Native Appalachian author Barbara Kingsolver has opened a new center focused on women’s opioid recovery in Virginia. Kingsolver won the 2023 Pulitzer Prize for Demon Copperhead, a novel about Appalachia’s opioid addiction crisis.

Now she is opening Higher Ground Women’s Recovery Residence in Lee County, Virginia, which provides a stable home for women who are learning to live sober after release from incarceration or inpatient substance abuse treatment centers.

Witnessing the Devastation

As a native Appalachian who lives on a farm in southwestern Virginia, Kingsolver knows firsthand how the national opioid epidemic “has changed so much of the texture of this place.” She has witnessed the devastation wrought by the pharmaceutical industry’s targeting of central Appalachia with sales of falsely proclaimed addiction-resistant prescription painkillers.

In the author’s words, “They came to harvest our pain when there was nothing else left.” 

Desperately Needed Recovery Services

In the process of researching for Demon Copperhead, Kingsolver delved deeply into the real life stories of individuals struggling with addiction and the loved ones who are often their caregivers.

The facility Kingsolver has opened in response to those stories, funded by proceeds from her Pulitzer-winning novel’s overwhelming success, offers desperately needed services to a region that has been ravaged by the opioid crisis.

Higher Ground fosters a safe and welcoming environment for healing from substance abuse, with private and semi-private bedrooms, a shared kitchen and a communal den. Perhaps most importantly, the center has helped to create a tight-knit support system of women who understand each other and the destructive impact of addiction on families and communities. 

Figuring it Out Together

This past June, an audience gathered at the Lee Theatre in Pennington Gap, Virginia to celebrate the center’s opening. When Kingsolver invited current residents onstage to share their experiences, they were more interested in discussing the bonds they have forged with housemates and staff members. 

35-year-old Syara Parsell, one of the center’s first residents, has already found work and enrolled in college classes. She says, “Together, we figure it out.” As Kingsolver says, in the end, the benefit to residents of the center “is not just sobriety, but belief in themselves.”

Finding NA Meetings

One of the best tools for achieving long-term recovery is meeting with like-minded people who are also sober.

You can find NA meetings in your area or call 800-934-1582(Sponsored) today.

To eradicate the opioid crisis, federal response efforts are intensifying as agencies ramp up resources to combat the Dark Net and international sources of illicit drugs.

The U.S. Immigration and Customs Enforcement (ICE) has noted that the rise of e-commerce has made the battle against opioids more difficult. Anyone with internet access can successfully place orders from their living rooms without going into the streets.

ICE personnel cite the 200,000 Americans who have died from fentanyl overdoses. Fentanyl is 50 times more lethal than other major opioids—50-100 times deadlier than heroin and morphine. Experts note that just one kilogram of fentanyl can produce over a million doses.

To combat the opioid crisis, federal agents like Greg Nevano are spearheading the charge. He is ICE’s Homeland Security Investigations (HSI) Deputy Assistant Director of the Illicit Trade, Travel and Finance Division. Nevano warns that drug users nowadays “get their fix just by ordering it online for much cheaper and get a more potent dosage.” The drug pusher on the street, whom the law would normally target, is largely a thing of the past.

Fighting the Opioid Crisis

One thing has become clear as agency personnel battle this epidemic. Law enforcement can’t handcuff the country out of their opioid addictions. An educated public and an engaged community are crucial partners to tackle trafficking head on. 

President Donald Trump has been active in combatting the crisis. He declared illicit opioids a national public health emergency back in October 2017. The president directed ICE to increase the number of agents and resources on the fentanyl field and to stop the flow of drugs into the country.

An International Reach 

The rise of fentanyl in the United States can be traced back to China’s chemical and pharmaceutical industries. These offshore companies manufacture copious amounts of drugs to export to the west with little regulatory oversight. ICE’s role is to cut off the illicit opioid trafficking from China and other nations from reaching American shores.

However, state and local officials don’t always have funding and resources to sustain the scope of the war against opioids. Here is where federal partners like HSI are brought in. Tripling HSI resources in heavily hit regions like Ohio helps law enforcement by providing crucial operational support and experts. The more resources put toward battling the crisis, the better the outcome for communities most affected by opioids.

What’s Next? 

To battle the opioid crisis, federal response is vital. HSI personnel team up with state and local partners to maximize its impact on transnational crime organizations operating within U.S. borders.

As is often the case, the solution to the problem lies in banding together as a nation to finally eliminate opioids from local communities.

Find NA Meetings Near You

As the government response continues to cut illicit opioids from their source, users can also do their part to turn their backs on drugs.

Take the first step by looking for NA meetings in your area or call 800-934-1582(Sponsored) today.

Fentanyl has overshadowed much of the opioid crisis in the public eye for the past several decades. But a growing number of new synthetic opioids called nitazenes have recently taken the American illicit drug market by storm. One report has noted that nitazenes have the same potency as fentanyl and in some cases are even higher.

Expanding the War on Fentanyl

President Donald Trump signed the HALT Fentanyl Act in July 2025 to classify fentanyl as a Schedule 1 drug. This strengthens the punishment for those convicted in fentanyl trafficking. But some experts contend that putting more focus and resources towards stopping fentanyl spread could lead to other drugs emerging to fill the void.

Dr. Nabarun Dasgupta of the Gillings School of Global Public Health in North Carolina tracks nitazene use. He states that the focus on fentanyl has encouraged the black market to switch to alternatives that are easier to trade and can hide in the shadows. Dasgupta’s team has detected nitazenes across 15 states with the largest concentration in Tennessee.

Taking a Closer Look

Alex Krotulski of the Center for Forensic Science Research and Education has done similar work. One problem with detecting nitazenes is that the technology required to identify them is not standard in autopsies, meaning nitazene-related deaths are likely underreported. Krotulski also contends that the United States lacks a “uniform way of tracking drugs” so tracking nitazines is difficult. 

Sheila Vakharia is a national expert on harm reduction. She agrees there was “no one consistent supply chain across all 50 states.” Vakharia also explains that new drugs typically start within one city and then spread to rural areas that lack tracking measures.

Finding a Path Forward

The current administration has recently requested cuts for the Centers for Disease Control and Prevention in 2026. On the chopping block is the National Center for Injury Prevention and Control. 

Dasgupta warns that cutting programs would further impede the ability to track and detect novel drugs. Nitazene usage is nowhere near the same level as the fentanyl trade, but concerns grow that the opioid epidemic will continue to grow in a new and potentially more lethal direction. Dasgupta says that “an unregulated drug supply is always going to be changing.”

If you or a loved one is impacted by opioids or other narcotics, there’s hope.

Check out local NA meetings on Narcotics.com or call 800-934-1582(Sponsored) .

Naloxone Texas, a statewide program that’s part of the University of Texas at San Antonio’s Be Well Institute on Substance Use and Related Disorders to prevent opioid overdoses in Texas, is deploying a new service on Texas college campuses this fall. It’s aimed at universities and colleges throughout the Lone Star State and offers overdose response training and free naloxone for students, staff, and faculty. 

Naloxone Can Save Lives

Naloxone is the generic of Narcan and rapidly reverses opioid-related overdoses. The drug can save a life when administered immediately after an overdose. The drug is similar to an EpiPen (epinephrine auto injector) or heart defibrillator in that trained bystanders can offer quick and effective life-saving measures before first responders arrive. 

In response to a growing opioid crisis in Texas that inordinately affects young adults, Naloxone Texas will target community colleges, private and public universities, and trade schools.

Dr. Tara E. Karns-Wright is an assistant professor in the Department of Psychiatry and Behavioral Sciences at UT San Antonio and director of Naloxone Texas. She expressed gratitude to the Texas Legislature and Texas Health and Human Services for funding the effort to provide every college campus with the resources and knowledge to respond to opioid overdoses.

“We’re making this life-saving medication more accessible and helping everyone become first responders in moments that matter most,” she said.

How Naloxone Texas Works

Naloxone Texas will be participating in back-to-school events across the state. These include hosting events at campuses in San Antonio, Austin, and Houston. Local staff and students can sign up for free naloxone kits at these events. They can ask questions and learn how to use the kits to prevent and treat overdoses. 

In addition to opioid overdose reversal kids, Naloxone Texas also makes available the following services to enrollees:

Evidence-based training services: There are virtual, on-demand teaching modules where participants learn to identify and respond to opioid overdoses. They can also understand the varied approaches to addiction treatment in general and how therapies are effective.

Naloxone distribution: Individuals and organizations may request free kits in bulk with an emphasis placed on areas where individuals are at high risk of overdose, as determined by county data.

Referrals to support services for adolescents and adults through the Be Well Texas Provider Network and the Be Well Clinic. Both offer in-person and virtual care for substance use issues. Referrals may also be given to NA recovery meetings throughout Texas.

Campus organizations, as well as student health services and college administrators, are urged to schedule customizable training workshops and request free naloxone kits by signing up here.

If you or someone you love is struggling with drug addiction, there is hope. Narcotics.com lists NA meetings around the nation, including online and virtual NA meetings.

For immediate support, call 800-934-1582(Sponsored) today.

Lily never planned on becoming addicted to oxycodone. Instead, she’d planned on running a marathon. But her life took an unexpected turn when she tripped during a morning jog and injured her knee. The pain was intense, and her doctor prescribed oxycodone to manage that pain.

Unfortunately, the oxycodone wasn’t enough to control Lily’s agony. She took more than the recommended dosage several times, just to take the edge off. And even though she told herself she had nothing to worry about, Lily really liked the feelings of euphoria the drug provided. She couldn’t run anymore, so she was feeling depressed. She secretly welcomed the opioid high.

Oxycodone Addiction and Opioid Detox

Lily started taking more oxycodone pills – and she took them with increasing frequency. She needed more of the drug in order to make her feel the desired high. Then one day, she ran out of pills.

That’s when Lily got sick.

Her muscles cramped up, she had a headache, she felt nauseated, and she was sweating profusely. She searched her symptoms online and quickly realized she had become physically dependent on the opioid painkiller.

The steady supply of opioids was no longer there, and her body’s systems were reacting with a fierceness in the drug’s absence. Lily understood in that moment she experiencing oxycodone withdrawal.

Symptoms of Oxycodone Withdrawal

Some of the typical symptoms people experience when they quit oxycodone include:¹

• Muscle cramps
• Vomiting and nausea
• Diarrhea
• Cold and hot flashes
• Anxiety
• Trouble sleeping
• Sweating
• Headache
• Watery eyes and nose

Note: It is possible to become physically dependent on oxycodone when you take it as prescribed. Your body gets used to the presence of the drug, so when you stop taking oxycodone, you can experience withdrawal.² 

What Happens After You Quit Oxycodone?

How long do the withdrawal symptoms last once you quit oxycodone? The process usually unfolds in the following timeline:

• Days 1-2: Initial withdrawal: Symptoms usually start 8-12 hours after the last dose of oxycodone.
• Days 3-5: Intensified withdrawal: Symptoms are usually at their worse during this time. Muscle aches are common, along with shaking and cramps.
• Days 6-7: Psychological withdrawal: At this point, physical symptoms lessen, and psychological symptoms grow stronger. Depression and anxiety are common.
• Days 8 and beyond: Detoxed: After eight to 10 days, oxycodone has usually been purged from the body (detoxed). Physical symptoms are gone. However, psychological addiction may still be present. If this is the case, you should seek additional treatment.

Is it Safe to Stop Oxycodone Cold Turkey?

Because she ran out of pills, Lily abruptly stopped taking oxycodone. Quitting cold turkey like this can produce very distressing symptoms, both physical and emotional.

For people who have other health conditions, the body’s physical reaction can cause serious issues. Even in healthy individuals, severe vomiting and diarrhea can cause life-threatening dehydration. And many people start using the drug again in a desperate attempt to make the oxycodone withdrawal symptoms stop.

To prevent this unhealthy cycle, it is usually best to taper off oxycodone as part of a professional opioid addiction treatment program. This is what Lily decided to do.

What’s the Process of Weaning Off Oxycodone?

Lily consulted with her doctor to develop an oxycodone tapering plan that worked for her. This plan would slowly wean her off the drug, minimizing withdrawal symptoms and helping Lily adjust to daily life without oxycodone.

Tapering plans typically include the following important steps when weaning off oxycodone:¹

• Flexible approach: The plan for tapering off oxycodone must consider the person’s risk, preferences, and goals.
• Initial decrease: The amount of the dosage decrease is less important than successfully achieving some form of initial decrease.
• Dose and interval: Tapering off oxycodone involves two separate processes: dose amount and the interval between doses. One or both can be adjusted throughout the weaning process.
• Slow progress: A slow taper is 5-10% dose reduction per month. This may be necessary if you’ve been using oxycodone for more than a year. A faster taper decreases doses by 10% per In extreme cases, where there is medical risk due to other conditions, a decrease of 30-50% may be appropriate. But this requires close monitoring.
• Scheduled dosing: If possible, it’s good to continue with the same dosing schedule. For example, if you’re used to taking prescribed oxycodone in the morning, continue to take it then.
• Pauses: Putting the tapering process on pause may be appropriate at some point in the process. This break gives you time to adjust to the new dosage and learn new coping skills.
• Progress: Tapering off oxycodone is considered a success as long as you’re making progress by reducing your oxycodone use.
• Support: During the weaning process, social support, mental health care, and physician supervision are important. Lily began seeing a counselor to help with her anxiety and depression.
• Healthy habits: Lily also benefited from developing ways to manage pain and maintain a healthier lifestyle. These included:
  • Good sleep habits
  • Healthy nutrition
  • Physical activity
  • Non-opioid pain medications

Medical Detox Helps You Successfully Quit Oxycodone

Sometimes, medications are used to help people detox from oxycodone. These FDA-approved treatments can help reduce oxycodone withdrawal symptoms and cravings. A healthcare provider prescribes the medication and closely monitors the patient’s progress. For some, this medical support can be the key for how to quit oxycodone.

Medical detox may involve one or more of the following medications:

• Buprenorphine: This is prescribed for moderate to severe oxycodone withdrawal. It reduces the person’s cravings for oxy and provides relief for withdrawal symptoms.³

• Methadone: This medication also reduces cravings and alleviates oxycodone withdrawal. It is used for medical detox from opioids that are longer acting, such as morphine.³
• Suboxone: This medication is a combination of buprenorphine and naloxone. It prevents cravings and blocks the intoxication effects of other opiates.⁴
• Other Medications: There are a number of drugs used during the detox process to treat withdrawal symptoms. Healthcare providers may prescribe medication to treat insomnia, nausea, diarrhea, and abdominal cramps. These may include temazepam, metoclopramide, and propantheline.³

Sources:

1. Sarah.Rinn,. (n.d.). Tapering and discontinuing opioid use. Minnesota Opioid Guidelines. Retrieved November 29, 2023, from https://mn.gov/dhs/opip/opioid-guidelines/tapering-opioids/
2. Doj/dea. (n.d.). Drugs of Abuse, A DEA resource guide (2020 edition). Retrieved November 30, 2023, from https://www.dea.gov/sites/default/files/2020-04/Drugs%20of%20Abuse%202020-Web%20Version-508%20compliant-4-24-20_0.pdf
3. Withdrawal management. (2009, January 1). NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK310652/
4. Grinspoon, P. (2018, March 20). 5 myths about using Suboxone to treat opiate addiction. Harvard Health. https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496

Suboxone withdrawal is worse than heroin withdrawal.

No one has ever been able to successfully taper off Suboxone.

Tapering off Suboxone is something that’s shrouded in both mystery and myth. While the thought of stopping the medication certainly generates a bit of anxiety, the unknowns and “what ifs” are truly the drivers of fear. What will it feel like when your Suboxone dose is decreased? Will it feel like you’re in withdrawal 24/7? Will anyone help you if the taper is going too fast?

By answering the what ifs and shining a light on the unknowns, tapering off Suboxone suddenly becomes a lot less frightening. Once the fear is under control, you’re free to play a leading role in your own recovery process.

What is a Suboxone Taper?

First thing’s first; let’s talk about what a Suboxone taper is and why it’s so important. Tapering is defined as gradually discontinuing or reducing the dose of a particular drug required by a patient over a prolonged period of time. Pay close attention to those last six words: “…over a prolonged period of time.”

The process of tapering is, by definition, meant to be slow.

Suboxone is an FDA-approved medication that has changed the way opioid addiction is treated. Its unique combination of two distinctive chemical compounds – buprenorphine and naloxone – give it the ability to virtually eliminate opioid withdrawal symptoms and minimize the risk of abuse. It takes time to recover from opioid use disorders, so most patients take Suboxone for an extended period of time.

Since buprenorphine is a partial opioid agonist, it does carry a risk of dependency. Given this risk, when you’re ready to stop taking Suboxone, a supervised taper is always recommended.

Trying to quit “cold turkey” without assistance can be dangerous and cause painful withdrawal symptoms, both of which increase your odds of relapse. A supervised taper, on the other hand, significantly lowers or eliminates withdrawal symptoms and prepares your body for life beyond Suboxone.

What to Expect During a Suboxone Taper

The road to a successful Suboxone taper begins with open, honest dialogue between you and your clinician. From those conversations, you will work together to develop a plan to reduce the amount of Suboxone you take. The result is a tapering schedule that is highly individualized and focused on your personal needs instead of being focused on adherence to one specific approach.

Your dosage can be lowered a little bit at a time over several days, weeks, or even months. According to the National Alliance of Advocates for Buprenorphine Treatment (NAABT), Suboxone should generally be lowered in increments of 2 mg at a time every few days. Keep in mind, however, this progress relies on your level of dependence and individual experience. If you’re on a well-structured tapering schedule, you should only feel mild withdrawal symptoms for a few days following a reduction in dose.

If, at any point during the taper, your withdrawal symptoms or cravings become more intense, talk to your clinician. He or she can readjust your dose or slow the taper. You may need to go back to a previous dosage level in order to stabilize or increase the amount of time in between dosage reductions.

In some cases, a medication called Naltrexone may be used after you’ve tapered off Suboxone. Naltrexone is an opioid antagonist medication that works by blocking the effects of opioids. When used after the Suboxone tapering process, it offers additional anti-craving properties that can strengthen long-term sobriety. If used before the Suboxone taper is complete, however, Naltrexone can cause precipitated withdrawal.

Getting Help With Your Suboxone Taper

Some people might tell you that getting off Suboxone is impossible – that no one can handle the withdrawals or function without the medication. Thankfully, that isn’t true. With proper treatment and support, you can successfully taper off Suboxone.

Tracy was aiming for a vein, but she missed. Instead of entering her bloodstream, the heroin went directly into the fatty tissue around the vein. It hurt, but she figured it was no big deal.

She was wrong…

4 Dangers of Missing the Vein With IV Drug Use

Injecting a drug (often called “shooting up”) means using a needle to deliver drugs like heroin, cocaine, and methamphetamine directly into a vein. When the needle fails to reach its target, this is called a “missed shot.”

A “missed shot” happens when a needle either: 1) doesn’t enter the vein properly, 2) enters the vein then slips out again, or 3) enters the vein and goes all the way through to the opposite side of the vein.

During IV drug use, when the needle slips or punctures the vein, it causes fluid to enter the tissue around the injection site. This often leads to infection, and from there, things can quickly go downhill. People can experience abscesses, cellulitis, vein collapse, and other complications.

Let’s take a look at four serious problems that can develop if IV drug users miss the vein.

#1 Abscesses

When a missed shot gets infected, you may get an abscess at the injection site. Your body is trying to fight the infection, so it sends cells to the damaged tissue to repair it. This causes the area to become swollen and fill with pus. (Pus is a mix of white blood cells that are sent to fight the infection, plus germs and dead tissue.)

Side effects of an abscess include:

• Redness of the skin
• Smooth swelling under the skin
• Pain in the infected area
• Warmth of the skin in that area
• A build-up of pus in the area

Because of the infection, you may also experience a fever and chills. Here’s how some people have described the abscess experience:

#2 Cellulitis

A missed shot can also lead to cellulitis. This is a deep, bacterial skin infection. It can occur when a break in the skin allows bacteria to invade (which happens when drugs are injected outside a vein). And it can be very serious.

Common symptoms of cellulitis include:

• Pain
• Tenderness
• Swollen skin
• Redness of the skin
• Bruising
• Blisters
• Fever
• Headache
• Weakness
• Chills

The pain and other symptoms start at the injection site, but the infection can spread quickly throughout the body. It can cause damage to tissue and tissue death. If you get cellulitis repeatedly, this can cause damage to your lymphatic drainage system and cause ongoing swelling of the affected arm or leg.

And the infection can enter your bloodstream, lymph nodes, bones, heart, or nervous system. At that point, it can become life-threatening. Complications from cellulitis can lead to amputation or even death. When you factor in the complications from addiction, it’s easy to see how things can spiral.

#3 Vein Collapse

Repeated missed shots can also cause your veins to collapse.

Here’s how it happens:

1. The injection causes damage to the lining of the vein.
2. Clots form around the damaged site.
3. The clots harden into scar tissue.
4. These clots narrow the vein, which restricts blood flow and causes future clots to form more quickly.
5. Eventually, the sides of the vein heal together (the vein “collapses.). There’s so much scar tissue that it draws the sides together and shuts off the vein.

Once a vein collapses, blood can no longer flow through it. Sometimes a collapsed vein can heal, but the damage can be severe enough that the collapse is permanent. In some cases, this can cause circulation problems.

#4 Substance Complications

In addition to the damage caused by the needle, the drugs themselves can irritate the vein or cause other issues. For example, research has shown that the acidity in heroin can damage veins. Researchers found that some batches of heroin have a pH level as low as 2.6 – which means the heroin is very acidic. (In comparison, lemon juice and vinegar both have a pH of 2.) Imagine the irritation your veins would experience with something that acidic flowing through them. With repeated exposure to such high pH levels, veins can develop life-threatening infections.

It’s also worth mentioning that, when people inject heroin that is mixed with cocaine, the cocaine actually numbs the injection area. That means you aren’t able to feel the typical pain associated with missing the vein. And when you can’t feel it, you don’t know there’s a problem.

IV Drug Users Can Expect Complications

Are complications from missed shots a common problem? Are you likely to experience one of these issues? Well, over half (56%) of people who inject drugs admit they’ve missed a vein. And one in six intravenous drug users reports experiencing a missed shot more than four times every month.

So, yes, IV drug use problems are common, and the risks are high.

How do we prevent opioid-related deaths?

Opioid-related overdose deaths continue to rise. But the public doesn’t want to deal with the problem in their city. Data from the Centers for Disease Control and Prevention show that overdose deaths rose nearly 30 percent in 2021.

The pandemic has only exacerbated the opioid crisis. And the crisis doesn’t have an end in sight, as newer, more potent opioids hit the street.

Public health officials are scrambling for solutions and agencies are increasing access to medication-assisted treatment. Communities are still largely opposed to methadone clinics in their town or city. This line of thinking is called “Not In My Neighborhood,” which is known by its acronym: NIMBY.

The only thing it’s doing is creating barriers to public health harm reduction efforts for the opioid epidemic.

Harm Reduction Helps Prevent Opioid-Related Deaths

Harm reduction services like methadone clinics, safety syringe exchanges, and even safe consumption sites are resisted in almost every city.

Sophia lives in New York City. She believes that the implementation of a safe consumption site is a disaster to the city.

“New York is already rife with addiction,” she says. “Bringing a ‘safe consumption site’ will only encourage addicts to swarm neighborhoods to use drugs, bringing crime, violence, and antisocial behavior to the city. I don’t want anything like that in my neighborhood!”

Those concerns are valid, and public safety concerns are important. However, Sophia does not get the full picture. However, medical professionals and researchers are working to shed light on the issue.

The Real Help of Harm Reduction

Dr. C. Debra M. Furr-Holden is an associate professor in the Bloomberg School of Public Health’s Department of Mental Health. She studies the effects of treatment centers on crime. Her Johns Hopkins Bloomberg School of Public Health research suggests there may actually be less serious crime near clinics than other community businesses. In fact, the research shows that drug treatment centers actually attract less crime than liquor stores and convenience stores.

Kathryn Stadeli is a surgical resident at the University of Washington. She is acutely aware of the effects of opioid-related overdoses in the state of Washington. She tells the Seattle Times that overdose-related deaths from fentanyl rose 70 percent in 2018 compared to the previous year.

Stadeli sees many of these deaths firsthand. She feels powerless over them.

“Unfortunately, opioid use disorder (commonly known as addiction) is not a disease I can cut away with a scalpel,” she says.

She suggests, however, that the use of certain medications can reduce the rate of opioid-related deaths by a staggering 50 percent. This method of treating opioid addiction is known as — known as medication-assisted treatment.

The problem: access.

Seattle, like many other cities, needs more medication-assisted treatment centers, like methadone clinics.

Stadeli talks about “Sarah,” whom she treated for a potentially deadly skin infection from injecting opioids. She explains that Sarah developed opioid use disorder after taking oxycodone for a sports injury. Like millions of other Americans who weren’t able to refill their prescription, Sarah turned to injecting heroin and fentanyl.

“I held her trembling hand as we wheeled her to the operating room; the fear invading her beautiful brown eyes when she asked me if she was going to die still haunts me,” Stadeli recalls.

Sarah had struggled to quit using on her own. Despite desperately wanting help, her situation and lack of housing meant that she wasn’t able to access the treatment she needed. Tragically, Sarah died from that infection shortly after her encounter with Stradeli.

“She was 22, and opioids killed her. Deaths like hers are preventable and unacceptable,” says the surgical resident.

The Benefits of Harm Reduction Services

Stadeli underscores the already substantial empirical evidence that that MAT is a far more successful treatment of opioid use disorder than alternatives, like rehab, resulting in less likelihood of overdoses. Those aren’t the only benefits.

The Substance Abuse and Mental Health Services Administration (SAMHSA) demonstrated that medication-assisted treatment:

• Improves patient survival
• Increases retention in treatment
• Decreases illicit opioid use and other criminal activities among people with substance use disorders
• Improves birth outcomes among pregnant women with substance use disorders
• Increases patients’ ability to gain and maintain employment

Yet, stereotypes about people who need medication, like methadone, persist. This stigma is a major barrier to treatment. This is why less than 10 percent of those with substance use disorder get the help they need.

In fact, research from the Recovery Research Institute shows that this stigma impacts the quality of care and how people with substance use disorders are treated.

Reducing Stigma to Prevent Opioid-Related Deaths

Given that level of stigma, it’s understandable why folks don’t seek help. And trying to quit on their own is an uphill battle with low rates of success. Added to that stigma is the public perception of bringing medication-assisted treatment centers to their communities, like Sophia mentioned.

Yet the evidence, like in Furr-Holden’s study shows the opposite to be true. Harm reduction facilities, like syringe exchange programs, methadone clinics, and other treatment facilities actually reduce the burden on the local economy by:

• Lowering rates of transmissible diseases, like HIV and hepatitis B and hepatitis C
• Reduce emergency department admissions
• Increased life expectancy and reduces overdose
• Improved access to treatment facilities and subsequently recovery
• Provided access to other critical services like housing and medical care
• Decreased the likelihood of engaging in criminal activities
• Reduced use of opioids
• Improved the likelihood of obtaining housing and employment
• Improves birth outcomes

Despite these overwhelmingly positive outcomes, being treated with methadone is still highly stigmatized. Most patients feel like they’re “dirty” for accessing this help.

How Can Destigmatizing Harm Reduction Services Prevent Opioid-Related Deaths?

Sarah Church, PhD, is the executive director of the division of substance abuse at the Albert Einstein College of Medicine. She mentions a quote from her colleagues, Murphy and Irwin, in a recent training:

After ten years of interviewing women and men in various stages of their methadone maintenance careers, recurring themes emerged, one of which was that being a methadone patient is a marginal identity; not quite junkie, not quite conventional. Clients’ efforts to manage this stigmatized identity were often shrouded in anguish and secrecy. Methadone patients were in a kind of identity limbo; a holding pattern between two extremely different social worlds. They were trying to affect an identity transformation; however, in many circumstances they were still associated with and defined by their ‘dirty secret.’

Prevent Deaths by Preventing NIMBY-ism

So, why we are still stigmatizing and resisting the very solutions to the opioid crisis because we don’t want it in our neighborhood?

Many would argue that, perhaps the solution to the opioid crisis isn’t only an increase in treatment facilities, particularly medication-assisted treatment facilities, but also the critical work of destigmatizing people with mental health disorders? What are your thoughts on the issue?

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.

You may know him as a young John Conner in Terminator 3: Rise of the Machines. Or you may recognize him as the child actor who co-starred with Mel Gibson in Man Without a Face in 1993.

Nick Stahl began performing at age 4 and was recruited by Hollywood at age 10. He was just 11 when Gibson discovered Nick’s talent, and his career took off from there.

And it was just two years later, at age 13, that Stahl discovered alcohol.

But let’s back up a bit.

Looking back at his childhood, Stahl gains some insight into why the stage was so appealing – and why alcohol was so appealing at a young age, too.

A Blanket of Fear

Stahl was raised by a single mom who worked two jobs to make ends meet.

Stahl recalls, “From a very young age, I was always under this blanket of fear, financial fear. There was this idea that if we didn’t come up with enough money for that month, we would end up on the street. That colored my outlook growing up. My default mode was untrusting, with this mentality of waiting for the other shoe to drop.”

“I don’t look back on my childhood with real fond memories,” he says. “But for some reason, when I did plays, that stuff shut off and I had this ability to just be very comfortable.”

And when he had his first drink at 13, he discovered a way to “shut stuff off” when he wasn’t on stage. The tense feelings disappeared.

“Suddenly, I had a freedom from thinking, from uncomfortability,” he explains. “I felt okay in my skin — and I hadn’t really felt that before.”

Full Steam Ahead

By age 16, Stahl’s career was in full gear, and he and his mother moved to Los Angeles. There, he discovered the party scene.

He recalls, “I was going to bars. I had a very easy time getting into these places. A lot of my friends were older, and I had a great time.”

“That became what I chased,” he says. For Stahl, the drugs alleviated anxiety. He wasn’t partying for fun, but for release. He explains, “Very early on, it was not ‘I want this,’ but ‘I need this.’”

Falling Apart

In 2001, Stahl starred in Bully, a true-crime drama. Brad Renfro, his co-star, also battled addiction at the time.

Stahl recalls, “He was more severe in his addiction than I was. He just progressed to a point where he had to have someone on set with him to keep him sober.”

Stahl knew he was headed in the same direction. He tried to stop the deadly addiction train he was on.

But none of that worked.

“Things started to get awful pretty quickly,” Stahl recalls. “I started to miss appointments. I put on a good front. The extent of my illness stayed hidden even from me. It’s common to justify, rationalize things. I looked around and said, ‘Everyone is partying the way I am.’ In retrospect, there were far less people going as hard as I did.”

In 2007, at age 27, Stahl entered rehab for the first time. In 2009, he tried again.

But Stahl couldn’t stay away from Hollywood for long. He went back – and was arrested multiple times. The charges included disorderly conduct and possession of meth.

Picking Up the Pieces in Recovering from Addiction

Despite his struggles, Stahl never lost an acting job. He was able to hold it together enough that he never got fired. But he knew he would soon, if something didn’t change. In 2012, he knew it was time to step away from acting for a while.

“I was physically there, but I was checked out,” he admits, “and I certainly wasn’t feeling any real enthusiasm for acting anymore. I knew that I had to step away, for self-preservation, but also for the preservation of my career, if I was going to have one again.”

Stahl spent the next five years in Dallas, “diving into his recovery” as he puts it.

Once he achieved sobriety, Stahl was able to give his life new direction. “It proved to be reconstructive for me,” he says. “That’s when I really started to piece together that I had neglected building a real life outside of the business. For many years, I had everything — but I didn’t have anything resembling a satisfying life. I didn’t have outside interests, I lost touch with friends and family. The film world made up too much of my identity.”

A New Life While Recovering from Addiction

When Stahl stepped away from Hollywood while recovering from addiction, he didn’t leave with millions in the bank. That meant he had to get a job like any other Joe. “So, I started working for a friend’s moving company,” he says.

“I tried other things. I worked at a coffee shop in New York for a little bit. Not only did I learn how to live as a sober person, which I didn’t know how to do, but I learned how to have a life outside the business.”

And this fresh perspective has allowed Stahl to re-enter show business with a healthy, sober outlook. “That passion inside me that burned for film and acting, it had dulled progressively over time,” he explains.

“But once I was separated from Hollywood, all of that started to come back. Over the past few years, whether I’m working on a film or auditioning, I don’t take it for granted, ever. I work much harder at it now. I just feel a renewed love for it.”

Clean for four years now, Stahl, age 41, is back in action with a full line-up of acting roles on his calendar.

But recovering from addiction comes first. “Recovery has to be the most important thing for me,” he says. “I put it first in my life. But I’m grateful for it, and it’s given me the opportunity to try to help people in the same situation I was [in]. It’s more important to me than making films. I search out people who have had similar struggles and show them how I got well. I speak from my experience and show them what worked for me.”

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.

80 members of Temple Sinai gathered for a Zoom call to hear their spiritual leader’s announcement.

They thought Rabbi Perice might have called the meeting to share that he and his wife were having a baby. Or that they were buying a home.

Or maybe that he was leaving his post.

Instead, he disclosed to his congregation that he’d been in recovery from opioid addiction for 10 years.

Perice explained that he shared this “because they trust me every day with the most vulnerable parts of their lives. What would it mean if I couldn’t trust them the way they trust me?”

Tearing Down the Stigma in Talking about Opioid Addiction

“When the rabbi told me in advance what he wanted to say, I thought it was a great idea,” said Johanna Schoss, president of the Temple Sinai board.

“For someone like the leader of our community, for whom people already have a lot of respect, to admit to having gone through a situation like this, it means that other people don’t have to be afraid to talk about it.”

“Addiction is still something that is thought of as taboo, but if our rabbi and our community can help in any way, it’s huge,” said past board president Stacey Blacker.

With this support and encouragement from leadership, Perice moved forward with his announcement. And the positive response has been overwhelming.

“I was overwhelmed by the support that this community showed me,” Perice said. “I’ve heard from probably 50 people, sharing personal stories, congratulations, all the nice things you would hope to hear after sharing something like this.”

Perice hopes Temple Sinai can get involved in addiction and recovery efforts through education and advocacy–like talking about opioid addiction. He knows firsthand how important the right support can be.

A Fateful Collision

It started in 2007, with a simple car accident. Perice was rear-ended and suffered shoulder, neck, and lower back injuries. His doctor prescribed pain pills, which Perice took as directed – at first.

“It didn’t just seemingly fix the pain at first. I had been dealing with anxiety and depression, and [the drug] gave me almost a sense of peace. It took away the angst about college and jobs. And something in my brain said, ‘I need more of this.’”

Perice upped his dosage. But the physical pain worsened and his addiction grew. When his doctor refused to prescribe any more painkillers, he began doctor shopping. And that’s when his life began to revolve around fending off withdrawal.

“I told myself, ‘I can’t be an addict,’” he said. “I was getting it from a doctor. I had legitimate pain. How can I be an addict? But after two years went by, doctors were no longer close to prescribing what I needed.”

“I needed to find other ways — calling friends and acquaintances, going into medicine cabinets and checking wherever I could get it. That’s when I was introduced to OxyContin, which is a very powerful opiate. That was the medication I was most actively using until the end.”

A Fateful Moment of Clarity in Talking about Opioid Addiction

In 2011, Perice’s life took a turn. One day in early spring, he ran out of OxyContin. He couldn’t find anyone who had the drug.

He was desperate to relieve his withdrawal. So, he called a known drug source and told him “I need something, anything.”

An hour later, the man brought Perice a bag of heroin.

Perice had never done heroin before. He sat in his bathroom, staring at the bag.

“It was a moment I can only describe as a moment of clarity. I was able to see that if I did this, I might die. I just flushed it down the toilet, called my parents, and said, ‘I need help.’”

He got treatment, which included a long-term medically assisted outpatient treatment, counseling, and physical therapy.

A New Path

Perice admitted, “Treatment saved me, but it didn’t give my life purpose. Re-finding my faith gave me purpose.”

Once he was “liberated from opioids” as he put it, Perice began considering the rabbinate. He entered Reconstructionist Rabbinical College in 2014 and was ordained in 2020.

He became the religious leader at Temple Sinai within a month of ordination.

After serving there for several months, Perice decided to share his secret with his congregation. And he’s glad he did. He described it as “a very powerful moment for me, and for my community.”

He added:

“But there are a lot of feelings about the issue [of addiction] in the world. Many people have dealt with this in their families. Addiction causes pain for everyone around [the person living in addiction].”

“So, it’s important to help people move through that pain. By removing the stigma and getting people help early, we can help them, and their families, heal.”

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.