August 28, 2018

With Help, There is Hope

David Godfrey

Substance abuse and addiction destroy lives. Productivity is diminished or destroyed, families and relationships are destroyed, and people die. Opioid abuse has grown to the extent that we classify it as a public health crisis—people are dying every day. The situation is not hopeless with treatment. 

I choose to contribute to the ‘treatment” themed track at the Senior Lawyers Division’s summit on opioids because I believe in recovery and new beginnings. There is life beyond abuse and addiction, but most people need help in the form of effective treatment to achieve long-term results.

My spouse is an alcoholic and has been in recovery for over 30 years. He tried quitting on his own and relapsed after a year. The second time around he was fortunate enough to receive treatment in one of the best programs in the world. Treatment helped him developed the tools he needed to deal with the challenges in life. He has gone on to a life of achievement. (He is a soon-to-be-retired college professor.) We met 28 years ago when was just a few years sober. If not for treatment, he would likely be dead, or if not dead, we would not have the relationship that we have enjoyed. There is saying in the treatment world that it is hard to love another person when you are in a relationship with substance abuse or addiction. His continued recovery has been a welcome part of our relationship.   

Opioids are a special challenge. The body becomes physically dependent on opioids—stopping brings both physical and emotional pain. Stopping is further complicated by the fact that opioids are prescribed for pain. Withdrawal brings physical pain resulting from craving the drug, the psychological impact of withdrawal, and unearths the underlying pain that the drug was prescribed to control.  For many, opioid treatment requires action on all three fronts. This is more than many most people can tackle without trained professional help.  

The background readings and discussion at the summit changed my mind on Medically Assisted Treatment—also known as drug replacement therapy. “Old school” thinking is that drug therapy was just replacing one addiction with another. The experts contend that with opioids they are replacing a harmful (and potentially deadly addiction) with other drugs that block with bodies response to the opioids without incurring the physical pain of withdrawal. This improves the ability to treat the addiction or dependence. Tapering—or gradually reducing the dosage to zero—from the replacement drugs shows a higher success rate than tapering from opioids.  Effective treatment still requires therapy to deal with the psychological impacts and alternative methods of dealing with underlying chronic pain.     

Access to treatment is essential to ending the opioid crisis. Treatment takes time and can be expensive. The cost of not making treatment available is a loss of productivity, broken families, destroyed relationships, and death. As a society, we need to do all we can to assure that every person who wants help has access to treatment.  We can’t stop the opioid crisis without access to effective treatment. With help and with treatment, there is hope.

To explore the background on treatment, see:

David Godfrey

David Godfrey is a senior attorney to the American Bar Association Commission on Law and Aging.  His research focusses on decision making, advance planning, legal ethics, and legal service delivery. He is on the board of the National Academy of Elder Law Attorneys.  He was previously responsible for age-related programming at the Access to Justice Foundation in Kentucky.  He earned his BA from Rollins College and his JD from the University of Louisville.