Addiction Medicine

There are many misconceptions about how people become addicted to drugs or alcohol, such as a lack of willpower or moral principles. However, for many people who become addicts, using drugs alters the way the brain functions. This causes the body to crave more drugs or alcohol for survival, like water or food. Addiction tends to run in families, which may make you more susceptible. Stress from environmental factors such as sexual abuse, peer pressure, and childhood neglect also play a role in developing unhealthy coping mechanisms that lead to drug and alcohol use. There are three major causes that may trigger you to become dependent on drugs and alcohol. The cause tends to come from deeper, underlying medical or psychological issues, including:

1. Heredity
2. Events from the past that still need to be reconciled
3. Current conditions you’re unable to cope with

If you are abusing drugs and alcohol, one or more of these underlying causes will be present. At Lynx Healthcare, we specialize in treating all of them. We have found that addiction isn’t usually the primary problem. Our approach is to address each of these underlying causes through a variety of therapies and get to the root of the problem, which has consistently led to successful treatment outcomes and a sober life for numerous people. What Do Drugs Do To The Brain? Dealing with Alcohol Addiction

Medication-assisted treatment, or MAT, is an integrated program designed to promote the process of recovering from opiate dependence. We start by doing a complete evaluation.

If appropriate, we would start Suboxone® with induction. In the first week we meet frequently to adjust your dose. Suboxone is an opioid agonist and affects the receptors in the brain. It's designed to reduce or eliminate withdrawal. In addition, Suboxone helps with opioid cravings, although cravings are often related to triggers.

Concurrently, you will engage in counseling - usually an intensive outpatient program. The goal is to learn about your addiction and learn tools to maintain abstinence because medication is only part of MAT. You'll need to engage in treatment.

Your addition specialist will screen for adverse childhood events (ACE). Individuals with childhood trauma may require mental health treatment. Many addicted patients have, unfortunately, experienced some sort of childhood trauma that has led to PTSD.

Our addiction specialists believe in treating the whole patient. A part of yourself is opioid dependence. We reject terms like addict because it does not describe the entire person. As an individual you are also a brother or sister, son or daughter, a father or mother, a husband or wife, and many other aspects of your life. Labeling you an addict is unfair. Unless we treat the whole patient we are unlikely to succeed.

Withdrawal and induction:

Dependence on opioids leads to withdrawal when the drug is stopped. You will need to stop using short-acting opiates like heroin, oxycodone, or hydrocodone for 12 hours before induction on Suboxone. If you start Suboxone too early you will experience precipitous withdrawal.

You will be induced on Suboxone after this 12-hour period. Within 45 minutes your withdrawal will diminish. Over the next few days the goal is to eliminate withdrawal. You will no longer be a slave to drugs. You will no longer need to plan your days around acquiring and using drugs.

Maintenance:

After a week or so your dose will be adequate to eliminate withdrawal and reduce cravings for opiates. We will re-evaluate weekly for:

• Dose evaluation
• Side effects of medication
• Urine drug screens

Performing a urine drug screen is important. We would not prescribe blood pressure medicine without checking blood pressure.

Success rate:

50% of patients who start Suboxone are still in the program after 6 months. The dropout rate often reflects readiness. Some patients simply are not ready for recovery. For the patients that stay in the program, most remain abstinent. This includes drugs like opiates, marijuana, and alcohol. Alcohol and benzodiazepines interfere with Suboxone and should not be used in the program.

Although marijuana is legal in some states, we do not consider this abstinence. The use of any drug to alter consciousness or mental status is not part of recovery. Approximately 10 to 20% of patients who smoke marijuana will become addicted. You will not be discharged because you are using marijuana initially at the time of your intake. Learn more about our position on marijuana.

Chronic pain is often treated with opiates. A number for those patients will become addicted. Addiction is the use of a substance despite harmful events on self or others. If you have taken more of your medication than prescribed or asked for early refills, you may be addicted.

The addition specialists at Lynx Healthcare will work closely with your pain specialist to provide and design the best program for you. Your addiction will not be ignored nor will your pain. Because 40% of addiction is inherited, you may have been born with a propensity for addiction. This is not your fault. Opiates can give you a feeling of elation and well-being. It is no surprise that some patients become addicted.

Many changes occur in recovery. It is a process that cannot be rushed. To pursue recovery, you need to make changes in your beliefs and behavior. This can be hard work. You need to pursue normalcy, a safe home environment, close friends, and family. Your relationships actually help change your brain chemistry. If you can, you need to return to things that bring you satisfaction like working, parenting, socializing, and participating in hobbies and activities that bring you pleasure.

You will engage in the treatment program for at least 6 to 12 months. You should be involved in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), and you need to work in a 12-step recovery program. That will at least take a year or two.

You most likely will not be on Suboxone for a lifetime. When you are ready you and your provider can agree on a taper that may take 3 to 6 months. When you taper off of Suboxone, however, your recovery is not complete. You still need to engage in AA or NA and counseling. We also recommend finding support among self-help groups.

In short, no. Addiction is a chronic disease requiring a lifetime of recovery. It gets easier but no one is cured. There are ads on television that claim there are cures, but these are false. Studies are clear: just as there is no cure for diabetes, there is no cure for addiction. However, it can be managed to promote a long and healthy life.

Congratulations on taking the first steps towards recovery. It takes courage and hard work. We look forward to answering your questions or perhaps working together. You are not alone.

Addiction is a disease associated with preoccupation with drugs. Finding and using the drug is done to avoid withdrawal. It is not the fault of the user. You are most helpful if you are supporting. Listen to the user’s troubles and needs. You can’t stop a user from using drugs, but you can direct them to treatment.

At the same time, don’t enable the user when they ask for money or even shelter. You cannot have a user in your home or enable them to use. When the individual seeks help earnestly, you can then offer assistance. Enabling a user only perpetuates drug use.

Recovery can take months to years. In the meantime, you can look forward to getting your friend or family member back. The goal of treatment is normalcy. The patient will be required to develop sober relationships, seek help from counselors, and attend Alcoholics Anonymous or Narcotics Anonymous. All of these things are positive and deserve your encouragement.

There are three general parts of the brain:

• The cerebrum is the “thinking brain” responsible for the five senses and making decisions.
• The cerebellum is responsible for balance and coordination and higher functions like interpretation or creation of music.
• The brain stem controls breathing, eating, appetite, sex drive, and other primitive functions.

The limbic system, which is not a distinct system but a collection of structures located in the middle of the brain, is responsible for emotions, memories, and behavior. It is sometimes called the “feeling brain.”

Addiction involves positive reinforcement, and addictive drugs trigger the release of dopamine, a neurotransmitter in the brain associated with pleasure. Some drugs produce pleasure equal to or greater than that of sex.

Addiction also involves negative reinforcement. Some people use drugs to forget or replace bad memories. Many patients who have addiction suffer from adverse childhood events or childhood trauma.

Both positive and negative reinforcement lead to altered motivational hierarchy. The drug becomes more important than relationships and responsibilities. As the addiction progresses, the lower feeling brain dictates behavior, overriding the cerebrum, or thinking brain. This is why drug use continues despite harmful effects beyond reason.

The “Theory of Two Pillars of Recovery” maintains that in order to overcome addiction, you must:

• Keep your distance: Stay away from people, places, or things that may trigger the use of drugs.
• Ask for help: You can’t do this alone. You need a medical provider, group or individual drug counseling, mental health therapy, and self-help groups like Alcoholics Anonymous or Narcotics Anonymous. You need to reach out to sober friends.