Why are we not yet overcoming opioid addiction?
The crisis is getting worse. More people are dying than ever before from opioids. Yet, we pour more and more money and resources into addiction treatment programs that do not work. Why do rehabs fail?
Addiction is a medical condition.
Why is it acceptable to treat a medical condition with spiritual programs and group therapy? Imagine going to a cancer center and being told that the treatment will be writing down your defects of character and making amends to those whom you have wronged. What if you had high blood pressure and your doctor told you to write a gratitude list?
Addiction is a chronic medical condition.
There are two types of illness, acute and chronic. An acute illness comes and goes. It can be treated and cured, like an inflamed appendix or a blocked gallbladder. Or, it just goes away by itself, like a cold. A chronic illness is there long-term, probably for life. Diabetes is a chronic illness. So is high blood pressure. HIV is now considered to be chronic. Chronic illnesses can be treated but not cured. With treatment, further sickness and death can be avoided.
What is the proper way to approach a public health crisis.
HIV was not always a chronic illness. Not long ago, HIV was a killer. Being diagnosed with HIV was a death sentence. The scientific and medical community worked hard in a coordinated effort to contain and control a deadly disease. Today, HIV can be controlled with medications. As long as patients continue to take their medications, they can live a long and healthy life. But, we all know better than to tell someone with a chronic illness to stop taking their medication. Or do we?
Addiction is a chronic medical condition.
I once visited a addiction rehab and was told by one of the administrators that Suboxone is not for long-term use. He told me that if Suboxone is used at all, it must be stopped within 1-2 weeks. That addiction treatment center administrator was not a doctor. He was a recovering addict who decided to serve and help other addicts to recover. Unfortunately, he is managing a medical facility, accepting insurance money, and recommending that the patients in his facility do not get evidence-based medical treatment.
So what is the solution to overcoming opioid addiction?
Don’t get me wrong. Spiritual principles have their place. Writing gratitude lists and working the 12-steps helps. Psychotherapy is essential in addiction treatment. Group sessions can help as well. Yet, medical treatment is the cornerstone of the treatment process in overcoming opioid addiction. Long term treatment with approved prescription medications saves lives.
There are three.
It may seem like there are a lot of different medications to treat opioid addiction. In fact, there are only three: methadone, buprenorphine and naltrexone. It seems like more because buprenorphine and naltrexone come in a variety of brand names and forms.
It is not trading one addiction for another.
This is a common misconception, that taking medication for addiction is just trading one addiction for another. It is not. Patients who take prescribed medication as directed are in recovery. They are able to function normally in their daily life. While there examples of people who fail with a particular medical treatment, this is not proof that medical treatment does not work. While a person taking medication may get physically sick if they stop too quickly, this is not the same as addiction.
There is no one-size-fits-all solution.
The complexity of addiction treatment comes in when a doctor must make careful decisions in choosing a treatment plan and making changes. As doctors, we must be careful and listen very carefully to our patients. We must not pressure patients to reduce or discontinue medication when it is working without any problems. We must resist pressures from family members, society and uninformed healthcare workers.
How can we all get on the same page?
In overcoming opioid addiction, we all need to agree on our approach. In order to do this, we must turn to science and evidence to see what works. Adam Bisaga, M.D. has written a book entitled, “Overcoming Opioid Addiction”. Dr. Bisaga is a nationally recognized expert in the field. In his book, he describes how patients, families and healthcare professionals must approach opioid addiction treatment. He presents the medical treatments that are proven to work and save lives. The book is easy to read. It is written for doctors and therapists. It is also written for families and patients. I recommend “Overcoming Opioid Addiction” to everyone. I especially believe that it should be read by all doctors and all healthcare professionals.
Buy this book for every US doctor.
About a decade ago, an organization that is made up of state medical board members decided to purchase a large quantity of a book that explained to doctors how to prescribe opioids responsibly. Even then, they thought it was important enough to buy these books and mail them to many doctors. I propose that a similar effort should be made with Dr. Bisaga’s book. Putting “Overcoming Opioid Addiction” in the hands of as many doctors as possible will save lives. The book gives doctors the information and confidence they need to treat opioid addiction properly.