The Heroin Epidemic in Georgia

After nearly three decades, America’s war on drugs wages on with very little to show for the efforts. Although trillions of dollars have been spent combating this problem, many of the American public is left wondering, “To what effect?” How can you win a war against a faceless enemy and when your citizenry are the criminals? There are no easy answers when it comes to ways of dealing with drug use within our society, but one thing is for certain, the opioid epidemic within our country is a rapidly growing public health crisis that needs to be addressed.

Opioid overdoses, which include prescription opioids and heroin, are responsible for 91 American deaths per day, which is four times higher than the rate in the late 90’s. An estimated 60,000 Americans will die this year alone by overdosing on Opioids. Of this population, an estimated 10% of the deaths are tied to Heroin use, which is merely a more concentrated and addictive form of an opioid.

In Georgia, the rising heroin epidemic threatens the health of every Georgian citizen regardless of socioeconomic status or geographic location within the state. This epidemic has devastated communities across the state, ruined families, wrecked futures and lead to increases in crime and poverty. While this article will focus on Heroin, it is vital to remember that heroin users are subsets and representative of an even larger portion of the population of opioid users; they are simply further down the line of their opioid abuse, since the vast majority of people start with pain pills and then move from there to Heroin. Therefore, when we discuss ways to curb this crisis, much of what is said can also speak to the opioid epidemic as a whole.

The state of Georgia has not weathered this watershed moment any better than the other states in the union. Unfortunately, Georgia has the 9th most prescription opioid overdoses a year, with an average of 1,400 Georgians dying due to overdose or medical complications and 158 of those being from heroin. According to SAMHSA (substance abuse and mental health services administration), approximately 948,000 Americans reported use of heroin last year alone. While the highest concentration of heroin deaths fall to north and northwestern Georgian counties, its scourge can be seen nearly every throughout the state.

One of the more noticeable trends seen in the heroin epidemic is the demographics shift of users. While it was once a more minority or low-income associated drug, we are now seeing it regularly abused by middle-class whites. The unspoken truth is that Georgians are dying from heroin almost every day. Because this problem is not going to fade away, it is essential as a Georgian citizen and a parent to be cognizant of what opioids are, why they are so detrimental to society and what is being done to address these critical issues.   

What are Opioids?

Opioids are a drug created for relieving pain that was originally created from the opium poppy.  This class of drugs acts on the central nervous system by activating the body’s opioid receptors. This can include natural, semi-synthetic and synthetic opioids. Opioids are generally used medicinally for pain relief of moderate to severe pain, although they can be used to treat other issues as well. While opioids deliver relief from pain, they also lead to physical dependence, respiratory depression, euphoria and other wanted or unwanted effects. Since these pharmacologic effects hinder pain and lead to a massive euphoric rush, opioids have high potential for misuse, abuse, or overdose.

Semi-synthetic Opioids

Semi-synthetic opioids are derivative of morphine, the most dynamic and powerful substance within opium and may be fused with other substances. Semi-synthetics were created to be alternatives to morphine or traditional painkillers. These include oxycodone, hydrocodone (vicodin) and heroin.

Heroin

Heroin is a semi-synthetic derived from morphine and is generally sold as a whitish powder that is cut with starch, powdered milk, quinine or sugars. Although pure heroin can be found as a white powder, it is rare to find it straight from the source unless you are in South America or Southeast Asia. It can be snorted, smoked or injected, with each means of consumption having different results when it comes to duration, potency, and immediacy of impact. “Black tar” heroin, the most common type of heroin found in Georgia, is an impure form of heroin that has been cut and mixed with other substances. It is almost always produced in Mexico and then shipped north. Black tar is injected directly into the veins or muscles.

Immediate Effects of Heroin

Heroin use leads to the following temporary effects:

• A rush of euphoria lasting up to 5 hours
• A runny nose and watery eyes
• A trance-like state lasting up to 6 hours
• Appetite loss
• Drowsiness
• Nausea
• Sensation of heaviness in limbs
• Severe itching
• Slow breathing and slow heart rate
• Small pupils
• Vomiting
• Unclear thinking
• Unnatural relaxation
• Warm, flushed skin

As a person habitually uses, physical dependence quickly becomes a serious issue. The hallmarks of physical dependence are an increasing tolerance to the drug and a rapidly shrinking period until withdrawal symptoms set in. As the body adapts to the Heroin, and physical dependence sets in, a person will require more heroin to achieve the same desired effects. As this increases so too do the additional health risks.

Because the body becomes accustomed to the presence of heroin within the system, when that is no longer present, a person will experience heroin withdrawal symptoms. These symptoms include muscle pain, anxiety, anger, vomiting, nausea, cravings and extreme itching. It is possible for the shock to the system to be so great that heroin withdrawals can literally kill Georgians, so it is wise to detox under medical supervision.

Severe Health Consequences of Heroin Use in Georgians

A large amount of Georgian’s who regularly use heroin, but did not die from overdose had to deal with a variety of health hazards that can be just as deadly including:

• Arthritis/rheumatologic problems
• Cardiac valve infection
• Chronic constipation
• Chronic insomnia
• Collapsed veins
• Depression
• Greater likelihood of contracting blood-borne viruses (other than HIV or hepatitis)
• Heightened risk of exposure to HIV
• Increased risk of contracting hepatitis
• Infection of heart valves and lining
• Kidney disease
• Liver disease (from hepatitis C or otherwise)
• Pulmonary infections and other complications
• Sexual dysfunction
• Skin abscesses or infections, possibly due to collapsed or scarred veins
• Unhealthy weight loss

Consequences of the Heroin Epidemic to the State

Aside from the tragedy of lives lost due to overdose, there are a variety of negative impacts heroin use has on the states. The economic burden of medical health care costs associated with opioid abuse in Georgia is north of $15 billion. That figure was just shy of a half billion dollars in the mid-2000’s and in the space of a decade has increased thirtyfold. An estimated 90% of all heroin users in Georgia began with opioids and pain pills, and as we have seen, these increases in use have lead to correlative increases in crime. Besides the more obvious organized crime controlling the supply of drugs in any given county within the state, there are a whole host of semi to serious crimes that come from heroin addiction and the poor decision making that generally results from use including, fraud, petty theft, grand theft, breaking and entering and violent crimes.

What Can You Do?

If you or a loved one is suffering from heroin addiction or some other form of opioid addiction, there are a variety of clinics throughout Georgia that were created specifically to help you get clean.  There are two primary forms of Georgian detox clinics you can choose from, and they are inpatient treatment centers, also known as residential, or outpatient treatment centers.

Inpatient Treatment vs. Outpatient Treatment

Inpatient rehab generally has a set time lasting from one to three months where in the heroin user remains at the facility for the duration of their detox process. At these facilities are a host of medical supervisors and professionals whose sole focus is to help you not only get clean from heroin but to help you understand why you used in the first place and how you will fight your addiction in the future. Inpatient comes with the benefit of a ton of amenities such as exercise classes, therapy sessions (either group or one on one) and the chance to learn from and interact with other Georgians who are also struggling with heroin abuse. Since you stay at the facilities full time, this is obviously a more expensive option.

If you have neither the money nor the ability to go away for at least thirty days, outpatient treatment centers are also available throughout the state. These centers monitor you through the stabilization period of detox, the most dangerous time, and then, once your body is free from physical dependence, you are released back to your life.

Understanding the Heroin Detoxification Process

While most people think heroin detox is simply the period where an addict “gets clean,” there are actually three stages to the entire process, and each one is extremely important. These stages also include the heroin withdrawal timeline and potential symptoms a user may experience during this period. In the case of heroin users, this is an extraordinarily delicate and challenging undertaking. It is messy and painful, which makes it understandable why some Georgians might be scared of it.

1. Assessment – the first step of detox is for a heroin abuser to meet with medical professionals and undergo a clinical assessment. During this evaluation, professionals will gauge the strength of the addiction and measure the consequences it has already wrought on the body. How long it takes to detox from heroin will depend on how strong the addiction is. From there, they will create a treatment plan unique to that user and ideal for addressing their specific issues.
2. Stabilization – this stage refers to the body returning to a state of normalcy, free from heroin dependence. It is the most dangerous of the stages since, as this detoxification occurs and the body is weaned off its dependence, the heroin user suffers various withdrawal symptoms including

• Angst
• Cramping
• Cravings
• Despair
• Diarrhea/nausea
• Hallucinations
• Hypertension
• Increasing Heart Rate
• Muscular spasms
• Severe Pain
• Sensitivity to noise or light
• Sweats
• Tremors

3. Finding Treatment – Once the user is free of heroin dependence and prepared to face the world the most important stage of the fight begins. Joining rehabilitation programs and regularly attending AA meetings is the only way to truly fight addiction.

What’s the Georgian Government Doing?

Early last year, Nathan Deal, the Georgian governor, signed three legislative efforts whose goals are to curb opioid and heroin abuse.

• House Bill 88 – This bill requires that the DCH (Department of Community Health) to establish minimum standards and quality of services for narcotic treatment programs that desire licenses. Further, it would tighten regulations on treatment centers to keep Georgian’s from taking advantage of loopholes in the system.
• House Bill 121 – This bill reschedules Naloxone as a Schedule V exempt drug. Naloxone is an emergency drug that combats opiate overdoses and shocks users back into consciousness. By exempting this drug, Bill 121 seeks to make Naloxone available for dispensary at any over-the-counter pharmacy in Georgia.
• House Bill 249 – This bill created several addendums to the Georgia Prescription Drug Monitoring Program. It compels physicians to do more thorough research on their patient’s prescription history and see if they are simply drug seeking. It also moves the PDMP under the wing of the Department of Public Health.

Conclusion

The heroin epidemic is leaving Georgia with increasing death tolls as well as a hefty bill of cost that covers crime prevention, treatment, and other healthcare. Besides all of the tragic overdoses, heroin is a scourge on the Georgian people, breaking apart families and lives, wrecking dreams and futures. It is a serious problem that needs even further discussion, study, and action.

If you or someone you know are dealing with heroin addiction, reach out to friends and loved ones, get help. There are a variety of inpatient and outpatient treatment centers throughout the state including a host of educational resources meant to aid you in this struggle. Even if it feels like there is no hope for you, do not despair, do not give in, there is light at the end of the tunnel, but that requires steps forward and the casting off of chains.

Sources:

“Georgia Opioid Summary.” NIDA. Feb. 2018. 14 Mar. 2019. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/georgia-opioid-summary

Hart, Ariel. “Five Things to Know About the Atlanta Area’s Opioid Epidemic.” AJC. 6 May 2018. 14 Mar. 2019. https://www.ajc.com/news/state–regional-govt–politics/five-things-know-about-the-atlanta-area-opioid-epidemic/e9VDPQVpNWakkLOJEnr3EI/

Langford, Jim. “Prescription Opioids and Heroin Epidemic in Georgia.” Substance Abuse Research Alliance (SARA).  Dec. 2017. 14 Mar. 2019. https://www.acponline.org/system/files/documents/about_acp/chapters/ga/substanceabuseresearchalliancegeorgia_preventionproject2017.pdf