The opiate addiction crisis that is currently happening in the United States is overpowering the level of treatment that is being offered and accessed by struggling addicts.
In other words, the opiate based painkillers, along with heroin, are currently winning the war. LA Times says that “The National Institutes of Health estimate that prescribed opiates were the gateway to addiction for close to three-quarters of new heroin users.”
In other words, heroin is the street drug that fills the role of “opiate.” But people are not starting out by using heroin directly. Instead, they are finding their way to heroin use through prescription painkillers.
Why is this happening so much more? And why now?
Part of the problem is that we are in the age of information now. Teens, kids, and adults are much more knowledgeable today about what drugs can give them a buzz versus which drugs will not. And as that information spreads and is more easily accessed and shared (thanks to the Internet), more and more teens and young adults are finding prescription painkillers in their parent’s homes, then abusing them.
This happens more and more frequently now, to the point that some experts even believe that pain pills are more widely abused than marijuana.
And the real problem is that even though opiate abuse has skyrocketed, the treatment for this has lagged far behind.
In order to understand what is truly going on, we need to establish what recovery from opiate abuse would look like in an ideal world.
In an ideal world, anyone who is struggling with opiate based painkillers, or with heroin, would quickly be diverted into a 28 day inpatient treatment program. There they would go through a medical detox, followed by education, peer support, 12 step meetings, and group therapy sessions. After that, they would be referred to follow up care, and some of these people would be prescribed MAT, which are medications that are used to help people stay off of opiates in a maintenance sort of way. One such medication is Suboxone, which is not addictive in the traditional sense but it helps to block the cravings that people get for opiates.
One of the barriers is that Suboxone has not been very accessible to people in the past, and it is not exactly handed out like candy at this point. It requires some pretty strict criteria to be an option for most people, and the drug is not cheap either. Combined with the fact that it is taken every single day, usually multiple times per day, for months or even longer, this is not exactly an option that can save the masses. Unfortunately it is only going to work for certain people in certain situations.
One of the biggest struggles for opiate addicts is the intense withdrawal symptoms that they experience when they stop taking opiates cold turkey. Why do these withdrawal symptoms even happen, and how can they overcome this particular challenge?
Opiate withdrawal happens because the human body normally produces its own “opiates,” or dopamine. Even your body, right now, is producing a tiny trickle amount of dopamine for your brain, just to give it a normal, everyday, functional baseline amount. This is necessary because if you were in a survival situation where you had to fight through some intense pain in order to live, your body needs a special system by which it can give you some temporary relief so that you can power through something painful. That is why your body produces its own dopamine, or its own opiates.
Now when the addict takes a prescription opiate, the molecules in that drug rush into the brain and they connect to the opiate receptors that are in the brain, and as a result more dopamine gets released into your body and you feel good. The problem comes in when an addict abuses a prescription opiate (or heroin) every day for any length of time, at which point their human body is going to say “Hey wait a minute, this person is providing plenty of dopamine for us every day, and therefore we really don’t need to produce our own natural supply of this stuff, because it is being artificially introduced every day.”
And so the body will shut down its own natural dopamine production completely.
This is not a problem so long as the opiate addict continues to abuse opiates. The day that they stop, however, they are going to start feeling the onset of those nasty withdrawal symptoms, the kind that resemble the flu: Achy body, upset stomach, chills, sweats, restlessness, and so on. After two or three days with no opiates these withdrawal symptoms will likely peak and be incredibly uncomfortable.
The solution for this is to go to inpatient treatment. Rehab centers typically include a medical detox (ask them to be sure, let them know that you need detox services). While in detox, the addict will be closely monitored and given certain medications that will help to alleviate the withdrawal symptoms.
At this point, the addict may also have the option of using an MAT solution for their addiction, such as Suboxone maintenance. Of course this will depend on the person, their situation, their insurance, and so on. Certainly MAT is not for everyone, but it can definitely help certain individuals. Talk with your doctor or your treatment professional to find out if this is right for you or not.
Regardless of whether you pursue MAT or Suboxone, the trip to inpatient treatment is really what sets you up for success. Without this visit to rehab you will likely still be stuck in some old patterns, with lots of triggers around you, and all the while you will be dealing with massive withdrawal symptoms. That is no way to get clean and sober. Go to inpatient treatment and do it the right way, make it easy on yourself, and get the professional help that you need.
The problem is not that treatment is lagging behind the epidemic, the problem is that not enough people are getting the professional help that they need. Addicts need to identify their problem, ask for help, and have the willingness to attend inpatient rehab. If more people would attend inpatient treatment then the rate of this epidemic could be slowed down considerably.