“I have a daughter who is addicted to heroin. She overdosed yesterday, died and EMS had to bring her back. She is begging for help to get detoxed and into rehab. I don’t know if your facility accepts this but she doesn’t have any form of insurance. She is technically homeless. If there’s anyway you can help us. Please give us a call back.”
This is just one of the many voicemails we receive every week from a concerned family or friend of an individual who continues to struggle with a severe opioid use disorder. Heroin and synthetic opioids kill one American every sixteen minutes. This will be the third year where drug deaths surpass the American casualties that occurred throughout the entire Vietnam war. We know opioids are so powerful they change our brain chemistry. That’s why addressing this specific crisis means changing the way we think about opioid addiction, treatment and recovery. It seems like a paradox, but the large majority of experts agree the best intervention for a severe opioid addiction is with other opioids.
There is a preponderance of data showing medication-assisted treatment positively impacts a number of critical outcome measures. Individuals decrease or abstain from illicit use, increase engagement in activities of daily life, gain employment, improve family functioning, decrease criminal activity, improve physical health, and increase psychological stability while decreasing high-risk behaviors. The largest cohort study on overdose risk to date recently illustrated the message. It followed 150,000 participants from all of England’s publically-funded opioid treatment programs. Individuals who received only psychological supports for opioid dependence were twice as likely to die by overdose. Well-delivered pharmacotherapy reduced cravings and facilitated access to essential healthcare and recovery supports. It’s hard to argue with these well-researched findings. Yet the the individuals and families we work with continue to encounter the debilitating impact of stigma surrounding their elected pathway to recovery.
Most of us agree that folks struggling with addiction issues are some of the most misunderstood in our society. Well-meaning people look at the symptoms of substance use disorders as if they indicate an inherent “badness.” A simple argument can be made that those engaged in medication-assisted treatment are a subset of that population experiencing a much more intense level of scrutiny. They are discouraged to speak about their unique pathway to recovery in mutual aid group meetings because it makes others uncomfortable. What kind of impact does this have when we talk about recovery in terms of building communities, inclusiveness and welcoming all pathways?
What kind of impact does this have on individuals who are ashamed to speak about how they were able to work again, go back to school, or be a present mother, husband or spouse? How poorly does it reflect on those in our own field when addiction professionals shun our most evidence-based treatment?
Imagine receiving news your spouse or child had developed a rare and extremely deadly form of cancer. A treatment modality existed offering a distinct advantage in saving this person’s life and achieving long-term recovery. This approach would include medical care, appropriate medications, as well as a comprehensive network of psychological and recovery supports. Despite this, imagine your loved one’s medical provider discouraged the well-researched and proven treatment and instead prescribed a regimen of meetings led by others suffering from the same diagnosis with no professional oversight. I imagine you and your loved one would feel defeated and helpless.
We know this approach to treatment works when the very criteria for diagnosing opioid use disorders start to disappear in the lives of those we work with. They are working instead of seeking heroin. They are reengaging with family and friends instead of isolating. They are revisiting or creating new values instead of staying preoccupied with cravings and seeking illicit drugs. We genuinely and humbly ask this of you. Welcome the individuals who have chosen this as their pathway to recovery, their families and loved ones into your own communities. Please allow them the space to recovery out loud with no fear of judgment or isolation. Welcome them as if their life depended on it – it often does.
Scott Luetgenau, MSW, LCAS, LCSWA
OTP Practice Manager, SouthLight Healthcare
APNC Board Member