Addiction is widely
misunderstood by the public and by many healthcare providers. It is
not taught in most medical schools.
Combating the opioid epidemic
will require providers to understand Opioid Use Disorder (OUD) and
its treatment.
Addiction is a chronic,
relapsing disease with extraordinarily high morbidity and
mortality.It is the
transition from controlled to impulsive and compulsive drug
intake.
Physiologic dependence is just
one aspect of addiction. The behavioral and social derangements
seen in addiction are the major source of harm for people with
substance use disorders.
Addiction is not a personal
failure of will. The role of genetics and environment are
enormous.
It is more useful to think of
addiction as a kind of “brain failure.”Dopamine and different dopaminergic systems are
severely affected by drug use, resulting in chronic changes and
even death to areas of the brain.
We do not stigmatize
patients with diabetes or CHF for life choices contributing to
their disease, nor do we refuse them care or make their care
conditional on their behavior. We treat them.
Opioid use disorder is a
treatable disease. It is time that ED providers start treating
it.
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