Pawlicki: Heroin and OpiateAddiction Difficult to Overcome

January 9, 2014 by

Curing someone of both opiate and heroin addiction is not a certainty.
Chardon doctor Matthew Pawlicki is among the dozens of Ohio physicians who can attest to the difficulties, successes and failures of treatment.
A general medical practitioner, Pawlicki took on heroin treatment about nine years ago at the request of the Lake-Geauga Recovery Centers, a private, nonprofit agency treating alcohol, drug abuse and mental illness.
The centers, which have facilities in Chardon and Mentor, asked Pawlicki if he would become state certified to treat heroin addicts through the use of Suboxone, also known as Buprenorphine, a medication commonly used in low doses to help people safely withdraw from opiate and heroin addiction without symptoms.
Since then, the centers have ceased using the medication for people admitted to its two 90-day residential substance abuse treatment centers, the Lake House for men and the Oak House for women, Pawlicki said.
He provided Suboxone prescriptions for clients cared for by the centers. The medication was prescribed only to clients who saw Pawlicki on a monthly basis.
Heroin is among the most dangerous illegal drugs used by addicts today.
When injected directly into the blood vessels, it gives the user “a very fast high.”
“If you inject too much, you die from an overdose,” he added.
Pawlicki also treated people addicted to opiates, which included prescribed pain-killing drugs such as Vicodin, Darvon, Oxycodone and Methadone, lesser opiates that also create a high, but are not as dangerous as heroin.
Acquiring and shooting up with heroin is the “next high” addicts usually seek after opiates because, not only is it cheap and easy to illegally acquire, it provides users a “higher high,” Pawlicki said.
The success rate for getting non-heroin opiate abusers off their drugs was usually greater than heroin addicts.
In his experience, less than 20 percent of most heroin users stay “clean” once they complete a recovery program.
“It’s sad, but that’s pretty much the success rate throughout the country because heroin is so addicting,” Pawlicki said.
Based on national research, he said about 13-14 percent of all Americans are susceptible to some kind of addiction, whether to drugs, alcohol, gambling or sex.
The key to any heroin and opiate addict’s cure is a willingness to be treated, Pawlicki said.
His patients included an equal number of men and women from all socio-economic levels.
“I’ve seen them all, from people from well-to-do families to those from broken homes,” he said.
Drug addiction is a complex disease. Heroin is among the drugs that change the brain in ways that foster compulsive drug abuse, making quitting difficult, even for those who want to, he said.
“Treatment is difficult, especially for the patient, unless that patient is willing to change his or her life and change the reasons behind his or her addiction,” the doctor said. “Unless he or she does that, it’s almost impossible to treat anybody against his or her will.”
In addition to taking Suboxone for a long period, he said addicted individuals have to be willing to change their lifestyle and remove themselves from acquaintances or surroundings that caused or contributed to their drug use a recovery key expressed also by judicial and other medical providers interviewed for stories in the Geauga County Maple Leaf.
According to the National Institute on Drug Abuse (NIDA), once heroin or another opiate is injected into the body, it is naturally converted to morphine and binds to natural opiate receptors located in the brain and throughout the body.
The brain’s neurons have specific nerve receptor sites in which morphine occurs.
This converted morphine has a chemical structure similar to endorphins in the brain, which control human emotions, pain and pleasure.
When these morphine molecules attach to endorphin-receptors on nerve endings, euphoric “highs” begin to develop the brain cannot naturally control.
Death from a heroin overdose occurs because it affects receptors in the brain stem nerves that control automatic processes, like breathing, Pawlicki explained.
Family background also is a factor.
Individuals whose fathers or mothers were alcoholics or drug addicts have a greater chance of following suit, Pawlicki said.
“It’s genetic, a lot of it, and you tend to see it more among people who have underlying mental health issues,” he added. “Addiction and mental health issues often run together a lot, but not every addicted person is mentally ill either.”
About three years ago, Pawlicki decided to stop treating opiate and heroin patients.
“There were multiple reasons to stop,” Pawlicki said.
Among reasons that influenced his discussion was the break-in of his Chardon medical office, he said.
The office was ransacked by a person looking for drugs, who was later arrested by Chardon police.