Profile of the Opiate Addiction Crisis

Fifty percent of Americans have a friend or family member with opiate addiction.

Posted Apr 03, 2018

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Mark presented in my office in withdrawal from opiate use disorder (heroin).  He reported using up to 2 grams a day of heroin intravenously.  His opiate use disorder began when he was 18 when he was injured in a football game and had to have shoulder surgery.  He felt really good right away when taking Percocet.  After his doctor stopped prescribing the prescription pain pill, he started buying it on the street.  Three years later, he had escalated to using heroin, which was cheaper than buying Percocet.  He had missed his chance to go to college on scholarship.  He had served six months in jail for possession and he had been to one rehab facility, staying clean only 1 month after discharge.  His parents were frustrated and angry that he was not able to stop using heroin.  They had kicked him out of the house multiple times but their fears of losing him meant he kept getting back in their good graces, even if only for a month – until once again he would steal from them or relapse.  Mark’s withdrawals included sweats, chills, goosebumps, runny nose and tearing eyes, nausea, tremors, dilated pupils, anxiety and irritability.  He wanted help but he also felt hopeless.

Mark’s story is not an uncommon one in my office where I treat addictions, eating disorders and mood and anxiety disorders. Currently 90 Americans die each day as a result of opiate overdoses, the most common of which is from heroin.  Over 200,000 people over the age of twelve have used heroin for the first time in the past year and over 400,000 people were regular users of heroin in the past month.  The majority of people using heroin first started by using prescription pain pills.

It is not uncommon that individuals with substance use disorders will also have some type of mental illness.  They are called “dual diagnosis” clients.  Almost 8 million adults are in this category.  Often symptoms of the mental health disorder are masked by substance use.  People with substance use disorders also suffer from nutrient deficiencies, insomnia and problems with digestion.  Therefore, an integrative approach to treating substance use disorders and their co-occurring diagnoses is very important.  

The 8 Cornerstones of an Integrative Medicine Approach to treating addictions and other mental health disorders will give you a good overview of what a whole-person approach might look like. 

  1. Make a complete diagnosis by taking a complete history and using screening tests to identify co-occurring diagnoses.
  2. Consider whether prescription medication is needed for stabilization of the patient.
  3. Use integrative therapies to help with body-mind integration, emotional release, deeper healing.
  4. Teach patients new skills to cope with their stress and to regulate their emotions to reduce the risk of relapse.
  5. Identify nutritional deficiencies and evaluate gut health.
  6. Psychotherapy to help patients gain insight into their behaviors and get at the root causes of their disorder.
  7. Use of supplements to replace missing nutrients, support mood and improve gut health.
  8. Encourage physical activity to reconnect with body cues and to learn healthy, stress-reducing coping skills.

One of the most important things to understand about addiction is that it is not about the drugs.  People may begin using either prescription pain pills or heroin because it feels good but quickly this shifts and the reason opiate addicts continue using is to avoid the pain of withdrawal symptoms as noted in the case at the beginning of this article.

Beyond this, the basis for addictions is childhood trauma.  While many people look at addicts as being "morally weak" the truth is that childhood trauma, defined by Canadian addiction specialist as "a loss of an essential part of yourself...a loss of security, trust, a sense of peace" is at the core of why people become addicts.

Drugs can be used to self-medicate unruly emotions, to obliterate memories or to deal with insecurities and low self-esteem - all of which can be the result of childhood trauma.  The most important part of treatment should focus on identifying and treating childhood and later traumas and helping patients understand the link between trauma and addiction. 

Substance use disorders (SUD), particularly opiate use disorder has become a significant problem in our society.   An integrative approach to treating SUD and their co-occuring disorders can enhance therapies such as 12-step meetings, psychotherapy and other approaches. But for recovery at the deepest level, you must treat the trauma to heal the addiction.