Friday, August 21, 2015

Opiate addiction spreading, becoming more complex

iStock Photo yamatao

By Matt Swayne, Penn State News
August 17, 2015

UNIVERSITY PARK, PA.-- The growing availability of heroin, combined with programs aimed at curbing prescription painkiller abuse, may be changing the face of opiate addiction in the U.S., according to sociologists.

While heroin abuse is still relatively rare, the use of the drug is not only increasing, but it is now being coupled with the abuse of prescription painkillers, said Shannon Monnat, assistant professor of rural sociology, demography, and sociology in the College of Agricultural Sciences at Penn State. She added that the heroin-prescription drug combination is also hitting groups that were not traditionally viewed as widespread opiate users.

"One of the things we've found is that the simultaneous use of heroin and prescription painkillers together has increased dramatically among whites and especially among young white men," said Monnat, who worked with Khary K. Rigg, assistant professor of mental health law and policy, University of Southern Florida.

Monnat described the recent trend as a domino effect of addiction that began in the 1980s and 1990s when the over-prescription of painkillers led to an increase in addiction to those drugs.

"Over the last several years there have been more restrictions put in place, including prescription-drug monitoring programs and the introduction of a tamper-proof opioid, making it difficult to crush, liquefy and inject the substance," said Monnat. "What this has done is restrict access to prescription painkillers for people who previously became addicted to them. These people sometimes transition into heroin, which has become incredibly cheap and easily accessible."

Some addicts who were introduced to heroin also turn to abusing both painkillers and heroin at the same time. While most opiate addicts are still addicted to only painkillers, the number of addicts using heroin and the number of users who are addicted to both painkillers and heroin are increasing faster than painkiller-only abusers.

"You don't eliminate the addiction simply by eliminating access to the drug," said Monnat. "People who are addicted to the morphine substance will find a substitute."

The three groups of opiate abusers are distinct demographically, socioeconomically and psychologically, Monnat added. While heroin abuse is typically characterized as being a problem in black, poor and urban areas, an increasing number of heroin and painkiller-heroin addicts are white, employed and live in rural and small urban areas.

The researchers, who released their findings in Addictive Behaviors, currently online, said that people who are addicted to painkillers alone tend to be the most socially connected of the three groups. Painkiller addicts are also the least socioeconomically disadvantaged and have better physical and mental health.

Professionals who treat drug addiction should recognize the unique needs of each group of addicts, according to the researchers.

"It's not enough to know whether someone is just using a prescription painkiller, but the practitioner would also want to know if they are using heroin," Monnat said. "The use of heroin puts the patient at risk of all kinds of other complications, such as HIV and sexual risk-taking behaviors and a very high risk of overdose."

The researchers used data from the 2010-2013 National Survey on Drug Use and Health. Respondents in the survey were grouped in three categories: heroin only users, prescription painkiller only users, and combination heroin and prescription painkiller users. Prescription painkiller-only users were the largest group, with 9,516 respondents. Combination heroin and prescription painkiller users were the next largest group, with 506 respondents, followed by 179 heroin-only respondents.

Read more PennState News

Narcotic Addiction Study: Adults in Their 50s Now Largest Group Battling Addiction

The study, conducted by researchers affiliated with New York University's School of Medicine (NYUSoM) and New York University's Center for Drug Use and HIV Research (CDUHR), wanted to clarify and illuminate age trends in opioid treatment programs. The primary focus of the research was to explore these trends in the older adult population.

Michael Lowenstein, M.D.
"Addiction at any age is heartbreaking," says Michael Lowenstein, M.D., Medical Director for Waismann Method. "However, the emergence of this age group is particularly troubling. After almost twenty years of addiction treatment, we are acutely aware of the unique treatment requirements that can arise in this population because of their increased number of co-existing medical problems. We are committed to doing all we can to best serve our older patients."

Since 1996, the number of older individuals (age 50 to 59) seeking treatment programs for painkiller dependence and addiction has increased from 2,891 (7.8%) to 12,301 (35.9%) in 2012. Additionally, patients in the 60- to 69-year-old age segment have also increased significantly. The researchers believe that the upward trend in these populations will continue well into 2020 and beyond.

In addition to opioid and painkiller dependence, heroin addiction is another common cause for the patients in this age group to seek treatment. Researchers did not express speculation about why they believe this segment is growing the way that it is. It is clear that more research is necessary.

In sharp contrast to the growth of the 50- to 59-year-old segment, the segments of patients ages 40 and younger have dropped. In 1996, that group was around 56 percent, but by 2012 it had decreased to about 20 percent.

"This problem, specifically among older patients, is quickly reaching epidemic proportions," says Dr. Lowenstein. "The number of older adults who have substance abuse disorders and the rapidly rising number of these patients entering drug rehab is alarming. Now we must make available medically appropriate programs that can succeed in providing detoxification and drug treatment to this age group in a safe and compassionate manner."

Painkiller dependence is not new. Most states have stringent requirements and protocols in place for doctors to follow when prescribing Schedule II narcotics. However, there is still work to be done. It is not perfect and that is why it is so important for these patients to have ample access to medical opiate treatment centers like the Waismann Method® that can successfully and comfortably offer assistance to patients who need help with opiate addiction and dependence.

For nearly two decades, the Waismann Method has provided state of the art treatment for opiate dependence. Dr. Lowenstein is recognized internationally as a leader in medical opiate detoxification and rapid detox. He is quadruple board certified in Anesthesiology, Addiction Medicine, Pain Management, and Anti-Aging, Restorative, and Regenerative Medicine.

Dr. Lowenstein and Clare Waismann R.A.S. work alongside a multidisciplinary team to provide superior services from detoxification to a specialized aftercare, built exclusively for opiate dependent patients. Domus Retreat, an exclusive rapid detox recovery center and opiate specialized treatment center, offers clients the supportive, compassionate environment that those struggling with addiction need to transition from medical opiate detox to a healthy, fulfilling, drug-free life.

The entire staff at Waismann Method® is committed to providing exceptional care in patient recovery, through every step of the treatment journey. To learn more about the Waismann Method Treatment Center in its exclusive location based only in Southern California, please visit