Delaware County Medical Society Winter 2017 - 28

FEATURE

Many would say when they hit Rock Bottom. Not necessarily
so. Evidence shows that getting help at any stage of addiction
can yield good results. The willingness to change is the goal.

the region in the brain wired for reward and help with
cravings and physical withdrawal after stopping substances.
Additionally, the need to assess for treatment for mental
health and/or medical conditions must be done.

Think of the cool pool of water and the awareness that a
drink right now will cause certain death. Most of us would be
willing to continue our journey, thirsty and tired, in the hopes
of a better option. A person in active addiction only thinks
of the need for immediate relief from withdrawal or pain and
compulsively drinks from that pool over and over and over.

Medical care frequently is neglected during substance use and
should be addressed. There is a higher risk of other chronic
diseases such as HIV, Hepatitis and other issues in those who
abuse substances. The relapse rate is comparable to other
chronic diseases such as Type 2 Diabetes and Asthma.
Recovery is measured in restoring overall healthy living
and abstinence from substance use. Like other chronic
illnesses, relapse of drug abuse can occur during or after
periods of success. Frequently the measure of success is
overall improved quality of life and restoration of a person's
goals for life. For some it may be stopping only heroin
and continuing alcohol or cigarettes and for others it is
stopping all substances. Quality of life should be the goal.

Understanding the
causes of substance use
disorder is important
but identification and
referral to treatment
is also a critical part
of the process.
Success in treatment involves detoxification, counseling,
medication and evaluation for mental health issues.
Patients can receive treatment in many different
settings with numerous approaches. The first step in
treatment is detoxification which involves medications
to assist in easing the discomfort of withdrawal as
well as preventing medical consequences such as
seizures from suddenly stopping either alcohol or
benzodiazepines (Klonopin, Xanax, Ativan and others).

Now imagine you are walking in the desert and you see a
pool and you read the sign that warns of certain death if
you quench your thirst there. After brain rewiring has begun
with detoxification, therapy, healthy living and medications,
you now are able to glance at the pool and continue
walking, knowing that the journey brings more reward than
the instant gratification of poison will ever give you.

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Early recovery with detox is only the first step. Follow
up from inpatient or outpatient detox with coordination
of care is critical. Most people will need counseling and
medications which help stop cravings or block a person's
ability to use substances. These medications help block

26 DELAWARE COUNTY MEDICINE & HEALTH

winter 2017

Dr. Aviva Fohrer is board certified in Family
Medicine and Addiction Medicine. She is a member
of the DCMS Board of Directors, the Delco
Heroin Task Force, a Delegate to the PA Medical
Society and author of a recent resolution to the 2017
PAMED House of Delegates addressing the need
to promote a better understanding of medicationassisted treatment. To contact Dr. Fohrer call (610)
455-4254 or email aviva@thaliamedical.com.

Table of Contents for the Digital Edition of Delaware County Medical Society Winter 2017