New answers for addiction through science

By: ROCKY HILL - Commentary: | Sunday, August 26, 2007 8:25 PM PDT ∞

A recent guest commentary in The Californian spoke to the significant increase in patients being treated for addiction to painkillers ("Painkiller addiction problems escalate," Jim Fent, July 26).

Our experience at Hill Alcohol and Drug Treatment mirrors those of the writer. Addiction to pain medications like Vicodin, Norco, Oxycontin, Fentanyl, Dilaudid and other opiates have increased dramatically.

However, the truly exciting story is the giant strides science has begun to make in understanding the biochemical mechanisms of addictive behavior and the creation of harm reduction alternatives.

For so many years, all addictive behaviors were seen as failings of morality or willpower. Our societal strategy reflected those beliefs by passing laws that focused on punishing the addict into "right behaviors." Campaigns like "just say no" appealed to those who sought an easy, quick, cheap solution. For those who didn't say "no," we have elected to allocate our tax dollars to incarcerate them with those well-versed in minimal values and anti-social behaviors.

Three years ago, we (with great skepticism and much research), began to use a new medication for pain pill addiction that promised no high to chase for the user, no tolerance by the brain to drive the user to higher and higher doses and most important, blocked the effects of the painkillers. It promised to eliminate both the acute (short-term) and chronic (long-term) withdrawal syndrome that had perviously tormented our patients with depression, loss of energy, appetite and ultimately, any enthusiasm for life. They couldn't work, play with their kids or even laugh.

We started our first patients on this medication with the assistance of a local physician and the results were startling. The first words out of each patient's mouth were the same: "I feel normal for the first time in so many years." Our recovery rate for opiate addicts skyrocketed from five percent to 95 percent. We had nurses, ballplayers, teachers and many others who had been struggling with fear and shame and fear finally able to "feel normal," not high, not hooked, just normal.

Most had started their addiction with a surgery or chronic pain condition and their physician's treatment was completely appropriate. Unfortunately, the receptor sites in their brains didn't care about theories of "appropriate pain management." Their brains were genetically prewired to produce an important response to the prescribed dose of analgesic.

Instead of feeling pain relief and falling asleep, they experienced a stimulation that, atypically, kept them awake at night. From the outset, their biological response was the opposite from the majority of the population. Likewise, their withdrawal experience was much more severe and long-lived.

This new medication is called Suboxone. It's really just the combination of two very old medications into a new hope for hundreds of thousands of those who find themselves unable to get past the months of post-acute withdrawal that follows cessation of painkillers.

Increasingly, science is working with the treatment community to find new ways to help those who, years ago, were deemed "hopeless." The results will save countless families the heartache of watching their loved one head off to jail, prison or the morgue. Few families have been untouched by the disease of addiction. Hope has never been greater in our field.

-- Rocky Hill of Temecula is the director of Hill Alcohol and Drug Treatment and Three Hills Sober Living.