Contrary to the claim of a popular commercial, there is NO cure for addiction. Like a lot of other diseases, diabetes for example, there is ONLY treatment. Using diabetes as a comparison is valuable because it doesn’t carry the stigma that is often carried with addiction. No one wakes up in the morning wishing to have either disease or consciously makes the choice to have either. Much to the contrary, most people deny the possibility that they could ever develop either of these diseases. Consequently, the denial process usually delays them from getting treatment which allows the disease process to worsen.
In the beginning stages of diabetes, adhering to a diabetic diet which includes abstaining from refined sugars and making lifestyle changes (including regular exercise) can often times prevent the worsening of the symptoms. In its early stages, substance use disorders can also be avoided by lifestyle changes and abstaining from the substance of choice as well as the use of support groups (which are often either faith based or 12 step programs). Without changing, individuals with either of these diseases are usually unable to stay in remission.
When the above changes aren’t effective enough, the next step would be some type of medicated assisted treatment. With diabetes, the next treatment of choice is often oral medications which act to decrease the sugar levels in the blood. With substance use disorders it depends on the substance of choice. If the substance is tobacco, nicotine replacement patches or gum may be used to avoid the harmful effects of inhaling cigarette smoke (lung cancer or COPD). In the case of Opioid Use Disorder, the first choice in medication assisted treatment is often buprenorphine which partially blocks the opioid receptors to help stop the cravings and withdrawals related to opioids. This often times allows individuals to stop the never-ending chasing for their drug of choice and focus on learning coping techniques to live a substance free life.
When these treatments are inadequate in stabilizing a patient, the next step for both diseases is more intense medication assisted treatment. In the case of diabetes, it is most commonly the use of insulin injections or an insulin pump to supply what the pancreas is no longer able to supply. In the event of opioid use disorder, it is most commonly an oral medication called methadone. Unlike buprenorphine, methadone fully blocks the opiate receptors in the brain so that even if an opiate is taken, the individual won’t get high; additionally, it stops the cravings and withdrawal symptoms. Methadone treatment may be short-term. But in cases of individuals who have experienced chemical changes to the parts of their brains that allow a person to feel and function normally by using its own natural opioids called endorphins, it may be life-long.
If left untreated, diabetes and substance use disorders are fatal. Both of them affect families, friends, and livelihoods. Both are incurable.
