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Addiction is one of the biggest problems facing our society today, but recovery is possible. National Recovery Month each September shines a light on success stories and new treatment options.
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A few of the promising new tools in the fight against addiction include peer navigators to help patients in crisis inside the ER, the widespread adoption of a medication to treat opioid addiction and a methamphetamine-binding antibody treatment to reverse the effects of intoxication or overdose.
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Recovery resources are also available through private and public health and human services agencies.
As an emergency medicine physician, Thomas Robey, M.D., PhD, deals with addiction on every shift he works. Each day, he estimates, two to five people come to his emergency room because of a fentanyl overdose alone.
Fentanyl is a particularly potent opioid drug that can be deadly in small doses. Some people who use illicit drugs—such as stimulants like cocaine and methamphetamine (meth) — recreationally, intentionally combine them with fentanyl. Others aren’t aware that the drugs are laced with fentanyl, fueling overdoses.
“I think we’re facing a turning point right now in terms of the severity of addiction and how it’s contributing to deaths,” says Dr. Robey, who works in the emergency room at Providence Regional Medical Center in Everett, where he also serves as principal investigator for emergency room-based substance use disorder trials. “As an ER doctor, I see the consequences. In fact, I don’t think we’ve ever had anything quite as potent as what we’re seeing now. Fentanyl is stronger than any street drug we’ve ever seen.”
Addressing addiction one relationship at a time
In addition to his work at Providence, Dr. Robey serves as medical director for the Snohomish County Diversion Center, a 44-bed facility in Everett that provides short-term shelter for adults who are homeless and have substance use disorders or other behavioral health issues. He notes that stimulant drugs like meth, which is found throughout the United States but is especially common in the western states, often cause psychosis and other mental health issues.
In the face of this crisis, however, there is hope. “We do have some new ideas and are discovering some exciting ways to address these problems,” Dr. Robey says. “They’re wins. They’re not the entire answer, by any means, but they are tools to help us in the fight.”
“I’m focusing on how we can build relationships with our patients who are suffering, and figure out how we can apply what we’ve learned over the past 40 years that we’ve been grappling with addiction issues to help reduce that suffering.” – Thomas Robey, M.D., PhD, Emergency Physician at Providence Regional Medical Center in Everett
National Recovery Month
National Recovery Month in September highlights hope. It’s an observance dedicated to promoting and supporting new evidence-based treatment and recovery practices for substance abuse and mental health. And, of course, celebrating the wins, including the more than 20 million Americans who’ve sought help for substance use disorder, which helps show others that recovery is possible.
“Substance use is everywhere,” Dr. Robey says. “There are very few people who don’t know of someone who’s struggled with dependence on alcohol or opioids or meth or cigarettes. It’s not easy to quit. But millions of people have. And most people who succeed do it with the support of others.”
Promising new tools to fight addiction
One of the wins Dr. Robey points to is a peer navigator research study he’s spearheading as principal investigator. It builds on the idea of using someone who’s recovered from addiction or mental health struggles themselves to help those currently struggling with these issues — a standard strategy for outpatient treatment — by bringing them into the ER.
“When people show up at the ER with an opioid overdose, there’s nothing they want more than to get the heck out of there,” Dr. Robey says. “But a lot of times we can’t let them leave right away.”
Having peer navigators available in the ER to sit with people and map out next steps can more effectively help them reach their goals, which is often to get out of the ER and get clean, Dr. Robey says.
“These peer navigators are helping our most vulnerable patients,” he says. “And they’re helping them because they’ve been there before.”
One peer navigator Dr. Robey has worked with, in fact, has helped dozens of people over the course of two years after overcoming his own addiction. “He was homeless on the streets of Everett for 12 years,” Dr. Robey says. “He had two brushes with death, one because of an overdose with heroin. But he’s been in recovery for seven years now and helps others struggling with addiction by connecting them with local programs or helping them get housing, or even as basic as finding a mattress. It’s the best kind of story.”
Another win Dr. Robey credits is the widespread adoption of buprenorphine, a medication approved by the Food and Drug Administration (FDA) to fight opioid addiction in the ER, doctor’s offices and treatment centers.
“Buprenorphine helps ease cravings and patients feel normal,” he says. “The fact that this is now a standard, front-line treatment is a huge win.”
But the biggest game-changer Dr. Robey sees in the addiction fight is a treatment he’s piloting for meth addiction through the METH-OD clinical trial, which he terms an “ace in the hole.”
The treatment involves using a monoclonal antibody to bind to the drug in a person’s blood and reverse its effects, particularly those related to psychosis.
“This is, I believe, the biggest game-changer in stimulant treatment in decades because it’s going to be the toe in the door for people to get their lives together,” he says.
Dr. Robey expects the treatment to receive FDA approval in the next three or four years.
Support and resources
Still, the best way to get help with addiction is by finding support, whether that’s through a peer navigator, a loved one or a doctor.
“When you want to get clean, one of the things I tell my patients is that the first step is finding someone you can talk about your problem with — someone who can listen and then help,” Dr. Robey says. “Once you make that connection, the chances you’ll succeed are much higher.”
You can also find support through available resources, including by calling 988 Lifeline, a suicide and crisis hotline that provides free and confidential support around-the-clock for people in distress, or by calling 211 for essential community services. Referral specialists for 211 help connect you with resources available from private and public health and human services agencies to meet your needs.
And, if you’re in a true health emergency, never hesitate to call 911 or go to the ER.
“The ER is the ultimate safety net if you really don’t know where to go,” Dr. Robey says. “That’s what we’re here for — people who need help in crisis.”
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Related resources
The dangers of fentanyl — one mother’s story
Fentanyl deaths and overdoses are spiking. A Swedish expert explains why.
Overdose deaths are rising. Swedish responds with treatment and support.
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
