The Faces Of Addiction : The Middle-Aged, Women And Fentanyl

The Faces Of Addiction : The Middle-Aged, Women And Fentanyl

Drug Addiction

Addiction Expert, Dr. Indra Cidambi, analyzes factors driving continued growth in drug overdose deaths.

New York, NY – March 15, 2017

The Centers for Disease Control (CDC) recently released data that showed that drug overdose deaths (excl. alcohol) rose 11% year-over-year to 52,404 in 2015, and has increased at an average annual rate of over 7% since 1999.

Overall overdose deaths rose to 16.3 per 100,000 in 2015 from 6.1 in 1999. “An analysis of the 16-year trend shows that the middle-aged, women and fentanyl were consistently driving growth in overdose deaths,” says Dr. Cidambi.

“In middle-aged adults, overdose death rates have risen the most (see data below) since 1999, likely due to declining economic security” says Dr. Cidambi. Recall, that a study by Princeton University in 2015 highlighted this fact and identified it as a causal factor in negatively impacting longevity among the white population in the country.

“Addiction rates among women are catching up with men, as they have more access to addictive medication,” says Dr. Cidambi, who has vast experience in treating women suffering from substance use disorders.

“Another significant driver of overdose deaths is fentanyl, which due to its potency, is used by drug dealers to spike other non-synthetic opiate products (heroin, street pills, etc.),” added Dr. Cidambi.

“However, individualized and innovative treatment modalities such as ambulatory detox have the potential to bend the trend.”

Dr. Indra Cidambi, a leading Addiction Medicine expert and Co-Founder and Medical Director at the Center for Network Therapy, New Jersey’s first outpatient detox facility notes that, “The rate of increase in overdose deaths is alarming for multiple reasons; the sheer number of people whose lives are being cut short by this disease is a huge tragedy and, additionally, society’s resources are strained by enormous criminal justice and treatment costs and loss of productivity.”

The middle-aged in crisis

The increased death rate among middle-aged white people of the baby-boom generation due to drug and alcohol abuse was well documented by a Princeton University paper published in September of 2015.

This group’s inability to find skill-appropriate jobs and pension insecurity driven by weak stock market performance are believed to be causal factors of addiction among this population. Additionally, Dr. Cidambi noted, “An increase in opioid pain pill prescriptions coupled with increased economic insecurity associated with globalization have come together to drive this population to dependence.”

Overdose deaths rose to 30 per 100,000 (from 5.2 in 1999) for the 45-54 age group and to 22 per 100,000 (from 4.2) for the 55-64 age group. More women seek solace in medication. Women are more likely to seek medication or self-medicate for emotional and psychological issues. “Anxiety, depression, borderline personality disorder and eating disorders more commonly affect women and provide them access to prescription medications that could be addictive,” says Dr. Cidambi.

Biology also predisposes women to get addicted faster as, for 2 similar intake, their bodies are exposed to the substance longer and at higher concentration levels than men. Women are the focal point of family logistics and they often juggle a demanding career as well. They turn to medication to deal with the stress and keep up the appearance of being able to juggle different responsibilities seamlessly.

Dr. Cidambi has been treating women with addiction issues for over a decade. She is aware of the issues women face when seeking and participating in treatment. “It is much more difficult for women to make that first call for help, as they sometimes feel they might be abandoning their role in the family,” says Dr. Cidambi. “Shame and fear also are barriers to women seeking treatment.” (To read more on this click on

Overdose deaths among women has grown faster than men in 9 of the past 16 years and overdose death rates are catching up with that of men – it was 11.8 per 100,000 for women in 2015 up from 3.9 in 1999 as compared to a rise in men to 20.8 per 100,000 from 8.2. The absolute number of overdose deaths among women grew 3.5 times between 1999 and 2015 (to 19,447) as compared to 2.9 times for men.

The fentanyl factor

“Fentanyl, a synthetic opioid, is incredibly potent (50 times stronger than morphine or heroin) and even a small increase in dose could be fatal,” says Dr. Cidambi. “That is not the only danger with fentanyl,” Dr. Cidambi adds. “Since it is made by combining chemicals, pills laced with fentanyl are being made locally by obtaining chemicals over the internet and importing pill making machines piecemeal. Regulating the sale of these chemicals over the internet is extremely tough.” Fentanyl and Tramadol users – rose 13 times (vs 3 times average) from 1999 levels to 9,580.

It is not all doom and gloom there is hope

“Despite the gloomy picture painted by CDC statistics, all is not lost. We can still win the war on addiction,” says Dr. Cidambi. Individualized treatment protocols to meet a patient’s needs and utilization of a gender-responsive treatment approach, increase the chances of the patient staying on the path to recovery after detoxification. “In my opinion, a combination of medication assisted treatment, more availability of treatment and new, innovative treatment models such as ambulatory detoxification can contain the spread of the epidemic, and, eventually, reverse it,” concludes Dr. Cidambi.

For more information on women and addiction, Dr. Cidambi’s innovation in addiction treatment or to learn more about the Center for Network Therapy please visit,

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Against The Law

Against The Law

We’ve all been there. Drinks with our workmates after a long day.

Celebratory drinks after a big win. Too many cocktails at a staff function.

Some offices even host regular social functions within the business premises.

More often than not, these are all just social gatherings that help employees bond, break barriers between different levels of management and encourage camaraderie.

But they can also lead to overindulgence. A few beers or a few cocktails, maybe a few hits off a joint, or maybe a few lines of coke.

When everyone is doing it, it seems like the norm and awkward not to participate. When people are in professional positions with great pay, it’s easy to take socializing to the next step.

Lawyers face the Pressure of the Profession

Anyone who has faced the pressure of graduating can attest to the level of stress. Law students are under far more stress. The tests are very rigorous and the euphoria of being accepted into a law program evaporates quickly. They face a great deal of work and stress. Studies show that, within a few months of joining law school, students show signs of anxiety and depression.

By the end of their first year, close to half show signs of depression. This often leads to anxiety medication and/or sleeping pills. It is also not uncommon for students to sell these prescription pills for extra cash, leading to easy availability of these medications on law school campuses.

When they finally finish school, they not only face an overwhelming load of work, but work often conflicts of their own moral and value systems. These need to be ignored and pushed aside in order to get the job done.

The competition in the profession is brutal and the drive to excel can quickly lead to mental fatigue. Consequently, seeking solace in alcohol and drugs or the abuse of prescription drugs is not uncommon. Over time, tolerance builds, and the patient needs to take more to feel the same effect.

Having a few beers at the end of the week can quickly turn into substance abuse, with prescription and street drugs. This type of self-medicating doesn’t end with graduation.


Finding a good job is daunting when you have to compete with all the other graduates. However, getting your foot in the door is only the beginning. Young lawyers find themselves in an unenviable position of being tasked with lowly and menial jobs. This can make them feel worthless and adds to the stress.

Long hours and ridiculous schedules take a toll. Add on the pressure of them having to meet various quotas: finding new clients, the win/loss ratio, etc. After working so hard, they worry constantly of being overlooked for advancement. Such stress damages their personal relationships. It’s no wonder they rank so high in depression and addiction.

There is also safety in following the herd. When many of your co-workers and peers all feel the same way, it feels good to stick together to take away the stress through the social norms of drinking and, sometimes, drugs.

Unfortunately, this can have the opposite effect after a while. Too much overindulgence leads to loss of control and sub-optimal work performance. This, in turn, may lead to financial pressures, which may intensify the dependence on drugs or alcohol.

Getting Help

The first step is always accepting that you have a problem. The person needs to recognize the damage being done to their health from alcohol, their career and their relationships.

The legal world is small, and it is never a good idea to have issues following you, like substance abuse or addiction. Losing a job due to addiction could do irreparable harm to one’s career.

The first step should be speaking directly to your employer, as there are programs in place to help their staff get the help they need. Talking to your immediate supervisor about the stress on the job and how it has affected you will be the first step to recovery.

Talking to your family and friends is also a good idea, especially if they have expressed their concern already. It’s more than just your job at stake, it’s your health and your future, as well.

If you have any questions or concerns, please contact us today.


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Addiction Expert Dr. Indra Cidambi Shares Tips on How to Help Children Affected by Addiction

NEW JERSEY-Our country is in the middle of a drug epidemic and, as per SAMHSA, 1 in 4 children in the United States is exposed to alcohol abuse or dependence in the family. More children are living in families with an illegal substance or prescription medication abuse. Leading addiction expert, Indra Cidambi, M D. says, “It is important to address the impact on children of parental substance abuse because such children have a predisposition to behavioral problems and abusing drugs or alcohol themselves~ They also could have more problems in school or social relationships.”

“Explaining the behaviors of an addicted adult or telling a child that a parent is going away for treatment, separating from the family or, even worse, has passed away is one of the most difficult conversations to have with a child,” says Dr. Cidambi. Children of addicts experience physical or emotional abuse and neglect, domestic violence, lack of boundaries or inconsistent messages about right and wrong “It will break anyone’s heart to have such a conversation with an innocent child,” says Dr. Cidambi who has been treating families dealing with a loved one’s addiction for over a decade. “However, the bright side is that these children can overcome the damage from a flawed environment with help.” She suggests some steps that will help children cope with, and eventually overcome they’re less than an optimal living situation.

1. Help them understand the situation.

Children are aware that things are not normal, but they may be confused. They need to understand that their parent is “sick” with a disease – alcoholism or addiction to drugs – and help them make sense of their parent’s behavior. “Having an insight into their parent’s behavior will add to their resilience,” says Dr. Cidambi.

2. Make it clear that it is not their fault.

Children tend to blame themselves for their parents’ behavior as they hear statements from their parent(s) that blame them for things being the way they are – for example, “If only I could have some peace and quiet, I would not feel the need to drink.” It is critically important to let children know, repeatedly if needed, that their parents’ addiction is not their fault.

3. Help them express their feelings.

“Children of people suffering from substance use disorders learn not to talk honestly, and discount, minimize and rationalize their feelings,” says Dr. Cidambi. They need to know that they are not alone and that it is ok to feel the way they feel, share their feelings and learn to express their feelings appropriately, including anger. Repressing their feelings could eventually lead to behavioral problems.

4. Facilitate problem-solving

Children who live with parents using substances are often left to fend for themselves. “They may come back to an empty home, and may have to fix a meal for themselves and their siblings and sometimes they may face neglect,” says Dr. Cidambi. Educating these children about the range of options available to them helps them better cope with their situation.

5. Link them to supportive individuals.

“Identifying and connecting these children to significant people in their lives who can provide a sense of belonging and acceptance is crucial,” says Dr. Cidambi. Such people could help the child to not have to act out a survival role~ It could be a grandparent, an uncle or an aunt. Linking them to support groups such as Alateen may also be helpful.

6. Help a Child, Be a Child

Children whose parent(s) suffer from substance use disorders often grow up quickly. However, a child is not an adult and they need an opportunity to have fun and act like children. Keeping them busy and keep them laughing. Let them know that there is more to life than their experience behind closed doors.

Providing a chance for children affected by families dealing with addiction a chance to heal is one of the best gifts they can receive at this stage in their lives. The above tips can help a child trapped in a family affected by substance use to overcome their circumstances and lead normal lives.


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