Author Archives: James Haggerty

About James Haggerty

Experienced Chief Executive Addiction Recovery and Mental Health Professional Business professional in the Addiction Recovery and Mental Health industry for the past 26 years. Caring, compassionate and strongly motivated to make a difference in the organizations I am affiliated with and welfare of the population we serve. Currently focused on advocating, educating and developing projects leveraging evidence based, real time technology to support individuals in recovery.

Fentanyl Overdoses Are Rampant, But Where Is The Drug Coming From?

Fentanyl Overdoses Are Rampant, But Where Is The Drug Coming From?

By now, most of America is well aware of the ongoing opioid epidemic, or has at least heard about it on the news a time or two. However, while most of the country recognizes the names of the most common opioids – names like heroin and OxyContin – and may even have a little knowledge regarding their effects, the true danger of fentanyl remains a mystery to many. What is Fentanyl? Why is it so dangerous? Where does it come from?

What Is Fentanyl?

Fentanyl is an opioid, which means that it is a compound that resembles opium in the way it physically or psychologically affects the user. Originally developed in 1959, fentanyl is a synthetic opioid meant to provide anesthetic and pain relieving effects to those who had recently had major surgery. Like other opioids, such as morphine and codeine, fentanyl was first produced for medical purposes.

Fentanyl is over 100 times stronger than morphine, which made it extremely effective at addressing pain during and after surgery. In the 60’s, fentanyl was administered as an intravenous dose to provide anesthetics before surgery. Due to the drug’s usage primarily in the hospital setting, there were no cases of fentanyl abuse at that time.

However, in the 1990s, manufacturers developed a fentanyl patch that could be applied to the skin for long-term pain relief, as well as a lollipop that could be consumed to provide pain-relieving benefits. Cancer patients enjoyed the pain relieving benefits of fentanyl, as well as the reduction in the emotional responses to pain. Unfortunately, recreational users did, as well.

Why Is Fentanyl So Dangerous?

As mentioned, fentanyl is extremely potent – 100 times stronger than morphine and 50 times stronger than heroin. In fact, even two milligrams is strong enough to cause death in adults. So, why do users risk death with such a strong substance? Sometimes, those using fentanyl are unaware.

In the early 2000’s, drug cartels began cutting fentanyl with a number of other illicit drugs, including cocaine, methamphetamines, and especially heroin. Sometimes, the cut drugs are diluted and sold in bricks; other times, the product is pressed into pills and sold as Xanax, OxyContin, or other prescription medications. Either way, a poorly mixed batch can feature areas rich in fentanyl, which is much stronger than the drugs it imitates. An unsuspecting user can consume high amounts of fentanyl without even knowing they’re using the drug.

What’s the motivation behind cutting fentanyl into other drugs? First, fentanyl’s ready availability from foreign laboratories makes it hard for dealers to pass up the ease of mass production. Compared to heroin, which takes months of growing and cultivating – not to mention land – accessing synthetic fentanyl is simply easier. In addition, the high potency of fentanyl means manufacturers must only include a little in each pill on order to give the user the effects of using another prescription opioid.

Diluting and cutting fentanyl can result in a great deal of money to be made. In fact, street values of a kilogram of diluted fentanyl can reach upwards of $350,000, all for a product that cost only $3,000 in its purest form. In pill form, that same kilogram can result in a million pills worth as much as $20 apiece – up to $20 million in profits for the seller.

Where Does Fentanyl Come From?

One source of fentanyl in the US is legal prescription medications. Some users improperly obtain and consume fentanyl lollipops for recreational purposes. Others remove fentanyl gel from the fentanyl patches and concentrate and inject or smoke it. Still, legal prescriptions are only one source of fentanyl.

Primarily, fentanyl in the United States comes from China, through multiple channels. One way Chinese manufacturers send fentanyl to the US is via direct mail. Consumers purchase fentanyl and other drugs over the dark web; the drugs are then packaged and arrive directly at the consumer’s mailbox, ready for consumption. Since fentanyl is so potent, the product arrives in tiny envelopes, packed in small packages that are easy to overlook with the large volume of international mail that passes through the US Postal System every day.

In many cases, fentanyl via mail is intentionally mislabeled so that it passes through other countries that proved less conspicuous than China. Often, packages travel through countries like Tonga and Canada before finding their way to the United States. Hundreds of shipments are seized each year, but hundreds more arrive at their destinations. When you consider just how potent a small envelope of fentanyl is, hundreds of shipments takes on a scary, new meaning.

However, in other cases the fentanyl pipeline is much more complicated than a direct route from China to US shores. First, much of the bulk fentanyl produced in China gets funneled through Mexico, where it is accessed and distributed by the same drug cartels that push other drugs across the US border. It is diluted, cut with other drugs, and distributed – usually through San Diego – to dealers across the county.

How does the fentanyl cross the border? The bulk of the US fentanyl trade comes from the Sinaloa and Cártel Jalisco Nueva Generación cartels. Like many other drugs, fentanyl reaches the US via the cartel’s smuggling routes on foot, via car, semi-truck, or boat. To that end, seizures of fentanyl have occurred in produce trucks, shoes, buses, and in airport passenger terminals.

What Can We Do About It?

Investigators in the United States and Mexico are working together to try and halt shipments of fentanyl from coming into the United States, which includes efforts to cease manufacturing, cutting, and transport operations in Mexico. Border security, mail inspections, and other efforts continue on both sides of the US borders with Canada and Mexico. China, as well, has begun efforts to curb fentanyl production with a series of regulations on the chemicals involved.

Still, officials are fighting a tough battle. Fentanyl has maintained its position as the most commonly overdosed drug in the United States since 2016, when it first surpassed other opioids in that respect. Similarly, between 2014 and 2015, officials saw a 2,400% increase in the seizure of fentanyl at the border. Cooperation among all countries and agencies is necessary to limit the amount of this truly dangerous drug that crosses our borders.

Could You Lose Your Job For Going To Rehab?

Could You Lose Your Job For Going To Rehab?

The decision to seek treatment can be lifesaving for many individuals experiencing addiction. Unfortunately, attending treatment takes time – often as many as 90 days, and sometimes more. The length of treatment can cause some individuals to assess the benefits of rehab against the potential risks taking time away from work and the rest of their lives.

Why Do Some People Fear Attending Rehab?

Although addiction can be a full-time job in itself, most people experiencing addiction hold steady jobs in order to support themselves, their families, and even the potential costs of addiction. When a physician, interventionist, counselor, or someone else suggests attending rehab, the prospect of leaving that job for the length of time necessary to complete rehab can seem daunting. Not only must the addicted individual face leaving the addictive substance behind, but friends and family as well.

When you add in the prospect of leaving a job for as many as 90 days, the idea of nearly three months without pay can compound already-present anxiety surrounding how you are going to pay for treatment in the first place. Then, the ultimate fear – what if there is no job waiting upon your return? Can your employer fire you for attending rehab?

Laws Exist To Protect You

Depending on the circumstances of your employment, laws are in place that may protect your ability to keep your job while you are in rehab. However, these laws only apply to companies of certain sizes. It is important to learn your rights before approaching the topic of rehab with your employer.

Once you enter rehab, the Americans With Disabilities Act (ADA) states that you are protected and cannot be terminated for reasons associated with your addiction. For example, missing work due to the treatment process – whether it is to participate in a weekly drug test or attend treatment – is a protected action under the ADA as long as you are using your vacation time or sick leave. If your employer fires you for seeking treatment, you may file discrimination charges against your employer. ADA regulations only apply to government agencies and companies with fifteen employees or more.

Similarly, the Family Leave and Medical Act (FMLA) states that employees may take as many as 12 weeks off to pursue medical treatment for a condition. This includes addiction disorders, allowing you to pursue treatment for up to 12 weeks without fear of reprisal. However, FMLA leave is generally leave without pay, unless your employer agrees to pay you anyway. FMLA regulations only apply to full-time employees of companies with over 50 employees. In addition, you must have worked at your company for at least 12 months.

What Are Your Options?

People Fear Attending Rehab

If FMLA or ADA does not apply to you due to the circumstances of your job, or if you cannot afford to miss work for a long period, attending a full, inpatient treatment program lasting 90 days or more may not be your best option. Instead, you may want to consider whether an outpatient treatment center is a better option. Although you may need to leave work for drug testing or sessions outside of the norm, it is possible to schedule outpatient treatment around a full-time work schedule.

Similar to inpatient rehab, however, those instances in which you must leave work early for sessions related to your treatment may occur, and similar questions may arise regarding missed work. You are still protected under FMLA and ADA if your company meets all size requirements. You are continuously protected from reprisal and discrimination resulting from your addiction.

Additionally, you may want to consider disability. If you are unable to work during treatment and earn less than $1,000 per month, you may qualify for disability payments. However, you must prove that your medical condition renders you unable to work, or that it has affected your work to the point where you cannot maintain employment. Ask a medical professional for more information.

What Should You Do Before Attending Treatment?

If you plan to attend inpatient treatment that will require you to miss work, or if you intend to schedule outpatient treatment that may interfere with your work schedule, you will need to discuss your upcoming absences with your employer. However, even if you believe outpatient rehab will not impact your work schedule, consider the fact that your treatment or the resulting withdrawal symptoms may affect your work performance. Usually, it is in your best interest to discuss these issues with your employer before they occur.

Before the conversation:

  • Know your rights. It is essential to take the time to learn about your rights to privacy and continued employment before entering into a discussion with your employer. To achieve this, you may want to speak with an insurance provider or medical professional with knowledge in these areas.
  • Familiarize yourself with your workplace’s drug policy. If you are well informed about your company’s drug policy, you are better able to reassure your employer that you do not intend to violate the policy. In addition, you can reassure your employer that your treatment plan is, in part, an effort to adhere to company policy.
  • Find your company’s HR representative. In most cases, HR is the appropriate place to have a discussion regarding your drug treatment plans. Reiterate that your treatment is an effort to improve your health as well as to improve your performance at work.
  • Have the conversation as soon as possible. Adequate notice that you are spending time away from work is a consideration to your employer, who can adequately plan for your absence. In addition, you will have sufficient time before beginning treatment to ensure your employer is respecting your rights.
  • Take care of responsibilities. Ensure that you leave your employer in a good position. Do your best to complete any projects that are your responsibility, and tie up any loose ends.

After You Return

Once you’ve completed rehab and return to work, the FMLA stipulates that you return to a similar position and work schedule as before so long as you continue to perform your job as expected. Your employer must keep the details of your addiction and treatment confidential, as well as the terms of your return. In some cases, you may have agreed to a return to work agreement. This document is an agreement between you, your employer, and the treatment center, and stipulates your continued sobriety, possible drug testing, and job performance as a condition of your continued employment.

Maryland Attorney General Unable To Stem Drug Price Gouging With Legislation

Maryland Attorney General Unable To Stem Drug Price Gouging With Legislation

Drug manufacturers in the United States have recently faced mounting public scrutiny and outrage over consistently escalating drug prices. Manufacturers have raised prices of vital medications by more than 6000% in some cases*, outraging Americans who rely on these medications to survive. Price gouging, or the practice of driving up the price of goods in the face of high demand when a product manufacturer has effectively “cornered the market,” is a major issue in the pharmaceutical industry with very real effects on American lives. Some state lawmakers have attempting to enact new laws and regulations to curb this worrisome trend, but so far, these efforts have largely failed.

Understanding Price Gouging With Pharmaceuticals

Most Americans witnessed one of the most recent developments in the fight against drug price gouging with the downfall of Martin Shkreli, the former CEO of Turing Pharmaceuticals who increased the price of a drug intended to treat a rare disease by nearly 5,000%, outraging patients and the general public and earning him the title of the “most hated man in America.” Shkreli is currently in prison for unrelated securities fraud charges and other crimes, but the impact of Turing Pharmaceuticals’ price gouging started an important conversation in the American public sphere about the justifiability of astronomical price increases on important drugs.

Maryland Steps Up To Fight Drug Price Gouging With New Laws

Maryland Attorney General Scott Frosh has been fighting pharmaceutical price gouging since 2017, championing a new bill intended to function as an anti-price gouging law that eventually passed on October 1, 2017. The new law allows the state Attorney General to take legal action against any pharmaceutical manufacturer that enacts an exorbitant or “unconscionable” price hike without justification.

Difficulties With Appeals

Many pharmaceutical manufacturers argue that the cost of developing complex medications justifies these price increases, and the Association for Available Medicines (AAM) fought Frosh’s new bill vehemently. The AAM argued the term “price gouging” was too vague to be included in official legislation and that such a law violates the Commerce Clause of the U.S. Constitution. This clause prohibits state governments from enacting laws and regulations that interfere with interstate commerce.

Unfortunately, these arguments held up in appellate courts, and although U.S. District Judge Marvin Garbis denied the AAM’s request for an injunction, he allowed their lawsuit to continue. A three-judge panel ruled that the lawsuit was justifiable and Frosh’s new law violated the U.S. Constitution’s Commerce Clause. Frosh responded to this decision by petitioning the U.S. Court of Appeals to reverse the decision, but they ruled against him and rejected this appeal on July 24, 2018. Their justification for this decision was that states should not have the right to impose regulations or consumer protection requirements on out-of-state manufacturers, even if those manufacturers intended to sell their products in those states.

Frosh Fights Back

Despite the U.S. Court of Appeals ruling that upheld the AAM’s lawsuit’s claims, Frosh and his team decided to reorganize their efforts and broach the issue with the United States Supreme Court. As of October of 2018, Frosh has helped spearhead the effort to convince the U.S. Supreme Court to reverse the U.S. Court of Appeals’ decision, citing the fact that any 1,000% increase in the price of a drug “defies common sense.”**

In his petition to the U.S. Supreme Court, Frosh argues that his anti-price gouging act contained objective examples of predatory practices among pharmaceutical manufacturers, but the Supreme Court has yet to hear the case.

Setting Precedent

Although Frosh’s anti-price-gouging law encountered hold-ups in the appellate court system, it served as an important catalyst that encouraged other states to start developing legislation to counteract price-gouging practices in the pharmaceutical industry.

On February 8, 2019, U.S. Senators Kirsten Gillebrand and Sherrod Brown co-sponsored new legislation aimed at fighting pharmaceutical price gouging***. Their new law would penalize any pharmaceutical company that engaged in any unjustifiable price gouging to exploit patients who depend on their products. Some of those patients suffer from cancer, diabetes, drug addiction, and other complex medical conditions requiring specialized medications.

This new law requires all pharmaceutical companies to report all price increases and include clear justification for such increases, such as objective manufacturing cost increases or increasing prices of necessary ingredients and raw materials. The law imposes heavy fines for companies that engage in any type of exploitative price gouging. Congressional representatives Mark Pocan and Marcy Kaptur have also co-sponsored similar legislation in the U.S. House of Representatives.

Pharmaceutical Manufacturers Respond

Many pharmaceutical companies have fought against these new legislative maneuvers, citing the rulings from the U.S. Court of Appeals against Frosh’s new law in Maryland and continuing to cite the U.S. Constitution’s Commerce Clause and protections for interstate commerce.

These companies have also attempted to justify their seemingly absurd price increases. In a recent interview with Financial Times****, Nostrum Laboratories representative Nirmal Mulye defended the company’s decision to increase the price of their drug nitrofurantoin from $474.75 to $2,392. Nitrofurantoin is a common antibiotic treatment for bladder infections and holds a spot on the World Health Organization’s list of essential medicines.

Mulye brazenly argued that selling a product at the highest possible price was a “moral requirement” of doing business, stirring up further outrage concerning predatory practices of American pharmaceutical manufacturers. He went on to further clarify these statements in other interviews, explaining that seeking profitability was an essential part of doing business and keeping a company alive.

Doctors Share Patient Stories To Draw Attention To Drug Price Gouging

Understanding Price Gouging With PharmaceuticalsThe Baltimore Sun***** recently published the story of a patient forced to choose between her life-saving heart medication and providing for her family. The grandmother of eight required a specific type of heart medication to support optimal heart function after overcoming a potentially fatal heart condition in the hospital. When she visited the pharmacy to fill her prescription and saw the $200 price tag, she decided to choose providing for her family over filling this expensive pharmacy order.

The woman’s doctor, Nicky J. Mehtani, reported the woman died of a heart attack shortly thereafter, after missing her required medication. Mehtani argued that neither negligent medical care nor ineffective treatment caused this woman’s death, but rather the predatory practices of pharmaceutical manufacturers pursuing profits at the expense of those who need their products to survive.

The Supreme Court has yet to rule on Frosh’s petition concerning his anti-price gouging law, and the viability of other new legislation aimed at curbing drug price gouging remains uncertain as well.

Long-Term Risks Of Methadone Maintenance

Long-Term Risks Of Methadone Maintenance

Opioid addiction is an ongoing problem in the United States, and every state has been reporting record numbers of new opioid addiction cases and overdose deaths year after year, for more than a decade. One of the reasons behind this ongoing epidemic is the tremendous addictive power of opioids. While they are tremendously effective painkillers, they are also very easily habit-forming and addictive. Once addiction sets in, withdrawal symptoms are very uncomfortable and may even turn fatal.

What Is Methadone?

Methadone is a synthetic opioid painkiller first used by the United States during World War II when injured soldiers needed painkillers, but morphine supplies were low. In 1971 the Food and Drug Administration (FDA) officially approved the use of methadone as a viable treatment for opioid addiction and other forms of substance abuse.

Today, the FDA allows the prescription of methadone for addiction treatment purposes as well as chronic pain. However, methadone remains a Schedule II controlled substance at the federal level because of its powerful effects and potential for abuse.

Short-Term Uses For Methadone

Methadone can help during opioid addiction recovery by helping a recovery patient taper off of his or her typical regimen of opioids. Acute opioid withdrawal symptoms are incredibly uncomfortable and often life-threatening in advanced cases of addiction. Sudden cessation can not only lead to intense cravings for more opioids, but also potentially fatal medical conditions like abnormal heart rate, organ failure, or stroke.

When an individual enters opioid addiction treatment, the first phase of treatment is detox, during which the attending caregivers flush the last of the drugs out of a patient’s body. Medically assisted detox generally offers the best chances of a successful detox process, while mitigating the risk of life-threatening medical complications from withdrawal symptoms.

Some treatment centers prescribe detox patients methadone because it offers relief from the symptoms of opioid withdrawal without the dangerous side effects of opioids like morphine or hero in. Methadone maintenance therapy has proven to assist with withdrawal symptoms and reduce the likelihood of relapse. However, there are risks with any type of methadone use, even in the short term. Long-term use entails even greater risks.

Long-Term Methadone Maintenance

Methadone is a synthetic opioid and shares many painkilling properties with other opioids like heroin and morphine. However, the effects are generally less pronounced than natural opioids or other synthetic opioids like fentanyl. Some doctors prescribe methadone as a treatment for chronic pain. A drug maintenance prescription like this may help a patient manage his or her chronic pain symptoms, but since methadone activates the opioid receptors in the brain it inherently carries a risk of chemical dependency.

Risks Of Long-Term Methadone Use

Risks Of Long-Term Methadone UseMethadone maintenance therapy may entail slightly less of a risk than abusing stronger opioids, but it is crucial for anyone undergoing methadone maintenance therapy to understand the risk of addiction and the signs of a habit forming. If a patient starts to experience withdrawal symptoms, he or she should speak with the prescribing doctor immediately to discuss alternative medications or even substance abuse treatment.

Over time, the human body naturally builds a tolerance to opioids with consistent use. A prescribed dose may work for managing chronic pain for months or even years before a patient starts to notice that a single dose is no longer as effective. This, unfortunately, encourages some methadone maintenance patients to begin abusing methadone by taking too much at each dose or altering the pills for more concentrated effects. For example, crushing a methadone pill and snorting the powder causes intense feelings of euphoria similar to those caused by a dose of heroin. These powerful reactions can quickly cause a methadone abuser to build an even stronger tolerance, propelling him or her further into chemical dependency.

Side Effects Of Methadone

Methadone side effects vary greatly on an individual basis. Milder short-term side effects may include upset stomach, sexual dysfunction, dry mouth, lightheadedness, and drowsiness. More serious possible side effects include fainting, seizures, anaphylactic shock, and even death from overdose. So how long does methadone stay in your system? It usually lasts up to two weeks but may remain detectable for even longer. The initial effects typically wear off within a few hours, but individuals who use a methadone maintenance treatment for chronic pain generally report long-lasting relief from each dose.

New Methadone Clinics Appearing Nationwide

In light of the ongoing opioid crisis in the U.S., new methadone clinics are appearing in metropolitan areas all over the country more frequently in recent years. A proposed methadone clinic in Baltimore met with protests from the local community, due to their concerns about the location of the clinic being too close to a local school, despite the fact that area crime statistics indicate that crime is less frequent around methadone clinics than liquor stores and corner shops.

Is Methadone Worth The Risk?

Despite the fact that methadone is a prescription medication that may aid in opioid addiction recovery, it may equate to trading one addiction for another in some patients. Everyone processes opioids differently, and depending on how long an addiction has lasted, and the severity of the addiction, an individual may find relief from opioid withdrawal symptoms with methadone treatment or the methadone may simply cause his or her addiction to last longer. However, some have made the argument that replacing one opioid for a less dangerous opioid is essentially the same as harm reduction.

Alternatives To Long-Term Methadone Use

Some chronic pain patients use methadone on a daily basis for several years without experiencing addiction or withdrawal symptoms, and the methadone manages their chronic pain well enough to carry on with daily activities. However, any long-term opioid use carries a risk of addiction. Any patient who relies on methadone maintenance therapy should closely follow his or her prescribing doctor’s directions for proper dosing and report any adverse symptoms immediately.

While methadone may help during opioid detox, this should only be a temporary measure that prepares the patient for rehab. Methadone can help reduce the appearance of withdrawal symptoms but may also inadvertently prolong an opioid addiction. Ultimately, methadone may offer relief from acute opioid withdrawal symptoms and chronic pain, unrelated to addiction, with appropriate use as directed by a physician, but it is essential to ensure responsible use or explore alternatives whenever possible to avoid the significant risk of methadone addiction.

Annapolis May Soon Offer Drug Test Kits That Detect Fentanyl In Drug Supplies

Annapolis May Soon Offer Drug Test Kits That Detect Fentanyl In Drug Supplies

In recent years, America has quietly been going through an opioid crisis that is only just now beginning to receive the attention it deserves. The most recent drug on the scene is fentanyl, a synthetic opioid that is now the main cause of overdose deaths in the country. Fentanyl is a white powder dealers and users can cut into cocaine without detection. This combination can easily lead to a fentanyl overdose.

New proposals would provide fentanyl test strips that would be available for anyone wanting to detect any traces of fentanyl in their cocaine. The idea has proven controversial, with some seeing it as a way to cut down on fentanyl deaths while others believe it avoids dealing with the real issue.

Cocaine And Fentanyl Overdose Deaths

In 2012, more than 4,400 people died from cocaine overdoses. Not counting methadone, only about 180 of those deaths involved a synthetic opioid like fentanyl. By 2016 – the last year for which we have complete data – cocaine deaths had risen to 10,400. Alarmingly, 4,200 of those involved a synthetic opioid other than methadone.

Cocaine overdose deaths are a problem that has traditionally hit the African-American community disproportionately hard. The use of heroin and fentanyl heroin, on the other hand, has arisen mainly in the white community. Some believe that the mixing of the two drugs could represent an opioid crisis spreading to a new demographic. But what is the reason for the link between the two?

Various Hypotheses

Though no one knows for sure why fentanyl is suddenly showing up in cocaine, there are a number of theories that experts find plausible.

  1. Users are mixing the two. They may be doing this unknowingly, because many dealers are selling fentanyl and calling it heroin. The problem is that fentanyl is far more potent, and if a user takes a heroin-sized dose of fentanyl, they could easily wind up taking too much. It is also possible that users are knowingly mixing the two together. A “speedball” is a mix of heroin and cocaine and has long been popular among drug abusers. As fentanyl increasingly replaces heroin, it is natural to find it as part of a speedball now.
  2. Dealers are mixing the two deliberately. There is some evidence to support this, as some batches of cocaine seized by police have tested positive for fentanyl. However, this occurrence is rare. It does not make much sense for dealers to mix the two, as one is an “upper” and the other a “downer”. Dealers don’t want to put their customers off any more than any other seller, and now that fentanyl is gaining notoriety as a dangerous drug, it makes less sense for dealers to risk the lives of people who are paying customers.
  3. Dealers are mixing the two accidentally. If a dealer uses the same table to cut their cocaine and fentanyl without cleaning it in between, this could lead to the two getting mixed together. This might explain why such a small proportion of seized cocaine batches actually have fentanyl in them.
  4. Better data. A final possibility is that the amount of fentanyl-linked cocaine deaths is not really changing, we are just getting better at detecting it as a cause of death. While it seems unlikely that this would explain the entirety of the apparent epidemic, some experts maintain it could be part of it.

Test Strips May Arrive Soon

Annapolis May Soon Offer Test Strips To Detect Fentanyl In CocaineAmidst the growing opioid crisis, Annapolis may soon offer test strips for fentanyl detection. A test kit could be as inexpensive as $1 per unit. The test itself is as easy as sprinkling a little bit of the drug into a cup of water and then putting the strip in the water. One line on the strip means there is fentanyl, two lines means there is none.

The effectiveness of such a plan depends on why fentanyl and cocaine are suddenly linked. If dealers are mixing fentanyl into their cocaine, whether by accident or on purpose, there may be a demand for the test strips if word about them spreads. However, as we have seen, there is scant evidence of widespread cocaine batches laced with fentanyl.

If it is principally users who are mixing the two, then there is no reason to believe there will be demand for a product that tells them what they already know, and cannot tell them how much fentanyl they have mixed in. We should also note that toxicology tests only determine the presence of cocaine and fentanyl in the body of the deceased. It is possible that the addict took the two drugs separately, which would further obviate the use of test strips.

We Should Have Seen This Coming

Test strips for fentanyl may do some good, but the drug problem is much bigger than that, and there are reasons to wonder just how much good it can do. Is someone who tests their drug supply and finds that it contains fentanyl going to get rid of it? It is likely that he or she may find it difficult to resist taking the drug if it means waiting several more hours until they can purchase more. Additionally, they may not have the money on hand to buy another dose. Although using the test strips suggests a level of self-care, those struggling with addiction also tend to lean towards high-risk behaviors.

Another issue is that the strips reveal the presence of fentanyl, but not the concentration. A person who decides to test their drugs has no way of knowing how much fentanyl the dealer mixed with the cocaine and may decide to risk taking the dose anyway.

Lastly, the mere availability of test strips does not guarantee that anyone will want to use them, or even see the need. If a user has already been taking fentanyl, even unknowingly, they may have developed a chemical dependency on the drug. If avoiding fentanyl means going through fentanyl withdrawal, they may see no reason to use the strips.

Treatment Is The Only True Solution

Ultimately, strips that test for fentanyl can have only limited usefulness at best. Even if someone struggling with addiction can use them to avoid taking fentanyl, they still are taking a harmful drug that can do damage on its own.  Any type of drug addiction makes it impossible to lead a normal, healthy life. The only way to make drug use safe, is to not take drugs at all, and that means a long-term addiction treatment plan.

Treatment centers, such as Echo Recovery in Maryland, give people the best hope to beat their addiction and start on the road to recovery. A good rehab center offers treatment, counseling, group therapy and a sponsor or mentor to support a person going through the recovery process. This is the best addiction relapse prevention. Those in Annapolis who require drug detox can contact Echo Recovery for help.

Every individual’s life experience, outlook and future goals are different. A treatment center will adapt their treatment plans to suit the individual. This offers the best chance at recovery, and recovery is the true goal for anyone with addiction problems. A fentanyl test strip is a band aid for a problem far worse than a cut to the skin.

First Responders Are In U.S. Classrooms Helping The Silent Victims Of Drug Abuse

First Responders Are in U.S. Classrooms, Helping the Silent Victims of Drug Abuse

The opioid crisis is causing far more damage beyond overdose deaths and increasing addiction rates. Drug addiction has had a profound effect on American families in every state. Every community has unique concerns when it comes to the opioid crisis, and American teachers are quickly becoming one of the most important forces of positive support in the country.

How American Teachers Are Stepping Up To Face The Effects Of The Opioid Crisis

The effects of drug addiction on a family may go unnoticed by outsiders. It’s difficult to tell the difference between a child suffering from the effects of addiction at home and the typical growing pains of the school-age years. However, American teachers are witnessing the effects of addiction on American children firsthand. More students are living in poverty and broken families than ever before, largely due to the ongoing opioid crisis. This makes teachers an important source of support for many American youths.

Families Fractured By Drug Abuse

Addiction takes a toll on a family. A parent with a substance abuse disorder will eventually deteriorate without intervention, and his or her children are likely to suffer the most when this happens. There are countless ways that drug abuse can harm a family, but children bear the brunt of this damage and often carry the scars for the rest of their lives. Addiction can also separate a child from his or her parents during the time parents are needed most; during the early years and school-age years.

Children In Foster Care And Poverty

Many areas across the country have been reporting higher entrance rates into the foster care system since the opioid epidemic started picking up steam. When a parent neglects financial responsibilities or endangers a child, the state intervenes and will typically place the child with a foster family or relative if possible. Ultimately, the state has a legal duty to rule in favor of the best interests of any children involved in any case.

Many parents have lost homes, custody, and even visitation rights due to substance abuse. Some go years without any contact. While there are plenty of avenues the government may take to separate a child from a potentially harmful parent, there are very few channels for reuniting families once a parent overcomes addiction.

Abuse And Neglect From Addiction

Drug abuse can lead to seriously damaging effects for any family. Some children have suffered physical and sexual abuse at the hands of addicted parents and relatives. Others have been trafficked to pay for a parent’s addiction. Many face neglect, homelessness, and poverty due to their parents’ habits and may come to school tired, hungry, and wearing filthy clothes.

Children who experience poverty, abuse, and/or neglect at young ages typically display significant behavioral and psychological distress for years to come. Seeing drug abuse firsthand at home can be traumatic and drastically impact a child’s outlook on the world. Children from fractured homes and those who go through the foster care system generally face a higher risk of developing substance abuse disorders themselves as well.

West Virginia Teacher Addresses Student Poverty

A recent Huffington Post report* covered the story of Gary Cruey, a middle school teacher in War, West Virginia, one of the areas of the country most acutely affected by the opioid epidemic. While the rate of foster care admissions in 2016 was 369 per 100,000 children, the rate in West Virginia skyrocketed to 1,221 per 100,000 children. Cruey reports that as many as half of the students he teaches live in foster care, with one parent, or another relative.

In 2014, McDowell County had the highest opioid-related hospitalization rate in the state, and West Virginia already reported significantly higher opioid abuse statistics than most other states. Cruey also reported that about 40% of middle school students in his district have individualized lesson plans or participate in special education. He attributes this spike in special education needs to the number of pregnant mothers abusing drugs in the area.

Long-Term Damage For Children Of Addicted Parents

The children who witness drug abuse at home often experience severe trauma. Even the children lucky enough to avoid physical and sexual abuse may still come home to find a parent dead from an overdose, eviction from unpaid rent, or a sudden removal from his or her home and foster care placement. The efficacy and safety of the U.S. foster care system has also been a hot topic of debate in recent years due to the increasing number of reports of abuse at the hands of foster parents and poor vetting practices in foster care services. Essentially, there is no guarantee that a child removed from his or her family home due to substance abuse will benefit in any way from foster care placement.

Overcoming trauma is difficult for anyone, but children lack the self-awareness of adults and may not be able to make sense of their environments. This leads to trouble learning, problems socializing, and an increased risk of drug abuse and criminal activity later in life. Teachers can play an important role in helping children in need by stepping outside their role as educators and offering support however they can. While this is an undue burden on American teachers whose job it is to simply teach, many undertake this burden because they want the best for their students and feel compelled to help however possible.

Finding Hope In Recovery

The resources available for fighting the ongoing opioid crisis are very limited, and while state and federal policymakers have made significant strides toward improving access to treatment and boosting the effectiveness of available treatments, there has been little progress in the way of improving the lives of children affected by substance abuse.

Echo Recovery offers a full range of substance abuse treatment services, including support for families struggling with homelessness. Learn more about the housing services we can provide and consider how you can start rebuilding in recovery.

Why Addiction Recovery Housing Is a Community Problem, and So Is the Answer

Why Addiction Recovery Housing Is a Community Problem, and So Is the Answer

What happens under one’s roof affects families and communities for generations. And so it goes with drug and alcohol addiction left untreated. This is the horrific truth for the people who live with the ramifications of the U.S. opioid epidemic and the fallout from other types of drug use. And the destruction is far-reaching. Addiction recovery housing is a community problem because of the stigmas and lack of financial resources surrounding substance abuse treatment and recovery.

What may be a roadblock to dealing with the stigmas and receiving the funding needed to make a dent in the issue is denial and failing to accept that the problem in Baltimore, D.C. and Pennsylvania exists to the extent that it does. It’s rampant.

Holiday Season Serves as a Painful Reminder of Drug Dependency

There’s a myriad of reasons why the cold winter season shows a more brutal depiction of drug use in America. Blizzard conditions create the harshest of circumstances for those destitute and living on the street. For a heroin addict who needs to choose between paying for heat in a home or scoring the next fix, warmth will wait. For the alcoholic, the spiritual season and pending New Year adds fuel to the fire of overconsumption, exacerbating stress for family members and friends who know full well what the holiday will bring.


How many households across America will have to hold an intervention during the Christmas holiday? How many will have their holiday dinner ruined because of a family member out of control on alcohol? How many others will cry because their son or daughter, brother or sister, aren’t welcome at the table? How many more will never come home?


Even if your family hasn’t been touched by substance abuse and overdose, finding a family that has is probably just a stone’s throw away. But even at that distance, their dysfunction will touch your home, hard.

Your Neighbor’s Drug Use Affects Your Home

Privacy is coveted. But there’s a fine line between love thy neighbor and a hostile takeover due to drug use. While this might seem dramatic, there is a cycle of behavior that eventually rears its ugly head when active addiction is present in a neighborhood.

Depending on the drug of choice, the user will try to keep the codependency hidden. As the craving for the drug continues, caution is replaced with a fevered need that must be met at all costs. Friends from their former sober life will be overshadowed by other users and dealers who can provide the fix. They come to the neighborhood, your neighborhood, at odd times of the day and well into the night.

Responsibilities and household obligations are seemingly nonexistent. For homeowners or tenants who are heavily immersed in drug use, property maintenance is forgotten. Landscaping is left to its own devices, showing neglect. Job loss will convert to missed mortgage or rent payments. As the decay in livelihood continues, risky behaviors and even violent or suicidal tendencies will increase. Crimes against those in close proximity to the user, such as theft and assault, are plausible occurrences to a neighbor.

Unless you know what to look for in the signs of drug and alcohol addiction, the problem could be staring at you every time you leave your home and head down the driveway to work. It’s hard to acknowledge something that we refuse to see.

What It Takes for Community to Come Clean

Accountability comes from the inside out, including the home. If there is suspected drug use in the home, seek out help. Consider professional guidance in orchestrating an intervention. It might require a few.

With the rate of relapse after drug or alcohol addiction treatment, many people are beginning to learn first-hand what we’ve known all along – 28 days to recovery won’t do much to last a lifetime. While you may not have a neighbor with a drug problem, you could wind up living across the street from a sober living facility. And that’s a good thing.

What Meth Can Do to the Value of Home

The damage done from drugs to a neighborhood can creep up to the unsuspecting.

Imagine if you had a neighbor across the street that seemed to be a recluse. Random people would come to visit but no one you would consider worth striking up a conversation with. So when another neighbor who lives three doors down tells you there’s a meth house in the subdivision, you quickly assume it’s the one across the street.

Wrong. It’s the one that had the young couple living there. They were talking about having kids soon.

However, they didn’t have a drug problem. They were short-term tenants renting there. The people with the drug problem were the tenants who lived there two years earlier. But why did no one know? And how are they just finding out about it now?

The owners decided to sell the home. The would-be buyers decided to do a home inspection of the property to make sure they knew what they were buying. Because of the increase in methamphetamine use, many people are including an inspection for meth exposure as part of their due diligence.

A property doesn’t have to be cleaned and decontaminated just when meth is cooked in the home. Meth users who smoke it will leave traces of meth in the air ducts, carpet, and walls. The environmental hazards from meth use are much like second-hand cigarette smoke with far more serious consequences, including liver, kidney and respiratory illnesses. Unless a sample test for the substance is done, there are no visible signs that meth ever existed.

Other risks to residents in any given neighborhood include the ties to other drug users and dealers that remain once the addict leaves the home, overdoses or dies. Those who crave a drug will seek out others they know who use and may have access to the drug they want or know people who provide a hook up. Drug addiction is a lingering problem for communities.

We are all directly or indirectly touched by drug and alcohol addiction. Through ECHO (East Coast Housing Opportunities) nonprofit, we can invest our time and community resources by joining together to be part of the solution.

Echo Recovery December 2018 Fundraiser Is Just the Start

It really does take a village. Even with the additional federal funding for changes in the way opioids and other medications are prescribed, drug addiction remains an ongoing problem. For every addiction detox and rehab available, there are scores of people who engage in the process, only to leave early or complete the program and succumb to the triggers of relapse. While this may be part of the normal process of recovery, there is a disconnect that must be addressed and circumvented.

Because drug and alcohol addiction is a behavioral disease that affects the mind, body and spirit, recovery is a lengthy endeavor. As the body and brain heal and search for realignment and chemical balance, those in recovery need a supportive bridge that can take them from the routine of therapy sessions and holistic practices in treatment to the freedom of sobriety and living on their own. That bridge is found in sober living houses.

Unfortunately, Maryland and surrounding states don’t have enough sober living houses to fulfill the need—not even close; which is why ECHO is amidst a fundraising campaign, just in time for the holidays.

ECHO provides the outreach, educating, informing and guiding communities to work together and forge new alliances in the fight against substance addiction. One of their primary focal points is in networking to coordinate and partner with treatment facilities, housing resources, philanthropic entities and individuals that can, collectively, make a difference and provide residences for the aftercare phase of recovery, known as sober living.

We invite you, your family, neighbors and friends to participate in sharing the opportunity to help communities better support sobriety through awareness, sober houses and everyday resources.

Jennifer Nilsson of ECHO is hoping to reach this year’s fundraising goal of $25,000 in addition to receiving new clothing and household item donations.

You can also join ECHO at their next fundraising event:

ECHO 2018 Year-End Fundraiser
Buffalo Wild Wings
December 12, 2018
4:00 pm – 9:00 pm

(5 Bel Air S Pkwy
Suite P1649
Bel Air, MD)
Maryland Recovery already knows the importance of sober living to success rates of addiction recovery, as it focuses on serving the initial phases of treatment and detox from drug and alcohol addictions. It considers ECHO a valuable and much needed resource for local and regional communities and hopes to foster a long term alliance.


Sober Living Home Success Rates - ECHO Recovery

Sober Living Home Success Rates

Do sober living homes provide value when it comes to substance abuse recovery? Of course, we will always reply, “Yes,” to this question, but can we quantify it?

There are a lot of variables in play when it comes to sober housing and determining what constitutes success. Nevertheless, we will draw upon a longitudinal study as well as other relevant statistics in order to demonstrate the great benefit of sober living homes.

If you’re looking for the universal success rate, there’s not one easy number to point to, but we can provide several related stats and facts that help paint a pretty close picture.

Sober Living Longitudinal Study in California

One of the most wide-ranging studies of sober homes came out of California last decade. Douglas L. Polcin, Ed.D., led a group of researchers who studied two different models of sober living houses from 2005 to 2010. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) funded this study, called “the first examination of sober living house residents using a longitudinal design.”

The Journal of Psychoactive Drugs published Polcin and co.’s findings in December 2010. The study tracked the results of 300 individuals who entered one of the two sober living communities on which Polcin’s team focused.

The two disparate models of sober living homes were:

  • A group of homes located in Berkeley, California with a direct connection to an outpatient addiction treatment program. At the time of the study, there were four houses and 58 beds in total.
  • A community of 16 “freestanding” houses (136-bed capacity) in Sacramento County, California. The first 30 to 90 days of residency were heavily structured, while residents enjoyed more personal freedom if they stayed longer than that. All residents had to abide by a curfew and attend 12-step meetings.

The research team interviewed all participants within their first week at one of the two sober living communities, and then conducted follow-up interviews at the 6-, 12- and 18-month marks. The study noted, “Average lengths of stay in both types of sober living houses surpassed the National Institute on Drug Abuse recommendation of at least 90 days to obtain maximum benefit.”

The average length of stay in the Berkeley sober living community was 254 days. The Sacramento County community boasted a still-impressive average length of stay of 166 days.

Sober Living Home Success Rates: The Findings

In the Berkeley sober living community, only 11 percent of interviewees said they were completely abstinent from drugs and alcohol over the six months prior to their initial (“baseline”) interview. During their stay in the sober home, that rate improved to:

  • 68 percent at the 6- and 12-month marks
  • 46 percent after 18 months

That’s right: The rate dropped between 12 and 18 months, but the researchers noted it was still significantly better than the baseline rate.

In the Sacramento County sober homes, 20 percent of interviewees said they were completely drug and alcohol abstinent over the six months prior to first entering the home. Over time, that rate improved to:

  • 40 percent at 6 months
  • 45 percent at 12 months
  • 42 percent at 18 months

Yes, the rate decreased here between 12 and 18 months, also. Why? The study noted that 68 percent of the Berkeley participants and 82 percent of the Sacramento County participants had left the homes by the 12-month mark. Arguably, the residents who stayed past that time may have been the ones who were struggling more with complete abstinence and needed extra time, driving down the rate over that final six-month period.

Sober Living Benefits: Additional Takeaways

The study noted that the alcohol and drug severity was already low among residents first entering one of these sober homes.

“Because severity was low there was limited room to improve on these measures. Nevertheless, we found significant improvement at 6 months for both alcohol … and drug (abstinence). Those improvements were maintained at 12 and 18 months,” the report said.

The researchers also found no statistically significant differences in outcomes among demographic subgroups (age, gender, ethnicity, education level, etc.) and different referral sources (self, family member, criminal justice, inpatient program, etc.)

The study also noted, “By 18 months nearly all had left, yet improvements were for the most part maintained.”

Researchers could not conclude that one model of sober living was better than the other, due to the differing demographics and objectives each model had. Ultimately, it comes down to what’s best for the individual.

In general, however, the researchers concluded that sober living houses are beneficial for people who are:

  • Completing residential treatment
  • Attending outpatient treatment
  • Seeking non-treatment alternatives for recovery (a sober, structured environment)
  • Entering a community after recent incarceration

Longer Programs Equal Reduced Relapse Rates

A related study worth pointing out has to do with the length of addiction treatment programs. For those who went to treatment for 90 or more consecutive days, the relapse rate was only 15 percent within the first year after completing treatment, according to the National Institute on Drug Abuse.

Compare that to the nearly 40 percent relapse rate within the first year among those who only received 30 days of treatment. Findings like these are why the NIDA has declared 90 days to be the new gold standard for addiction treatment program lengths.

The NIDA has never stipulated that patients need to complete all 90 days in an inpatient rehab facility. A combination of inpatient and outpatient treatment, uninterrupted, can be just as effective, especially if the individual takes advantage of sober living accommodations while participating in an outpatient program.

Even the previously mentioned NIAAA-funded study concluded, “there are several significant advantages” when pairing outpatient treatment with sober living accommodations. Among the many benefits is the lack of arbitrary discharge dates by the program, allowing the individual to decide when he or she is ready to transition to greater independence.

“Some residents probably benefit from the mandate that they attend outpatient treatment during the day and comply with a curfew in the evening,” according to Dr. Polcin and his research team.

Sober Living on the East Coast

ECHO Recovery believes strongly in helping people find access to recovery homes that are tied to structured outpatient programs. Through the generous donations we receive, we also may be able to offer financial aid to certain clients to cover a portion of their costs for staying in a sober home.

Whether you’re brand new to rehabilitation or currently in an inpatient program, ECHO Recovery can help you find sober living accommodations on the East Coast along with ongoing outpatient treatment. Contact us if you’re ready to start or continue your journey to addiction recovery.

Learn the Rules of Sober Homes

How To Pay For Sober Living Recovery Home Stays - ECHO Foundation

How to Pay for Sober Living and Recovery Home Stays

When you come to the end of a rehabilitation program, your funds may be drained from not working, and your insurance company has likely payed for all of the treatment it’s going to pay for. Perhaps you can get your insurer to cover outpatient treatment, but any other resources you may need – such as sober living accommodations – will probably be out of pocket.

So, what are your options if returning home is untenable at this time and you need to stay a few more weeks in a drug- and alcohol-free environment? A recovery home is the ideal situation you’re looking for, but paying for it won’t be easy.

Unless you have a few thousand dollars lying around after completing rehab, here are some tips for helping you pay for a recovery home stay as you continue to become accustomed to sobriety:

Will Insurance Cover Sober Living? Try to Use Your Insurance Plan

Just because the chances aren’t great that your insurance plan will cover a recovery home stay doesn’t mean you should avoid looking into it. There are so many insurance companies and unique plans out there that it’s hard to say with 100 percent certainty that you will or will not be covered.

Perhaps you have a higher-end policy that might cover this kind of expense, or if you’ve had a doctor deem sober living as medically necessary, then there’s a higher chance your insurer may cover it. Another possibility is you’ve had the foresight to add on certain options to your insurance plan, which may now cover extended care and accommodations for drug addiction.

You can’t know for sure unless you call up your insurance company directly and ask them if sober living is specifically covered, or what you have to do to get it covered. If you employer provides your insurance, you may be able to get your answers through a human resources representative at your workplace.

The moral of the story is: Don’t rule it out until you’ve asked.

Explore the Recovery Home’s Payment Options

If you’re interested in a specific recovery home, contact them to explore their payment options. They may be able to find a solution that works with your budget. They may offer financing so that you don’t have to put down the money all at once. Perhaps they will also offer a grace period before you start having to pay the loan back.

Some recovery homes are able to offer scholarships and financial aid in order to offset some of your costs. At ECHO Recovery, we take monetary and household good donations in order to help clients afford their fees and to so we can keep our recovery homes stocked with everyday communal items.

The takeaway here is to communicate with your desired recovery home and explore their payment plans before ruling out sober living completely.

Work While You Reside at the Recovery Home

Many recovery homes require you to work at least a part-time job while you enjoy their accommodations, so this can factor in to how you pay for their fees. Although the job you find (or resume) likely won’t cover the entire cost of recovery home living, it will certainly help. It may also factor into the loan terms they offer you if you approach them about a payment plan.

Seek a Private Loan

By no means are you relegated to the recovery home when it comes to seeking a loan. You can approach a bank or another reputable lender in order to seek one of the following types of loans:

  • Personal
  • Medical
  • Hardship

In fact, you may want to do this and secure your terms and then approach a recovery home and ask about their payment plans. This way, you can choose the best terms possible for your budget, and you won’t regret not exploring more payment options.

Please note that while you can take out a loan for sober living and possibly qualify for a scholarship from the recovery home itself, there are no federal grants available for “drug-free supportive housing” at this time, according to the federal Center for Substance Abuse Treatment.

Look into Nonprofit Scholarships and Sponsorships

There may be nonprofit organizations either in your hometown or located near your desired recovery home that can offer you financial assistance for sober living. It’s doubtful they will be able or willing to cover the entire cost, but any aid they can offer will help.

The recovery facility you look into may bring up this option if you talk to them about payment plans; they may work with local nonprofits in order to help their clients afford the accommodations. Otherwise, do an independent search online for a charity or nonprofit that may offer financial aid for your sober living stay.

Other Potential Options to Pay for Sober Living

And, if all else fails, or if there’s a certain dollar amount that you’re having trouble covering, there a few last-ditch efforts you can try, such as:

  • Ask a friend, family member or close neighbor if they would be willing to lend you the money until you can pay them back.
  • Sell off personal property or assets that can help you cover the sober living costs.
  • Dip further into your checking account or into your personal saving account, if you haven’t done so already. Be sure to leave enough to live off when you return home.

We understand that you would have to set aside some pride and personal comfort in doing any one of these three things, but consider what’s at stake here: your life and your health. If you finish rehab before you’re really ready and then you relapse, most of the work you did and most of what you’ve spent will have been for not. We say “most” because sometimes you can get right back on track quickly.

Think of the long-term implications of not following through with your recovery, and also think of the success you could find if you maintain sobriety for years on end. Look at rehab and sober living as an investment into your future.

Recovery Housing on the East Coast

ECHO Recovery can help you with a stable place to stay as you pursue outpatient addiction treatment or if you simply want more time in a sober environment before returning home. Our recovery homes emphasize life skills and encourage employment in addition to any treatment you’re receiving and support groups in which you’re participating.

Through various generous donations, we’re able to offer financial aid to many of our clients, as well. Find out more about the services we can provide to support you or your loved one’s walk toward recovery by clicking below.

Explore Our Recovery Housing Services