We’ve all heard about “the opioid crisis” of recent years.  Through multiple scientific studies, it becomes clear that drug use can damage portions of the user’s brain that are supposed control urges and drives.  Sometimes drug use starts as appropriate use, or misuse, of prescription medications.   Sometimes drug use develops with a very poor decision to get high, sometimes in an ill-conceived attempt to self-medicate untreated, or inadequately treated pain or mental health issues.

Whatever reason leads to drug misuse, if it continues then most people, not all, will suffer damage to some brain pathways.  These neurolgical pathways seem to be similar for most forms of dependency – opioid (narcotic) drugs, many sedative drugs (especially the benzodiazepines), alcohol, nicotine, appetite control, gambling behavior and other dependencies.  The common denominator has been found to be in the so-called reward center, involving the pathways connecting nucleus accumbens, pretegmental area, prefrontal cortex, etc.  The net effect is to disturb control neurotransmitters, dopamine, etc.  The sufferer loses control and desire becomes compulsion.  An unfortunate result for some is loss of nearly everything they hold dear:  relationships, money, employment, health, home.

Some people can “treat” themselves, and a few can actually discontinue their use of drugs, alcohol, cigarettes.  Recent studies suggest there are genetic reasons for the difference.   One of the concepts that is quite certain:  the young brain is more susceptible to being damaged, and damage is likely to be greater in the adolescent.  This susceptibility gets less as the brain develops, which continues in the mid- and late twenties.

A good explanation of the brain in addiction can be found in the Harvard Mental Health Letter :  How Addiction Hijacks the Brain (click)

Drug dependence does have some treatment; as with most all forms of medical treatment, results are not guaranteed.   At the Freeman Center, we use Medically Assisted Treatment (MAT).  There are 3 medications that are approved for the treatment of opioid dependence:  Methadone, Buprenorphine (Suboxone), Naltrexone (Vivitrol).  For the last 10+ years, I have been working in the field of addiction medicine.  I have developed Suboxone programs in Conway, NH and Portland, ME, and been the medical director of methadone clinics in Portland and Lewiston.

MAT can minimize drug craving and/or drug use and start the road to recovery.   We offer MAT services here at the Freeman Center.   We cannot offer methadone treatment, as it can be used only in Federally licensed methadone clinics.   MAT is usually combined with regular counseling trained addiction counselors, which we can arrange with approved counselors, locally.  Additionally, we strongly encourage our patients to be regularly involved in 12-Step meetings.