Austin, Texas – In continuance with our weekly article State of Affairs, Vertava Health is now focusing in on the Lonestar State. Last week we learned prescription drug abuse was on the rise and quickly devouring Tennessee. Officials warned us that a heroin takeover mirroring the one in the Northeast could be making its way to the South. Much like the spread of contagious diseases, the epidemic moves in sweeping patterns across the country. While prevention is the key to stopping the spread, treatment is vital to our survival. It is a disease in our own back yard that is stealing lives daily. Our most effective tool is education and localizing specific addiction trends on a local level to pinpoint what is headed where next. So far, all of the experts agree on one thing: the most effective method of prevention is education.
As a feature reporter for Vertava Health, I was able to speak one-on-one with Research Professor Dr. Jane Maxwell of the University of Texas in Austin. Dr. Maxwell is the senior research scientist at the Addiction Research Institute of the School of Social Work, as well as a nationally recognized professor with a special interest in the patterns of substance abuse on the US-Mexico border. Her research, which was recently released to us, provides an extensive insight into the epidemic in this state.
Meth Made in Mexico
Dr. Maxwell found an increasing presence and use of a more potent type of methamphetamine called P2P (phenyl-2-propanone), which is primarily manufactured in neighboring Mexico.
“The decrease in methamphetamine indicators after the 2006 ban on the sale of large quantities of pseudoephedrine to produce the illicit drug reversed in 2008,” says Dr. Maxwell. “Indicators are now at similar or higher levels than ever seen in Texas.”
The research suggests that the current supply with higher purity and potency is due to the Mexico-made P2P. Methamphetamine indicators are increasing to levels they were at before the drop caused by the stricter laws. Importation of liquid methamphetamine from Mexico into Texas has also increased, as water bottles containing meth and water are walked across the border and the liquid is converted to ice or powder within the state.
“Street outreach workers report they see more psychotic episodes occurring among methamphetamine users,” says Dr. Maxwell. “It has a quicker effect.”
That fast effect is due to the potency of this new kind of meth, which is purer and more potent than the meth made with pseudoephedrine.
Alcohol Stays on Top
Alcohol still by far holds the top spot as the #1 drug of choice for Texans. Of particular concern: binge drinking. Most of the people surveyed reported that when they drank, they drank five or more beers at one time. Dr. Maxwell says part of the problem is due to the fact that there’s no shame in drinking, it’s legal and it’s accessible. 28% of all the clients admitted to publicly funded treatment programs in the state had a primary problem with alcohol. While the numbers are alarming, there are even bigger fish to fry.
“The proportionate number of high school seniors driving drunk has actually gone down,” says Dr. Maxwell. “What’s holding steady is the number that are driving high.”
The data re-iterates what Dr. Maxwell is saying. High school seniors reporting driving drunk has decreased from 29% in 1990 to around 10%, while the amount of teens driving high is at a resting 11%.
Grip and Sip
Texas has recently seen a decline in problems related to opiates other than heroin, however, hydrocodone continues to be the most widely abused prescription drugs.
“Drinking codeine cough syrup continues to be driven by the rap music promoting ‘sippin’ syrup’ and recent cases of popular singers getting in trouble because of their use of ‘syrup’,” says Dr. Maxwell.
“The increases in heroin use are related to decreases in the use of other opioids,” says Dr. Maxwell.
New research has found the primary types of heroin in Texas (Mexican black tar and powdered brown – which is black tar turned into a powder by combining it with diphenhydramine or other substances) is being sold on street corners much like crack. And it craves younger and younger victims. The average age of a person who died from a heroin overdose 10 years ago was around 41. Most recently, 33.
In the last decade, scientists have developed new medications to assist in treatment of opiate addiction. Besides methadone maintenance, we now have buprenorphine and naltrexone, which can be very effective. The problem is that even with these very effective drugs, nationally we can only treat a third of all the individuals who are dependent on heroin or prescription pain pills.
“These drugs are very effective but are not readily available to all those who need treatment,” says Dr. Maxwell. “To treat the high demand of patients the state will need to come up with more accessibility.”
Another drug on the rise that Dr. Maxwell finds alarming is the popularity of synthetic drugs. The reason: they’re changing as fast as you can learn them. Drugs like “spice” are on the rise.
“We’re now in the 8th or 9th generation of most synthetic drugs,” says Dr. Maxwell. “They keep evolving, and smart manufacturers keep changing molecules in them to keep them legal.”
Laboratory drug tests that use to look for things like JWH (the first noticeable synthetic drug), are in most cases out of date, because you can’t even find the drug anymore it’s so outdated.
Use of MDMA (or Molly) is changing both in Texas and across the nation. The amount of MDMA in a Molly capsule is increasing, which makes it more deadly.
“Three years ago a lot of people didn’t worry about Molly because what we saw in America was a more watered-down, weaker version of the drug,” says Dr. Maxwell. “Then you saw a stronger version being manufactured in Belgium and Luxemburg, and deaths in New York and Canada.”
Warnings have been issued in Europe about this and an even stronger version of the drug surfacing at many music festivals. There was even a death just in October at Austin City Limits.
The Houston Cocktail
Alprazolam (Xanax), a benzodiazepine, is one of the ingredients in a popular new trend in and around the Houston area called the “Houston Cocktail” or “Holy Trinity”. It is primarily a mixture of Norco, Xanax and Soma that users compare to a heroin-like high.
Users get the euphoria mostly from the Norco (hydrocodone), and the Xanax mellows you out. Any combination of these drugs when not used in a properly prescribed manner is highly addictive and can cause death.
Drug Dealers are in the Recycling Business
Old drugs like mescaline and psilocybin (mushrooms) have re-appeared and are being bought by and upgraded to fit today’s users.
“We only have the capacity and means nationally to treat about ⅓ of the people who need help,” says Dr. Maxwell. “That means ⅔ of people in need of help are going without treatment.”
“The state has effectively cut down the distribution of prescription pain meds and continues to work toward keeping them off the streets,” says Dr. Maxwell. “But the withdrawal is causing people to turn to drugs like heroin. Imagine the worst case of the flu you’ve ever had and multiply it. People in withdrawal are desperate to feel better and they will turn to heroin to ease their discomfort.”
One of the most effective mechanisms to encourage treatment is through the drug court system. A lot of crimes like burglary are committed because the suspect is desperate for money to buy more drugs. In the drug court, the probation officer and the treatment provider become a team to work together to use the legal power to get the drug user to attend and participate in treatment. They share the results of all urinalysis and the progress of the individual in both counseling and probation requirements. While many urban counties have drug courts, rural counties within the state may not.
“The drugs are changing and being produced at a higher rate than we can educate parents,” says Dr. Maxwell. “Historically, when we talk about prevention, we’ve told people to talk to your kids at the dinner table. To tell them about drugs. How can parents who know nothing about these new drugs talk to their kids about them? It’s a whole new world. How do educate the parents and encourage them to talk to their kids about drugs they know little about?”
Help is on the Way
Vertava Health learned about the problem in Texas months ago when our call center treatment specialists were flooded with calls from the state. We are happy to announce plans for a full-scale multi-million dollar treatment campus 35 minutes outside of Dallas. It will feature 40 acres of landscape including a reflecting pond, bridges, a tranquility tree house, zip line therapy, miles of hiking trails, and fire pits all designed to heal the mind, body and spirit from the disease of addiction.