The Death of Philip Seymour Hoffman Highlights the Increased Use of Heroin

We lost a great actor with the death of Philip Seymour Hoffman. Once again the danger of drug use has resulted in the loss of life. He sought treatment for his addiction but failed to avoid an untimely death.

photo of Philip Seymour Hoffman by Jean Jacques Georges

Philip Seymour Hoffman at the Paris premiere of The Ides of March in 2011 by photo by Jean Jacques Georges

Hoffman death puts focus on heroin’s comeback

Hoffman, 46, was found on the bathroom floor of his New York City apartment with a syringe in his left arm and glassine bags usually associated with heroin. Police say they are investigating substances found in the apartment to determine which drugs were present, but Hoffman has been open about his drug use, which included prescription pills and heroin, and his decades-long struggle to stay sober.

As authorities crack down on clinics that prescribe pain pills by the thousands and pharmaceutical companies change their formulas so the pills are more difficult to abuse, opiate addicts are turning to cheaper and more-plentiful heroin.

In recent years, the number of people abusing prescription pain pills has dropped steadily as heroin use increased. The number of people 12 and older who regularly abuse OxyContin dropped from 566,000 in 2010 to 358,000 in 2012, the National Survey on Drug Use and Health reported in December. The number of regular heroin users soared from 239,000 in 2010 to 335,000 in 2012, the survey found.

The tragedy caused by the abuse of drugs damages millions every day. We have to do a better job of reducing the damage done to society due to the abuse of drugs. Celebrities shine a light on the problem but it is a widespread problem that has an immense impact throughout society.

Related: Russell brand’s testimony on dealing with drug addictionPrescription painkillers kill more every year in usa than heroin and cocaine combined Eminem’s ‘relapse’ explores his drug addition and rehabilitation

Prescription Drug Abuse in the USA

Some key findings from the Council of State Governments study on Prescription Drug Abuse in America (from 2004). The report is obviously a bit outdated but the problem continues to grow.

  • More than 6.2 million people were current illicit users of prescription drugs in 2002.
  • In 2001, prescription drug abuse and misuse were estimated to impose approximately $100 billion annually in health care costs.
  • In Florida, there were 328 deaths attributed to heroin overdoses in 2001 compared to 957 deaths due to overdoses of the prescription pain medications. The trend continued in 2002, when more Floridians died from prescription drug overdoses than use of illegal drugs.

Prescription Drugs: Abuse and Addiction from the NIH (revised in 2011).

Although most people take prescription medications responsibly, an estimated 52 million people (20 percent of those aged 12 and older) have used prescription drugs for nonmedical reasons at least once in their lifetimes.

The number of prescriptions for some of these medications has increased dramatically since the early 1990s. Moreover, a consumer culture amenable to “taking a pill for what ails you” and the perception of prescription drugs as less harmful than illicit drugs are other likely contributors to the problem. It is an urgent one: unintentional overdose deaths involving opioid pain relievers have quadrupled since 1999, and by 2007, outnumbered those involving heroin and cocaine.

Years of research have shown that addiction to any drug (illicit or prescribed) is a brain disease that can be treated effectively. Treatment must take into account the type of drug used and the needs of the individual. Successful treatment may need to incorporate several components, including detoxification, counseling, and sometimes the use of addiction medications. Multiple courses of treatment may be needed for the patient to make a full recovery.

Related: How effective is drug addiction treatment?Center for substance abuse treatment (US HHS)Brett Favre overcomes painkiller addiction

Drug Treatment Funding Can More Than Pay For Itself With Reduced Crime Costs

Some interesting details and data from Texas government web site.

Drug users constitute a large and growing proportion of the criminal justice population. Drug users not only commit a substantial amount of crime, but as the frequency of drug use increases, the frequency of crime increases and the severity of crimes committed also increases.

Drug use in the general population appears to have declined over the past decade, yet the number of drug-involved offenders is increasing. The number of convictions for drug violations in Texas has increased from 8,103 in 1980 to 23,126 in 1988, a 185 percent increase in less than ten years.

Estimates of lifetime drug users among the nation’s incarcerated population range from 80 to 87 percent.

The American Correctional Association notes that more than 95 percent of drug and alcohol offenders will be discharged from prison, most without receiving any treatment. Because of the high association between drug abuse and recidivism, it is in the public interest to place offenders in the kinds of treatment programs that have been found effective. A noticeable reduction in drug use and criminality can occur with an alliance between the criminal justice system and drug abuse treatment.

Public expenditures for drug abuse treatment are wise and prudent investments. Treatment works to reduce crime, drug abuse, and recidivism. Sustained reductions in recidivism can be achieved up to six years after treatment. With appropriate drug abuse treatment more than 75 percent of offenders with chronic substance abuse histories can reenter the community and lead socially acceptable life styles.

For every dollar spent for drug treatment, $11.54 is saved in social costs, including law enforcement costs, losses to victims, and government funds for health care.

Research has shown that funds invested in drug treatment reduces future criminal justice costs for treated offenders. Every dollar spent on residential drug treatment in probation saves $2.10 in future criminal justice costs. Every dollar spent on outpatient drug treatment in probation saves $4.28 in future criminal justice costs.

This is an old report, from 1997 but the basic model doesn’t change. A large amount of criminal activity is driven by drug addiction. To reduce crime in society drug addiction needs to be reduced. While success rates of drug addiction treatment centers are far from perfect the results more than pay for the cost – just in reduced crime costs (without even considering the better lives these people lead and the benefits to their children and loved ones).

Related: The Rise and Fall of America’s First Prison for Drug AddictsResults of 4 Year Study of Women in Drug TreatmentAlcohol is a Major Cause of Drug Rehab AdmissionsHow Effective is Drug Addiction Treatment?

Fighting Drugs With Drugs

An Obscure Hallucinogen Gains Legitimacy as a Solution for Addictions

Ibogaine, a brown powder derived from the African Tabernathe iboga plant, has intrigued researchers since 1962, when Howard Lotsof, a student at New York University and an opiate addict, found that a single dose erased his drug cravings without causing any withdrawal symptoms. Unfortunately, the hallucinogen can increase the risk of cardiac arrest, and the U.S. Drug Enforcement Agency lists it as a Schedule 1 substance, a classification for drugs like ecstasy and LSD with “no known medical value” and “high potential for abuse,” making it difficult to get federal funding to run clinical trials.

Animal tests, however, have shown the drug’s medicinal promise. “Rats addicted to morphine will quit for weeks after receiving ibogaine,” says Stanley Glick, the director of the Center for Neuropharmacology and Neuroscience at Albany Medical College. And addicts have reported positive effects in Mexico and Europe, where ibogaine therapy is legal. “Going cold turkey is horrible. There’s vomiting and diarrhea and pain and a constant drug craving,” says Randy Hencken, a drug user who was treated in Mexico. “After ibogaine, I didn’t feel any symptoms or cravings. I’ve been clean for nine years. Heroin and cocaine no longer have any power over me.”

Despite these successes, ibogaine lacks scientific credibility. “As great as ibogaine seems, no one knows exactly how effective it is as a treatment,” says Valerie Mojieko, the director of clinical research for the Multidisciplinary Association for Psychedelic Research (MAPS), a privately funded Massachusetts-based nonprofit. So starting this month, MAPS will enlist Clare Wilkins, the director of Pangea Biomedics, to run the first long-term study to gauge the drug’s lasting effects at her clinic in Mexico (where patients already pay $5,000 for the treatment).

Nearly seven million Americans abuse illicit drugs, costing the nation an estimated $181 billion a year in health care, crime and lost productivity.

We certainly need better ways to treat drug addiction. Current methods are helping people. But current methods fail far too often for too many people. The way to find better treatments is to run medical studies and analyze the results.

Related: Looking at the Evidence of Treating AlcoholismNIH on How Effective Drug Addiction Treatment Is?Principles of Effective Drug Treatment and Rehabilitation

Principles of Effective Drug Treatment and Rehabilitation

Principles of Effective Treatment from the United States National Drug and Alcohol Treatment Service

Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences. While the path to drug addiction begins with the voluntary act of taking drugs, over time a person’s ability to choose not to do so becomes compromised, and seeking and consuming the drug becomes compulsive. This behavior results largely from the effects of prolonged drug exposure on brain functioning. Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior.

Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual’s life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is typically a chronic disease, people cannot simply stop using drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives.

Too often, addiction goes untreated: According to the National Survey on Drug Use and Health (NSDUH), 23.2 million persons (9.4% of the U.S. population) aged 12 or older needed treatment for an illicit drug or alcohol use problem in 2007. Of these individuals, 2.4 million (10.4%) received treatment at a specialty facility (i.e., hospital, drug or alcohol rehabilitation or mental health center). Thus, 20.8 million persons (8.4 % of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive it.

Scientific research since the mid–1970s shows that treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective treatment programs:

  • Addiction is a complex but treatable disease that affects brain function and behavior.
  • No single treatment is appropriate for everyone.
  • Treatment needs to be readily available.
  • Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.
  • Remaining in treatment for an adequate period of time is critical.
  • Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatment.
  • Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
  • An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
  • Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse.
  • Treatment does not need to be voluntary to be effective.
  • Drug use during treatment must be monitored continuously, as lapses during treatment do occur.

When looking for drug rehab centers it is valuable to keep these facts in mind. Even the best rehab centers have many failed attempts to beat drug addiction. By finding centers that have adopted scientifically tested strategies success rates can be improved.

Related: How Effective is Treatment for Drug Addiction?Methods to Treat Drug and Alcohol AddictionDrug Rehab Centers in Los AngelesUniversity of Wisconsin-Madison Program Aims to Improve Drug Treatment

Decline in the Misuse of Prescription Drugs in the USA

The US Department of Health & Human Services Substance – Abuse & Mental Health Services Administration reports a significant decline in the misuse of prescription drugs. The misuse of prescription drugs decreased significantly between 2007 and 2008 among those aged 12 and older, including among adolescents, according to 2008 National Survey on Drug Use and Health (NSDUH). However, the national survey showed that the overall level of current illicit drug use has remained level at about 8%.

The annual NSDUH report also indicated that progress has been made in curbing other types of the illicit drug use. For example, past month methamphetamine use among those aged 12 and older dropped sharply from approximately 529,000 people in 2007 to 314,000 in 2008. Similarly, the level of current cocaine use among the population aged 12 and older has decreased from 1.0% in 2006 to 0.7% in 2008.

Promising results from the latest survey also were also found for the most part among youth (12 to 17 year olds). Among youth there was a significant decline in overall past month illicit drug use, from 11.6% in 2002 to 9.3% in 2008. The rate of current marijuana use among youth has remained level at about 6.7% over the past few years while there have been significant decreases in the current use of alcohol, cigarettes and non-medical use of prescription drugs since 2007.

Historically, young adults have had the highest rates of substance abuse, and for most types of illicit substance abuse the levels have remained steady over the past year. However, over the past three years there has been a steady drop in the rate of heavy alcohol use by full time college students aged 18 to 22 – from a high of 19.5% in 2005 to 16.3% in 2008.

“The survey findings are important because they often point to emerging patterns of substance abuse,” said Gil Kerlikowske, Director of National Drug Control Policy. “Although we see some success reversing trends in prescription drug abuse, there are indications that progress in other areas may be at a standstill, or even slipping back, particularly among youth.”

The NSDUH continues to show a vast disparity between the number of number of people needing specialized treatment for a substance abuse problem and the number who actually receive it. According to the survey 23.1 million Americans need specialized treatment for a substance abuse problem, but only 2.3 million (or roughly 10 percent of them) get it.

The complete survey findings are available on the SAMHSA web site.

Related: Prescription Drug Abuse: Pain Killers Can Lead to AdditionMethamphetamine Abuse Costs U.S. $23.4 BillionDrug Rehab Centers in Los Angeles

Prescription Drug Abuse: Pain Killers Can Lead to Addition

Prescription drug abuse: Pain conditions can lead to addictions by Jennifer Wezensky

According to the 2007 National Survey on Drug Use and Health, an estimated 6.9 million people ages 12 or older used prescription medications for nonmedical use in the month before being surveyed. That total included 5.2 million using pain relievers, 1.8 million using tranquilizers, 1.1 million using stimulants and 350,000 using sedatives.

In 2003, the U.S. Department of Health and Human Services reported that about one-third of all U.S. drug abuse is prescription-drug abuse.

Locally, as many as 30 percent of the patients in the inpatient and outpatient treatment at the Community Healing Centers are addicted to prescription drugs, said Sally Reames, executive director of the nonprofit substance-abuse-treatment agency. And many have “secondary” addictions to alcohol, she said, a potentially fatal combination.

People often mistakenly believe that prescription drugs are safe because a doctor is prescribing them, said Dr. Michael Liepman, a professor of psychiatry at Michigan State University Kalamazoo Center for Medical Studies and medical director of the Jim Gilmore Jr. Community Healing Center. Many patients who end up addicted to prescription drugs start with a legitimate pain condition.

“Sometimes people think, ‘If one pill makes me feel better, three will be better,'” said Dr. Richard Tooker, chief medical officer for Kalamazoo County. In the case of pain killers derived from opium, increasing the amount taken can be deadly because these drugs decrease brain activity, breathing rates and heart rates.

The prescription drugs that Reames has observed are most often abused are Vicodin, OxyContin and the anti-anxiety medication Xanax.

Liepman said he sees extensive addiction to opiate pain killers, anti-anxiety drugs such as Xanax, Klonopin and Ativan as well as abuse of drugs prescribed for attention-deficit hyperactivity disorder.

The problems due to abuse of prescription drugs are not as widely known as the problems caused by illegal drugs. While both are serious for many that would not consider taking illegal drugs the dangers of prescription drugs and alcohol are the biggest risks. People must be careful to use powerful drugs as directed and even then understand there are real risks to doing so.

Related: Methamphetamine Abuse Costs U.S. $23.4 BillionBrett Favre Overcomes Painkiller Addiction

Methamphetamine Abuse Costs U.S. $23.4 Billion

Methamphetamine Abuse Costs U.S. $23.4 Billion

Almost two-thirds of the costs caused by methamphetamine use resulted from the burden of addiction and the estimated 900 premature deaths among users in 2005. The second largest cost category was crime and criminal justice, including the costs of arresting and jailing drug offenders and dealing with non-drug crimes committed by methamphetamine users, such as thefts committed to support their drug habit.

Loss of productivity, the removal of children from their parents’ homes because of methamphetamine use, and drug treatment were among the other factors associated with the economic cost of the drug.

The study cited the production of methamphetamine as another cost category, explaining that producing the drug requires toxic chemicals that can result in fire, explosions and other dangerous events. The resulting costs cover such things as cleaning up the hazardous waste generated by methamphetamine production and injuries suffered by emergency workers and other victims.

Related: Why Can’t Drug Addicts Quit on Their Own?National Alcohol and Drug Addiction Recovery MonthDrug Rehab Centers in Los Angeles

Brett Favre Overcomes Painkiller Addiction

photo of Brett Favre Nov 2006

Brett Favre’s addiction to painkillers (1996)

After the seizure had ended and he had come to his senses, Favre looked into a sea of concerned medical faces and saw Packers associate team physician John Gray. “You’ve just suffered a seizure, Brett,” Gray told him. “People can die from those.” Favre’s heart sank. Upon hearing from doctors in the room that his dependence on painkillers might have contributed to the seizure, he thought, I’ve got to stop the pills, I’ve just got to.

Last season Favre went on such a wild ride with the prescription drug Vicodin, a narcotic-analgesic painkiller, that Tynes feared for his life. He scavenged pills from teammates. At least once he took 13 tablets in a night. But on Tuesday of last week, during his final telephone call before entering the Menninger Clinic, a rehabilitation center in Topeka, Kansas [which moved to Florida in 2003], to treat his dependency (and also to evaluate his occasional heavy drinking), Favre told SI that he hadn’t taken Vicodin since the seizure. “I quit cold turkey,” he said, “and I entered the NFL substance-abuse program voluntarily. I don’t want a pill now, but I want to go into a rehab center because I want to make sure I’m totally clean.

Tynes wiped her eyes. She took a deep breath. She sniffled a few times. “You know,” she said, “he’s changed already. He talks to me again. He takes Brittany and me out. He pays attention to us. A few days ago he hugged me and he thanked me for everything I’ve done, and he said some really nice things to me.”

She wiped her eyes again. “I said, ‘I can’t believe it. The old Brett’s back!'” Time will tell. The true test will start in September.

Time has shown the answer, after struggles for several years, as Brett Favre has continued his amazing NFL career with great success.

Through triumph & tragedy, Deanna and Brett Favre remain a constant

After doctors found severe liver damage in 1996, Brett agreed to enter rehab, and was able to kick his addiction. He and Deanna were married several months later and welcomed daughter Breleigh in 1999, but his problems with substance abuse had not ended. By 1999, Brett had returned to heavy partying, and was abusing alcohol. Deanna contacted a divorce attorney, which helped scare her husband into quitting drinking entirely, according to Deanna.

The 1990s tested their relationship, but Deanna ultimately appreciated that Brett chose to seek help. “He was battling a disease,” she says. “I was trying to support him, and when he started making the right choices by getting the help he needed, that made a difference.”

Life had stabilized for the Favres by 2003: Brett was sober and a Super Bowl-winning icon in Green Bay, and Brittany and Breleigh were healthy and happy. “We were at a good spot in our lives,” Deanna says.

Then, in December 2003, Brett’s father died in a car accident. The following October, Deanna’s 24-year-old brother Casey was killed when his all-terrain vehicle hit a patch of gravel and flipped. Casey had recently overcome his own drug problems, and his girlfriend was eight months pregnant when he died.

In her memoir, Deanna described the loss of her brother as the darkest time in her life, but the darkness would not pass quickly – just days after Casey’s funeral, Deanna was diagnosed with breast cancer at 35.

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Center for Substance Abuse Treatment

The Center for Substance Abuse Treatment is part of the United States Department for Health and Human Services. CSAT promote the quality and availability of community-based substance abuse treatment services. CSAT also supports free treatment referral service to link people with the community-based substance abuse services they need.

The treatment locator includes more than 11,000 addiction treatment programs, including residential treatment centers, outpatient treatment programs, and hospital inpatient programs for drug addiction and alcoholism. Listings include treatment programs for marijuana, cocaine, and heroin addiction, as well as drug and alcohol treatment programs for adolescents, and adults.

CSAT offers a list of questions to find answers to when looking for a rehab center, including:

  • Is the program run by state-accredited, licensed and/or trained professionals?
  • Is long-term aftercare support and/or guidance encouraged, provided and maintained?
  • Is there ongoing monitoring of possible relapse to help guide patients back to abstinence?
  • I think it also makes sense to learn about the success of those using the center and how the rehab center’s treatment matches your needs.

    Related: Methods to Treat AddictionStudy: Drug Treatment Success Rates in EnglandAging of the Population in Rehab