Richard Taite’s self-serving article contains numerous untruths and mischaracterizations, and I welcome the opportunity to clear up the record.
Addiction treatment is changing, and must; it’s just not changing fast enough. The misuse of heroin and prescription painkillers (collectively classified as opioids) has been labeled an epidemic by the Centers for Disease Control, and people are dying in record numbers from overdose. Here at the Hazelden Betty Ford Foundation, we’ve seen a pronounced increase in the numbers of opioid-addicted patients. This population also has unique problems -- like hypersensitivity to pain -- that often undermine their ability to remain in treatment and ultimately achieve long-term abstinence. Our response to these unique challenges combines all of the best available treatments for opioid dependence, including Twelve Step programs, specific psychotherapies and certain medications, to give those with opioid dependence the best chance for lifelong recovery.
Our new program for opioid dependence, the Comprehensive Opioid Response with Twelve Steps (COR-12), provides certain medications (Suboxone or Vivitrol, not methadone) for some patients. These medications are evidence based, reduce the risk of overdose death, increase engagement in treatment and are extremely beneficial in preventing opioid use when prescribed correctly for the right people. Our program has resulted in more patients staying for full treatment and a reduction in overdose death upon relapse after treatment. These patients experience the same joy and heartache of early recovery, whether on medications or not. Our goal is to engage them long enough in recovery-based activities that they can ultimately go off the medications. This is being realized every day in our outpatient settings as these patients dramatically change their attitudes, start to witness the real gifts of recovery and transition off medications.
Some see medication assistance and abstinence as diametrically opposed. We do not. Even when medications are part of our protocol, abstinence is still the objective. The medication, in those cases, is simply a part of the path to abstinence. We call it COR-12. But one also might call it the “Third Way” because it strikes a reasonable, common-sense balance grounded in the Twelve Steps and based on abstinence, while also utilizing the safest, life-saving medications that keep these patients engaged in recovery long enough to achieve long term sobriety.
Our commitment is absolutely to abstinence, and always will be. Using medications conservatively and according to the evidence, as we do, does nothing to compromise that commitment. Any characterization of our approach as “harm reduction” is simply inaccurate and uninformed.
We have chosen to use everything at our disposal to treat opioid addiction, due to the escalating crisis and high death rate. We remain absolutely committed to Twelve Step recovery, in fact even more so having witnessed these people engage in recovery and reclaim their lives. We are doing research on our method and the early results are very encouraging. We hope other programs will do the same, use the science and the spiritual, provide these medications, engage more people in treatment, save lives and ultimately help more get into long term recovery.
Marvin D. Seppala, MD
Chief Medical Officer, Hazelden Betty Ford Foundation