Pertrovich says that in many cases, the medical community has created addicts. “We fed into it, giving patients more and more pills,” she states. But Fadul offers the caveat that “doctors are not malicious, they’re just undereducated” with respect to pain management and addiction risks. When a patient enters his clinic, his goal is a full assessment to evaluate any co-morbidities along with the addiction. The next step is to determine which of three addict categories applies to the patient. According to his diagnostic criteria, they are either partygoers who just like to get high (a type that is very hard to stop, he adds), or they need drugs to avoid getting “dope sick,” a condition whereby a person gets physically ill and needs drugs to feel alive and well, or lastly, they would like to be over the addiction but their environment pulls them back and they are not strong enough to get off the drugs on their own. Another addiction group is senior citizens who get hooked on pain medication after surgery, and their doctors continue to prescribe medication because they ask for it once dependence takes hold. In his practice, Fadul says he has charted four gateways to addiction through what might be considered ordinary circumstances, where pain medicine is routinely prescribed. He cites visits to dentists for oral surgery, emergency room stays for injuries, major surgeries such as joint replacements and lastly, “pill parties” where students raid medicine cabinets and deposit their bounty into a bowl for random consumption. He also reports that some addicts have turned to home invasions strictly to target pills, for their own use and for sale, with some carrying a street value of $50 per pill. While the statistics on relapse are grim, Fadul has measures to prevent that outcome. He seeks to dodge some of the missteps in others’ approaches, such as offering counseling too soon, before patients are ready to explore their issues, or offering an excessive amount, with some programs administering about 10-20 hours per week, leaving little room for work or childcare. Treating a patient only with drugs and no counseling is also doomed to fail, he says. Another pitfall is poor home and social environments. Successful treatment requires a holistic approach that addresses all the elements, he explains. Patients also need to recognize that addiction is a chronic disease, demanding lifelong vigilance. He notes that alcoholics can be the hardest to treat and require an in-patient approach for several reasons. If they stop drinking all at once, they risk seizure or death, so medication is necessary to get them off their dependence. Most other addicts can be treated on an out-patient basis with a shot of vivitrol, which prevents the high feeling from any drugs and lasts 28 days, or with suboxone, so they don’t become “dope sick.” Fadul has noticed that women seek treatment in greater numbers than men, and they have a higher success rate. He attributes this to the pull of responsibility, often for children. As of September, at least 385 victims in Cuyahoga County have died of opioid overdoses in 2016, far in excess of exceeding the 228 deaths in 2015. Additionally, lab results have confirmed that at least four Cuyahoga County overdose deaths are due to carfentanil, a large animal sedative, 100 times more deadly than fentanyl and 2,500 times more deadly than heroin. Despite these statistics, Fadul notes that addicts are “professional survivalists.” They can be “smart and crafty, which is how some continue their habit for years,” he adds. His hope is that addicts find treatment, if for no other reason than the cost savings to themselves and the centers that become involved. Fadul reports that the average cost of handling addicted people, including hospital stays to treat seizures or cardiac arrest, law enforcement encounters, theft, etc. is around $75,000 while addiction treatment is $5,000 - $7,000. Fadul says he recognizes that addiction can be neither nefarious nor innocuous, but rather the consequence of circumstances. No matter the cause, “it remains a very ugly thing,” he states. Now that pain is more readily being understood as the “fifth vital sign,” particularly when it manifests in chronic forms, patients need to remain mindful and heed the risks associated with treatment by opioid medication. Last month, Aaron Marks shared his story. Now, he represents the Northern Ohio Heroin and Opioid Task Force, and received the Attorney General’s Award for Outstanding Contributions to Community Partnerships for Public Safety, in Washington, D.C. REDISCOVER YOUR PURPOSE We are here to help you and your loved ones fight the chronic disease that is addiction. You are not alone. Providing Primary Care and Addiction Medicine Services Specialties Include: Heroin • Alcohol •Tobacco Prescription Meds • Gambling 13170 Ravenna Rd, Suite 108 Chardon OH, 44024 440.409.7055 • Geauga@FadulHealth.Com Repair. Rebuild. Reconnect. 100% Confidential. Insurances Accepted Anthem • Cigna • Medical Mutual • Medicare • United Health December 2016 n Beachwood Buzz 15