Editorial

Cory Monteith Dies of a HeroinOverdose at Age 31

The news of the death of Cory Monteith spread very

quickly. He began to abuse marijuana and alcohol at

the age of 13 (McDonough, July 18, 2013). Cory beganabusing other drugs at the age of 16. By the time he

was 19, he entered his first treatment center. This

sad news made me wonder about the many nameless

addicts who are struggling with heroin addiction.

The Substance Abuse and Mental Health Services

Administration (SAMHSA) conducted a survey on

drug use and health in 2007. At that time, 9.4% of

the U.S. population aged 12 or older needed treatmentfor an illicit drug or alcohol use problem. Of the people

who needed treatment, 8.4% did not receive it. The

health care cost of heroin averages 11 billion dollars

a year. The overall cost of illicit drug use is 193 billion

dollars per year (National Institute on Drug Abuse,

2013a). The United States Department of Health and

Human Services considers the abuse of heroin to be

a chronic brain disease. The younger people arewhen they become addicted, the greater chance

for relapsing (National Institute on Drug Abuse,

2012). Approximately 40% to 60% of people have

a genetic vulnerability.

Heroin causes the release of 2–10 times the nor-

mal amount of dopamine in the brain. It is well known

that dopamine controls the reward and pleasure cen-

ters of the brain. The brain adapts by reducing thenumber of dopamine receptors in the reward circuit.

This in turn reduces the abuser’s ability to enjoy the ef-

fects. Heroin brings on a trance-like calm. The effects

Pain Management Nursing, Vol 14,

of heroin cause the brain to change over time, which

challenges the person’s selfcontrol (National Institute

on Drug Abuse, 2013b). Long-term use causes analtered amount of glutamate, which can then impair

cognitive functioning. In adolescents’ brains, the areas

that control decision-making, judgment, and self-

control are still developing. This makes them espe-

cially susceptible to risk-taking.

Effective treatment is complex, and no single

treatment is appropriate for everyone. Many drug ad-

dicted individuals also have other mental disorders. Be-havioral therapies are the most commonly used forms

of treatment. Medications may play an important

role in recovery. Methadone, buprenorphine, and

naltrexone are effective. The medications, given

after detoxification, suppress withdrawal symptoms

and relieve cravings (National Institute on Drug

Abuse, 2009).

Data about the effects on addicts’ families are notas well known. Many suffer from theft of their valu-

ables, automobile damage costs, shame, and feelings

of helplessness. It is difficult to separate how the ef-

fects of the drug are causing the addict to behave in

a different and negative way which differs from previ-

ous behavior.

Joyce S. Willens, PhD, RN, BCCollege of Nursing, Villanova University

Villanova, Pennsylvania

REFERENCES

McDonough, M. (2013, July 18). Cory Monteith, ‘Glee’

actor, dies at 31. Obituaries. The Washington Post. RetrievedJuly 18, 2013 from http://articles.washingtonpost.com/2013-07-14/local/40575328_1_cory-monteith-glee-s-finn-hudson.

National Institute on Drug Abuse. (2009). DrugFacts:Treatment approaches for drug addiction. Retrieved July 18,2013 from http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction.

National Institute on Drug Abuse. (2012). DrugFacts: Un-derstanding drug abuse and addiction. Retrieved July 18,

2013 from http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction.National Institute on Drug Abuse. (2013a). Trends & Sta-

tistics. Retrieved July 18, 2013 from http://www.drugabuse.gov/related-topics/trends-statistics.National Institute on Drug Abuse. (2013b). DrugFacts:

Heroin. Retrieved July 18, 2013 from http://www.drugabuse.gov/publications/drugfacts/heroin.

� 2013 by the American Society for Pain Management Nursing

http://dx.doi.org/10.1016/j.pmn.2013.07.004

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