September is National Recovery Month, launched in 1989 to promote new evidence-based treatments, celebrate the vibrant recovery community and service providers who provide support, and offer hope to those still struggling.
Three years ago this month, Pennsylvania joined Strong City Farman effort led by the American Farm Bureau Federation and the National Farmers Union to bring attention to the opioid epidemic in farming communities and provide resources for those struggling with addiction.
The scale of the crisis in rural America was staggering, with 74% of farmers and farm workers saying they had been directly affected by opioids, with three in four farmers saying it was easy to access large amounts of non-prescription opioids, and one in three adults. saying drug treatment was readily available.
“Drug addiction is a complex disease that cannot be reduced to simple neurobiology,” said Dr. Adam Scioli, medical director and chief of psychiatry at Caron Treatment Center in Wernersville, Pennsylvania. The non-profit drug rehabilitation facility was founded as Chit-Chat Farms by recovering alcoholic Richard Caron and his wife, Catherine (Tildon) Caron, and opened its doors to its first patients in 1959.
Multiple factors play a role in both the ddevelopment of a substance use disorder and its progression, Scioli said, including co-occurring mental health issues, such as depression or anxiety, which may also require management.
Sickness, not sin
“I had a mentor here many years ago who had a very, very simple way of summarizing it,” said Reverend Jack Abel, senior director of spiritual care at Caron. “He was a Catholic priest, but he used to say, ‘Jack, from what I understand, it’s a disease, not a sin.’ And I think that can be helpful, sometimes, for people who have a strong religious background.
Religious communities in particular may tend to view addiction as a moral failing when it is not, he said. Such a view can contribute to a reluctance to seek help, he said, and offer the false solution that a person in active addiction can simply make better choices, or simply repent.
“One of the things that sort of defines addiction, in my experience, is that it’s frustrating and irrational,” Abel said, and so appealing to an addict’s power of reason can be useless. Thus, he says, it is difficult to intercept addictive behavior without intervention.
Faith communities excel in caring for the sick, he said, and so caring for the afflicted is about changing the mindset of that community.
“It’s a different approach, where we encourage healing instead of repentance,” Abel said. “And that’s the direction I’ve always tried to take with people, whether they’re religious or not.”
don’t go away
“Over the last 20 years, I would say, the increase in the total number of deaths involving opioids, particularly fentanyl and other synthetic opioids, has increased dramatically,” Scioli said, adding that the opioid crisis has eventually declared a national public health problem. emergency in the fall of 2017.
Fentanyl, which is about 100 times stronger than morphine and 50 times stronger than heroin, is sold by prescription, usually as a slow-release patch for the treatment of severe pain. It is also made in illegal drug labs.
“We are acutely aware here at Caron of the need to address substance use and, in particular, opioid use, as there is a high likelihood of death,” Scioli said. “It can certainly happen very quickly. This can certainly happen from the first use. And the unfortunate fact is that the opioids people are ingesting have become more dangerous because fentanyl has adulterated them or because people are actually looking for fentanyl.
A lot of fentanyl overdoses happen to people who don’t even realize they’re taking the drug, he said.
Opioids are in a class of their own when it comes to treating addiction, Scioli said.
“At Caron, we actually have an opioid track where we focus on opioid use disorder exclusively as a separate and distinct phenomenon, which requires a biopsychosocial spiritual approach,” he said. .
This approach involves ensuring the patient has a safe and comfortable withdrawal, helping them decide whether to use a drug – such as buprenorphine (Suboxone) – to help them recover and recover. ensure he has the support network to sustain him once he leaves the treatment facility. .
“Addiction is definitely a family disease, and we’ve recognized that since our origins,” Scioli said. “There is an expression here at Caron that resonates with me, that ‘the patient is the family and the family is the patient’. We’ve talked about the importance of a supportive environment, and that includes, when someone starts treatment, making sure that family members or loved ones understand that addiction is a disease and not a choice. and that there will be certain supports that their loved one needs to be successful, not just changes at home, but changes in attitude towards their loved one, who is now a patient.
Unfortunately, Scioli said, not everyone is able to overcome addiction.
“And when there is a loss, the loss is felt by many more people than that person who was trapped in addiction probably ever realized. The disease of addiction does not discriminate based on socio- economic, sex or profession, whether or not you have children or are a child.