When one medication or method doesn’t work, we try again with something else. There is help and there is hope.
Dr. Karen Hulbert, family medicine and obstetrics specialist, ThedaCare
September is National Recovery Month, and experts say it’s a good time to look at substance use disorder and how best to get medical treatment for the condition.
“Substance use disorders are a public health crisis,” says Dr. Karen Hulbert, a ThedaCare family medicine and obstetrics specialist who has a subspecialty certification in addiction medicine. “They not only affect the health of the individual but also leave a dramatic impact on the family, on the community, and on our health system.”
An Increasing Issue
Dr. Hulbert cites Wisconsin ranking third in the United States for adult binge drinking. That means four or more drinks for a woman and five or more drinks for a man on a single occasion. The use of opioids — which include prescription pain medications, heroin, and fentanyl — also remains high. Overdose deaths in Wisconsin rose 34% from 2019 to 2020 — and that’s before the pandemic started.
Cocaine use and deaths have been on the rise over the past three years, Dr. Hulbert says. Benzodiazepines — which include alprazolam, lorazepam, clonazepam, and diazepam — also are a commonly misused prescription substance.
“With the isolation that was imposed on people during the pandemic, not only has mental health in general worsened, there has been an increase in substance use. Additionally, the pandemic made accessing treatment for substance use disorder much more difficult,” Dr. Hulbert says, adding that many new patients have been hesitant to use telehealth services to access the medical care they need.
How to Reverse the Trend
Experts say awareness is vital in addressing the issue — both self-awareness in the person with a substance use disorder and seeing the signs in people within one’s family and social circles.
The American Society of Addiction Medicine defines addiction as a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with substance use disorder engage in behaviors that become compulsive and often continue despite harmful consequences.
For many people, seeing their primary care provider can be a good place to start to get help. Individuals with a substance use disorder can complete an online assessment that can help identify the best place to obtain a full evaluation before starting treatment, Dr. Hulbert says.
Offering support
Playing a key supportive role in the recovery process, family and friends can take that same assessment on behalf of a loved one. This can help confirm whether that person might have a problem with alcohol and/or drug overuse.
“Someone in recovery has many reminders of their drug use (place, people, events), and they need support and encouragement to help them avoid and respond to triggers,” Dr. Hulbert says.
Family also can help search for the right medical professional for their loved one to see for help. Sometimes that’s enough for the individual with substance use disorder to seek the support they need.
Dr. Hulbert also points out a downside to family involvement. This can happen when loved ones perpetuate misconceptions. These include sentiments like: “using medication to treat addiction is just trading one drug for another” or “medication is a crutch,” or “being truly sober means no medication.”
“None of this is true. Medications for addiction treatment are effective and support recovery,” Dr. Hulbert says.
Who’s Most at Risk
Biology is one risk factor. “For instance, when people say ‘alcoholism runs in my family,’ it means that there is a genetic component for addiction,” Dr. Hulbert says. “That can put other people in the family at a higher risk if they start using that substance.”
Other risk factors include underlying mental health disorders and a person’s environment. “Triggers can include a chaotic home and abuse, a parent’s use of substances and attitudes toward them, and peer influences,” Dr. Hulbert says.
Furthermore, Dr. Hulbert notes that drugs change the brain’s structure and workings. Some of those alterations can be long-lasting. Brain imaging studies have shown that drugs cause physical changes in the areas of the brain that are critical to judgment, decision-making, learning, memory, and behavior control.
“So besides harming a person’s physical health, they can change how someone thinks and feels,” Dr. Hulbert says.
Substance use disorder — like diabetes or heart disease — is a chronic condition, meaning there is no cure. However, it can be managed. People with addiction can — and do — recover.
“When one medication or method doesn’t work, we try again with something else,” Dr. Hulbert says. “There is help and there is hope.”
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