Cocaine addiction may not be something anyone would set out to develop, but the reality is that too many people have developed this addiction and lives are lost as a result. Doctors and scientists continue to focus on research to better understand the addiction and potential treatments, but there is still much work to do.

A recent Science Daily release focused on a story that explored the pharmacological strategies for reducing the self-administration of cocaine. This study focused on animals to identify the potential in treatments for adults.

The primary excitatory neurotransmitter in the brain is the glutamate. This neurotransmitter has been identified more than once as the key to drug addiction. This element is also an important piece to learning and memory. Receptors involved in the glutamate have been identified as potential targets for drug addiction recovery methods.

In a study of rats by scientists at The Scripps Research Institute, it was determined that glutamate antagonists changed into opposite directions during the development of addiction. This pathway helped to better explain what happens during the transition from casual cocaine use to addiction.

If the right glutamate receptors can be targeted in treatment, recovery may hold more promise for cocaine addicts. Study authors do warn, however, that such treatments may only be effective in early stages of cocaine abuse.

It is also important to note that all types of cocaine use and abuse are not alike. When cocaine exposure is done to different extents by different users, different adaptations may occur in the brain systems. Further research must be conducted to identify one method in a number of potential addicts.
 

For those who find it increasingly difficult to stay awake – despite an appropriate amount of sleep – medication may be introduced for treatment and relief. While such an approach can help to improve the outlook for the individual, no medication is without risk and the individual should be fully informed before starting any type of regime.

One such medication is modafinil, which is the generic drug for the brand name Provigil. This medication is prescribed for individuals wishing to improve wakefulness when excessive sleepiness is present. It is a common medication given for individuals suffering from narcolepsy or other sleep disorders. Modafinil works well in such situations as it is a wakefulness-promoting agent.

It is not totally clear as to why modafinil helps individuals to be more awake, although it is assumed that the drug alters the natural chemicals in the brain known as the neurotransmitters. It has been shown to effectively stimulate alertness and can improve functioning of the frontal lobe of the brain. The medication’s ability to stimulate and improve functioning was different than standard stimulants.

This medication has been known to cause dependency and even addiction in certain users and therefore individuals must assess dependence risks versus benefits of the medication before taking it long term. Likewise, even if the medication will only be used in the short term, gaining more information is a good idea.

In some situations, modafinil has been used to treat ADHD and early studies showed significant promise. In one clinical trial, however, one child – out of 933 – developed a life threatening skin rash, known as Stevens Johnsons Syndrome. While it is argued that the rash was not a result of the medication, the FDA refused to approve the use of the medication in the treatment of ADHD.

Doctors are not held to the standards of the FDA, however, in their prescribing practices. While the FDA forbids manufacturers to advertise their product in the treatment of any condition that has not been approved, doctors can prescribe the medication if they believe it is the right fit in the situation. This “off label” prescribing provides more leverage for the doctor and greater options for the patient.

Interestingly, modafinil has also been prescribed for the treatment of cocaine addiction, although it has not been approved for such uses and studies are still relatively small on the impact the medication can have for those addicted to cocaine.

Modafinil does affect the brain’s reward center, which highlights its potential for dependency and abuse. One NIAAA study stressed that additional research should be conducted as it is still unclear as to the potency and risk involved in taking modafinil long term.
 

Maybe you think smoking a little weed now and then is harmless. Perhaps your children told you this or perhaps you smoked marijuana when you were growing up. What’s wrong with getting a little buzz to take the edge off? Marijuana isn’t addictive, is it?

Well, contrary to proponents of legalization of marijuana, the truth is that smoking marijuana can lead to an addiction to the substance in some individuals. But not everyone who tokes on a joint becomes addicted. Let’s look at the facts.

THC and Other Ingredients

The main component of marijuana is delta-9-tetrahydrocannabinol or THC. Marijuana is a mind-altering drug that also contains some 400 additional harmful chemicals, including known carcinogens. And much of the marijuana available on the street is laced with addictive drugs such as PCP. Unless you’ve got a prescription for medical marijuana, you never really know what you’re getting.

But the THC in marijuana today is much more potent than that available in the 1970s. Today’s pot delivers the desired effect in record time. Beyond elevating mood and relaxation, and depending on the level of THC in it, marijuana today may cause users to experience euphoria, hallucinations, and paranoia.

Marijuana is the Most Commonly Abused Drug

Marijuana is the most commonly abused illicit drug in the United States today. Despite calls for legalization, raw marijuana remains a Schedule I Controlled Substance. That makes it against the law to possess or use marijuana – although penalties and enforcement varies. Adolescents are generally introduced to marijuana by their friends in elementary or junior high school. Many graduate to smoking pot from using inhalants. Peer pressure plays a big part in adolescents’ use of marijuana.

But it feels good – and everyone’s doing it, say your teens. Don’t buy it.

Marijuana, Alcohol and Other Drugs

After being introduced to marijuana, many teens use it in combination with alcohol and other drugs. Any one of these can prove addicting, especially in individuals with a vulnerability to addiction (a genetic predisposition) but, taken together, the combination can increase the risk of addiction.

Marijuana’s Therapeutic Use

In a number of states, marijuana is available with a prescription for medical use only. There are stringent requirements for medical marijuana dispensaries, and much controversy surrounding the issue. Nevertheless, there are therapeutic benefits from smoking marijuana or taking prescription THC in pill or suppository form for people who have chronic diseases causing intense and unremitting pain such as cancer or for cessation of nausea in those undergoing chemotherapy. There are other conditions that are considered appropriate for marijuana prescription, and these are spelled out in state laws.

Long-Term Use Can Lead to Addiction

Drug craving and withdrawal symptoms can make it extremely difficult for a marijuana smoker to stop using the drug. Just saying you’ll stop smoking is one thing. Going through with it is another. Users report feeling irritable, anxious, unable to sleep, and increased feelings of aggression.

To avoid unpleasant withdrawal symptoms, users resume smoking marijuana. The longer a person uses marijuana, the more likely he or she is to use more of it and more often. This is classic addiction, according to many scientists and researchers.

Marijuana Abuse Can Be Treated

Most marijuana abusers or those who are addicted can benefit from professional counseling, including behavior modification therapy. This may occur in individual and/or group sessions. There is currently no medication approved for treating marijuana abuse.
 

Substance abuse is a widespread and serious problem in society today. An estimated 17.8 million Americans aged 18 or older are current illicit drug users. Of this number, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), an estimated 12.9 million people (72.7 percent) are employed either full or part-time. The number of unemployed illicit drug users increased from 1.3 million in 2007 to 1.8 million in 2008, primarily because of an overall increase in unemployed persons. Think about the implications of 12.9 million people working today that are using (and abusing) illicit drugs. If you are an employer, there’s a very good likelihood that you have one or more of these drug-using employees.

It’s tough for employers to know where to turn and what to do about drug use in the workplace, but one thing is certain: if you don’t do anything, the situation will only worsen, and may result in tragedy, legal problems, fines, economic loss or other consequences. Clearly, then, it is in the best interest of employers to create and implement a comprehensive drug-free workplace policy and provide employee assistance for or referrals to appropriate substance abuse treatment facilities.

Who Abuses Drugs in the Workplace?

Surveys by the federal government have identified the following as drug users in the workplace. The drug user tends to be:

• Male
• Between the ages of 18 and 25
• White
• Less educated
• Divorced or never married
• Low paid

Which Industries are Most Affected?

While drug use in the workplace is not limited to any particular industry, some industries stand out as having the most numbers of drug-using employees. These include:

• Food preparation workers
• Bartenders, waiters, and waitresses
• Construction workers
• Other service occupation workers
• Material moving and transportation workers

Costs to Employers as a Result of Substance Abuse

Alcohol and drug-abusing employees cost billions of dollars in lost productivity, injuries, and medical costs each year. Just one employee that is chronically hung over or slipping out to do drugs on a break or at lunch can wreak havoc in the workplace. Multiply that by several employees, and you can really have a problem.

It is estimated that problems directly related to alcohol and drug abuse cost American businesses $81 billion in a single year. Research studies of drug-abusing employees show that they function at only 67 percent of their normal capacity.

Accidents and fatalities increase with substance-abusing employees. Up to 40 percent of all industrial fatalities and 47 percent of industrial injuries can be linked to problems with alcohol use and alcoholism. As for drugs, employees who use drugs are 3.6 times more likely to be involved in an accident in the workplace and 5 times more likely to file a workers’ compensation claim than non-drug using employees.

Absenteeism and employee turnover increases dramatically with substance abuse. One shocking statistic is that an estimated 500 million workdays are lost each year due to alcoholism. Drug-using employees are 2.2 times more likely to ask for time off or early dismissal, 2.5 times more likely to have absences of 8 days or more, and 3 times more likely to be late for work. In terms of employee turnover, illicit drug users are more than twice as likely as those who do not use drugs to have changed employers three or more times in the past 10 years.

Medical costs to employers for substance-abusing employees also increase. It costs employers about twice as much in medical claims for drug-using employees as non-drug using employees.

How to Decrease Substance Abuse Impact in the Workplace

Among the many things employers can do to decrease the impact of substance abuse in the workplace, perhaps the most important first step is to implement a drug-free workplace program.

You may know that, in 1988, the Drug-Free Workplace Act was passed requiring all federal grantees and some recipients of federal contracts to agree to provide a drug-free workplace as a condition of receiving any federal money. In such a drug-free workplace, all employees are required to adhere to a program of policies and activities that are specifically designed to provide for a safe workplace and a drug-free environment. Key to the policies and activities is that they discourage alcohol and drug abuse while encouraging substance abuse treatment, recovery, and return to work for employees who have problems with substance abuse.

It is important to note that, even if your company or organization is not required to have a drug-free workplace program, you can still benefit greatly from implementing one.

Drug-free workplace program components may include the following:

• Having a written policy
• Providing employee education
• Requiring and providing supervisor training
• Giving employees access to assistance
• Drug testing

The U.S. Department of Labor advises that while a drug-free workplace program can be effective without all five of the aforementioned components, employers should at least explore all five when developing such a program.

Program planning and philosophy are important to the development of an effective drug-free workplace. Some companies and organizations focus on identification or detection, apprehension, and discharge of those who use drugs, wielding a law enforcement model that treats such employees as criminals. Other companies focus more on performance and emphasize deterrence and assistance because they view employees who use alcohol drugs as impaired but otherwise capable employees. Experts say that the best drug-free workplace programs strike a balance between the two different types of philosophies. On the one hand, employers want to send a clear message, and on the other hand, they want to encourage employees to seek assistance if they are experiencing problems with drugs or alcohol.

Sometimes this balance is difficult to achieve. It involves adroitly navigating elements that are often competing. These include the rights of employees and the rights of employers, the need to know and rights to privacy, detection and rehabilitation, and respect for employees and the safety of all.

Benefits of a good drug-free program include decreases in absenteeism, accidents, downtime, employee turnover, workers’ compensation costs, and employee disciplinary problems. Other benefits that may result from a good drug-free program include increases in productivity and profits, customer satisfaction, health status, and employee morale.

Steps to Implementing a Drug-Free Workplace Program

In order to implement an effective drug-free workplace program, employers have a few basic steps to follow. These include delving into the following:

• Assess the nature and extent of alcohol and drug use in your organization.
• Develop and implement an alcohol and other drug abuse prevention policy.
• Choose and employee assistance program (EAP) that suits your organization’s needs.
• Develop and implement employee education and supervisor training.
• Evaluate the effectiveness of an alcohol and other drug abuse programs in terms of cost and human factors.
• Understand the technical, legal, and employee relations aspects of alcohol and other drug testing.
• Identify signs and symptoms of alcohol and other drug abuse.

In addition, it may be helpful for employers to research what other similar organizations are doing and determine what resources are available, collaborate and cooperate with workers, assess your current situation as well as determine any special needs, and determine whether any state or federal laws apply.

Uninsured Workers and Substance Abuse

In its February 2010 issue, The NSDUH Report (http://www.oas.samhsa.gov/2k10/177/177EmpNoIns.htm), from the National Survey on Drug Use and Health (NSDUH), states that more than 18.4 million full-time employees in the U.S. aged 18 to 64 (15.5 percent of full-time adult workers in that age range) have no health insurance. Of this number, an estimated 3.0 million uninsured full-time employees (16.3 percent) needed substance use treatment in the past year. Specifically, 13.3 percent needed treatment for alcohol use, 5.6 percent for illicit drug use, and 2.7 percent for both alcohol and illicit drug use.

Of the uninsured full-time workers who needed substance use treatment in the past year, 12.6 percent (378,000 individuals) received treatment at a specialized facility. The remaining 87.4 percent needed treatment but did not receive it, including 6.6 percent who recognized they needed treatment and 80.8 percent who did not perceive a need for it.

Contrary to what many in the general public may believe, uninsured adults are not mostly unemployed or part-time workers. In reality, the more than 18 million adults working full time who had no health insurance represent more than half of all nonelderly uninsured adults.

With the Health Care Act signed into law by President Barack Obama in March 2010, employers will be required to provide health insurance for employees, or face penalties in the form of fines. How the specifics of the coverage work out have yet to be determined – even if the new health care law is allowed to stand after pending legal challenges, or whether it is ultimately repealed.

Who pays for substance abuse treatment is one part of the health care equation. Another, and perhaps even more compelling part, is the necessity for such treatment.

How Do Employers Measure Success?

In today’s tough economic times, it’s easy to want to dismiss anything that costs a significant amount of money and/or involves a great deal of time and effort. But substance abuse (drugs and alcohol) are critical barriers to any organization’s overall success – not only in terms of profits, but also in terms of public and private perception and image and employee morale, productivity, and stability. In essence, you get what you pay for.

Give adequate time for the drug-free workplace program you implement to begin showing results. You should be able to see whether or not it’s effective within a year or so. Be sure to get guidance from experts so that you’re looking at the right set of criteria to measure effectiveness. You can always add to the program, building upon the successes you achieve along the way.

Resources for Employers

There are many resources for employers available through the following links:

• Cost Benefit of Substance Abuse Prevention – Includes links to SAMHSA/CSAP Workplace Managed Care Financial/Cost Research Evaluation Guide, Peer Support Program Cost Analysis, What’s the Return on Investment: Workplace Managed Care, Resource Guide to Costing Workplace Managed Care Programs, Review of Return on Investment Studies, and Cost Interview Guide for Internal Employee Assistance Program Case Studies

• Making Your Workplace Drug-Free: A Kit for Employers – Provides credible, authoritative, evidence-based information, resources and tools for producing and maintaining drug-free workplace policies and programs. The kit was assembled by the Division of Workplace Programs, in the Center for Substance Abuse Prevention, SAMHSA, U.S. Department of Health and Human Services. The kit guides employers through the process of understanding legal requirements (federal, state, and local statutes), building a team, assessing the workplace, developing a policy, planning and executing a program, and evaluating a program.

• Workplace Resource Helpline – 1-800-WORKPLACE or 1-800-967-5752 – The Workplace Helpline is a toll-free, confidential consulting service which provides technical assistance and guidance in developing and evaluating programs and policies designed to address alcohol and drug problems at work. The Helpline is staffed by trained workplace specialists that can help design a program to meet employer’s specific workplace needs. Consultation is provided on policy development, drug testing, supervisor training, and employee education and employee assistance programs. The service is provided free by the Center for Substance Abuse Protection (CSAP).

• 10 Most Frequently Asked Questions – The 10 most frequently asked questions of the Workplace Resource Helpline cover: What is an ideal policy for employers to adopt to successfully deal with substance abuse in the workplace? Is there a sample or model policy my company can use to develop an effective drug-free workplace program? Can I legally require my employees to take a drug test? If I suspect one of my employees is using drugs, can I require him to take a drug test? How should I determine which employees to include in a random drug testing program? My company received a contract from the federal government. Do I have to drug test my employees? How should I deal with an employee whose drinking is affecting job performance if the employee is covered by the Americans with Disabilities Act? Do I have a responsibility to provide rehabilitation? Where can I find Drug-Free Workplace Program training for my supervisors in my community? Can my company use non-certified laboratories for drug testing? How much advance notice should I give my employees before implementing a Drug-Free Workplace Program? For the answers to the questions, go to the link.

• Laws and Regulations – Available through the U.S. Department of Labor, this website includes links to help employers become familiar with state and federal laws that impact when, where, and how they can implement a drug-free workplace program. Areas covered include state laws, ADA and Rehabilitation Act, Family and Medical Leave Act, and other federal laws.

• Drug-Free Workplace Advisor – Also available through the U.S. Department of Labor, the elaws Drug-Free Workplace Advisor assists users to build tailored, drug-free workplace policies and provides guidance on how to develop comprehensive drug-free workplace programs.

• Institute for a Drug-Free Workplace – Formed in 1989 by four companies, today the Institute for a Drug-Free Workplace consists of nearly 100 major businesses and organizations, including many of the largest U.S. companies. It educates employers, employees, legislators, public officials, the courts, media and the public at large about: the dangers of substance abuse; the impact of substance abuse on the workplace; the most appropriate, effective and legally acceptable means for employers to address substance abuse; rights and responsibilities of employers and employees; legislative, regulatory, and legal developments, and the role of the employer in a national effort to combat substance abuse and its debilitating effects.

The popularity of cannabis in Australia appears to be growing, according to a recent ABC News report. The National Drug and Alcohol Research Centre has shown a dramatic increase in the number of long-term cannabis users being admitted to the hospital.

The Centre has found that the number of Australians seeking treatment with cannabis-related problems has increased 30 percent since 2002. The increase in the rate of harmful use was mostly found among those over the age of 30.

Overall, the good news is that the rate of cannabis use has been dropping. In the past year, roughly 9 percent of Australians have smoked the drug, down from 11 percent in 2004. The challenge is that according to researchers at the University of New South Wales found those who are using the drug are using a larger quantity and using it more often.

Amanda Roxburgh, senior researcher at the university’s National Drug and Alcohol Centre, reports that the rate of harmful use of the drug has dramatically increased, particularly among those within the 30 to 49-year-old sect.

“We’re seeing an increase in cannabis-related harms, particularly hospital admissions, for things like cannabis dependence in particular,” she said in the ABC News. “And we’re seeing particularly in 30 to 39-year-olds, the admissions have increased quite a bit, as have the 40 to 49-year-old age group. What we think that reflects is a longer-term use over a long period of time.”

Roxburgh also highlighted that hospital admissions are generally for individuals seeking treatment for cannabis dependence, although a small number do seek help for cannabis intoxication or cannabis-induced psychosis. Old users are twice as likely to report daily use compared to the 14 to 19-year-old age group.

When it comes to addiction, the never-ending search for the high is relentless. As addiction claims the user’s body and mind, everyday existence consists of thinking about using, getting the drug, using, and then thinking about using some more. Two drugs that are much in the news lately are responsible for a lot of heartache across America. One is OxyContin, a legally-prescribed Schedule II controlled substance pain medication commonly abused, while the other, black tar heroin, is an illegal Schedule I narcotic for which there is no approved medical purpose. Both are highly addictive, and both have serious side effects and long-term consequences. When black tar heroin is substituted for OxyContin, however, the results can be deadly.

Let’s take a look at each drug in more detail.

What is OxyContin?

OxyContin is a brand name for the prescription narcotic painkiller oxycodone. Oxycodone is a long-acting, strong pain reliever (opiate-type) similar to morphine and is prescribed by physicians to treat moderate to severe chronic pain (such as cancer pain). The medication is intended to be used for severe pain that is expected to last for a long time. It is not intended to be used for mild pain, for pain that will go away in a few days, or for prevention of pain following surgery.

Side Effects – Oral OxyContin has numerous side effects which may include: constipation, drowsiness, dizziness, dry mouth, headaches, increased sweating, and lightheadedness, loss of appetite, nausea, weakness, and vomiting. Some of these side effects may decrease after the patient has been using the drug for a while. Patients who experience persistent or worsening symptoms are urged to talk with their physician or pharmacist immediately. In addition, older adults may be more sensitive to the drug’s side effects – especially shallow, slow breathing and drowsiness.

Warnings – OxyContin warnings include the advice that patients who are prescribed the drug for severe pain should take it as directed by their physician and not on an as-needed basis. The drug should only be taken (60 milligram, 80 milligram, or 100 milligram tablets) by persons who already have been taking moderate to large amounts of high-strength medication such as morphine. When a person who has not been used to such potent medication begins taking OxyContin, serious and possibly fatal breathing problems (such as shallow and very slow breathing) can occur.

Oral OxyContin should be swallowed whole. Broken, crushed or chewed tablets may release large and possibly life-threatening amounts of the medication into the body.

Who Should Not Take OxyContin – Individuals with any of the following conditions should not take OxyContin:

• Taking any habit-forming drugs

• Misuse or excessive use of drugs

• Abnormal nervous system function affecting mental alertness

• Abnormal heart rhythm

• Abnormally low blood pressure

• Addison’s disease

• Asthma attack

• Bile duct tract spasm

• Brain lesion

• Chronic lung or breathing passage problem

• Enlarged prostate

• Epileptic seizure

• Gallbladder disease

• Head injury

• High pressure within the skull

• Inflammatory bowel disease

• Intense abdominal pain

• Liver problems

• Mood changes

• Narrowing of the tube that empties urine from the bladder

• Pregnancy

• Severe bloody diarrhea from antibiotics

• Significant decrease in lung function

• Slow heartbeat

• Stomach or intestinal tract operation

• Suicidal thoughts

• Toxins from microorganisms causing diarrhea

• Underactive thyroid

Withdrawal Symptoms – As with any narcotic that has been used excessively or for a long period of time, cessation of use generally causes a variety of withdrawal symptoms. Cessation of OxyContin use may produce: diarrhea, difficulty sleeping, irritability, runny nose, and stomach cramps. To prevent withdrawal symptoms in patients who have been prescribed OxyContin for severe, chronic pain, the doctor may gradually reduce the dose or change the medication.

Interactions – OxyContin may interact with other drugs or herbal products taken at the same time. Interactions may not always occur, but they can increase the risk of serious side effects or cause medications not to work properly. The following products may interact with OxyContin: cimetidine, pain medications (opiate partial agonists such as butorphanol, nalbuphine, pentazocine), and naltrexone.

The risk for serious side effects (shallow or slow breathing or severe dizziness or drowsiness) may increase if this drug is taken with other drugs or products that affect breathing or cause dizziness. This includes alcohol, anti-seizure drugs (such as phenobarbital), anxiety or sleep medication (such as alprazolam, diazepam, and zolpidem), muscle relaxants, narcotic pain relievers such as codeine, and psychiatric medications (such as amitriptyline, risperidone, thioridazine, and trazodone).

Allergy medications and cough or cold products may also contain ingredients that cause drowsiness.

Addictive Potential – OxyContin, a Schedule II controlled substance, has an abuse liability similar to morphine. It is often involved in criminal diversion. Abuse and addiction to OxyContin can occur, especially when used for non-medical purposes and/or in conjunction with other psychoactive substances. This risk increases among persons who abuse alcohol and/or other drugs, or have abused them in the past. Doctors advise that patients take the medication exactly as prescribed in an effort to minimize the potential for addiction. Patients should never give (or sell, trade or otherwise share) their prescription OxyContin to others.

Overdose can occur, which can prove fatal. Symptoms of overdose may include cold/clammy skin, slow/shallow breathing, limp or weak muscles, loss of consciousness, pinpoint pupils, severe dizziness, and severe drowsiness progressing to the point of stupor or coma, and slow heartbeat. If overdose is suspected, contact a poison control center or hospital emergency room department immediately.

Deaths due to overdose of OxyContin have been reported when the drug was abused and misused by ingesting, inhaling or injecting the crushed tablets. Risk of fatal overdose is further increased when combined with alcohol use and/or other central nervous system depressants (including other opioids).

What is Black Tar Heroin?

Heroin is an illegal Schedule I narcotic. There are different variations of heroin throughout the world, differing in quality, strength, imperfections and additives, and color. Among the various types of heroin that are popular, there are two types predominant among drug users in the United States. On the East Coast, South American “white” heroin is most popular, while on the West Coast and increasingly across the country, Mexican “black tar” heroin is the drug of choice.

Sometimes referred to as “muck,” “negro,” or “pigment,” black tar heroin has a black, sticky, hashish-like, non-powdery consistency, although it may also appear as a dark-orange or dark-brown powder, often adulterated. Black tar heroin is less expensive than white heroin, but has effects (highs) that are the same. Black tar heroin is produced primarily in Mexico. Mexican cartels and drug trafficking organizations (DTOs) are flooding the United States with black tar heroin.

Through the use of ingenious marketing campaigns where the drug peddlers come to the clients instead of vice-versa, Mexican black tar heroin has rapidly gained a foothold in this country. Black tar heroin is cheaper by far than OxyContin, whose street cost per pill can be $80, but black tar heroin is also far more deadly.

Effects of Black Tar Heroin Long-Term Use

Black tar heroin can have physiological effects in the user that are different than those of white heroin. Users of black tar heroin are also at greater risk to different disorders as a result of taking the drug.

One of the major problems facing black tar heroin users is the hardening of veins, which renders them unusable at a more rapid pace. This condition, known as venous sclerosis, may occur in persons who inject the drug intravenously. The collapse and hardening of the veins causes users to inject subcutaneously (under the skin), which causes its own problems.

Black tar heroin’s gummy consistency (tar-like) is one reason why needles clog up. This necessitates needles being thoroughly rinsed or washed between uses. Researchers recently found that this may account for why black tar heroin users have less incidence of HIV/AIDS infection than other drug users. Black tar heroin users are also less likely to share needles.

Necrotizing soft tissue infection and life-threatening bacterial infections are a risk with use of black tar heroin. Subcutaneous injection, a process known as “skin popping,” predisposes users to necrotizing fasciitis or necrotizing cellulitis, while injecting the drug deep into the muscles predisposes users to necrotizing myositis. Another risk is wound botulism, where the person’s wounds become infected with botulism.

Signs of Heroin Use

Users of heroin, including black tar heroin, may display some of the following symptoms:

• Constricted pupils

• Drowsiness

• Euphoria

• Impaired mental functioning

• Nausea

• Slowed breathing

Withdrawal Symptoms

Physical symptoms occur upon cessation of black tar heroin use. Some of these symptoms include:

• Cold flashes with goose bumps

• Diarrhea

• Insomnia

• Involuntary kicking movements

• Nausea

• Muscle and bone pain

• Restlessness

• Vomiting

Symptoms of Heroin Overdose

Heroin overdose symptoms may include the following:

• Cold, clammy skin

• Convulsions

• Pinpoint pupils

• Shallow breathing

• Coma

• Death

Addictive Potential

Use of black tar heroin in any form – injecting, inhaling, smoking or swallowing – can cause immediate harm and lead to addiction. As an illegal, Schedule I drug, heroin (including black tar heroin) is in the group of the most highly addictive drugs.

There is no safe way of ingesting heroin. Users can die from an overdose or become addicted by snorting, smoking or injecting it. Addiction can even result after the first or second use. Once addicted, black tar heroin users suffer severe cravings for the drug and are constantly in search of the next dose.

Why Users Substitute Black Tar Heroin for OxyContin

It boils down to a simple case of economics and availability. Black tar heroin offers the same – or better, some users would say – high as OxyContin, but it’s far less expensive. On the street, OxyContin goes for about $80 per pill, and users require 5 to 6 pills a day. Compare that to about $50 for a day’s worth of black tar heroin, and it’s a no-brainer.

Black tar heroin is also easier to come by for users and addicts. With the ingenious marketing and home-delivery campaign that suppliers of Mexican black tar heroin have introduced into the U.S., users can place their orders by phone and the drug is delivered to the location of their choice. No longer do users have to go to seedy parts of town, putting themselves at risk of criminal behavior (attacks by gangs, other drug users, and arrest). In addition, the new targets for the drug are white and members of the middle class. And the supply of black tar heroin to the U.S. is steadily increasing.

So, too, are the deaths. With potency far greater than in years past, today’s black tar heroin is far more addicting and dangerous than other heroin on the streets. Users, having no tolerance for the increased purity, quickly become addicted or may overdose and die.

New users, especially, seeking a quick high, have no knowledge of the potentially life-threatening consequences. Once they are addicted, they are locked into the downward drug spiral so common to long-term addiction. It isn’t that they can’t be treated, but that they often don’t wish to change their addictive behavior. For many, long-term use of black tar heroin results in massive bacterial or soft-tissue infections, wound botulism, and other complications – any of which may end in death.

Statistics Tell Only Part of the Story

The percentage and total numbers of users and/or abusers of pain relievers and heroin (which would include black tar heroin, but are not broken down as to type of heroin), are an interesting way to look at the problem. It is important to put the prevalence of these two drugs into perspective.

Heroin – According to the 2008 National Survey of Drug Use and Health (NSDUH) (http://www.oas.samhsa.gov/nsduh/2k8nsduh/2k8Results.cfm), approximately 3.8 million Americans aged 12 or older reported trying heroin at least once during their lifetime. This represents 1.5 percent of the population aged 12 or older. NSDUH data show approximately 453,000 (0.2 percent) reported past-year usage of heroin and 213,000 (0.1 percent) reported past-month heroin use.

In 2008, 114,000 persons aged 12 or older tried heroin for the first time within the past 12 months. The average age at first use (among recent initiates aged 12 to 49) was 23.4 years in 2008.

Among students surveyed as part of the 2008 Monitoring the Future Study, 1.4 percent of 8th graders, 1.2 percent of 10th graders, and 1.3 percent of 12th graders reported lifetime use of heroin.

Pain Relievers – Prescription drugs are the most commonly abused drug after marijuana. Painkillers such as Vicodin and OxyContin are the prescription drugs most commonly abused by teens. Data from the 2008 NSDUH show that that were 2.2 million new users of pain relievers in 2008, with the average age of first nonmedical use of 21.2 years.

In 2008, the number of new nonmedical users of OxyContin aged 12 or older was 478,000, with an average age at first use of 21.8 years among those aged 12 to 49. OxyContin initiation, however, is down from 615,000 in 2004.

According to the 2008 Monitoring the Future Study, OxyContin use is higher today than it was when it was first measured in 2002. The annual prevalence rate is 2 percent for 10th grade and 5 percent each for 8th and 12th grade students. The main point, according to MTF press release material (http://www.monitoringthefuture.org/pressreleases/09drugpr.pdf), is that “these two dangerous [includes Vicodin in the reference] and highly addictive narcotic drugs remain at high levels of use among American teens.”

Availability, Price, Easy High

Both black tar heroin and OxyContin produce a relatively quick and easy high. In certain areas of the country where Mexican black tar heroin has made inroads and garnered acceptance among the population, it is easier and much cheaper to obtain than OxyContin.

Drug-seeking behavior, the motivation to search out and use the drug of choice, continues unabated regardless of whether the drug is black tar heroin or OxyContin. The main difference appears to be the potential for quicker addiction with black tar heroin and for the potentially deadly consequences of misuse, abuse, and overdose.

While the U. S. Drug Enforcement Agency (DEA) and law enforcement agencies vigilantly seek to apprehend and prosecute drug traffickers of black tar heroin, in the end, it appears that only by raising public awareness and intensifying education about the dangers of this illegal drug will have any hope of stemming the rising number of deaths.

Too cheap, too easy to come by and too potentially deadly – make Mexican black tar heroin a much more lethal substitute for OxyContin. Users, abusers and addicts of either drug should not only be made aware of the dangers, but should also seek treatment to overcome their dependence or addiction.

Every day it’s the same thing. You come home and your partner is stoned out of his or her mind on marijuana, or snorting coke, doing crack, speedballs, shooting up or popping pills. Things are rapidly going downhill, if they haven’t already. You’ve talked to your partner until you’re blue in the face, and still nothing changes. What more can you do? How in the world can you make him or her stop doing drugs? The answers may surprise you.

You Cannot Change Someone Else

Your first recognition has to be that you cannot change another person. It’s as simple and as complex as that. Sure, you want to change them, but it’s just not possible. Why? It has to do with inner motivation and genuine desire. Think about when your parents, or siblings or friends (even a supervisor at work) told you to do something that you a) not only didn’t want to do, but b) if you did do it, you’d only pretend to, or do it half-way. Your heart really wasn’t in it, since it wasn’t something that you initiated. The same principle applies when one person tries to enforce their will on another with respect to getting help for drug abuse. But the consequences are more immediate and severe.

When a person is addicted to drugs and/or alcohol, they are supremely resistant to any hint that they have a problem. They may react violently to threats or even encouragement to get treatment. The bitter truth is that until the person is ready to accept that they have a drug problem and seek treatment for it, nothing you or anyone else can do will change their mind.

So, since you cannot change the addict, what should you do? Read on.

Take Care of Yourself

In order for you to be a helpmate in your partner’s (hopefully) eventual healing, you have to take care of yourself first. This is not a selfish motive, but one that ensures that you are physically, psychologically and emotionally able to assist your partner at the time he or she is ready to get addiction treatment.

Make sure you get enough sleep, exercise regularly. Maintain your social network – which may be difficult if you feel you have to stick around and monitor your partner’s actions. You need to have an outlet for your own sanity, whether that’s a hobby, recreational pursuit, going to movies or concerts, or just taking a walk in the neighborhood, nearby park or strolling the beach.

This also means that you have to set aside time to devote to your own personal development. You may wish to enroll in a class, pursue getting or completing your degree, or learning a new skill that may benefit you at work or to enable you to get a different job.

Of course, taking care of yourself will not go unnoticed by your drug-using partner. He or she may be jealous of your time away, forbid you to do anything outside of work, or insist that you only do things together. What can you do then?

Here are some tips:

• Be creative – Don’t lie to your partner, but find ways to communicate the point that you need to do this, that it’s important for you and list the reasons. Recognize, however, that rational arguments probably won’t work – especially if your partner is high.

• Pick your time – If your partner is more clearheaded in the morning, choose that time to have a discussion about your needs in the relationship – relative to having time to take care of yourself. If you know that mid-day or dinnertime is better, aim for a talk after a meal – but not during. People tend to be more amenable to ideas when they have a full stomach, as opposed to being agitated or easily upset when they are hungry. If your partner doesn’t eat regularly or has nutritional deficiencies due to drug use, that’s another problem. You know your partner’s moods best. Select the appropriate time to talk about your need to do things for yourself.

• Enlist help of others – Who is closest to your partner beside you? Is it their parent, sibling or another friend? Perhaps they can join you in a discussion with your partner about your need/desire to take a class, participate in a hobby, recreational activity or something else. You may even start out by doing things with that person. Maybe all of you can do things together to begin with. That may satisfy your partner that it’s important for you to do things outside the house. Eventually, your partner may be convinced that it’s okay for you to do them alone, or with other people.

Educate Yourself

In order for you to deal with your partner’s drug abuse, you need to know what it is that you’re dealing with – not in a general sense, but specific to the substances your partner is addicted to. One benefit of the Internet is that you have ready access to information and resources through a number of 12-step groups, federal, state and local organizations, and various treatment centers.

If your partner is addicted to cocaine, for example, check out the website of Cocaine Anonymous. Download literature or read what they have online to find out as much as you can about the addiction. Narcotics Anonymous is a 12-step group for numerous substance addictions and there are other groups for particular addictions, such as Marijuana Anonymous and Crystal Meth Anonymous.

You may ask why you should look into those resources when you are not addicted. It helps because these sites have information on symptoms, what you can do, books, tapes, articles and newsletters that may offer invaluable insight to you as you prepare for the time when your partner may be ready to get help – either through treatment or attendance at a 12-step meeting.

But your education doesn’t stop here. Let’s say that you’ve been trying to deal with your partner’s drug abuse for a long time, or it’s become particularly difficult and you feel you just can’t cope anymore. You may be considering leaving your partner. There may be children involved, which makes the situation even more difficult. You need help to sort things out for yourself, help which can only come from others who are in a similar situation. There are 12-step groups for partners, spouses, family members and close friends of drug addicts, many of which are listed on the abovementioned 12-step sites. Since many drug addicts are also alcoholics, you may wish to consider those partner affiliate sites in addition to those dealing with drug addiction.

Some of these sites for family/partner/spouse/friends include:

• Al-Anon/Alateen – Toll-free at 888-4AL-ANON (888-425-2566), L.A. number: 818-760-7122

• Adult Children of Alcoholics – L.A. number: 310-534-1815, or Torrance, California at 562-7831

• Co-Anon (Cocaine Addicts Family Groups) – Toll-free at 800-898-9985, or Tucson number: 520-513-5088

• Nar-Anon – Toll-free at 800-477-6291, or Southern California: 310-547-5800

Many offer in-person, online or telephone meetings, so there’s always help and support you can receive. Similar to the 12-step groups for drug addicts, these fellowship websites have a wealth of information that you can read online or download for later review. Sign up for newsletters or search out their books (many of which may be available in your local library or bookstore). The point is that you need to hear how others in your situation deal with the problem of a drug-addicted spouse. While each person’s circumstances are unique, you will undoubtedly hear something that can help you in your own situation.

Attend Meetings

After you’ve identified the appropriate 12-step family/partner support group, start participating in meetings, either in-person or online or by phone. Since those affected by another person’s drug use often cannot immediately discern the right or most effective thing to do or say when there’s a flare-up or a crisis, having the support of others who have been in the same situation is invaluable. If nothing else, it will show you that you’re not alone. Others have been there and have made it through. Some of their stories and strategies may work for you, or you can adapt them to your own situation.

Of course, there’s no guarantee that your partner will ever decide to get help for his or her addiction. If you plan to remain in the partnership, however, you will need emotional support and resources to be able to do so. Take advantage of what is available to you through family support groups for addiction.

Ensure your Safety

Never jeopardize your safety or that of any others in the family due to your partner’s drug abuse. If there’s even a hint of domestic violence or sexual abuse, leave as soon as you can safely do so (and take the children with you). There’s simply nothing productive that ever comes out of remaining in an abusive situation. The other person may promise to never hit you again, but when under the influence of drugs and/or alcohol, those promises will be worthless. Instead, you and your children will be at risk.

Have a plan in place for when and if you need to leave in a hurry. Know where you’re going to go, whether that’s to a friend’s home, that of your parents, a church-sponsored or other shelter. This doesn’t mean that you leave forever, however, just that you remove yourself and others from possibility of harm. Whether or not you ultimately decide to leave your partner is a decision that only you can make after careful deliberation.

Keep a list of phone numbers handy for emergencies, including someone to pick you up if necessary. It may also help to have an emergency fund set aside that your friend or family member holds for you so that you can be on your own for a few days or however long it takes.

Stop Enabling

Getting an addict to quit doing drugs is never easy. One thing that you will need to do at some point – when your partner is serious about quitting drugs – is to stop enabling his or her drug use. You will need to learn how to say “No.”

This also means that you stop making excuses for your partner’s drug abuse. Although painful, the truth about your situation is probably something others are already aware of. By denying its existence, you are only giving your partner leeway to continue the addiction.

Give it Time

Nothing will happen overnight, that much is certain. Not your healing or ability to deal with your partner’s drug abuse, and definitely not your partner’s willingness and readiness to accept that he or she has a problem and agreeing to get help. The best that you can do now is to follow the practical tips to take care of yourself, realize you cannot change someone who doesn’t wish to change, become as educated as you can about addiction, seek support from others through 12-step groups for those who are affected by another’s drug use, stop enabling and make sure you’re safe.

As for your decision to stay or to go, ask yourself how strong your commitment is to the partnership or marriage. What are the benefits to sticking it out and what are the disadvantages? How will you be able to make it on your own? Do you feel that you are abandoning your partner if you leave? Do you feel his or her drug addiction is somehow your fault? Before you make any decision, seek counseling and or help to determine what’s real and what may only be an unnecessary fear. Above all, recognize that there are many millions of Americans who have either a drug or alcohol addiction or problem, or a combination, and their partners somehow find a way to deal with the situation.

Find the strength inside you and do what is necessary to move forward. Use resources available to you and don’t feel that you have to go it alone. Yes, you can deal with your partner’s drug abuse. But first, you have to do what’s right for you.