health
continued from page 54
person’s life. Without that next fix, the
says, “The first rule for treatment of
person will experience withdrawal
opiate-use disorder comes right from
symptoms. Keeping withdrawal in
the Mishnah. ‘Hillel says: Do not judge
check becomes more important than
your fellow until you have stood in his
any other commitment in the addict’s
place’ (Avot 2:4). We have not experi-
life.
enced what the patient has, and we
“What the addict has to do to get
should not judge the patient.”
the next dose often has
Feinberg Consulting in West
more anti-social conse-
Bloomfield provides case man-
quences than the drug
agement for people coping with
dependency itself.”
addictive drugs and for their
And if he doesn’t get
families. When people come in
that next dose? A person
looking for treatment recom-
would suffer withdrawal
mendations, “we do a thorough
symptoms, which an addict
assessment that provides the
avoids at all costs. Addicts
information necessary to make
Steve Feldman
feel compelled to find the
appropriate recommenda-
next dose and that search
tions,” says Steve Feldman,
replaces social, occupa-
COO at Feinberg Consulting.
tional and recreational activities.
But sometimes, he says, the situa-
Everything revolves around avoiding
tion calls for a dramatic intervention.
withdrawal.
“Recently, we coached a family on
inviting their relative to come to a
TREATMENT METHODS
meeting about the crisis in the fam-
Opiate-use disorder is treated with
ily,” Feldman says. “He attended. The
methadone-assisted recovery. A dose
other family members each shared a
of methadone can last for 24 to 100
letter they had written him, sharing
hours. During that period, the client
their thoughts about him and about
does not have to worry about with-
how he had changed — not to blame
drawal and can begin to focus on the
or shame him, but, please, please,
rest of life, including job, interactions
to get him to accept help. He did
with people and concern for mental
decide to enter a residential facility in
health. As the client rebuilds the
another state.”
network of life, he or she can begin to
Feldman explains that helping the
taper off the use of methadone.
individual also means helping the
family and the whole support sys-
The patients also need intensive
tem. “By the time we get a call about
counseling.
someone in crisis, there has usually
“We do compassion-based therapy,”
been a breakdown in the whole sys-
Gomez says. “Compassion differs
tem. Intervention means finding an
from pity. Pity lets us off the hook.
alternative to the road the person is
Compassion makes demands. It
means that we have to say, ‘Let’s figure now on. A person addicted to drugs
or alcohol is on a road that leads to
out how to make this better.’”
pain and misery and destruction.”
Even with counseling and metha-
At first, Feldman notes, the family
done, Gomez reports that “the recov-
ery rate stays at about 50 percent. The response is likely to be, “It is not so
client has to be ready to overcome the bad; we do not need to do anything
today.”
addiction for this treatment to work.”
“The disease wants that response,”
The long course of treatment and
the uncertain results frustrate observ- Feldman says. “It thrives in shadow.
ers. While ER physicians and emer-
We illuminate options. There is an
gency medical technicians generally
alternative to the pain and misery of
work to stabilize their patients in cri-
active addiction.”
sis, addiction medicine physicians and
Feldman travels the country to
counselors like Gomez work with the
learn about treatment alternatives.
patient over the long term to help him
“Each treatment center has its own
or her change.
strengths and specialties,” he says. “We
This also involves a change in the
try to vet the facilities from a clinical
way the public perceives the disease
and an ethical standpoint. We want to
of addiction and the way individuals
know which facility would be a good
struggling with the disease are per-
fit for which client. Some specialize in
ceived.
working with clients of a certain age;
some work exclusively with male, or
Sometimes patients get written
female, or gay, lesbian, or transgender
off. People who make policy want to
clients; some with clients who suf-
punish. Maybe long prison sentences
will prove effective. Yet Gomez asks, “If fer only from addiction, and some
with clients who have mental health
it were your son or wife or daughter,
issues.”
would you write them off so easily?”
Finding the proper facility is diffi-
Gomez, speaking as a drug rehabili-
cult and confusing to navigate on your
tation counselor and also as a rabbi,
Discover
Award-Winning Care
St. Joe’s is a nationally award-winning health
care provider, offering excellence in the
areas of Cardiovascular, Orthopedic, Cancer,
Women’s Health, and Pulmonary care.
We take great pride in earning the trust of
the community and in being the health care
provider of choice for North Oakland County
residents and their families.
For a referral to a St. Joe’s physician or
more information, visit stjoesoakland.org
or call 800-372-6094.
2159570
56
November 30 • 2017
jn