Opioid addiction is an unfortunate, common, and often tragic reality across the U.S. population. It’s important to know the options for treating addiction in case someone close to you needs help with overcoming this serious problem. Addiction treatments were among the subjects addressed in the HealthStream webinar, “Opioid Misuse and Addiction: Strategies for Preparing Clinicians and Staff,” presented by Dr. Andrew MacPherson, a 20-year emergency trauma and EMS physician in Victoria, British Columbia, Canada. As a member of the American Red Cross Scientific Advisory Council for the last 15 years, MacPherson has served as Chair for the First Aid Sub Council. He also is credited as an author of the 2015 ILCOR First Aid guidelines and has served as a leading educator for medical students, residents, paramedics, and practicing emergency physicians throughout his career.
Though addiction in a loved one can seem overwhelming, MacPherson assured the audience that treatments have been successful and outlined the three broad stages of them: supervised detox, inpatient or residential care, and long-term outpatient care.
Supervised detox focuses on the physiology of addiction and what occurs when the use of narcotics ends. During this chemical withdrawal, the subject can experience nausea, GI distress, anxiety, and other symptoms that result over several days to multiple weeks from upregulated opioid receptors, until the brain chemistry starts to settle back to normal.
Inpatient or Residential Care
A recovering addict typically moves to an inpatient or a residential system where access to narcotics is obviously decreased. Importantly, this phase of treatment also addresses how you manage or cope with what's happening in your world and develop healthy strategies for generating your own native and internal endorphins and opioids.
Long Term Outpatient Care
In a long term outpatient environment, the subject is connecting with people that have recovered and continue to stay recovered. Fellow recovering addicts share their success stories about the progress they've been able to achieve. One important source of value during this phase for the subject is “really being able to have an open conversation with people that understand how you've experienced the draw, the pull, and the easy out of a narcotic fix.“ During this phase of recovery the patient is continuing to work and stay “clean.”
The Duration of Recovery
MacPherson admits that “recovery often takes a long time and medication to keep “the brain’s opioid receptors settled.” He reminded listeners that addiction can be connected to other underlying mental health conditions, such as social anxiety disorder or depression, which can all be helped by medication in the long term. MacPherson shares that addiction medicine is still learning exactly the right route for using medication, from the treatment regime to the effects of using Methadone, a well-known, long-acting narcotic Naltrexone, an opioid antagonist that blocks some of those open opioid receptors without a corresponding “high” and changes the physiology of the brain slowly, and Suboxone, a mixture of Naltrexone and long acting narcotics similar to Methadone. Studies have shown that when people are on this medication-assisted treatment (MAT), it decreases the risk of overdose and especially “the risk of going out on the street, seeking illicit substances, the consequences of being unsure with what you're taking, plus the risk of IV injections, etc.” Although effective, MacPherson reminds us that MAT is controversial and the subject of numerous ongoing debates.
Access the full Webinar, the first in our three-part series, Managing Opioids, Pain, and Chronic Disease, Critical Steps in Addressing Population Health.
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