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Heroin: Addiction and Treatment

February 28, 2014  |  Falmouth Enterprise

By Dr. Michael Bihari 

The growing epidemic of heroin abuse has received much attention during the past several months. Our region of the country has been especially hard hit as noted by the increasing number of heroin overdoses and deaths reported in the news. The Risky Business column will continue to focus on the problem with a series of articles about heroin abuse and addiction.

Addiction Is a Long-term Illness

Opiate dependence and addiction, including heroin and prescription painkillers such as Percocet, Vicodin, and Oxycontin are complex problems. Unfortunately many people mistakenly believe that people with a drug addiction have a character defect or moral weakness. However, most medical researchers now consider dependence on drugs to be a long-term illness, like asthma, hypertension (high blood pressure), or diabetes.

Treatment Basics

The goal of treatment is to stop drug use and allow people with an addiction to lead active lives in their family, workplace, and community. However, a major challenge is keeping people in treatment long enough for them to achieve this goal. Treatment programs that offer the best hope for long-term remission may include the following components:

Complete assessment of an individual is needed to help professionals design an effective treatment plan. program that best suits him or her. 

Detoxification is a period of medically monitored withdrawal from drugs. Treatment in a healthcare setting is necessary to prevent medical complications and minimize discomfort and anxiety. By itself, detox is not a solution, because many addicts will eventually resume taking the drug unless they get further help.

Continuing care programs follow detox and stabilization and are based on an individual’s ongoing treatment needs and may be provided in several types of settings including inpatient, outpatient, therapeutic communities, and other community-based health settings. Within these settings a treatment plan may include:

  • Individual counseling focuses on motivating the person to stop using drugs, repair damaged relationships with family and friends, build new friendships with people who don’t use drugs, and create a recovery lifestyle. 
  • Group counseling members usually support and try to help one another cope with life without using drugs, share their experiences, and talk about their feelings and problems with others who have similar issues. 
  • Medical care for related health issues such as HIV/AIDS.
  • Education about substance abuse to help people learn about their illness and how to manage it.
  • Life skills training that may include learning and practicing employment skills, social skills, communication skills, anger management, stress management, and money and time management.
  • Relapse prevention training teaches people how to identify their relapse triggers, how to cope with cravings, how to develop plans for handling stressful situations, and what to do if they relapse. A trigger is anything that makes a person crave a drug.
  • Orientation to self-help groups such as  Alcoholics Anonymous, Narcotics Anonymous, and other twelve-step programs. 
  • Treatment for mental health disorders. Many people with drug addiction also have emotional problems such as depression, anxiety, or post­ traumatic stress disorder. Treating both the addiction and mental disorder increases the chances that the person will recover. 
  • Family education and counseling services that can help family members understand the causes, effects, and treatment of addiction; and, provide information on how to deal with an addict in the family.
  • Medications often help in the treatment process. Although there are no medications that can cure dependence on drugs, some do help people stay abstinent and can be lifesaving.

Choosing a Treatment Program

If you are addicted to opiates finding the right treatment is critical. Drug abuse treatment is not "one size fits all." Treatment outcomes depend on the extent and nature of your problem; availability of a wide range of treatment options; and the quality of interaction between you and your addiction treatment provider.

The National Institute on Drug Abuse suggests five questions to ask when searching for a treatment program:

  • Does the program use treatments backed by scientific evidence? Effective drug abuse treatments can include behavioral therapy, medications, or, ideally, a combination.
  • Does the program tailor treatment to your specific needs? No single treatment is right for everyone. The best treatment addresses a your various needs, not just the drug you abused.
  • Does the program adapt treatment as the your needs change? Your individual treatment plan must be assessed and modified as needed to meet your changing needs.
  • Is the duration of treatment sufficient? Remaining in treatment for the right period of time is critical.
  • How do 12-step or similar recovery programs fit into drug addiction treatment? Self-help groups can complement and extend the effects of professional treatment.

Gosnold on Cape Cod

Gosnold, with sites throughout Cape Cod, is the major local addiction treatment program. Gosnold’s treatment philosophy is based on the belief that addiction is a chronic illness.  According to the Gosnold website, “Our programs are designed to help patients have longer periods of remission, less frequent periods of regression, and improved life functioning during remission.”  To achieve this goal Gosnold uses “current evidence-based practices including, Medication Assisted Treatment (Vivitrol and Suboxone), Motivational Interviewing, Contingency Management, Solution Focused Therapy, Cognitive Behavioral Therapy, Twelve Step Facilitation and Alternative Therapy (Yoga, Meditation, Equine Facilitated Learning).  These approaches are complemented and supported by intervention, comprehensive family services, recovery coaching, and alumni follow-up and support.”  

People with alcohol or drug dependence problems can and do recover!

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