T he Long Journey Out of Opioid Dependency
“I was in so much pain that, some days, when I came home from work, I would sit on my couch, not move until the next morning, without eating…”
Jean-Marie, a fifty-year-old glazier, remembers vividly the agony that consumed him after being diagnosed with degenerative disc disease.
In 2012, a scan revealed a spinal birth defect that led to the degeneration of his vertebral discs. His doctors first prescribed painkillers and muscle relaxants, but the relief was short-lived. Subsequently, they turned to a powerful painkiller – sustained-release morphine, in a brand called Skenan.
No doctor warned him of the risk of dependency associated with high doses. Jean-Marie admits he didn’t read the instructions. For a week, the pain subsided. When it inevitably returned, his emergency fix provided temporary relief.
“I was in the moon,” he confided to his doctor, hoping for a solution. The doctor, seeming unfazed, suggested yet another form of morphine – Actiskenan, a faster-acting morphine. He took six tablets a day. “I took it to be able to work: you are in pain, you take one and you can leave,” he shared with a sigh.
Jean-Marie was taking around ten pills a day. He became dependent.
A Spiral of Dependency
Every three months, his prescription was renewed. No physical examinations, no probing questions.
Then, in 2017, the inevitable happened. Vomiting, sweating, diarrhea. He found himself in the emergency room, consumed by the agony of withdrawal.
“They gave me my dose, and I felt better,” he recalls.
The emergency doctor pointed him toward addressing his addiction. Referral in hand, Jean-Marie found himself at the university addiction service in Lyon, under the care
of Dr. Benjamin Rolland, who had recently founded the Lyon Resource Center for Addiction in May 2023. Slowly, month by month, Jean-Marie began to wean himself off the drugs that had come to both soothe and enslave him.
One question haunts him: why wasn’t he warned? “Why was I allowed to gorge myself on medications from 2012 to 2017? Why didn’t anyone tell me?”. The emotional wound of neglect persists.
An Ongoing Challenge
For many, opioids provide relief from agonizing pain. But they also hold a dangerous potency. Opioids encompass both natural substances like morphine, codeine, and synthetic ones like fentanyl or tramadol. Due to their effectiveness in combatting moderate to severe pain, often stemming from conditions like cancer, post-surgical recovery, or chronic pain
These drugs target opioid receptors within the brain, playing a key role in regulating pain perception. They also significantly elevate feelings of pleasure, reward, and well-being.
Walking the tightrope between pain relief and addiction is a complex and delicate process.
This is a story of navigating those complexities.
It’s an ongoing battle.
What are the underlying psychological and emotional factors that can contribute to opioid addiction?
## Interview with an Expert on Opioid Dependency
**Host:** Welcome back to the show. Today, we’re talking about a serious issue affecting millions: opioid dependency. With me is Dr. Brian Fuehrlein, a leading expert in addiction medicine and psychiatry from Yale University.
Dr. Fuehrlein, thank you for joining us.
**Dr. Fuehrlein:** My pleasure.
**Host:** We recently came across the story of Jean-Marie, a fifty-year-old glazier who became dependent on opioids after being prescribed them for chronic pain. Sadly, his experience isn’t unique. Can you shed light on why opioid dependency is such a prevalent problem?
**Dr. Fuehrlein:** That’s right, Jean-Marie’s story is unfortunately all too common. Opioids are highly effective painkillers, but they come with a significant risk of addiction. This is partly due to their powerful effects on the brain’s reward system, triggering the release of dopamine and creating a feeling of euphoria. Over time, the body builds a tolerance, requiring higher doses to achieve the same effect. This can lead to dependency and eventually, addiction. [ [1](https://www.psychologytoday.com/us/blog/addiction-outlook/202402/ask-the-expert-interview-with-yales-dr-brian-fuehrlein) ]
**Host:** In Jean-Marie’s case, he mentions he wasn’t warned about the risks of dependency. What role do doctors play in curbing the opioid crisis?
**Dr. Fuehrlein:** Doctors have a crucial role to play. They need to be diligent in assessing patients’ pain, prescribing opioids judiciously only when absolutely necessary, and carefully monitoring patients for signs of addiction. Open communication with patients about the risks and benefits of opioids is essential.
It’s crucial to explore alternative pain management techniques like physical therapy, mindfulness, or non-opioid medications whenever possible.
**Host:** How can someone like Jean-Marie break free from opioid dependency?
**Dr. Fuehrlein:** Treatment for opioid dependence often involves a multi-pronged approach. This can include medication-assisted treatment, behavioral therapy, and support groups. There are medications that can reduce cravings and withdrawal symptoms, making it easier to taper off opioids safely.
Combined with therapy, these treatments help individuals address the underlying psychological and emotional factors contributing to their addiction.
**Host:** This is valuable information, Dr. Fuehrlein. Thank you for shedding light on this critical issue and providing insights into potential solutions.
**Dr. Fuehrlein:** My pleasure. It’s important we all understand the risks associated with opioid use and work together to address this crisis.
