Scott L. Havsy, DO, JD, DAAPM
Certified in Pain Management

What Is Addiction?

Addiction is a condition that occurs when a person ingests a substance (alcohol, cocaine, methamphetamines, nicotine, oxycodone, etc.) or engages in an activity (gambling, sex, shopping) repeatedly. The behavior can be pleasurable at first, but the continued use or action becomes compulsive in nature, resulting in undesirable outcomes.

The word addiction is used in several different ways and often times is misused by the medical profession. One definition describes physical addiction as a biological state where the body adapts to the presence of a drug. Over time, the drug no longer has the same effect on the individual, as he or she develops a tolerance to the drug or uses that drug for something other than its intended purpose (pain management). Sometimes, the person engages in poor decision making, such as doctor shopping or obtaining the drug through illegal sources, just to get their next fix.

When addiction exists, the use of a specific drug often interferes with your ability to work (always late, too sick to come in to work, poor performance, etc.). In addition, addiction can deteriorate social relationships (marriage and parenting issues) and can accrue significant debts. In some cases, it can take thousands of dollars a month to maintain one’s drug habit. Oftentimes, legal issues are also involved in addiction, leading to felony convictions and arrests. Lastly, one must look at the medical consequences of drug use, especially intravenous drug use that can lead to Hepatitis C and AIDS.

Many doctors make the mistake of labeling a patient an addict, especially with patients who have legitimate chronic pain. These patients use ongoing pain medication to help them function throughout the day, improving their ability to work as well as increase their ability to engage in daily living activities. In reality, that individual is functionally dependent on pain medication and is not an addict. This functional dependency on pain medication is similar to a diabetic being functionally dependent on the use of insulin.

The medical profession also assumes that, when an individual goes through withdrawals, they are an addict. This is incorrect in the case of those who need pain management daily. A person can develop withdrawals on even small amounts of pain medications, or when they stop the medication unexpectedly.

The majority of addictive behavior is not related to physical tolerance (undergoing withdrawals when stopping the drug), contrary to the what the majority of doctors believe. The continued use of drugs results in addiction when users are emotionally “stressed” when they cannot consume their drug of choice. Stressors, such as physical, verbal, emotional, and sexual abuse are often the underlying cause of an addiction that develops over time.

Treatment of Addiction

In Dr. Havsy’s practice of addiction medicine at Living & Wellness Centers, PS in Tacoma, he focuses primarily on narcotic addiction to drugs such as heroin, oxycodone (Perc-30’s), OxyContin, Norco (hydrocodone), Tramadol, MS Contin, and others.

The primary medical treatment for reducing the cravings of narcotics is the use of Suboxone or Subutex. Each medication contains buprenorphine which strongly binds to the opiate receptors in the brain, resulting in a reduction of cravings for narcotics. In essence, you are fooling the brain into thinking the offending narcotic is attaching to the opiate receptors, when in reality it is the buprenorphine. Suboxone also contains naltrexone, which reverses the effects of narcotics.

By reducing cravings, one significantly decreases the desire to use opiates to achieve the “high,” thus reducing debt, as well as the social, legal, and medical ramifications associated with illegal drug use. Buprenorphine products such as Suboxone or Subutex are not the cure-all, though, but are merely a portion of substance abuse treatment to help the individual get off the roller coaster ride that is narcotics. It is a stepping stone to feeling normal without drugs, as it makes sure the drugs get out of your system.

The next phase of addiction treatment is counseling.

Why Counseling?

The cornerstone of treatment for substance abuse is counseling to help a person understand the underlying causes of their drug use and how the addiction began. Typically, individuals with substance abuse problems had a less-than-stellar childhood, sometimes involving physical, emotional, and sexual abuse. There may be abandonment issues to address, as well. Counseling helps individuals deal with childhood and adult trauma in a safe setting.

Counseling helps people confront themselves in a “normal state,” rather than trying to bury their emotions in their “altered” drug state. When a person is high, they don’t think about their problems or the negative consequences of their behaviors. They have to deal with all of this after the high wears off.

With counseling, people learn to understand the underlying problems that led to or created their addiction, as well as how to deal with daily stressors or triggers that may lead the addict back to using drugs. Essentially, the individual with a substance abuse problem will learn how to deal with life without “the help” of drugs.

Many individuals who seek addiction treatment go to an inpatient facility for 30 to 90 days, but when discharged, they have poor follow-up care. This often results in relapse and drug use almost immediately upon release. Counseling ranges from weekly meetings of group therapy and individual counseling (one-on-one) to intensive outpatient therapy, which involves multiple weekly group therapy sessions.

Did you know that without therapy, the relapse rate approaches 80%. With therapy, the relapse rate is only about 20%.

Why choose counseling and inpatient treatment over basic addiction group meetings?

While attending AA or NA group meetings is beneficial, this is not a substitute for counseling. Being around individuals who are clean and sober does help people maintain their sobriety, though. Attending regular meetings can keep a person sober and provide support from people who understand.

Many individuals benefit from residential treatment involving counseling while functioning in a drug-free environment (without the influence of a negative home environment). This helps them strengthen their daily coping skills and encourages drug-free commitment.

For additional questions or narcotic treatment feel free to call the office of Dr. Havsy at 253-473-2663 to inquire about his addiction treatment program.

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