A 43-year-old man died Friday from an overdose of the prescription drug Fentanyl, and a 20-year-old woman also overdosed but was revived, an official said Monday.

The two were in a house with other friends on the 1000 block of Sixth Street West, Katchka said. When the woman collapsed, friends called her mother, who came to the house and immediately called paramedics at approximately 1:30 p.m. Friday. She was taken to the hospital and revived.

Drug Addiction, Drug Rehab Illicit use of pharmaceutical fentanyls first appeared in the mid-1970s in the medical community and continues in the present. United States authorities classify fentanyl as a narcotic. To date, over 12 different analogues of fentanyl have been produced clandestinely and identified in the U.S. drug traffic. The biological effects of the fentanyls are similar to those of heroin, with the exception that many users report a noticeably less euphoric ‘high’ associated with the drug and stronger sedative and analgesic effects. Because the effects of fentanyl last for only a very short time, it is even more addictive than heroin, and regular users may become addicted very quickly. Additionally, fentanyl may be hundreds of times more potent than street heroin, and tends to produce significantly worse respiratory depression, making it somewhat more dangerous than heroin to users. Fentanyl is most commonly used orally, but like heroin, can also be smoked, snorted or injected. Fentanyl is sometimes sold as heroin, often leading to overdoses. Many fentanyl overdoses are initially classified as heroin overdoses. Fentanyl is normally sold on the black market in the form of transdermal fentanyl patches such as Duragesic, diverted from legitimate medical supplies. The patches may be cut up and eaten, or the gel from inside the patch smoked. To prevent the removal of the fentanyl base, Janssen-Cilag, the inventor of the Fentanyl patch, designed the Durogesic patch. The Durogesic patches contain their fentanyl throughout the plastic matrix instead of gel incorporated into a reservoir on the patch. Manufacturers such as Mylan have also produced Durogesic-style fentanyl patches that contain the chemical in a silicone matrix, preventing the removal of the fentanyl-containing gel present in other products. However, the plastic matrix makes the patches far more suitable to transbuccal use and far easier to use illicitly than its gel filled counterpart. Another dosage form of fentanyl that has appeared on the streets are the Actiq fentanyl lollipops, which are sold under the street name of "percopop". The pharmacy retail price ranges from US$10 to US$30 per unit (based on strength of lozenge), with the black market cost anywhere from US$15 to US$40 per unit, depending on the strength. Non-medical use of fentanyl by individuals without opiate tolerance can be very dangerous and has resulted in numerous deaths. Even those with opiate tolerances are at high risk for overdoses. Once the fentanyl is in the user’s system it is extremely difficult to stop its course because of the nature of absorption. Illicitly synthesized fentanyl powder has also appeared on the US market. Because of the extremely high strength of pure fentanyl powder, it is very difficult to dilute appropriately, and often the resulting mixture may be far too strong and consequently very dangerous. Some heroin dealers mix fentanyl powder with heroin in order to increase potency or compensate for low-quality heroin. In 2006, illegally manufactured, non-pharmaceutical fentanyl often mixed with cocaine or heroin caused an outbreak of overdose deaths in the United States, heavily concentrated in the cities of Chicago, Detroit, and Philadelphia. Baltimore, Pittsburgh, St. Louis, Milwaukee, Camden, New Jersey,Little Rock, and Dallas were also affected. The mixture of fentanyl and heroin is known as "magic" or "the bomb", among other names, on the street. Several large quantities of illicitly produced fentanyl have been seized by U.S. law enforcement agencies. In June 2006, 945 grams of 83% pure fentanyl powder was seized by Border Patrol agents in California from a vehicle which had entered from Mexico. Mexico is the source of much of the illicit fentanyl for sale in the U.S. However, there has been one domestic fentanyl lab discovered by law enforcement, in April 2006 in Azusa, California. The lab was a source of counterfeit 80-mg OxyContin tablets containing fentanyl instead of oxycodone, as well as bulk fentanyl and other drugs. The "China White" form of fentanyl refers to any of a number of clandestinely produced analogues, especially α-methylfentanyl (AMF), which today are classified as Schedule I drugs in the United States. Part of the motivation for AMF is that despite the extra difficulty from a synthetic standpoint, the resultant drug is relatively more resistant to metabolic degradation. This results in a drug with an increased duration. ________________________________ If you have been arrested for driving under the influence of alcohol in Des Moines, IA and you have been ordered to take the IA state ordered Drug or Alcohol Assessment or State Required DUI Course and State Required 12 Hour or 48 Hour OWI Programs then you should consider the ALPP Institute in Des Moines, IA.

By JOE CREA

Crystal methamphetamine helped Jack, a 36-year-old D.C. man who asked to remain anonymous, cope with his HIV-positive status. The drug was a pure escape from reality. It increased a level of selfishness that he had never known and left him a man with a “huge ego and no-self confidence.”

His personality, once under control, was no longer, thanks to what he refers to as the “devil’s drug.” On Sept. 11, 2001, he remained holed up in a Boston hotel room with crystal meth, a “club drug” also known by nicknames like Tina, T, crank and speed. He smoked all day, paranoid that the police would soon break down his door.

Jack didn’t stop thinking of himself until he read in the Wall Street Journal a few days later that a Brooks Brothers clothing store near his old office on Wall Street had been turned into a morgue for victims of the 9/11 terrorist attacks. Jack, who describes himself as a “space cadet” who frequently forgets and loses things, patronized the store. The news about the clothing store saddened him, and he vowed to clean up his act.

He tried to sober up after Sept. 11, but soon relapsed. He lost his job, his home and was $50,000 in debt. Destitute, he received some financial help from an acquaintance and checked himself in to Cumberland Heights, an in-patient rehab center in Tennessee. When he first met with one of the counselors at the recovery center, the most difficult question he had to answer was, “What is your address?”

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“I had lost my apartment two weeks ago, and I was homeless without a job,” Jack said. “It was terribly humbling and humiliating.”

Jack had gone from working as a Wall Street executive to pouring coffee at Starbucks in three years — all because of his crystal meth addiction.

“Crystal wants to get us alone where it does the most damage,” Jack said. “It robbed my soul of what I thought was so important. It’s the devil’s drug.”

Alex loses his friends
Alex, a 25 year-old gay man who also asked to remain anonymous, said he views his addiction to crystal as a “choice,” but he began using abusively because “everyone around me was doing it, and I wanted to feel that I belonged.” It was never a physical craving, he said, but more like a social obligation.

“I honestly believe that I did [crystal] because everyone around me was doing it,” Alex said. “If everyone else was doing it, why shouldn’t I? People would look at me differently if I wasn’t going to do crystal.”

Alex said he had never experimented with any drugs other than marijuana and ecstasy before he began using crystal meth two years ago. He said that early on he would use nine dosages, or “blows,” out of a quarter bag in one evening, but that eventually he would take double that, or a half-bag, over one extended period of use.

“I also did it for the fun of it,” Alex said. “The music in clubs became more intense, it made me all horny. It gave me this high that I didn’t have to think about anything else.”

But when he went sober, Alex lost all of his “friends,” because they continued to use crystal. He tried to hang out with his old acquaintances, but said no one wanted to hang out with the “sober kid.”

“There was a core group that I was kind of close to, and they would say, ‘Oh, we are here for you,’ but in reality, they were placating me,” Alex said. “They were happy for me, but they were still getting fucked up. So, with me being sober, and everyone else remaining fucked up around me, I recognized the situation and wanted to get out.”

Descending into paranoia
At the height of his addiction, Clinton, a 31-year-old gay man, was extraordinarily paranoid. He was taking crystal at work to “keep himself going,” thinking that if he could get through the workday, he would be able to get home and sleep for 15 hours.

One evening, after going without sleep for days, his paranoia intensified after he returned home from work. He was convinced for eight straight hours that the police were going to raid his home. He ran around his house and flushed all his drugs down the toilet.

When he realized that that the police weren’t coming, he decided that lesbians in the neighborhood were playing a “huge joke” on him. With his mental capacity severely impaired, he began to pace his house, stare out of his windows and run outside to “try to catch them.”

During this time, sex for Clinton, in all its raw, uninhibited glory, became routine and comfortable. Clinton would meet men online, at clubs and at a local sex club. He describes the sex as “never safe” but “by the grace of God,” he remained HIV-negative.

“I should be positive,” Clinton said. “As far as I’m concerned, I won the lottery. I’d say that roughly 60 percent of the individuals who I know [from crystal meth anonymous meetings] are positive.”

Slim data on gay use
There is very little statistical data to show that crystal affects gays disproportionately. But many treatment specialists and former users have their own theories about why so many gay men fall victim to Tina’s addiction.

Marc Cohen, president of the United Foundation for AIDS and head of the Crystal Meth Community Educational Forum in South Florida, said he believes that gays are disproportionately affected by crystal because it reduces inhibitions, provides the “biggest bang for the buck,” heightens levels of arousal and provides a sense of connection.

“It’s the stigma amongst gay men themselves that drives people to the drug,” Cohen said. “The positives discriminate against those who are negative. If someone is HIV negative, they aren’t invited to the barebacking party. A positive person might not feel comfortable having bareback sex with a negative guy. But when meth becomes a part of the equation, it breaks down discrimination and, as a result, with meth around, discrimination doesn’t exist.”

Some activists have argued that gays are drawn to crystal because of an intolerant society. Clinton scoffed at that notion and said the “worst enemies of gay men are gay men.”

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“It’s not the religious right or Republicans pushing us away, we have more or less assumed a place in society,” Clinton said. “We’ve passed the tipping point, in the sense that people have accepted that we are now a part of society. Even the most conservative of people aren’t talking about running us out of the country or firing us all from our jobs.”

Cohen and Clinton agreed that crystal meth provides the user with the raw, “natural” sexual feelings of the type common in a 17-year-old male just beginning to sexually mature, which can be attractive lure for someone seeking to jump-start his sex life.

“When you are young and having sex, you are like a kid in a candy store,” Clinton said. “But as time goes by, you really start, through your body’s own natural process, to come to the realization that with sex, things aren’t new anymore. Sex starts to lose its edge. It becomes less fun. Crystal can give that edge back to you. That unadulterated, unbridled sexual charge that you had when you were younger.”

But it is this desire to return to a sexual innocence, a clean slate, that motivates the average crystal user. Cohen said that this craving is often so strong that many don’t even consider the many negative side effects of the drug until they notice the aesthetic impact of crystal.

“Many are in a strong state of denial about the side effects and manifestations of usage,” Cohen said. “Only until their health diminishes, jobs are lost, teeth rotting and sores appear, will they do something about it.”

Rotten teeth, sores, stroke
Cohen described in graphic detail the physical side effects of the drug. For the user who smokes crystal — considered by users to provide a more mellow high but cited by treatment workers as one of the worst ways to take the drug — the smoke promotes gum decay and rots the teeth.

Sores and ulcerations appear inside the mouth, making the crystal user vulnerable to STD and HIV transmission.

The drug crystallizes in the lungs. Cohen also said that many habitual users will likely develop “skin eruptions” due to the amount of toxins in their body.

Cohen said these eruptions begin to break through the skin and the user, believing that he feels bugs crawling in his skin, will scratch furiously, thus breaking open the sores and allowing bacteria and infection to enter the body.

Cohen said that smoking is often the next option of usage for the crystal user since most of the delicate cells in the nasal cavity are destroyed after the drug is repeatedly snorted. When the user’s mouth is destroyed, they will often choose to inject or take the drug through the rectum.

Through any mode of ingestion, the drug creates a frenzied state of paranoia, causes intense respiratory distress and the user risks a cardiovascular stroke, Cohen said.

“Taking crystal is like taking your foot and stepping on the gas pedal on a cold winter morning,” Cohen said. “This is especially the case if you are using needles. The impact is so strong you can have a heart attack at any moment.”

Life of the party
Randy Pumphrey, the program director for the Lambda Center, which provides treatment for methamphetamine users in Washington, D.C., said that gay male culture is often youth-obsessed and crystal falsely allows them to recapture a bit of their youth. Pumphrey said that it is a very common drug for the 35- to 40-year-old gay man who doesn’t want to deal with the aging process.

The Lambda Center partners with the Psychiatric Institute of Washington and the Whitman-Walker Clinic.

“These are guys who can’t stay out long enough, feel that they are no longer the life of the party,” Pumphrey said. “Crystal provides the venues for people to be the life of the party and amps up the experience of life. They feel virile again.”

Pumphrey added that the drug is also a favorite for the gay man just coming out of the closet because it allows them to feel “comfortable and intimate.”

Dangerous sexual experiments
Pumphrey said that a huge danger of crystal meth is that it often leads users to experiment sexually in dangerous ways.

“Yes, it can be romanticized and an individual can return to a teenage innocence, but I’ve had clients who pushed themselves into places where they wanted to act out fantasies like being gang raped, and more often than not they were not ready to deal with the implications of that kind of sex,” Pumphrey said. “The drug has a cruel edge. It takes folks down a path that if they weren’t high, they wouldn’t go. Or if they went down that road sober, they would have better prepared themselves for it.

Pumphrey said that some of his clients have acted out abuse from their childhood while on crystal. The trauma that they’ve experienced as a child and the new trauma they experience with a partner goes beyond normal sexual boundaries.

“When they come down from being high, they are stuck with the real memory of what they did,” Pumphrey said. They might not be prepared to handle what that means. There is a lot of guilt and shame then attached to that experience.”

Returning to sex
Many crystal meth abusers say they have a difficult time understanding how to have sober sex. Clinton, who has had sex a few times since he went sober in January, said that now the former user must bring “more to the table rather than a cute face and nice body.”

“You actually have to like their personality,” Clinton said. “If that’s missing, I can’t have sex with them.”

Jack said that meth changed him from being prudish on matters of sex to taking a promiscuous attitude, and he added that having sex sober again is something he has to work hard at doing.

“The first time was awkward,” Jack said. “It’s more about intimacy. Making out and watching a bad movie on Lifetime. Not about having sex and going [clubbing].”

Pumphrey said that rehabilitating this mindset is very difficult.

“It’s something they have to learn, and it is difficult,” Pumphrey said. “It’s hard to come back to your partner and having sex for 25-30 minutes when you are used to having sex all weekend long. Suddenly, all of these other relationship issues start surfacing.”

Cohen added that many individuals who go into recovery don’t want to commit to having protected sex.

“They want to continue having unprotected sex, … bareback sex,” Cohen said. “They will often give up crystal, but in its place they will still have bareback sex. We see a lot of that.”

Drug Treatment for Adolescents

Most American youth try drugs and alcohol when they are teenagers; some will develop serious substance use problems.

But treatment for teens is scarce and often hard to find: although more than one million teens need drug treatment, only one in ten actually receive help. Why is adolescent treatment so scarce? Lack of state and federal funding for treatment programs as well as shrinking insurance benefits for drug treatment are two major reasons. Without adequate insurance, many parents simply cannot afford to get the kind of help their children need.

When parents realize their children have drug problems and must find treatment, they frequently do not know where to turn. The family is often in a crisis situation, when decisions must be made quickly. Yet very little information is available about what parents should look for in choosing a program. Most parents are concerned about cost: do their employee benefits cover drug treatment? If so, for how long? If their coverage is limited, will they be able to pay to get the best possible treatment for their teenager? What kind of treatment will work? Should their teen be sent away to a residential program or can he or she be treated in his or her own community while still living at home? How long will treatment take – a few weeks, months or even years? Parents face bewildering questions they don’t know how to answer, or even how to find answers. They may also feel frightened or ashamed that their teen has substance use problems. And they may also recognize that their own alcohol and drug use problems have contributed to the problems their child is experiencing.

In order to help parents and other concerned adults find help for their teens, Drug Strategies, a nonprofit research institute, developed Treating Teens: A Guide to Adolescent Drug Programs. This guide describes nine key elements that are important in successful teen drug treatment and provides reliable information on 144 adolescent drug programs. Treating Teens gives hotline telephone numbers to find treatment in each state; definitions of frequently used treatment terms, and 10 important questions parents should ask when selecting a program for their teen.

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FIVE QUESTIONS PARENTS SHOULD ASK A TREATMENT PROGRAM

1. Is your program specifically designed for teens? If so, how?

Most treatment programs are designed for adults, not teens. Even if programs say they treat teens, they may in fact just be including them in adult programs that have a few activities for younger people. Adolescents have unique challenges, such as relating to their families, dealing with peer groups, getting an education, finding a job. They also are different developmentally than adults. Effective adolescent programs should address not only drug use problems but also the many aspects of a teen’s life.

2. What questions do your staff members ask to determine the seriousness of the teen’s substance use problem and whether the teen will benefit from this particular program?

Good programs usually ask a brief set of initial questions to explore the severity of the youth’s drug use. How long has the teen been using? Is he or she addicted? What other kinds of problems does the teen have? Is he or she involved in delinquent behavior? Answers to these questions will help a program decide if they can provide the kind of help needed. Once the teen is admitted to the program, the teen’s problems will be examined in much greater depth. This kind of assessment should include a physical exam to determine if there are any medical conditions related to the substance use problem; a psychiatric exam to determine if there are mental health problems, such as depression, that must also be treated; a review of the teen’s educational progress, and a review of the teen’s relationships with his peers. Does he have friends? Are they involved in drugs? The program may also ask in-depth questions of the family about how well family members communicate, whether there are discipline problems, whether there is a history of substance use within the family. The program will develop as complete as possible a picture of the adolescent’s problems so that the counselors can design a treatment plan to address them successfully.

3. How does the program involve the family in the teen’s treatment?

Family involvement in the teen’s treatment is critically important. Regardless of how well or badly the teen and the family relate to each other, parents are the dominant reality in the lives of most teens. Parents are also the major source of financial support, including medical insurance, if any. Most teens live at home, and their recovery will depend on how supportive the home environment will be in helping them build new lives free of alcohol and drug use.
Recent studies of adolescents who stop using drugs report that parental involvement, new friends and motivation are keys to success. Programs should encourage parents (or other caregivers) to participate in counseling, group meetings, drug education and other activities offered by the program. Occasional telephone calls between the parents and the program counselors are not enough. Families should also be asked to examine their own alcohol and drug use and to get treatment themselves when necessary. Programs should teach the family how to be more effective parents, including how to discipline children reasonably. The more the family is involved in the treatment process, the more likely the teen will succeed in treatment.

4. How does the program provide continuing care after treatment is completed?

The period after treatment is vitally important: most adolescents relapse in the first three months after treatment. However, continuing care services can greatly increase the likelihood of sustained recovery. Developing follow-up plans while the teen is still in treatment is important in providing a structure for the teen and his family, so that treatment gains continue. These plans may include relapse prevention training, referrals to community resources and periodic check-ups by the program with the adolescent and his family. Twelve-step meetings can also be helpful for some teens in recovery, although finding 12-step meetings specifically for teens can be difficult in some communities. Unfortunately, many programs do not provide continuing care, and parents must try to support the teen’s recovery as fully as possible. Parents can identify services within their community that will help the teen live without drugs, including well supervised recreational programs, counseling, and community service. Parents should stay in close touch with their children every step of the way. Parents who believe that their children can overcome their problems and be successful in school make a powerful difference even when faced with difficult circumstances. (In Treating Teens: A Guide to Adolescent Drug Treatment the help hotline numbers can provide referrals to resources in each state.)

5. What evidence do you have that your program is effective?

Very few programs have formal, scientific evaluations that m

easure their treatment success. However, even without such evaluations, other information can be helpful. For example, completing the entire course of treatment is closely related to success. Retention rate is an important indicator of whether a program is effective. How many teens drop out? How long do they stay in treatment? How many actually complete treatment? Other useful things to ask about are whether teens in the program show improvements in school performance (better attendance and grades) and family relationships (better communications, less aggressive behavior). How does the program monitor drug use among teens in treatment? Do they conduct drug tests? If so, how often do they test? What are the results? Good programs should have test results that show that teens in treatment are staying clean.

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1. Odor of substance in breath and clothes – persons who uses illegal drugs tends to smell bad or unusual if he or she is smoking marijuana, cocaine, or other illegal drugs.
2. Poor physical appearance – major changes in physical appearance if suddenly you find your son or daughter change in his physical appearance, forget to comb his hair, forgets to bathe and takes the fashion sense of other drug abusers.
3. Suddenly covering of his arms and legs – drug users who uses needles always wear clothes that can cover there body wear the needles are been use. they wear clothes like this even if its inappropriate.
4. Sunglasses is his/her best friend – Bloodshot eyes can be seen in drug abusers because of methamphetamine found in drugs.
5. Mood swings – Something might be wrong if a bubbly personality starts to become withdrawn and humorless or a normally reserved person becomes loud and boisterous. Watch out for self-destructive tendencies.
6. Unexplained loss of valuables at home – A dug abuser needs money to support his habit. His school allowance will not be enough.
7. Recent adverse life event – He is going through problems he cant handle like parents separating, losing a girlfriend, or sexual physical abuse.
8. School performance is getting worst – He is good student now getting failing marks. Discipline problems cause school authorities to call him in.
9. Out in school – He is always absent from class and gives false excuses.
10. Drug using group of friends – If his friends have a history of drugs or still using drugs then you should be very concerned. Look into the kinds of social gatherings he attends.
11. Decrease communication with other family members – He stops communicating with a favorite sibling, and he doesn’t consult parents when making important decision.
12. Repeated overt intoxication – Family members and friends actually witness him in high or exhibiting unusual behavior.

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If you think your kid is doing drugs, don’t panic, talk to him. Be gentle and non-violent or confrontational. Discuss the problem and how you can help. Make it clear that you are there to support and not to condemn.

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