Wait, what did she say? Heroin?
No, I am not having a flashback to 1969. I am not singing Magic Carpet Ride, loudly, to the Doors (well, maybe…) I am talking about Heroin and that makes me think of Crosby, Stills, Nash and Young, Iron Butterfly and wearing bell bottoms. Who’s with me? I was barely a teenager in 1969, but I do remember some things. People were smoking marijuana, dropping LSD and shooting Heroin. People who used Heroin were called Junkies and they were far away from our world in Atlanta, Georgia. I recently read the new Allman Brothers book One Way Out written by Galadrielle Allman. I learned that several Allman Brothers Band members were detoxed from Heroin in 1969. I did not know that.
Well, the world has changed since 1969 and so has Heroin use.
In the past three years, I have seen an increase in clients coming to my office for Heroin use. Most of these people started with pain pills and hop scotched over to Heroin. Prescription opiates are seen as clean drugs. They are prescribed for someone. (It isn’t always YOU, but that seems to be such a small point) Opiate use is cool. And make no mistake; none of my clients have difficulty finding Heroin or pills. Beginners raid their parents or grandparents medicine cabinets for pills. Professionals accompany other people to the doctor and then the drug store. Then they purchase the pills from that friend. Helpful….
But alas, there are problems! The “high” changes and tolerance begins to builds very quickly, within months of first use. Pills are expensive, roughly a dollar per milligram. It is not unusual for a person to eat, snort or shoot 200-300 milligrams of opiates per day. Fairly quickly, the user will suffer physical withdrawal symptoms if they cannot afford to buy or obtain more prescription opiates. Opiate withdrawal is very uncomfortable (not deadly but very uncomfortable). So, the jump to Heroin doesn’t seem as crazy when they are in withdrawal. People can purchase $50 of Heroin which may get them high but will certainly keep them from suffering withdrawal from pills. Hey, it may kill them. While $50 per day isn’t cheap, it sure beats spending $2-300 per day. Every one of my clients who have made this change from pills to Heroin believes that they have miraculously graduated from medical school! They always, say “I’ve got this, Miss Grace. I know exactly what dose that I need to be doing.” Amazing!
So, the stigma of being a junkie is gone. Unfortunately, there is still no room for “oops!” The Heroin users of 2014 do not look like Heroin users of 1969. They can be businessmen. They are children of professional people in our community. They are well educated. They have resources; parents who have or will pay for multiple rehab programs for them. They certainly do not think of themselves as junkies and they really do not appreciate it when I call them junkies. They will have paraphernalia around them. There will be straws or needles.
They get to counseling primarily through two avenues. Many are sent though the court system. They may or may not have ever been busted with Heroin. Some have been busted with DUI or other drug charges. Others are referred by their doctor because they are taking the drug Suboxone (basically the new Methodone).
Why do people use Heroin? Now that is a good question. Basically, I see hundreds of people each year. What I see are people who have made a train wreck of their lives because they are unwilling or afraid to live their lives plain, like the rest of us. They believe that they are incapable of having fun just being thrilled with plain old life. They have to tweak life to squeeze a little bit more out of it, never realizing that there will be a massive payback, emotionally, physically and financially.
Again, the world has changed since 1969 and so has Heroin use. But some things are still the same. Heroin is fairly expensive and available. Heroin use is deadly!! Overdose is rampant. Users accidentally use too much because they don’t know what they are doing! They also mix drugs and alcohol with often catastrophic results.
Heroin use is back.
1) Alcohol is a drug. IT is not a fruit or a vegetable. Does this sound dumb? Well, there are a lot of people in this country who don’t get it.
2) You can be charged with DUI/Drugs while driving under the influence of your medication prescribed by your doctor, especially if you are taking 4 times as much as you are supposed to. Especially if you are mixing medications. Especially if you are not eating properly. You absolutely can kill someone while driving under the influence of the medication that you are prescribed by your doctor. And you will be charged with a felony. The police/judicial system used to be undereducated as to how to deal with prescription drug abuse, but by golly we aren’t now.
3) The abuse of Ambien, a prescription drug used for sleep problems, is a growing problem in America. When taken at bedtime Ambien is a wonderful aid for individuals with difficulty sleeping. But, when taken with other medications such as alcohol or God forbid with street drugs, it can be a problem. People who take 2 to 100 times the dosage of Ambien just to have a good time can definitely have problems. Plain old individuals will have problems with sleep eating, sleep sexing and sleep driving on Ambien even if taken correctly.
4) Possession of even a crumble of a hydrocodone without a prescription is a FELONY! Surprise! If your Aunt Effie gives you a Oxycodone for your killer migraine headache and you get pulled over for speeding, you can and probably will be charged with a FELONY.
5) People who start taking narcotics or opiates who have pain and those who start taking those medicines who never had pain can end up at the same place. Narcotics (are the same as opiates for the purpose of this article) are physically addicting, even when taken as prescribed. Physical withdrawal symptoms can include feeling like you have the flu, muscle aches, problems sleeping and sweating. They last from 4-30 days. Withdrawal from narcotics is usually not life threatening.
6) Overdose from narcotics can be life threatening. In our county, we have been averaging (roughly) one deadly overdose per month from prescription medication for the past 8 years.
7) Overdose from benzodiazapines (Xanax) is usually not deadly, but when mixed with a few pain pills, a few Somas, a cold beer or 12 beers, it is frequently deadly.
8) Withdrawal from Xanax can be deadly. You should not attempt to stop taking any medication without the direction of your medical professional, but especially Xanax. Symptoms can lead up to and include seizures.
9) Withdrawal from alcohol can be deadly. Isn’t that silly? The legal and socially acceptable drug can cause physical withdrawal symptoms leading up to and including seizures. Do not stop drinking abruptly after long periods of steady use without consulting a medical professional.
10) Alcohol abuse during pregnancy causes the most damaging birth defects of all of the usually abused drugs.
As a part of the Cherokee County DUI/Drug Court team, I attended the National Association of Drug Court Professionals Training in Washington, DC in July of 2013. I arrived at the training with barely 3 hours of sleep after attending a family wedding in Cleveland, Georgia. I rented a car that was way too big for me to maneuver on 3 hours sleep. I scrubbed every inch of concrete in the entire airport parking deck, narrowly missing a metal crossbeam which I had mistaken for an alleyway and scarring my team members for life, before we reached the “overflow hotel” for the conference. It was not traumatic; it was an adventure! During the conference, the city government cut the water off in the main hotel which housed events for our 4000 attendees and 4000 middle aged women(all dressed in red) celebrating 100 years of their sorority. It was not traumatic. Each day we had to get ourselves to and from the main hotel, by boat, a thousand dollar taxi ride or a trolley with 16 changes but it cost a buck forty five. It was not traumatic. On the way home on the airplane, an unidentified male sitting in the tiny seats directly behind the judge and DUI Court Coordinator, threw up all over the airplane. That was semi-traumatic!
So, when I noticed the word “Trauma” printed in 11 titles of the training sessions for the conference, I was on alert. You see, I have been practicing Social Work in the state of Georgia since March 16, 1981. Since I have been around, we the professionals, have designated” buzz diagnoses” which define most of our clients. These buzz words change about every decade or so, with new research on different illnesses and with new social problems. The current “diagnosis de jour” is Post Traumatic Stress Disorder. Right or wrong, that’s the deal.
When I first came into the business of counseling, we didn’t use the word “trauma” much. When we did use it, we were referring to Vietnam Vets, especially POWs. Later, the term “trauma” was stretched to include children who had been physically abused. In the 1990s, we widened that term to include battered women. The circle of the trauma definition has grown. And that is fine. So, now the big earth shattering news is that previous trauma in a patient’s life is being associated with their possibility of recovery. Well, no shit!
There is of course, trauma associated with recovery itself. No one stops drinking or shooting heroin because they had one incident that they think might be dysfunctional, but it’s kind of on the line. No, people don’t make a change in their substance use unless something terrible, something traumatic happens. Duh! Trauma for our field is defined as feeling helpless and hopeless in a situation beyond your control. Well, when you work in the field of substance abuse, our patients lives could easily be written as a made for TV movie. Car wrecks, relatives who have inbred, having a bondsman on the Christmas card list are routine. I had a guy look me in the eye and say “Grace, do you mean that no one has ever gotten stabbed at your house on Thanksgiving before?” He was serious.
It doesn’t seem like a big stretch to surmise that a person who experienced trauma earlier in their lives might self medicate with alcohol or drugs. Self medicating is a coping skill that may work for a while. When it stops working, then counselors enter the picture. So, what do you do? How do you treat this patient? What do you do first? 1) Get them sober first, period. Get them good and clean and sober. After a minimum of six months of continuous sobriety, then work on the mental health issue, the trauma. 2) Some stuff needs to be left alone. I am of the mind that some patients may have trauma that just needs to stay buried in the back yard. 3) Some of these folks will be ok, with or without our latest research on trauma and the impact on recovery. They are genetically mutants, tougher than a John Deere Tractor and they will survive; you need to tell them that. 4) We need to encourage and challenge these folks to be as healthy as they can be.
Sometimes, I believe that we label too much stuff. Not every move we make or don’t make has to have a diagnosis, list of symptoms, dysfunctional code. Sometimes we get so into living the diagnosis, that we make it a lifestyle. Now that is dysfunctional. We need a code for that one, by golly!
So, in summary, I do not want to ignore trauma and the impact it can have on a person forever. There is some really bad stuff that happens to people, in war, in accidents, in life. And those people may have difficulty in the recovery process. It’s like having another layer on a cake, more to deal with. But, people are stronger than they think. I see miracles almost every day; I see people who live through horrific events and manage to build healthy lives. That’s what I’m talking about!