The opioid and heroin epidemic is making headlines in Kentucky daily. According to the Kentucky Office of Drug Control Policy, 1,248 Kentuckians died from overdoses in 2015.
In recent months, we have seen the deadly emergence of powerful new drugs like carfentanil, or “elephant heroin,” as it’s known on the streets. These deaths are only the tip of the iceberg of the thousands of individuals and their families who are suffering from the disease of opioid dependence.
In the medical community, we are working on diagnosing the disease, treating it and attempting to decrease the risk of spreading other diseases such as hepatitis C and HIV. For years, the medical community has recognized that addiction is a disease state, with changes in the body and the brain after long-term use of drugs.
The medical community can offer medications to help with withdrawal from medications. This may be done in an outpatient setting under a doctor’s care, or in a hospital or residential rehabilitation setting.
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We are increasingly using medication to prevent withdrawal and decrease the danger in which people put themselves to obtain and administer drugs, such as intravenous drug use.
One example, methadone, can be administered at a methadone clinic. Another, buprenorphine, commonly known by the trade name “Suboxone,” can be administered by physicians who have undergone special training and licensure to prescribe this in an outpatient clinic. There are other medications such as naltrexone (commonly known as the trade name,”Vivitrol”) which can be used to decrease craving.
Family members of individuals with opiate addiction can now obtain naloxone to give someone in the event of a drug overdose so that there is time to reach the nearest emergency department. A prescription is needed to obtain this medication, and your doctor will give directions on how to administer it.
Medication may not be needed to treat opioid dependence. And medication alone is not sufficient to treat opioid dependence. Some people may need long-term residential treatment programs that are available throughout the state. Other individuals may need an intensive outpatient program that meets several days a week and includes an evaluation of other issues, such as depression, anxiety and post-traumatic stress disorder. Some programs also incorporate 12-step programming, such as Narcotics Anonymous, and other evidence-based treatment.
When suffering from a substance use disorder, recovery may begin with starting a conversation with your doctor.
Dr. Clark Lester is a psychiatrist who practices at Baptist Health Richmond.