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Hey guys, I got this letter from my current Dr. I found this letter very informative and helpful on understanding what causes opiate dependency & addiction. I hope you find it very helpful also! And for those of you who haven't came clean yet to their family or others, this is a very good letter to help them understand what we're going through, Good Luck! :bouncing: Oh, and sorry so long!!!!!! :)


What You Need To Know About Your Addiction
Drug addiction is a medical illness. Informed physicians and other scientists recognize addiction as a medical illness. Many people make the error of considering drug addiction a personal choice or a personal shortcoming. "There's something wrong with any person who would use drugs," they say, and they don't mean it in an understanding manner. Well, they are partially correct because there is something wrong with a person who suffers from addiction but it isn't a personality issue or an issue of self-worth. A person who suffers with addiction has brain chemistry that doesn't function as it should and the reason it isn't working properly is due to an inherited gene. It is a disease very similar to clinical depression in its mechanism.
About 98% of all human beings produce a certain brain-chemical that helps them tolerate pain and sever stress. This chemical increases pain tolerance and creates a sense of well-being. It makes a person believe they are going to be ok when things get uncomfortable. It is one reason why human beings can survive serious injury and stress. This brain-chemical is called morphine. Most people don't realize that all mammal brains make morphine(morphine allows a fox caught in a trap to chew off its leg, run away on 3 1/2 legs and survive to live another day. It allowed a young man who was rock climbing in a canyon to cut off his arm when it got caught between 2 rocks and trapped him for days until he was dying from exposure to the elements and starvation. So, what does this have to do with drug addiction?
2% of all human beings don't make morphine. They don't make it cause they inherit a gene that doesn't allow the morphine system to work properly. These people feel pain worse than most and they don't generally deal with stress. But the real problem is that a person don't know they don't make morphine until its too late. As long as they never get an opiate or alcohol in their body there isn't a serious problem, although, the fact that they never feel quite right may lead them to use other mind-altering drugs like marijuana, cocaine, benzodiazepines (Zanax,Valium,etc.) or alcohol before they try an opiate. But the real proof of this genetic problem shows up when a person takes morphine or any other opiate and it energizes them, makes them feel more alert, better than they have ever felt before. This almost always means the individual has addiction genetics.
Some people discover their addiction genetics when prescribed pain medication by a physician. Unfortunately too many physicians don't know that a patient should not like the feeling they get from an opiate. If they like the opiate, the drug needs to be stopped immediately and some non-narcotic painkiller prescribed in its place.
Also the individual needs to be warned that they are carrying the gene that will cause addiction to alcohol or opiates or both. For some reason they are not yet clear to researchers, alcohol is also a great risk to people who carry this addiction gene.
The 98% of humans whose brains do make morphine will generally feel sick when they take an opiate. Opiates will make them groggy or sleepy. These people will not like taking an opiate. They don't have the disease and can't get it. They can become chemically dependent on an opiate or any other drug that can cause chemical dependence(barbiturates,bezodiazepines,amphetamines,cocaine) by using too much for too long, but once they suffer through the chemical withdrawals(nausea,vomiting,cramps,sweats,and even seizures), they don't crave the drug or need it anymore. They are done with it. So, we don't want to confuse chemical dependence with the disease of addiction. They are different and must be treated differently. And again, it's very difficult for someone who isn't carrying the addiction gene to become chemically dependent on opiates because if a person makes morphine properly in their brain, taking opiates will not make them feel good at all.
So now you can understand why and how you become addicted to opiates. Your need for opiates is very similar to the need a diabetic has for insulin or the need a person with an under-active thyroid gland has for thyroid hormone. You have a need for opiates because your body doesn't make morphine or cannot properly use what it makes and it is normal for morphine to be present in every human body. This model of addiction is the way the disease should be perceived. It is this model that in the mid-nineteen-sixties led to the discovery that a potent long acting opiate called methadone could help people from suffering from addiction.
Methadone is used to establish a steady safe blood level of opiate in a patient suffering from addiction so they will not crave opiates and so they can work, think, drive, raise their children, be a spouse, and a contributing member of the community. In short, the replacement of a normal needed body substance allows a person suffering from addiction to live a reasonably normal life. And because they feel better, they are able to work with a counselor and gain insight into their sickness so that many can eventually become sober(free of all drugs that can cause addiction) with the help of Alcoholics Anonymous or Narcotics Anonymous.
Overall, about 15% of patients who suffer with opiate addiction do achieve long-term sobriety. The number isn't higher because it isn't easy to get an remain sober but methadone maintenenance is also very successful as long-term treatment for those who are unable to maintain sobriety. About 35% of people who try methadone maintenance rehabilitation actually succeed at controlling their addiction. Generally speaking, the older a person suffering from addiction becomes the harder it is to become and stay sober. It is easiest for those under 30, hardest for those over 50. If you are under 30 and serious about getting sober it will generally take 18-24 months of treatment and hard work. As you get closer to 40 that timetable will increase. In my 40 yrs. of treating people with addiction I have not seen a patient over 52 years of age become and remain sober.
But keep in mind that if you cannot succeed with sobriety(which is difficult and requires a lot of energy) there is no reason no to succeed with long-term methadone treatment. Have you ever heard anyone tell an insulin-dependent diabetic to just sop taking his/her
insulin? If it is normal for a human being to make morphine in their brains but they don't because of an inherited disease, what is the difference between putting the morphine back inside compared to putting the insulin back inside? There is no difference except in the phobic view of some people who cannot recognize that addiction is a disease that is very similar to diabetes or clinical depression in that something necessary isn't being produced properly to the body.
But there are other issues that can cloud this picture, other issues that feed the phobic erroneous view of addiction. Once a person develops the constant need for opiates that individual may also develop characteristics that enable him/her to obtain the opiates they now need or crave. For the most part these are not good qualities, often involving manipulative, maladaptive, anti-social, and self-destructive behavior. And sometimes when a person who suffers with addiction also suffers with other serious emotional disorders that become uncontrollable. They are mostly intoxicated by drugs and unsafe in normal environments. Such people cannot be helped in out-patient treatment settings. Their behavior spawns society's terrible lack of understanding and compassion for those who suffer from the disease of addiction. These people need intensive inpatient addiction and psychiatric care in a hospital setting. Unfortunately this kind of care is not widely available or affordable.


Good Luck,

J.M. Degross, M.D.
Consulting Physician
Specializing in Addiction Medicine, Nephrology, and Palliative Care





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