Addiction Treatment Entering New Era By June Scharf Dr. Zaid Fadul, an addiction treatment specialist who resides in Beachwood, is helping to usher in a new paradigm in addiction treatment, predicated on a deeper understanding of patients’ lives. As an example of the new thinking he brings to the issue, he begins his program with a simple question: What is your why? The question breaks down into two concerns – Why do you use drugs and why do you want to get clean? He believes that the dark secret shading why some people get hooked on drugs is that it accompanies isolation, a condition that finds users in an emotionally compromised state. This explanation has fueled an additional breakthrough in the understanding of addiction: the opposite of usage is not sobriety, it’s connection. “People need a pull in their lives, a pull to get up in the morning and go do something,” he says. “It can be work or family, but the environment definitely counts. Nurture, more than nature, makes a big difference.” The addiction itself also creates isolation, so it’s a vicious cycle that leaves a victim with no lifeline. A statistic he cites to support this theory is that only 10-15% of drug users have the biology for a chemical addiction, also called an addictive personality. The rest come to it by other routes. “When we treat patients, I always ask, who is going to help care for you when you go back home,” he explains, stressing the importance of having that pivotal human connection. Fadul sees patients at his own clinic, the Geauga Medical Therapy Center in Chardon, which combines primary care services along with addiction treatment. Open since September 2015, the clinic is designed to “make patients feel human and welcome, and to re-armor them for life.” He understands that they “screwed up and face a lot of judgment,” so part of his agenda is to build them back up, he says. He cites that 80% of addiction generally stems from an underlying issue such as depression, anxiety or an addictive personality where the reward pathway is out of balance. When drugs channel an excessive amount of dopamine into the brain, it generates irresistible feelings and encourages repeat behavior. The way that addicts ordinarily find their way to rehab is by either facing jail time or court-mandated treatment. For those who voluntarily enter, their treatment will be covered by insurance, since all health plans cover it, according to Fadul. According to the State of Ohio Board of Pharmacy, another recent development to aid out-patient treatment is the presence of more than 1,300 pharmacies in 84 counties, representing 65% of all pharmacies, that carry naloxone (obtainable without a prescription). This medication reverses an overdose caused by opioids, including heroin and fentanyl, by restoring breathing in a matter of minutes. Fadul points out that one of the culprits for increased addiction to pain medication is coaches of high school and college athletes who want players on the field. When athletes become injured, the too-frequent solution is pain pills that may not be well managed and can lead to dependence. Katlyn Petrovich, the nursing supervisor in Fadul’s practice, cites medical establishments as another link in the chain that leads to addiction. She says she recalls feeling the pressure, while working in a hospital setting, to treat patients with pain medicine in excess of what was needed. But she describes the situation as a byproduct of concerns over patient reviews. Doctors and hospitals don’t want to receive low marks, and they are concerned that anything short of knocking out all pain will be poorly perceived. Fadul says the sweet spot with pain treatment is a three or four on a scale of one to 10, with 10 being the worst amount of pain felt. “A score of zero or one is where addiction can enter and a person can feel euphoric,” he explains. The sweet spot with pain treatment is a three or four on a scale of one to 10, with 10 being the worst amount of pain felt. A score of zero or one is where addiction can come in and a person can feel euphoric. – Dr. Zaid Fadul Addiction Specialist Geauga Medical Therapy Center Pictured: Katlyn Petrovich, nursing supervisor and Dr. Zaid Fadul, both of Geauga Medical Therapy Center in Chardon. 14 Beachwood Buzz n December 2016