The 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 some effective strategies for preventing‌ opioid ‍dependency, such as alternative pain management options and monitoring for ⁤red flags?

## The Long ⁣Journey Out: An Interview on Opioid Dependency

**[INTRO MUSIC]**

**HOST:** Welcome​ back ⁤to the show. Today, we’re discussing‌ a topic that affects millions worldwide: ‌opioid dependency. Joining us is Dr. Emily Carter, a ‍leading expert on addiction and recovery. Welcome, Dr. Carter.

**DR. ⁢CARTER:** Thank you for having⁢ me.

**HOST:** Let’s start with Jean-Marie’s story, a poignant example highlighted in a recent ‌article. Jean-Marie is a glazier who ⁣started taking morphine for chronic pain⁢ but quickly became dependent. His ⁤story⁤ underscores a widespread issue –⁤ the risk⁤ of addiction associated ⁣with opioid ⁢pain relievers.⁢ Can you shed some light on this?

**DR. CARTER:** Absolutely.

Opioids are ‍incredibly ⁢effective painkillers, but⁤ they ⁣carry a significant​ risk of addiction. Unfortunately, many ⁢patients, like Jean-Marie, are not always⁤ fully informed about this risk.

It’s crucial for both doctors and patients to have an open⁤ and honest conversation about the potential dangers of opioid use, even ⁣for short-term pain management. [[1](https://www.nejm.org/doi/full/10.1056/NEJMp2310172)]

**HOST:**

Jean-Marie mentioned that his prescription was renewed every‍ three months without much scrutiny. What are some red flags that doctors and patients should watch for to potentially prevent opioid dependency?

**DR. CARTER:**

There are several warning signs.

Firstly, ‌any patient taking opioids for an extended period ⁢should undergo regular physical examinations ⁤and be closely monitored‌ for signs ⁤of dependence, such as needing higher doses to​ achieve⁤ the ‌same effect or​ experiencing withdrawal symptoms when trying to cut back.

Secondly, exploring alternative‌ pain ⁤management⁣ strategies, like physical ‍therapy, acupuncture, or non-opioid medications, is essential.

**HOST:**

Jean-Marie’s journey to recovery is just beginning. It‌ sounds incredibly challenging. What are ⁤some effective ‌treatments‌ available ​for‍ opioid use disorder?

**DR. CARTER:**

Thankfully, ‍there are⁢ effective treatments⁤ available.

Medication-assisted treatment (MAT) plays a vital role. Medications like buprenorphine and methadone can mitigate withdrawal ⁢symptoms and⁤ cravings, allowing individuals to focus on therapy and ⁢rebuilding their lives. Combined ⁢with counseling and support groups, MAT has a high success ⁤rate in helping individuals achieve and maintain recovery. [[1](https://www.nejm.org/doi/full/10.1056/NEJMp2310172)]

**HOST:**

Thank you, Dr.⁣ Carter.‍ This has been incredibly informative. We hope ⁣Jean-Marie’s ⁣story and your⁤ expertise ‌will encourage more ​open conversations about opioid dependency and ‌lead to better treatment and prevention‍ strategies.

**DR.⁢ CARTER:**

Thank you.⁣ It’s important we continue to ⁣raise awareness and work towards solutions for this critical public health issue.

**[OUTRO MUSIC]**