An open letter to people with substance use issues in the New River Valley of Virginia
A guest post by Sanjay Kishore
If you’re reading this, you may question whether or not you have an issue with substance use, whether that’s alcohol, heroin, meth, or prescription drugs. If you do you have concerns, you may feel like you can overcome it on your own, or with the help of your friends or family. You may feel that you don’t need any outside help from folks like I am – medical providers – because you feel like you might be cheating on “real recovery.”
I’m here to offer you another view. My name is Sanjay. I was born and raised in Southwest Virginia, and graduated from Radford High School. Right now, I’m a medical student at Harvard.
I am becoming a doctor to serve people. I want to share with you my understanding of effective treatment for addiction, straight from the halls of Harvard, so you can understand how to overcome substance use issues and addiction and get the help you both deserve and need.
Your path to success is much harder because of where we are from. That’s the honest truth. In our area, many people believe that all substance use issues are moral failings. We are taught that it is a person’s fault for even trying substances in the first place, and their own problem if they develop an addiction to them. Society tells us that the only way to fix the problem is to have enough willpower to simply “choose ” to stop being addicted. If you can’t do that, it’s believed you deserve to be punished – sent to jail, separated from your kids, fired from your job.
That narrative is not based in truth and science. More importantly, it has been responsible for the unnecessary deaths of thousands of individuals in our region alone. Addiction is a health issue. It can be treated quite effectively. And, most importantly, it’s not cheating to accept medical help for addiction. It simply makes sense to get health care for a health problem.
You may be resistant to going to a doctor. However, to get proper treatment, including medications and counseling, you have to be willing to see a medical provider to undergo a comprehensive evaluation of your physical and mental health. Medical providers like I am can AND want to be a part of your team. We are ready to help you through this process.
You can help us help you by separating the concepts of addiction and dependence in your mind. Addiction is a medical illness. Dependence is a physical response to the presence of a substance, such that a person feels physical withdrawal symptoms when that substance is absent. All people have dependence upon air and water and suffer without them. Taken over time, some medications, including antidepressants, blood pressure stabilizers, and opioids, result in drug dependence. Simply having withdrawal does not mean you are addicted. Infants may be born dependent upon substances, but they are not born with the medical illness of addiction. This is very important to understand when thinking about treatments that exist for addiction.
Scientific evidence has demonstrated that there are multiple treatments for addiction that can help save lives and transition people to recovery. These include a combination of medications, counseling, and other recovery support services. Importantly, withdrawal management alone is not proper treatment. Over 50% of patients with substance use disorders who enter short-term detox programs are not connected to proper follow-up treatment and return to use. Staying connected to medical professionals and other treatment providers will help you recover.
While medications are the first line of consideration for treatment of addiction, unfortunately, medical professionals in our area may not be willing to prescribe medications. There are some who do, however, and it is important for you to seek them out. It is important for you to try, and to ask directly for medications that may assist you. Medications for addiction can be very effective.
Medical professionals can help with other health problems. A significant proportion of people with substance use disorders have an underlying mental illness, such as anxiety, depression, or bipolar disorder, or a history of childhood trauma. Even if you have a specific substance use disorder that does not have a targeted treatment, medical experts have the ability to help manage other issues you may have that could help make your transition to recovery that much easier.
You may not even know you are suffering from a mental illness. For instance, many disorders can manifest themselves as physical symptoms, sometimes as pains and weaknesses, other times as nausea and diarrhea. It’s important to establish a relationship with a medical provider who can evaluate you through taking your history, performing a comprehensive physical exam, and ordering appropriate laboratory tests.
At the same time, many forms of drug use can place individuals at increased risk of other medical conditions. Sharing needles through injection drug use can transmit diseases like HIV and hepatitis C, which can cause devastating consequences, but can be treated by medical professionals if caught early. Some people re-using and sharing syringes can get bacterial infections of the valves of the heart, called endocarditis, which is a life-threatening condition.
Persistent alcohol use can cause liver failure, cancer, and pancreatitis, and requires monitoring of enzymes in your blood. Cocaine use can cause increased strain on your heart, and even lead to heart attacks.
I hope you are convinced by the case I, Sanjay, a fellow citizen from Southwest Virginia, have made: If you have the health condition of addiction, you need and deserve health care.
If you have substance use concerns, it can be extraordinarily helpful to establish a connection with a medical provider. This doctor, nurse practitioner, physician’s assistant, or other medical professional can help you connect with not only the right treatment for your addiction, but make sure you are safe, screen you for any other diseases that you may be at risk for, and link you to proper treatment for other conditions related to your mental and physical well-being.
I, and other members of the medical profession, are here to help you.
Sanjay Kishore is a fourth-year student at Harvard Medical School with hopes of becoming a primary care physician. He was born and raised in Radford, Virginia, where he first learned of substance use disorders and addiction. He then received his B.A. from Duke University, where he designed his own major entitled, “The Social Determinants of Health.” He worked with leading health policy experts as a Villers Fellow with progressive advocacy organization Families USA. As a community organizer, he founded Virginia’s first student-run health insurance enrollment campaign. He is a recipient of a 2017 Paul and Daisy Soros Fellowship for New Americans.
Sanjay advocates for the establishment of safe injection facilities in Southwest Virginia:
- The time is now: Safe injection facilities in Virginia, Roanoke Times, 4/8/18
- The case for needle exchanges in Southwest Virginia, Roanoke Times, 5/14/18
This guide to requesting medical care for addiction may be helpful to take to medical appointments.
The views expressed are the author’s alone and do not necessarily reflect the positions of any institutions or individuals associated with the author. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.
