The tragic death of actor Philip Seymour Hoffman has re-awakened us to the pervasiveness of opioid addiction and its perils.

Part I of our four part series on addiction, by Samantha Stainburn

Say “Long Island,” and people typically think of manicured lawns, high-achieving schools, beautiful beaches and wineries.

But, increasingly, the region is also being associated with a shocking new social problem: addiction to opioids—a group of painkillers that includes prescribed drugs like Vicodin and OxyContin and illegal substances like heroin. Over the past few years, drug-addiction-driven crimes and overdose deaths have grabbed a greater percentage of newspaper headlines. In June 2008, for example, the overdose death of 18-year-old Natalie Ciappa, found dead in a garage after a house party in Seaford, drew attention to the fact that teenagers in middle class and affluent neighborhoods are using heroin. And the June 2011 robbery of Haven Drugs in Medford showed how legally prescribed drugs can lead to addiction, with tragic consequences. During the robbery, David Laffer, a 33-year-old addicted to painkillers, shot and killed a pharmacist, a 17-year-old store employee, and two shoppers while stealing more than 11,000 pills containing hydrocodone, the main ingredient in Vicodin.

The recent, tragic death of actor Philip Seymour Hoffman from an apparent heroin overdose has re-awakened us to the pervasiveness of opioid addiction—especially among the affluent—and its perils.

Audrey Freshman

Audrey Freshman

“Drug abuse has always been a part of society,” says Audrey Freshman, director of continuing education and professional development at Adelphi University’s School of Social Work. “The drug itself tends to shift over time.” The rise of opioid addiction on Long Island is connected to the growth in treating psychiatric issues with new antidepressants and mood stabilizers in the 1990s, she says. Today’s young people “grew up with a lot of pharmaceuticals in their parents’ medicine cabinet,” she observes. “So the idea of pharmaceuticals being dangerous isn’t the same as it was for past generations.”

Add to that the liberal prescribing of painkillers for minor procedures like root canals and the proliferation of drugs to treat Attention Deficit Hyperactivity Disorder in children, and young people have access to a lot of pills that can be swallowed or chopped up and snorted. “The age of onset of drug addiction has come down a little bit,” Dr. Freshman says. “In the 1980s, people were maybe 20 or 21 when they first used cocaine. Now it’s the late high school years” that people are trying highly addictive substances.

Policymakers and law enforcement officials are fighting back by making it harder to obtain opioids. In 2012, the New York State Legislature unanimously passed the Internet System for Tracking Over-Prescribing (I-STOP) Act, a law designed to prevent drug users from obtaining several prescriptions for the same drug by visiting different doctors. Now, doctors are required to check a patient’s narcotic prescription history in a real-time state database before issuing or refilling a prescription. However, tightening the supply has had the unwelcome effect of promoting heroin use, as drug users have sought out other, cheaper alternatives. Heroin dealers, recognizing an opportunity, are now selling “bundles” of heroin that used to cost $150 in 2006 for $80, and smaller amounts for as little as $7, according to the Long Island Council on Alcoholism and Drug Dependence.

Clearly, steps also need to be taken to reduce Long Island’s demand for opioids. That’s a task that Adelphi faculty and alumni have embraced. The School of Social Work’s Office of Continuing Education and Professional Development recently launched a Postgraduate Certificate in Addictions and regularly offers workshops on contemporary thinking on substance abuse. The Gordon F. Derner Institute of Advanced Psychological Studies offers a concentration in substance abuse counseling as part of its psychology master’s program. “My mission is to make Adelphi a center for clinical trauma and addiction studies, spreading the word about the newest techniques to treat addiction,” Dr. Freshman says. Faculty at the School of Social Work and the Derner Institute study addictions of all kinds—including drugs, alcohol, energy drinks and the Internet—providing insights that can help experts craft effective treatments.

Kristina Monti

Kristina Monti

Overcoming addiction is a painful process. Kristina Monti, a Ph.D. candidate at the School of Social Work, saw this in her four years as a supervisor at the 62-bed detox unit at Beth Israel Hospital in New York. During her tenure, the facility helped its patients—mostly men ages 35 to 50 who were often homeless—wean themselves off alcohol, heroin and prescription drugs safely.

“If they had tried to detox themselves off of alcohol or prescription drugs, it would be dangerous,” Ms. Monti explains. “They could have seizures or heart attacks.” The healthcare workers used medications like Phenobarbital (for alcohol abuse), methadone (for heroin or opiate abuse) and Klonopin (for abuse of prescription benzodiazepines like Klonopin or Ativan), tapered down over a week or two, to help the patients avoid physical effects of withdrawal like shaking, seizures, extreme vomiting and gastrointestinal discomfort.

But as the patients’ addictions subsided, they had to face their demons. “When people get sober, their feelings start coming back, and those feelings were why they started to use in the first place,” Ms. Monti says. “The emotional discomfort of not numbing themselves anymore makes them very anxious.” After leaving the hospital, many relapsed and died—or returned to the detox unit again and again.

Ms. Monti and her colleagues looked at the highest users of their detox unit and found that patients who were able to develop a stronger connection with the staff were able to take the next step, go to rehab and stay sober longer than they had before. So the detox unit team strived to create that supportive atmosphere. And in the face of daunting odds, patients sometimes surprised Ms. Monti.

“I just got a letter from a patient I always worried about,” Ms. Monti says. “When I would hear someone had fallen on the subway tracks, I would check to make sure it wasn’t him. He said he’s sober now, and he told me, ‘I didn’t realize what you were trying to do at the time, but now I do, and I thank you.’ I think he kept coming back because he knew it was a safe place for him and people wouldn’t judge him.”

Victoria Roberts, a Master of Social Work candidate at Adelphi who’s also completing the Postgraduate Certificate in Addictions program, knows firsthand that while overcoming addiction is a challenging process, often plagued by setbacks, it can be done. After recreational drug use turned into an addiction she could not control, she was arrested for selling narcotics and spent time in prison. “My addiction happened so fast and lasted so long,” Ms. Roberts recalls. “I hit various bottoms before I changed. It wasn’t jail. It wasn’t being homeless. What really brought it home was my son got arrested.” She decided she had to become a leader in her family to stop another generation from losing its way.

At eight months clean, she got a job as a receptionist in a law office in Hempstead, New York, which provided the stability she needed to be able to study for paralegal certification. She went on to earn an associate degree and then a Bachelor of Science in Sociology at the SUNY College at Old Westbury. She’s been sober for almost two decades now, and has one son who attends CUNY-Brooklyn College’s graduate program and one son who is a file clerk at a law firm. Persistence is critical in overcoming addiction, she says. “There are so many people for whom things don’t fall into place, and because it doesn’t fall into place, they give up. Many people have a preconceived notion about how things are going to be, so they don’t attempt anything. It’s a real struggle to understand if one thing doesn’t happen, it doesn’t mean the next thing won’t happen.”

Ms. Roberts’ course work at Adelphi has given her insights into addiction beyond her personal experience, she says. One study she read about divided people addicted to the same substance in the same treatment program into two groups. “They gave one group a medication to address their addiction and the other group a placebo, but they did everything else the same—wellness, yoga, positive reinforcement, and acupuncture,” she says. Images of the brain were taken of every participant. “The brains of the people receiving the placebo reacted the same way as the people on the chemical,” Ms. Roberts says. “That answered the question for me: You can do something different if you believe you can do something different. You have to believe that your life can be different and it will be.”

This piece appeared in the Adelphi University Magazine Spring 2014 edition.

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