Experts recommend several measures to help patients kick drug dependency or addiction:
- Don’t try to stop without medical supervision. Withdrawal from opioids is unpleasant, and can be eased with drugs like methadone or buprenorphine. (Two formulations of the latter, Suboxone and Subutex, are the first narcotic drugs approved to treat opioid addiction that can be prescribed in a doctor’s office.) Regular benzo users must slowly taper their dosage, as sudden withdrawal can cause extreme psychological symptoms and, occasionally, seizures.
- Find the right help. Patients with an addiction typically need support well beyond the detox stage. Of those who made an unsuccessful effort to get drug treatment in 2007, the number one reason was they couldn’t afford it.
- How to pay for it. Private insurance coverage can be spotty, with higher copayments and limited coverage for drug treatment. Under original, fee-for-service Medicare, there is a 50 percent copayment for outpatient substance-abuse treatment, rather than the usual 20 percent—but beginning in 2010 the copayment will gradually be reduced. Many facilities charge on a sliding scale or offer some kind of assistance.
- Consider all your options. A rehab program isn’t the only game in town, says Frederic Blow, an expert on substance-abuse issues among older people at the University of Michigan. “Treatment programs work for older individuals,” he says, “but there are lots of ways to do this, like going to mutual self-help groups, a minister or rabbi, or your primary care doctor.”
- Deal with the underlying problem. Successfully kicking a destructive prescription drug habit may also mean finding other ways to deal with the condition the drug was meant to address. In the case of benzodiazepines, this could entail learning to manage anxiety through cognitive behavioral therapy, getting more exercise and adopting better sleep habits to ease insomnia.
During his weeks at the Hanley Center, Gallagher embarked on two recovery plans. “First is my 12-step program,” he says. “I know I can’t be a husband and a father if I don’t do that.” The other is a steady, disciplined program to ease his pain, which has included aquatherapy, massage, meditation, acupuncture, nonnarcotic painkillers and simply pacing his activities through the day. “It’s amazing,” he says. “All of the sudden your life takes on totally new meaning. I would say this is the happiest time in my life.”
STAYING SAFE WITH CAGE
Have you ever. . .
C—felt you should Cut down on your alcohol or drug use?
A—been Annoyed by someone criticizing your drinking or drug use?
G—felt Guilty about your drinking or drug use?
E—had a drink or used a drug in the morning as an “Eye opener” to decrease hangover or steady your nerves?
CAGE is one of several questionnaires doctors frequently use to evaluate patients for possible substance abuse. Two or more positive responses might indicate a problem, and should be followed up with a more complete evaluation.
If you’re taking potentially habit-forming prescription drugs like opiate painkillers or tranquilizers, it’s also important to:
- Give the doctor a complete history, including other medicines you’re taking and any substance-abuse problems or mood disorders you may have experienced.
- Talk to your doctor if the prescribed dosage doesn’t seem to work and you find yourself needing or wanting more medication.
- Alert your physician if you experience side effects like sleepiness, unsteady gait or difficulties with concentration or short-term memory.
- Avoid mixing drugs like opioids with central nervous system depressants like tranquilizers and alcohol. It’s dangerous.