At the recent candidate forum in Crawfordsville, the opioid crisis was mentioned by county council candidate Greg Wilcox who correctly identified the problem as a disorder. Everyone seems to agree that the crisis connects to a multitude of issues, from victims dying to jail overcrowding to rising medical costs and more. If you are a particular age, you probably remember back in 1971 when then President Richard Nixon declared a war on drugs.
That was almost half a century ago and it’s a war that, if we’re not losing, we’re certainly still fighting.
I heard an interesting presentation from Dr. Nicholas Piotrowski, an addiction psychiatry specialist in Lafayette who is the Medical Director of Addictions for Wabash Valley Alliance. He gave a talk comparing how the medical community typically treats patients with diseases like diabetes as opposed to substance abuse disorder patients.
Let’s start with diabetes. Teams of specialists get involved so the patient has an expert at every turn. A long-term plan is set up for what is likely life-long treatment. The idea is to start the treatment as soon as the disease is detected. And medicine is prescribed to give the patient the best chance of success.
Now let’s take a look at how substance abuse disorder is typically treated.
A team of specialists? Not likely. Long-term plan? Fat chance. If there is any help that doesn’t involve a trip to the emergency room or law enforcement, it could well come from an over-taxed social worker or counselor who probably has far more patients than they can see. Early stage treatment? Some medical experts will tell you that the addict has to hit rock bottom before real and lasting improvement can begin. And medication? Despite conclusive evidence that some drugs are helpful in treatment, there is a belief that cold turkey is the only way to go.
Can you imagine if we treated diabetics or cancer victims that way? Of course not. So why do we do it?
“The one word answer in my opinion is stigma,” Dr. Piotrowski explained. “People apply a moralistic view instead of a medical view. Addiction is a criminal issue, a moral issue or a social issue, and not a medical issue. Our understanding has changed quite a bit.”
How so?
“Why do substance abuse disorder people make bad decisions? Well, it turns out that there are issues with the brain,” Piotrowski said. “To some degree, addiction seems impossible to eradicate. One of our challenges as a society is to do everything we can to help people not develop substance abuse disorder – and treating those who do. And approach it in a more human understanding. It is not linear. Even with the best treatment we have available it takes time.”
Time is something many addicts don’t have. The fact is, professionals who can help are vastly outnumbered by those in need. So instead of sitting in a waiting room, many of those suffering from addiction end up in already overcrowded jails . . . or worse.
“The roadblock in all of this is that there aren’t enough licensed therapists and counselors,” Zoe Frantz said. Frantz recently came on board with Wabash Valley as the Chief Strategy Officer and Director of Business Development. She explained that the organization has openings for licensed therapists, licensed clinical addiction counselors, licensed marriage and family counselors, case managers . . .
The need is endless. The applicants are not.
Wabash Valley has an office in Crawfordsville on Darlington Avenue. Frantz said those who need help can start there.
Last week, Wilcox made the point that the crisis isn’t limited in its scope. It touches almost everyone. Unless and until things change – from treatment strategy to perception to how many professionals go into the field – the crisis remains.
Two cents, which is about how much Timmons said his columns are worth, appears periodically on Tuesdays in The Paper. Timmons is the publisher of The Paper and can be contacted at