Helping others beat addiction

Wednesday, October 18, 2017

Doctor, counselor share experiences in jobs

Many have heard the debilitating effects that methamphetamine has on the individuals who choose to use it, and no one is more familiar with those effects than the emergency room physicians who treat patients in crisis.

Trent

Dr. Tom Trent, Cox Monett emergency department medical director, discussed his experiences in treating addicts.

Winters

“On the average, about 10 percent of the patients we treat at Cox Monett’s emergency room are addicted to meth,” he said. “They often present with chest pain, respiratory distress, psychosis, depression, anxiety or poor dentition.”

Meth is made from a common cold medicine and a variety of household poisons, and the effects these substances have on the human body are legion.

“Meth rapidly ages the body and creates not only the conditions previously mentioned, but some that are permanent, including cardiac conditions, dental damage and the social consequences arising from decisions made while under the influence, which may include arrest and incarceration, along with social and family problems,” Trent said. “When a patient addicted to meth presents in the emergency room, we treat the conditions associated with their presentation and honestly council him or her on the destructive effects methamphetamine has on their bodies and lives. Sometimes, patients are simply trying to access pain

meds, anxiety meds, and other types of medications through a trip to the emergency room.”

Those suffering a real medical emergency should be honest about their illicit drug use.

“We ask patients if they are using illicit substances, and it’s detected in urine,” Trent said. “As physicians, we offer the best practice possible to every patient, regardless of their life choices. Providing untrue information to a clinician apprehends the decision-making ability when time is most crucial.”

Perhaps more intriguing is the thought processes behind an individual’s decision to use meth, and how clinicians work with clients to help break those addictions.

Chris Winters, MS/LPC, a counselor with the Barry County Drug Court, said there are a plethora of factors that contribute to addiction.

“A vast majority of clients are trying to find pleasure or trying to avoid pain,” he said. “When they start using meth, the euphoric feeling they receive from the brain is overwhelming. The receptors in the brain are flooded with dopamine, the pleasure-feeling chemicals produced by the body, to the point that some of those receptors are burned out. The reason addicts keep chasing that first high, and never quite achieving it, are due to changes in the brain chemistry. Meth hijacks those receptors and floods the pleasure pathways. It’s unnatural. And no matter how much an addict uses, it’s never the same as that first high.”

As the cycle of use escalates, brain chemistry continues to change and clients tend to get lost in an ever-widening downward spiral.

“Often, my clients tell me they have lost everything,” Winters said. “They’ve lost jobs, families, belongings, even their homes. A client will fail to see the harm caused to their own family by that addictive behavior. They lose that frontal cortex process, where moral reasoning is developed. The brain stem, what we call the ‘old’ part of the brain, controls all those automatic functions for survival, like breathing, blinking your eyes, and yes, it controls the cravings of an addict. It’s my job to educate them on the process of addiction and the process of recovery.”

That education is not an easy task.

“Drug Court focuses on teaching clients the immediate consequences of using the drug,” Winters said. “We work on developing delayed gratification, where the client starts at the bottom, works hard and then gets the reward. Meth is the opposite of all that. It’s immediate gratification.

“Unfortunately, when someone uses high doses of meth, they tend to develop hallucinations and aggressive behaviors. Meth tends to have a high addiction rate in a very short amount of time, whereas other substances, such as alcohol, are cumulative in their effects and addiction. One of the things we work on in drug court very early on is the denial and justifications clients need to tell themselves as an excuse for using. We incorporate step work, much like Alcoholics Anonymous, where they have to admit they are powerless over the drug.”

The process is not as easy as memorizing a few steps in a program.

“The client has to want to change,” Winters said. “But sometimes, the wanting isn’t enough. We have to work on people’s ambivalence toward change. They have to fill out a pros and cons list, and what they want out of life versus what they will have if they continue to use the drug. And we have to help people see the destructive nature of the drug.”

It’s disappointing to Winters when a client, who has struggled very hard to get clean, relapses into the lifestyle.

“I’ve seen them go back into the drug culture and then come back into counseling,” he said. “It’s part of the job. I understand addiction and part of the disease is understanding relapse is possible. We don’t look at it as failure. We try to figure out where in recovery they are weak, and work on those issues.”

Part of the challenge for addicts are the triggers that create an overwhelming urge to succumb to temptation.

“We try to determine what trigger led to what thought that led to relapse,” Winters said. “Did they run into an old acquaintance? Did they experience a life event that caused a stressful reaction? Stress is the number one relapse trigger among addicts.

“One of the things we utilize in drug court is the evidence-based treatments that have been studied and proven to work. Clients learn new skills, practice them, then come back and discuss what worked and what they were thinking. We also utilize empathy training, teaching clients to reason how they would feel if someone treated them the way they have treated others. They have to understand the things they do affect others, good or bad.”

Other strategies include learning about relapse triggers, high risk situations and how to set boundaries when former acquaintances call.

“Boundaries are somewhat difficult for some clients,” Winters said. “It’s not just the brain that has been affected, but their entire lifestyle. In a small community, it is difficult to avoid former settings or people, and even family holidays that might lead to a relapse. That’s why it is important for clients to build those sober support networks like Alcoholics Anonymous, Narcotics Anonymous and Celebrate Recovery. It’s the ‘birds of a feather’ theory. If clients spend time with others who are strong in their recovery, it’s going to strengthen their recovery.”

Although meth, and other addictive substances, can impact the brain’s chemistry, there is hope.

“Sometimes, the drug will change the brain chemistry permanently,” Winters said. “But, the brain has a tendency to heal — to re-wire itself. It takes two years for the dopamine levels to get back to average. But the brain is able to create different pleasure pathways.

“I believe, and hope, people can fully recover from addiction,” Winters said. “It happens every day. One of the best parts of my job is seeing people stay in recovery and live a healthy lifestyle.

“We are such a stressed society, we have to learn to cope, somehow. But you don’t have to be drunk or high to have fun. Addicts are not bad people. They are sick people who do bad things under the influence of the drug. We need to help these people and hold them accountable. Drug Court works. They will need to stay in programs like NA and Celebrate Recovery for the remainder of their lives, but sobriety is possible. And Drug Court is the vehicle that gets them there.”

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