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Treating addiction like other diseases

Recorder/Paul Franz
Dr. Ruth Potee: Addiction changes how the brain works.

Recorder/Paul Franz Dr. Ruth Potee: Addiction changes how the brain works.

“The bottom line with all of this is this is a disease,” said Dr. Ruth Potee, a Greenfield doctor who treats opioid addicts. “Relapsing, remitting, that is not any different from hypertension, diabetes or depression. It changes people physiologically so that in order to function like normal they need the drug.”

As one of the relatively few family physicians locally licensed to subscribe heroin replacement therapy Suboxone — she said the licensing procedure is not onerous — Potee believes part of the solution is to begin fully treating addiction as a disease, with addiction treatment offered alongside every other disease.

A doctor with a family practice out of Valley Medical Group, Potee is one of two general practitioners in the area prescribing Suboxone to treat addiction, and is more or less at capacity.

“It just changes the way the brain works, it changes the same way the pancreas changes when you’re obese and you stop producing insulin, what causes diabetes; it has a very similar impact, yet with all of these types of things, this disease of addiction, and I’m going to use addiction in the broad sense here, addiction to nicotine, alcohol, opiates, it doesn’t really matter.People think that the person was at fault, they were weak, they led bad lives, they came from bad families, all of that, when of course none of that is true.”

Potee argues anyone can become addicted, with genetic predisposition now considered less of a factor than it has been made out to be, and draws a line graph to illustrate a typical addiction scenario.

“People start out in normal range, or depressed, and they use this and it makes them feel great,” she said, the line climbing rapidly above the center axis representing normal mood. “They take 10 milligrams of oxycodone and they use it as a pill and they get high and then they feel normal again.”

“It makes them feel good, they have fun, it’s something they do with their friends and it makes them feel happier than they’ve actually felt in a long time. For whatever reason people are looking for joy and maybe this drug makes them feel some joy.” But the chemicals are rewiring their brain circuitry, making it harder and harder to feel normal without the drug and making the descents deeper and darker.

Over time they might start to snort or inject the pill, ramping up the intensity as they chase the feeling of their first high, which they will never feel again, Potee said.

The spikes in the graph climb higher, but instead of coming down to the normal range, they begin crashing well below it as they experience withdrawal.

The National Institutes of Health lists early symptoms of opiate withdrawal as follows: agitation, anxiety, muscle aches, increased tearing, insomnia, runny nose, sweating and yawning.

These may be followed by abdominal cramping, diarrhea, dilated pupils, goose bumps, nausea and vomiting.

Unlike severe cases of alcohol or benzodiazepine withdrawal, opiate withdrawal is not life threatening, although this may seem like a minor distinction to the person experiencing it.

One recovering addict compared full withdrawal to the feeling of the worst flu you have ever had, multiplied five or 10 times.


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