Doctor-led website helps opioid addicts break free
VANCOUVER — Three years ago Jenn Dutton was a successful psychiatric nurse, living in a Vancouver suburb with her boyfriend and his two children.
After a rear-end car accident left her with painful whiplash injuries in her back and neck, Dutton’s physician prescribed Percocet, an opioid pain reliever. Thus, innocently, began her descent into hell.
“I had a happy life, great family and good, supportive friends and I had never struggled with addiction,” she said. “In my car accident I had the kind of soft tissue injuries you’d expect, but I was also diagnosed with a rare chronic pain syndrome, burning mouth syndrome, due to nerve damage in my neck.”
At first, Dutton took the recommended dosage of four tablets a day, but she soon began to increase her dosage and — in retrospect — display classic addict behaviour, rationalizing her dependence as pain management.
“The addiction developed quite quickly, probably within a month,” she said. “Within two months I was manipulating my doctor, always asking for more. Because my doctor trusted me and because I was a health-care professional and I knew what to say and what not to say, after two months I was on the maximum dose allowed, which is 12 Percocets a day.”
Dutton is not alone. About 800,000 Canadians use prescription opioid drugs, such as oxycodone, codeine, fentanyl, morphine and hydromorphone, according to the Canadian Alcohol and Drug Use Monitoring Survey. More than 240,000 Canadians admitted to abusing them in the past 12 months.
Addiction researchers typically estimate that as many as 90,000 Canadians are addicted to heroin and other opioids. Not surprising, since Canada last year displaced the United States as the world’s leading consumer of opioids, according to the International Narcotics Control Board.
Like many opioid addicts, Dutton continued to work even in the depths of her addiction, which came to include OxyContin.
“I thought everything was fine, but looking back I was only partially present,” she said. “For the first month I wasn’t taking them during the day because I wanted to be clear-headed for work, but that didn’t last very long.”
Professional pride and the shame of losing control of her addiction added to Dutton’s state of denial.
Eight months after her accident, Dutton’s nerve condition was mostly healed, but she continued to obtain as much Percocet and OxyContin as ever, waking up each morning in withdrawal and struggling to make it to work.
“Doctors need to be really careful as patients request higher doses because (addiction) can come on so quickly,” Dutton said. “I feel quite badly for manipulating my doctor now that I am back to being a decent person.”
Dutton finally confessed her addiction to her now exboyfriend and her mother and they decided to attempt a home cure. She stayed off the pills for about one month. “Even though I was in health care I had no idea where to begin looking for help with an opioid addiction,” she said. “I thought foolishly that I could take care of it myself.”
But once Dutton talked herself into one pill at bedtime, it was only days until she was back to taking pills from the moment she woke up until she went to bed.
A few months later, consumed by self-loathing and pondering suicide, Dutton began to look for help online.
“There was nothing out there that told you where to begin and what steps to take,” she said. “I Googled everything about addiction.”
A word-of-mouth referral led Dutton to one of the city’s few addiction specialists, Dr. Jennifer Melamed, and after two rounds of treatment, she broke free of her addiction.
Melamed was one of several specialists, experts and patient advocates who consulted on the new website opioidrecovery.ca, launched this week by Dr. Joel Bordman, with arm’s-length financial support from Reckitt Benckiser Pharmaceuticals in Canada.
“We decided it was absolutely necessary to provide something for people struggling with addiction to let them know where to go; there was nothing out there,” she said.
The website contains selfassessment tools to help people who think they may be addicted — or their families — to recognize the warning signs. There are also descriptions of how detoxification and treatment works, links to support groups and detailed instruction on how get help. A page of specialist doctors is under construction.
“Drug use in the beginning is a choice, but addiction is in many ways a disease of insanity, in which people keep making the wrong choices and they don’t know how to go anywhere else,” said Melamed.
The site is also designed to be a resource for physicians, many of whom have little training in managing or even recognizing addiction in patients, she said.
She sees the website as a low-barrier entry point for people who have to reach out for help before they can make a serious attempt at recovery.