WILMINGTON – Director Orman Hall of the Ohio Department of Alcohol and Drug Addiction Services spoke to drug court participants and concerned citizens at this week’s Clinton County drug court hearing to explain how people become addicted to opiates and why the problem is widespread.
Hall said any and all drugs that people may become addicted to produce euphoria, which occurs by increasing dopamine in the brain.
The more people use drugs to get that feeling of euphoria, the more tolerant of the drug they become, Hall said.
“An early-stage alcoholic might consume a six-pack of beer on a daily basis, but a later stage alcoholic might consume the hard liquor equivalent of a case (of beer),” he said. “That is about a one to four ratio from the standpoint of early-stage to late-stage alcoholic.”
In the case of opiate addiction, Hall said a typical opiate user may consume 30 milligrams of the opiate the first couple of times they ingest the drug.
The more a person uses an opiate, though, the more tolerant they become. Hall said one patient a fellow doctor worked with ingested 1,000 milligrams of opiates every day.
“Around 100 milligrams (of opiates) could potentially be a lethal dose,” Hall said.
People use a lot of heroin because of the intense high they get while on the opiate, he said.
“If somebody uses heroin, they have an intense high that lasts for a very brief period of time,” Hall said. “That rapid-acting mechanism for heroin … is what drives people to use more and more.”
If a person is used to taking 100 milligrams of opiates and then stops using for a month, when they go back to using, their tolerance will be gone.
“They are at serious risk of overdosing,” Hall said.
About 85 to 90 percent of people who are addicted to heroin have said they were first exposed to opiates through prescription drugs, which may or may not have been prescribed to them, he said.
“There are still some economic incentives for the health care system to use opiates,” Hall said. “I think we really need to take a step back.”
In 1997, people were using 11,000 grams of opiates per 100,000 population, Hall said. In 2011, that jumped to more than 90,000 grams per 100,000 population.
Overdoses have also increased, he said. In 1979, there were less than 200 people who overdosed. In 2014 that number was 2,500, with 500 overdoses being accounted for by fentanyl.
“There are now more people in treatment for opiate addiction than are in treatment for alcohol,” Hall said.
There are many different things available besides treatment centers for people to get over their addictions. Three medications – Methadone, Buprenorphine and Naltrexone – can all help heroin addicts get over the addiction, Hall said.
Methadone is one of the most studied medications and has been around since the 1970s.
“When used appropriately, it is highly effective,” he said.
To counteract heroin’s fast-acting high, Methadone lasts a long time, he said.
“It’s very useful in terms of treating … people who have significant long term history with heroin,” Hall said.
Like Methadone, Buprenorphine is also a safe and long-acting opiate, counteractive to heroin, Hall said.
Naltrexone, or Vivitrol, is different than both Methadone and Buprenorphine because Naltrexone is a shot instead of a pill.
The shot helps block the opiates from reaching the brain.
“It is a very effective medication, especially in drug court settings,” he said.
The federal government, Hall said, is taking steps to make sure addicts have access to the three different medications to help them get over their addiction to drugs.
“I think this is an appropriate position,” he said. “Drug court and treatment medication is a winning combination for those people … who are struggling with opiate addiction.”
The Clinton County You-Turn Recovery Docket is looking for new participants. Applications can be found online at you-turn-drug-docket.org.
Reach Dylanne Petros at 937-382-2574, ext. 2514, or on Twitter @DylannePetros.