Opiate addiction and treatment

Opiate addiction has been in the news lately, although it’s a very old problem. Throughout the years since healthcare professionals turned their attention to opiate addiction and treatment, there has been limited success treating opiate addicts. Part of the problem has been a lack of understanding of addiction in general, and a specific misunderstanding of opiate addiction. The stigma of opiate addiction, especially when the opiate is Heroin, has not abated much even with educational efforts by those few who do understand the problems of opiate addiction and treatment.

When people think about Heroin addicts, they see an unwashed, tattooed, skinny man with long. stringy, unkept hair. Hollywood has portrayed this version of the Heroin addict many times. They never show the business person who shoots up Heroin with his clean white shirt sleeve rolled up after a stressful day at the office. The former version might be more common, but no one is born that way — even the dirty, strung out Heroin addict, after years of addiction, was once someone’s beloved son or daughter, perhaps starting out with dreams and ambition. Addiction is progressive. Addiction takes its toll over time. Addiction can happen to anyone, rich, poor, old young, female, male, etc.

The reason that opiate addiction is hard to treat is because the withdrawals are so painful. There’s now medication, like Suboxone, which can alleviate opiate withdrawals so that the opiate addict can get into treatment and start a recovery program. But Suboxone is not the total answer, it’s only the first step. I believe opiate addicts need at least group therapy and individual therapy. Being around other opiate addicts trying to recover helps a person break through the guilt and shame and understand they’re not alone. Narcotics Anonymous provides long term peer support, after treatment and after Suboxone. The goal of all opiate treatment should be abstinence. Sometimes there are medical reasons to continue medicine, but that’s a call better made by a doctor who understands addiction.

Where many opiate addicts get in trouble is through drug substitution. An opiate addict who’s been through treatment might think there’s nothing wrong with drinking beer or wine, since their addiction is to opiates — sadly, many therapists don’t object to this choice of drug substitution – some will simply tell the client they should be careful. Addiction to alcohol is very similar to addiction to opiates, and what happens is that the opiate addict either becomes addicted to alcohol or eventually switches backs to opiates. But any mood altering drug affects judgment, and when judgment is affected it’s much easier for a person to make bad decisions, especially when someone offers them their drug of choice, or they find themselves in a group where the drug is being used. Addiction is a chronic brain disease, and science is still discovering what causes addiction. What we’ve seen in addiction treatment is that the brain has to heal and adjust through abstinence over a long period of time, and if a person is putting some other addictive drug in their system, recovery doesn’t materialize.

The key to opiate addiction, treatment and long term recovery is recovery management. An opiate addict has to first get past the withdrawal and cravings – the gain a full understanding of opiate addiction and recovery –  then look at gaining relapse prevention tools – then become part of a support system that encourages the use of the relapse prevention skills – then manage recovery for the long term with the realization there won’t be a time in the future when drugs can be used without the same or worse happening, it’s usually worse.