ABUSO OPIOID Y ADDICCION

Your Health: Opioid Abuse and Addiction Among Americans on the Rise
Rallie McAllister, M.D., M.P.H.
Abuse of narcotic painkillers is a rapidly growing problem in the United States. According to the National Institutes of Health, inappropriate use of these medications has more than doubled since the early '90s.

Amber, a 33-year-old native of Stanford, Ky., is recovering from her addiction to prescription painkillers. After abusing OxyContin and other opioid drugs for more than six years, she lost everything she cared about.

"I lost my husband and my job because I stayed high all the time," she said. "Then I lost my house and my car because I spent every dime on drugs."

When Amber was arrested for illegal possession of narcotics two years ago, she lost custody of her two young children. That, she said, was the wake-up call that prompted her to get the help she needed.

Amber's situation is far more common than most of us would like to think. Drug addiction affects millions of Americans in all walks of life.

"Opioid addiction is on the rise, and it's causing huge problems in this country," said Bryan Wood, M.D., president and founder of SelfRefind, a drug treatment program with clinics throughout the United States. "Addiction causes people to lie and steal from the people they love, and it costs them their jobs, their friendships and their families. If left untreated, it ultimately costs them their lives."

After suffering so much heartache and misery, most people who are addicted to narcotics eventually reach the point that they're desperate to stop using the drugs. Unfortunately, quitting isn't a simple matter.

"Opioid addiction isn't a personality flaw or a moral deficiency, it's a disease," explained Wood. "Recovering from addiction takes more than just willpower; it requires medical treatment by trained professionals."

Opioid dependence is characterized as a brain disease by many medical experts and organizations, including the World Health Organization. The condition has been shown to cause changes to the structure and function of the brain that persist long after drug use has ceased. Overcoming dependence isn't as simple as eliminating the drug of abuse from the patient's body. The structural and functional changes in the brain can trigger drug cravings even years after an individual's last use.

"Once you're hooked on the drugs," Amber explained, "you're not using them to get high anymore. You have to use the drugs just to be able to function, because they keep you from going into withdrawal."

In most cases, withdrawal is an agonizing process that can last for days. Symptoms include sweating, extreme anxiety, severe chills and painful muscle cramps, as well as violent episodes of vomiting and diarrhea. Long after the physical symptoms of withdrawal have resolved, most individuals continue to experience an overwhelming yearning for the drugs they once abused. Because these cravings are so intense, many patients in recovery quickly relapse and return to drug abuse. Proper medical care helps many patients avoid the painful symptoms of withdrawal and dramatically reduces their drug cravings. For more than 30 years, the drug methadone has been prescribed for the treatment of narcotic addiction.

"Unfortunately, methadone treatment is fraught with failure," said Wood. "Because it has a high potential for abuse and a poor compliance rate, it's generally held in low regard by patients and the community."

Earlier this year, Wood and other physicians at SelfRefind Clinics began prescribing Suboxone, a relatively new medication indicated for the treatment of opioid dependence. Approved by the Food and Drug Administration in 2002, the drug has been used by more than 400,000 patients around the world.

"In the U.S., Suboxone is available only from specially trained physicians," said Wood. "This drug is drastically changing the way we treat addiction in the U.S."

Patients suffering from addiction get almost immediate relief from withdrawal symptoms. In the weeks that follow, they enjoy freedom from cravings, allowing them to fully focus on resolving the issues that led to their addiction in the first place. One of the most attractive features of the new drug is its low potential for abuse. The drug is properly administered under the tongue. If it is intentionally misused by crushing it for injection or inhalation, it precipitates signs and symptoms of withdrawal. A number of clinical trials have shown the drug to be safe and effective in helping people overcome their addiction to prescription painkillers and other opioids, including heroin. Amber, who started treatment with Suboxone five months ago, is well on her way to recovery.

"It's easier than I ever thought it could be," she said. "I feel like I've finally got my life back." ======== Rallie McAllister is a board-certified family physician, speaker and the author of several books, including "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her website is www.rallieonhealth.com. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.
Copyright 2008 Creators Syndicate Inc.