Alaskans are increasingly abusing multiple drugs, making treatment difficult

Sage, an 18-year-old from Anchorage, recently spoke about his substance abuse at a Volunteers of America Alaska community event. We are not using Sage’s last name to protect his privacy. He said he started smoking weed in sixth grade.

“I ended up smoking weed that was laced with either fentanyl or heroin because I suddenly felt really heavy, nauseous, had a lot of itching, and had a really weird taste in my mouth,” Sage said.

He recalled other times when he took combinations of medications or times when he wasn’t sure what he was taking.

“I was taking Adderall, meth, weed, Xanax, as well as alcohol and nicotine,” Sage said. “That was one of the worst nights of my life.”

According to Katie Schneider, a physician assistant who runs the Southcentral Foundation detox center, Sage’s experiences are fairly typical of today’s drug abuse. She’s seen the way Alaskans use drugs change over her 20 years in the field, and when she started, she said people were mostly using single substances.

“In recent years, we’ve really seen a huge shift in the way many people frequently consume large amounts of substances together,” Schneider said.

Experts say Alaskans are more likely to combine substances, known as “poly-substance abuse,” and become addicted to more than one drug. According to drug testing labs, 93% of fentanyl-positive samples last year were positive for at least one other drug.

Over the last decade, the number of fentanyl users who combined the drug with stimulants such as methamphetamine and cocaine rose from about 40% to over 90%. Opioids and stimulants represent a particularly risky combination, and the rise of this combination is being referred to by some experts as the fourth wave of the opioid epidemic.

Like Sage, Schneider said many people in Alaska don’t know exactly what’s in the substances they abuse. Fewer people have access to prescription painkillers on the black market, and more people are taking pills made in small, illegal laboratories without knowing the ingredients.

At the detox center, Schneider focuses on helping people in the first days and weeks of sobriety, and she said that work is much more difficult when people are addicted to more than one substance.

“It makes withdrawal management more complicated,” Schneider said. “It makes drug treatment much more difficult, and I think it just complicates things for people in general.”

She said people in addiction treatment have more difficulty identifying their triggers when they have used multiple substances. Certain drug combinations, such as opiates and benzodiazepines like Xanax, increase the risk of an overdose, according to Schneider.

“And if you see alcohol combined with any of these other things that can weaken your central nervous system, all of these things together can impair your ability to breathe, which can lead to death,” Schneider said.

About sixty percent of overdoses last year in Alaska involved two or more drugs, and nationally, multiple substance abuse is a leading reason for the rise in opioid-related deaths.

The Alaska Department of Corrections is the largest behavioral health provider in the state. Adam Rutherford, head of the ministry’s health and rehabilitation services division, said he has seen an increase in the number of people using multiple substances. Alaska’s geographic location makes drug trafficking difficult, which is why many Alaskans use all available drugs because the selection is so limited.

“You’ll notice when there’s an influx of substances because if there’s a big introduction of heroin into our system, suddenly everyone’s using heroin and other things,” Rutherford said. “Or if there’s a meth rollout, there’s that switch.”

And across the country, fentanyl is being added to more drugs like methamphetamine and even heroin because it is cheap, relatively easy to make, effective and easier to smuggle.

Despite the increasing complexity of multi-substance addiction, physician assistant Schneider said recovery is within reach. She said when people are affected by multi-substance addiction, the safest option is to seek professional help at an inpatient detox facility.

“That doesn’t mean we can’t treat it or that it’s going to be bad,” Schneider said. “It’s just that sometimes when experiencing certain withdrawal symptoms, I’ve heard people say things like, ‘Lie on the couch,’ and if you’re using multiple substances, get help from a doctor.” Make sure it There is someone who knows about withdrawal to advise and monitor you, as it can be more complicated. And it could actually harm you, and we don’t want that.”

18-year-old Sage, who shared his story of drug abuse with his peers, got professional help.

“I’m currently completely sober and I actually got a job today,” Sage said.

The audience of peers and adults erupted in applause.

He said he hopes young people stay away from drugs completely. But if that’s not the case, he suggests testing medications with reagent kits, which are easy to order online. This way people can know exactly what they are taking.

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