I’ve recently been learning about addiction and some of the things I have heard have shocked me, especially the statistics. Alcohol and drug detoxification can be fatal – you can’t go cold turkey by yourself if you are severely addicted. Medical care is essential for a safe recovery from addiction, but due to the lack of funding for mental health services, this is not always possible.
Does stigma cause lack of funding?
In my opinion, there is a shocking deficit in the funding for addiction services. I believe that anyone willing to commit to recovery should be provided the appropriate support and treatment. There should not be a waiting list for addiction; overdose and securing drugs or alcohol from illegal ways, could cost many lives as these people wait for help. People look down on those suffering from addiction, but it is a disease like any other. We pay for medication for those with Type 2 diabetes, when weight loss, exercise and a healthy diet has much better outcomes, and incurs no cost at the expense of the NHS – simply because people aren’t willing to make lifestyle changes. In addition, people often turn to substance abuse when they are suffering from other problems, such as mental illness or bereavement, therefore I find it incredible that people lacking empathy describe this as “self-inflicted”. Addiction could happen to anyone – the wealthiest and the poorest people are those most commonly afflicted – had you been born into a different environment, you could be one of those struggling without help.
Today, I heard that if someone was to go to their GP to seek help for their addiction, their GP would tell them to keep drinking/using while they are put on a waiting list for help. The GP is giving the best advice – abruptly stopping alcohol/drug consumption if you are heavily dependent on it is very dangerous and is not something anyone should attempt without medical supervision. However, it is devastating that someone who has made the brave step to seek help, for a condition associated with so much shame, gets turned away and put to the end of a seemingly never-ending queue. Psychological therapies are recommended for treating addiction, these include Cognitive Behavioural Therapy, rewiring your thoughts, and Interpersonal Therapy, getting to the root of your problems. Since addiction commonly occurs alongside mental health issues, all conditions should be treated to ensure a full recovery.
Treating alcoholism is not a quick and easy task, but it can be done. The goals of treatment are to give the addict their life back; to allow them to become a contributing member of society and to overcome the grips of this terrifying disease. The withdrawal stage is very difficult, but winning the fight against the addiction comes in the months following, when the patient continually makes the choice to avoid alcohol. Resisting the urge to drink, especially when you return to your normal environment, social life and pressures without your normal coping mechanism, requires a lot of strength. For anyone interested in sobriety, check out this best selling book which provides amazing insights.
If the patient is diagnosed with a severe addiction, or suffers from an illness such as epilepsy, inpatient treatment is recommended. Detoxing from severe alcoholism is normally undergone in a residential facility, however, it can take place at home but this is rare. To detox at home (providing that is a suitable environment) there must be a solid support network for the patient, that is able to provide 24/7 supervision, along with the ability to cope with the traumatic withdrawal process.The patient will be given IV vitamins, as addiction often causes deficiencies which can be life-threatening. The patient will also start off with 40mg of diazepam, a high dose of an anti-anxiety medication, to help with the withdrawal symptoms and this will be reduced gradually to ensure the patient doesn’t become addicted to it. Dehydration and nausea, which can result from the withdrawal process, require treatment which would be IV fluids and anti-sickness medication. There should be a dramatic improvement in symptoms within 5-7 days and the recovery process continues from there.
There are several medications available to prevent relapse; these work by either reducing cravings for alcohol or by causing unpleasant effects to the patient as soon as alcohol is drank. Disulfram, also known as Antabuse, immediately triggers a hangover upon consumption of alcohol – the patient experiences palpitations and nausea. Some patients in the recovery process don’t take this medication on the days they wish to drink, however, this can be lethal. The disulfram will still be present in the body, even if it hasn’t been taken that day, and the reaction with alcohol will still occur and can be severe. Consequently, if a patient is taking this medication then they need to be committed to sobriety or they should try another drug like Naltrexone, which will solely make drinking seem less appealing.
For opiate addictions, such as heroin or painkillers, substitution therapies are available. This means the patient is no longer having to secure drugs through illicit means and they are receiving a safe dose. Methadone and buprenorphine are two substitution therapies commonly dispensed in the pharmacy, the dose prevents withdrawal symptoms but does not give the patient a “high”. The dose starts off low and gradually increases as a safety precaution, in case the patient is still using opiates, as this could cause an overdose.
The goal of this treatment is to slowly wean the patient off of opiates, however, sadly many people spend their full life reliant on methadone. If more importance was placed on addicts making a full recovery, more effort would be made to reduce the dosages of replacement therapies which could only have a positive impact on their lives. Furthermore, 364 people per year in Scotland die from an overdose of methadone in combination with other opiates causing respiratory depression – this frightening stastitic highlights that not enough is being done to help those trying to recover. If the patient is supplementing their methadone dose with other drugs, then the treatment is not working for them and an intensification of therapy is required – which may include more psychosocial intervention or an increase in dose of methadone.
Cocaine addiction has no substitution as of yet, but there is a possibility of using dexamfetamine as a substitution therapy.
In conclusion, addiction is a horrific disease and we should be doing more to help treat it. Waiting a year to access treatment for addiction is ridiculous; no physical disease, that has a comparable rate of fatality, would ever have to wait so long to get medical attention. I believe the stigma against addiction causes the lack of money spent on medical attention. However, addicts are humans too, they are just like any other people and is it socially acceptable to rely on drinking a bottle of expensive red wine a day – that is a drinking problem too. We need to change our attitude towards addiction and push for a change on stance on funding treatment for addicts.