‘A nightmare nobody wants to live’

Skyrocketing use of heroin by suburban residents is number one health care crisis

UNION COUNTY — The skyrocketing use of heroin and other opiates has become the number one health care crisis confronting New Jersey. Drug overdose deaths now surpass the number of deaths from motor vehicle accidents.

Statistics never lie, especially when it comes to the influx of this street drug into suburban communities.

In 2013, for instance, 16,652 residents from suburban towns throughout the state sought treatment for heroin addiction compared to 10,765 urban residents.

The state has not turned a blind eye to this epidemic. Recently a task force on heroin and other opiate use by youth and young adults tackled the issue head on, producing a comprehensive report, “Confronting New Jersey’s New Drug Problem,” an action plan the task force hopes will address this alarming rising heroin and opiate epidemic. Whether it does, depends heavily on changing the perception of opiate and heroin abuse.

One thing made crystal clear by the task force’s findings is that first and foremost this is a new kind of drug crisis, one affecting countless young people previously thought to be at low risk of addiction.

For example, the staggering number of admissions to state-licensed or certified substance abuse treatment programs due to prescription drug abuse has increased more than 200 percent over the last five years, and nearly 700 percent over the last decade. Of even more concern is that 40 percent of opiate admissions for treatment involved those 25-years-old or younger.

Although much has been done in recent years to respond to this emerging crisis, such as Project Medicine Drop, which encourages citizens to properly dispose of unused medications before they fall into the hands of adolescents, much remains to be done, the state said.

It is noteworthy that last year Gov. Chris Christie signed into law the Overdose Prevention Act, which will save lives by taking the stigma away from those seeking medical help when an overdose occurs. The law says that when someone is trying to help another who is suffering from an overdose, they will not be penalized for any potential drug use of their own.

The governor also announced an historic plan to ensure “parity” in mental health and substance abuse treatment benefits for more than 200,000 members of the School Employees Health Benefit program. This plan should serve as a model for wider reform to ensure access to affordable mental health and substance abuse treatment for those in need.

While these steps are critically important, the state report noted, there is much left to do.

Hearings held by the state task force in 2012 and 2013 brought out heartbreaking testimony from parents who lost their children to a heroin or opiate overdose, parents trying to save their children, young people in recovery, addiction and law enforcement professionals and all those with a stake in this alarming increase in the use of heroin and other opiates. It was an eye opener for the task force charged with addressing this heroin and opiate epidemic.

“The lessons learned from the grieving parents who mustered the courage to share their tragic stories were especially important, not only in revealing problems without the current system and practices, but also in highlighting the human aspects of this public health crisis,” the report noted.

No one knows the unbearable, unremitting pain of losing their child to a heroin overdose more than Cheryl Stankov of Mountainside. This mother watched helplessly as her 24-year-old son George slipped further into the alluring world of heroin addiction, eventually dying of an overdose in April 2013 in Times Square.

Stankov is not afraid to use her name, or have people learn of the terrible addiction that took the light of her life away. What she does want is for parents to listen to her warning about how pain killers for herniated spinal discs led to the death of her boy. And when he could not get prescriptions drugs any longer he did what most do when addicted and turned to street heroin.

George was in and out of rehab centers, but because the rules only allowed him to be treated in-house for 28 days at a time, it was not enough to save his life.

For Stankov, the death of her son, a young man that had such promise, was devastating.

“It was a nightmare nobody wants to live,” she said. But the death of her son led to her working with a non-profit group called City of Angels, which helps addicts get the rehab they need. Although heroin took her son, Stankov only has to walk into her front yard to find solace. A tree planted in George’s memory gives her strength to go on. If she should waver for a moment, a stone at the bottom of the tree reminds this loving mother “We only part to meet again.”

According to the state report, understanding the various pathways to heroin abuse is vitally important because it helps lay the groundwork for stopping this epidemic that has hit New Jersey and Union County hard.

“We see at least two distinct routes that need to be cut off,” the state report said, pointing out that one pathway starts with people who use opiates prescribed for someone else. Some of this abuse can be traced to the increased availability of prescription drugs found in household medicine cabinets.

“For countless generations, parents have understood the need to lock the liquor cabinet to prevent their teenage children and their party guests from gaining unauthorized access. Today parents must recognize the need to take precautions against raiding of the medicine cabinet,” the state report said.

Another distinct pathway to heroin abuse arises in the course of actual medical treatment, which leads to these patients resorting to various means to maintain their supply of medications that initially were prescribed to alleviate pain.

From lying to physicians and doctor shopping, to prescription fraud and purchasing the same medications on the street, when all these options are exhausted, the state found these abusers turn in desperation to other opiates that are more affordable and available.

From there it is a short, perilous trip into the world of cheap, pure heroin. But, in order to understand the effect heroin has on the body, one must visualize what takes place when this drug is inhaled or injected.

Heroin is the most fast-acting of all opiates. When injected, it reaches the brain in 15 to 30 seconds; smoked heroin reaches the brain in 7 seconds. The peak experience through this route lasts, at most, a few minutes, according to the U.S. Centers for Disease Control and Prevention. The surge of pleasure starts in the abdomen, and a warmth spreads throughout the body, creating intense euphoria, and a period of tranquility follows that lasts up to an hour.

Experienced users will inject between two and four times a day. Higher doses of heroin normally make a person sleepy, and at higher doses still, the user will nod off into a semi-conscious state. The effects usually wear off in 3 to 4 hours, depending on the dose.

Although the urban legend is all heroin users became addicted after trying the drug once, it is just a myth, according to therapists and physicians LocalSource spoke with throughout the investigation for this series of articles.

Regular heroin abuse can and does lead to tolerance, which means it will take more and more of this opiate to achieve a high, which makes heroin overdose and death a constant risk.

Understanding heroin addiction means knowing just how quickly the drug can overpower the body, taking over the core processes in the brain that control pleasure and discomfort, according to heroin.com, a New Jersey resource network on heroin.

The first step in overcoming heroin addiction is drug detox, the process of cleansing the body of the harmful toxins found in heroin. There are two primary types of heroin detox: natural and medical.

With the natural process, a person goes “cold turkey,” ceasing all intake of the drug entirely and allows their body to readjust. With this comes very uncomfortable withdrawal symptoms that often lead to relapse.

Medical detox usually involves the use of methadone, a synthetic opiate given in gradually smaller doses until the individual overcomes their addiction to the physical addiction of heroin.

However, even with all the willpower in the world, most therapists maintain almost no one can break the cycle of heroin addiction on their own. Professional help, usually in the form of a heroin rehab program, is the most comprehensive form of heroin addiction treatment.

Most heroin rehab treatment programs feature three core components: detox, which is treating the physical addiction to heroin; counseling addressing the psychological dependence on the drug; and aftercare, which aids in coping with life after heroin.

For those fortunate enough to come to terms with their heroin addiction, the standard 30- to 60-day treatment plans are often not enough to bring about the desired recovery results.

In the case of these individuals who have a long history of relapse or are a danger to themselves, there are long-term rehab programs that offer a much more deliberate and comprehensive approach to treating the disease.

But even after an addict recovers, there are daily hurdles that stand in the way of their sobriety.
Long term residential treatment centers for teen drug abuse provide a safe, supervised, highly structured recovery environment. Therapies combined with professional clinical services address addiction and living skill problems for teens with a diagnosis of substance abuse.Treatments include high level professional case management designed to address the particular addiction and impaired living skills needed, including substance abuse counseling, educational and community support services.

However, the biggest hurdle for the county, state and country remains building public awareness. The state report pointed out that past campaigns were highly successful in that they stigmatized heroin and opiate abuse.

“Today, however, we must not only repeat and reinforce that traditional anti-drug message, but go further by explaining to the public the connection between prescription pills dispensed by trusted pharmacists and heroin sold by a street dealer,” the state report said, adding the problem they face in presenting that message is compounded by the widely-held stereotype of what a person addicted to opiates looks like.

“Many of the New Jerseyans whose lives have already been affected live in quiet tree-lined neighborhoods. Their stories defy the conventional stereotype of heroin abuse,” the state report pointed out.

Jane, 19, of Westfield, lives in such a neighborhood. Her name was changed to protect her privacy. She is the daughter of a well respected, very well-to-do attorney and stay-at-home, hands-on mother. This teen lived a life many envy. Yet this perfect cocoon of protectiveness was no match for the dark addiction that grabbed a hold of their family and dragged them into hell.

Jane, in recovery for well over a year, readily confessed that those dark days of mainlining heroin is a memory that is hard to shake, as is the urge to use again. It is always there, lurking, luring, and urging this teen to come back to the euphoria, comfort and oblivion this opiate provides.

Nothing will ever quite be the same for this family that, at one point, almost collapsed under the strain of blame, fear and helplessness. This teen admitted the stigma of heroin abuse kept her from seeking help from anyone, especially her parents.

“The stigma of heroin abuse is not something that is easily changed,” she said, adding, “when people think of a heroin addict they have a picture in their mind of someone living on the street, not a teenager living in a house that costs $800,000.”

“It’s a dirty secret here in towns like mine and others. Well, wake up suburbia, your kids are dying. They are in their bedrooms with the plush carpet and big screen TV blaring while injecting heroin they bought from a guy who could have raped or killed them. They are scared, helpless, and afraid. Open your eyes, I beg you,” said Jane, who overdosed once and came very close to dying.
Since then, this teenager has worked to ensure other teens see the reality of recreational drug abuse.

“Teenagers don’t understand that prescription drugs can lead to heroin use. They live in the moment and then it’s too late, they are hooked,” said the Westfield resident.

“Everyone needs to face that this is no longer a problem that only happens in inner cities like Newark. It is happening here in towns like mine and yours to good kids, good families,” said Jane, adding, “heroin addiction is a disease, an epidemic that will destroy not only your children, unless you start talking about it.”

Therapy is working for this teen who once had a dream of being an attorney like her father. Today the only “dream” she has is making it through one more day without heroin. Every day, she pointed out, is another step forward. Therapy has helped her stay on course and come to terms with why she fell into opiate abuse.

“Don’t fool yourself. This can happen to your kid. It is happening in all those good places where money is supposed to buy you happiness. Here is a wake up call – money can’t buy you happiness and it can’t protect your kids from going down the same road I did,” said the teen, adding “if you don’t believe me, then leave that prescription for Vicodin in the medicine cabinet. It’s a time bomb and you don’t want to take a chance that it might go off.”

The state report pointed out that the message that needs to get out must be targeted at those in society who are least likely to read their report or any other report about opiate addiction and heroin.

“It is tragically ironic that when parents believe that their households are beyond the reach of heroin traffickers, their children may be at greater risk of falling prey to heroin addiction.

These families fail to recognize their vulnerability and that, in turn, makes it more likely that they will not take affirmative action in their households to prevent and deter abuse, and more likely that they will not recognize the red flags of opiate abuse if and when it invades their world,” the state report said.

NEXT WEEK: Where to get help and cracking down on heroin traffickers.