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We're reminded again of opioids' stranglehold

February 4, 2014
by Gary A. Enos, Editor
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On the cover of our most recent print issue (November/December 2013), we labeled opioid dependence a “formidable foe” in the face of increasingly complex treatment strategies. Our cover story opened with, “The names of emerging drug trends come and go, but for years now opioid dependence has remained the most prevalent and puzzling issue being addressed and analyzed in the nation's public and private drug treatment facilities.”

Since that publication went to press, scattered reports of spikes in overdose deaths linked to opioid use have surfaced in several states. Then in the lazy afternoon hours preceding the Super Bowl last Sunday, word arrived that heroin had apparently played a leading role in extinguishing the radiant talent of actor Philip Seymour Hoffman.

“Formidable” hardly seems to do justice to this foe right about now. Communities fight on, but it sure feels like opioids are winning.

My initial thought as Hoffman's death hit the national wires went something like, “This will hit the field like a punch to the gut.” The 46-year-old actor reportedly had maintained sobriety for more than two decades after battling addiction in his youth, but had relapsed in the past year and spent a short time in treatment.

I'm asking members of our Addiction Professionals group on LinkedIn to comment on whether these difficult headlines offer any teachable moments for professionals. Here are a couple of the comments posted so far:

From a recovery coach: “From my experience, living in long-term recovery requires identifying and accepting my personal truths and creating a life that embraces and enhances my uniqueness.”

From a professional who works with parents of addicted children: “The popularity of the actor and the force behind his death is a tragic educational opportunity, and much good can come from this sad outcome. Teach awareness. Help others recognize the power of addiction. This was not some 'stupid teenager' or 'drug-addled musician' (he's referring here to stereotypes that people use to dismiss similar incidents). This was a cool guy, great actor, father, and a near middle-aged man. The lesson is right there to give.”

I also noticed this week that David Kerr, former director of Integrity House in New Jersey, wrote in his own blog that in the face of such a powerful and cunning addiction, “Mandatory residential treatment must be available to every addict leaving jail or prison or directly following a non-fatal OD! Most addicts won't or can't make responsible decisions while in the grip of the disease, so their family or the courts need to make it for them and there must be an element of force built into the referral to a long-term treatment program.”

Such a mandate might not have saved an artist whose work made me think, “Wish I could perform my craft as well as he did his,” but perhaps it could do its part to prevent society from losing countless others too soon.

What are your thoughts about the proper response to the latest cruel headline?



I run groups in an office based opioid treatment center. I am "out" to my clients regarding my own sobriety/clean time. I spent the entirety of our groups this week reflecting upon the fact that this disease wants us dead and regardless of how much clean time one might have, a program of recovery needs to be in place. We can have so much to live for, but the opiates take us to a place where nothing else matters. I think the message was strong. I know it was for me personally.

Several articles have mentioned that Mr. Hoffman stated pubically that after 23 years of living in addiction recovery he relapsed into active addiction after being prescribed an opiate medication. This is a reminder of the importance of every addict and prescriber understanding addiction and how, despite years of abstinent recovery "craving" can be innocently reignited.

One very experienced addiction medicine family physician that I greatly admire in Minnesota reminds patients that, "addiction is like a pilot light on a stove - it's always on." Patients in addiction recovery and ALL prescribers need to be aware that legimate use of some over-the-counter or prescription medications can trigger craving and lead to an unintentional relapse, suffering and death.

We need to speak-up for the population we serve and demand that all prescribers receive better education on addiction, be aware of alternative medications to treat pain, and use informed caution when prescribing specific medications to persons with active addiction or a history of addiction - regardless of the number of years in recovery.

We also need to educate our patients about how to make informed decisions regarding over-the-counter and prescription medication use, and be aware that certain substances may put them at risk for relapse.

Gary Enos


Gary Enos


Gary A. Enos has been the editor of Addiction Professional since its inception. He also...

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