EDITOR’S NOTE: This is the second in a series of guest opinions looking at the opioid addiction epidemic in Massachusetts. This is the view of a psychiatrist.
By Dr. Jennifer Michaels
Posted Nov. 18, 2014 @ 2:40 pm
Updated Nov 18, 2014 at 4:52 PM
EDITOR’S NOTE: This is the second in a series of guest opinions looking at the opioid addiction epidemic in Massachusetts. This is the view of a psychiatrist. Honor student, son, heroin addict, patient. Wife, nurse, heroin possession, convict. Father, Academy Award winner, heroin overdose, deceased. Beneath the tranquil surface of denial lurks a ravenous leviathan, the disease of addiction. Unlike our society, the disease of addiction knows no prejudice. Right now we’re battling a national epidemic. Addiction to heroin and opioid pills has reached levels previously unseen in our state and country. Heroin addiction is so pervasive and severe that Americans are more likely to die of an opioid overdose than a motor vehicle accident. I have been treating people who suffer from the disease of addiction for over 20 years. This is what I’ve learned:
Opioid addiction is a brain disease
People who suffer from heroin addiction have a bad disease; they are not bad people. Heroin hijacks the part of the brain that makes us feel rewarded and happy and erodes our ability to experience natural joy. The addicted brain develops faulty wiring that reinforces harmful, compulsive behaviors. The addict is compelled to use at any cost. Lost jobs, anguished families and broken laws are the byproducts of active addiction. The honor student I now treat had his first exposure to opioid pills after sustaining a sports injury. In addition to dulling his physical pain, the pills generated a sense of carefree calm. Weekend use evolved to daily use. Within months he discovered the pills were essential to his functioning. Without them he couldn’t eat, sleep or concentrate. Unable to secure another prescription or afford the premium of pills on the street, he tried heroin. Initiation to heroin felt less like an option and more like a necessity to avoid the agonizing withdrawal from opioids.
Naysayers recite statistics suggesting that a majority of heroin users relapse after inpatient treatment. However, a treatment program limited to one week of detoxification constitutes inadequate care. We understand that people suffering from diabetes or other chronic illnesses require long-term treatment with regular monitoring. Comprehensive treatment of any chronic disease, including heroin addiction, promotes symptom reduction, remission and resumption of a meaningful life. A frequently cited study compared two groups of heroin users. One group received year-long treatment, the other group received only one week of care. A majority of those in the year-long treatment group stayed sober during the year of monitoring. In contrast, 20 percent of the one-week treated group had died by one year follow-up. Treatment works, but only when it’s appropriate treatment.