From The Caregiver’s Perspective (NAPSA)—“It’s just not anything we expected,” explained Ohio resident and nurse Lisa Roberts. “She was a typical, happy kid who did well in school—a straight-A student. Then, for eight years, thatall changed.” Lisa is referring to her daughter Mary’s addiction to opioids, an issue plaguing millions of individuals in our country.’ Opioid addiction can have devastating consequences for those in the throes of addiction as well as their friends and family. Despite increased awareness around the issue of opioid dependence, caregivers may not recognize signs of addiction before the problem spins out of control. And worse, most are unprepared for the downward spiral that ensues. Mary’s addiction began when she started using pain medications to manage back and knee pain caused by spending long hourson her feet as a waitress. The medications were not prescribed to her, but rather provided to her by a co-worker. Mary didn’t see the potential danger in using them, since they were prescribed by physiciansto people every day. Sadly, the danger wasvery real, and before long, Mary found herself physically dependent on the medications, spending almosther entire paycheck on opioids. “I started noticing that Mary was less concerned with her appearance. She stopped fixing her hair or putting on makeup—things she had always been very picky about,” explained Lisa. “Then she becamevery withdrawn, moody and evasive. She just wasn’t herself.” After Lisa received a warning from one of Mary’s friends about her pain “But at that point, it was too late—she was addicted.” Historically, opioid dependence had been viewed as a failure of motivation, willpower or character.’ More recently, however, scientists have proven that addiction has a biological basis whereby the repeated use of opioids may lead to physical changes in the brain. Over time, science has showna person’s brain can adapt to the regular use of opioids, leading the individual to need these drugs to function.’ Lisa witnessed this firsthand as her daughter spiraled further into addiction. As an adult living on her own, Mary needed pain medications just to function day to day. Unfortunately, this often meantbeing late to work when she ran out of gas—all her money wasspent on pain pills at this point—or taking long lunch breaks to go outin search of opioids to keep from gettingsick. “She was in complete misery,” re- counted Lisa. “She would get sick to the point where she couldn’t even get out of bed if she didn’t have opioids in her system. She would do anything to get her hands on pain medication—sometimes evenliterally selling the shoesoff herfeet to have moneyto feed her addiction.” Mary was 19 when she wentto rehab for thefirst time. After 30 daysin the program, she was discharged, but relapsed shortly after returning home. This was the first of seven voluntary admissions to various inpatient residential treatment facilities in an attempt to enter recov- ery over the course of the nextsix years. Somestays lasted as long as 10 months. Each time, Mary relapsed uponrelease. “Manyofthe programs were focused on abstinence alone and didn’t treat my daughter’s addiction as a medical con- @ relapsed. I kept an overdosereversal kit just in case, and I was vigilant in watching for any signs of relapse. It was very stressful and disappointing to watch her try so hard andrelapse every time.” Research has shown that combining medication with psychosocial support is a comprehensive wayto help patients with addiction, and including medica- tion with psychosocial support is now considered the optimal evidence-based approach to treatment.’ Treatment options include naltrexone, buprenorphine and methadone, as well as psychological support such as cognitive or behavioral therapy.’ Some medications, such as buprenorphine and metha- done, mimic opioid use. Other options, such as naltrexone, block the effects of opioids. Treatment plans should be tailored to the individual, and people should discuss with their providers what's bestfor them.’ “For years, I hoped that rehab would work for her, but my hopes and dreams were crushed manytimes. Mary wasusing heroin at that point and hadstarted to give up on herself, but I refused to,” stated Lisa. Lisa found an outpatient program that offered medication coupled with counseling. After seven previous attempts at recovery, Mary tried one more time andfinally found success with the program. As of today, Mary is off opioids and is continuing on her path to recovery. “We were lucky in many ways—I know many people who have lost loved ones to opioid addiction,” said Lisa. “It is so difficult to watch someone you care about go through somethingasterrible medication use, she confronted her as addiction, but you can’t give up. No daughter one night in her room after matter how dire things may seem,there she was acting suspiciously. Mary broke dition, and she relapsed every time,” are options outthere that canhelp.” down in tears, admitted to having an said Lisa. “Some would not even discuss For more information about opioid issue and promisedto stop takingpills. medication. I worried abouthertoler- dependence and treatment options, “T really think she meantit,” said ancelevels going up and down and her please visit www.endopioiddependence. Lisa, looking back on that moment. risk of overdose being increased if she com. wee nee en nen enn ne nnn ene ee WNT we nnn nn en nen nn ne 1 Substance Abuse and Mental Health Services Administration. (2015). Results from the 2014 National Survey on Drug Use and Health: Summary ofNational Findings. Retrieved September 2, 2016 from http://www.samhsa.gov/data/sites/default/files/NSD UH-FRR1-2014/NSDUH-FRR1-2014.pdf 2 National Institutes ofHealth. Effective Medical Treatment of Opiate Addiction: Consensus Development Conference Statement November 17-19. (1997). Retrieved September 2, 2016 from http://consensus.nih.gov/1997/1998treatop iateaddiction108html.htm 3 Williams JT, MacDonald JC, Manzoni O.Cellular and synaptic adaptations mediating opioid dependence. Physiol Rev. 2001; 81: 313. 4 5 Power, E.]., Nishimi, R.Y., Kizer, K.W. Evidence based practices for substance use disorders. National Quality Forum, Washington, DC; 2005. NASADADFactSheeton Opioids. (2015). Retrieved September 2, 2016 from http://nasadad.org/2015/02/nasadad-releases-fact-sheet-on-opioids/ Cavacuiti C. (Ed.). (2011). Principles ofAddiction Medicine: The Essentials. Philadelphia, PA: Lippincott Williams & Wilkins. 7 National Institute on Drug Abuse. (2010) Drugs, Brains, and Behavior: The Science ofAddiction. Retrieved September 2, 2016from http://www.drugabuse.gov/publications/drugs-brains- behavior-science-addiction/treatment-recovery 6 UNB-001440