Opioid Addiction:
Almost all of us have some form of addiction-
some behavior that we know isn't good for us
but that we do anyway for a moment
of not feeling our pain.
Functional Medicine looks for root causes of problems,
and dealing with addictions of all types-
carbs, chocolate, dairy, alcohol, sex, shopping, excess debt-
should be part Functional Medicine doctor's routine practice.
The major underlying cause of addiction
is unresolved trauma, particularly
Adverse Childhood Events (ACEs).
The "ACES" study showed that children with more then 4 ACES
are not only more likely to have addiction and behavioral issues
as adults, but are also more likely to have virtually every
chronic disease that was studied.
In fact- the problem is much greater then even the ACEs study
reveals. The ACEs study picked only 10 of the most common and
most studied of a great number of possible significant
traumatic childhood events. Had they included more-
racism, bullying, watching a sibling being abused,
losing a caregiver (grandmother, mother, grandfather, etc.),
homelessness, surviving and recovering from a severe accident,
witnessing a father being abused by a mother,
witnessing a grandmother abusing a father,
involvement with the foster care system,
involvement with the juvenile justice system-
the results would have been even worse.
So how does one come to deal with these issues?
How can one learn to deal with the pain that- in one form
or another- eventually comes to us all?
In the past it was thought that addiction was a behavioral
problem- and obviously, on one level, it is.
Working with a psychologist, particularly one trained in
some type of emotion based psychotherapy can be beneficial to a point.
(I like "It's Not Always Depression" for more information)
Still, Carl Jung was quite a psychologist and stated:
“The greatest and most important problems of life
are all in a certain sense insoluble….
They can never be solved, but only outgrown….
This ‘outgrowing’, as I formerly called it,
on further experience was seen to consist
in a new level of consciousness."
Carl Jung
A new level of consciousness.
The results of treating addictions through
psychotherapy alone have been disappointing.
Patients with multiple traumatic events
improve with 6 primary health behaviors
5 of them are used daily in functional medicine.
Functional medicine helps a lot.
(The other one is mental health).
Mindfulness practice is one of the 6.
Mindfulness practice is a core teaching in both
Functional Medicine and any complete 12 step program.
Fix your body with Functional Medicine.
Develop a practice of mindfulness that is authentic to you.
Do a real 12 step program to confront your
resentments from yesterday and your fears of tomorrow.
Then you can beat your addiction.
For those who have used opioids to treat
physical, emotional and spiritual pain,
there is an special urgency to get treatment.
Over 70,000 Americans died of opioid overdose in 2017-
double the number of just 10 years earlier.
For this reason we offer a special FM program
for those with opioid dependence.
Patients in the Functional Medicine/ MAT Opioid
Treatment Program are seen every 4 weeks
and are billed the same as all Functional Medicine patients.
They are required to participate the Health+ program.
Cost of the program is $350 for the initial 90-120 minute visit,
$200 every 4 weeks for a 25 minute FU visit,
and $25 per urine drug screening (done in office).
Patients with less then 3 months since
last using opioids will be drug tested every 2 days.
Since the suboxone maintenance is integrated
into actual medical issues beyond the addiction,
PPO insurance reimbursement for the visits
should be excellent.
DrB has a DEA waiver to administer suboxone for opioid addiction.
Our comprehensive opioid addiction treatment program includes:
1. MAT for suboxone or naloxone maintenance therapy;
2. Functional Medicine techniques to address core
physical issues that contribute to addiction;
3. Functional Medicine techniques to address ACEs (see below)
4. Outpatient drug testing as necessary depending on individual
patient needs.
Patients in our opioid treatment program must be actively involved
in a 12 step program and DrB requires contact with your sponsor to
assure that you are "doing a program."
There are 12 step programs that demand total abstinence
from all alcohol and drugs while doing a 12 step program.
This makes sense for alcohol, marijuana and many other drugs.
It does not always make sense for opioid dependence.
The chances an opioid addict can make a year clean
without a maintenance program is small.
My belief is that most do better to get on suboxone to stop opioids,
get a comprehensive 12 step program into place,
and address the multiple ACEs issues medically.
The suboxone gives you time to get the other pieces into place.
Once your 12-step program is strong and you are
routinely engaged in the behaviors that address your ACES,
then talk about weaning off suboxone and total abstinence.
Of course, some opioid addicts quit and do have long term sobriety.
But others quit and seem to be doing well-
but then, sometimes after years of abstinence- go back to drugs.
The statistics are clear: without MAT,
fewer then 5% of those who quit opioids make it a year.
Many of the 95% who go back will be part of the
over 17,000 will die this year from opioid overdose.
Or the more then 20,000 projected to die next year.
And on and on and on.