Tips to Better Understand Substance Abuse and Opioid Disorder

This post was written by Jefferson emergency medicine physician, Priya E. Mammen, MD, MPH.

This time of year has its own place in most of our hearts and minds. The holidays are periods when we look forward to spending time with family and friends, when we crave the warmth and coziness of relaxing by the fireplace, and when we may let down our guards a bit and give in to just one more piece of cake or a cookie before bed.

For those who suffer from substance use disorder, and especially opioid use disorder, this season represents much of the same. But the complex illness of addiction prevents them from enjoying and experiencing the holidays as many of us can. As an emergency physician, I have seen the effects of opioid use disorder on individuals and their families and have watched the anguish of parents and loved ones at feeling overwhelmed by not knowing how best to help.

Our understanding of addiction has come a long way and science and research shows us that any substance abuse and opioid use disorder changes brain chemistry and overall physiology. Addiction is not a behavioral choice, but often becomes a physical need all the way down to the cellular level.

Below are some tips that can help you and your loved ones better understand the complexities of substance abuse and opioid disorder. Use this information to celebrate the New Year with a journey to long term recovery:

  • Stigma related to substance use disorder causes a barrier to safety and recovery.
    • The shame that a person may feel from their drug use can lead them to even more unsafe behaviors, such as not seeking out help or using alone. The shame or guilt that a family may feel from knowing their loved one is engaged in illegal and unsafe drug use may prevent them confronting the issue head on or seeking out services or resources early in the process.
    • Substance use disorder is not a moral failing – it is a potentially life threatening chronic disease. Beginning with this in mind, make an effort to reach out to foster a conversation free of judgment or disapproval, to better understand how to help an individual or a family who is dealing with substance use disorder. Increased education and understanding of addiction can lessen the stigma that may prevent forward progress.
  • As an emergency physician, I know overdose prevention is an essential and critical first step to addressing the opioid epidemic.
    • Opioid overdose is reversible and deaths are preventable with naloxone. In the state of Pennsylvania, thanks to our Physician General Rachel Levine, anyone can walk into any pharmacy and ask for naloxone – even without a prescription – due to the Standing Order for Naloxone. Any physician can also write a specific prescription for the patient or the family to have naloxone available at home.
    • Keep naloxone easily accessible at all times. Know the signs of accidental overdose and be prepared to intervene as soon as possible.
    • Research shows us that even short periods of abstinence from opioids deceased tolerance and increases risk of overdose. Someone with opioid use disorder may do their best to avoid using during time with the family for the holidays, but go back to using their usual amount which may now be too much. Arm them with naloxone and the plea to never use heroin or opioids alone.
  • It is time to rethink holiday celebrations.
    • For many of us, holiday cheer also includes a glass of adult eggnog or champagne, but prominence of alcohol at holiday celebrations can cause increased stress or temptation for those with substance use disorder.
    • Come together as a family to start new traditions that are recovery centered such as making a family gratitude list or vision boards for the New Year.
  • Medication assisted treatment (MAT) such as methadone, buprenorphine or Naltrexone, has been found to be the most effective treatment for opioid use disorder.
    • While detoxification may be better known, it has a very high relapse rate and treatment failure. Many of us around the city are working to increase access to MAT to ensure anyone with opioid use disorder has access to appropriate treatment.
    • Know where to get help and how to get more information on which treatment modality may be the best for you or your loved one. In Pennsylvania there is a hotline for individuals and families seeking support 1800 662-4357
  • Develop a relapse plan together.
    • Recovery from substance use disorder is not a linear path. Going back to #1 above, opioid use disorder is a potentially life threatening chronic disease. And just as with any chronic disease, there may be setbacks along the way to longterm treatment. Be prepared for these ahead of time by making a plan together. Once again, this is not a moral failure, but in many ways, the nature of the disease.

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