Effects of heroin use include disease, death|
Tuesday, October 27, 2009
By Josh Woods Staff Writer
This week The Progress has partnered with Clearfield-Jefferson Heroin Task Force to help educate our readers on what we can do as a community to address heroin and other drug use in conjunction with Red Ribbon Week. Red Ribbon Week, started in 1985, is the largest, most visible prevention awareness campaign in the nation. It was started after the torture and brutal murder of Drug Enforcement Administration Agent Enrique "Kiki" Camerena during an undercover investigation of a multimillion-dollar narcotic manufacturing operation. In recognition of Red Ribbon Week, The Progress and Heroin Task Force encourage you to tune in each day to learn about heroin, its effects and consequences, community involvement and drug treatment. Today, our series provides a look at the effects of heroin and other opiates.
Heroin and other opiates can have a number of detrimental effects to the human body. Heroin use has been linked to Hepatitis C, AIDS, mental health issues, withdrawal, overdose and death.
Dr. Tuesdae Stainbrook, DuBois Regional Medical Center Infectious Disease Coordinator, said sharing heroin needles creates a great risk of passing on infectious disease.
"When I first got here six years ago I noticed there were a lot of young people here with Hepatitis C," said Dr. Stainbrook. "Most of the Hep C cases were from IV drug use ... 80-90 percent of new infections were from it."
Hepatitis C can cause liver disease, inflammation of blood vessels and sores and affect one's joints and kidneys. It can also worsen diabetes. The two most common symptoms are fatigue and right upper quadrant pain, Dr. Stainbrook said.
"The average from the time Hepatitis C is acquired until the time end stage liver disease occurs is 20 years," said Stainbrook.
Currently, with the sponsorship of Clearfield-Jefferson Drug & Alcohol Commission, free Hepatitis C screenings are offered throughout both counties. A home access test paid for through a Bureau of Drug and Alcohol state grant and Roche Pharmaceuticals determines if one has been exposed to Hepatitis C. A second screening, a PCR test or viral load test, paid for with a donation from DRMC, determines whether one has chronic Hepatitis C.
Rural Health Outreach Coordinator Dana Johnson stressed the testing is strictly confidential and if anyone has any risk factors it is important that they take advantage of the free testing. Testing sites are located throughout Clearfield and Jefferson counties. Appointments may be scheduled by contacting the Drug and Alcohol Commission at 371-9002. Johnson said those who engage in high-risk behaviors should be tested every six months.
"The sooner they are diagnosed the more successful the treatment will be," said Dr. Stainbrook. "We're trying to educate people that earlier treatment leads to a better chance of success for preventing liver disease, cirrhosis and cancer. The less fibrosis or scar tissue they have the better."
Hepatitis C is treated with two medications, regulated interferon and Ribivirin, depending on the genotype. Stainbrook said there are six genotypes of the virus and genotypes 1, 2 and 3 are the most common in the United States. Genotype 1, the most common, takes 12 months to treat. Genotypes 2 and 3 are treated in six months. The success rate of treatment depends on age, sex, the amount of liver damage and whether or not the patient is a smoker, a drinker or is coinfected.
Like Hepatitis C, sharing heroin needles can also pass on HIV and AIDS. All three are passed on through the exchange of bodily fluids. There are no vaccinations for either Hepatitis C or HIV, Stainbrook said.
"Not everyone who has Hep C has HIV and not everyone that has HIV has Hep C," said Stainbrook. "The national average is 30 percent. That's how many are coinfected. We don't see that trend here. There's just not a lot of HIV cases in this area."
Clearfield-Jefferson Mental Health/Mental Retardation Crisis Specialist Mary Brown said the negative impact of heroin on mental health is that it affects stability. She said there is no way of knowing if illicit drug use can be specifically linked to mental health issues; however, such use might cause negative long-term effects to the brain.
"Simply put, if someone already has mental health concerns taking a drug that messes with the mind is adding extra instability," said Brown.
Drug-addicted people with mental health issues are referred to the Drug and Alcohol Commission in addition to mental health counseling.
"It depends on the severity," said Brown. "For some people we recommend outpatient treatment. For others we recommend inpatient treatment."
Information provided by the National Institute on Drug Use says opiates in general can cause drowsiness/nausea, constipation, confusion, sedation, respiratory depression and arrest, addiction, unconsciousness, coma and death. Because heroin's purity is uncertain it carries an increased risk of accidental overdose. Symptoms of heroin use include slow breathing, tiny pupils and coma.
Dr. Mohamed Hassan, DuBois Regional Medical Center neonatologist and Neonatal Intensive Care Unit medical director, said heroin can also affect pregnancies.
Expectant mothers who use heroin can pass on the drug to their fetus through the umbilical cord. Dr. Hassan said once the cord is cut, babies whose mothers use heroin or methadone can experience withdrawal symptoms. A mother's heroin use can cause a baby to have neurological and gastrointestinal problems as well as heart arrhythmia. Neurological problems include excessive crying, irritability and seizures. Seizures, Hassan said, can cause brain damage.
Babies born to opiate-addicted mothers are closely monitored for withdrawal symptoms for five to seven days after birth, Hassan said. If a baby is identified as having withdrawal symptoms, NICU staff uses a scoring system every four hours to monitor its withdrawal. Babies who have withdrawal are administered a calculated dose of morphine for two to six weeks. The dosage is reduced by 10-20 percent every three or four days, he said.
Hassan said 28 babies were identified as having drug withdrawal symptoms last year at DRMC and the hospital averages one to two per month. He said hospitals typically recommend opiate-addicted mothers seek methadone treatment, because continued heroin use is extremely harmful to a fetus. Quitting heroin or other illicit drugs cold turkey might cause the mother to suffer withdrawal, which, in turn, would be detrimental to their pregnancy.
"I always tell (drug-addicted) mothers if they have visited a methadone clinic that is a good indication that they are trying to help themselves and the baby," said Hassan. "There is a misconception that Children and Youth Services is going to step in and take their baby away. That is a myth.
"I always tell the (drug-addicted) mothers we are just here to help you. There is no judgment or lack of respect. We treat you just like any other person. I believe motherhood is motherhood between anyone. Mothers should understand we are here to help."
For more information about heroin or other drugs contact Clearfield-Jefferson Drug & Alcohol Commission at 1-800-892-9002 or visit the U.S. Drug Enforcement Administration or National Institutes on Drug Abuse Web sites at http://www.dea.gov/concern/heroin.html and http://www.nida.nih.gov/.