Archive for September, 2014

Heroin: Mom struggles to help addicted daughter

Posted on: September 22nd, 2014 by sobrietyresources

September 22, 2014

ORANGEBURG – Every alert — every buzz, every ring — from Jayne Read’s phone brings a surge of dread.”I think it’s going to tell me my daughter is dead,” she said. Read said her middle daughter, Carmen, is 23 years old and deep into heroin addiction. She is petite — 91 pounds and two inches shy of 5 feet tall — and has been living in an abandoned brick building in Newburgh. Boards cover its windows. Waist-high weeds separate it from the sidewalk.”If she died there, nobody would know,” she said. Read, a single mother who lives in Washingtonville and works as a paralegal in Orangeburg, has spent much of the last few years trying to get her daughter the inpatient care she needs. “When she’s herself, she’s incredible,” Read said of Carmen. “The greatest kid in the world.” Read said her daughter, burdened by a range of emotional issues, began abusing prescription drugs in high school. Later, a “bad boyfriend” introduced her to heroin. A stint in jail two years ago had little lasting effect. Nor did a combination of inpatient and outpatient care at Richard C. Ward Addiction Treatment Center in Middletown. Even after she overdosed in 2013 and medical crews used Narcan, a heroin antidote, to revive her, she went back to using, developing a habit that costs $100 a day to maintain.

Heroin: Treatment admissions on rise in the Hudson valley
Read has no illusions about how her daughter, who is unemployed, finds the money. “She tells me what she does to get the drugs,” she said, wiping away tears as she sat in a conference room in her office. The instances when Carmen surfaces to ask for her mother’s help are infrequent and unpredictable. Fleeting though they may be, those are the moments, Read said, when she feels she has the best chance to get her daughter off the street and into treatment. “When your children come to you and ask for help, they need it that second,” she said. Not counting private treatment facilities, there are 472 beds for detox and rehab treatment in Putnam, Rockland and Westchester counties, according to the state Office of Alcohol and Substance Abuse Services. Despite that capacity and the eagerness of treatment providers to help — in interviews, representatives from Phoenix House, Putnam Family and Community Services, Arms Acres and other facilities in the area all said they bend over backward to find a place for people asking for care — obtaining that care has proven to be a difficult process for Read and her daughter. It’s a hard truth familiar to parents throughout the Hudson Valley, where heroin use, as it has in much of the country, has soared in recent years.

Heroin arrests in Putnam County, for example, have risen 300 percent over the last two years. In 2012, Westchester ranked among the top 10 counties in the state for opioid-related hospitalizations. It was designated a “high-intensity drug trafficking area,” qualifying it for federal aid. Rockland and Putnam have since applied for the designation, too. For Read, Carmen’s periodic pleas for help prompt a flurry of calls to treatment centers around the region. Those facilities that take her calls ask about insurance before anything else. When Read mentions Carmen’s Medicaid coverage, the conversation typically stops. Treatment providers acknowledged in conversations with The Journal News that insurance companies — and their policies about what they’ll pay for and what they won’t — often interfere with care. Meanwhile, the cost of private treatment, Read said, is out of reach. Inevitably, Carmen is drawn back to the street, back to the abandoned building in Newburgh.

It happened again in August. Carmen called her mother for help, and Read drove her to a hospital in Port Jervis. There, with Carmen sick from the effects of heroin withdrawal, a social worker told Read her daughter did not meet the criteria for inpatient treatment. So Read took her in, worried about how Carmen’s presence in the home would affect Read’s youngest daughter but desperate to keep Carmen from that decrepit building in Newburgh. It didn’t last. “Every moment that went by, the drug was pulling her. Two days later, she said, ‘Take me back. I give up.'”

Read drove her daughter back to Newburgh. After saying goodbye, she snapped a photo of her, in light-blue pants, her bleach-blond hair pulled into a ponytail, as she strode through the weeds toward the building. Weeks went by before Read got another late-night call from Carmen. Her boyfriend had just beaten her up. She needed help.

This time, their fortune changed: On Sept. 6, Arms Acres, a 162-bed facility in Carmel, took Carmen in. Medicaid agreed to pay for three days of detoxification treatment. A subsequent 28-day stay was arranged but later reduced to 14 days. Read cited the limitations of Carmen’s insurance coverage as the reason for shortening — by half — her stay. “She wants this so badly,” Read said. “She’s got a fighting chance.” For the moment, with her daughter in care, Read no longer jumps when her phone rings. She doesn’t live in constant fear. “I can breathe again,” she said.

Heroin Detox Symptoms

Posted on: September 20th, 2014 by sobrietyresources

Published: September 20, 2014

Are you considering getting off heroin? Whether you have been using heroin regularly or occasionally, getting off heroin will be good for you. Apart from its addictive properties, heroin may give rise to numerous blood borne diseases and further complicate your life.  However, when opiate metabolites exit the system, the individual usually experiences withdrawal symptoms, the intensity of which will vary among users. So, what can you expect?

Typically, heroin withdrawal symptoms start to occur between 6 and 12 hours after the last use, peaking within 1 to 3 days, and gradually subside over the following couple of days. Some cases lead to post acute withdrawal syndrome (PAWS), which can persist for weeks and months after cessation. In this article, we review the most commonly experienced acute and protracted withdrawal symptoms of heroin detox and the possible side effect. At the end, we welcome your feedback, shared experience and additional questions regarding symptoms from heroin detox. We try to answer all legitimate questions with a personal and prompt response.

Symptoms of heroin detox

When people physically dependent on heroin quit taking the drug, their body needs some time to adjust to the absence of heroin. As a result, certain symptoms occur. The most commonly experienced acute withdrawal symptoms during heroin detox include:

  • abdominal pain
  • anxiety
  • body and muscle ache
  • chills
  • constipation
  • cravings
  • depression
  • diarrhea
  • insomnia
  • irritability
  • nausea
  • profuse sweating
  • running nose
  • tearing
  • vomiting

In some cases, acute heroin detox is followed by prolonged withdrawal symptoms, or, Post Acute Withdrawal Syndrome (PAWS). PAWS can make the whole withdrawal process more lengthy and potentially uncomfortable. In fact, this syndrome can last for weeks, months or even years after quitting heroin and should be adequately addressed. The most common protracted symptoms following heroin detox are:

  • anxiety
  • depression
  • fatigue
  • insomnia
  • irritability

While these symptoms do not cause physical pain and, as such, are bearable, they still require proper treatment. After all, recovery from heroin dependence is a long-term process. People serious about addiction recovery need to be constantly wary of people and situations that could trigger relapse.

Heroin detox side effects:

Medical complications associated with heroin withdrawal can occur and should be quickly identified and treated. However, these complications are seldom life-threatening. Heroin detox side effects can include:

  • Anxiety disorders, especially those involving panic anxiety, also might show increased intensity during heroin withdrawal.
  • Any condition involving pain is likely to worsen during withdrawal because of a reduced pain threshold and the lack of analgesia (pain relief) afforded by heroin use. This phenomenon is particularly common with dental pain and chronic back pain.
  • Fever may be present and typically will respond to the detoxification process. However, other causes of fever should be evaluated, particularly with intravenous users, because HIV infection, viral hepatitis, abscesses, infected injection sites, and pneumonia occur commonly in this population and always require medical attention.
  • Severe gastrointestinal symptoms such as vomiting or diarrhea can lead to dehydration or electrolyte imbalance (rare).
  • Underlying cardiac illness could be made worse by increased blood pressure, increased pulse, and/or sweating that is characteristic of heroin withdrawal.

Treatment for heroin detox symptoms

To start heroin detox, a person has to be determined to give up on heroin and prepared to endure the physical symptoms that will occur during this process. In any case, medical assistance offers humane assistance during detox, as symptoms can get pretty tough and side effects can trigger relapse. Medications which can address common heroin detox side effects include:

  • benzodiazepines
  • buprenorphine
  • methadone
  • clonidine

The administration of medications is only one reason to consider a medical detox clinic during heroin withdrawal. Medical professionals are able to monitor the intensity of the symptoms, assist and give medications if certain complications arise. For example, most individuals can be treated with oral fluids, especially fluids containing electrolytes, and some might require intravenous therapies. Having to go through this painful stage alone is likely to cause a relapse in case the intensity of the symptoms become unbearable.

However, if you decide to detox from heroin at home, make sure you consult a physician to get approval first. Together, you can talk about whether going cold turkey or a gradual decrease of the dose is better suited for you. Each person require a custom detox program, depending on the level of dependency, duration of use, medical history, etc. Oftentimes abrupt stopping of heroin use is not what doctors would recommend, as severe cravings are likely to make one think that reaching for heroin is the best solution to stop the pain and possibly overdose as a result of the pain. Finally, the support from close and sober people is essential throughout the whole process, so make sure you have these people around you during this time.

Learning to overpower overdoses: Topsfield EMTs receive naloxone training

Posted on: September 18th, 2014 by sobrietyresources

Posted Sep. 18, 2014 @ 3:30 pm


By Anna Burgess
[email protected]

Topsfield firefighters are now fully equipped to deal with any narcotic overdose that may come their way. Last Monday, Fire Captain Jen Collins-Brown led a comprehensive training session for all 30 EMT firefighters in town to learn how and when to administer the opioid antagonist naloxone. Naloxone, often referred to by the brand name Narcan, is an overdose-reversing drug that has been carried by some paramedics for years. Earlier this year, however, state regulations on naloxone expanded to allow all first responders with basic EMT training to carry and administer the drug without fear of legal repercussions. Collins-Brown said the Topsfield Fire Department has discussed training their firefighters with Narcan for “a long time,” and the new regulations made it possible to finally do so.

“The impetus to do this was seeing more and more overdoses of various substances as a chief complaint,” Collins-Brown said. “We work in conjunction with Northeast Regional Ambulance, so they’d have paramedics coming too, but we’re usually there before them. We have the opportunity to make a difference, to more rapidly treat the patient.” Collins-Brown trained 25 firefighter EMTs last week. She said that previously, only five of their staff members had been trained to use naloxone. “The paramedics on Topsfield Fire have carried Narcan for over 10 years, and have frequently used it,” she said. “Now all the firefighters, all the EMT basics and intermediates are able to use it.” The training itself, Collins-Brown said, was a lecture combined with an interactive tutorial on how to administer naloxone. They covered the “physiology of opiate overdoses” including how to recognize when an overdose is happening.

When assessing a patient, Collins-Brown said the first thing to do is manage his airway, because the biggest issue with overdose is usually that a patient is not breathing. Also, she noted, it’s important to be aware of “hazards on the scene,” like hypodermic needles. The training included an interactive portion, Collins-Brown said, “on a manikin, showing how to set up the equipment and administer it.” During training, the firefighters also discussed what to do after administering naloxone. “It’s not without risks, because you put the patient into immediate withdrawal,” Collins-Brown said, “so they’re often vomiting and there is potential for cardiac arrhythmia.” She said it’s important for an EMT to monitor the patient, because he could relapse. “The opiate is still in their system,” she explained. “It has a much longer half-life than Narcan does.” Collins-Brown said the training was very successful, and her trainees were very receptive to learning the skills needed to stop an overdose. “Everybody wants to help and to feel more empowered and have more tools to help people,” she said. “It’s obviously going to lead to a better, more positive outcome.”

Stopping America’s Hidden Overdose Crisis

Posted on: September 16th, 2014 by sobrietyresources

Sept. 16th, 2014

Fatal overdoses of prescription drugs are on the rise, but patchwork laws make them tough to stop

The woman who showed up in the emergency room of Boston Medical Center with a life-threatening apparent overdose of painkillers was contrite. She promised to follow a plan to ease her pain with medications that did not contain opioids, the principal ingredient of prescription drugs including oxycodone and fentanyl whose vast increase in use has led to an epidemic of overdoses. Then she went across town and got another doctor to prescribe them anyway.This kind of “doctor-shopping” by patients addicted to opioids is one of the primary reasons drug overdoses have become the leading cause of injury death in the Unites States. There were nearly 17,000 fatal overdoses of pain medications in 2011, the last year for which the figure is available, according to the Centers for Disease Control—more than from heroin and cocaine combined, and triple the number in 1990. Yet 12 years after the launch of a federal program that encouraged states to share information about patients’ prescription histories, there remains no single national database to thwart doctor-shopping. Meanwhile, the various prescription drug monitoring programs in separate states follow a patchwork of different rules—including whether or not doctors are even required to check them before prescribing opioids to patients.

The safety net is even patchier for veterans, whose rates of opioid overdose are double the national average. The Veterans Administration medical system, the nation’s largest hospital network, serving nearly nine million people, only last year agreed to report its patients’ prescription histories to state registries or check prescriptions from outside providers. But the process is voluntary; VA doctors are not required to follow any of the safeguards. “If you don’t use the system, you’re not going to detect misuse,” says Melissa Weimer, an assistant professor of medicine at Oregon Health and Science University and medical director at the substance-abuse treatment center CODA Inc.

Weimer is an advocate of sharing prescription information across state lines through so-called prescription drug monitoring programs, known as PDMPs. Many states have adopted PDMPs in the last few years in response to the overdose crisis and now every state except Missouri have or plan to develop a monitoring program. But the rules differ widely. In many cases, registration by doctors is voluntary. Even among states that require doctors to sign-up and use the PDMPs, only a handful mandate that they check the prescription histories of every patient. Efforts to make that mandatory have largely failed after opposition from medical groups. In Oklahoma, which has the nation’s fifth-highest drug overdose mortality rate, a state House bill to require that doctors check the registry was defeated in late May after medical associations said it would be burdensome and legislators called it regulatory overreach.

“As soon as you start talking about databases and tracking people and tracking prescribers, there’s pushback,” says Daniel Alford, director of the Safe and Competent Opioid Prescribing Education program at the Boston University School of Medicine, who treated that woman in the emergency room. He says doctors ask themselves, “‘Do I want the feds monitoring my prescribing patterns?’” The paperwork doctors are required to file under the current laws doesn’t have to be submitted by providers in most states for as long as seven days, and often takes another week or two to show up in the prescription monitoring system. “If you’re an ER physician, that’s not going to do you any good if the patient you’re seeing has just been to another emergency room that day, getting more of the same drugs,” says Heather Gray, legislative attorney for the National Alliance for Model State Drug Laws, a federally-funded nonprofit research organization. Then there is human error. Misspelled names or missing middle initials can make patients disappear in the shared databases. “It starts to frustrate you to the point where you question whether you want to invest time in looking at this as opposed to doing other things,” says Alford. But the biggest drawback is that many of the PDMPs don’t talk to each other, meaning that a doctor in Georgia, for example, may not know that a patient seeking a prescription for oxycodone received a similar one in Oklahoma the week before.

“It’s a huge problem that I don’t have access to data from doctors and pharmacies in other states,” says Joanna Starrels, an assistant professor at Albert Einstein College of Medicine and Montefiore Medical Center. Starrels published research in the Journal of General Internal Medicine showing that doctors are often lax in monitoring potentially addictive opioids. It’s a pressing concern: her own practice in the New York City borough of the Bronx is within easy reach of New Jersey and Connecticut. Tired of waiting for a national prescription database, groups of states and a pharmacists’ association have created three of their own. But not all states are members, those that are don’t always border one another, and each PDMP works differently. That’s because each state has different rules about what information is collected, how it’s organized, and who can see it. In some states, for example, law-enforcement agencies can have access to prescription information in cases that they’re actively investigating, while in others, such as Vermont, they need to get subpoenas. The vast increase in the number of opioid overdoses, and its cost—estimated by the Centers for Disease Control at about $56 billion in healthcare and law-enforcement expenses and lost productivity—has started to create momentum for improvement.

Several states have tightened the rules about reporting prescriptions, including shortening the deadlines for doing it, and making registration by doctors mandatory.

The governors of five of the six New England states are collaborating on a regional interstate PMDP to foil doctor-shopping. (The sixth, Republican Paul LePage of Maine, has said he’d rather use law enforcement to confront the problem.) And under a pilot project in Ohio, physicians can now check their patients’ prescription histories not just in their own state, but in neighboring Illinois and Indiana. A new proposal, by the Prescription Drug Monitoring Program Center of Excellence at Brandeis University, calls for also making prescription histories available to medical insurers, including prescriptions they now can’t see—the ones obtained outside of patients’ health plans for potentially unscrupulous purposes. This is likely to provoke privacy concerns, especially as states differ on whether sharing prescription information violates the federal Health Insurance Portability and Accountability Act (HIPAA), which protects patient records. Wisconsin, for example, has determined that healthcare providers can disclose prescription information without the patient’s consent if required by state law, while California says it cannot be divulged to anyone other than prescribers unless part of a criminal investigation. Oregon, meanwhile, requires that patients be informed about the process. All of this potential for confusion is one reason that for many doctors on the front lines, the most effective measure would be a national registry.

“There should be one database that all providers report to,” Starrels says. “I understand there are privacy concerns with that, but you could get around some of those by allowing access to certain data only to local prescribers, or perhaps requiring patients’ permission. But if I’m seeing a patient who just moved here from California and reports being prescribed oxycontin for the past three years, I should be able to check that.” Even if such a system existed, however, “and was miraculous and worked without any problems, and all the states talked to each other, it still wouldn’t solve the problem,” Weimer says. “Maybe you would detect the most egregious doctor-shoppers, which would be great, but then you’d have a lot of doctors who don’t know what to do with the information, or a lack of access to addiction services, or persistent pain that isn’t treated.” On top of that, says Peter Kreiner, principal investigator at the Brandeis center, people who become dependent on opioids have proven extraordinarily resourceful. “As some of the smarter people doing this behavior realize what’s being implemented,” Kreiner says, “they’d probably come up with new ways around it.”

Painkiller Overdose Deaths Are Rising, but Not Fast; Methadone Restrictions Credited

Posted on: September 16th, 2014 by sobrietyresources

September 16, 2014

According to government officials, powerful painkillers overdose deaths are raising but slowly and this could have been caused by new restriction which has been put on methadone. There have been more than 41,000 drug overdose deaths across US which are up from 38000 in the preceding year. 50% of these deaths have been caused by prescription or OTC medicines. The soaring overdose death rate for many years in the US was fed by prescription opoid painkillers. Of late these numbers are not rising fast according to a new report by CDC.

Opioid pain relievers are prescription drugs and in 2011 accounted for 17000 overdose deaths. This is three times the deaths which have been caused by heroin or cocaine. Death rates from some opioid painkillers, like OxyContin and Vicodin, have continued to rise steadily. The light in the tunnel is that there has been a slowdown in the rise of opioid painkiller overdose rates. In the periods in between 1999 through 2006, the rates were increasing by 18 percent each year. However from 2007 to 2011 it has been 3%. The major contribution to this fall has been the deaths tied to Methadone.

Methadone is prescribed for treating Heroin addiction and is also prescribed as an analgesic. The FDA had way back in 2006 warned Doctors that Methadone has potential for misuse and in 2008 methadone manufacturers decided to limit the distribution to hospitals and addiction treatment programs, Government is contemplating new measures to lower the overdose death rates with other opioid based painkillers. The first step has already been taken and from next month Vicodin and other medicines containing the opioid hydrocodone will become Schedule II drugs and prescriptions will be limited to a 30-day supply, and renewals will require a new written prescription. Next month a new Federal Rule will enable patients to return unused drugs like opioid painkillers to pharmacies for disposal.

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Is it Alcoholism?

Posted on: September 15th, 2014 by sobrietyresources

September 15, 2014
Monday on GTU Joey Douglass from LDS Hospital Behavioral Health talked about alcoholism and alcohol abuse. There are an estimated 8 million people in America dependent on alcohol and it’s not always clear to see when drinking has crossed the line from moderate or social use to alcohol abuse.

Alcohol definitely has a place in our society, if used appropriately. It’s used in medications, celebrations, cooking and religious ceremonies and can be harmless and enjoyable. The problem is that it has a high potential for abuse and dependence. Signs of abuse are often found when close relationships suffer due to frequent arguments related to drinking, physical fights, engaging in risky behaviors like drunk driving and a host of health problems and legal troubles like being arrested for a DUI or public intoxication.

The body can become physically dependent on alcohol which makes heavy and repeated use difficult to stop for the user, and a medical concern. Some signs and symptoms of withdrawals can be tremors (fine motor movements of the hands, tongue and even eye lids); diaphoresis (heavy sweating), tachycardia (fast heart rate), mood instability, and even delirium.

Help is available. Treatment options for Alcohol Abuse:
Seek professional medical treatment. Let them help you determine the best course of action. Detoxing from alcohol on your own can be dangerous and even deadly! According to signs and symptoms of withdrawal usually are apparent within 6 hours from the last drink but can occur sooner than this. Even if the blood alcohol level is still significantly elevated. Seizures and delirium can occur. Your medical team will decide the best treatment options to help avoid this.

After safely detoxed, continuing treatment is a necessity. The person needs to stay away from alcohol. Complete cessation with an active plan is the key to success and many people increase their success after detox when they participate in formal intensive counseling.

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CDC: Prescription Painkiller Overdose Deaths Have Quadrupled in US

Posted on: September 15th, 2014 by sobrietyresources

The U.S. Centers for Disease Control and Prevention (CDC) released a new report yesterday showing U.S. deaths from prescription painkiller overdoses have quadrupled since 1999. In the report, drug-related poisoning jumped from 1.4 per 100,000 in 1999 to 5.4 per 100,000 in 2011. The drugs that account for the most deaths were semisynthetic opioid analgesics, such as hydrocodone, morphine, and oxycodone.

Hydrocodone relieves moderate to severe pain as well as coughs. Morphine is commonly prescribed before or after surgery to help alleviate pain and oxycodone is used to relieve pain from injuries — as well as arthritis, cancer, and other conditions. From 2006 to 2011, deaths involving benzodiazepines increased an average of 14 percent per year, contributing to 31 percent of deaths. Benzodiazepines are anti-anxiety drugs that are used to treat panic disorders.

The report shows that in the last 10 years adults aged from 55 to 64 and non-Hispanic whites experienced the greatest increase in the rates of opioid-analgesic poisoning deaths.
The report said, “Drugs—both illicit and pharmaceutical—are the major cause of poisoning deaths, accounting for 90 percent of poisoning deaths in 2011. Misuse or abuse of prescription drugs, including opioid-analgesic pain relievers, is responsible for much of the recent increase in drug-poisoning deaths.”

Here are a few tips the CDC suggest to avoid drug overdosing or poisoning:

  • Never tell children medicine is candy to get them to take it, even if your child does not like to take his or her medicine.
  • Dispose of unused, unneeded, or expired prescription drug.
  • Never share or sell your prescription drugs.
  • Keep medicines in their original bottles or containers.
  • Turn on a light when you give or take medicines at night so that you know you have the correct amount of the right medicine.
  • Never take larger or more frequent doses of your medications, particularly prescription pain medications, to try to get faster or more powerful effects.

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Camden police have saved nearly 40 overdose victims using Narcan

Posted on: September 15th, 2014 by sobrietyresources

on September 15, 2014 at 4:36 PM, updated September 15, 2014 at 4:49 PM

Camden County Police Department Officers Edwin Cortez and Benjamin Patti have saved the lives of three more drug overdose victims over the last week using Narcan, authorities reported. On Sunday, Sept. 7, just before 2 p.m., Cortez responded to the corner of Broadway and Liberty Street where a man who had used heroin was unconscious and turning blue inside a vacant building, police said. Cortez administered one dose of Narcan and the man soon became responsive and alert before being taken to Cooper University Hospital for further treatment.

Cortez responded to another heroin overdose — at Broadway and Clinton Street — on the morning of Friday, Sept. 12, after being flagged down by a pedestrian. Cortez found a man lying on the ground unconscious in a vacant lot. He administered a dose of Narcan but the victim remained unresponsive. EMS arrived and administered a second dose before transporting him to Cooper for further treatment.

On Saturday, Sept. 13, around 10 a.m., Patti responded to the 1100 block of Baring Street where a man who had used heroin was unconscious in an alley behind a vacant home, police said. Patti administered two doses of Narcan, and the man began to regain consciousness after the second dose. He was then taken to Cooper for further treatment. With these three incidents, Camden County Police Department officers have now saved the lives of 38 overdosed drug users by administering Narcan.

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Three things you need to know about drug overdoses

Posted on: September 14th, 2014 by sobrietyresources

14 September 2014, 9.21pm PST

In 2012, 103,000 people around the world lost their lives to drug poisoning or overdose. As terrible as this waste of life seems, it’s important to remember that drug overdoses are not inevitably fatal. An overdose is when there’s too much of a drug (or combination of drugs) in the body for it to cope. You can overdose from illicit substances, such as heroin, or prescription medications, such as valium or opioid painkillers.

Overdose deaths in Australia claim an extraordinary number of lives; in 2012, fatal overdoses outnumbered road deaths for the second year in a row (1,427 overdoses to 1,338 road deaths). Such deaths are more likely in regional and rural areas than in capital cities. Perth has the highest rate of all capital cities, followed by Adelaide, Brisbane, Sydney and Melbourne. Overdoses are not just something that happens to young drug users. Australian Bureau of Statistics data provided to the Penington Institute (not available online at the time of publication) shows the number of middle-aged women dying from accidental overdose has more than doubled in a decade.

Indeed, women aged between 30 and 50 are now almost four times more likely to die of an unintended overdose than in a car accident. Heroin used to be the main cause of overdose during the late 1990s, but by 2007–08 prescription opioids accounted for 80% of the overdose cases admitted to hospital. In Victoria, for instance, coroner’s reports show pharmaceutical drugs have become increasingly common in fatal overdose.

This year, the Victorian Coroners Prevention Unit noted in a report to the Coroners Court that pharmaceutical drugs played a causal or contributing role in around 80% of Victorian overdose deaths between 2012 and 2013, whereas illegal drugs played a part in around 40%. The fact that pharmaceuticals could be causing more overdose deaths than illegal substances means that it’s possible for any one of us to encounter someone having an overdose, so here are three things you should know about drug overdoses.

1. Giving up drugs can increase risk of overdose
When someone uses a drug regularly, they develop tolerance to it. This means they need to use more to get the same effect. But if someone hasn’t been using regularly for whatever reason, including not being able to get drugs, their tolerance will drop. When people take drugs after a break from using, the amount they take could be too much for the body to cope with and lead to an overdose. Substantial evidence from a number of longitudinal studies indicates that the period immediately following release from prison and the period immediately following discharge from an abstinence-based rehabilitation facility pose a significantly elevated risk of overdose.

2. Snoring can be a sign of overdose
People often die from overdoses after family and friends notice them snoring loudly and leave them to “sleep it off”. The unusual snoring noise characteristic of an overdose results from a reduction in the size of the airway and in the volume of air able to move in and out of the lungs with each breath. Heroin and pharmaceutical opioids are depressants, so they relax the bodily processes. This means an overdose will cause breathing to slow. Left untreated, the brain struggles to function because of lack of oxygen, blood pressure decreases and the heart rate slows, ultimately leading to cardiac arrest. For people who are substance users, snoring is not normal. Rather, it may be a sign of a significant and life-threatening emergency – try to wake the person immediately. Other signs of an opioid overdose are:

  • blue lips or fingertips
  • floppy arms and legs
  • no response to stimulus
  • disorientation and
  • unrousable (can’t be woken up) unconsciousness.

3. It can take hours to die from an opioid overdose
Early reports of the death of Philip Seymour Hoffman had a police official saying it was clear the acclaimed actor died of an overdose because he had a needle in his arm. A statement like this can be a little misleading because an overdose from opioids does not cause the user to fall dead on the spot as they suggest. An overdose death can occur within minutes, but it often takes hours. This leaves a large window of opportunity during which a range of measures can be taken to save that person’s life. Calling an ambulance is the best thing you can do. Paramedics will have a drug called naloxone, which is a rapidly acting antagonist to heroin and related drugs. It is saving many lives that could be lost to overdose.

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