Medication-Assisted Treatment – Battling Opioid Addiction in Tennessee

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The Opioid Crisis Continues to Sweep the Nation

It’s 2019 – more than two years since Trump announced that America was facing a public health emergency. The emergency wasn’t a deadly virus or a food shortage or a lack of medicine. This epidemic was caused by the use of heroin and legal narcotic painkillers. In the past decade, more than half a million people have died from a fatal opioid overdose. This is an emergency indeed.

After Trump declared this emergency, the federal agency Health and Human Services (HHS) followed up, reporting that 140 Americans were dying every day from drug overdoses, and 91 of these tragic  deaths were specifically caused by opioids.

Soon after, HHS created a 5-point strategy to combat the epidemic and ultimately save lives. We have yet to see if HHS’s strategies have been fruitful simply because the data is not available yet for study. Nevertheless, the opioid epidemic rages on.

Meanwhile, Integrated Health Centers Medical Director Dr. Daniel Sumrok came up with his own set of strategies for combating the opioid crisis – and they are working. He treats addicted individuals in a new and progressive way. Some have even called his work “revolutionary.” (More on this later).

How is the Opioid Epidemic Affecting Tennessee?

This public health emergency has reached far and wide, with virtually no city or town untouched. Sadly, this includes the Great State of Tennessee with cities like Nashville getting hit hard.

Tennessee ranks in the top 15 states for the number of tragic drug overdose deaths in a given year. According to the TN Department of Health, there were 1,304 opioid overdose deaths in Tennessee in 2018 (the most current data available). This means that three Tennesseans died every day of the year in 2018 from an overdose. While this number is staggering, it comes as no surprise.

In 2018 alone, Tennessee doctors wrote 6,052,014 opioid prescriptions. That same year, the U.S. Census estimated that there were only 6.7 million people living in TN in 2018. Interesting. That means every person who lived in Tennessee could have received a dose of addictive painkillers and there would still be almost 700,000 more prescriptions left to fill.

Thankfully, in response, the Tennessee State Government put together a comprehensive plan to end the opioid crisis in our state. We are waiting for overdose fatality statistics from 2019 to see how the plan will hold up under scrutiny.

What are Opioids?

We have covered a lot of ground so far. But, we haven’t specifically addressed a very important question: what are opioids? It may seem redundant to answer this question. Most Americans probably have at least a basic understanding of opioid drugs at this point due to extensive news coverage.

Nevertheless, education is very important when it comes to substance abuse treatment. The more we know, the more equipped we are to treat addiction and empower people seeking recovery.

To keep it simple, let’s just say that opioids are a specific classification of drugs derived from opium, which is found in the poppy plant (grown in places like Afghanistan and Columbia). These are powerful, highly addictive substances.

Morphine, Codeine, Oxycodone/Oxycontin, Hydrocodone, and Fentanyl are all classified as legal opioid drugs when they are prescribed for a legitimate medical reason – namely, pain management.

Heroin also falls into this classification of drugs. Reports indicate that as much as 80 percent of all new heroin users started out abusing prescription painkillers. They switched to the illegal street drug because it is cheaper and easier to get.

What is Opioid Addiction?

You have likely heard at least one widely accepted definition of opioid addiction. For instance, NIDA defines addiction “as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain.” NIDA considers addiction as both a complex brain disorder and a mental illness.

In the United States, the 12-Step Model (think Alcoholics Anonymous or NA) is the most popular method for treating opioid addiction. In this view, addiction is a disease that is progressive, chronic,  and fatal if left untreated.

Dr. Sumrok has a completely different perspective. He believes that ritualized compulsive comfort-seeking (commonly called “addiction”) is an appropriate response to what he calls “Adverse Childhood Experiences” or ACEs. Just like bleeding is a normal response to being stabbed, substance abuse is a normal response to trauma.

Opioid Withdrawal Symptoms Keeps Users Addicted

As we have mentioned, opioids are highly addictive. This means that when a user doesn’t take their regularly scheduled dose, they will get very sick and experience withdrawal symptoms.

Withdrawal symptoms are agonizing. Plus, they can be deadly, lead to a stroke, or cause a seizure. 

These symptoms include flu-like symptoms, extreme head-to-toe body aches, vomiting, diarrhea, and a number of other nasty manifestations of withdrawal.

An opioid use disorder becomes a vicious cycle. Addicted people use the drugs because they are physically addicted and will get very sick if they do not have their proper dose. So, people will chase after a fix and do whatever it takes to get it. They may want to quit, but the withdrawal symptoms will drive them back to drug use every time.

Are You Hooked on Opioids?  

Addiction can be tricky. It thrives on denial and dishonesty. It tells you things aren’t as bad as they seem; that you can quit anytime you want to. You may think your family and friends are just nagging you when they express concern or you might make excuses for your behavior. Or, maybe you think you have your drug use under control, when it is actually controlling you. 

Nobody wants to admit to themselves or their loved ones that they are addicted. Unfortunately, there is still a stigma associated with addiction. 

But, we want you to know that there is no shame in admitting you need help. In fact, reaching out for help requires great courage. Getting honest with yourself about your substance use is the first step to healing.

Please take a moment and answer these questions as honestly as you can with a “yes” or “no.”

  • Are you purchasing opioids illegally?
  • Do you use illegal drugs like heroin regularly?
  • Are you reliant on prescription opioids like Oxy to get you through the day?
  • Do you get sick if you do not have your usual dose?
  • Do you lie to your family and friends to hide your drug use?
  • Are you spending a considerable amount of money to support your habit?
  • Do you miss work or important engagements because of your drug use?
  • Have you had any legal problems because of your substance use?  
  • Do you often question if you are addicted?
  • Have you tried to quit on your own, but found that you could not?

If you answered “yes” to any ONE of these questions, you might be in trouble. And, the fact is that people who are not addicted do not sit around wondering if they have a substance use disorder.

That nagging feeling you may be experiencing – the one that says you have a drug problem – is definitely something to be concerned about.

We want you to know that recovery is possible. Meet real people in Tennessee who have struggled with an addiction to opioids or lost a loved one to a fatal overdose. You are likely to see similarities and relate to these people in a special way.

How is Opioid Addiction Usually Treated?

There seems to be some common themes among those who treat OUD in rehabilitative settings. In fact, many might argue that most rehabs offer a cookie-cutter, one-size-fits-all approach.

For example, traditional programs typically follow the same timeline:

Patients undergo an assessment to determine their appropriate level of care. Patients will usually be told that they need to go to a detox (which typically lasts 3-7 days). Then, after detox, patients will attend either an inpatient or intensive outpatient program that lasts up to 90 days. This will be followed with sober living, regular 12-Step meeting attendance, and ongoing therapy.

We believe every individual should have a treatment plan specifically designed for them. Everyone is different and what may work for one person may not work for someone else.

We Have a Unique Approach to Addiction Treatment

There are some stark differences between our program and other programs. For starters, Integrative Health Centers is not a rehab. We are a primary care facility that offers individual opioid addiction treatment services in Tennessee. We also practice general medicine. People come to see us for different reasons and we provide custom treatment plans to every one of our patients. We care about health and healing.

Our Opioid Recovery Program is offered in McKenzie and Nashville, Tennessee. It is unlike any program of its kind in the state. Dr. Sumrock’s formula is fairly simple.

“Treat people with respect instead of blaming or shaming them,” he said in an interview with ACES Too High News. “Listen intently to what they have to say. Integrate the healing traditions of the culture in which they live. Use prescription drugs, if necessary. And integrate adverse childhood experiences science: ACEs.”

Dr. Sumrock said his patients respond very well to this approach.

The Connection Between Addiction and Adverse Childhood Experiences

This is another example of how we differ from the average rehab. Remember that Dr. Sumok categorizes addiction as “ritualized compulsive comfort-seeking,” which is the direct result of an Adverse Childhood Experience, or “ACE.” He believes one of the solutions to the problem is the healing that only happens in trauma-focused therapy.

ACEs are negative childhood experiences that have the potential to harm a child’s developing brain. These experiences will change how a person responds to stress. ACEs lead to addiction, chronic disease, and mental illness.

Here, we work with patients to heal old wounds so they can stop engaging in self-destructive behaviors like substance abuse.

What is an Adverse Childhood Experience?

Adverse childhood experiences are traumas that children experience from birth to 17. Here is a list of the 14 different types of ACEs:

  • Physical abuse
  • Emotional abuse
  • Sexual abuse
  • Emotional neglect
  • Physical neglect
  • Domestic violence
  • Household substance abuse
  • Incarcerated care provider
  • Mental illness in the home
  • Witnessing violence
  • Living in unsafe neighborhoods
  • Experiencing racism
  • Living in foster care
  • Experiencing bullying

This list represents the most severe traumas one may experience during childhood. But, you might be surprised to learn that most children enter adulthood carrying the pain of at least one of these events.

An ACE Study revealed that 64 percent of all Americans experienced at least one Adverse Childhood Experience during their younger years.  

Learn more about the science behind ACEs.

What is Medication-Assisted Treatment (MAT)?

We have mentioned that Dr. Sumrok’s approach to opioid addiction treatment may seem unconventional. However, Dr. Sumrok incorporates evidence-based methods, including Medication-Assisted Treatment into his practice. He believes the use of drugs like Buprenorphine are one of the solutions for painkiller abuse; one that is widely underused.

To keep it simple, Medication-Assisted Therapy (also commonly known as “MAT”) combines behavioral therapy with medications that are used to treat substance use disorders like OUD.

For example, Buprenorphine (commonly sold under the brand name “Subutex”) is often used during this type of treatment. It has proven to be highly effective. This is just one of many opioid replacement drugs used to treat an OUD.

This medication allows addicted people to stop abusing heroin or prescription narcotics while essentially bypassing the withdrawal process. This allows them to stop using dangerous drugs like heroin or Fentanyl.

A doctor must oversee the use of MATs like Buprenorphine. That’s where Dr. Sumrok steps in. At the beginning patients are given an appropriate dose of medication. Slowly over time, the dosage is reduced so the person is basically “weaned” from opioids until they are no longer using them at all.

During the time that they are using Buprenorphine, they will undergo behavioral and trauma therapy.  

Buprenorphine (like other MATs) is a semi-synthetic opioid partial agonist. It produces effects that mimic heroin, Methadone, and prescription narcotics. However, the user does not experience a buzz from the medication like these other drugs. Plus, the likelihood for addiction is significantly lower.

There are many reasons why MAT is effective in treating someone with an OUD. Here are just a few:

  • The medication suppresses symptoms of withdrawal, which makes quitting more comfortable
  • MATs decrease cravings for opioids, reducing the likelihood of a relapse
  • An opioid replacement drug minimizes illegal drug use because scoring drugs on the streets is no longer necessary
  • Users can benefit from MAT while continuing to work, attend school, take care of their families, and complete their daily tasks.
  • Perhaps most importantly, Medication-Assisted Therapy allows people who want to stop using opioids an opportunity to deal with very deeply-rooted issues that led to the addiction in the first place.

Here is everything you ever wanted to know about Medication-Assisted Treatment, provided by the Centers for Disease Control and Prevention.

What is Trauma-Focused Treatment?

Keep in mind that MAT is just one piece of a much larger picture.

In order for someone to recover from a painkiller or heroin addiction, they must understand how trauma plays a role in their situation. By confronting negative events and experiences that stemmed from childhood, addicted individuals are able to experience healing. When trauma is healed, behavior changes.   

Drugs like Buprenorphine help aid this process. They allow an addicted person to slowly and safely withdraw from heroin and prescription painkillers. Taking medication also allows them to engage in trauma-focused treatment, which ultimately addresses the root causes of their problems.

At Integrated Health Centers, we create a safe and nurturing environment that fosters healing and growth. This encourages patients to take an honest look at their upbringing and reexamine their current self-destructive behaviors.

No one chooses to be addicted. It just kind of happens. Trauma survivors begin self-medicating to ease the symptoms of Post-Traumatic Stress Disorder. Because these substances are highly addictive, they result in substance abuse and ultimately addiction.

Why is it so Important to Incorporate Trauma Therapy with Addiction Treatment?

According to Dr. Sumrok, “the solution to changing the unhealthy ritualized compulsive comfort-seeking behavior of opioid addiction is to address a person’s adverse childhood experiences (ACEs) individually and in group therapy; treat people with respect; provide medication assistance in the form of buprenorphine, an opioid used to treat opioid addiction; and help them find a ritualized compulsive comfort-seeking behavior that won’t kill them or put them in jail.”

He explains the brain science behind adverse childhood experiences like sexual assault or domestic violence to patients. He believes their addictions are a normal – and a predictable – result of childhood trauma.

From this perspective, Dr. Sukrock’s patients come to understand that they have nothing to be ashamed of. They heal their wounds and move forward in a more positive direction – without painkilling drugs.

If You Want to Find Freedom From Addiction, We are Here

If you are addicted to opioids, we want to help. Integrative Health Centers is dedicated to the success of our patients and the improved health of Tennessee. This is NOT a traditional rehab center. It is a primary care doctor’s office.  We provide effective trauma-focused treatment for those who have an opioid use disorder.

Opioid addiction is a life-threatening condition that can be fatal. We believe that no one should have to die from a fatal overdose and leave behind a grieving family. And, of course, living a life trapped in the miserable hopeless addictive cycle is no life at all. Imagine what your life would be life if it didn’t revolve around your drug use. 

Addiction treatment is truly a matter of life or death. If you are ready to get help, we’re here.

In the meantime, check out these addiction treatment resources in McKenzie, TN and Nashville, Tennessee.