Tag Archives: Addiction Is A Disease

History repeats itself, unless we learn from prior experiences.  This is true in many aspects of life, and unfortunately it takes a toll on all of us in terms of individual and community well-being and longevity of life. This is evident not only in the wars that are fought around the world, but in our approach to medical care.  Knee jerk reactions have no place in medical decision making, and especially not by politicians who choose to ignore the data of scientifically proven treatments.  This is why I felt compelled to speak out about the recent legislative proposal in Maine to limit treatment options for opiate (Heroin & OxyContin) addiction.

This is also why I wrote the book, Addiction on Trial – to demystify and destigmatize the disease of addiction, but through the back door to reach a wider group of readers.  The book is written in a “novel” approach, as a murder mystery/legal thriller based on medical and legal truths – which will entertain, enthrall and educate; and I am appreciative of the 4.9 star Amazon rating. I hope you will enjoy both my Op-ed below as well as my page turning thriller, Addiction on Trial.

Thank you and please spread the word that repeating historical mistakes with politically motivated knee jerk reactions needs to end!

Sun Journal

Steven Kassels: Drug addiction is a medical issue, not a political issue

By Steven Kassels

Lewiston Sun Journal: Published on Sunday, Feb 8, 2015 at 12:12 am

We, as a society, have arbitrarily differentiated between acceptable and unacceptable drug addictions. Why else would our politicians enter into medical decision making?

After 50 years of accepted science, we know that the cost of not treating opiate addiction is up to 12 times greater than the cost of the treatment itself (National Institute of Health). Likewise, the benefits of having multiple medications available to treat various illnesses (patients respond differently to treatment regimens) have been well documented.

So why do some politicians want to insert themselves into the medical world and make arbitrary decisions about which medications to pay for when it comes to the disease of addiction, particularly when the political decisions fly in the face of medical science?

For those who want to believe addiction has no biological, psychological or sociological components (like the disease of diabetes), surely you will agree that abusing substances can cause disease. It is commonly accepted that Vice President Dick Cheney smoked way too many cigarettes (nicotine addiction) and Hall of Fame baseball player Mickey Mantle drank way too much beer (alcohol addiction). To one we gave a mechanical heart, followed by a heart transplant, and to the other we gave a new liver. They had “acceptable” addictions.

But how about the Vietnam veteran who came home addicted to heroin? Or young men and women who become addicted to painkillers after suffering some type of accident? Are there really “good addictions” and “bad addictions”? Is there really a difference between addictions?

If the differences are so great, why does the medication naltrexone decrease cravings in alcoholics and also block the effects of heroin? Are the addictions really all that different?

Why does methadone treatment still carry such stigma? And why are some politicians in Maine considering defunding it? Is that based in science or bias?

If we look back in history, it was President Richard Nixon who stated in 1971, “ ... methadone is a useful tool in the work of rehabilitating heroin addicts, and that tool ought to be available to those who must do this work” (Special Message to the Congress on Drug Abuse Prevention and Control). And in 1999, Mayor Rudy Giuliani — a mayor as tough on crime as any modern politician — initially recommended ending methadone treatment in New York, but upon review of the scientific data, he reversed his decision (Mayor Relents on Plan to End Methadone Use). Science won out.

By contrast, have you ever heard of politicians trying to prohibit coverage for other medications, such as Valium, because they have addictive qualities and thereby limiting doctors’ ability to treat certain illnesses? Have our politicians ever decided that people who smoke cigarettes should not get blood pressure medications because the condition is self-inflicted, chronic and might last years or decades?

Why do we have a heroin and opiate epidemic? We can blame doctors; we can blame pharmaceutical companies; and we can even blame our elected officials who decided to go to war in Afghanistan (U.S.’s $7 Billion War on Drugs Helped Grow Afghanistan’s Heroin) — but blame gets us nowhere.

Our focus should be a doubling of effort to limit the demand for drugs, and the way we limit the demand is through treatment. Incarceration, which is the failed and more expensive approach proposed by some politicians in Maine, just leads to a revolving door.

Some Maine politicians are also trying to claim that treatment with the medication Suboxone — which is a costly prescription medicine often provided through doctors’ offices, is superior to its less-costly relative Methadone — which is provided through heavily regulated clinics that are required to offer counseling and screening services to patients.

But, this is another political approach to a medical issue, and is short on science. Suboxone not only has a ceiling effect that makes it ineffective for many patients, it also has no mandatory requirement for patient counseling that is essential to effective addiction treatment.

We must remember that not all patients are the same, and every patient does not respond the same. Suboxone works for some and methadone is better for others. Should our politicians enter into the practice of medicine by defunding methadone, which is considered the gold standard for opiate addiction treatment?

Much has been made of government not getting involved between a doctor and a patient. I find the current proposal to defund methadone just that.

We cannot let decisions be based on fear, bias or a lack of understanding scientific studies. NIMBY does not work. Opiate addicts live in our communities and in our families, and they work in our businesses.

Politicians should not practice medicine, and they should not defund methadone. Treatment with this scientifically proven medication is fiscally responsible, and cutting it will put patients back on the street, increase crime, jeopardize public health and raise our taxes.

That is bad medicine for Maine.

Steven Kassels, MD, has been board certified in emergency medicine and addiction medicine. He serves as medical director of Community Substance Abuse Centers in Lewiston and Portland, and is the author of “Addiction on Trial — Tragedy in Downeast Maine.”

http://m.sunjournal.com/news/columns-analysis/2015/02/08/steven-kassels-drug-addiction-medical-issue-not-political-issue/1650811

Author : skassels
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September is National Recovery month, which is now in its 25th year!  "National Recovery Month is a national observance that educates Americans on the fact that addiction treatment and mental health services can enable those with a mental and/or substance use disorder to live a healthy and rewarding life. The observance’s main focus is to laud the gains made by those in recovery from these conditions, just as we would those who are managing other health conditions such as hypertension, diabetes, asthma, and heart disease.”

Recovery Month spreads the positive message that behavioral health is essential to overall health, prevention works, treatment is effective, and people can and do recover.  This year’s theme, ‘Join the Voices for Recovery: Speak Up, Reach Out,’ encourages people to openly speak up about mental and substance use disorders and the reality of recovery, and promotes ways individuals can use to recognize behavioral health issues and reach out for help.”

So this month, I wish to again focus my blog on further destigmatizing and demystifying the disease of addiction. This illness has no socio-economic barriers and two recent articles definitely reinforce this.  It is time to abandon any and all preconceived stereotypical notions we might have!  Give it up!  We are all affected, regardless of skin color, race, religion, education or employment status.

Please check out these two articles and be sure to let me know what you think!  Vermont Quits War on Drugs and Whites Account for Rise in Heroin Deaths

I hope you will consider reading my book “Addiction on Trial” and remember that its subtitle could just as easily read “Tragedy Anywhere USA”.  Please also consider checking out a previous blog: We Need More Doctors Like Saul Tolson to better understand the biological, psychological and sociological components of addiction.  And just imagine what it must be like to be the parent who gets a call that your son is A Heroin Addict in Jail

September is Recovery Month – Spread the word!!!

Author : skassels
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Unfortunately, life got ahead of me this summer as I went into a “full steam ahead” mode to get the word out about my book, interspersed with visits from three of my grandchildren.  I apologize for not having kept up with my self-imposed schedule of blog postings about my author endeavors and current addiction medicine related matters. To all of you who have read Addiction on Trial, thank you; and if you posted a review on Amazon, an extra thank you 🙂 

As you can see from my events listings, I will also be doing some traveling over the next few months.  I am looking forward to presenting at the Flight Attendants Drug & Alcohol Conference in Baltimore and at the Union League Club in New York City.  I must admit, the event in New York City is going to be a little extra special, as the Union League Club membership has included fifteen Presidents.  I am honored to be asked to speak about my book and the disease of addiction; and will be returning to the club in December for their annual book fair. The College of the Atlantic has also chosen my book as part of their curriculum for Psychology courses, and I will be visiting the campus this winter to meet with students, who I am certain will keep me on my toes.

Speaking of students, learning about addiction and related diseases need not stop after formal education.  I would like to share with you an article about how the National Basketball Association is educating its players about drugs and to again applaud the dedication and work by Chris Herren.

I hope everyone is having an enjoyable summer, and I again wish to thank all of you who have been so supportive of my book and my mission to entertain while educating through the back door … or maybe the side door 🙂  I will keep you posted on the progress of the next Shawn Marks Thriller, as I am currently working on the sequel, Lost to Addiction.  Shawn Marks, that egotistical but likable big shot Boston attorney, will definitely have his hands full as he attempts to defend the son of a wealthy shipping magnate. The adventures with Marks will continue as he travels to Europe and to the seedy underground of drug distribution centers in Guadalajara Mexico to solve this murder mystery.  Stay tuned!

Author : skassels
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Together we are spreading the word and effecting change, albeit one town at a time; maybe even just one person at a time - but changing hearts and minds requires patience and persistence!  I hope you will all consider passing this blog along to others, and I hope my book will continue to convert the "naysayers".  Please let me know your thoughts and also please consider signing up for a group discussion with me about the disease of addiction, spurred by my novel, "Addiction on Trial".  Just go to the Book Clubs tab above.  Thanks and keep up the fight!

The article below was written by Charles Eichacker in the May 2014 Health Quarterly, Ellsworth Maine.  Thank you Charlie !!!

Click on the image to read the article.
Ellsworth ME Health Quarterly May 2014 (1)

Author : skassels
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We are all the same and yet we are all different. The art of medicine, yes – medicine is an art as much as a science – dictates the need for individualization of care. Every person with hypertension has elevated blood pressure and every person with diabetes has high blood sugar, but approaching every patient with the same illness in the same manner results in cookie cutter medical care and ignores the need for individualization of care.

The same may be said of those afflicted with the disease of addiction. We all must keep an open mind regarding the best treatment approach. Having preconceived notions that a twelve step program should work for everyone; or that believing in a higher power is essential; or that suboxone is better than methadone; or that no replacement medication is better than any; or that underlying anxiety should never be treated with medication if the person has a prior history of addiction; or that one type of psychotherapy is best . . . or that every patient with hypertension first must alter their salt intake before starting medication; or that every diabetic will carefully watch their diet; or that . . . or that . . .

You get my point. I commend Mike Tyson, former heavy weight boxing champion, for telling us his story and finding his path to recovery.

Click here for NYT - Mike Tyson article

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Author : skassels
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