We know the stats are grim: Between 1999 and 2010, the quantity of prescription opioids sold to U.S. pharmacies, hospitals and doctors’ offices nearly quadrupled, according to the Atlanta- based Centers for Disease Control and Prevention. That includes drugs such as oxycodone, hydrocodone and methadone.
Patients who have used prescription opioid painkillers are 40 times more likely to abuse or be dependent on heroin, CDC researchers say. And every day, 91 Americans die from opioid overdose, according to the agency.
By now, many of us know a face behind those sad numbers. But we may not realize the full extent of the problem, and too few of us know how to help.
“Addiction, particularly opioid addiction, is growing rapidly. It really covers every age group, every demographic. We’re seeing it everywhere,” says Jeff Richardson, executive director of Mosaic Community Services, a division of Sheppard Pratt Health Systems. “The data suggests that it is affecting every age range, from kids to young adults to seniors.”
With a problem this large, what can anyone do? The first step in dealing with a family member’s addiction, Richardson says, is to educate yourself about the nature of the disease.
“It’s really important that people recognize there’s a huge stigma associated with addiction,” he says. “People see it as being a willful act or a weakness, but this is a brain disorder.” Despite public education efforts, many affected by addiction see it as a failure, and as a result, don’t seek the treatment they really need, he says.
What addiction looks like
To see “what kind of disease this really is,” Richardson says, the National Institutes of Health has published brain scans of people fighting addiction. “If anyone has any doubts of the physical impact [of addiction] on the brain, those are some very compelling pictures. We need to start talking about this like any other medical challenge. We need to start attaching the head to the rest of the body.”
Every Wednesday, Sheppard Pratt offers free lectures for families and people struggling with addiction and “everyone’s welcome to attend,” Richardson says. (See “Resources” for more info.) In addition to education, he says the program can “help families talk to other families who are struggling with this, and feel that it’s not … their own individual struggle.”
Tammy Lofink says she was shocked to learn about the seriousness of her son Rob’s addiction.
“I’d spend hours, days, on the phone trying to get my son help,” Lofink remembers. “I’d take him to the hospital and they’d release him.”
He was only 18 when he died more than three years ago. Kids in his generation “are using pills like our generation was drinking and smoking pot. But pills are so much more addictive,” Lofink says. “I had no idea that opiate pills and heroin were the same thing, but they were. Heroin is just cheaper.”
Rob was a “smart, funny guy” who “didn’t fit into the box,” Lofink says. But she believes he might have been attempting to self-medicate an underlying condition: attention deficit disorder. The opiate “quiets their mind. With ADHD, the mind’s always racing. It helps, and pretty soon that’s how they’re dealing with life.”
Her advice to other parents: “Get them into therapy. Therapy is huge.”
Next, family members need to understand that the addict must be an active partner in the process. Lofink says she learned this the hard way. “I was always trying to save Rob,” she recalls. “I was working harder than he was. He wanted to work on his recovery for me, for his girlfriend, for his grandfather. But he wasn’t doing it for himself.”
The best approach is one that shows love and concern, but also truthfulness, says Howard Reznick, manager of prevention education at Jewish Community Services. “Share with them what you factually saw and what you smelled and be as specific as possible,” he says. “Then make a statement of care and concern. Timing is everything. ”
Setting boundaries is an important self-care tool for friends and family members of active addicts, he adds. “If it’s producing too much pain for you, be honest about that pain and your willingness to protect yourself.”
“Depending on the age of the child or the adult, and their willingness to seek treatment, there are a number of options with varying degrees of intensity and resources,” Richardson says.
Sheppard Pratt has integrated behavioral health into GBMC’s primary care practices, so that nine out of 10 GBMC outpatient primary care practices have substance abuse staff. “That might be a first step for some people,” Richardson says. “It might be a way to introduce
the conversation. They might be unwilling to meet with an addiction provider, but might be willing to meet with their primary care physician.”
Treatment will depend on individual needs. Inpatient treatment, which often can range from three weeks to a couple of months, “is not always best,” Richardson says. In those cases, there is outpatient treatment.
None of it is a quick fix. “When someone gets inpatient treatment, then leaves with no follow-up, relapse rates are very, very high.” Richardson says. He compares addiction to diabetes. “We don’t treat them when they go into diabetic shock, give them insulin, and just hope they’re OK.”
One reason addiction is so problematic is that it’s currently treated as an episodic event. “But it’s a brain disorder that needs ongoing support and treatment,” Richardson says, and recovering addicts “learn to live a different lifestyle.”
Reznick, too, compares the disease of addiction to a chronic illness like diabetes. “It requires vigilance, management, lifestyle training, sometimes medication,” he says. Reznick has recently produced a series of four podcasts, “Hooked: Personal Stories of Addiction,” in which he interviews “incredible people” who are in recovery or dealing with a family member’s addiction. The podcasts are available through the website IfIKnew.org.
Lofink recently opened a sober living house in Westminster, Reclaiming My Life, which seeks to help newly sober girls adjust to life after treatment. Newly sober addicts, Lofink says, “don’t know how to live in their world. A sober living house can provide a safety net, to see if they’re ready.”
Residents have to pay rent, go to support meetings every day for 90 days and adhere to a nightly curfew. After that, they attend four or five meetings a week, and become increasingly responsible for themselves.
Lofink’s nonprofit, Rising Above Addiction, also runs family meetings in Carroll County and is a community partner that supports the newly created county drug court, where violators are asked if they’re willing to enter treatment instead of jail. “We can help them get a bed, go into sober living, get into extended care, navigate the system and more. Anything I can do to help,” Lofink says.
The fact is support is out there. “I wish I’d known about the recovery community,” she says. Her goal is to grow that community and save lives in doing so. “To think that Rob’s death has saved countless lives makes it a little easier. But,” she adds, “I still have dark days.”
Rising Above Addiction,
Sheppard Pratt, sheppardpratt.org
Jewish Community Services,
Baltimore Area Narcotics
Partnership for Drug-Free Kids,
National Institute on Drug Abuse,
The Dick Prodey Lecture Series is held at The Conference Center at Sheppard Pratt each Wednesday,
7 to 9 p.m. The lectures are free and sponsored as a partnership between Kolmac Outpatient Recovery Centers, Sheppard Pratt Health System and
the National Council on Alcoholism and Drug Dependence of Maryland. kolmac.com/our-patients/dick-prodey-
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