Cocaine, Heroin and Overdose

For an addict, there is such a thing as “more high.” Even if tolerance says otherwise. With some drugs, such as marijuana, a continued effort to increase one’s euphoria may not be that dangerous. But for drugs like prescription opioids or heroin, riding the line between intoxication and overdose is never in one's best interest—but highly sought after. What is considered to be a good high, can quickly turn into a deadly overdose.

The death toll related to drug abuse is almost always focused on opioid narcotics these days. While such drugs do not need any help with regard to being dangerous, addicts will commonly mix opioids with other narcotics, sometimes “uppers” and sometimes with more “downers.” It is quite common for people who mix opioids with benzodiazepines to experience a fatal overdose. However, there is another trend that has the power to take one’s life, commonly referred to as “speedballing.” That is mixing opioids and cocaine together, to be injected simultaneously. You may be aware that a number of celebrities have lost their life to the admixture, including:

• John Belushi
• Chris Farley
• Philip Seymour Hoffman

The general public almost never hears about cocaine anymore, being overshadowed by drugs like heroin and fentanyl. If you did hear about cocaine, it is likely that it was because somebody famous died using the drug recently. But make no mistake, cocaine abuse is still a very real problem affecting many Americans. And for those with an opioid use disorder, who are finding that their tolerance is making it difficult to experience euphoria, cocaine might be the solution they consider. Anyone who has ever done a speedball will tell you that there is no other high quite like it, or as dangerous.

While cocaine use rates have been down in recent years, the U.S. Drug Enforcement Agency's (DEA) 2016 National Drug Threat Assessment has shown a significant increase in cocaine-related overdose deaths in recent years, according to the U.S. News & World Report. Cocaine can be deadly on its own; but when mixed with opioids the drug becomes exponentially more fatal.

“When there are no opioids involved in cocaine-overdose deaths you see an overall decline in recent years,” says Christopher M. Jones, an acting associate deputy assistant secretary with the Department of Health and Human Services. “But when you look at cocaine and opioids together, we see a more than doubling in the number of overdoses since 2010, with heroin and synthetic opioids increasingly involved in these deaths."

Treating Depression and Anxiety With Marijuana

When looking for a silver lining in the American electorate's ever changing stance on marijuana, two things often come to mind. 1) Medical marijuana and legalized recreational use will keep countless Americans out of jail or prison. 2) The loosening of the legislative grip on marijuana allows for some long awaited (previously impossible) research to be conducted. The findings of which will hopefully lead to more informed decisions regarding the use of cannabis.

Marijuana, like alcohol, is often used as a stress reliever at the end of a long day of work. While the stereotypical “pot” smokers are teenagers and young adults with Bob Marley shirts and healthy appetites, your average pot smoker is often the farthest thing from that picture. In fact, with the lightening of policies related to marijuana, we can now see a more accurate picture of cannabis users, free from what is portrayed in Hollywood. And what is being seen is college freshmen to businessmen partaking in marijuana use.

More American adults than ever can now easily access marijuana, so it is vital that they know the risks. When people think about the risks associated with cannabis use, cognitive and memory problems often come to mind. But, past research has found connections between heavy cannabis use and mental illness, especially among teenagers and young adults. Users beware!

There are also many pot smokers who use marijuana to self-medicate anxiety and depression. However, it has long been uncertain how effective marijuana is for treating mental illness, and it is likely that the drug may actually worsen one’s symptoms. Researchers at Colorado State University conducted a questionnaire-based analysis of 178 college-aged, legal users of cannabis to shed some light on how the drug affects emotional processing, KDVR reports. The findings were published in PeerJ.

The researchers found that people who use cannabis to treat their depressive symptoms, had less anxiety but were more depressed, according to the article. Those who used the drug to lessen anxiety symptoms had fewer symptoms of depression, but were more anxious.

The findings are important, and hopefully will influence some people’s choice to use the drug for alleviating symptoms of depression or anxiety.

Reversing Overdose Has A Heavy Price

In a perfect world, opioid addicts would have free-access to the lifesaving drug naloxone. The drug can reverse the deadly effects of an opioid overdose, and one could argue that doctors should co-prescribe naloxone when they write an opioid prescription and community outreach programs should handout naloxone free to heroin addicts who cannot afford to buy it from a pharmacy. Sadly, that is not the world we live in, but some lawmakers in the United States have been fighting to expand access to the miracle drug, which has proved difficult because of price.

If one were looking to buy naloxone, they can expect to pay upwards of $150 for two doses. Certainly, you cannot put a price tag on life, but if you can’t afford the naloxone kit you may lose yours. Lawmakers have received a lot of pressure from addiction experts to reign in the ever-increasing price of the lifesaving drug. This week, experts called on the government to act in The New England Journal of Medicine, according to HealthDay. The experts write:

“Naloxone’s price increase is part of an overall trend of increasing prescription-drug prices for both new brand-name drugs and old, off-patent generics. Public frustration with rising drug prices has led to a number of recent policy proposals, including Vermont’s new legislation requiring companies to justify price increases, California’s attempt to constrain drug payments, and the recently proposed and bipartisan-supported Fair Accountability and Innovative Research Drug Pricing Act. None of the federal or state initiatives expanding naloxone’s availability, however, address the drug’s rising cost.” 

Part of the issue is that there are limited options. An increase in demand for the drug has the expected effect of drug makers seeing an opportunity to increase profit, regardless of the deadly consequence of people being unable to afford the drug. Here are the numbers:

• Hospira (a Pfizer Inc. company) charges $142 for a 10-pack of naloxone —a 129 percent increase since 2012.
• Amphastar's 1 milligram version of naloxone costs around $40—a 95 percent increase since September 2014.
• A two-dose package of Evzio (naloxone) costs $4,500, a more than 500 percent increase over two years.

“The challenge is as the price goes up for naloxone, it becomes less accessible for patients,” said study lead author, Ravi Gupta, a fourth-year Yale medical student. "Taking action now is essential to ensuring that this lifesaving drug is available to patients and communities."

The Naloxone Yo-Yo Effect

It could easily be argued that naloxone, the lifesaving overdose reversal drug sold under the brand name Narcan, is one of the most important drugs ever produced. If it's administered in a timely manner, the life of an opioid addict can be spared from what would have otherwise resulted in an overdose death.

In the United States, practically every first-responder has been trained to administer the drug, in response to the staggering overdose death rates linked to the epidemic plaguing America. Additionally, a number of states have taken certain actions, making it much easier for addicts and their families to acquire the ever important drug—in many cases a prescription is not required for obtaining the miracle drug.

While the United States has the highest overdose death rates in the world, after decades of over prescribing painkillers and a burgeoning heroin market, our neighbors from the North have hardly been spared. In fact, between November 17-23, there were nearly 500 overdoses that required paramedics in the greater British Columbia (B.C.) area, CTV reports. Situations that would usually be considered routine, involving naloxone treatment. However, it turns out that addicts have begun mixing naloxone with their heroin in an attempt to protect oneself from an overdose.

Obviously, the method is far from the right course of action. The act of using an opioid, followed by naloxone, is being called “yo-yoing” or the “yo-yo” effect, according to the article. Heroin causes feelings of euphoria; naloxone reverses those effects by essentially starting a process of drug withdrawal—a real up and down experience. One that is far from pain-free.

In B.C. paramedics are arriving at the scene of overdoses and seeing empty vials of the overdose reversal drug, the article reports. Addicts are getting a false sense of safety from yo-yoing, but Paramedic Sophia Parkinson says that a person who uses naloxone needs to be followed up with by medical personnel, as the effects of the antidote can be fleeting.

Please take a moment to watch a short video on the Yo-Yo Effect:


If you are having trouble watching, please click here.

Bipolar Disorder Increases Substance Use Disorder Risk

It is well understood that it is of the utmost importance to treat the whole patient in the field of addiction medicine. A significant number of people seeking help for a substance use disorder, also have other mental health issues to contend with; it is common occurrence which can complicate one’s ability to work a program of recovery. Many people will actually develop a problem with drugs and alcohol as a result of using the substance to help cope with untreated mental illness; if substance abuse counselors fail to address a client's co-occurring disorder while in treatment, then there is an increased risk of relapse down the road.

Over the years there has been a plethora of research conducted which indicates that people with a mental illness, such as depression, are at an increased risk of addiction. It might even be fair to say that a mental illness begets mental illness, in some cases. Studies also point out that a person with a co-occurring disorder, otherwise known as dual diagnosis, has a much better chance of long term recovery, if they are treated for the addiction and co-occurring disorder at the same time.

The most common co-occurring mental health disorders that addiction patients have, include:

• Anxiety Disorder
• Bipolar Disorder
• Depression
• Post-Traumatic Stress Disorder (PTSD)

As was mentioned earlier, people with mental illness are often far more likely to have addiction problems, compared to the general public. This was the results of a new study conducted recently that found that adolescents with bipolar disorder are more likely to abuse drugs and alcohol, and develop a substance use disorder later in life, HealthDay reports. The findings were published in the Journal of Clinical Psychiatry.

The study involved 105 adolescents (average age 14) with bipolar disorder and 98 teens without the disorder, according to the article. Of which, 34 percent of the teens that were bipolar also had substance use disorder, compared to only 4 percent in the control group. The researchers followed up five years later with 68 of the participants with bipolar patients and 81 of the control group. The findings revealed that half a decade later, nearly half of those who were bipolar also had substance use disorder, compared to 26 percent of the control group.

Treating Cocaine Addiction

Despite the fact that the main focus regarding addiction these days is centered upon opioid use disorder, a form of addiction involving prescription painkillers and heroin, many Americans continue to regularly abuse cocaine. It is often the case that both opioids and cocaine are used in conjunction, as addicts attempt to maintain a delicate balance between the downing effects of opioids and the upper effects of cocaine. A practice commonly referred to as “speedballing.” You may be aware of the fact that a number of notable celebrities have lost their lives due to speedballs, such as John Belushi.

When cocaine is used on its own, the chances of an overdose are significantly less than that of opioids. Drugs in the opioid family cause severe respiratory depression which can easily lead to death. Part the reason that opioid addiction has garnered the attention of mainstream media to the degree that it has is the result of how deadly that form of drug can be. But rest assured, cocaine addiction can severely impact the course of one’s life, and without treatment it can be extremely difficult to find recovery.

Unlike opioid addiction, there are currently no accepted drugs to help people get off, and stay off, of cocaine. There isn’t a Food and Drug Administration (FDA) drug to treat cocaine addiction. However, new research suggests that blocking certain brain-cell receptors, specifically a receptor referred to as the TrkB, could reverse signs of cocaine dependency, ScienceDaily reports. The findings were published in the Journal of Neuroscience.

"I think this study could help revive the idea of targeting TrkB signaling to treat addiction," said The Scripps Research Institute (TSRI) biologist Candice Contet, senior author of the study. 

While blocking the TrkB has not been tested on humans, the technique showed great promise in rat models, according to the article. The researchers found that rats that learned to self-administer cocaine infusions, reduced their use of cocaine markedly when the TrkB blocker was given to them—exhibiting decreased signs of dependence. The findings are extremely important, especially when you consider that over 2 million Americans abuse cocaine.

People struggling with addiction may not be able to admit their need for help. If your cocaine problem is affecting your marriage, parenting, employment, friendships, finances, and spirituality, it’s time to call Celebrate Hope’s Christian addiction treatment center.

Genetic Underpinnings of Alcoholism

Addiction is a complex disease that few understand, and one that no one may ever understand completely. What is well understood is what can happen if the disease of addiction is left untreated—jails, institutions and death. Alcohol continues to be the most commonly abused mind altering substance, and is the fourth leading preventable cause of death in the United States, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

People often muse over why do some people become addicted to alcohol, while others do not? Naturally, the answer to that question involves a number of different factors, from genetics, brain chemistry and environment.

The science behind addiction is complicated, but research teams around the globe continue to shed light on the disease—a disorder which affects tens of millions of people. In fact, researchers at Purdue and Indiana University have identified 930 genes associated with alcoholism, as well as neurological pathways which could potentially serve as targets for treating the disorder, according to a Purdue University press release. The findings of the study were published in PLOS: Genetics.

The research teams compared the genomes of rats, that exhibited compulsive drinking behavior, to rats that abstained from alcohol use, according to the report. The researchers point out that it took decades to breed rats to consume alcohol. Scientifically, it was important to do so when you consider that rats are mammals that humans share a majority of genes. While the research is promising, the scope of factors at play may make it hard for pharmaceutical treatments to be created.

"It's not one gene, one problem," said William Muir, a professor of genetics. "This trait is controlled by vast numbers of genes and networks. This probably dashes water on the idea of treating alcoholism with a single pill."

Research will continue and at Celebrate Hope our Christian alcohol rehab program continues to be  offered in conjunction with advanced medical treatments from Hope by the Sea. This allows clients to have access to fellowship, physical fitness, and faith-building activities. Each program empowers addicts to reconcile with God and loved ones. In treating alcohol abuse, our counselors recognize that every addict’s struggle is unique.