Doctor panelists and community members weigh the role of medication in addiction treatment

Representative Tom Dent sheds light on stigma surrounding mental illness

Doctor+panel.+Photo+by+MJ+Rivera

Doctor panel. Photo by MJ Rivera

MJ Rivera and Zileni Milupi

Friendly chatter, free food and educational discussions created a welcoming atmosphere as attendees walked in the Hal Holmes Community Center for the Doctors Talk Addiction seminar on April 28. 

Hosted by Merit Resources, the seminar was the second part of the “Let’s Talk Addiction” series first launched in September, Recovery Month, in 2020. 

Melissa Denner, CWU alum, licensed mental health counselor at Merit Resources and organizer of the event, said that her passion for addiction recovery treatment is what inspired her to pitch this event to her boss and help put it on. 

“It’s not just [about] the medical illness or disease,” Denner said. “It’s understanding the person with the addiction and understanding the experience of living in active addiction, and the process of experiencing finding a way out into active remission. It’s much more than an illness because it’s attached to people that we love.” 

Organizing the event 

Merit Resources is a local drug treatment and rehabilitation center that provides outpatient drug and alcohol treatment services in Ellensburg, Yakima, Sunnyside, Wapato, Toppenish, Pasco and Kennewick, according to meritresources.org

Denner explained that the feedback and attendance for the first part of the series was positive enough to create a second part of the series featuring a panel of medical professionals. 

“This idea of having a series so that we could bring together professionals who have frequent contact with people with substance use disorder or work directly with people with substance use disorder and include community members and family and friends, as well as people in recovery with lived experience,” Denner said.

Denner hopes the event brings relationships and connections in the community. She also mentioned how important it is for CWU students to be part of community discussions. 

“I often think of Central when I’m doing things within the community, because students are here and some students at my last event came and they were one of the people who gave me the most positive feedback,” Denner said. 

Pre-seminar 

Vicki Strickland, drug court case manager at Merit, had been helping with preparations for the seminar for the past couple of months. 

“I would say the importance of the event is to educate the community about addiction,” Strickland said. 

Treatment director of Merit Pedro Lopez explained that one of Merit’s main goals of the event was to spread public awareness in regards to medication for opioid use disorder. 

“What I wish to learn more is medications for opioid use disorder, medication assisted treatment, and really be able to see how we can bridge in medication treatment, a different type of cognitive behavioral therapy and how these two work together to get to the truth,” Lopez said

Medications and addiction

Denner asked the three panelists a series of questions that they took turns answering, and she took breaks between questions to give the audience a chance to ask their own questions.

Panelists included Clinical Pharmacist Dr. Nancy Hecox, PharmD, who specializes in chemical dependency, Executive Medical Director of the Washington Physicians Health Program (WPHP) and Clinical Associate Professor of Psychiatry at the University of Washington School of Medicine Dr. Chris Bundy and Board-certified family medicine specialist Dr. Greg Rehmann M.D.

Bundy spoke on the magnitude of the addiction issue that America faces and the role that medication plays in solving this issue.

“Medications are certainly a critical part to get you to dance, but they’re definitely not a part of an overall comprehensive approach to addiction,” Bundy said. “We don’t have an opioid epidemic in this country, we have an addiction epidemic in this country. Alcohol kills more people than opiods every year. Nicotine kills a quarter of magnitude more people than alcohol every year. But we’re really focused on opioids right now and we really need to look at the larger picture of addiction.”

Bundy said that addiction treatment from medicine has not been tested to its full capacity- there need to be more long-term data from longer studies.

“I hope that we have increasingly better treatments for the variety of different substances that can kill people,” Bundy said. “And that we stop thinking in terms of, ‘there’ll be a medication that will fix this,’ we need to do other things in addition to medication.”

Rehmann and Hecox felt similarly about the role of medication in addiction recovery; however, Hecox spoke more on abstinence from all medications as an end goal, while Rehmann leaned more towards catering to the goals of each individual.

“I love what [Hecox] said is that the final goal is abstinence- and it may not be for everyone,” Rehmann said. “I’m not the arbiter of somebody else’s recovery…Do you have a goal, is it a goal of abstinence?”

Hecox and the other doctors agreed that every addict’s recovery plan is their own and should not be compared to anyone else’s.

“Just because my frame of reference about what recovery is, doesn’t mean that has to be your frame of reference,” Hecox said. “Just because it’s just the way I did it or worked for me, it may not work for you.”

Cause and prevention

Bundy highlighted other important factors in recovery, such as a strong support system, that can help alongside medications.

“Never underestimate the value of the milieu of peers in terms of enhancing motivation and getting people over the next hurdle,” Bundy said.

In order to prevent cases of addiction in the future, Bundy said there needs to be a new way to approach the topic in education.

“There’s a whole field of early education, of drug education, in schools,” Bundy said. “Lots of things haven’t worked, like the ‘just say no’ generation. So, I think in terms of how you bring this to young people in schools is super important.”

Rehmann explained that one of the common misconceptions about drug use has to do with fentanyl. Rehmann and Bundy added that fentanyl addiction is mainly caused by illegal production and distribution.

“It really goes back to the [fact that] fentanyl is being produced illicitly and not by the corporations,” Rehmann said.

“In China actually, and then shipping in the US through Mexico,” Bundy said. “It’s actually a lot cheaper to make fentanyl in our lab in China than it is to grow opium in the opium poppy fields of Afghanistan…there’s definitely a market reason why fentanyl is what we see now in the illicit drug supply.”

According to Bundy, ever since cannabis legalization, the illicit cannabis drug supply has actually increased in the U.S. rather than decreased. 

“Beware of the temptation to oversimplify,” Bundy said. “I’ve just really learned the hard way that it’s rarely a simple story. There’s rarely a simple answer. Things are complex, and [we need to] treat complex problems with complex solutions.”

Washington state representative Tom Dent spoke after the doctor’s talk about his connection to substance use.

“There’s a lot of stigma around mental health,” Dent said. “In particular, around addiction recovery, alcoholism, substance abuse, whatever the current term is. And it’s something that we can, everybody in this room, could work and change. Because there doesn’t have to be.”