A Brief Lesson in the War on Drugs

War on DrugsSince the war on drugs began almost 50 years ago, we have learned much about the science of addiction. Today, we know that when an adolescent is exposed to substances that produce pleasure chemically, the individual’s brain undergoes permanent changes regarding their balance of pleasure and pain. The typical response to substances that cause the release of unnatural levels of dopamine can lead to a lifelong compulsion to use substances to cope with the demands of daily life.

 

It doesn’t matter what the drug of choice is – the result is the same. The individual will use the drug repeatedly, regardless of the unpleasant consequences. This habit is the heart of addiction. It is a lifelong condition that requires lifelong attention and, in many cases, lifelong treatment. It’s important to understand that punishment – even the threat of jail time – is not a deterrent for a person who is struggling with addiction. Conventional logic cannot sway the parts of the brain driven by addiction. Punishments may make the punishers feel as if they have more control – but they do nothing to address the real problem.

How the War on Drugs Was Born 

That’s why the war on drugs is such a controversial topic. Like any war, we can view the war on drugs through very different lenses. President Richard Nixon started this war himself in 1971 when he signed into law the Comprehensive Drug Abuse and Prevention Control Act. He also established the DEA (Drug Enforcement Agency). These actions were in response to so many soldiers returning home from the Vietnam War and turning to illicit drugs as a way to cope with the atrocities they’d witnessed and experienced. Drug use skyrocketed, from marijuana to heroin.

The Futility of Criminal Punishment 

The war on drugs prompted two distinct schools of thought regarding what the primary focus should be. The first was an attack on the availability of illegal drugs. Allocate more efforts and resources toward making these drugs harder to access, said this school of thought. Regulate and criminalize the drugs themselves. This initiative comprises all the efforts to control the transport, sale, and distribution of illegal drugs – both in the US and across borders.

As the Reagan administration continued this fight and even scaled up efforts to reduce the supply of drugs on our streets, our prisons overflowed. In fact, the US now has the highest incarceration rates in the entire world. One in five people in prison is there for a drug-related offense, with nearly half a million people incarcerated for nonviolent drug offenses, such as possession or trafficking. The problem with imprisoning individuals who are addicted to drugs is that it simply doesn’t help. Withdrawal in prison can be dangerous, drugs are readily available in prisons anyway, and most incarcerated addicts – fully 95% – will resume using their drug of choice after their release.

The Rewards of Real Help

Also, studies are showing us that most individuals who suffer from addiction have a common thread of child trauma. The dopamine release they experience from the first onset of drug use provides a reward so pleasurable that it helps them cope with this trauma and then often the desire for more develops a dependence that they become an addiction. From the knowledge of associated childhood trauma and early exposure, the other school of thought approached.

This thought was instead of working so hard to keep drugs out (which isn’t working), we should be focusing on reducing the demand for these substances – we spend our energy and resources on making people want drugs less. We accomplish a lower demand for drugs through education, prevention, early intervention, and long-term treatment.

This approach – education regarding the risks associated with recreational drug use and early intervention before drug or alcohol use becomes a problem – has been shown to be highly effective. Unlike punishment, which is a reaction to the problem after the problem has already become advanced, education helps prevent the problem in the first place, early intervention keeps a small problem from becoming a big one, and long-term treatment programs support addicts over the months and years as they rebuild their lives.

The Future of the War on Drugs 

As the battle rages on in the US, the struggle over the right allocation of resources will continue. There are countless possible approaches to find the appropriate balance, but the future of prevention must include more education, early intervention, and chronic disease management. Just like the management of a physical disease such as high blood pressure, addiction recovery requires lifelong attention.

At Pathway Healthcare, we believe in the science-backed methods of education and long-term rehab programs. Because addiction is different for each person, we use an individualized approach when it comes to helping our patients. We provide highly effective treatments for addictions to substances such as alcohol, opioids, and other drugs in a professional outpatient environment. We invite you to get in touch if you are experiencing a struggle with addiction and require assistance. We treat all our patients with respect and work to remove the stigma associated with addiction. Contact us today for real help.

Q&A with Dr. Taylor on the Opioid Takedown


On April 17th, 2019, the Appalachian Regional Prescription Opioid Strike Force charged 60 people in 7 states as part of the largest government takedown during our National Opioid Epidemic. The charges were for illegally prescribing and distributing millions of pills such as opioids, benzodiazepines, and other drugs.

Among the defendants were 53 doctors, pharmacists, nurse practitioners, and other medical professionals. A fair question after removing so many doctors, pharmacists, and medical professional from their posts is what does this mean for those patients and communities?

In this video, we chat with our Chief Medical Officer of Behavioral Health, Dr. Stephen Taylor to best answer this question and more.

Patients who suffer from substance abuse disorders like opioid addiction and dependency, alcohol addiction, and other illicit drug use are victimized when their medical care providers do not offer evidence-based treatment and therapies.

First, it’s time for society to no longer hold negative connotations against those with mental health disorders and addiction. We must realize that these often are co-occurring disorders and do our part to shatter the stigma so they can have the support they need to take the first into an evidence-based recovery program. (Read more about supporting someone in recovery.)

Dr. Stephen Taylor is a thoughtful and articulate psychiatrist with over 20 years of practice experience. IN the above video he addresses the importance of eliminating the stigma surrounding those who are fighting addiction and what one needs to look for, understand and ask when seeking evidence-based treatment.

Dr. Taylor’s life’s work and greatest passion, both as a quadruple-board-certified practitioner and as an educator and presenter to various audiences, has been to provide education and specialized care to adolescent and young adult patients and their families afflicted with drug and alcohol addictions and general psychiatric disorders. You can learn more about him here.

We enjoyed speaking with him and hoped you find his wisdom helpful as you learn more. If you or someone you love is looking for an evidence-based, outpatient treatment option for addiction, dependency or mental health disorder or would like to talk with one of our staff about options, you can find a Pathway Healthcare treatment office near you.

For more resources, you can visit our Page on how to support people in recovery. We know sometimes those around individuals in recovery want to support their family and friends, but maybe don’t know how. We have some suggestions here: https://pathwayhealthcare.com/how-to-support-people-in-recovery/

Opioid Takedown

On Wednesday, April 17th, 2019 the Appalachian Regional Prescription Opioid Strike Force charged 60 people in 7 states as part of the largest government takedown during our National Opioid Epidemic. The charges were for illegally prescribing and distributing millions of pills such as opioids, benzodiazepines, and other drugs.

Among the defendants were 53 doctors, pharmacists, nurse practitioners, and other medical professionals. A fair question after removing so many doctors, pharmacists, and medical professionals from their posts is what does this mean for those patients and communities?

For the patients, it means an opportunity for better, safer treatment. Access to quality, evidence-based care, and treatment for those who are fighting an addiction to opioids or other drugs is essential. For the communities, it means they too will become safer. One of the doctors charged was accused of prescribing opioids in exchange for sexual favors. Others were providing staff with blank pre-signed prescriptions to offer to patients, and another doctor was prescribing a single patient 15 opioid pills per day. Some of the accused doctors were providing prescriptions to personal friends who paid and Facebook friends. It’s discouraging to hear how doctors, who are to be trusted with our personal health and safety took advantage of people in vulnerable positions. No doubt creating some doctor-induced opioid addictions for their own prosperity.

The treatment of opioid use disorder (OUD) has come a long way over the past 50 years. We now have an excellent arsenal of therapies to combat this chronic, but deadly disease. OUD, like other addictions, can be successfully managed but there is no cure and relapse is always a threat. Like other chronic diseases, the clinical progression of addictive disorders, including OUD, can be best characterized by periods of exacerbation and periods of remission but the patient is never disease-free.

For too long, those in the fight of their lives over an opioid addiction thought when the supply of opioids tightened their only option was to turn to the streets or wake up at 4am to stand in line at a for their daily dosage of medication. This just isn’t right quality care is affordable and available. It’s time that those of us not fighting this addiction realize we are graciously only one injury away from not being prescribed the same pain medication that caused the battle of addiction these same, good people are suffering from today. It’s vital to lay the stigma surrounding addiction to rest and be committed to supporting those with substance abuse disorders find a treatment that is evidence-based and effective.

Today, we have strong evidence supporting the use of basic medication approaches to the treatment of opioid use disorder. Two of these medication approaches is partial agonist therapy in the form of buprenorphine, and antagonist therapy in the form of naltrexone.

It is essential to understand that there is not a “one size fits all” approach to treating the complex disease of addiction. Peer support groups such as AA/NA may work well for some, while others may respond better to individualize, private counseling. Some patients will respond best to naltrexone while others may require treatment with buprenorphine. Throughout their disease, the treatment drug of choice may even change. Patients may need to stabilize on buprenorphine then move to antagonist therapy with naltrexone. The process may reverse itself requiring the patient to go back to buprenorphine after a period of stabilized care on antagonist therapy or complete abstinence from all medication. No single FDA approved drug class used in the treatment of OUD is the best option for all patients. It is vital that doctors and patients have access to medications like naltrexone and buprenorphine to employ the use of the right medication for the right patient at the right time.

It is also crucial that treatment providers be in constant review of best practices. As a treatment provider, we are committed to bringing access to the best, evidence-based care to those who need treatment for OUD and other substance abuse disorders. Our biggest obstacles often are the policies that are set in place to protect communities. We have the opportunity to treat in several states, and every state has different procedures for governing treatment. It’s never without difficulty and obstacles that we work hard to help the addiction community recover. Like the laws that determine our speed limits, we must be willing to be advised to caution our pace in effort to protect those around us, not just ourselves. At Pathway Healthcare we understand we must follow all relevant federal and state laws and requirements and we maintain high standards within our programs as an effort to remain committed to the rights of our patients and reach as many people as possible with the very best, evidence-based care available.

Find a Pathway Healthcare treatment office near you.

What’s the difference between opiates and opioids

pills
One of the most common problems doctors see every day are patients in need of pain relief. They are usually in the kind of pain that an over-the-counter medication will not relieve and are in need of a doctor’s recommendation or prescribing pen to experience the relief they need to operate their lives as normal.

Unfortunately, the over-prescribing of opiates and opioids in America to treat pain has thrust our nation into an epidemic of silent addiction and it is time to understand what these medications are, what they do inside the body and why so many are addicted.

What are Opiates and Opioids?

Opiates are chemicals that are derived from the poppy plant and activate the bodies opioid receptors found in the brain giving a ‘feel good’ sensation. An opioid is a name originally used to describe the synthetic chemicals which either activate, partially activate, block or do a combination of these three actions on different subtypes of the opioid receptors. Today, the term opioid is often used to include both natural opiates, derived from the poppy plant like heroin and morphine, and synthetic chemicals like oxycodone and fentanyl. The term opioid may also refer to opioid receptor antagonists like naloxone and naltrexone and to partial agonists like buprenorphine.

How do Opiate and Opioids Work Inside the Body?

Opiates mimic the effect of beta-endorphin only with a much greater potency. Beta-endorphin is the bodies’ natural opioid receptor activator. When these opioid receptors are activated it results in the release of the pleasure-producing neurotransmitter, dopamine. Normally this process compels us to strive for things that are good for our survival like drinking water when we are thirsty or eating when we are hungry. Even the motivation to avoid painful situations before they occur is driven by this process. Beta-endorphin is nature’s pleasure hormone when things are going well for our survival, opiates and opioids are a chemical trick.

Synthetic opioids can be designed to have different effects on different opioid receptors in the body and have different potencies. Opioids can be engineered to activate some opioid receptors subtypes with different strengths or to block certain receptors and activate others. For example, Fentanyl works like morphine as it binds to the brain’s opioid mu receptor, but is 100 times more potent. Buprenorphine weakly activates the mu receptor and it also blocks the kappa receptor. (Both Mu and Kappa are opioid receptors that occur naturally in the body.) This is why Buprenorphine is known as a partial agonist. Buprenorphine has a ceiling effect on its activation of the opioid mu receptor. It is dose dependent only until it hits a certain level of plasma concentration and then it stops giving significant increases in reward with each dose. While the ceiling effect is not absolute, it does tend to reduce the abuse potential when buprenorphine is administered as directed in the opioid tolerate patient. Other synthetic opioids, like naloxone and naltrexone, can occupy the opioid receptors but do not activate it and create no reward. They will also block the effects of other opioids and opiates rendering them ineffective. This reversal effect of antagonist (blockers) on agonist (activators) is what creates the lifesaving effects of naloxone. In short, synthetic opioids allow scientists to create a much more sophisticated and specific approach to the manipulation of the bodies opioid receptor system.

How does Addiction to Opiates and Opioids Occur?

Pain (both physical and emotional) is the bodies most important defense mechanism. It drives us away from harm and destruction. Pain constantly tells us “don’t do that, it’s bad for you.” Pleasure (physical and emotional) is also important. Pleasure compels us to do certain things that are important to our survival. Under normal conditions, our balance of pain and pleasure is determined by our circumstances or the way we perceive that we are surviving in our environment.

There are about a hundred chemicals known to scientist that trick the bodies known pain and pleasure circuits creating a false sense of pleasure. When opioids create this sense of pleasure over time the brain will try to reset its baseline setting. This is the way of sensing pain even though the person is trying to trick their senses into a perception that their circumstances are better than they are. This effect is called tolerance and results in the need for higher and higher doses in order to achieve the same effect. The problem becomes further complicated by the fact that when the drug’s effect wears off, the pain and pleasure balance does not go back to a balanced state. When the opioid’s effect goes away the patient’s perception of their circumstances becomes a very painful state both physically and emotionally. Back pain seemingly does not heal, and patients become angry, depressed and apathetic. The need to use an opioid in order to feel normal is called dependence. Often the most common symptom of opioid withdrawal is physical pain.

In opioid addiction, physical withdrawal is only the tip of the iceberg. Craving becomes an all-consuming preoccupation of one’s attention. It is an unrelenting obsession to regain the balance of pain and pleasure. Craving can be divided into two categories. The first is tonic craving which is thought to be related to plasma concentrations and receptor activation of the drug addiction. Tonic craving is a continuum of mild withdrawals. The other type of craving is known as phasic craving is related to triggers. Triggers are environmental perceptions that remind the subconscious mind of the pleasure associated with the drug of addiction. Triggers could be people or places. They could even be smells, sounds or sites.

Brains that have been exposed to opioids over a long period of time often develop a condition of anhedonia or pleasure deafness. Once a person’s brain becomes dependent on the drug, they cannot experience pleasure or even contentment without it. Without the drug, their world becomes a very painful and dark place. This condition is known as chronic dysphoria or always present physical and emotional pain.

What to Remember and Know about Opiates and Opioids

Pain is important for survival. Pain compels us to avoid harm. Yet, human nature compels one to seek relief for pain and it is important to be aware of chemicals like opioids that highjack and short-circuit this process. They should be used with extreme caution and for the shortest amount of time possible so the body maintains a natural, healthy balance of pleasure and pain.

(Article was written by Dr. Brent Boyett, D.O., D.M.D., Chief Medical Officer for Pathway Healthcare, a national treatment center for substance abuse and dependency.)

Jaw-Dropping Numbers From the Opioid Crisis

The opioid epidemic in this country is real – and is growing. An estimated 22% increase in drug overdose deaths in 2015 to 2016 speaks to this truth. We at Pathway Healthcare are focused on helping those affected by this epidemic. We are here to help. We care and we understand the impact drug and alcohol addiction and dependency can not only have on an individual but also on family and friends. Pathway Healthcare provides a highly effective, lasting treatment program for opioid, alcohol, and other drug addiction and dependency by utilizing scientifically proven methods and medications in a supportive, professional out-patient environment.

The numbers are continuing to climb in opioid use related deaths and we are here to make a difference. We understand that seeking help can be unnerving, please see the message from our CEO and know that we at Pathway Healthcare are here to help you on your pathway to recovery.

Read More from Julia Laurie at Mother Jones:

About 64,000 Americans died from drug overdoses last year—a staggering 22 percent increase from the 52,404 in 2015—according to the first government estimate of drug deaths in 2016. Overdoses now kill more Americans than HIV did at its peak in 1995, and far more than guns or cars do today.

The numbers, released by the Centers for Disease Control and Prevention, are provisional and will be updated monthly, according to the agency.

Fueling the rise in deaths is fentanyl, a synthetic opioid up to 100 times more potent than morphine, and fentanyl analogs, or slight tweaks on the fentanyl molecule. This has not always been the case: As the chart below shows, the drivers of the opioid crisis have changed from prescription painkillers to heroin, and then to fentanyl.

As Dan Ciccarone, a professor at the University of California-San Francisco School of Medicine, recently wrote in the International Journal of Drug Policy:

This is a triple epidemic with rising waves of deaths due to separate types of opioids each building on top of the prior wave. The first wave of prescription opioid mortality began in the 1990s. The second wave, due to heroin, began around 2010 with heroin-related overdose deaths tripling since then. Now synthetic opioid-related overdoses, including those due to illicitly manufactured fentanyl and fentanyl analogues, are causing the third wave with these overdose deaths doubling between 2013 and 2014 .

The epidemic is straining the capacity of morgues, emergency services, hospitals, and foster care systems. Largely because of prevalent drug use and overdose, the number of children in foster care nationwide increased by 30,000 between 2012 and 2015.

This spring, President Donald Trump created a commission led by New Jersey Gov. Chris Christie to advise the administration on how to respond to the epidemic, but the administration has yet to act on its recommendations.

Credit: Julia Laurie at Mother Jones

The True Statistics of Opioid Addiction

opioid epidemic usa

Opioid addiction is an epidemic.

That line appears in headlines, news stories and online conversations in modern media. Opioid dependency has become so common and widespread that we now have put it in the same leagues as smallpox and polio outbreaks of the past and it’s still gaining speed. With every year, the numbers increase and we see the statistics become more and more troubling.

Drug overdoses are the current leader in accidental deaths in the United States and the majority of these deaths are caused by opioid use. According to the National Institute on Drug Abuse, 90 people a day die from overdosing on opioids, adding up to 20,101 overdose deaths due to prescription drugs and 12,990 overdose deaths due to heroin in 2015 alone. Combined, opioid-related overdose deaths take up nearly half of the reported accidental overdose casualties from 2015, putting it ahead of every other drug category on the market.

The number of opioid dependency cases in the United States is just as staggering. The world of opioid addiction treatment and research estimated approximately 2 million prescription pain reliever users and 591,000 heroin users out of the 20.5 million drug dependent people cataloged in 2015. This number has been growing in parallel with the number of prescription pain relievers sold. In the past ten years, the number of overdose deaths and prescription pain reliever sales has quadrupled. This correlation may not be proof of the cause of these rising numbers, but it does show that there is a commonality in the trend between the data.

Prescription pain relievers are a big player in the opioid crisis as four out of five people with opioid dependency site these drugs as the starting point of their addiction. These prescriptions from doctors account for nearly all overdose incidents involving pain relievers. Many people who have had surgery or an injury and were prescribed opioid-based pain relievers to manage pain symptoms, find themselves struggling with some form of dependence. While not all of these patients get to the point where they require treatment for opiate addiction, there are many that will have difficulty with withdrawal discomfort and continued cravings that might need a specialist’s intervention.

Overcoming the statistics for opioid addiction and overdose may seem impossible when you’re already struggling with your addiction, but Pathway Healthcare is here to help people fighting opioid addiction and dependency. We work to reduce the numbers of victims of opioid abuse by using proven methods of therapy combined with medication to give patients the best chance at recovering. By providing a welcoming, supportive environment, our staff hopes to give every patient a chance at reaching their recovery goals. When you need substance abuse treatment in Jackson, MS, Pathway Healthcare can give you the care you need.

Call Pathway Healthcare to schedule an appointment and learn more about the services available through our facility.

How Does One Become Addicted to Opioids?

How does opioid addiction begin?

Becoming addicted to opioids is not something that users typically set out to do the first time they attempt to abuse a substance. As possibly the most addictive substance available over the counter in a prescription drug form, or on the streets as the illegal drug, heroin, opioid addiction can come out of nowhere for the most unexpecting of users.

Who Uses Opioids The Most?

As a common prescription drug for users that are in intense and severe pain, recovering from major surgeries or in a chronic level of pain, opioid addictions can creep into the all-American household without warning or notice of just how addictive and deadly the drug may be. In North America this year, the numbers are rising for patients with non-life threatening or cancer conditions that will be prescribed opioids. Women, forty years and older, are the most common users of abusing prescription opioids. Long-term use of opioid pain relievers for chronic pain is associated with the addiction of said pain-killers, leading to a misunderstanding and confusion of what exactly an opioid addiction is.

An opioid addiction; a group of signs or symptoms and behaviors that indicate a person is both physically and psychologically dependent on the substance. Typically the person will continue to use opioids despite the fact that drug use is causing significant physical, personal or social problems.

In dealing with opioid addiction, a user recognizes that there is a substance abuse issue that is hindering their quality of life. Opioids are classified as a powerful drug that is primarily prescribed to treat severe pain. They carry a high risk of addiction because of their powerful effects. There are various forms of addiction and withdrawal from opioid dependency. The factors that influence the degree to which a person is considered in a substance dependency are evaluated by the cravings and increased tolerance a person has to an opioid. In order to feel the drugs faster and more intently, a user may begin to smoke, snort, crush or inject the substance.

Becoming Addicted To Opioids:

  • needing to take more of the drug to get the same effect
  • accessing two or more physicians for prescriptions
  • buying opioids on the street
  • feeling withdrawal symptoms when the use of opioids suddenly stops
  • experiencing cravings to use
  • making the use of drugs a priority over family, work and other important obligations

Pathway Healthcare gathers findings of the causes and risk factors for opioid addiction through a combination of physical and psychological factors. The compulsive and illicit use of prescription drugs or opioids can be learned from and alleviated through therapies, medication and group counseling. Treatment options are available through Pathway Healthcare to support and assist patients and their families through the withdrawal period of opioid addiction. Pathway Healthcare provides the tools to return to your life after becoming addicted to opioids.