Chester County Medicine Winter 2020 - 9

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Know your facts. Addiction can also be called SUD or
substance use disorder, and Opioid Addiction can also be called
OUD or opioid use disorder. Babies are not born addicted; it is
impossible for an infant to be addicted. The proper terminology
is born dependent, exposed in utero, or born with neonatal
abstinence syndrome (NAS).
Employ non-judgmental terminology and actions. This
increases the likelihood that a patient will seek and maintain
treatment. When someone comes to a medical professional for
help with a substance use disorder, it often takes every bit of his
or her will and physical and emotional energy to reach out. These
conversations begin with well-intentioned words, but can devolve
into condescension based on preconceived ideas. Avoid using
terms like addict or junkie. Always use person-first language, such
as "Joe has a marijuana use disorder." "Sara is a person in need
of treatment for an opioid use disorder," and "John is a person
in long-term recovery." When speaking about toxicology results,
avoid calling the results dirty/clean, instead use the terms positive/
negative.
Include family members in your conversations. Behind
every patient is a devastated family holding onto the hope that
their loved one will find recovery. When possible, include
family members in the planning process. Listen to what the
family members are saying, or ask for their thoughts. Often,
family members have been traveling this long, dark road with
their loved one and can provide valuable input. Involving the
family from the first step also allows the family unit to better
understand what processes they may need to put in place before
their loved one comes home. A family member's substance use
impacts the entire family unit. If you're able to refer parents and
caregivers to sources of emotional support for themselves, please
consider recommending resources like Al-Anon, Nar-Anon, or the
Partnership for Drug-Free Kids free parent coaching program.
Be mindful following an overdose episode. Do not tell patients
or their family members that the use of Naloxone (Narcan) should
be limited per person -- this medication is a temporary opioid
blocker, not a treatment. It is a lifesaving tool that should be used
as many times as necessary. Keep in mind that when a person has
recently been revived with Naloxone, they may be irritable. If the
patient is not able or willing to answer questions, give them some
space and revisit.

Reserve judgment and opinions. Addiction is a disease, and
when someone comes to you for help, personal opinions do not
matter. Avoid hallway or side conversations about the patient,
or discussing the patient with coworkers in front of the patient
or family members. We know our children sometimes appear
to be behaving emotionally much younger than their age. This
is believed to be the result of using substances at a young age.
Sometimes, taking an extra moment to explain the process makes
all the difference in your ongoing relationship with the patient and
their family.
Changing the way that we speak about substance use disorder
in a clinical setting is a critical first step toward helping our
communities recognize addiction as a disease. Your compassion
and effort can be the difference between a patient refusing to ask
for help and helping them start and stay on a lifelong recovery
journey.
Kathy Strain is an educator with Drug Free Workplace
PA, a state-funded program that assists employers with policy
development, training, and resources. They also provide substance
use education and signs and symptoms of use to health systems
and community organizations such as Scout troops, schools, places
of worship, and college and universities. Kathy can be reached at
KStrain@dfwpa.org.

This article was first published in the Fall edition of Central PA
Medicine, the official publication of the Dauphin County Medical
Society. It has been reprinted with the permission of the author and
the Dauphin County Medical Society.

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