How to stem heroin tide in North Idaho
Maureen Dolan and the Cd’A Press should be commended for her excellent and timely front page article on the topic of the frightening heroin epidemic. In my position as a treatment provider for individuals suffering from addictions, I have witnessed a recent surge in heroin use in northern Idaho. Anything that can be done to improve the conversation about this issue is a good thing. To that end it is important to add a few words about all opioids/pain medications and treatment of opioid addiction.
Opioids — substances related to opium — include drugs such as codeine, hydrocodone, oxycodone, Oxycontin, and heroin. This is important to know because the current heroin epidemic in this country and this state rides the wave of opioid pain medication use. Opioid pain medicines are typically indicated for short-term use. They are not effective for long-term control of non-cancer pain.
Unfortunately, a subset of individuals are prone, genetically or socially, to physical dependence on these medications. When a person dependent on these pain medications either runs out of the medications or is taken off them, painful withdrawal symptoms usually follow.
Heroin dealers, well aware of this phenomenon, wait in the shadows to offer relief. The black tar heroin they typically provide is not only less expensive than prescription opioids, it is also much more potent and addictive. Along with the increased potency of heroin comes the increased risk of death from overdose. Research indicates the vast majority of recent opioid and heroin overdose deaths have been accidental (if you have a family member or friend addicted to heroin or pain pills, ask your physician about nasal spray naloxone — a potential life-saving antidote to opioid overdose that may be administered by a lay person).
It is important to include in this discussion a few words about treatment of substance use conditions. Addictions, accurately diagnosed, are diseases and need to be treated as such. This is no longer a theory or a concept. By definition, diseases are conditions with recognizable signs and symptoms, consistent anatomical and functional changes, and identifiable causes. Scientific research has demonstrated addictive illnesses meet these criteria. The National Institute on Drug Addiction (NIDA) website is replete with data on the disease of addiction. This site also includes unbiased studies which demonstrate treatment for these conditions are effective.
Unfortunately, treatment of addictive illness is neither readily available nor sufficiently funded. Despite recent passage of parity laws mandating equal coverage of these conditions, insurance companies frequently deny authorization of benefits for addiction treatment. Legislation required to enforce parity has been slow in coming. Until the day when elected officials tackle this issue in earnest, treatment needs to be aggressively sought on a case-by-case basis.
In the greater Coeur d’Alene community, the Northern Idaho Crisis Center, (208) 625-4884 is available to assist patients in finding brief respite from this illness and potential referral to sources of help. Your primary care physician may provide valuable assistance, and hotlines such as the SAMSHA helpline noted in Maureen’s article can be of great help. The Kootenai Health Chemical Dependency treatment program, (208) 625-4848 may be contacted for additional information and help. Local hospital emergency departments are available in case of emergencies.
If you or yours are suffering from any form of addiction, please seek help.
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Eric Heidenreich, MD, is a Coeur d’Alene resident.