By Ryan Schefdore
We are witnessing one of the most lethal drug epidemics in history. According to the Centers for Disease Control and Prevention, almost four Americans die from an opioid overdose every hour, with 90 fatalities each day.
Addiction and overdoses have become commonplace in many communities across the country, and that upward trend is showing no signs of stopping. Unless the entire medical community is mobilized to treat this problem, addiction to prescription painkillers will continue to spread and wreak havoc across every facet of our society.
While many pundits are quick to assign blame for the quagmire we find ourselves in, very few people are openly discussing how to help people suffering from substance abuse. So, what can dentists do to combat the relentless march of opioid addiction?
Primarily, we can all remind ourselves to stay vigilant in the fight and actively recognize the symptoms of opioid abuse. Patients who are struggling with an addiction to opiates often display several indications, including:
- Noticeable elation or euphoria
- Marked drowsiness
- Constricted pupils
- Slowed breathing
- Intermittent nodding off or loss of consciousness
- Doctor shopping (getting multiple prescriptions from different doctors)
- Shifting or dramatically changing moods
- Social withdrawal or isolation
- Sudden financial problems
Furthermore, a major indicator of all addiction is the continued use of a substance even when the patient has been made aware of its negative side effects. Take the time to explain the risks of prescription medication, and acknowledge any patient who refuses to accept the dangers involved.
A Plan for Action
Let’s say that you know someone who is showing signs of addiction. What now? What can or should you do to help?
Before you do anything else, realize that addiction is a medical issue that requires professional help. We all like to play the hero, but we must concede our limitations. Unless you are a close friend or family member of a struggling addict, or unless you are a licensed physician specializing in addiction treatment, you are most likely ill-equipped to understand a patient’s drug problem, let alone treat it. Despite how painful it may be to admit, you must appreciate that substance abuse requires specialized help that you are most likely unable to provide.
The first step in treating drug addiction, then, is for these afflicted people to confront their denial. Addicts are usually the last people to realize they have a problem. Others will see the signs, but addicts will be completely absorbed by their own denial. Treatment won’t be possible until they acknowledge the signs of their problem. Many people refer to this point as hitting rock bottom, where the addiction has caused so much chaos in their lives that it is practically impossible to deny its effects. Until these patients admit that they have a problem, there is very little anyone can do to help.
Next, educate your patients and ask questions. Make sure that you discuss the risks involved in taking prescription painkillers with your patients, as well as how easy it is to become addicted. Their reaction to this information will be very telling. When talking to your patients about their drug use or abuse, a few simple questions will help shed some light on the reality of their situation. Some examples are:
- How long have they been taking the medication?
- When was the last time they used?
- How often do they use (per week, month, etc), and how much do they take each time? Has either number increased?
- What was their mental state before their last dose? Calm? Irritable? Drowsy?
- How much do they spend on medication per week? Per month?
Also, be sure to keep thorough records and participate in drug-monitoring programs. In many areas of the country, doctors are able to check online for the drug history of “at risk” patients. These databases typically store information about any potentially dangerous drug a patient may currently be taking and its recommended dosages.
Record keeping like this has proven to reduce the over-prescription of addictive painkillers and avoid contraindications of drug treatments. The names of these programs and how to enroll in them differ from state to state and from region to region, so check with the members of your local medical community to learn more.
Sadly, until addicts admit that they have a problem and request help, these suggestions are really all you can do to help them. But if a close friend or family member is struggling with addiction, you can always organize an intervention with the help of a licensed substance abuse counselor or a physician who specializes in drug treatment.
Interventions can take many forms. Thanks to television, most people are familiar with the “surprise intervention” where family and friends tearfully beg unwilling addicts to accept treatment for their disease. But when done correctly, interventions can be very calm and nurturing experiences. Interventions have three primary objectives:
- To educate addicts about the ways their destructive behavior affect them personally and others around them
- To offer a structured treatment plan consisting of specific steps, goals, and guidelines
- To provide possible outcomes in case a loved one refuses to accept treatment
The ultimate goal of an intervention is to get the addict to accept help (treatment), and it is most effective when supervised by a medical professional familiar with the issues such as a licensed clinical psychologist, a medical doctor who specialises in addiction, or a psychiatrist.
Next, you can help enroll the addict in a drug treatment program. Supervised by substance abuse specialists, in-patient drug treatment programs are some of the best ways for addicts to gain control of their lives. Also, they give addicts a chance to get away from the psychological triggers that may contribute to their substance abuse.
Most drug treatment programs utilize a combination of pharmacological therapies (medications) and psychotherapy or behavioral therapies. Medications used to treat opiate addiction include antidepressants, methadone, buprenorphine, and naltrexone. Medical cannabis is still being researched as a treatment. Therapies used to treat opioid abuse include cognitive behavioral therapy, dual diagnosis treatment, educational sessions, family and/or couples therapy, medication maintenance therapy, and motivational interviewing.
Finally, listen and stay involved. Take the time to sit down with addicts and talk with them, not at or to them. Many people fall into the hole of substance abuse simply because they feel isolated and ashamed. By reminding them that you are their partner in this struggle, and that facing addiction does not make them bad people, you will give them a reason to persevere. If they have the will to get better, they will find a path to wellness and achieve it.
If you know patients or loved ones who are struggling with an addiction to opioids, it is important to get them to acknowledge the problem themselves and ask for help. After addicts ask for help, there are many paths available for them to receive the medical assistance and psychological support they need. It is important for all of us to realize that chemical dependency is an incredibly dangerous medical condition that deserves professional help. Furthermore, addicts must be able to rely on family and friends during their treatment, so stay involved and keep an open mind.