As a science-fiction thriller, no one would believe this. Unfortunately, this is what’s happening in our country today. The drug is Fentanyl, 10 times stronger than heroin and manufactured in China for import to the United States. Drug users can become addicted after their first dose. Once addicted, people lose voluntary control, unable to stop themselves from using day after day. The drug literally controls their brain, robbing them of rational thought and the free will to stop using and return to normal life.

This may sound melodramatic to you, but I see the wreckage of addiction and the devastation it causes to the addicts and their families at the RecoveryWorks rehabilitation treatment program. Please don’t think that this can’t happen to your family, or that this does not happen every day in your neighborhood. Let me tell you about of one of my patients who grew up in a nice neighborhood, not far from my office in Scripps Ranch / Mira Mesa.

Jane is not her real name. She uses fake names anyway, when she does whatever she has to do to pay for her drugs. At 18 years old, Jane is a pretty girl who still looks younger than her real age. She had been a normal high school kid, active in school and making good grades until her junior year. She started using a few Vicodin and Xanax from her parent’s medicine cabinet, and then stealing pills from her friends and neighbors. She even hit the medicine cabinet at an “Open House” viewing of a home for sale in the neighborhood. Her parents began to notice the mood swings and anxiety attacks that happened whenever she was under the influence of, or in withdrawal from, the pills. A particularly horrible panic attack lead to a visit with the family doctor, who prescribed Xanax in a daily dose.

Having her own prescription opened up a new world for her, because she could sell the pills and buy more Vicodin and OxyContin. As her habit progressed, she drained the savings account that she had been saving from age five with birthday money. Her parents had to replace several cell phones and then her laptop computer that had been “lost” when she needed more and more money to support her habit. When the pills became too expensive, she discovered that smoking or injecting heroin / fentanyl is actually cheaper than pills, spending $20, and then $40 a day.

Her parents were alarmed by her constant demands for money and by the screaming fits of anger when they refused. Their daughter began to stay out all night and then sleep most of the day. The cheerful girl who never broke the rules was now a sullen, apathetic 18-year-old who refused to go to school at all. When they found a supply of drugs and $1000 in cash in her underwear drawer, they could no longer deny the seriousness of the problem. They scheduled an intake appointment for the RecoveryWorks treatment program, but Jane refused to get out of the car. When I went outside to invite her to come in, I could see the drooping eyelids and pinpoint pupils that were obvious signs of opiate intoxication.

Her parents broke down as they told me what it was like to watch their daughter become trapped in a downward spiral over the past year. They felt guilty and blamed themselves. They could not understand why Jane was so angry with them, even though they had tried over and over to give her whatever she wanted.

I explained the changes in the brain that occur as opiates take control. The centers of the brain that control hunger and pleasure are hijacked by fentanyl. People become completely obsessed with getting and using drugs, and are completely unable to feel pleasure, or to feel much of anything at all except the powerful opiate effect. As their tolerance builds, they actually don’t feel much pleasure from the drug, but they will certainly feel the crushing depression and overwhelming withdrawal sickness when they can’t get it.

Once their daughter became addicted, her ability to think and feel normally had been taken away from her. She was unable to think of anything other than the next dose of heroin, mixed with fentanyl. Without it, she knew she would become violently ill and severely depressed. Her parents met with the RecoveryWorks family therapist / interventionist to make a plan to get Jane into a detox program to safely get her off of addicting drugs.

Jane refused to go into treatment, and her mother could not stand the thought of banishing her from the house unless she stopped using drugs. Although she was afraid her daughter could die from an overdose, she actually had the thought that she would rather find her dead at home in her own bed than out on the street.

Unable to say no, the family kept putting money on her debit card and she continued to use. When she heard about an even stronger variety of heroin, she was eager to try it. She convinced her mother that she needed $40 for a haircut, which was just enough money to buy the drug. The new heroin was stronger because it contained more Fentanyl. After one dose, Jane stopped breathing, turned blue and slumped over the steering wheel of her car.

A neighbor saw her as she was losing consciousness and called 911. The doctor who lived next door managed to keep her alive until the paramedics could get there. She made it to the emergency room, resuscitated and brought back to life.

When she was medically stable, her parents were told to take her directly to Restore Detox Centers. After a week at Restore, Jane and her parents were able to attend the Wednesday evening family program at RecoveryWorks. She started the RecoveryWorks Intensive Outpatient treatment program, and monthly injections of Vivitrol to block craving and to block the high from using opiates. It took a near death experience to convince her, but Jane is now committed to the outpatient rehab program, and to learning how to live a drug-free life.

Ask the Addiction Expert

What are the signs of addiction to look for?

  1. Loss of interest in usual activities
  2. Sudden shifts in mood or temper
  3. Unexplained absences or need for cash
  4. Intoxication with drooping eyelids and constricted pupils
  5. Withdrawal with cramping, sweats and dilated pupils
  6. Declining grades, work performance or family participation

Do you have questions for Dr. Smith?

Contact 858-530-9112

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