Addiction can begin (and end) at the doctor’s office

Scientific studies show if you are opiate addicted, you are cutting your life by 20 years.

Many people shop for doctors — going to many doctors, complaining of low back pain, migraine, arthritis due to playing the violin, and even pain from operations that never took place.

Surprisingly, some doctors prescribe an elephant’s dose of pain killers containing opiates, without a proper medical work up or even a copy of an operative report. Some doctors are so trustful they won’t even check for a patient’s scars if they are in a personal area.

I have a pharmacy report of a young female who was able to get 120 tablets of Oxycodone from two physicians from the same medical group in Sussex County in one month. She consumed 4-6 tablets per day with the blessing of her doctor, who prescribed them based on her complaints, without a medical exam.

On the one hand, medical doctors are not police, and we have to trust our patients without lie detectors, but as President Reagan said when Soviet President Gorbachev asked him, “You don’t trust me?” Reagan answered, “I do trust, but verify.”

Unfortunately, the catastrophic increase of doctors who prescribe pain killers like vitamins creates a new breed of medically-induced opiate addicts. If I did not see it every day, I would never believe that some licensed physicians are operating like drug dealers.

When patients become addicted to pain killers they ask their doctors to increase the dosage. They ‘lose’ their prescriptions or ‘accidently’ drop their prescriptions in the toilet bowl. Their doctors eventually realize they have an addicted patient and suggest a pain management doctor or inpatient detox.

But as you can imagine, patients are not in a hurry to be compliant.

Often they shop for doctors in other counties or states. They don’t encounter much difficulty when they mention they would gladly pay cash.

Such situations have developed over time because we never had a centralized database for information regarding controlled substances. We were more than 20 years behind New York, which established triplicate prescriptions for every controlled substance. One copy goes to the pharmacy, a second to Albany, (for their centralized data bank computer) and the third to the prescribing doctor.

Recently, NJ drug monitoring computer network joined with a National network.

If some of the readers have an addiction problem, you should be made aware now that the new rules have come into effect. I would like to suggest such patients begin to look for professional help as soon as possible.

The combination of the genetic and environmental events like significant stress, sexual abuse in childhood, and other untreated mental disorders, e.g. clinical depression, trigger a genetic predisposition to opiates dependency.

It happens in two types of situations, one of them starts with legitimately prescribed pain killers and progresses. The patient needs more doses more frequently. When doctors detect a problem and stop prescribing, the patients switch to street drugs.

The other situation is when hidden mental disorders, which manifest mostly between 13 and 20 years old, allow an entry gate for opiates. They self medicate initially by starting to smoke cigarettes, later marijuana, alcohol and some of them end up with heroin/painkillers.

In my professional opinion, they need treatment more than to be behind bars but many judges do not understand this. There is progress — in drug courts, where judges are more educated in substance abuse.

The good news is that we have a major breakthrough which allows detoxifying in an outpatient setting. We can place them on the special medication called Suboxone, and provide them with a comprehensive treatment program, not only for addiction but also for underlying mental disorders.

Eventually we take the patient off Suboxone after detox and place him on the injection of Vivitrol once a month. Vivitrol is a medication which blocks brain receptors from cravings and an opiate-induced high and doesn’t allow the patient to feel any pleasure or high from consumption of any opiates.

One injection per month prevents many health and social catastrophic events and saves thousands of dollars on lawyers’ fees.

Now opiate addiction disorder can be well restrained, disarmed and controlled.

I have seen many young ladies who naively expected that their unconditional love could help their boyfriends or husbands to stop the addiction without doctors. Unfortunately, I have not seen one successful case of this type of idealistic treatment.

We have to understand that opiate addiction is not only a social disorder but a combination medical/biological disorder that requires pharmaceutical methods of intervention. Of course it has to be supported by psychotherapy and family support. Acupuncture shows a good therapeutic effect as well.

Dr. Leibov is a local psychiatrist in Sparta who is also an addictionologist. He wrote this in response to our 4-part heroin series.