Addiction is a Disease
A Conversation with Addiction Expert Dr. Andy Mendenhall
Why are you and your practice involved with the West Linn Community Task Force?
I am passionate about teaching. More importantly, I see addiction and chemical dependency which affect 9.4 percent of our population as a poorly understood disease that affects nearly every family in this country. HealthworksNW (which is based in Beaverton) is committed to providing community based education regarding chemical dependency and mental illness.
What is the scope of the drug and alcohol abuse problem?
Forty percent of American males and 27 percent of females abuse something in their lifetime: this means use of alcohol, nicotine or other drugs that have a negative impact on some manner on their life, such as school or work performance, interpersonal relationship issues. Substance abuse also creates legal issues that abusers and their families must deal with.
Remember, this isn’t an isolated problem. Some 9.4 percent of Americans become dependent or addicted to something during their lifetime. This means that people continue to ‘use a substance despite harm.’ Often people become so attached to their drug or alcohol use, that they fail to perform in their personal lives, start to break the law, or suffer negative health consequences (liver disease, hepatitis, HIV, sexually transmitted diseases) as a result of their addiction behavior.
What are the available treatment options for people who are using?
Lots of opportunity exists for people to change their behavior and stop “getting high.” The first step is for a person to figure out that they want or need to stop. This is not always easy, because many people who are abusing or addicted to drugs don’t want to stop. Getting high feels good for many people and the brain is evolutionarily programmed to remember the experience of getting high. This memory makes it difficult for people to forget the experience. One way to describe addiction is, “The brain cannot forget the experience of getting high.” For an addict, getting high is the experience that life becomes built around.
For people who have decided they are ready to get clean and sober, lots of opportunities exist.
The most important thing to remember is that it is very difficult for people to do this alone. It is important for people to talk with their friends and family, and their doctor , counselor or pastor or rabbi about what is going on. From this point, a person can start going to AA or NA and families can
start going to Al-Anon or Narc-Anon.
Many people need to have some kind of group treatment. This means meeting in group with other people struggling with drug or alcohol abuse or addiction. Groups can be at a local clinic or treatment center from once a week to every day of the week.
Some people are best suited for treatment at a place where they live for a month or more. Residential treatment is an opportunity to ‘hit the reset’ button. There is no opportunity to use drugs or alcohol, and there is full immersion into a treatment environment with meetings
and groups throughout the day.
Most people can be successfully treated while they remain in school or at work. The evidence shows that these individuals are more successful as they are usually earlier in the stage of the disease of addiction when they come for treatment.
An important concept to remember is that getting help early is best. It is easier for the brain to forget drug and alcohol use when it has been part of someone’s life for a shorter period of time. Equally important is to remember that it is NEVER too late to get treatment.
It’s just a little “pot,” so what’s the big deal?
Marijuana is a powerful psychoactive drug that changes the brain’s dopamine level in profound and potent ways. The experience of smoking marijuana is socially acceptable in many circles and leads to frequent and potent reinforcement of marijuana abuse.
Ten percent of people that go to residential treatment because they are unable to feel normal without marijuana and are therefore unable to stop using marijuana without help.
Marijuana use is associated with poor academic performance and impaired short- and longterm memory. In addition, there is good evidence that permanent changes occur that affect risk taking behavior and long-term judgment. Patients who use marijuana for 6 months and then quit between the ages of 15 and 19 are five times more likely to suffer significant psychiatric illness (depression, anxiety, or schizophrenia) by the time they are age 45 than agematched controls who did not smoke marijuana.
At least our kids aren’t using hard drugs, right?
Wrong. In the State of Oregon in 2009, 17.8 percent of people age 15-25 abused prescription drugs at least once in the prior year. Nationally, in 2007, 20 percent of high school seniors had abuse vicodin and 5 percent had abused oxycontin once in the prior 12 months.
These drugs create potent reinforcement and quickly create deep physical dependency. Evidence exists that prescription opiate medications are the gateway drugs to heroin in young adults. Marijuana use rates compare to prescription pill abuse in the State of Oregon, and nationally marijuana is slightly more prevalent over the last 3 years.
It is important to remember that the population of marijuana abusers are the population of risk takers who are more likely to take other drugs, drink alcohol, use nicotine and/or drive drunk. The belief that marijuana is “safer” is a completely false belief based on the above facts.
Can a group such as the West Linn Community Task Force make a difference?
Yes. Awareness and education are critical factors in reducing and preventing drug and alcohol addiction. Our society has done a poor job of effectively educating our population about the disease of addiction. This disease is shrouded with mystery, denial and shame. We must remember that we are a species that is biologically programmed to seek out pleasure. Our society needs to openly talk about these issues and hopefully each person will be better educated about risk taking, and more informed regarding their own mission of “brain ownership.”
Dr. Andy Mendenhall is a graduate of Oregon Health and Sciences University and completed his family medicine residency at OHSU. He served as a Clinical Leadership Fellow prior to moving to Newberg, Ore., to enter family medicine practice. While in Newberg, Dr. Mendenhall became a consultant physician for Hazelden Springbrook, a substance abuse and addiction treatment center in Newberg. This work led to board certification in Addiction Medicine by ASAM/ABAM in 2008. Dr. Mendenhall pursued additional training in pain management and spinal diagnostics and is Diplomate Eligible with the American Academy of Pain Management. He currently leads, along with his associates, HealthworksNW. HealthWorks NW is a unique clinic composed of skilled clinicians with background in psychiatry, chemical dependency and pain management. The professionals work together to serve each client with an interdisciplinary approach to treatment.
Drug and Alcohol Abuse Counseling and Mental Health Service Providers
24-hour crisis line and referral service. 503-655-8401
An adolescent mental health and substance abuse residential program located in Gladstone, Ore. 503-722-4470, www.northwestbhs.com
Portland-based outpatient treatment center or drug-abusing teens. 503-243-1065, Visit their website
Portland-based provider of mental health and substance abuse counseling services. 503-230-9654, www.cascadiabhc.org
A provider of mental health and substance abuse services with multiple Portland-area locations. 503-645-9010, www.lifeworksnw.org
Provides psychiatry, chemical dependency and pain management care. 503-644-7300, www.healthworksnw.com
Provides drug and alcohol treatment services in the Portland-area. 503-253-5954, www.changepointinc.com
Drug and alcohol treatment services at multiple Portland-area locations. 503-239-8400, www.codainc.org
Offers substance abuse and chemical dependency services at multiple Portland-area locations.
Refer to www.westernpsych.com for specific location contact information
West Linn-based provider of adolescent counseling services including drug and alcohol issues.
A national database for rehabilitation and treatment options. www.addictioncareoptions.com
A list of drug treatment centers and programs throughout Oregon. Visit their website.