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Talking to loved ones about heroin

BY Dan Lustig

Last Modified: Feb 5, 2014 09:10PM

When an artist of great talent dies due to addiction, as did Philip Seymour Hoffman on Sunday morning, we have an occasion to talk with people we love.

Too often, it takes a tragic death to remind us of the importance of substance abuse treatment. And yet, contrary to the seeming message of that death, addiction is truly a preventable disease and a treatable medical condition.

Hoffman’s performance in “The Hunger Games: Catching Fire,” as the subversive Plutarch Heavensbee, made him visible to our kids — just as their generation struggles with drugs for the first time in their lives. His death can teach them — and us — a lesson.

With a needle in his arm, and dozens of bags of heroin in his apartment, Hoffman’s death represents both the drug’s resurgence and the many addicts we are seeing today. Just two days before he died, New York City police busted a Bronx-based distribution ring, finding 33 pounds of heroin worth $8 million, one of its largest finds on record.

Addiction has been the No. 1 killer in Illinois since 2006. The DuPage County coroner’s office says yearly heroin deaths there began climbing about six years ago, to the low-40s from the mid-20s. That is one every eight or nine days. Victims are overwhelmingly white males.

Hoffman said last year he had been clean and sober for 23 years, since his college days, but relapsed. His decline should bring attention to the heroin epidemic in Chicago’s suburbs. Addiction is a chronic relapsing disease.

Addiction affects all socioeconomic classes. Its grip on our children and on young adults is very strong.

The vast majority of kids start with unused, opiate-based, prescription painkillers from their parents’ medicine chests.

Once hooked, they seek inexpensive, small quantities of relatively pure heroin. Chicago is a heroin distribution hub. An extensive marketing network has evolved here to serve them.

Addicts seek heroin’s short-term effects. In the brain, it is converted to morphine. It rapidly binds to opiate receptors. Abusers typically report a surge of a pleasure sensation — a “rush.”

The intensity of the rush depends on how much of the drug is taken and how fast it reaches the brain. Then, the abuser feels drowsy for several hours, as heroin clouds mental function by its effect on the central nervous system. Cardiac function also is severely impacted as heroin slows breathing.

Kids in treatment say they are told that because of “purity,” addiction will not result. They snort, again because they are told it prevents addiction. They are wrong on both counts.

Addiction itself is one of the most detrimental effects of long-term heroin use. Once present, it often takes years to move individuals into recovery.

Families and loved ones often do not understand that concept. Concerned as they are, they often feel that once an individual enters treatment, they should be “cured.” But many individuals cycle in and out of treatment before reaching any period of sustained recovery.

The harsh reality is that there is no cure for addiction. There is only remission, not unlike to other chronic health-care conditions.

Death by heroin overdose is a particular risk, since no one knows what they are ingesting.

This makes it imperative that treatment, medication-assisted therapies and other support services are available when individuals require it, and that managed-care entities address addiction services comprehensively, as with other medical conditions.

Overcoming an addiction is extremely difficult, and especially so when loved ones, trying to help, seek a cure — often before the patient is ready for treatment.

If Hoffman’s death starts kitchen table conversations that help families, then some small good will have come of it.

Talk about drugs. Talk about heroin and addiction with your children. Start today.

Go to the National Institute on Drug Abuse website. Its “parents” section has many answers and provides language to help you speak with your children.

A generation of kids is experiencing drugs for the first time. Give yours the benefit of what we have learned. You might prevent another tragedy.

Dan Lustig, Psy.D., heads clinical programs at Haymarket Center, a nationally recognized substance abuse treatment facility.

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