heroin addiction & recovery 101 · understanding heroin addiction & recovery 101 a personal...

Heroin Addiction& Recovery 101One man's understanding

of the opium invasion

by Ron CalhounCopyright 2016

All rights reserved. No part ofthis publication may be reproduced,distributed, or transmitted in anyform or by any means, includingphotocopying, recording, or otherelectronic or mechanical methods,without the prior writtenpermission of the publisher, exceptin the case of brief quotationsembodied in critical reviews andcertain other noncommercial usespermitted by copyright law.

Copyright © 2016by Ron Calhoun

Ron CalhounHeroin Doesn't CarePO Box 675Independence, KY 41051

HeroinDoesntCare.org

This eBook is providedat no cost to you. Butplease, understand, it

isn’t free.The information in thiseBook has been paid forby thousands of brokenhearts and millions of

fallen tears fromcountless parents,

spouses and loved oneswho have loss someoneto a opium overdose.

While the content ispriceless, it came at a

tremendous price.

Understanding Heroin Addiction & Recovery 101

From injury to addiction – Dave was afirefighter with a major municipality. He

had "never ever tried pot.” Once in awhile,

he would have a beer. He was married,

had children, and loved being a

professional firefighter. Then he had an

accident. At the scene of a fire, he fell two

stories.

After several months of recuperation, he

was ready to return to his job. When Dave

had left the hospital he had been given a

prescription for an opiumbased pain

reliever. But there was a problem. Dave

developed a terrible flulike illness after he

stopped taking the pain pills. He returned

to his doctor who explained that he must

have become addicted to the prescription

medication.

But that couldn’t be possible. Dave had

been careful to follow the doctor’s orders

and take the physician ordered medication

exactly as instructed. But now his


doctor said there was nothing he could do

to help him.

In short, Dave has an accident related

injury, he took medication according to the

doctors instructions, became addicted to

the medication, and his doctor addressed

Dave’s addiction by telling him there was

nothing he, the doctor, could do. Some

months later Dave was arrested for

breaking into a house to get drugs.

Understand, Dave never took pills to get

high. First, he took them to dull the pain.

Next, he took the pills to avoid the pain of

withdrawing.

Dave is just one of thousands who have

become addicted to an opiumbased

prescription while following doctors orders.

Dave had nevereven tried pot


Prescriptions pain pillsA few years ago there were two types of

people who were being prescribed

opioidbased pain pills. (Opioidbased

means the basic ingredient is opium, which

is what heroin is made from) The first

group was people with legitimate illnesses

or injuries. The second were people who

misused the medications to get high and

either got prescriptions at multiple doctors

or pill mills.

Over time, many of the people with

legitimate illnesses accidentally became

addicted to the medication. Those

accidentally addicted to opioidbased pain

pills were still getting them from their

doctors even tho the pain was gone. But

that would change.

Realizing there was a problem states

enacted laws to monitor doctors who

prescribed opioidbased medications.


Abusers could no longer get prescriptions

from multiple doctors and quarterly blood

test proved the patients were taking the

pills and not selling them. Prescriptions

became harder to get.

In Kentucky the monitoring program is

called KASPER, which stands forKentucky All Schedule Prescription

Electronic Reporting.

As control of prescriptions tightened those

who had accidentally become addicted

along with those who purposely misused

the pills now had to find some other way to

maintain their addiction. Many were now

faced with buying pills on the black market

aka the street.

Mexican cartels jumped in and used this

opportunity to set up more elaborate heroin

distribution methods throughout the United

States. So we had two problems, first

prescriptions drug abuse, which lead to the

second problem, heroin abuse.


Side note: morepeople die from

prescriptionspain pills than

heroin.


AddictionAccidental and deliberate users werenow purchasing pills and heroin on thestreet.Opium (heroin) users don’t necessarily

become addicted from only one use.

Before becoming an addict your body

builds up a tolerance to the drug. At some

point, the user may experience flulike

conditions known as dope sick. Even users

who use only small amounts and only use

occasionally can build up a need for the

drug to avoid becoming dope sick. It

becomes necessary to use the drug so

they can feel normal.

At this point, when the drug is needed to

feel normal, the user is now an addict. Why

do I say that? Because stopping the use of

the drug will cause severe withdrawal, flu

like, dope sick conditions, therefore, they

will continue using the drug in order not to

go through withdraw.


The difference in the level of usage to feel

normal, or get high increases over time

with use. The user’s body builds up a

tolerance and will need more of the drug to

maintain the desired effect.

A problem arises because the level

needed to die from an overdose, is not

much higher than the amount needed for

the desired result (feeling normal or getting

high). We will call the amount needed for

an overdose the ceiling.

The difference from desired results to the

ceiling decreases over time so that user is

getting increasingly close to the overdose

ceiling.

People overdose from one of two ways.

For example, the victim passes out, lies on

their back, exasperates and chokes. But

the most common way is the victim has hit

the ceiling and the body becomes so

relaxed that the brain forgets to tell


the body to take a breath. An overdose

may last a number of hours because the

victim may still breath occasionally. Given

enough time, however, the body will die.

...the mostcommon way (tooverdose) is thevictim has hit

the ceiling andthe body

becomes sorelaxed that thebrain forgets totell the body totake a breath


Treatment and Recovery

Addicts need this narcotic to feel normal.

Not having the drug in their system causes

withdraw. The first step in recovery is to

cleanse the drug from the user's body by a

process known as detox.

Recovery starts with detox. But howhard is it to get into a detox?

According to aUniversity of Kentucky study:• For every 100 people who want to quit

and call for help, we only have help of any

kind for 24. Most are put on a waiting, but

76% will never get help.

• We can only help 24 of every 100 whobeg for help

• In Greater Cincinnati, it is estimated we

can only help 1 person out of 9 or 11%.

89% never make it off the waiting list.


A personal storyIn 2014 I attended an awareness event at

a park in Kenton County, Kentucky. A

young woman, mother of a twoyearold

daughter, came to the event and asks for

help. She explained that she had been

using pills and started using heroin. She

explained that she was not using a needle,

“yet.” She had gone to the local emergency

room (ER) and asks for addiction treatment

fearing, without treatment, she would soon

start injecting.

The ER told her, “You’re not bad enough.”

Where she ask what “bad enough” meant

they explained she wasn’t experiencing an

overdose at the time. She ask if they would

help her if she was overdosing and they

explaining they could keep her for three

hours and then she would have to leave.

The ER told her,

“You’re not bad enough.”


So now she has come to this addiction

awareness event to ask for help. Six

different awareness groups sprung into

action. People pulled out cell phones,

started calling detox centers. In the three

counties that make up “Northern Kentucky”

there is only one detox center, Droege

House. Droege House has a total of eleven

detox beds. Eight for men, three for

women, they had no openings.

The advocates kept calling. Fifteen

minutes later and still no detox bed. But

the young mother was assured an opening

would be found. Thirty minutes, calls were

now being made to other parts of the state.

Fortyfive minutes, they were now calling

Tennessee and still no room.

...they were nowcalling Tennesseeand still no room.


One of the advocates started to tell the

young lady that they were still trying. And

then it happened. The young lady who had

arrived at the event with a hopeless heart

with tears in her eyes was gone. She had

come to the event, begged for help, had

six groups trying to find her help, and she

had simply lost hope and walked away.

She had been told over, and over there

was no help to be found. She gave up.

Everythingstarts with

detox.


But what happens if you're one of thelucky one who gets into a detox center?

Even if the user can get into detox they

are still in danger. It is important to

understand after a successful detox the

users body has lowered its tolerance to

heroin. The overdose ceiling has also been

lowered now to an unknown level.

Therefore, if the person reuses any

amount they can die from an overdose.

After a user detoxes and the body has

reset it’s tolerance level (ceiling) the

desire to use the drug is still present.

Just like cigarette smokers who have daily

activities, which causes triggers to smoke.

Opium users also have daily triggers and a

psychological desire to continue using the

drug.

After detox the overdoseceiling is lower, but the

desire to use is still present


Time is needed to recoveryThe users body and brain must be given

enough time to recovery. The users mind

must be given enough time to heal and

learn how to respond to these triggers.

NOTE: A couple of days of detox and 30days of treatment is not enough time forsomeone to learn how to respond totriggers.

A recommended pathway to recovery is to

start with detox (7 to 10 days), after which

the client should be directed to a program

that teaches life skills perhaps a residential

program and/or the working of a 12 step

program. Detoxed clients should be

allowed to use Suboxone or Vivitrol for

longterm care. Suboxone and Vivitrolboth suppress the desires and cravingsof addiction, however Vivitrol blocks opioid

receptors in the brain so that users cannot

get “high” for approximately a 28 to 30 day

period. Either medication should only be

used under the direction of a doctor.


MedicationAssisted Treatment (MAT)and Behavioral Therapy

Suboxone and Vivitrol are two forms of

medicationassisted treatment. Doctor

supervised medicationassisted treatment

(MAT) gives the client’s brain time to heal

and time to unlearn triggers. Theimportance of time cannot be overstated.

How long should a person be on MAT?The answer is, as long as their doctor

believes it is needed. For some it may be

two weeks, others two years, and still a

few may have to take medication for the

rest of their life. The goal is, under the

supervision of a doctor, when the doctor

and client believe they are ready, they

should be able to gradually wing the client

off of the medication.

One challenge facing clients during this

period is living in the same conditions they


lived in before recovery. Daily triggers for

example, if clients have to go back to the

same neighborhood, in the same family, or

the same drug filled surroundings as

before, recovery is jeopardized. Therefore,

sober living facilities, for example, Oxford

House, allow clients to fully rehab and

reintegrate back into a successful

recovery.

When helping someone recovering from an

opium addiction, think long term.

Next, how soberliving facilitiesallow clients to

have needed time


Sober living facilities allow clients tolive in a house, have jobs and takeresponsibility for their lives.

Clients are expected to pay rent, contribute

to the purchase of food and maintenance

of the house. The house is expected to be

selfsustaining.

It has been learned that one of the triggers

of relapse is a client trying to deal with the

normal stresses of life. Paying bills, raising

kids, dealing with the death of a loved one

are enough to send many people into

experiences of depression or anxiety.

Recovering addicts are people too. They

have normal everyday problems, for which

they use to selfmedicate. Sober living

facilities allow clients to gradually take on

those responsibilities and those anxieties

and learn how to cope with them without

selfmedication. How long should you

“work a program?” The answer, as long as

you plan on being alive. Recovery is a

lifelong process.


The Transtheoretical Model

Stages of Recovery

Two wellknown alcoholism researchers,

reverse engineered the stages of

changing behavior. The researchers, Drs.

Prochaska and Diclemente started withpeople who had successfully recovered

from addiction and had been in recovery

for ten to twenty years. They started with

people who had succeeded and looked at

what had worked.

Drs. Prochaska andDiclemente started

with people who hadsuccessfully recoveredfrom addiction and had

been in recovery forten to twenty years.


The Transtheoretical Model

Stages of Recovery

They published the findings in 1983. The

model is called The Transtheoretical

Model (TTM).

The model has been updated over the

years. On the following page is a

breakdown of how I understand the model

and what it means in easy to understand

English.

Is this the ONLY model of recovery. No,

but it's a great place to start.

• Stages 1: Denial• Stages 2: Interruption• Stages 3: Acceptance• Stages 4: Determination• Stages 5: Action• Stages 6: Maintenance


Stages of Recovery• Stages 1: Precontemplation (Not Ready, Denial)No intention to take action.

• Stages 2: Interruption (Distraction, Wakeup call)

lost a job, lost family, overdose, arrested or others

problem – Dr. Jeremy Engel calls this, the Distraction

stage.

• Stages 3: Contemplation/Acceptance (GettingReady) They are starting to understand they have a

problem. They are “on the fence.”

• Stages 4: Preparation/Determination (Ready,decision time) This stage is still not recovery. It’s

thinking about and planning for recovery. They are

determined to commit to a plan of action.

• Stages 5: Action/Implementing the plan – Theyhave a plan and more importantly they are modifying

behavior. Finding a Detox is generally part of

your preparation while starting detox is part of Action.

They have started on the road to recovery. They are

working a plan and changing behaviors. They may

make a public commitment. They are “building a new

pattern of behavior”, which will take time.

• Stages 6: Maintenance – Person has been able to“sustain” new actions for at least six months. They

have a support system that helps them prevent

relapse. New, better behaviors are a part of their life.


Relapse is not a stage of

recovery in TTM but is seen as

a return to an old behavior.

You don’t need to go back to

the first stage because of a

relapse you can start at the

action stage. Also, going back

to the action stage is a good

way to strengthen maintenance.

Understanding Heroin

Addiction & Recovery 101

by

Ron Calhoun, Founder

Heroin Doesn't Care

[email protected]


Resources andWebsites

HeroinDoesntCare.orghttp://www.samhsa.gov/

Opioid Treatment Program Directoryhttp://dpt2.samhsa.gov/treatment/directory.aspx

MedicationAssisted Treatment (MAT)http://www.samhsa.gov/medicationassistedtreatment

SAMHSA.gov is the single most

important website and resource you

and I have.

Go to the SAMHSA.gov website & bookmark the page

Recommended reading

Dreamland: The True Tale ofAmerica's Opiate Epidemic

Book by Sam Quinones

Google Search:

"purdue pharma doj settlement"

http://www.samhsa.gov/

http://dpt2.samhsa.gov/treatment/directory.aspx

http://www.samhsa.gov/

http://www.samhsa.gov/medication-assisted-treatment

http://dpt2.samhsa.gov/treatment/directory.aspx

http://heroindoesntcare.org/

About the author

Ron Calhoun

Ron Calhoun is a videographer from Independence, Ky wherehe lives with his wife Donna. He was a professional entertainermost of his adult life but came off the road and started college atthe age of 52.

"They told me I was a non-traditional student, which for thefirst three months I thought meant I showed up and paidattention."

He double majored in public relations and electronic media withminors in journalism and sports marketing.

He is currently in production of a documentary web serierscovering opium addiction and recovery. He is the founder ofHeroin Doesn't Care, a nonprofit electronic media creator.

He has twice been presented the Chair's Award from NorthernKentucky University Department of Communication, College ofInfomatics, received a Blue Chip Media Award for ProfessionalDocumentary, and commissioned a Kentucky Colonel by thegovernor of Kentucky.

www.HeroinDoesntCare.Org/blog

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