According to drug experts in that area the number of heroin seizures in the county increased by almost 800 percent in 2010. The staggering figures were shared in a town hall forum, organized to educate the public on the growing heroin problem.

To date, Chicago is the leading city in terms of the number of individuals addicted to heroin. The rising problem in DuPage County only helps to solidify Chicago’s leading role in the country.

Karen Notko, who has been with the Treatment Alternatives for Safe Communities program for the past 19 years, joined a panel of the State’s Attorney’s Office, law enforcement and addiction specialists to establish a call to action for the community to take part in reversing the trend.

Notko encouraged attendees to do their part in addressing the problem, arguing that education, prevention and treatment do work. She offered the help of her program to attendees who needed intervention.

DuMEG director, Steve Loan, noted that heroin is the teenage drug of choice and with an increase in the heroin supply; kids are experimenting more and more. As a result, some are overdosing and have no idea how powerful or deadly the drug can be. Even in situations where deaths are occurring, it doesn’t seem to be enough of a warning to get others to stop. The experts suggest the community will have to get involved to make a difference.
 

What Heroin is and How it is Used

The National Institute on Drug Abuse (NIDA) describes heroin as an addictive drug that is processed from morphine and usually appears as a white or brown powder, or a black, sticky substance known as “black tar.” Street names include smack, ska, H, and junk. Heroin can be injected, inhaled, smoked or taken orally. Injected heroin accounts for the highest percentage of male and female users, with 43 percent of male and 56 percent of female users choosing this route of administration. Inhalation ranks next, with 36 percent of males and 27 percent of females. Smoking, oral, and other routes of administration account for 11 percent, 5 percent and 1 percent (female) and 12 percent, 8 percent, and 1 percent (male), respectively.

Scope and Demographics of the Problem

Data from the 2007 Treatment Episode Data Set (TEDS) shows that in 2007, there were just over 1,600 adolescent substance abuse treatment admissions for heroin abuse. The average age at first use was 14.8 years and 16.3 years at admission to treatment. This indicates approximately 18 months of heroin use prior to treatment. Even more troubling, more than half (56 percent) of adolescent heroin admissions had at least one prior treatment episode.

The majority of the adolescent users were non-Hispanic whites (72 percent male and 83 percent female), followed by Hispanic (19 percent male and 11 percent female), non-Hispanic Black (4 percent male and 3 percent female). American Indian/Alaska Native, Asian/Pacific Islander and Other were 1 percent each for male and the same for female with the exception of 3 percent for other.

The NIDA-funded 2008 Monitoring the Future Study (available at the University of Michigan website at http://www.monitoringthefuture.org/) showed that 0.9 percent of 8th graders, 0.8 percent of 10th graders, and 0.7 percent of 12th graders had abused heroin at least once in the year prior to being surveyed. In 2008, 453,000 Americans age 12 and older had abused heroin at least once in the year prior to being surveyed by the National Survey on Drug Use and Health (NSDUH), available from the Substance Abuse and Mental Health Services Administration (SAMHSA) website.

Source of Referral to Treatment

In terms of referring sources to treatment for adolescent heroin abuse, the percentages show a different split. Criminal justice system accounts for 39 percent of adolescent male treatment referrals versus 25 percent for female adolescents. Individual/self is nearly equal, with 31 percent female and 30 percent male. In the next three referring sources, the percentages are higher among females: substance abuse care provider (21 percent), other caregiver (11 percent), and other health provider (9 percent). Among males, the respective percentages are 15 percent, 7 percent and 6 percent, respectively. School referrals were 3 percent for both male and female adolescents.

Other Substances of Abuse and Co-occurring Disorder

Another issue that deserves attention relative to prevention and treatment considerations is the TEDS statistic that 87 percent of adolescents reporting heroin abuse also reported abuse of other substances. Marijuana led with more than half (56 percent) of heroin admissions also reporting marijuana abuse. Cocaine was third with nearly one-third (32 percent) reporting cocaine abuse and almost one-fifth (19 percent) of adolescents reporting heroin abuse also reported abusing alcohol.

In addition, almost one-third of adolescents with heroin abuse also suffer from a co-occurring psychiatric disorder. Interestingly, male adolescent heroin abusers were less likely than female counterparts to have a co-occurring psychiatric disorder (27 percent versus 37 percent).

Why Teens Abuse Heroin

Heroin is relatively cheap and easy to obtain in many major American cities, suburbs, towns, and rural areas – especially since the introduction of Mexican black tar heroin in the 1990s and the proliferation of drug trafficking distribution centers across the country ever since. Short-term effects include an immediate surge of euphoria and clouded thinking followed by alternately wakeful and drowsy states. You can recognize a heroin addict by the “nods” – where the eyes drift close and the head slumps forward.

Mexican black tar heroin is significantly cheaper than white or brown powdered heroin – and many times more potent. It’s also a steal compared to opioid painkillers such as OxyContin and Vicodin.

Medical Complications of Long-Term Use

Chronic heroin abuse has numerous long-term medical consequences. Users who inject the drug face increased risk of scarred and/or collapsed veins, abscesses (boils) and other soft-tissue infections, liver or kidney disease, and bacterial infections of the blood vessels and heart valves.

Lung complications, including various types of pneumonia and tuberculosis, often result due to the poor overall health of the heroin abuser as well as from the depressing effect the drug has on the respiratory system.

Another danger is that many of the additives in street heroin may include substances that do not readily dissolve and result in clogging of the blood vessels leading to the brain, kidney, liver, or lungs. This may cause infection, or even death, of small patches of cells in the body’s vital organs. Immune reactions to these and other contaminants may cause arthritis and other rheumatologic problems.

Sharing of injection equipment or fluids can also lead to some of the most severe medical consequences of long-term heroin use: infections with hepatitis B and C, HIV/AIDS, and many other bloodborne viruses. Not only will these infect the abuser, but they may also be passed along to sexual partners and children.

Heroin Abuse Can be Fatal

In terms of classical conditioning, a person tries heroin, likes the euphoria, tries the drug again and again, builds up tolerance, requires more of the drug and more often, and becomes dependent or addicted to the drug. Whenever he or she tries to get off the drug, withdrawal symptoms occur within hours. These are accompanied by intense and unrelenting cravings for the drug that push the individual back into using.

When a heroin addict uses the exact amount of the drug that they normally use, but the surroundings are different than normal (environment), or he is injected when he is not expecting it, or the purity level of the heroin is more potent than anticipated – death can occur in an instant. It is estimated that about 1 percent of heroin addicts die each year after injecting their normal dose. This is nothing short of Russian roulette. You never know when the next dose may kill you.

Treatment for Teen Heroin Addiction

As with any heroin addict, treatment cannot begin until the individual undergoes complete detoxification to eliminate the drug from the body. Medically-supervised detox assures that the patient receives round-the-clock attention and care to help minimize withdrawal effects. Following detox, the patient can then begin a personalized treatment program that has been created according to their individual needs.

Most treatment programs for heroin addiction, including those for teens, consist of individual counseling and group therapy sessions, as well as educational lectures, learning how to identify triggers, developing effective coping mechanisms, sessions on relapse prevention, and aftercare. Family treatment is also crucial in helping to prepare the family for the teen’s return to the home environment.

Prevention Programs

To be most effective, prevention programs need to be targeted at adolescents before the probable age of first use (the age of 14).
In addition, treatment professionals should thoroughly examine the types of programs they provide to adolescent heroin abusers. If the adolescent client is at least 16 years old and has parental consent, the use of opioid maintenance therapy may be recommended – in addition to cognitive behavioral therapy. Treatment Improvement Protocols (TIPs) from the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), cite experts in the field that say buprenorphine should be the treatment of choice for adolescents with short-term heroin addiction.

Age-appropriate relapse and recovery services should potentially also be required both to promote and sustain recovery for adolescent heroin abusers.

Prevention programs should include family-based, school, and community prevention programs.

• Family-based prevention programs – Since family bonding is the bedrock of healthy, enduring relationships between parents and children, family-based prevention programs should parenting skills; practice in developing, discussing and enforcing family policies on substance abuse, and training in drug education and information. Parents need to know how to effectively monitor and supervise their children to prevent drug abuse, learn about substance abuse so that they are up-to-date on the harmful effects of these drugs, and adopt changes to parenting behavior that can reduce later risks of drug use in their children.

• School prevention programs – Prevention programs can be designed for use in pre-school and elementary school – to get a jump on creating the awareness about the harmful effects of drugs. Reinforcement of these messages with continuing substance abuse prevention programs in middle school and high school is also necessary. Such programs in the upper grades should focus on reinforcement of anti-drug attitudes, drug resistance skills, strengthening personal commitments against drug abuse, communication, self-efficacy and self-assertiveness, study habits and academic support, and peer relationships.

• Community prevention programs – Research shows the benefits of consistent community-wide messages of drug prevention programs. Community prevention programs aimed at specific populations – such as key transition points between middle and high school – offer benefits even among high-risk families and children. Two or more effective programs, such as school-based and community-based, may be more effective than a single prevention program. Community prevention programs may occur in multiple settings: the media, clubs, schools, and religious organizations, among others.

Teen Heroin Abuse Affects Many People

When a teen abuses heroin, it isn’t just the teen that suffers. Teen heroin addiction causes major harm to the lives of many people – family members and friends included. Often, this results in lifelong hurt and irreparable damage to relationships.
In addition there are the other problems that are strongly rooted in heroin addiction: robbery and burglary, teen pregnancy, legal and social difficulties, and major illness (in addition to heroin addiction).

Imagine a teen who first started using heroin at age 14 and increased use to a point where injecting the drug occurred daily for about 18 years. The result is a person whose life is a never-ending pursuit of smack, body wracked and ruined, relationships strained to the point of breaking, and a seriously warped psychological outlook. Does this sound incredible? It isn’t. Real-life stories such as this are vividly documented on series such as Addicted and Intervention.

The fact is that without treatment, a heroin addict – any heroin addict, teen or adult – will continue to deteriorate until they wind up institutionalized, in jail, or dead. It’s as simple and as bleak as that. But treatment can be effective – if the addict genuinely wants to quit the downward spiral and commits to getting and remaining clean and sober.

Prevention and Treatment – Both Are Necessary

In the end, there’s no single solution to teen heroin addiction. But the combination of consistent prevention messages and programs along with effective treatment can go a long way toward helping to reduce the problem.

When the Partnership for a Drug Free America launched anti-heroin campaign in the mid-1990s, the rates of heroin abuse were dramatically reduced. It is widely believed that there’s a generational forgetting that occurs, in that one generation that hears and absorbs the anti-drug messages is succeeded by another that has not heard such messages (because they don’t exist or the focus is on another drug) and is enticed to try the drugs.

Is it necessary to scare our kids into pledging never to try drugs? Scare is not the appropriate word to use, but educating them on the dangers of drugs and alcohol is not only a wise preventive parental practice – it is also an effective one. Couple parental-based prevention programs with those in the school and the community, and there’s an excellent chance that heroin (and other addictive substances) will once again fade into the background. For those who are addicted, effective treatment programs continue to offer the best hope for recovery.

Newsday recently published a piece that examines the habits of a heroin user, signs of abuse and how to find treatment options. Jeffrey Reynolds, executive director of the Long Island Council on Addiction and Drug Dependence suggests that parents look for patterns in their child and go with their gut.

Teens using heroin will often display irritability, anger, unusual sleeping patterns and dramatic mood swings. While these things can also be common in normal teenagers, parents have to be tuned in to pick up on what is normal and what is out of place. If any of these things is accompanied by a sudden change in friends, the disappearance of household valuables and late nights, immediate action should be taken.

Teens who are dealing with a serious addiction will need to spend a week in a detoxification center. This will allow their withdrawal symptoms to be controlled and smoothed by medication.

Once the detox step is complete, both inpatient and residential rehab centers are available to treat the teen. Stays can range anywhere from one week to 18 months, depending upon the severity of the problem. Once the teen has completed this stage, he or she is generally recommended to outpatient treatment, counseling and even self-help groups.

An important thing for parents to remember is that teen addicts are often swift to resist treatment, even if they acknowledge they have a problem. An intervention can be an effective move, but can also cause significant damage if not handled correctly. Reynolds recommends that families seek professional advice and even help before attempting an intervention with their teen.