Pioneering research to fight addiction in Maryland

Posted at 8:03 PM, Dec 22, 2016

Dr. Eric Strain is a Professor of Psychiatry at the Johns Hopkins School of Medicine who's been studying addiction for more than 20 years.

Strain said he does believe there are more people getting addicted to heroin and opiates.

"I think I see it, and I think that what the national surveys suggest is that there's also more problems with heroin and other opiates going on across our country," Strain said.

The reasons for the growing numbers are varied.

"We're coming out of an era when physicians were prescribing more opiate pain medicines for people. If you expose more people to those medicines, those who  might have a vulnerability to becoming addicted to them do become addicted to them. And some of them now are also starting to migrate over to using heroin," Strain said.

With all the information available about the dangers of heroin, why do people start using inn the first place?

One of the things we know is that there is a lot of variability in how people respond to a medicine like an opiate, like a pain medicine. Some people take them and  they really don't like the effects. They actually avoid them, they find them dysphoric or they don't feel good to them," Strain said.

But there are also those on the opposite end of the spectrum when it comes to that type of drug.

"And then certainly at the other end of the spectrum there are some people who will take an opioid and they report that even after the first dose they'll say that it gave them an incredible sense of high or a pleasurable effect. That's probably some genetic vulnerability because there is some evidence that people who become addicted to a substance have a family history, that suggests that it runs in the family," he said.

Strain said family history is something to be aware of when using medications such as prescription opiates.

"The overwhelming majority of people exposed to opiates don't become addicted to opiates. But I think that what we've become sensitized to, both as a medical profession and as a culture, is that there is this risk that some people will, and we need to be conscious of that. And I think for the person who is getting an opiate or has a family member getting an opiate, they should be asking themselves, do I see signals that this person might become addicted to this medicine," Dr. Strain said.

The largest clinic in Baltimore, Turning Point, treats more than 2,000 patients a day, most with a daily dose of methadone.  Dr. Strain said the medical evidence supports this type of treatment.

"There are medicines that can be helpful for the treatment of heroin addiction, things like methadone or buprenorphine or naltrexone. They're all FDA-approved medications; there are ample studies showing that they can be very effective and safe and very useful for people," he said.

Some people, or their families, have enough resources for a residential treatment program. Dr. Strain said while those programs can be helpful, addicts and their families should consider it the beginning of a solution, not the end.

"Changing the place, getting out of the environment into a new environment for a period of time to recalibrate perspective can be useful for some people.  That's just the first step in a process, and again, it's a lifelong illness. It's something that doesn't get cured overnight. And it's not something that's cured after 30 days. It's something that's an ongoing struggle," Strain said.

Families in crisis should know there is help that can work. Strain said people have to recognize that the person addicted to drugs must have his or her own motivation and desire to be helped.

"We live in a culture where we want quick fixes to things. We want to take an antibiotic for a week and be done with it. We want something that will make us feel better quickly, and this is a lifelong struggle. I think for those people who embrace that and recognize that, they really have a wonderful perspective on life. Because the people I've known who have struggled with addiction and are abstaining often have a greater appreciation for the small things in life because they've seen just how bad life can be," he said.