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Date: November 22, 2024 Fri
Time: 11:57 am
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Results for heroin addicts
3 results foundAuthor: Kane-Willis, Kathleen Title: Understanding Suburban Heroin Use. Research Findings from the Reed Hruby Heroin Prevention Project at the Robert Crown Center for Health Education Summary: Mexican heroin production has increased significantly since 2002 from an estimated 6.8 metric tons to a production level of 50 metric tons in 2011 - a more than seven-fold increase in just seven years. This increase in production has made heroin more available in many areas across the country, including Missouri, New York, North Carolina, Illinois, Pennsylvania and South Carolina. Patterns of suburban heroin use have been reported nationally and in Illinois: - Though heroin use levels may be somewhat stable, use is increasing among young people in many suburban and rural areas, according to the US Department of Justice. - Illinois has seen an increase in young suburban users, evident in public treatment admissions and hospital discharge data. For example: Among 20 to 24 year olds, from 1998 to 2007, hospital discharges for heroin use among Chicagoans declined 67 percent but increased more than 200 percent in the Collar Counties. National survey and treatment data indicate increases in youth heroin use: - According to the National Household Survey on Drug Use and Health, initiations to heroin have increased 80 percent since 2002. - Among those ages 12 to 17, survey data indicates that nearly 34,000 youths initiate to heroin in a given year. - Among those ages 12 to 17, survey data indicates that nearly 3,753 youths used heroin on any given day, not necessarily for the first time. - Treatment admissions among those in their teens and their 20s increased by about 56 to 58 percent from 1996 to 2006. - The majority of youth aged 12 to 17 entering public treatment for heroin across the nation were white (76 percent), followed by Latinos (16 percent), with only 2 percent of those entering treatment being African American. - In Illinois, nearly 70 percent of youth under age 18 admitted to public treatment were white. Injection drug use is increasing among younger heroin users: - Over a ten year period, injection drug use has increased among heroin using teens by 94 percent, with about 70 percent of teens reporting injection currently. - Injection drug use among 20 year olds entering treatment for heroin increased by 110 percent, with more than three quarters reporting injection drug use. The academic literature has demonstrated some linkage between the usage of opiate pills to the initiation of heroin and survey data demonstrate that: - In 2008, over 900,000 12 to 17 year olds initiated to prescription pain pills. - While cannabis initiation trumps prescription pain pill initiation, (59 percent vs. 17.1 percent), the second most common illicit drug initiation was to prescription pain pills. Understanding Heroin Use, Addiction and Dependency Heroin has one of the highest dependency liability profiles of any licit or illicit drug--only nicotine ranks higher. As such, the fear the public may have about the increasing heroin use among young people is understandable. Of those who are offered heroin, about 20 percent will try it, and of those, 25 percent will proceed to dependency. The academic literature indicates that the life trajectory of heroin dependent persons is poor, with extremely negative outcomes. There is little information available in the literature on this emerging population of suburban heroin users. In order to build a profile of suburban heroin use and users, the researchers decided to use a "life map" approach. This approach allowed the research team to build profiles of suburban heroin users in order to better understand this growing population. Heroin Interview Findings Among the interviewees, the researchers found three pathways to heroin: 1. Pill Use to Heroin -- Use and dependence on opiate pills prior to using heroin (e.g. using heroin as a replacement for opiate pills when they were difficult to obtain) - One third of the sample was dependent on opioid pills like Oxycontin or Vicodin before transitioning to heroin. - One participant had become addicted after being prescribed Vicodin by his doctor. - Pill users' perception of heroin use were softened (e.g. they were less scared to try it) once they realized the connection between opioid pills and heroin. 2. Cocaine Use to Heroin Use of heroin to ease the effects of cocaine binges (e.g. using heroin to "come down" from the cocaine) o Users who binge on cocaine generally find that they require something to stop the cocaine binge and enable them to fall asleep. Roughly one-third of our sample initiated to heroin in this manner. 3. Poly drug use to Heroin - Poly drug use to heroin was the most common path to initiation among our sample, with just over one third initiating to heroin in this manner. Characteristics of Heroin Initiation - All of the interviewees first initiated use to heroin by inhalation - "snorting" or "sniffing" heroin. Most of the interviewees thought that heroin used this way was "less addictive" or had no addictive qualities at all. - The mean age of first use of heroin was 18.4. Three of the interviewees used heroin at age 15. - All of the interviewees, except one, transitioned from sniffing to injection. - One third of our sample began to use heroin while they were in high school.- Among the higher SES participants, heroin use spread throughout the high school peer group and many people became dependent. - The majority of those interviewed had little or no idea what heroin use dependence consisted of or the withdrawal syndrome associated with it. - Many became addicted quickly after initiation, but dependency was generally identified by another person (someone who was dependent). Interviewees thought that the withdrawal syndrome was the flu or some other illness. Interviewees had minimal drug knowledge: - The majority of heroin interviewees had little or no education regarding heroin use and dependency. - Many indicated that if they had known about heroin - (and other opioids) -addictive and dependency profile, they would not have become addicted. Characteristics of the Sample - More than 75 percent of the interviewees self-reported mental health disorders or exhibited symptoms of mental health disorders. - The high levels of mental health disorders - self-report or observed symptoms - indicate that one reason for using or continuing to use heroin was to ease these symptoms; thus selfmedication was common in most interviewees. - More than two-thirds of the sample exhibited sensation seeking behavior. Negative Experiences Related to Heroin Use Health Mortality rates for heroin dependent persons are extremely high. Over 50 percent of heroin dependent persons will be dead before the age of 50, with the mean age of death being 30. Overdose is a common danger that both novice and dependent users with extensive use backgrounds may face: - About one-third of the sample experienced multiple overdoses. - Two interviewees had friends who died from heroin overdoses. Heroin use causes major health problems, including heart disease, blood borne pathogens from injecting (HIV/HCV/HBV) and dental problems. Heroin dependent individuals have high rates of co-occurring disorders (COD), which makes them more prone to die from suicide than the general population: - One third of the sample suffered significant scarring from injection, amputation or limb damage as a result of injection drug use. - About half the sample had missing teeth, caused by the lack of saliva in the heroin dependent person. - At least three of the interviewees had been hospitalized for a serious event related to drug use including endocarditis, abscesses at the injection site, cellulitis and other infections. - Three of the participants attempted suicide on more than one occasion. Education, Employment and Housing - More than a third lost jobs due to heroin dependency. - More than half left educational programs due to heroin dependency (this includes high school and college). - Nearly half the sample experienced a period of homelessness. Crime Victimization - More than half of the female interviewees had been subject to a crime. Three were victims of violent sexual assault (all while living in precarious housing/homelessness situations). - At least one male was subject to a hold-up at gunpoint by other users. - Many of the interviewees indicated that they had been victims of other forms of crime, such as having money stolen during drug transactions, generally with other users. Criminal Activity As the heroin user becomes more dependent and loses employment, the normal trajectory indicates that the heroin dependent individual will commit crimes to support their habit. Generally these crimes are acquisitive crimes, which are crimes to obtain money. Violent crime is not common among heroin dependent users: - About 75 percent of the sample committed some form of theft¡Xincluding theft from parents, shoplifting, and burglaries. - Those who engaged in drug selling after their addiction did so to provide money for heroin. About half of our male interviewees engaged in drug selling. - Another way in which heroin dependent individuals in our sample paid for heroin was by giving other users rides to the city to purchase heroin. - More than half of the female interviewees engaged in sex work (prostitution) after they had become dependent on heroin. - More than 70 percent of our sample reported an arrest after becoming dependent on heroin. - About half of the sample had at least one felony conviction. - Nearly one-third of our sample experienced incarceration. More men than women (3:1) experienced incarceration after being dependent on heroin. Challenges Overcoming Addiction/Dependency Once heroin dependency is established, the life trajectory of heroin users tends to be one of treatment followed by relapse. This pattern generally continues throughout the individual's life: - The majority of our sample (80 percent) had been in some form of treatment more than one time. - More than half of the sample had used heroin in the three months preceding the interview. - About a third of the sample indicated that while they had not used recently, they would if they had the opportunity. Details: Chicago: Illinois Consortium on Drug Policy, 2015. 77p. Source: Internet Resource: Accessed September 15, 2016 at: https://www.robertcrown.org/files/Understanding_suburban_heroin_use.pdf Year: 2015 Country: United States URL: https://www.robertcrown.org/files/Understanding_suburban_heroin_use.pdf Shelf Number: 147872 Keywords: Drug Abuse and CrimeDrug Abuse TreatmentDrug OffendersHeroin Addicts |
Author: Kane-Willis, Kathleen Title: Diminishing Capacity: The Heroin Crisis and Illinois Treatment in a National Perspective Summary: National Trends - This rise of heroin use has been a major focus of concern among government agencies such as the Centers for Disease Control (CDC), the Substance Abuse Mental Health Services Administration (SAMHSA), and the Office of National Drug Control Policy (ONDCP) and data verify these concerns: - In 2013, the number of individuals (681,000) reporting past year heroin use was significantly higher than in 2007 (314,000), nearly doubling over the six year period. - In 2012, those entering treatment reporting heroin as this primary substance of abuse increased to 16% of all treatment admissions, the highest level since data collection began in 1992. - Heroin overdoses (poisonings) have nearly quadrupled from 2002 to 2013, with 8,200 deaths in 2013. Illinois Trends While heroin treatment episodes are reaching historic highs nationally, in Illinois treatment admissions for heroin are significantly higher than the nation as a whole, for example: - Nationally, heroin treatment admissions comprised 16.4% of total state funded treatment in 2012, while in Illinois heroin admissions make up one-quarter of all treatment admissions for the state, and are 56% greater than the nation as a whole; - In 2012, the Chicago Metropolitan Area percentage of treatment admissions for heroin was more than double the national average (35.1% vs 16.4%). - From 2006 to 2012, heroin was the second most common reason for Illinoisans to enter state publicly funded treatment, after alcohol. In 2000, it was the 4th most common reason. Heroin use is not only rising in urban areas area but is also dramatically increasing in rural and suburban counties. - In 2007, treatment episodes for heroin comprised just 4% of total publicly funded treatment in Metro East Illinois, but by 2012, heroin made up 18% of all treatment episodes - a fourfold increase in just 5 years. - In 2007, treatment admissions in Decatur for heroin comprised just 3% of the total, spiking to 23% in 2012, representing a 6-fold increase. - In 2007, treatment admissions in Peoria-Pekin for heroin were 7% and by 2012 it was 16%, a 119% increase. - Between 2007 and 2012, treatment episodes for heroin more than doubled in Bloomington-Normal and Champaign- Urbana from 5% to 11% and 6% to 13% respectively. According to survey data heroin use is increasing especially among young people in Illinois. - In 2007, 2.5% of Illinois youth reported using heroin in the past year, while in 2013, that number increased to 3.8%, a nearly 50 percent increase in just six years. - The greatest percentage increase occurred among females - a 90% increase over that time period. Males were more likely to report using heroin - nearly six percent in 2013. The Chicago Metropolitan Area ranks in the top for both emergency department mentions for heroin and number of individuals who were arrested and tested positive for heroin. - Arrestees from Cook County tested positive for opiates (including heroin) at a rate of 18.6%, higher than any other area in the nation. - Arrestees from Cook County also self-reported using heroin more times per month than those from any other jurisdiction, (26.8 days per month). - Arrestees from Cook County reported using heroin in the last three days more than those from any other region (15.7%). - The Chicago Metropolitan area ranked first in the country for the total number of mentions for heroin (23,627) nearly double the number for New York City. - Chicago also reported the highest number of heroin mentions among African American mentions (13,178), nearly four times more than New York City (3,463) and nearly 6 times higher than Detroit (2,311). - Among whites, only Boston had more ED mentions for heroin (10,045), but Chicago was second (7,024). - Chicago ranked highest in the number of ED mentions for both women and men. Adjusting for population, Chicago ranked 2nd highest in the number of mentions overall, behind Boston. Declining Treatment Capacity: Illinois in National Perspective While heroin use is increasing in every area of the state, there has been an alarming and dramatic decrease in treatment from 2007 to 2012. - Illinois ranked first in the US for the decline in treatment capacity over this period, a loss of more than half of its treatment episodes, 52% decrease over the five year period. - In 2007, Illinois ranked 28th in state funded treatment capacity, but in 2012 Illinois ranked 44th, or 3rd worst in the nation; only Tennessee and Texas ranked lower. - In 2012, Illinois's state funded treatment rate was (265 per 100K) more than 50% lower than the US rate. - When compared to other Midwestern states, Illinois had the lowest rate of state funded treatment. Minnesota's rate was 2.7 times Illinois's rate (982.1 vs 256.6), Ohio's rate was twice as high as Illinois, Wisconsin rate was 1.8 times greater, and Indiana's rate, which was lower than that for any Midwestern state, aside from Illinois, was still 43% higher than Illinois. Illinois State funding for addiction treatment decreased significantly: - From 2007 to 2012, General Revenue Funding decreased by nearly 30% ($111M vs $79M), while Medicaid funding decreased by 4% over this time period. - These decreases in funding continue in FY 16, where the proposed budget represents a 61% decrease in state funded addiction treatment; - Including Medicaid increases from FY13 to FY16, addiction treatment funding (including Medicaid), still dropped by 28% overall ($163M in 2007 to $116M in the proposed FY16 budget) Details: Chicago: Illinois Consortium on Drug Policy, 2015. 39p. Source: Internet Resource: Accessed September 15, 2016 at: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/ICDP.aspx Year: 2015 Country: United States URL: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/ICDP.aspx Shelf Number: 147874 Keywords: Drug Abuse and AddictionDrug Abuse and CrimeDrug Abuse TreatmentDrug OffendersHeroin Addicts |
Author: Kane-Willis, Kathleen Title: Hidden in Plain Sight: Heroin's Impact on Chicago's West Side Summary: The West side of Chicago may be mentioned in media reports, but in passing -- a place where suburban or increasingly rural users travel to in order to purchase heroin. However, Chicago's West side has not been spared from the health consequences of the heroin crisis, which are severe, significant and mostly silent. While the focus remains on suburban and rural users, the majority of hospitalizations for opioids (including heroin) and publicly funded treatment admissions data paint a different picture: In 2013, 80% of the State's heroin treatment admissions occurred in the Chicago Metro Area; Analysis of Illinois Department of Public Health Data indicate that the majority (67%) of total Illinois hospitalizations for opioids, including heroin, occurred in Chicago (2010 data) and 79% occurred in Cook County, while about 3% occurred in DuPage county (2,711) in the same period; West side hospitalizations for opioids, including heroin, comprised nearly 1 out of 4 opioid hospitalizations for the entire State (23%); West side hospitalizations make up 35% of the Chicago's total, compared to 7% for the North Side, and 20% for South side of Chicago; The majority of those hospitalized for opioids on Chicago's West side were Black (83%). Diminishing Capacity Illinois publicly funded treatment capacity has declined rapidly. This decline in funding impacts those across the state but particularly those in the Chicago Metro Area, and may have a disparate impact on Black individuals - especially those in areas like the West side -- who are attempting to gain access to treatment. For example: In just 5 years, from 2009 to 2013, the Chicago Metro Area lost 61% of its publicly funded treatment capacity compared to a state decline of 54%; Blacks entering publicly funded treatment for heroin from the Chicago Metro Area comprised 58% of the Chicago Metro Areas treatment episodes for heroin; The only area with a larger change in treatment episodes occurred in the Bloomington Metro area which experienced a 63% reduction in capacity from 2009 to 2013, while rural areas decreased by 39% and Peoria Metro remained stable. Mortality The image presented in news media and other forums suggests that heroin overdose is primarily a white problem, but analysis of Illinois Public Health data sets paints a different picture: The heroin overdose mortality rate was significantly higher for African Americans (8.94 per 100,000) than for whites (5.86). Latino deaths were too low to calculate a significant rate, but both white deaths and Black deaths increased rapidly between 2013 and 2014; Fifty-seven percent of overdoses among Blacks were due to heroin, while 37% of whites died from heroin overdoses. Chicago had the highest rate of heroin overdose (7.42 per 100,000) significantly higher than Suburban Cook (4.73), Will (5.42), Lake (5.55), McHenry (5.53), DuPage (4.72), Kane (2.86). Arrests and Neighborhood Disparity The majority of the attention paid to the West side in regard to the heroin crisis and use is policing, arrest and incarceration rather than health based solutions for heroin use disorders. These policy and policing decisions have an impact on not only the community but on our spending for the state. Even as arrests for heroin possession declined by 30 percent from 2010 to 2015 across the City of Chicago, the West side neighborhoods of West and East Garfield Park experienced an increase in the heroin possession arrest rate from 2010-2015; The four Chicago neighborhoods with the highest rates of arrest for heroin possession in 2015 include West Garfield Park (2,983 arrests per 100,000), East Garfield Park (1,925 arrests per 100,000), North Lawndale (1,375.58 arrests per 100,000) and Humboldt Park (per 100,000), which all located on the West side of Chicago compared to a City rate of 141 per 100,000; To put these arrest rates in context, the rate for heroin possession arrests in West Garfield Park (2,983 per 100,000) was more than 20 times higher than the rate for the city as a whole (141 per 100,000), East Garfield Park's was about 13 times higher than the city’s rate, North Lawndale 9 times higher and Austin (642 per 100,000) 4 times the city's rate; West Garfield Park's rate was 2,000 times higher than Lincoln Park's arrest rate (1.56 per 100,000) and compared to Hyde Park, West Garfield Park's rate of arrest was 766 times higher than Hyde Park's rate (3.89 per 100,000). In five areas of Chicago, no arrests for heroin possession occurred during 2015. Incarcerating individuals costs $25,000 per year, while jail time costs about $150 a day. As the state reconsiders its policies regarding both crime reduction, cost savings and reducing prison populations, it is important to recognize that providing treatment, such as methadone, returns $12 for every dollar spent. Imprisoning individuals with heroin use disorders, a health condition, is neither cost effective nor as effective as treatment in the community. Treatment in the community returns significant savings to taxpayers and societyi in public health and economic savings. POLICY RECOMMENDATIONS Increase Community Based Treatment Capacity - Particularly Medication Assisted Treatment According to analysis, Cook County has high treatment need and not enough providers for opioid use disorders, for example: In Illinois, for everyone 1,000 residents 3.8 people has opioid use disorders than could be treated under the current system. Currently Cook County can only treat about 15,000 individuals but the need is much higher than the system can accommodate currently. Create a Misdemeanor Classification for Small Amounts of Drugs Heroin and other opioids, no matter the amount, are currently felonies in Illinois but this is inconsistent with federal law, and many other states have created misdemeanors for personal use, for small amounts of drugs other than cannabis. Illinois policymakers have introduced legislation to reduce amounts under 1 gram from a felony to a misdemeanor. According to polling of Illinois residents, 78% of Illinoisan believe in reclassifying small amounts of drugs from a felony to a misdemeanor. Not only would this policy change help prevent the collateral consequences of felony convictions on those with substance use disorder, but it would yield a cost savings of $58M over three years according to a fiscal impact analysis conducted by the Sentencing Policy Advisory Council. Provide Methadone and/or Buprenorphine Maintenance in Cook County Jail and Create Linkages to Treatment Providers There exist a number of models, like the Riker's Island model in New York City, where individuals who are addicted to heroin or other opioids are provided with opioid agonist (e.g. methadone, buprenorphine) treatment in jail and then are linked to continuing methadone or buprenorphine treatment providers in the community. These programs have demonstrated great success in both lowering crime and retaining individuals in treatment - which is one of the biggest predictor of treatment success; Research demonstrates that methadone maintenance yielded better results than counseling alone for detainees in terms of one month and yearly relapse rates. Naloxone Dispensing in Different Environments Researchers have consistently demonstrated that more naloxone distributed in the community lowers the fatal overdose rate overall. In order to ensure that persons who are at high risk for overdose have access to naloxone (which is now covered by Medicaid as private insurance under Public Act 099‐0480), it is essential to ensure that it is more widely distributed under "standing orders," in the following settings: In the Emergency Department, hospitals should prescribe or distribute naloxone to individuals who have experienced overdose; In Treatment Centers and after Detox , according to the American Society of Addiction Medicine, naloxone education and distribution programs should be incorporated into the treatment system; In Cook County Jail, Cook County Jail is now launching a pilot to ensure that individuals have access to opioid overdose education and naloxone. This program should be expanded. Increase Access to Harm Reduction Practices Harm reduction practices are an excellent way to bridge the gap to reduce the health consequences of heroin use. Harm reduction practices include the following: Syringe exchange, including cookers, cottons and needles to stop the spread of blood borne pathogens and naloxone distribution; Housing First initiatives, which do not require complete abstinence from substances, before being housed; Safe use and consumption facilities, staffed with medical professionals to ensure that overdoses can be reversed as safe consumption facilities also reduce fatal overdoses in the community. Details: Chicago: Illinois Consortium on Drug Policy, 2016. 24p. Source: Internet Resource: Accessed September 15, 2016 at: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/ICDP.aspx Year: 2016 Country: United States URL: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/ICDP.aspx Shelf Number: 147875 Keywords: Drug Abuse and AddictionDrug Abuse TreatmentDrug OffendersHeroinHeroin AddictsNeighborhoods and crime |