Understanding what addiction is and isn’t

636129210263038876-Rob-PleimanRob Pleiman is the executive director for NKy Med Clinic.

In the nearly 15 years I have worked in addiction treatment, there have been different trends relating to specific substances. The folks we care for range from young adults, senior citizens, to rich to poor and covers all ethnic groups. This disease does not discriminate and often has a tight hold on people. The past weeks have been particularly challenging.

As reported in The Enquirer, the increase in overdoses has been attributed to batches of heroin that have been intentionally adulterated with the more powerful opioids, fentanyl and carfentanil.

My agency, a provider of medication-assisted treatment (MAT) in Northern Kentucky, has seen the tragic effects of this trend. Nearly every patient who has entered our treatment program over the past several months has submitted drug screens that were positive for fentanyl. When asked, most patients are completely unaware of the presence of fentanyl in the heroin they have been using.

Sadly, these are people who confront this disease with no idea that they ingested substances of this magnitude.

The consequences of the more potent opioids’ presence in the heroin supply are far reaching. Aside from the increased number of overdoses, the more potent opioids create a higher tolerance level and more intense craving and lead to more severe withdrawal symptoms.

This generally leads heroin users to seek out more drugs, more often to keep the withdrawal symptoms away and to meet the increased tolerance level. With every additional episode of use or increase in the amount used, the opportunity for overdose and death increases.

This speaks to the importance of treatment models involving medication assistance. Without medication assistance, opioid users are not likely to commit to a drug-free lifestyle because the withdrawal symptoms and cravings are too severe to tolerate.

Even if the number of detoxification treatment beds were increased, cravings persist for an extended period of time and many opioid users will return to using, which is a known risk factor for overdose and/or death.

Fortunately, the majority of recent overdoses have not been fatal due to the hard work of emergency responders and hospital staff but surviving an overdose needs to be followed with referrals to the appropriate types of treatment to prevent additional episodes of overdose.

It is incumbent upon us to continue to raise awareness as to what addiction is and is not. It is also essential that all addiction treatment providers collaboratively address the challenge and be on the lookout for these more lethal substances. This starts with treating substance users as individuals and addressing their emotional, physical, psychological and spiritual needs – as the medical community does with all diseases.