Drug addiction can come on quickly. But acquiring a physical dependence takes time, commitment.
Jeremy Galloway knows the difference.
After 10 years of shooting heroin into his veins, a jail stint and broken relationships, the 37-year-old Dahlonega resident is finally clean. He no longer feels like another statistic.
Galloway can recall the first time he used heroin. And it opened a primrose path.
“I wouldn’t say I was addicted right off the bat, but it kind of fixed something in my brain,” Galloway said. “I could tell a difference the next day. It felt like medicine. It got rid of the anxiety.”
Addiction is best understood by the consequences it has on an individual’s life — work, relationships — and the compulsive drive to score the next high.
Dependency is the body’s physical adaptation to chronic drug use, requiring more and more of a substance to attain a feeling of “normalcy.”
For Galloway, heroin at first seemed like a “miracle drug,” a cure for his depression, but revealed its true nature over time.
Galloway found himself using three or four times a day, still able to maintain a job, but the drug eventually became all consuming.
“I had to find other ways to get money ... to keep up the habit,” Galloway said, which included stealing for a fix.
More and more Americans can relate. A recent report from the Centers for Disease Control and Prevention and U.S. Food and Drug Administration finds that 2.6 out of every 1,000 residents 12 and older used heroin between 2011 and 2013, a 63 percent increase in use of the illicit drug over a 10-year period.
It’s a retro drug craze — except what’s old is not just new again, but worse than before.
Heroin abuse or dependence has climbed 90 percent, and deaths from overdoses quadrupled during that period, resulting in 8,257 deaths in 2013.
More than half a million Americans used heroin that year, a nearly 150 percent rise since 2007, according to the report.
Increase in heroin use has been seen across all major demographic groups, including women and the wealthy, in addition to the stereotypical inner-city and suburban youth junkies.
Admissions to methadone clinics are up. So, too, are emergency room visits. And more babies are being born addicted to opiates.
There has also been an increase in hepatitis C infections from intravenous needle use.
How did we get here?
Heroin’s growing toll has been seen here in Hall County. Emergency 911 Director Gail Lane said 387 overdose-related calls for help were made in 2014.
The rise in heroin use corresponds with an increase in prescription drug abuse over the last decade. Prescription painkillers, for example, are involved in 68 percent of opioid overdoses treated in emergency rooms, according to the CDC and FDA report.
“Prescription drug abuse has become a major epidemic in the last 15 years,” said Mohak Davè, Northeast Georgia Medical Center’s chief of emergency medicine. “At first, this was associated with a slight decrease in heroin abuse, but now heroin abuse has quadrupled since 2002. In fact, the CDC reports that drug overdoses now surpass car accidents and gunshot wounds as the leading cause of death from injury in the United States.”
Oxycontin, a popular opioid prescribed for pain relief, was reformulated in 2010, causing supplies to restrict and prices to spike. That pushed many users into the black market.
By comparison, heroin is cheap, fairly easy to acquire and has a longer, more intense impact marked by immediate euphoria and crippling withdrawal, including vomiting, nausea and diarrhea.
But the pain is no match when the dependence kicks in.
“With tighter supply of prescription drugs, some patients with addiction have resorted to heroin abuse,” Davè said. “Heroin supplies have also increased in the illicit drug market, making it cheaper as compared to prescription drug alternatives.”
As heroin use grows, emergency medical professionals have been called on to save the day.
Christie Grice, battalion chief of business services for Hall County Fire, said several lives have been saved in the local area this year thanks to medications that reverse the effects of heroin and other opiates, including a woman who recently overdosed on prescription painkillers and fell into cardiac arrest.
“Naloxone is one of the most important drugs,” Grice said. “If we don’t give this medication, then they’ll actually end up dying.”
Studies have shown naloxone has a success rate as high as 98 percent.
“It’s literally day and night,” Galloway said. “Raising the dead, I guess you could say.”
Jeremy Sharp, a student at the University of North Georgia who founded the Students for Sensible Drug Policy chapter, said hundreds of lives across Georgia have been saved by naloxone.
“So far, we have over 300 opioid reversals in about a year and half,” he added.
Focus on treatment becomes more critical
“We are facing challenges from both prescription and illicit drug use, which require greater focus on addiction recognition and treatment,” Davè said.
But the first step in treatment is often fighting stigma.
Addiction and dependency is not a matter of will power, health professionals say. It’s not a matter of morality.
That’s why Sharp helped lobby lawmakers last year to sign a medical amnesty law that essentially encourages drug users to call for medical help in the event of an overdose by granting some immunity from prosecution.
When it comes to weaning a user off heroin or other opiates, treatment plans often include a variety of methodologies, including therapy to address addiction and methadone to treat dependency.
Rustin McAlister, medical director of the Lanier Treatment Center, a methadone clinic in Gainesville, described heroin addicts as having an imbalance in the brain, and withdrawal can cause severe digestive complications, anxiety and depression.
Methadone, a synthetic drug that blocks the high associated with heroin use, was a first step for Galloway to get clean.
Now he is taking suboxone, which binds and coats the brain’s receptors and restricts the effects of opiates. Galloway said it has the added benefits of not creating a buzz and lasting longer than methadone.
He takes the medication orally each morning, letting what looks like a breath strip dissolve under his tongue.
“There’s really not any potential for abuse,” Galloway said.
Galloway is hesitant to call it fate, but he feels like he has something to offer now given all he’s been through.
And so he’s taken to becoming an advocate for addicts, passing out overdose prevention kits, attending “Harm Reduction” conferences and using his writing talent to engage a wider audience about his belief that drug use should be treated, not criminalized. “I feel like I have a lot of people who depend on me,” Galloway said, adding that he hopes his personal struggles can show other addicts how to step back from the brink. “It means a lot more coming from someone who doesn’t use anymore.”