Survey: nearly half of Americans have a family member or close friend who’s been addicted to drugs

It’s a statistic that shows America’s drug addiction crisis is truly an epidemic.

This is America on a drug addiction epidemic: Nearly half of US adults have a close friend or family member who’s been addicted to drugs.

That comes from a Pew survey of US adults conducted in August, which found that 46 percent meet the criteria.

Pew Research Graph

It’s not just opioids. According to the National Survey on Drug Use and Health, in 2016 approximately 20.1 million Americans 12 or older had a substance use disorder. About 2.1 million had an opioid use disorder. The biggest group was for alcohol use disorder, with about 15.1 million reporting an alcohol addiction. (A caveat: Since the survey is based on households’ self-reports, these are very likely underestimates.)

But opioids have been the key driver of the recent US increase in drug overdose deaths, from nearly 17,000 overdose deaths in 1999 to more than 64,000 in 2016. We don’t have reliable drug-by-drug data for 2016 yet, but over the previous few years nearly two-thirds of overdose deaths were linked to opioids.

Last week, President Donald Trump declared the opioid epidemic a public health emergency — activating a very limited set of tools to address the crisis. This week, his opioid commission is expected to release its final recommendations on dealing with opioids.

The opioid epidemic goes back to the 1990s, with the release of OxyContin and mass marketing of prescription painkillers, as well as campaigns like “Pain as the Fifth Vital Sign” that pushed doctors to treat pain as a serious medical problem. This contributed to the spread of opioid painkiller misuse and addiction, which over time also led to greater use of illicitly produced opioids like heroin and fentanyl. Drug overdose deaths have climbed every year since the late ’90s as a result.

Last week, President Donald Trump declared the opioid epidemic a public health emergency — activating a very limited set of tools to address the crisis. This week, his opioid commission is expected to release its final recommendations on dealing with opioids.

The opioid epidemic goes back to the 1990s, with the release of OxyContin and mass marketing of prescription painkillers, as well as campaigns like “Pain as the Fifth Vital Sign” that pushed doctors to treat pain as a serious medical problem. This contributed to the spread of opioid painkiller misuse and addiction, which over time also led to greater use of illicitly produced opioids like heroin and fentanyl. Drug overdose deaths have climbed every year since the late ’90s as a result.

The issue has really turned into two simultaneous crises — which Keith Humphreys, a Stanford University drug policy expert, has described as the dual problems of “stock” and “flow.” On one hand, you have the current stock of opioid users who are addicted; the people in this population need treatment or they will simply find other, potentially deadlier opioids to use if they lose access to prescribed painkillers. On the other hand, you have to stop new generations of potential drug users from accessing and misusing opioids.

Addressing two crises at once will, obviously, require a lot of resources. But as I previously explained, we have a pretty good idea of what these resources would go to: They could be used to boost access to treatment, pull back lax access to opioid painkillers while keeping them accessible to patients who truly need them, and adopt harm reduction policies that mitigate the damage caused by opioids and other drugs.

Some states are attempting to confront this issue. Vermont, for example, has built a “hub and spoke” system that treats addiction as a public health issue and integrates treatment into the health care system. Potentially as a result, the state was the only one in New England to have a drug overdose death rate below the national average in 2015.

Link to the full article here: Survey: nearly half of Americans have a family member or close friend who’s been addicted to drugs

Success Story: MAT, Combined with Counseling, Working for North Carolina Woman

Lona Currie is alive. She’s lucky and she knows it, but for a long time, she only wished she would die. That’s the depths that her addiction and co-occurring depression had taken her before she finally found the treatment she needed to recover.

Lona, 43, began drinking alcohol excessively when she was just 11 years old while spending the weekend drinking with her father. She realized even at that young age that alcohol would take away the pain of a childhood filled with mental, sexual, and physical abuse at the hands of her stepfathers. Making matters more complicated, she realized at a young age that she was gay, something that was not readily accepted in the small towns in North Carolina and Alabama where she grew up. When she was 14, she discovered opioids in her grandmother’s medicine cabinet and “found something that could take every wrong in your life and make it tolerable. I found out what happiness and joy was.”

“There’s a big difference between someone who gives you medication and someone who wants to cure you.”  -Lona Currie

Flowers Blooming Through Pavement

Now, Lona is a fierce advocate for the use of medications for treatment paired with counseling to treat her opioid use disorder. She knows firsthand that taking a medication alone without counseling does little to address her underlying causes of addiction. “People think just the medicine will do the job, but the rest is in the head.”

In Lona’s case, depression and a childhood filled with physical and emotional abuse fueled her disorder, one that could not be adequately addressed until she began a regimen of methadone paired with counseling. “There’s a big difference between someone who gives you medication and someone who wants to cure you,” Lona says.

But the road Lona had to take before finding a treatment that worked for her was challenging.

After a stint in the Army, Lona suffered an undiagnosed stomach condition and was a frequent visitor to emergency rooms and clinics. Soon, she was identified as someone who was misusing opioids, and clinicians refused to prescribe her more, so in an effort to stop the pain she turned to black tar heroin. Though she took any drug she could get her hands on-cocaine, heroin, marijuana-after 1996, it was all opioids, and as often as possible. She overdosed three times, and was revived by Narcan each time, and once spent a week in a coma.

“I was losing people I loved and I was angry it wasn’t me,” she says. “There’s nothing positive in the life” of a person with an opioid addiction.

Each time she sought treatment, which she did numerous times, she faced the stigma that so many of those addicted to opioids face. “When you’re addicted, it’s important to tell the truth,” she says. “But you’re not honest because you are treated so badly when you do tell the truth.” She’d tried methadone alone, and it worked-for a while. When she relapsed that last time for nine months, it changed her life.

“I got to a place where I said, ‘I just don’t want to do this anymore.'”

That’s when she found the program she is still in today and credits it for saving her life. Her wife, who also has an opioid use disorder, has been in recovery one and a half years. While Lona has found methadone to be most effective for her, her wife has found success with buprenorphine to treat her opioid use disorder.

Now, even small things are huge victories: holding a steady job, creating a budget, paying bills. “I learned how strong I am,” she says.

Do you have a success story?

PCSS Projects wants to hear about your positive outcome, changes in your prescribing practices, community efforts, etc.

Email Jane and share your success story with her!

 

8 Care Principles to Improve Substance Use Disorder Treatment

Task force cites medication-assisted treatment, universal screening as key to better outcomes.

More than 20 million Americans struggle with substance use disorder (SUD), and upwards of 33,000 people died from opioid overdose in 2015. Fortunately, effective treatment exists. Medication-assisted treatment (MAT), which pairs U.S. Food and Drug Administration-approved drugs with behavioral therapies, reduces both illicit opioid use and overdose fatalities.

But access to MAT remains elusive for many people largely because treatment providers do not always provide their patients with the evidence-based care shown to be most effective. Public and private payers can play a key role in addressing this problem by encouraging their enrollees to use providers who deliver high-quality, evidence-based care and rewarding those who do.

As a needed step in this direction, the new Substance Use Disorder Treatment Task Force— launched last spring by Shatterproof, a national nonprofit organization dedicated to the implementation of evidence-based solutions to address the SUD epidemic—created a list of national principles of care for SUD treatment to help guide effective care. These eight evidence-based principles have been shown to improve health outcomes and save lives. Sixteen insurance companies have agreed to identify, promote, and reward SUD treatment that aligns with these principles, which are:

  1. Universal screening for SUD across medical care settings.
  2. Personalized diagnosis, assessment, and treatment planning.
  3. Rapid access to appropriate SUD care.
  4. Engagement in continuing long-term outpatient care, with monitoring and adjustments to treatment.
  5. Concurrent, coordinated care for physical and mental illness.
  6. Access to fully trained and accredited behavioral health professionals.
  7. Access to FDA-approved medications.
  8. Access to nonmedical recovery support services.

Nurse Signing Ipad Office

The task force brings together public and private payers as well as advocates, policymakers, and other stakeholders. The Pew Charitable Trusts hosted the inaugural meeting of the task force this fall, during which members met to outline and discuss principles of care. Following that meeting, the group refined and reached consensus on the final list, with principles based on research from the past 30 years, including recommendations from the 2016 “Facing Addiction in America: Surgeon General’s Report on Alcohol, Drugs, and Health.”

The task force will continue its work by focusing on implementing the principles, providing a platform to learn and share innovative strategies, and measuring the initiative’s success. In particular, the task force will examine the possibility of establishing a process for certifying providers who have implemented the principles. It will also engage with the broader stakeholder community in the next phases of work.

By joining together, patients, providers, and payers have the opportunity to dramatically increase the quality of substance use treatment in the United States. Incorporating these evidence-based principles of care in insurance programs is a much needed step forward in addressing the opioid epidemic and improving the lives of people with SUD and their families.

Link to original article here: 8 Care Principles to Improve Substance Use Disorder Treatment

Fault Lines Documentary on Addiction Features Chillicothe

CHILLICOTHE – Four young girls bounce on a trampoline, laughing just before the sounds of a 911 call cut in: “My mom is on the floor and my step-dad’s face is pale and they’re not waking up.”

The juxtaposition of what should be a carefree childhood with the reality hundreds of Ohio children are facing is how the newest Fault Lines short documentary “Heroin’s Children” opens. While the child’s 911 call and other children’s calls in the 25-minute documentary are from elsewhere in Ohio, the intimate stories shared are Chillicothe residents.

Fault Lines, which is Al Jazeera English’s Emmy and Peabody award-winning documentary program, is the latest of a seemingly never ending line of non-local news and documentary programs drawn to Chillicothe to show the toll the opiate epidemic is taking on the community, the state, and across the nation.

While seemingly being the poster child of an epidemic has been trying for the community, Fault Lines Senior Producer Laila Al-Arian said it was the willingness of the community to talk openly about addiction that attracted her attention.

“When I started doing research about the impact of the heroin crisis on children, I came across some great reporting from Chillicothe, including local profiles and pieces in the Gazette. Unlike a lot of other cities and towns across America, it’s clear that many people in Chillicothe are open to speaking about their experiences with drug addiction, so we found that many doors were open to us,” Al-Arian said via email.

“The fire chief, police captain, mayor, school principal, hospital and so many others were so open about giving us access to their spaces and their lives. The prevailing attitude that we came across in Chillicothe is a willingness to tell this story because only when people can see it for themselves will they be able to grasp the severity of the problem … During a time when there seems to be so much suspicion and mistrust of the media, we found it refreshing that people saw a point to meeting and talking with a crew from Washington DC.”

The documentary is emotionally intense. Josh Rushing helps guide the conversation, presented from different perspectives. There’s Amanda Howard who shares how the grip of heroin addiction impacted her ability to be a mother; Tisa Beeler who talks about raising her four granddaughters; and Alexis Lightle who heartbreakingly struggles with wishing her parents had never been addicted to drugs even though it means she’d never been born.

Girl Sad Sitting By Tombstone

“Their lives are even more precious than my own, I think,” Lightle told Rushing, wiping away tears. Her dad, Andrew Lightle, died of a drug overdose in November 2015 – one of 40 who died of drug overdoses in Ross County that year.

“Heroin’s Children” also touches on community solutions through a visit to Adena Regional Medical Center where Donna Collier-Stepp runs a program for pregnant women who are addicted to drugs. While Rushing was there, women shared their shame, guilt, and fears.

“The women were incredibly strong and brave, and wanted to tell their stories in order to help others. So many of them said they were tired of the stigma associated with drug addiction and that they were willing to speak on camera because if they could help one person or one family, it would have been worth it,” Al-Arian said.

The documentary also went along with the Chillicothe Fire Department to a double overdose on Clay Street where there’s also a woman holding a baby talking to first responders. Ross County Coroner Dr. John Gabis appears in the documentary, referring to the epidemic as the black plague, a zombie apocalypse.

While the Fault Lines crew saw a variety of different ways Chillicothe is attempting to combat the opiate epidemic, such as the drug-free school programs and efforts by the Heroin Partnership Project, Al-Arian said they could only fit so much into a short documentary and wanted to really focus on intimate stories. However, she said they are planning additional shows where they intend to delve more into how communities are responding to the opiate epidemic.

Chillicothe Firemen Ambulance

“It was … inspiring to see how Chillicothe as a community is coming together to really openly talk about the issue and do something about it, including the program at Chillicothe High School that encourages kids to be drug free,” Al-Arian said.

She is hopeful showing the toll addiction has on families and children can help break down stigma and lead to more action to combat the opiate epidemic.

“I hope this short film gives people a real sense of what it’s like being in a family struggling with drug addiction and to understand the impact its having on people, whether it’s your friends or neighbors or people who live across town,” she said. “I hope more empathy and understanding will create an urgency to devote the necessary resources to fight this epidemic and help families who are suffering.”

“Heroin’s Children” is available to watch in full on the Fault Lines’ YouTube channel at:  “Heroin’s Children:” Inside the US Opioid Crisis

Naloxone reverses 93% of overdoses, but many recipients don’t survive a year

(CNN) As the opioid overdose epidemic continues to surge, public health officials and first responders have turned to naloxone, the drug that reverses overdose, to help combat the rising tide. New research from Brigham and Women’s hospital in Boston shows its effectiveness.

A review of emergency medical services data from Massachusetts found that when given naloxone, 93.5% of people survived their overdose. The research looked at more than 12,000 dosages administered between July 1, 2013 and December 31, 2015. A year after their overdose, 84.3% of those who had been given the reversal drug were still alive.

“With this reversal agent, we’re saving the vast majority of people,” said Dr. Scott Weiner, lead author of the study and an emergency physician at Brigham and Women’s Hospital. “These are people who got naloxone by ambulance. So we saved them. The lesson learned is not that naloxone is failing; it’s working.”
Pill Bottle Syringe White Powder
But it also means that once saved from an overdose by EMS, a patient had about a 1 in 10 chance of not surviving a year. About 35% of those who were dead a year later died of an opioid overdose. And that should be a concern, Weiner said: “It doesn’t treat the underlying problem.”
The findings are being presented Monday at the American College of Emergency Physicians’ annual conference in Washington.
In 2014, only 12 states allowed basic EMS staff to administer naloxone for overdose. Today, laws in every state allow the drug to be administered by anyone, from a physician to a family member.
Dr. Sharon Stancliff, an expert on opioid overdose prevention, said that although it has long been known that naloxone is effective at keeping people alive, it was the first time she recalled seeing such specific numbers regarding its effectiveness.
“It’s really important data, and there’s a lot we can do with it,” said Stancliff, medical director of the nonprofit Harm Reduction Coalition, who was not involved with the research.
According to the US Centers for Disease Control and Prevention, last year alone, there were an estimated 64,000 fatal drug overdoses, most of them from opioids. And for each fatal overdose, there are approximately 30 nonfatal overdoses — many of the cases appearing in emergency rooms across the country. In fact, between 2005 and 2014, the rate of opioid-related emergency visits increased by 99.4%.
Stancliff believes that these hard numbers could be used to help persuade emergency rooms to change how they handle overdoses.
Weiner agreed and said the next steps on what to do with a patient are key in helping stop the drug overdose crisis. In emergency rooms, once people recover from an overdose, they may be given a list of phone numbers for treatment centers but not much else.
It is important to get people “engaged in treatment as soon as possible,” he said. A number of innovative emergency departments are working toward this, whether by bringing recovery specialists into the emergency room or even by having treatment facilities nearby.
“Some of the ERs in New York are really jumping on it, starting people on buprenorphine,” a medication used to help wean people off opioids, Stancliff said.
Weiner hopes that these data can be used to help persuade clinicians to figure out the next steps — and persuade patients to take those steps.
“If I’m taking care of a patient in the ED, I want to be able to tell them what the real chances of dying are if they continue using. I can look them in the eye and say, ‘you have a 1 in 10 chance of dying in a year if we don’t get you treated,’ and I think that’s really powerful,” Weiner said.
Written by: Nadia Kounang, CNN

Healthcare Providers Helped Bring About the Opioid Epidemic; Now It’s Time to Help End It

Some programs already in place, many more needed

By Toby Cosgrove., M.D.

Cleveland Clinic president and CEO

Too many of the stories we hear about opioid-related deaths start the same way – with a patient prescribed a pain medication for an injury or medical procedure.

The stories then progress to street drugs like heroin or fentanyl, leading all too often to death. In 2016, about 60,000 Americans died of opioid abuse, an American death toll greater than the whole of the Vietnam War.

This has to stop and healthcare providers have a key role in turning the tide. One of the most sobering statistics, from a physician’s point of view, is that over 75 percent of opioid and heroin deaths begin with a prescription pain killer. The healthcare industry bears some responsibility.

That’s not to say that patients aren’t in legitimate pain. They are, maybe as many as 100 million by some estimates. But we as healthcare providers have to approach pain differently, smarter.

Declaring the opioid crisis a National Public Health Emergency is a good first step. But we in healthcare can’t wait for Washington. We have approaches at our disposal that can effect very real change.

Cleveland Clinic Statistic

Better policies have shown to make a difference quickly. In just the past few months, we’ve:

  • Reduced the number of opioid prescriptions exceeding 3 days by 50 percent in our emergency departments, simply through education and communication.
  • Reduced the number of patients receiving opioids by one-third in a group of colorectal surgery patients.
  • Hired a full-time Doctor of Pharmacy, who as a pain-management specialist can improve prescribing practices and clinical care.
  • Designated every hospital unit with “pain champions,” who are conversant with alternative pain strategies.

What it boils down to is this: healthcare providers have to make this a priority and we have to give physicians the tools they need to effect change.

Essentially, we can attack the opioid epidemic in four ways: giving healthcare providers the prescribing tools and resources they need; insisting on team engagement among hospital departments; tracking prescribing data and demanding accountability; and sharing information with other hospitals in the region.

Our electronic medical records system has been an indispensable tool. It has allowed us to connect directly to the Ohio Automated Rx Reporting System (OARRS); now, a physician can see a patient’s history of controlled substances within seconds while formulating a treatment plan. Also, our patient-provider agreements and consents are stored electronically so anyone who cares for that patient can see it, review it and update it as appropriate.

At the same time, we can use the electronic medical record to gather data so that we truly understand current practice – What type of patients are being prescribed narcotics? Which departments prescribe opioids most often? – then use that data to standardize care across the system.

Cleveland Clinic Statistic 2

Here are a few more approaches we’re using at Cleveland Clinic:

A Twist on “Just Say No”: Saying “no” to patients who are seeking narcotics for pain relief is difficult. That’s why we’ve instituted training courses for physicians on how to decline opioid requests from patients, with an emphasis on being compassionate. These are difficult conversations and the stakes are high. We must help our physicians navigate this by giving them the skills, strategy and practice to show empathy while managing emotion, setting boundaries and employing de-escalation tactics when needed.

Getting Back on TREK: Back pain strikes about 31 million Americans at some point during their lives. All too often, the first-line treatment is surgery or pain killers. At Cleveland Clinic, we are offering a different approach. Back on TREK (Transform Restore Empower Knowledge) is a pilot program treating patients with chronic low back pain (with or without leg pain), with the goal of restoring function through non-surgical treatment approaches and providing patients with tools to manage their pain without narcotics. The program utilizes a combined treatment approach of psychologically informed physical therapy; pain neuroscience education and behavioral medicine sessions utilizing cognitive behavioral therapy and psychological education techniques. More than 60 percent of patients showed significant improvement in pain and disability; over half demonstrated significant reduction in fatigue, pain interference, and overall physical health.

Painless mastectomy: An experimental drug, Exparel, is a local, time-released anesthetic used after a mastectomy to help patients with the worst of the pain — the first four days — so patients can avoid opioids.

Narcotic-free colorectal surgery: A program at Cleveland Clinic Akron General replaces narcotics with pre-surgical pain management, peripheral nerve blocks during procedure, and encouragement for the patient to get out of bed and move around within 4 to 6 hours of getting to the recovery floor. Of 80 patients in the program, one-third avoided narcotics. As a result, readmission rates and surgical costs dropped, hospital stays were shortened by 50 percent, risk of complications were reduced, and recovery improved with less pain.

New “ERAS” of recovery: Several medical centers, including Cleveland Clinic, have been developing the concept of “fast-track” or “enhanced” recovery after surgery. Recently, comprehensive research has indicated that an ERAS (“Enhanced Recovery After Surgery”) methodology that permits patients to eat before surgery, limits opioids by prescribing alternate medications, and encourages regular walking reduces complication rates and accelerates recovery after surgery. ERAS can reduce blood clots, nausea, infection, muscle atrophy, hospital stay and more. Patients are also given a post-operative nutrition plan to accelerate recovery, and physicians are using multi-modal analgesia, limiting the use of narcotics.

The good news is that the fight against the opioid epidemic is moving in the right direction. Everyone – hospitals, physicians, lawmakers, law enforcement and the general public – see this as the national emergency that it is.

By leveraging the tools at our disposal – or by creating new tools – we can save lives.

Link to original article here: Healthcare Providers Helped Bring About the Opioid Epidemic; Now It’s Time to Help End It

How to Be Human: Talking to People with Addiction or Substance Use Disorders

Shifting our perspective from ourselves to them

When it comes to addiction, using people-first language doesn’t always cross everyone’s mind. In fact, it hadn’t actually crossed mine until recently. Several years ago, many close friends experienced addiction and substance use disorders. Others in our extended friend group overdosed and died.

Before working at Healthline, I worked as a personal care assistant for a woman with disabilities throughout college. She taught me so much and brought me out of my able-bodied ignorance — teaching me how much words, no matter how seemingly small, can affect someone.

But somehow, even when my friends were going through addiction, empathy didn’t come so easily. Looking back, I’d been demanding, self-centered, and at times mean. This is what a typical conversation looked like:

“Are you shooting up? How much do you do? Why won’t you return my calls? I want to help you!”

“I can’t believe they’re using again. That’s it. I’m done.”

“Why do they gotta be such a junkie?”

At the time, I was having a hard time separating my emotions from the situation. I was scared and lashing out. Thankfully, a lot has changed since then. My friends stopped misusing substances and got the support they needed. No words can convey how proud I am of them.

But I hadn’t really thought about my language — and others’ — surrounding addiction until now. (And maybe getting out of your early 20s helps, too. Old age brings wisdom, right?) I cringe at my actions, realizing that I’d been mistaking my discomfort for wanting to help.

Many people frame well-intended conversations wrong, too. For example, when we say, “Why are you doing this?” we really mean, “Why are you doing this to me?”

This accusatory tone stigmatizes their use — demonizing it due to stereotypes, belittling the actual brain changes that make it difficult for them to stop. The overwhelming pressure we then place on them to get better for us actually debilitates the recovery process.

Maybe you have a loved one who had or is currently experiencing a substance or alcohol use disorder. Believe me, I know how hard it is: the sleepless nights, the confusion, the fear. It’s OK to feel those things — but it’s not OK to act on them without taking a step back and thinking about your words. These linguistic shifts may seem awkward at first, but their effect is enormous.

DEPENDENCE VS. ADDICTION

Not everything is an addiction, and not all ‘addictive’ behaviors are the same

It’s important not to confuse these two terms so we can fully understand and talk clearly to people with addictions.

 

Term Definition Symptoms
Dependence The body becomes used to a drug and usually experiences withdrawal when the drug is stopped. Withdrawal symptoms can be emotional, physical, or both, like irritability and nausea. For people withdrawing from heavy alcohol use, withdrawal symptoms can also be life-threatening.
Addiction The compulsive use of a drug despite negative consequences. Many people with addiction are also dependent on the drug. Negative consequences can include losing relationships and jobs, getting arrested, and doing harmful actions to get the drug.

Many people may be dependent on a drug and not realize it. And it’s not just street drugs that can cause dependence and addiction. People prescribed pain medications can become dependent on the meds, even when they’re taking them precisely as told by their doctor. And it’s completely possible for this to eventually lead to addiction.

First, let’s establish that addiction is a medical problem

Addiction is a medical problem, says Dr. S. Alex Stalcup, medical director of New Leaf Treatment Centerin Lafayette, California.

“All of our patients get an overdose kit on their first day. People thought it was creepy at first, but we give Epi-Pens to people with allergies and devices for people who are hypoglycemic. This medical device is for a medical disease,” he says. “It’s also another way of explicitly stating this is a disease.”

Since New Leaf started providing overdose kits, deaths have also been averted, says Dr. Stalcup. He explains that folks who carry these kits are really just dealing with major risk factors until they get better.

What you call someone with an addiction can bring unfair biases

Certain labels are charged with negative connotations. They reduce the person to a shell of their former self. Junkie, tweaker, drug addict, crackhead — using these words erase the human with a history and hopes, leaving behind a caricature of the drug and all the prejudices that come with it.

Man-Painted-Blue-Tattoos

These words do nothing to support people who need help getting away from the addiction. In many cases, it only prevents them from getting it. Why would they want to make their situation known, when society judges them so harshly? Science backs up these prejudices in a 2010 study that described an imaginary patient as a “substance abuser” or “someone with a substance use disorder” to medical professionals.

Researchers found that even medical professionals were more likely to hold the individual to blame for their condition. They even recommended “punitive measures” when they were labeled as an “abuser.” But the imaginary patient with a “substance use disorder”? They didn’t receive as harsh of a judgment and would probably feel less “punished” for their actions.

Never Use Labels
  • junkies or addicts
  • tweakers and crackheads
  • drunks or alcoholics
  • “abusers”

MAINTAINING RESPECT AND DIGNITY

A person is a person is a person:’ Labels aren’t your call to make

But what about when people refer to themselves as a junkie? Or as an alcoholic, like when introducing yourself in AA meetings?

Just like when talking to people with disabilities or health conditions, it’s not our call to make.

“I’ve been called a junkie a thousand times. I can refer to myself as a junkie, but no one else is allowed to. I’m allowed to,” says Tori, a writer and former heroin user.

“People throw it around… it makes you sound like s***,” Tori continues. “It’s about your own self-worth,” she says. “There are words out there that hurt people — fat, ugly, junkie.”

Amy, an operations manager and former heroin user, had to balance burdensome cultural differences between her first-generation self and her parents. It was difficult, and still is to this day, for her parents to understand.

“In Chinese, there are no words for ‘drugs.’ It’s just the word poison. So, it literally means you’re poisoning yourself. When you have that harsh language, it does make something seem more severe,” she says.

“Connotations matter,” Amy continues. “You’re making them feel a certain way.”

“Language defines a subject,” says Dr. Stalcup. “There’s a huge stigma attached to it. It’s not like when you think of other conditions, like cancer or diabetes,” he says. “Close your eyes and call yourself a drug addict. You’ll get a barrage of negative visual images you can’t ignore,” he says.

“I feel strongly about this… A person is a person is a person,” Dr. Stalcup says.

Don’t say this: “She’s a junkie.”

Say this instead: “She has a substance use disorder.”

CLEAN VS. DIRTY

How racism and addiction play into language

Arthur*, a former heroin user, also shared his thoughts on the language surrounding addiction. “I have more respect for dope fiends,” he says, explaining that it’s a hard road to travel and understand if you haven’t gone through it yourself.

He also alludes to racism in addiction language, too — that people of color are painted as addicted to “dirty” street drugs, versus white people dependent on “clean” prescription medications. “People say, ‘I’m not addicted, I’m dependent cause a doctor prescribed it,’” Arthur adds.

Perhaps it’s no coincidence that there’s growing awareness and empathy now, as more and more white populations are developing dependency and addictions.

Empathy needs to be given to everyone — no matter race, sexuality, income, or creed.

We should also aim to remove the terms “clean” and “dirty” altogether. These terms hold belittling moralistic notions that people with addictions were once not good enough — but now that they’re in recovery and “clean,” they’re “acceptable.” People with addictions aren’t “dirty” if they’re still using or if a drug test comes back positive for use. People shouldn’t have to describe themselves as “clean” to be considered human.

Don’t say this: “Are you clean?”

Say this instead: “How are you doing?”

Just like with the use of the term “junkie,” some people with use disorders may use the term “clean” to describe their sobriety and recovery. Again, it’s not up to us to label them and their experience.

ONE DAY AT A TIME

Change won’t come overnight — we’re all a work in progress

“The reality is and will remain that people want to sweep this under the rug,” says Joe, a landscaper and former heroin user. “It’s not like it’s going to change overnight, in a week, or in a month,” he says.

But Joe also explains how quickly people can change, like his family did once he began treatment.

It may seem that after a person has overcome their substance use disorder, everything will be fine going forward. After all, they’re healthy now. What more could anyone want for a loved one? But the work doesn’t stop for the former user.

As they say in some circles, recovery takes a lifetime. Loved ones need to realize this is the case for many people. Loved ones need to know they themselves need to continue to work to maintain a more empathetic understanding, too.

“The aftermath of being a drug addict is sometimes the hardest part,” explains Tori. “To be honest, my parents still don’t understand… [Their language] was just really technical, medical language, or that I had a ‘disease,’ but to me, it was exhausting,” she says.

Dr. Stalcup agrees that the language families use is absolutely critical. While it’s wonderful to show an interest in your loved one’s recovery, he stresses that how you do it matters. Asking about their progress isn’t the same as if your loved one has diabetes, for example.

With addiction, it’s important to respect the person and their privacy. One way Dr. Stalcup checks in with his patients is asking them, “How’s your boredom? How’s your interest level?” He explains that boredom is a big factor in recovery. Checking in with specific questions catered to your friend’s interests will show you understand while making the person feel more comfortable and cared for.

Don’t say this: “Have any cravings lately?”

Say this instead: “What have you been up to, anything new? Wanna go on a hike this weekend?”

TAKEAWAY

Language is what allows compassion to thrive

When I started working at Healthline, another friend began her recovery journey. She’s still in treatment, and I can’t wait to see her in the new year. After talking to her and attending a group meeting at her treatment center, I now know I’ve been dealing with addictions in a totally wrong way for years.

Now I know what I, and other people, can do better for their loved ones.

Uphold respect, compassion, and patience. Among the people I talked to about their addictions, the single biggest takeaway was the power of this sensitivity. I’d make the argument that this compassionate language is just as important as the medical treatment itself.

“Treat them how you’d want to be treated. Changing the language opens doors to different ways of behaving,” Dr. Stalcup says. “If we can change the language, it’s one of the fundamental things to lead toward acceptance.”

No matter who you’re talking to — whether to people with health conditions, people with disabilities, transgender people or nonbinary folks — people with addictions deserve the same decency and respect.

Language is what allows this compassion to thrive. Let’s work on breaking these oppressive chains and see what a compassionate world has in store — for all of us. Doing this will not only help us cope, but help our loved ones actually get the help they need.

The behaviors of a person with an active substance use disorder may make you not want to be compassionate. But without compassion and empathy, all we’re left with will be a world of hurt.

*Name has been changed at the request of the interviewee to preserve anonymity.

A very special thank you to my friends for giving me guidance and their time to answer some hard questions. Love you all. And very big thank you to Dr. Stalcup for his earnestness and dedication. — Sara Giusti, copy editor at Healthline.


 

Link to original article here: How to Be Human: Talking to People with Addiction or Substance Use Disorders

Suboxone Is Sober: 4 Myths That Keep Heroin And Pain Pill Users From Trying This Life-Saving Treatment

Suboxone (the popular name brand of medication buprenorphine/naloxone) reduces cravings and the withdrawal effects from heroin and pain pills. Any heroin or pain pill user knows that a fear of the horrible physical and emotional opiate detox can keep us using long after we want to quit. Even if we’ve tried to quit (and I’m speaking from experience), we might end up using again because we can’t make it through those first brutal days of detox.

Suboxone helps you survive opiate detox, and stabilizes you for life sober. Brand names Suboxone, Zubsolv, and Bunavail (different forms of the same medications, buprenorphine/naloxone) are expert-backed options categorized as medication-assisted treatment for opiate addiction. They’re medications that, with counseling, act as treatment to help you stay sober. Thus, medication-assisted treatment.

Large expert organizations like SAMHSA, NIDA, and the World Health Organization agree that medication-assisted treatment decreases opioid use, opioid related-deaths, and increases success in treatment. This isn’t up for debate, studies show medication-assisted treatment saves lives, and keeps people sober.

It should be a no brainer, right? If medication-assisted treatment like Suboxone works, and we’re in the midst of an opioid epidemic, you think it would be welcomed with open arms. You’d be thinking wrong. Less than ½ of privately funded treatment centers offer medication-assisted treatment, and less than ⅓ of patients struggling with opiate misuse ever receive it. (source)

A sponsor told me a long time ago, “Just because you’re an addict, doesn’t mean you have to be in pain.” I’ve carried that belief with me, and I believe it to be true for all opiate users who are struggling to quit today. Let’s bust four myths about Suboxone and other types of medication-assisted treatment, that keep many addicts in pain today.

1. Myth: A drug is a drug is a drug.

This is a response to Suboxone heard in Narcotics Anonymous meetings. A drug is a drug is a drug, and if you’re on one, you aren’t sober. But this simply isn’t true. You know it, and I know it. All drugs aren’t created equal. Street drugs cut with fentanyl can kill you, and can make you so high you fall asleep eating ice cream in your bed, or worse. Suboxone, or other forms of buprenorphine/naloxone, can reduce the likelihood that you’ll relapse and die. When taken as prescribed, then can improve your quality of life and chances of long-term recovery. That’s seriously sober to me. (source)

2. Myth: Suboxone makes you high.

This myth stems from Suboxone’s medication-assisted treatment precursor, methadone. Methadone can create a slight euphoric effect, and it can make you tired. But Suboxone is a partial opioid agonist, with a weaker side effects than heroin or methadone. It has a “ceiling effect” meaning if you do feel any sort of buzz (which most users don’t report, a switch from heroin or pain pills to Suboxone is not pleasant – trust me, I’ve done it), it will level off even if you increase your dose. Meaning that by definition, you won’t be able to get high. You’ll be stabilized. (source)

Suboxone different packets

3. Myth: Suboxone is trading one addiction for another.

There’s a big difference between addiction and dependence. Physical dependence is an aspect of taking certain drugs. Antidepressants like SSRI’s, certain blood pressure medications, and epilepsy medications all cause physical dependence. This means that if you stop taking these medications, you with experience some type of withdrawal from them. Does this mean we’re all addicted to our antidepressants? Nope. It means our bodies have adapted to them.

But addiction is a brain disease, characterized by compulsive drug use despite harmful consequences. This means if you can’t stop taking antidepressants despite the fact that you’ve spent all your money on them, your friends and family have told you they can’t stand to be around you when you’re on them, and you’ve missed a ton of work because of them, but still, you crave them like crazy and stay up at night taking just another Effexor, Cymbalta… that would be addiction. This is not what happens with medication-assisted treatment, or antidepressants, or plenty of other doctor-prescribed medication when we take it as prescribed. With Suboxone, just the opposite happens. Cravings decrease, and you can focus on daily living free of addiction. (source)

4. Myth: Suboxone is mood-altering, so you can’t take it and be sober.

Outside of any 12-step meeting, you might find some folks vaping and chugging Monster Energy drinks. All that nicotine, caffeine, and sugar is mood-altering. But it’s a certain kind of socially acceptable, so we encourage it. Living Sober, the Alcoholics Anonymous guide on how to get through early recovery, recommends reaching for something sugary to beat cravings. What is that sugar doing? It’s altering your mood. We need to think past the mood-altering rule and into a more personal and private decision of self-care. What works for you? What doesn’t work for you?

cigarette and cup of coffee

The reality is, opiate addiction is mood-altering, even after you quit using. When you misuse opiates long-term, you throw your brain chemicals off balance. That imbalance can lead to Post-Acute Withdrawal Syndrome, with depression, cravings, and sleep disturbances continuing long after short term withdrawal has ended. You feel funky, and your mood is altered. This can stack the decks against you. Because your brain is trained to turn to a single solution when you feel bad: USING OPIATES. Suboxone solves this problem by giving your brain back the chemicals your opiate addiction depleted, while also keeping you from getting high.

Is it easier, in the world of drug addiction, to categorize all drugs as bad? It might be, on the surface. But that sort of black and white thinking doesn’t serve us in recovery. It’s tempting, as we all point fingers at big pharma, to tell everyone to screw all meds. To say, “Just suck it up. Stop using, without any help.” But it sounds easy until you’ve been there. We’d all gladly kick opiates without any help if we could. But there’s a solution that makes the process of opiate addiction a little less painful. So let’s start treating it like one. Suboxone isn’t the enemy here. Heroin and pain pill addiction is.

Link to original article: Suboxone Is Sober: 4 Myths That Keep Heroin And Pain Pill Users From Trying This Life-Saving Treatment

Heroin-addicted cry out for treatment now, but help can be slow

An average of nearly 500 calls a day rang into Cincinnati’s Center for Addiction Treatment (CAT) in September. The website caught 1,100 visits a day.

The phone and web traffic for CAT’s services are two measures of how many people want help for heroin addiction. Problem is, immediate treatment is hard to get.

“We are not close to treatment-on-demand ability,” said Sandi Kuehn, CEO of the West End-based center.

Offering services when people want them would put Cincinnati among the national leaders in the battle against heroin addiction. Experts cannot name a city that has all forms of treatment on demand.

Addiction doctors say that the Cincinnati region does not have enough treatment facilities for everyone who needs the help. Many who want treatment do not know how to get what is available, and many who are addicted do not have the means, including transportation or a phone, to find treatment.

Cincinnati skyline river

Treatment on demand for heroin addiction usually means quickly providing medication to stop a patient’s cravings and help stabilize them, then finding long-term treatment that includes counseling.

Addiction experts say it’s important to give people treatment when they ask for it because people may want treatment one minute, but succumb to heroin the next.

Not having treatment on demand is “like denying treatment to a person with advanced heart disease,” said Linda Richter, director of policy research and analysis for the National Center on Addiction and Substance Abuse.

One user’s story: No phone, no treatment

Justin Warfield, 30, is in the Hamilton County jail awaiting treatment. He thinks being in jail is the only way he can get help.

When he was homeless in July, he said he’d tried to get residential treatment but abandoned the idea because it seemed impossible to do.

“You have to call every day,” he said. “I don’t have a phone. I can’t even call my mom.”

Justin Inmate Prison

Even if he’d had a phone and a way to charge it, Warfield said he’d probably call a heroin dealer before he’d keep in touch with a treatment center.

“It’s hard-wired into my brain at this point,” Warfield explained.

His mother, Colleen Owens of Camp Washington, has seen her son vacillate between wanting treatment and refusing it over the years.

“When they want help, they need to be able to get help then, not later,” Owens said. She sobbed, adding, “Later might be too late.”

While Greater Cincinnati and Northern Kentucky aren’t able to promise treatment on demand yet, we are getting closer.

More help faster, but without a bed

Addiction treatment is becoming more available in the Cincinnati area, with outpatient clinics and programs “popping up all the time,” said Nan Franks, CEO of the Addiction Services Council, a Greater Cincinnati nonprofit.

But while the clinics have shorter wait times than inpatient treatment, clinic treatment usually requires an appointment. The clinics mostly offer FDA-approved medications buprenorphine and injectable naltrexone for opioid addiction. They match medication with counseling.

BrightView Health has four locations in Southwest Ohio “with more under development,” said founder Dr. Shawn Ryan, a certified addiction expert. The first opened in 2015. “We’ve gone from zero- to about a 1,000-patient capacity,” Ryan said.

His clinics offer same-day and next-day treatment. People can walk in and get what they need, Ryan said. Patients are given buprenorphine as soon as they are medically approved for it. “That can be within hours,” he said.

The Center for Addiction Treatment opened its outpatient clinic in September, which is when calls nearly doubled. Kuehn said clients can get treatment in 24 to 48 hours.

In Northern Kentucky, Dr. Michael Fletcher, a certified addiction expert, has openings in his Chemical Addiction Network clinic. And St. Elizabeth Physicians just expanded its Journey Recovery clinic to try to meet the demand.

Going from ER directly to treatment

One way to get more people treatment when they are likely to want it is by offering it in emergency rooms to overdose survivors, rather than handing them a resource list and watching them walk out the door.

St. Elizabeth Healthcare recently brought the concept to our region. On Oct. 1, it started a pilot program at its Edgewood hospital to try to get OD patients into treatment before they leave the hospital.

Syringe on Ground

The St. E “bridge” program provides an addiction medication, buprenorphine, to overdose survivors and a peer recovery specialist to guide people into treatment.

It’s a form of treatment on demand that’s gaining favor across the nation.

Dr. Ross Sullivan pioneered his program in Syracuse in 2016 as an emergency doctor at Upstate University Hospital. He prescribed buprenorphine to patients who’d overdosed. Within months, he had approval to start a clinic for the ER patients. Like at St. E, a peer recovery specialist secures full treatment for the patients.

As of his last count, Sullivan had 165 patients referred by the ER. Of those, 132 showed up to their clinic appointment, and from there, 86 percent were linked to treatment.

It’s difficult for families, but hopsitals can’t coerce patients into treatment, said Dr. Leana Wen, Baltimore’s health commissioner, who has gained national attention for her city’s “kitchen sink” response to heroin.

 In Baltimore, four hospitals offer buprenorphine induction, but all hospitals connect overdose survivors with an outreach worker. That social worker “follows them out the door,” Wen said, staying in touch with them until they are ready to get treated.

One user’s story: Arrested to get treated

Katerra Jervis of Elsmere, a longtime heroin user, knew she wanted help. The only way she knew how to get it was to get herself arrested. So that’s what she did on March 22.

“I just wanted help so bad I didn’t care what I had to do,” said Jervis, 29.

She made her decision after a friend sent her a link to an Enquirer story about the jail’s evidence-based treatment program.

She showed up at the Campbell County jail, and Newport police cited her for public intoxication. Jervis says she “faked” her way into the citation. A police report states she had “pinpoint” pupils and was “a danger to herself, others and public property.”

The officer stated that Jervis “wanted to get help to end her addiction to heroin” and that “she wanted court-assisted addiction help.”

She pleaded guilty to disorderly conduct and got in. She graduated from the program Aug. 28 and took a two-year follow-up program option.

“It’s the best thing that ever happened to me,” Jervis said.

Jason Merrick, director of an addiction services program at the Kenton County jail, wasn’t surprised at Jervis’ story, adding that such situations “probably occur more often than we would admit or know.”

Helplines work, if people know about them

For those who can call, the Cincinnati area has two 24-7 heroin helplines staffed with addiction counselors who are finding treatment fast for people who need it.

 

“We probably have access every day,” said Addiction Services Council’s Franks.

The council’s staff is tapped into the treatment community and can cut through the runaround that so many describe they face when searching for help.

But not everyone knows about the helplines.

Amanda Cicchinelli of Loveland, whose son, Austin, struggled with heroin addiction for three years, said she was unaware of a helpline. Over the years, she said, she hunted for treatment repeatedly for her son.

”We made countless phone calls through the years,” Cicchinelli said. “It was a never-ending cycle of walls and barriers. Waiting lists and restrictions. Desperation became the deciding factor in where he went – not the program or treatment offered.”

Austin Cicchinelli, like most people with heroin addiction, wanted and didn’t want treatment. He cycled in and out of programs, his mother said, propelling her into a frantic search for help for him again and again.

Amanda Austin mother son

He kept a diary in 2016 that chronicled his thoughts about addiction, his wish to help others, his own need for help and, ultimately, his hopelessness.

July 23: “I wish I could build a time machine and stop myself from all of the choices.  I would show myself the things I was too naive and blind to see.  I would stop myself from ever even buying my first bag of weed.”

Aug. 21: “A woman I met on the streets overdosed. I bet people just look at her and think she’s just another addict. Nobody cares about an addict. No one contemplates that she is her parents’ daughter.”

Oct. 4: “I’m one shot away from being another T-shirt.”

Cicchinelli used heroin for the last time on June 26 this year.

“He was 21 when he died at his grandparents’ house, down the road from me, in Loveland,” his mother said.

Why can’t we get on-demand treatment?

How much more addiction treatment is needed isn’t clear, because the size of the opioid problem isn’t known.

Health officials in the region say they can’t provide an educated guess about the number of people who use heroin and other opioids, much less an actual count of the population. The research and data just aren’t there.

Vine St Over The Rhine Cincinnati

“If folks don’t come into the picture because of criminal justice, treatment, emergency types of reasons, we don’t know they exist,” explained Jennifer Mooney, the family health division director for Cincinnati Health Department.

Nationally, the federal Substance Abuse and Mental Health Services Administration estimates one in 10.8 people who need addiction treatment get it at a specialty program. Put another way, that’s roughly 2.3 million of the 21.7 million who reported in a 2015 survey that they needed treatment.

Even if the size of the problem were clear, there are other barriers to treatment and removing them “is complicated,” said Kenton County’s Merrick, who also is board president of the Kentucky chapter of People Advocating Recovery.

One problem, for example, is that insurance companies often require pre-authorization for treatment. People Advocating Recovery plans to ask the Kentucky legislature to hasten the process.

“If they could figure out a way to do this, we could give people treatment immediately,” Merrick said.

Another problem: Money.

Often, those who ask for treatment don’t have insurance. They have to get signed up, and that represents a delay. Beyond that, Merrick said, most treatment centers are understaffed and underfunded, making it difficult to provide immediate treatment.

Dr Mina Kalfas with patient

A final barrier is the misunderstanding that those who are addicted don’t want help, said Dr. Mina “Mike” Kalfas, a Northern Kentucky addiction specialist who has more than 200 heroin patients.

“Just about everybody I know battling addiction falls into one of two categories: Those that want help and those that have given up,” he said.

How to get help for yourself or somebody else

For 24-7 help, call the Addiction Services Council:

• Cincinnati area: 513-281-7880
• Northern Kentucky: 859-415-9280

The Social Life of Opioids

New studies strengthen ties between loss, pain and drug use

In the story of America’s opioid crisis a recent tripling in prescriptions of the painkillers is generally portrayed as the villain. Researchers and policy makers have paid far less attention to how social losses—including stagnating wages and fraying ties among people—can increase physical and emotional pain to help drive the current drug epidemic.

Man pondering Sea

But a growing body of work suggests this area needs to be explored more deeply if communities want to address the opioid problem. One study published earlier this year found that for every 1 percent increase in unemployment in the U.S., opioid overdose death rates rose by nearly 4 percent.

Another recent study from researchers at Harvard University and Baylor College of Medicine reported U.S. counties with the lowest levels of “social capital”—a measure of connection and support that incorporates factors including people’s trust in one another and participation in civic matters such as voting—had the highest rates of overdose deaths. That review of the entire U.S. mined data from 1999 through 2014 and showed counties with the highest social capital were 83 percent less likely to be among those with high levels of overdose. Areas with low social capital, in contrast, were the most likely to have high levels of such “deaths of despair,” with overdose alone killing at least 16 people per 100,000

Overdose is now the nation’s leading cause of death for people in the prime of life. And suicide- and alcohol-related deaths have also risen—most dramatically in regions with the highest levels of economic distress. “It will be hard to address the addiction and overdose crisis without better understanding and addressing the neurobiology linking opioids, pain and social connectedness,” says Sarah Wakeman, medical director of the Substance Use Disorder Initiative at Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School.

Connecting opioid use to social stress is not a new idea. Forty years ago the late neuroscience pioneer Jaak Panksepp first proposed the now widely accepted hypothesis that our body’s naturally produced opioids—endorphins and closely related enkephalins—are critical to the nurturing bonds that develop between parents and offspring and also between monogamous mates in mammals. Panksepp’s work and that of others showed that blocking one opioid system in the brain—which relies on the mu-opioid receptor—increased the distress calls of infants separated from their mothers in species as varied as dogs, rats, birds and monkeys. Giving an opioid drug (in doses too low to produce sedation) reduced such cries.

Panksepp also observed similarities between maternal love and heroin addiction. In each situation animals would persist in a behavior, despite negative consequences, in order to gain access to solace from the partner—or the drug. But, as Panksepp (who died in April) said in an interview several years ago, major journals rejected his paper in the 1970s because editors said the idea that motherly love was similar to heroin addiction was “too hot to handle.”

Since then, however, data supporting the link between opioids and bonding has only grown. It has been expanded on by researchers including Thomas Insel, former head of the National Institute on Mental Health; Robin Dunbar at the University of Oxford; and Larry Young, professor of psychiatry at Emory University.

Young showed that oxytocin, a hormone previously linked mostly with labor and nursing, is crucial to the formation of pair bonds as well as bonds between parents and infants. “The feelings that infants or adults feel when being nurtured—warmth, calmness and peacefulness—come from a combination of opioids and oxytocin,” he says. “These are the same feelings that people who take opioids report: a feeling of warmth and being nurtured or loved.” When a social bond is formed, oxytocin reconfigures the mu-opioid system so that a loved one’s presence relieves stress and pain—and that person’s absence, or a threat to the relationship, increases distress. For example, Young’s research shows normally monogamous prairie voles do not develop pair bonds with their mates if their mu-opioid system is blocked; other studies have found that mice genetically engineered to have no mu-opioid receptors do not prefer their mothers to other mice the way normal baby mice do.

A paper Young published this month, in collaboration with researchers at the University of Tsukuba in Japan, found prairie voles that have bonded with a mate not only experience more anxiety when separated from their partners—they also experience more physical pain during the separation, by various measures including response to a painful injection and pain from heat. “Bonding somehow changes your pain threshold—so if you lose that bond, then your pain reduction and natural analgesia is lost,” he says. This paper did not measure mu-opioid receptor binding, but other work with humans strongly suggests it is involved.

Recent human studies have specifically found that a partner’s presence can reduce pain, and supportive touching such as hugging is linked to activation of mu-opioid receptors in the brain. In addition, a study published last year found that administering an opioid blocker decreased people’s feelings of social connectedness—both when they were in the lab receiving e-mails of support from close friends or relatives and when they were at home during the four days they took the drug—compared with when they took a placebo. And, whereas the drug reduced overall levels of positive emotion, it had a larger effect on positive emotions related to feeling connected and loved.

All of this suggests that recognizing the connections between bonding, stress and pain could be critical to effectively addressing the opioid crisis. “Understanding the biology and commonalities between trusting social relationships and the opioid system can change the way we think about treatment,” Young says, noting that neither the punitive approach of the criminal justice system nor harsh treatment tactics are likely to increase connectedness. In essence, if we want to have less opioid use, we may have to figure out how to have more love.

Link to original article here: The Social Life of Opioids

Written by:  Maia Szalavitz