I didn’t truly understand opioid addiction until it killed my son

Over many years, as an emergency physician, I have resuscitated countless patients who died of drug overdoses. I knew I had to stop everything else I was doing and treat the overdose patient immediately because he could die within minutes. We had to clear a resuscitation room and, upon arrival, begin ventilation, place an IV in her scarred veins and quickly inject naloxone (Narcan). Usually they would start breathing again and wake up confused and angry, suddenly in acute withdrawal, writhing in pain, vomiting and moaning in agony. Most pulled out their IVs and looked for an exit. If they had to fight their way out, they did. Nobody said, “Thank you.”

I was angry for years and didn’t try to stop her from going back on the streets. Eventually, I was able to put my emotions aside and focus on the rest of the patients I had to treat. I never thought about it Why Overdose patients behaved like this. Even as an instructor at Johns Hopkins University and Harvard, I knew nothing about addiction treatment because I was never trained in it—not for a single hour. that substance use disorder (SUD) is a treatable illness.

I only found out after my youngest child, Macky, died of an opioid overdose.

Understanding should come first

At some point I realized that addiction is a disease and not a choice or a moral failure. Before I found out, I thought that punishment was the solution, and I believed the myths that addicts needed to “hit rock bottom” or only deserve “tough love.”

Late in Macky’s journey, I realized that he was reacting to this Understanding, compassion and love, but I found it difficult to maintain that self-control in the face of his SUD and the behaviors that come with continued use. With the emotional support of our family, professional counseling, and the right medications, he eventually made a recovery. He rebuilt his life – he went to school and worked. But then he had to undergo surgery after a car accident. Macky was injected with fentanyl before surgery and died of an overdose 26 days later.

Stigma remains the biggest challenge in healthcare

Just days before Macky died, he told me that stigma was the biggest obstacle he faced in his attempt to recover. He felt rejection and contempt from the community and health care providers who believed his addiction was his own fault and refused to help him. He knew that many doctors believe that “addiction is a crime to be punished, not a disease to be treated.”

Now I’m wondering: can we change this attitude? Can we imagine the patient in front of us as a member of our own family, show empathy and acceptance, and fulfill our obligation to treat them? If the clinical situation is challenging or unfamiliar, shouldn’t we seek support from an expert? These were also questions that Macky asked.

It is now a fallacy to believe: “I am doing my part to end the addiction. I don’t prescribe opioids!” We are in the age of illegal fentanyl and The is what is killing our family members, non-prescription drugs. Overprescribing is a dark part of our past, but the problem now is fentanyl – cheap, readily available and a ubiquitous adulterant in street drugs. We know how to manage pain responsibly, and we must know that even as legitimate opioid prescribing declines, overdose deaths are rising because people in pain often turn to the streets for relief and unknowingly use fake ones Find fentanyl filled pills.

We must also recognize that the vast majority of people with SUD in the United States cannot find effective treatment. But it is our It is our responsibility to set aside our judgment and do our best to provide appropriate treatment.

What can you do to treat a substance use disorder?

First, be prepared. Most people who die from an overdose have seen a doctor in the year before their death. How grateful would you be if someone in your family needed help for SUD and a doctor offered to help them recover instead of turning them away?

Prescription pills didn’t kill my son – street drugs did. Our patients and families will not be protected from death from drug poisoning if we simply turn our patients away when they are in severe or persistent pain. This often leads them to find an alternative with a friend, online, at school or on the street. They simply won’t know that what they found is fentanyl.

Most people with a substance use disorder do not have access to effective treatment, but we can change that. We know what works and we have a responsibility to help as best we can.

It is time for all of us in healthcare to take a step forward, let go of our hostility toward people with addiction problems, and face our own fears about SUD treatment. Most people can be treated with safe and effective medications right in the doctor’s office. The only “treatment bed” the patient may need is the safe, loving bed in their own bedroom.

James Baker, MD, MPH, is president of the Massachusetts Society of Addiction Medicine, physician expert for the Massachusetts Consultation Service for the Treatment of Addiction and Pain, associate medical director of Merrimack Valley Hospice, and assistant professor of medicine at Tufts University School of Medicine.