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Wednesday
Apr112018

* * Anne Giles wants us to know about opioid use disorder

Blacksburg’s Anne Giles is on a mission to educate us on opioid use disorder. Anne is in recovery from addiction to alcohol and is acutely aware of the problems and stigmas associated with addiction.

Anne spent most of her formative years in Blacksburg, getting her bachelor's and master’s degrees at Tech. She left Blacksburg in 1983, earned a master's in counseling in Florida, and returned to Blacksburg in 2006 to spend more time with her mother during her final years.

In 2008, Anne started a technology company that proved not to be successful. Meanwhile, she began volunteering on the Board of the New River Valley Community Services. “I was so uplifted by their programming that I asked to work there,” she told me. “I was hired part-time as a counselor and I have been there for several years, and that’s what I’m doing now professionally.

“Opioid use disorder is one of many substance abuse disorders. It is one of the few that research shows that responds well to medication, to two in particular: methadone and buprenorphine. Methadone is only available at federally regulated clinics. However, buprenorphine is inexpensive and plentiful, but heavy regulation limits access to it.”

“We have declared that we have an opioid crisis across the nation, but the medicines known to treat it are essentially inaccessible. Most people with substance use disorders have experienced some sort of trauma. Physical trauma. Mental Trauma. Sexual trauma. Neglect. Violence. Loss. Death. All of it. Often someone is traumatized in childhood. Childhood trauma is correlated with mental illness in adulthood.

“Human beings have used substances for thousands of years. The beauty of being human is that we take risks, we adventure, we discover and explore. We desire, we long. 5000 years ago in Sumer, the Sumerians were ingesting beer. We have way more problems with alcohol than with opioids.

“Marijuana. Caffeine. We use substances for many purposes. When our use persists despite negative consequences, then it becomes a problem. That’s the definition of an addiction. Functionality in taking care of oneself. Functionality in maintenance of relationships. Functionality in citizenship or at work. When these functions are impaired, use has become a problem.”

Admitting to be virtually ignorant on the topic, I asked, “How big a problem is this?”

She said, “If death rate is what we care about, there are many more things that are causing pre-mature death than opioid use disorder. But basic humanity calls us to alleviate suffering. People with opioid addiction are suffering. Medications are denied them, and they are suffering. If you had diabetes, and you were not permitted access to insulin, I would be upset about it.

“Doctors have to be waivered to prescribe these medications. They have to go through training and are limited in the numbers of patients to whom they can prescribe.

“I would like for our citizens to speak to their representatives, their elected officials, to ask, ‘why can’t people have these medications?’

“I developed alcohol use disorder following the Virginia Tech shootings. Fifteen percent of people who experience violence develop PTSD (post traumatic stress disorder). Of those, 5% develop addiction. We live in a whole community affected by the event.”

“Why were the 15% different?” I asked.

“There are many pre-disposing factors to experiencing trauma in a way that develops into PTSD,” she said. “There are numerous research studies on known factors. It’s a social phenomenon (following these shootings). It happened at Columbine. It happened here. I’m sure it will happen in Parkland (Florida).

“The problem with substance use disorder is that it is perceived to be a moral and personal failing. The Surgeon General’s report that came out in 2016 disabuses us of that notion. It is a health condition. But the majority of people still think it’s a personal problem or failing. The research doesn’t support that. We’re having a national conversation on a number of fronts, and this is one of them. There’s a larger problem with Americans not valuing science and knowledge. Changing beliefs with knowledge is harder than I thought it would be. The problem with substance use disorder is that it can result in pre-mature death. It’s an emergency. We need to honor the facts.”

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