Learn about the disease of addiction. Learn how opiates and opioids change the brain, and what treatments will put you on the path to recovery
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Addiction is a chronic disease; similar to other chronic diseases such as type 2 diabetes, obesity, and cardiovascular disease. Like other chronic diseases, addiction runs in families (genetic component) and is affected by both the environment and lifestyle choices of a person. Addiction is treatable with the right treatments such as long-term lifestyle changes and medication assisted treatment (prescription medications). Just like in other chronic diseases, recovery is a lifelong process, and relapse is common in those suffering from addiction.
According to the National Institute on Drug Abuse (NIDA):
“Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and lead to many harmful, often self-destructive, behaviors.”
Addiction is a treatable, chronic disease that can be managed successfully.
Research shows that combining lifestyle changes and behavioral therapy, with appropriate medications, is the best way to ensure success for most patients. Treatment programs must be personalized to address each patient’s unique needs including their drug use patterns, and underlying medical, psychological, and social challenges.
Like other chronic diseases, people suffering from addiction need ongoing care. We cannot expect that a person with addiction will go to a detox program or drug rehabilitation program for a short period, and then be cured. This is the same for all chronic diseases. We cannot expect someone with diabetes to get treatment for 30 days and then be cured. Addiction requires long-term treatment, and responds best to treatment that is personalized for each patient’s life story.
We are in the midst of an opioid addiction epidemic in the United States. The Centers for Disease Control (CDC) has called the prescription opioid epidemic the worst of its kind in U.S. history. Opioid addiction includes addiction to both prescription painkillers and non-prescription drugs like heroin. Prescription painkillers include drugs like oxycodone (Percocet), Oxycontin, morphine, hydrocodone (Vicodin), Opana, hydromorphone (Dilaudid) among others. As prescription pain medicines are becoming more difficult to obtain, more people are turning to heroin. In fact, according to the CDC, 75% of heroin users began with using pills.
Any long-term use of opioids puts you at risk for addiction, even if the drug is used as prescribed. Opioid users become physically dependent on opiates, because of changes that occur in the brain as it adapts to regular exposure (daily use) of the drug. Opioid dependence is a medical diagnosis that characterizes a person’s inability to stop using opioids even when it is in their best interest to do so. Opioid dependence is a major part of opioid addiction. When the drug is then taken away or stopped, opioid withdrawal symptoms occur as the body tries to readjust to the loss of the drug. Withdrawal symptoms can also occur when the dose of the drug is decreased. Withdrawal symptoms can be very intense, uncomfortable and include both physical and psychological aspects.
Most people who use opioids will develop a tolerance to them. This means that you need more and more of the drug to get the same effect. Using higher doses puts people at risk of overdose.
In the treatment of chronic diseases, it is essential to look for the root cause of the illness. Often people who suffer from addiction are using drugs to “self-medicate” because they don’t feel well. This means something different for everyone. Some people use drugs to help them deal with their chronic pain, while others use them to help with underlying anxiety and depression, among other bothersome symptoms. Existing untreated medical conditions often cause people to self-medicate with drugs.
At Livingwell Preventive Medicine, we believe that feeling well and taking back your health and wellness, are essential to addiction recovery. Our alternative addiction treatment program works together with you to help you strengthen your body, restore your wellness, and give you the tools to successfully treat your addiction. This “holistic” approach significantly increases success compared to traditional addiction treatment programs.
Dr. Stacy Livingwell uses an integrative approach to addiction treatment. She uses functional medicine to help you find the root causes of your illness, instead of just treating your symptoms. This means searching for underlying triggers contributing to your addiction, and treating the “whole person”, not just the addiction. Doing so will reduce the cravings that cause addiction. Dr. Stacy will take the time to get to know your life story and personalize treatment to your specific needs as an individual.
Dr. Stacy uses advanced lab testing to search for root causes of illness and symptoms. She tailors your treatment program to your unique needs, and helps you feel well again. Your addiction treatment program will include a combination of lifestyle changes and medication, when appropriate. Dr. Stacy specializes in using natural and alternative methods to help support your health.
Integrative addiction treatment means combining conventional treatments with alternative and holistic methods to achieve the best results. Conventional treatments include Medication-Assisted Treatment for opioid dependence (Buprenorphine, Suboxone). We use an evidence-based approach to your care, following current guidelines and recommendations from SAMHSA, NIDA, ASAM.
Accordingly, we recommend addiction counseling and behavioral therapy, and provide referrals in the Boulder, Colorado area to help you find the provider who best fits your needs. We will work together with the provider of your choice to coordinate your care as you continue in recovery. Working with a counselor allows you to work towards restoring your relationships that may have been damaged by your addiction, and to develop a support system to aid in your recovery.
Our alternative and holistic treatment methods include a combination functional medicine and natural treatments personalized according to your individual needs. This approach ensures all aspects of wellness are considered, including mind, body and spirit.
- Wellness coaching
- Innovative lab testing to detect underlying imbalances
- Nutritional assessment and counseling
- Nutritional supplements
- Herbal medicine
- Sleep evaluation and support
- Movement and exercise
- Mind-body medicine (yoga, biofeedback, progressive muscle relaxation….)
- Referrals to area specialists (acupuncture, massage, craniosacral therapy….)
Most importantly, we work with you through a compassionate and respectful doctor-patient partnership. You will always be treated with respect here. Our program offers warm, private, outpatient treatment to support you in your recovery. We work together with you to help you find hope and healing.
Medication assisted treatment (MAT) is the use of medications including buprenorphine, methadone, and naltrexone to treat opioid addiction. Buprenorphine is used in medication-assisted treatment to help people reduce or quit their use of heroin or other opioids like prescription painkillers.
Buprenorphine (Suboxone) is an important part of successful opiate addiction treatment for many patients. Research has shown that opioid abusers that attempt abstinence-based treatment have a very high relapse rate, with more than 90% returning to opioid abuse within one year. Medication assisted treatment with Buprenorphine (Suboxone) gives those suffering from addiction the best chance at recovery.
Buprenorphine is an opioid medication, that is FDA approved for treatment of opiate addiction, given in the privacy of a physician’s office. Buprenorphine/Naloxone are the active ingredients in Suboxone, Zubsolv, and Bunavail. Buprenorphine can be prescribed for take home use by patients in an outpatient treatment program. This makes Buprenorphine different from methadone treatment, because methadone must be administered in a specialized clinic setting. Using Buprenorphine (Suboxone and other similar products) allows much better access for patients seeking opioid addiction treatment.
Buprenorphine is a “partial opioid agonist” which makes it different from other opioids (such as oxycodone, hydrocodone, Oxycontin, heroin).
Naloxone is a medication approved by the Food and Drug Administration (FDA) to prevent overdose by opioids such as heroin, morphine, and oxycodone.
Click here for a graphic/image to better understand how buprenorphine works.
The medication supports patients in recovery by allowing for:
- Less cravings for opioids
- Less euphoria (“high”) and less physical dependence
- Relief from withdrawal symptoms
- Reduced use of illicit opioids (like heroin)
- Blocking the effects of other opioids
With successful buprenorphine (Suboxone) treatment, the addictive behavior often stops. Patients regain control over drug use and see an end to the constant cravings, compulsive behaviors, drug seeking, and loss of control.
Relief from these symptoms of opiate addiction, allows patients to have a chance to work on the other aspects of their addiction- lifestyle, social situation, psychological aspects and more. This enables patients to take back their life and control their own health and wellness.
Dr. Stacy Livingwell specializes in helping patients suffering from opioid addiction by using medication assisted treatment with buprenorphine. Dr. Livingwell completed training and certification in Buprenorphine and Office-Based Treatment of Opioid Dependence through the American Society of Addiction Medicine. She continues to maintain her certification through SAMSHA’s waiver program.
Buprenorphine treatment is tailored to each patient’s individual needs.
One of the following buprenorphine/naloxone medications is selected.
- Suboxone (most commonly known currently)
- Zubsolv
- Bunavail
Buprenorphine Treatment Process (Medication Assisted Treatment)
Induction:
After intake into the Livingwell Preventive Medicine program, we will support you as you are changed from your current opioid of choice (prescription painkillers, heroin, methadone) on to Buprenorphine. The first step is known as the “induction” phase as you are started on to the Buprenorphine. You must arrive to the induction visit experiencing mild to moderate opioid withdrawal symptoms. This is done under close monitoring by the doctor. You will then be given your first dose and your response to the initial dose will be assessed. The doctor may also recommend additional medications to help reduce withdrawal symptoms if necessary. Your dose of buprenorphine will be adjusted until you no longer experience withdrawal symptoms or cravings. Urine drug screening is generally required for all patients during the initial phase of treatment.
Stabilization and Maintenance:
Once the correct dose of buprenorphine (Suboxone) is determined, you will remain at this dose. At ongoing follow up visits, the doctor will continue to assess whether your dose is working, or needs to be changed. Treatment compliance will be monitored. You will come for regular office visit appointments according to your individual treatment plan. The length of time patients spend in the “maintenance phase” varies between individuals, and will be determined through your work together with the doctor.
Buprenorphine (Suboxone) is prescribed as part of a comprehensive addiction treatment program. Your progress through opiate addiction recovery, in the buprenorphine treatment program, will be enhanced and supported by our integrative addiction services.