• Alyson Kuroski-Mazzei
  • Eric Edwards
  • Steven D. Passik
  • Jamison Monroe
Medical Director, Forterus Health Care Services, Inc.

Dr. Alyson Kuroski-Mazzei

Mediaplanet: Why has the abuse of opioids grown into a national epidemic in recent years?

The prevalence of nonmedical use of prescription medication varies significantly across the country and is due, in part, to several factors including an increase in prescription practices, misuse by cohorts of individuals such as young adults, doctor shopping, online purchases and stealing from family and friends who have them legally prescribed.

MP: What role does medication adherence play in preventing addiction to prescription medications?

Medication adherence and following the recommended dosage and frequency of prescribed medication is essential to avoid misuse, overuse, abuse and/or dependency of various prescription medications including opioids, benzodiazepines, stimulants and other sedating medications.

MP: In your experience, what have been the most successful treatment options for recovering addicts?

For those with substance use disorders, it is best to seek treatment at an accredited facility that can assist with treatment for the substance use disorder(s) and co-occurring illnesses. Depending on the substance(s) used, medical detoxification followed by a comprehensive residential and/or intensive outpatient program is recommended.

MP: What resources do you recommend for the friends and family members of addicts?

For friends and families of those with substance use disorders, support is available through peer led support groups, such as Al-Anon, Alateen and/or Nar-Anon. These groups educate friends and family members and provide a supportive environment to discuss the effects of addiction on the family system.

MP: Why is routine monitoring and an individualized approach particularly important?

Often patients with substance use disorders have co-occurring diagnoses, such a trauma history, eating disorders, chronic pain and/or diabetes, which require individualized treatment plans. By routinely monitoring/creating individualized plans, there is a higher rate of compliance with treatment recommendations and improved management of the patients’ medical and/or psychiatric needs.

MP: What are the most promising addiction treatment options on the horizon?

Addiction is a multifaceted disease that requires a holistic model of care including treatment that integrates evidence based medical and clinical care to address the patients’ substance use disorder(s), co-occurring psychiatric and medical issues as well as a focus on relapse prevention, pharmacologic interventions and 12-step programming.

Chief Medical Officer and Vice President of Research and Development, Kaléo

Eric Edwards, M.D., Ph.D.

Mediaplanet: Why has the abuse of opioids grown into a national epidemic in recent years?

It is difficult to point to any one single factor associated with the increase in the non-medical use of opioid pain relievers (OPR). From 1999 to 2011, consumption of oxycodone increased by nearly 500 percent. During this same time period, there was an even larger increase in individuals seeking treatment for addiction to OPRs and deaths related to prescription opioids quadrupled. The correlation between opioid consumption, overdose deaths and opioid addiction treatment admissions is alarming.

MP: What role does medication adherence play in preventing addiction to prescription medications?

Data suggests addiction to opioids is highly prevalent in chronic pain patients. Therefore, practitioners should be cautious when prescribing opioids for the management of moderate to severe pain and should discuss with patients the importance of taking their medications as prescribed. Additionally, practitioners should discuss other risks associated with non-adherence, including life-threatening respiratory depression that can lead to hospitalization and/or death.

MP: In your experience, what have been the most successful treatment options for recovering addicts?

Multiple studies support buprenorphine and methadone maintenance treatment as effective options for opioid addiction. Injectable naltrexone is also available. Medication should always be combined with counseling and support from family and peers. Unfortunately, despite strong evidence supporting the use of these treatments, challenges remain. Many patients relapse and are at an increased risk for life-threatening opioid overdose and less than half of Americans addicted to prescription opioids and heroin are currently receiving any treatment.

MP: What resources do you recommend for the friends and family members of addicts?

There are many excellent resources for family members and friends of individuals who are struggling with the disease of opioid addiction. Some recommended resources from the Substance Abuse and Mental Health Services Administration (SAMHSA) include Medication-Assisted Treatment for Opioid Addiction: Facts for Families & Friends; What is Substance Abuse Treatment? A Booklet for Families; and SAMHSA’s Opioid Overdose Prevention Toolkit - Safety Advice for Patients and Family Members.

MP: Why is routine monitoring and an individualized approach particularly important?

Each person brings a unique set of circumstances associated with their struggle to overcome opioid addiction and avoid life-threatening consequences. Individuals may have genetic differences (affecting opioid metabolism) or underlying comorbid diseases (e.g., COPD) that may increase the risk for relapse or unintentional overdose. Additionally, many struggling with opioid addiction were once medical users for an underlying chronic pain condition, further supporting the need for an individualized approach.

The print edition of "Medication Addiction" to USA Today featured an incorrect citation attributed to Eric Edwards. The corrected version is featured above.
Vice President Clinical Research and Advocacy, Millennium Health

Steven D. Passik, Ph.D.

Mediaplanet: How has the widespread use of pain medications contributed to the national epidemic of opioid addiction in recent years?

Pain drugs can have a therapeutic benefit for patients. However, these potent medications can cause harm if not used, stored or disposed of properly. The current epidemic was exacerbated by a well-intentioned effort, which began 20 years ago to help patients with pain by prescribing powerful new opioids without being fully educated on strategies and tools to minimize potential harm. Proper prescribing and monitoring can help reduce the risk of misuse and abuse.

MP: What role does medication monitoring play in preventing addiction to prescription medications?

Medication monitoring as part of a treatment regimen for pain and mental health is an important tool for clinicians, as it helps them to know whether their patients may be taking their prescribed medications and whether they may be taking other substances. If a clinician receives unexpected results, this provides an opportunity for them to intervene and administer help if needed.

MP: As a clinician, what do you think are the most successful treatment options to help pain patients trying to recover from addiction?

Every patient is different. For those patients who suffer from pain and addiction, an integrated approach including addiction professionals can result in expert attention to both problems.

MP: What resources do you recommend for the friends and family members of patients who suffer from addiction?

There are myriad approaches to addiction treatment. Patients and their friends and family should understand that and seek out someone who can help the person find the best approach for them.

MP: Why are routine monitoring and an individualized approach particularly important?

A risk based treatment approach helps clinicians design a program that meets the needs of the individual patient. Some low risk patients may need minimal oversight and monitoring, where as higher risk individuals may need more. What’s been missing is risk stratification and getting people into treatment scenarios that are matched to their risk.

MP: What are the most promising addiction treatment options on the horizon?

Removing the stigma of getting treatment, and improving access are the most promising developments. It’s important that we recognize that the misuse and abuse of prescription medications is a public health crisis that will require a community-based approach.

Founder and CEO, Newport Academy

Jamison Monroe

Mediaplanet: Why has the abuse of opioids grown into a national epidemic in recent years?

We've seen a massive uptick in the use of opiates due to ease of access for virtually everyone. With pharmaceutical companies pushing more and more uses for medications, there has been a huge excess of prescription drugs available to the public. Daily, we see unsuspecting teens begin a routine opioid pain medication regime, only to become addicted and ultimately turn to heroin. It's tragic.

MP: What role does medication adherence play in preventing addiction to prescription medications?

It’s certainly a major component in the overall prevention model. However, the solution begins long before that medication is ever prescribed. Early awareness campaigns are critical for both patients and physicians with regard to addiction and prescription medication abuse. We know that adolescent awareness campaigns positively impact the way people perceive addiction as adults, however, if the physicians themselves aren’t actively looking for ‘drug seeking’ behavior and intervening accordingly, the prescription abuse issue will persist.

MP: In your experience, what have been the most successful treatment options for recovering addicts?

In our experience, treatment protocols must be individualized according to each unique situation, which means there is no one-size-fits-all approach. We choose to focus on, and see the best results, when we focus on, and heal, the issues that are causing teens to act out—trauma, abandonment, low self-esteem, anxiety, depression, abuse, neglect and incongruent family systems. 

MP: What resources do you recommend for the friends and family members of addicts?

While we offer a full list of support tools for families struggling to help an addict and themselves, the most imperative step is to reach out to a reputable, accredited addiction expert to design a treatment and support plan for the entire family. Addiction is a family disease and frankly, if the entire support system doesn’t get some help and tools, the addict is far less likely to thrive in sobriety.

MP: Why is routine monitoring and an individualized approach particularly important?

It is well established that addiction is not just a disease, but also one of the most destructive forces known to man. Just like any other disease, heart disease or diabetes, proper monitoring and continuing care is necessary to achieve life-long, sustainable healing. With so many social and cultural influences promoting the recreational use of drugs and alcohol, having an ongoing support system is a necessary defense against relapse.

MP: What are the most promising addiction treatment options on the horizon?

The future of addiction treatment isn’t one solution, it’s a collective set of tools brought forth by a battery of experts from different fields. While we hear about new scientific advances every week in the press, I strongly believe that a return to human connection though yoga and meditation is the best treatment option available.