Category: Addiction

Recovery is about stories. Stories of hope, stories of change.

In addiction, the stories we tell about ourselves do not tend to have happy endings. Rarely are we the authors of our own journeys, and if we were to assign ourselves a character, it would not be the hero/ine. More often we see ourselves as the villain, or the victim, or a combination of both. Sadly, in recovery we often continue to tell ourselves stories that keep us stuck. Sit in your average 12-step meeting and you are likely to hear the same story shared over and over again; only the names and places are much different.

Sit in them for too long and you may find yourself, as I did, subtly altering your own tale of recovery to fit the dominant narrative: you have a disease that is “doing push-ups” as you speak, getting stronger even as you recover day by day; without the group, without a mysterious Higher Power, you are powerless, defect-ridden, and utterly self-centered. You must call yourself an addict forever, lest you forget.

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Addiction is a health issue, not a moral failing, and physicians need to champion public policy changes that put treatment first and reverse the “absurd” focus on the war against drugs, which has never and will never work, say editors of the BMJ. “All wars cause human rights violations and the war on drugs is no different,” write Fiona Godlee, MD, editor-in-chief, and Richard Hurley, features and debates editor of the BMJ.

The editorial was published online November 14 in the BMJ. Docs Can Make a Difference Criminals who control the supply of drugs are responsible for “appalling violence” that has resulted in 65,000 to 80,000 murders in Mexico alone during the past 10 years.

In the United States, putting drug users in prison for even minor offenses has led to the highest incarceration rates in the world, and thousands have been killed in the Philippines since President Rodrigo Duterte called for brutal vigilantism against those who deal drugs. They note that the war on drugs is costing society at least $100 billion annually, yet it has clearly failed to make a dent in either the supply or demand of illicit drugs or reduce addiction rates or harm.

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When babies are born dependent on opioids, typically they are whisked away from their mothers, put into the neonatal intensive care unit (NICU), dosed with morphine to get them through withdrawal, and gradually weaned off the drug—a process that can take weeks.

Research now suggests that this long-established standard of care may be the worst way to care for a newborn with opioid dependency, or neonatal abstinence syndrome (NAS). The NICU is busy, noisy, and bright, filled with beeping machines, other crying babies, and bustling nurses. Infants are fed not when they’re hungry but e very three hours on a schedule. When they cry, there may be no one to hold them if the nurses are busy attending to other babies. And when they finally can sleep, they may be awakened to be poked and prodded for medical tests and treatments.

A new initiative is turning NAS treatment on its head with a shockingly simple concept: treat the baby like a baby and the mom like a mom. Keep the baby and the mother together. Keep the baby out of the NICU. And don’t give the baby opioids unless absolutely necessary.

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