By Michael J. Mancino, M.D. – Associate Professor / Program Director, Center for Addiction Services & Treatment at the University of Arkansas for Medical Sciences Department of Psychiatry, Psychiatric Research Institute | Photography by Lori Sparkman Photography | Shot on location at University of Arkansas for Medical Sciences Department of Psychiatry, Psychiatric Research Institute
In 2017, close to 2 million Americans were estimated to be addicted to opioids and 11.5 million Americans reported misusing prescription opioids in the past year. As Arkansas continues to have one of the highest opioid prescribing rates in the country, the risk of addiction and misuse are high. Addiction is misunderstood by many, but there are several resources available that provide education about addiction and its treatment.
Physical dependency on a drug and addiction to a drug are not the same. Addiction is a chronic brain disease defined as persistent drug use despite harmful consequences, like the inability to maintain relationships or social and professional requirements. Physical dependency is the body’s adaptation to the drug. When someone becomes dependent, they can require higher doses of a drug to achieve the original effect – which is called tolerance. They can also struggle with withdrawal or symptoms that occur after lowering the dose or stopping use of a drug. Physical dependence alone does not equal addiction, but it often accompanies addiction.
It is important to recognize addiction is a disease that can be diagnosed by a health care provider. To be diagnosed with opioid addiction (opioid use disorder) someone must meet two of the 11 criteria which can include taking opioids in larger amounts or over longer periods of time than intended, having cravings or a strong desire to use opioids, and tolerance or withdrawal.
For those facing addiction, help is available. Medication Assisted Treatment (MAT), or the use of medications in combination with counseling and behavioral therapies, may help some people sustain recovery. There are a number of different medications available for this purpose. Vivitrol is a monthly shot that blocks the effect of opioids in the body. Buprenorphine and methadone are also opioids, but they are used in treatment because they help decrease the cravings brought on by addiction and can help some people stay in treatment longer as well as decrease the risk of overdose.
There is work being done to increase the number of MAT providers in the state that provide programs to help increase access to MAT for patients with opioid use disorder. Healthcare providers interested in learning more about MAT should visit https://psychiatry.uams.edu/clinical-care/cast-2/matriarc/. For individuals that suspect they may have an opioid use disorder, discuss your symptoms with your primary care provider or visit the following website to find a MAT provider close to you: https://www.samhsa.gov/medication-assisted-treatment/practitioner-program-data/treatment-practitioner-locator.
Opioid use disorder and all other substance use disorders are chronic diseases just like diabetes. Like diabetes, they can be treated and properly managed. As we continue to educate and work to remove the stigma associated with substance misuse, we will be able to help a lot more people.