Powerful words from Massachusetts on the Stigma of Opioid Addiction

Thank you, Massachusetts, for a powerful, and empowering, public health message! 

May all of us step up to the challenge of changing our language -- and actions. 

The Stigma of Opioid Addiction

                                   from Massachusetts department of Health and Human Services

It’s a huge public health threat – addiction to powerful opioid painkillers.  But you can help by changing the way you think about, talk about and treat people with addiction. Words like “junkie,” “addict” and “druggie” can hurt and stand in the way of recovery. There are perceptions that addiction is a personal choice (when in fact it’s a disease), that addiction is a sign of human weakness, or a lack of morals or willpower.  While the initial decision to take drugs may be voluntary, neurological changes to the brain restrict a person’s self-control. The disease hinders the ability to resist impulses to take drugs despite harmful consequences.

A stigma is a mark of disgrace that sets a person or a group apart.  Stigmas aimed at people with substance use disorders come from many sources including personal shame and disgust at one’s own appearance, behavior and feelings of being unworthy of help, negative labels from friends or family, negative attitudes from healthcare providers, the media, law enforcement, places of work and government agencies.

We are all affected by the current epidemic of opioid addiction. Many of us know someone who struggles with addiction, or who is in treatment.  What can we do?

• We can take a stand against stigma. 

• We can support treatment opportunities. 

• We can encourage people in recovery.

          We can talk about addiction with our friends and family.

          Each of us can commit to not using hurtful or damaging words about those who struggle with addiction.  

Hillary Clinton's substance use initiative

On this Labor Day, I thought it fitting to highlight Hillary Clinton's newly unveiled proposal for how she would address alcohol and drug addiction as President.

We know that one of the best ways to help people achieve and maintain recovery is through treatment, often including a medication. When people are able to manage their chronic illness (or illnesses as if often the case), they are more likely to return to work or school, reconnect with their families, and improve their quality of life. All those things we celebrate today.

So please check out the attached story and the link to the complete proposal:

http://www.huffingtonpost.com/entry/hillary-clinton-addiction_55e6fca6e4b0c818f619ceca

Complete proposal:

https://www.hillaryclinton.com/p/briefing/factsheets/2015/09/02/combat-addiction/

buprenorphine portrayal and response from Stop Stigma Now

Dr. Phil Paris from Stop Stigma Now comments on buprenorphine portrayal in the media. Education on and promotion of safe medication use for all medications is necessary; not just for opioids. 

What was the drug Dylann Roof was holding when arrested in February?

                                                       By BIANCA SEIDMAN  CBS NEWS  June 19, 2015

When Dylann Roof, the suspect in the deadly shooting at the Emanuel AME Church in Charleston, was arrested last February on trespassing charges at a mall in Columbia, South Carolina, police said he was carrying the drug Suboxone, the brand name of a narcotic that's considered milder than others drugs in its class, such as oxycontin, heroin and vicodin. It is prescribed as a drug for the treatment of opiate and painkiller addictions. 

Suboxone has been a helpful tool in fighting opiate addictions without the need to send patients to methadone clinics."While its safer than heroin or methadone if you take it as directed, if you don't it's as dangerous as any of these other drugs," says Dr. Eric Wish, the Director of the Center for Substance Abuse Research at the University of Maryland.

Many people who use Suboxone are already opiate dependent and for them it's a milder drug.  But side effects of the drug may be greater for those who use it recreationally and not for its intended purpose of opiate recovery. Law enforcement seizures of buprenorphine drugs, which include Suboxone and generics, has increased from 90 to 10,537 packages between 2003 and 2010.

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Response from Dr. Philip Paris, Stop Stigma Now

The introduction of Suboxone has been life saving for thousands of those suffering from opioid addiction.  But, like every other medication prescribed by doctors, when misused it can have serious side effects, including a fatal overdose.  This is true for each and every medication in our medicine cabinet from aspirin to Tylenol.  Unfortunately, the possible use of Suboxone by the accused killer of those praying in a Charleston church will surely be used by those who stand against the use of any medication in treating opioid addiction.  

Amazing article in Huffington Post

Jason Cherkis, reporter for the Huffington Post, has written one of the best pieces I've ever read on heroin addiction and the current, tragic state of its treatment in the US. Very motivating and heart wrenching at the same time! http://goo.gl/8WQ4yP

Selected References for Treatment of Opioid Use Disorder with Methadone

This is a list of selected references that I have compiled to help those interested in learning more about the evidence base for the treatment of opioid use disorder with methadone.

https://dl.dropboxusercontent.com/u/24514445/Selected%20References.pdf

Here are a few of my favorite......articles

Oldies but goodies:

This is Tom McLellan's article on addiction as a chronic disease.

This is Tom McLellan's randomized trial of methadone vs methadone plus counseling and wrap-around services.

This is Annie Umbricht's study of on-site primary care in an opioid treatment program vs referral to a nearby primary care practice.

Enjoy!