NEW YORK— As authorities investigate the apparent heroin death of actor Philip Seymour Hoffman, experts say that narcotic addiction and overdose deaths are epidemic in the United States, particularly in the northeast.
According to federal reports, about 669,000 Americans use heroin - a figure that has doubled since 2007. Overdoses of drugs, both legal and illegal, kill more than 100 people every day, more than the number who die in automobile accidents.
A major factor in the upsurge, drug-treatment specialists say, is middle class people in their 20s and 30s who become addicted to prescription painkillers such as Oxycontin, and then turn to heroin.
“Someone will typically start on an opioid painkiller, and basically it becomes expensive, and they need to take more and more to get that high, and then they need to move over to heroin. And it happens very quickly,” said Allegra Schorr, an owner of the West Midtown Medical Group, an outpatient addiction-treatment center in Manhattan, and president of the Committee of Methadone Program Administrators of New York State.
Physician Stuart Kloda, an addiction medicine specialist in private practice, notes that those who quit heroin and then relapse are especially vulnerable to fatal overdoses.
"If at the end of your initial addiction, you were using, say, five bags of heroin, and then a couple of months go by and you start injecting heroin again, and you decide okay, ‘I'm going to inject five bags,’ your risk of overdose is very high, because your body is not tolerant of that amount of the drug,” he said.
Kloda and Schorr say that deaths like Hoffman's are preventable, because treatments that combine counseling with opioid replacements like methadone or Suboxone (buprenorphine and naloxone) are highly effective.
But they say not all drug rehabilitation programs are current in their treatment approach.
“They are not offering appropriate medical therapy for addiction, and they’re not offering Suboxone,” Kloda said, calling it “one of the best drugs that has been developed for addiction, in a very, very long time. Basically, in one day, once it's started, and the person finds the right dose, they’re out of withdrawal, everything is great," he said. "You’re fine, you feel good, and I consistently see people do well,” both at work and in their personal relationships.
Kloda says traditional self-help groups, like Narcotics Anonymous, are invaluable in offering social support and interaction with other recovering addicts. "It's like free group therapy, cognitive therapy," he said. But he said although it’s not official NA policy, “a lot of group members are anti-medications, even anti-depressants. So people have had their peer groups drop them, or they’ve relapsed, because they had a sponsor who told them to go off their medication."
Schorr says that for many addicts, opioid-replacement drugs are as necessary as a diabetic’s insulin. "The risk of relapse is always present," she said, "but one of the things that’s so important to know is that we do have answers.
"We know that medication with counseling is the answer. We have study after study," Schorr said. "It's heartbreaking for people in this field to know that here is this epidemic, and we have treatment available, and that people are searching and don’t know the answer exists, but the answer is here."