It’s time to end the stigma of opioid addiction

October 26, 2017 | by Aaron Weiner, Ph.D.
Categories: Healthy Driven Minds

The opioid epidemic continues to destroy lives every day. From 2010 to 2016, there has been an almost 500 percent increase in opioid use disorder, according to a recent study of Blue Cross and Blue Shield members.

On Thursday, Oct. 26, 2017, President Donald Trump’s administration declared the opioid epidemic a public health emergency.

While this declaration will help draw attention to the problem and provide some additional resources, the more powerful statement will be the way we talk about addiction every day. That we’re not calling people addicts or junkies anymore. When we don’t stigmatize people for this.

The stigma surrounding opioid addiction kills a vast number of people. Many people taking pain pills are afraid to share that they’re addicted, worried about what their family or their physician will say. They keep the addiction a secret, which can prove deadly.

In 2016, our Edward-Elmhurst Opioid Task Force began work to curb opioid addiction. We’re working in tandem with the Illinois Department of Public Health’s action plan, which consists of three pillars: Prevention, Treatment & Recovery, and Crisis Response.

We recently released a set of comprehensive prescribing guidelines for our physicians across all specialties, providing them with a best-practice model for how to prescribe narcotic medications for both acute and chronic pain.

We have asked all of our employed physicians to obtain training in the prescription of opioid medication by June 1 of 2018, and are providing them both in-person and online learning opportunities to meet this expectation.

In addition, we have upgraded our electronic medical record to integrate the Illinois Prescription Drug Monitoring Program, and designed a dosage calculator to help physicians better understand the amount of opioids they are prescribing if they opt to prescribe multiple, or stronger, medications, such as Norco and Oxycontin.

In support of treatment, Linden Oaks Behavioral Health, the psychiatric service provider for Edward-Elmhurst Health, has opened a long-term medication assisted therapy clinic, adding to our existing continuum of behavioral health services.  Recovery from opioid addiction is a long-term endeavor, and research tells us that the use of targeted medications, such as Suboxone, dramatically increases a patient’s chances of success.  Expanding access to Suboxone and similar opioid maintenance medications is imperative, and we hope other healthcare institutions, as well as independent physicians will join us in offering these service to our patients in need.

Lastly, if someone overdoses, we all must be ready to respond and save their life. Our emergency department records show that overdoses do not discriminate by age – both young and old come to Edward and Elmhurst having overdosed, from heroin, fentanyl, or prescription medications.

Having naloxone, commonly referred to as Narcan, on hand in the event of an emergency can save someone’s life – it is the antidote to an overdose, averting death for 30-90 minutes, enough time for an ambulance to arrive.

Effective treatment is available: Medication Assisted Therapy

It’s devastating to see a loved one struggle to stop using heroin or prescription pain relievers. The grueling nature of opioid withdrawal is one of the main reasons users continue drug use.

Effective treatment is available though, says the National Institute on Drug Abuse, and it’s decreasing both opioid use and opioid-related deaths, as well as increasing a patient’s ability to function and stay in treatment.

It’s called medication-assisted therapy (MAT), and it combines professional counseling with medication for a whole-patient approach to opioid addiction.

Unfortunately, nearly all U.S. states do not have sufficient treatment capacity to provide MAT to all patients with an opioid use disorder. Less than half of privately-funded substance use disorder treatment programs offer MAT.

Linden Oaks Behavioral Health’s newly opened MAT Clinic in Naperville offers medication-assisted treatment to area residents trying to quit opioids.

A visit to the Linden Oaks MAT clinic includes outpatient medical consultation, including individual medication meetings, and group therapy.

From the medication side, the three primary drugs for opioid addiction treatment are methadone, buprenorphine (Suboxone®), and naltrexone (Vivitrol®). Methadone and Suboxone virtually eliminate withdrawal symptoms and cravings by activating the same receptors in the brain as other narcotics. Both also significantly reduce the euphoric effect of other opioids while taking either medication.  Vivitrol works similarly to methadone and Suboxone, and is a lighter option for individuals further along in their recovery from opioid use. Linden Oaks’ MAT Clinic provides prescriptions for Suboxone and injections of Vivitrol.

For patients in early recovery, Suboxone offers some advantages over methadone. It is less sedating and easier to taper off. Also, patients can pick it up from a pharmacy, and receive as much as a month’s supply at a time. Methadone requires daily visits to a clinic, at least initially. It’s more intrusive in your life. And the naloxone in the medication can reverse an overdose if the Suboxone is misused and injected.

These medications take away withdrawal symptoms. You don’t have any cravings. If you used an opioid while on these medications, you wouldn’t feel anything. You’re not getting high off these medications. You take them once a day and you don’t have to worry about anything physical from your withdrawal. 

With the withdrawal symptoms and cravings controlled, a patient can focus on getting well. And the goal is not to keep prescribing indefinitely. The patient will be prescribed the lowest comfortable dosage at any given point, and they will get help tapering off of it until they are ready to be on their own.

Therapy groups are the other component of treatment, to address the social and psychological aspects of addiction. One-hour group sessions incorporate several research-backed types of therapy:

  • Cognitive behavioral therapy helps patients challenge negative patterns of thought that lead them to unwanted emotions and behaviors, including acting on cravings.
  • Motivational interviewing explores patients’ mixed feelings about change, resolving feelings of ambivalence and enhancing motivation for sobriety.
  • Mindfulness increases a patient’s awareness of thoughts and feelings, allowing them to respond to them thoughtfully, rather than just react.  Mindfulness helps cultivate calmness even when faced with unwelcome events, such as cravings or triggers for use.

Just as the medication dosage is tapered off, participation in group therapy also tapers off based on the patient’s needs. Initially, weekly sessions are the norm. If everything goes well, therapy is cut back to every other week, and then monthly visits.

We don’t want to keep someone in treatment for any longer than they need to be.  We give them all the support they need early in the process, and provide them with tools to cope with life’s challenges when treatment is over.

The MAT program is open to anyone who is motivated to stop using opioids. No physician referral is needed.  Some people can begin their treatment journey at the clinic. Others use it as a step-down from a more intensive treatment level.

To schedule a free, confidential assessment call 630-305-5027 and tell them that you would like to find out if the MAT Clinic is right for you.

Related blogs:

How medicine can break opioid addiction

Fighting opioid addiction with the help of medication

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