Fentanyl Addiction

Millions of Americans struggle with Substance Use Disorder (SUD), ranging from addiction to legal and illicit drugs to alcohol. And although more than a million Americans receive treatment for SUD, millions more don’t receive specialized treatment. 

According to National Survey on Drug Use and Health (NSDUH) statistics in 2019, people in the previous year (2018):

• 4 million people had a SUD
• 5 million had an alcohol use disorder
• 6 million had a marijuana use disorder
• 1 million had a cocaine use disorder
• 438,000 had a heroin use disorder
• 1 million had a methamphetamine use disorder
• 558,000 had a prescription stimulant use disorder
• 681,000 had a prescription tranquilizer or sedative use disorder
• 4 million had a prescription pain reliever disorder
• 6 million had an opioid use disorder

What is drug addiction?

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 experience.”

The National Institute on Drug Abuse defines drug addiction–or Substance Use Disorder (SUD)–as “a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.” 

Since it involves parts of the brain relating to “reward, stress, and self-control,” drug addiction is a brain disorder that may affect the brain long after addiction recovery.

What causes addiction?

Drug addiction develops in many causes and circumstances, usually through recreational experimentation or medical use as prescribed by a doctor. 

Some drugs are highly addictive, such as opioids, requiring less use and dosage while more quickly causing addiction in users. On top of the addiction, your body becomes dependent on the substance, causing withdrawal symptoms when your consumption of the drug diminishes from the dosage you habitually take.

According to Mayo Clinic, some individuals are more at risk of drug addiction than others, depending on certain factors, including the following:

• Family history of addiction
• Mental health disorder(s)
• Peer pressure
• Lack of family involvement
• Early use
• Taking a highly addictive drug

What are the parts of the addiction cycle?

There are typically six parts to the addiction cycle, and the duration of each stage depends on the individual and the particular substance being used.

1. Initial use
2. Abuse
3. Tolerance
4. Dependence
5. Addiction
6. Relapse

Initial Use

The initial substance use begins the addiction cycle, although it isn’t typically enough to cause addiction (unless it’s a drug like heroin or methamphetamine). 

Typically, a person will be introduced to a substance through a doctor’s prescription, illicit use, peer pressure, or legal use at age 21. Following this, addiction occurs when substance use reaches a level of abuse.

Abuse

Abuse of a substance depends on the kind of substance and how it affects your body. Abuse is typically exhibited in habitual, reoccurring use along with a frequent increase in dosage to feel the “high.”.

Tolerance

Prolonged use of a substance naturally causes changes in your body, particularly your brain, that develop a bodily tolerance to the drug and dosage you’re habitually consuming. 

As your body increases its tolerance to the substance, you don’t experience as significant of a high as you would during your initial or early use, requiring an increase in dosage to experience the same high as before.

Dependence

After prolonged drug abuse, your body will change to the point of becoming dependent on the drug for normal function, sometimes proving to be as extreme as anhedonia–the reduced ability to feel pleasure.

Addiction

SUD is a chronic mental disorder identified by certain signs and symptoms developed by the American Psychiatric Association (APA).

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), SUD can be identified by the following criteria:

• Prolonged use of the substance or in more significant amounts than intended
  
• Inability to reduce dosage or stop using the substance completely
  
• Spending a lot of time obtaining, using, and recovering from the effects of the substance
  
• Experiencing cravings or intense desires or urges for the substance
  
• Failing to fulfill obligations at home, work, or school due to substance use
  
• Continuing substance use despite having interpersonal or social problems that are caused or worsened by substance use
  
• Giving up social, recreational, or occupational activities due to substance use
  
• Using the substance in risky situations
  
• Continuing substance use despite having a physical or mental problem that is probably due to substance use
  
• Tolerance, or needing more of the substance to achieve previous effects
  
• Withdrawal, meaning that unpleasant symptoms occur when you stop using your substance of choice

Relapse

The unfortunate reality of addiction is the experience of relapse despite treatment for drug addiction. Drug dependency, withdrawal, and lack of self-control are among many factors that can play into an addict’s relapse. The challenge is finding the proper treatment for the individual that will make the most progress in overcoming addiction.

What are the most common addictions?

Categories of Substance Use Disorders, as defined by the DSM, include:

• Alcohol Use Disorder
• Cannabis Use Disorder (Marijuana Use Disorder)
• Phencyclidine Use Disorder
• Other Hallucinogen-Use Disorder
• Inhalant Use Disorder
• Opioid Use Disorder
• Sedative, Hypnotic, or Anxiolytic Use Disorder (Benzodiazepines or like drugs)
• Stimulant Use Disorder (Cocaine, meth, etc.)

The Opioid Crisis

From 1999-2019, the Centers for Disease Control and Prevention recorded nearly 500,000 overdose deaths from opioids in the United States. 

What are opioids?

Opioids interact with opioid receptors in your cells. Medical professionals typically prescribe them to treat chronic pain, and the effectiveness of opioids is a primary reason they’re so addictive. Common conditions for which doctors prescribe opioid medications include cancer pain, post-surgical pain, vascular pain, and acute pain.

Examples of opioids include:

• Fentanyl
• Heroin (Made from morphine)
• Oxycodone (OxyContin®, Percocet®)
• Oxymorphone (Opana®)
• Hydrocodone (Vicodin®)
• Hydromorphone
• Morphine (Kadian®, Avinza®)
• Methadone
• Codeine
• Meperidine
• Tramadol
• Carfentanil
• Buprenorphine

What is the most effective way to deal with addiction?

Different types of rehabilitation and addiction recovery programs are available for those seeking to overcome their addiction and dependency on any sort of substance, be it drugs or alcohol.

Programs include:

• Medical Detox – We utilize medication-assisted treatment to help mitigate physical withdrawal symptoms. Soul Surgery also offers optional group and individual therapy to help alleviate the mental withdrawal side effects.
  
• Inpatient Treatment – Our goal is to facilitate healing and recovery in physical, emotional, and behavioral health. We maintain clinical excellence using evidence-based treatment approaches, cutting-edge modalities, and highly specialized and caring staff.

• Intensive Outpatient Treatment (IOP) – Soul Surgery offers various groups, including psycho-educational groups, individual therapy, family therapy, and relapse prevention groups. Our sessions are always patient-centered and focused on substance use disorders and mental health services.

Treatments for Substance Use Disorder (SUD)

Within these programs, there is a range of treatments available, depending on the recovery needs of the individual patient, including the following:

• Holistic Integration MedSpa
• BioFeedback
• EMDR
• Dual Diagnosis
• Medication-Assisted Treatment
• Equine Therapy
• Accelerated Resolution Therapy

Excessive drinking is the leading cause of preventable deaths in America, shortening the average age of those who’ve died by alcohol to 26 years.

Since drinking is so common to the social fabric of our society, it can be difficult to tell the difference between abusing alcohol and alcoholism. Plenty of people have had the experience of either a friend or themselves drinking too much and feeling the repercussions for it the following day, usually chopped up to a lapse in self-control. But lacking self-control goes deeper in the case of alcoholism, making it impossible for an alcoholic to drink alcohol responsibly again.

What is Alcoholism (Alcohol Use Disorder)?

According to The Big Book by Alcoholics Anonymous (AA), alcoholism has to do with your lack of self-control when drinking alcohol, especially when controlling the amount you drink after the first beverage.

“If, when you honestly want to, you find you cannot quit entirely, or if when drinking, you have little control over the amount you take, you are probably alcoholic.” – The Big Book

After drinking the first drink, an alcoholic will characteristically not stop drinking until something else stops them, typically sleep or unconsciousness due to the amount they drank.

How is hard drinking or binge drinking different?

Alcoholism is distinct from other forms of alcohol abuse, such as heavy or binge drinking.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) distinguishes binge drinking and heavy drinking by how much and in how little time someone drinks alcohol.

• Heavy Drinking: “For men, consuming more than four drinks on any day or more than 14 drinks per week; For women, consuming more than three drinks on any day or more than seven drinks per week.”

• Binge Drinking: “For a typical adult… consuming five or more drinks (male), or four or more drinks (female), in about 2 hours.”

What are the qualities of an alcoholic?

Besides the lack of self-control over how much an alcoholic drinks after the first glass or bottle, self-centeredness is characteristic of alcoholics, according to The Big Book:

“Selfishness–self-centeredness! That, we think, is the root of our troubles. Driven by a hundred forms of fear, self-delusion, self-seeking, and self-pity, we step on the toes of our fellows…” – The Big Book

And out of the self-centeredness rampant in the alcoholic comes the “retaliation” of their loved ones and others around them who are certainly affected by their behavior, bringing upon themselves hurt and heartbreak.

What are the root causes of alcoholism?

If the root cause of alcoholism were identified, it likely would be curable. Unfortunately, there is no known single root cause for what makes some more susceptible to alcoholism and others not at all.

Some known risk factors make one more at risk of becoming an alcoholic, including:

• Genetics
• Family History
• Underage Drinking
• Frequent Drinking
• Mental Health Conditions
• Trauma
• Male Gender
• Social Influence

Does stress cause alcoholism?

According to the NIAAA’s Alcohol Alert Number 85, the body’s main stress hormone, cortisol, “interacts with the brain’s reward or ‘pleasure’ systems,” implying that stress likely contributes to motivation for heavier drinking and potential alcohol abuse.

American Statistics

The CDC reports that every year, about 140,000 Americans die from excessive alcohol use, making every one-in-five deaths among adults between the ages of 20 and 49 years.

Besides death, many of the damaging health effects of alcohol abuse include chronic health issues, including:

• High Blood Pressure
• Heart Disease
• Stroke
• Liver Disease
• Cancer

Other more immediate health effects of alcohol abuse include

• Injury
• Violence
• Poisoning
• Unintended Pregnancy
• Sexually Transmitted Diseases
• Poor Pregnancy Outcomes

One of the most complex parts of having a loved one who struggles with addiction is their denial of having a problem and, therefore, an unwillingness to seek treatment. In such a case, a formal intervention, either planned by the family or a professional interventionist, is an intentional way to motivate your loved one to begin their recovery journey.

What is an Intervention for drug or alcohol abuse?

An intervention for drug or alcohol abuse is a planned meeting or confrontation with the addict, typically consisting of family members, friends, religious leaders, and even professional interventionists specializing in planning and executing interventions.

Addictions that commonly warrant intervention include

• Alcoholism
• Prescription Drug Abuse
• Illicit Drug Abuse
• Compulsive Gambling

Three types of intervention models include

• Johnson Model: Created by Vernon Johnson, the Johnson Model includes the family and an interventionist who confronts the addict without prior knowledge of the meeting.
  
• Invitation Model: Created by Ed Speare and Wayne Raiter, the Invitation Model involves interventionist-led workshops where the entire family or support network–including the addict–are invited to participate, providing an environment where they can discuss how addiction affects the family.
  
• Field Model: Like the Johnson Model, the Field Model is a confrontational meeting without the addict’s prior knowledge; however, the interventionist leading the confrontation is trained for crisis scenarios that may occur during the intervention process. This is typically recommended to those with a loved one struggling with addiction and comorbidities such as depression or bipolar disorder.

How does an intervention work?

1. Plan the Intervention: Consult a professional, be it a counselor, addiction professional, psychologist, mental health counselor, social worker, or interventionist, to ensure no stone is left unturned in preparing for confronting your loved one about their addiction.

2. Research and Gather Information: Compile information from everyone regarding what they’ve observed and how the addiction has impacted their lives/relationships with their loved one. Also, research addiction and the particular substance use disorder that your loved one is currently struggling with, allowing not only for a better understanding and perspective on their struggle but help you and everyone on the team to come to the intervention from a positioning of empathy.
   
3. Form an Intervention Team: A mixture of those within the addict’s family and friend network and professionals outside will provide balance for focusing on facts and information during the planning, rehearsal, and intervention process.

4. Define Specific Consequences: Friends and family must anticipate the possibility the addict rejects treatment, and each person must individually decide their response regarding their relationship with the addict in the case of rejection.

5. Write Down What to Say: Each member of the intervention group who has a relationship with the addict will discuss and write down how their loved one’s addiction has negatively impacted their life. Ideally, each person will position what they have to say with the hope that the addict can and will overcome addiction if they accept recovery. Also, establishing which treatment options to present to your loved one during the intervention is essential.

6. Have the Intervention Meeting: The addict will be invited to the designated location for the intervention without their prior knowledge. Each team member will share their thoughts and feelings about their loved one’s addiction and explicitly communicate the consequences if they don’t accept any treatment options.

7. Follow-Up: This involves everyone’s willingness to change behaviors and environments to support the addict’s recovery and prevent ease of relapse. Ongoing therapy and support for each intervention team member are equally important.

Who should be doing the intervention?

Not everyone’s situation is the same, so it depends on the context of your loved one, but intervention teams typically include:

• Friends of the Addict
• Members of the Addict’s Family
• Spouse, or Girlfriend/Boyfriend
• Religious Leader
• Therapist
• Professional Interventionist

What makes a successful intervention?

There’s no one-size-fits-all approach to intervention, given every addict’s situation has nuances, and therefore, there is no guarantee that an intervention will work. That being said, there are general ways to be productive when engaging an addict in an intervention context, fostering a fruitful experience not only for your struggling loved one but for you and the rest of your intervention team as well:

• Plan your intervention beforehand.
  
• Research the addiction your loved one is struggling with.
  
• Designate a single point of contact for the entire intervention team.
  
• Share any new information or updates with the entire team.
  
• Stage a rehearsal intervention to fine-tune your confrontation strategy.
  
• Anticipate objections and intentionally plan responses.
  
• Avoid anger and hostility; channel love and charity.
  
• Stick to the intervention plan, especially when it gets emotional.
  
• Don’t settle for less than an immediate decision from the addict.
  

What treatment programs should be presented in the intervention?

A drug or alcohol intervention should typically include information about various treatment options, while the most appropriate for an individual will depend on their unique needs and circumstances. 

Consider working with a substance abuse treatment professional to determine the best plan of action.

Detoxification

This process allows the body to rid itself of the substance, which may involve medications to manage withdrawal symptoms.

Inpatient Treatment

Inpatient treatment involves your loved one living at a residential facility for a period, typically from several weeks to several months. During this time, they will receive intensive therapy and support to address their substance use disorder and any related mental health issues.

Outpatient Treatment

Outpatient treatment allows your loved one to live at home while regularly attending therapy and other sessions. Outpatient treatment may be a good option if they have a strong support system at home and don’t require the intense structure of inpatient treatment.

Support Groups

Participation in support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), has been dramatically effective for ongoing recovery support for those with substance use disorders. These groups provide a sense of community and support as individuals work to maintain their recovery.

What is Rehabilitation?

Rehabilitation for drug addiction and alcoholism is a structured program that helps individuals with substance use disorders recover from their addiction and achieve long-term sobriety. Rehabilitation programs can vary in length and intensity but typically involve a combination of therapies and other interventions designed to address addiction’s physical, psychological, and social aspects.

Types of rehabilitation programs include

• Medical Detox for Drug or Alcohol Abuse
• Medication-Assisted Treatment
• Inpatient Treatment
• Intensive Outpatient Treatment (IOP)
• Family Care
• BioFeedback
• EMDR
• Dual Diagnosis

During rehabilitation, individuals may participate in various therapies, including

• Individual Therapy: Involves one-on-one sessions with a licensed therapist or counselor. It can help individuals identify the root causes of their substance use and develop coping strategies to prevent relapse.

• Group Therapy: Brings together a small group of individuals with similar experiences and challenges to support and encourage one another.

• Family Therapy: Involves sessions with a therapist and the individual’s family members. It can help families understand the impact of addiction on the individual and the family and work together to develop healthy communication and support strategies.

• Cognitive-Behavioral Therapy (CBT): Focuses on helping individuals change negative patterns of thought and behavior that contribute to substance use.

• Accelerated Resolution Therapy: An evidenced-based, rapid-eye-movement therapy for treating trauma, anxiety, depression, sleep problems, self-esteem problems, and other issues.

The treatment most appropriate for you or your loved one will depend on each individual’s unique needs and circumstances.

Luxury Rehabilitation Centers

Luxury drug rehabilitation centers are high-end treatment facilities typically located in picturesque or secluded areas that offer a range of upscale amenities and services beyond traditional substance abuse treatments.

In addition to therapy and other evidence-based treatments, luxury rehabilitation centers typically offer additional amenities, such as

• Private rooms
• Gourmet meals, dining options
• On-site fitness facilities or access to local recreational activities
• Spa services, including massage therapy
• Holistic treatment options such as acupuncture or meditation
• Equine therapy

Keep in mind that while luxury rehabilitation centers may offer a more comfortable and upscale environment, they are not necessarily more effective at treating your loved one’s substance use disorder than a traditional treatment center.

Ongoing Recovery

Alcoholics Anonymous (AA)

Alcoholics Anonymous (AA) is a self-help organization founded in 1935 that supports people struggling with alcoholism. AA is based on the 12-step model, which outlines an individual’s steps to achieve and maintain sobriety. 

The 12 steps include the following:

• Admit we are powerless over alcohol—that our lives have become unmanageable.
  
• Believe that a Power greater than ourselves can restore us to sanity.
  
• Decide to turn our will and lives over to God’s care.
  
• Create a searching and fearless moral inventory of ourselves.
  
• Admit to God, ourselves, and another person the exact nature of our wrongs.
  
• Become entirely ready to have God remove all these defects of character.
  
• Humbly ask Him to remove our shortcomings.
  
• Make a list of all persons we harmed, and become willing to make amends to them all.
  
• Make direct amends to such people wherever possible, except when doing so would injure them or others.
  
• Continue to take personal inventory and, when we were wrong, promptly admit it.
  
• Seek through prayer and meditation to improve our conscious contact with God as we understand Him, praying only for knowledge of His will for us and the power to carry that out.
  
• Have a spiritual awakening as a result of these steps. We try to carry this message to alcoholics and to practice these principles in all our affairs.

AA is peer-led, relying on the support of individuals who have achieved and maintained sobriety to guide others working toward recovery. 

AA meetings are typically held in local communities and are open to anyone seeking support for their recovery from alcohol addiction. AA is based on anonymity, and members are encouraged to respect one another’s privacy.

The Big Book

The Big Book is the common name for the book of AA, which is the primary text of the organization and was first published in 1939 by Bill W. and Dr. Bob – the founders of AA.

It also contains a collection of personal stories from AA members who have achieved and maintained sobriety through the program and a detailed explanation of each of the 12 steps.

Narcotics Anonymous (NA)

Narcotics Anonymous (NA) is an organization similar to AA, founded in 1953 to support individuals struggling particularly with drug addiction. 

NA is also based on the 12-step model, with minor modifications focusing on recovery from drug addiction rather than alcohol addiction.

The basic principles of NA are

• A recognition that substance abuse is a disease that can be overcome with the help of a higher power and the support of others.
  
• A commitment to abstinence from all drugs, including alcohol.
  
• A willingness to work through the 12 steps of recovery with a sponsor (a member of the organization who has achieved and maintains sobriety)

Like AA, NA is a peer-led organization, relying on the support of those who have achieved and maintained sobriety to guide and support others seeking recovery. 

NA is also based on the principle of anonymity.

Begin Your Recovery Today with Soul Surgery

Soul Surgery’s unique blend of cutting-edge, evidence-based treatment, upscale facilities, and passionate and professional staff gives our patients the best chance at overcoming drug addiction and its short-term and long-term mental and physical effects.

Feel free to reach out if you or a loved one are struggling with addiction and would like to begin your journey to recovery today.