Facing the opioid epidemic in Snohomish County: Part II

In my last piece, "Facing the Opioid Epidemic in Snohomish County (Part 1),GÇ¥ I discussed the opioid and heroin epidemic in the United States today and how it has impacted the local Monroe and East Snohomish County region.

I also outlined the disease, how it can impact a person and some of the telling signs that distinguish when person in your life may need help to treat this disorder, as well as some tips on where to start.

In the second half of this piece, I'd like to discuss the different forms of opioid and heroin abuse treatment, the types of medications that are often used and what steps need to be taken for a person to successfully fight against opioid abuse disorder and live a longer, healthier life.

What is Treatment?

"TreatmentGÇ¥ is a word that gets thrown around a lot. There are many forms of treatment for substance use disorder SUD.

I often use a cancer analogy when describing SUD. Cancer, of course, is a very serious disease that has the real chance of killing you. Its treatment usually involves a combination of surgery, radiation, immunotherapy and chemotherapy. If the disease goes into remission, we are grateful for our life. If it does not, we reassess the situation and move forward in an effort to achieve remission.

Well, substance use disorder is a very serious disease as well. Estimates are that only 40 percent of alcoholics and 20 percent of opioid addicts achieve remission. Life expectancy is also significantly reduced with SUD.

So, here is the analogy:

Surgery ' In SUD, "surgeryGÇ¥ might include medical detoxification, treatment of mental health issues, management of pain or taking care of health issues that have been ignored.

Radiation ' The "radiationGÇ¥ is formal SUD treatment. This may be inpatient or outpatient. It usually involves both group and individual counseling by licensed professionals; it often begins intensely then tapers over time. People are monitored for substance use, and if they are unable to stabilize, they are often referred to a higher level of care.

Chemotherapy ' This involves some form of an ongoing personal recovery program. Most commonly this means participation in a 12-step program. There are other options, but I would suggest exhausting trials of these 12-step programs before going to other programs.-á In cancer, we would not say, "Well, I am just not a chemotherapy personGÇ¥ and expect to get the same results as if we had done chemotherapy. So, why should we expect our substance use disorder to go into remission without doing the work of recovery? The desire to drink or drug is not coming from the rational thinking brain; it is coming from the animal instinct brain.

Abstinence medications

There are FDA-approved medications available to treat both alcoholism and opioid dependence. These medications are largely underutilized as they are only offered by a third of the treatment programs in the country.

At The Recovery Center at EvergreenHealth Monroe, we assess each patient for the appropriateness of using Medication Assisted Treatment (MAT) in an effort to improve sobriety rates. Medication is not the whole answer; it's just a help.

Mutual self-help

Twelve-step programs have helped countless people obtain sobriety and achieve recovery. Though they "don't work for everyone,GÇ¥ they are not to be dismissed lightly. They have the additional advantage of being available in virtually every community in the country and they function on small donations (usually a dollar or two, and you don't even have to give that). Often people express that they don't want to talk; You don't have to. Just say, "I'm only here to listen today,GÇ¥ and that's fine with everyone in the room.

Others struggle with the concept of a "higher power.GÇ¥ In 12-step programs, the "higher powerGÇ¥ is not defined. Ask yourself this: Have drugs or alcohol become a higher power to you? That is, when you drink or drug, who wins? If the alcohol and drugs win, you might want to rethink whether you have a higher power. If you do decide to go, I recommend going to six meetings, just to get a realistic idea of what goes on there.

Try different meetings too; they are not all the same. There is a 12-step program for those whose lives are impacted by another's drug and alcohol use. It's called Al Anon, and if you are trying to help someone and not making progress, you might try going to Al Anon.

Recovery is work

Recovery from substance use disorder is an inside job with outside help. It requires a movement toward the desire to change from the individual who suffers. As this develops, the outside help that many are ready to offer becomes more meaningful.

The biggest pitfall for many is the idea that they can continue to use some drugs and alcohol and somehow go back to the brain that they had at the beginning of their use. For most, this is simply not possible. In SUD, we change our brain. Recovery from SUD means healing the brain. This may not be possible while still using drugs and alcohol.

A few years ago, The Betty Ford Center published a consensus opinion of a definition of recovery.

Recovery involves voluntary abstinence from mood-altering substances, taking care of one's personal health and developing a sense of citizenship surrounding one's life. People come to us asking for help with abstinence. We can usually obtain abstinence, but to keep it, you have to work a recovery program. In my opinion, it's a sweet deal.

A word of hope:-á people can and do recover from substance use disorder, including opioid use disorder. Millions of people are leading rich productive lives in recovery. You or your loved one has every chance of being in recovery.

It comes down to a willingness to change, then taking action.

John D. Patz, D.O., is the medical director at The Recovery Center at Evergreen Health-Monroe