I am a recovering opiate addict, and this can happen to anybody. I know intimately what it feels like to think that no one is there for you. I know that feeling because that was me. I am one of the injured survivors of the 1999 Columbine High School shooting. My best friend was killed right in front of me, and I was shot twice. So when I left the hospital that day, I had a 30-day supply of medication for my physical pain. I had surgery for a labral tear in my right hip, and they just kept prescribing and prescribing and prescribing. I found some medication. I was with a friend at his grandfather's house, and it was a Vicodin prescription. When I was a senior in high school, I had to have my wisdom teeth pulled, and after that surgery, my doctor prescribed opioids. These were prescribed for physical pain. My emotional pain was really the problem, but nobody talked to me about that. They don't tell you anything. They just say, okay, you know, here's something for the pain. All that I knew back then was that a lot of highly educated people had prescribed me medications that were supposed to make me feel better, and they were working. I was hooked probably within two weeks. I only cared about one thing, and that was the medication. I was able to mask my addiction very well, and everybody was willing to turn a blind eye because I was still able to fake it. I'm not a bad person, but I knew that what I was doing was wrong, and I didn't know how to stop it. It just consumes you. Anytime I would try to stop taking them, I would start to go through withdrawals. I made this promise to myself that I would never, I would never experience those withdrawal symptoms again. I made a connection who used heroin, and I was determined to try it, to try it. Heroin was a lot easier, and it was cheaper. I didn't have a lot of money. I almost was content with the fact that I was going to be a heroin addict, and this was going to be my life. Your chemical structure has changed. If it was that easy to stop, so many people out there wouldn't be going through the things that they're going through. It just stopped a long time ago. A lot of misconceptions that people have about addiction is that we don't have any guilt and any shame about it. That's not true at all. This shame with addiction, it's like carrying a huge boulder with you everywhere you go, and it just eats away at you. Nobody wants to feel that lonely and hopeless. It's decaying to your personality. It's decaying to your life, and then it starts affecting your relationships. My husband couldn't figure out why this drug seemed to be so much more important to me than him and our family. Having to tell my family was scary, but being addicted was scarier. It's okay to go to family that hasn't talked to you in a long time or that you're struggling with and to just say, okay, I'm done. Help me. If you don't feel like you can come forward and talk to a loved one or a family member, talk to a professional. There's a world of recovery out there that wants to help. You just have to tap in. The biggest weight in the world had been lifted off of me. I had a chance to be who I wanted to be, which was not an addict. It's possible to have a meaningful life again. Today I'm happy. Today I'm productive. Today I'm connecting with people. I'm doing things. I feel like I'm free today. Hello and welcome. I'm Dr. Sarah McKeown, the Executive Director of the Governor's Institute on Substance Abuse in Raleigh, North Carolina. I wanted to take a moment to introduce this course to you. I can't emphasize enough the importance of your knowing as much as possible about the treatment of pain. No matter what practice area you choose, pain touches every aspect of medicine and dominates many. Because of this, it's critical that you be equipped with a solid understanding of pain and pain management. Also, ubiquitous across specialties are addiction and substance use disorders in general. So knowing as much as possible about preventing, identifying, and treating opioid and other substance use disorders will prove beneficial in your practice. Predictably, there is significant overlap between pain and substance use disorders, including addiction. When used appropriately, the impact of opioids on alleviating suffering could be irreplaceable. But estimating and managing the potential risk of opioid use disorder is essential. This course, Practical Skills for Serious Opioid Problems, Meeting the DEA Waiver Requirements, will review important principles and equip you with the tools to help you navigate the common conundrums of pain management and opioid use disorder and co-occurring mental disorders. You'll have the opportunity to learn from Dr. Stephen Wyatt, an addiction psychiatrist, Dr. Jim Finch, a family physician by training who has practiced addiction medicine for many years, Dr. Kelly Fedorio, a primary care physician providing office-based treatment, and Dr. Stephen Pracken, a psychiatrist additionally boarded in pain management who specializes in the treatment of the high-risk pain population. You are among the first students in the nation taking this course. It's provided by the Governor's Institute through grant funding from the Substance Abuse Mental Health Services Administration, SAMHSA, and through a partnership with the Providers Clinical Support System, also funded by SAMHSA and led by the American Academy of Addiction Psychiatry with a coalition of national professional organizations. PCSS is an initiative at the forefront of educating physicians and other clinical professionals on evidence-based practices in the prevention, identification, and treatment of opioid use disorders. I encourage you to listen closely to these modules as you consider the significant impact of addiction and other substance use disorders as you have experienced them across specialties in your training, in your community, and likely in your personal life. I further encourage you to consider the important role you will play in prevention and treatment. In New York City, one New Yorker dies every seven hours from a drug overdose. What everyone in health care now knows, we're in the middle of an opioid overdose epidemic. And like HIV early on, where lots and lots of clinicians stepped up, learned a new skill, learned how to practice caring for people with a disease that had not at that point been well described or understood or known how to help people survive, it took dedicated health professionals to step into the problem and look what a difference they were able to make and we were able to make. And I think this is such a moment. And it's a time of great challenge. It's also a time of great opportunity. This is a chance to step in and really make a huge difference in your patients' lives, in the population, from a population health point of view, to reverse the overdose epidemic. We need doctors and now nurse practitioners and physician's assistants to help turn the epidemic around. Like HIV, this, I think, for health professionals is the same kind of moment. We need lots more people willing to care for people deliberately with substance use disorder, willing to do it well. It's not so hard to do it well and it's very satisfying.

opiate addict

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prescription medication

addiction

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