NEPA Vital Signs - Summer Fall 2017 - 19

S U M M E R / F A L L 2 017

Our goal is to work in tandem with providers and care teams,
actively coordinating any Medically Assisted Therapy (i.e. Vivitrol
and Buprenorphine), social supports and case management care
we may provide to their patients.

Do you know someone who may be struggling with an
opioid use disorder? Connect with our Director of Behavioral Health, Scott Constantini, to learn how The Wright
Center's Center of Excellence can work with you to help
them break the grips of addiction.

For patients, our Wright Center COE provides and actively
coordinates vital medical, social, behavioral and lifestyle services
and links them to essential counseling services to help break the
cycle of addiction. Most importantly, we provide hope.

SCOTT CONSTANTINI is the Director of Behavioral Health
at The Wright Center. Scott works to ensure that patients receive
treatment for mental health and addiction issues, as well as
physical needs.

Addiction wins when kept in the shadows. Let's help our
patients beat it and find the light.

ust about 10 years ago I wrote an
opinion editorial called "Exploring
the Mysteries of Addiction" for the
Scranton Times/Tribune. Fast forward 10 years
and we are so much deeper into this crisis
than anyone imagined - or maybe the denial
was just too strong. So let's take a little time
and think about the serious problem with
the disease of addiction.

to help us with day to day activities. There is
an excellent website by Harvard Health Publications which describes this beautifully. In
short - "Addictive drugs provide a shortcut
to the brain's reward system by flooding the
nucleus accumbens with dopamine. The
hippocampus lays down memories of this
rapid sense of satisfaction, and the amygdala
creates a conditioned response to certain
stimuli." 1 I highly recommend going to this
Who is at risk and what is behind this risk? site for additional information.
Have you ever seen a family with 3 or 4 children
where 2 or 3 of the children are what we would
Another known risk factor is traumatic
consider good kids? And yet there is the 1 child brain injury. This includes any type of trauwho deviates from the family norm and begins ma - i.e. surgery, infection (meningitis),
to experiment with drugs (this includes ciga- concussion, or more serious injury. When a
rettes and alcohol - because they are both also brain is injured the area of the brain which
drugs). Why? All of the children in the family controls pleasure - Dopamine release in
were raised the same - had the same rules, had the nucleus accumbens - may be damaged.
the same family lived experience, and fortunate This may result in an irregular response to
enough to grow up in a supportive and loving Dopamine and other external chemicals.
family environment. So why did that one child
supposedly veer off? If I knew the answer to
We also know that the earlier a person
that question we could solve this problem.
tries addictive agents the more likely that
person is to develop a substance use disorder.
If we look at known risk factors part of In addition the method of delivery impacts
the question will be answered. There is a the possibility of developing an addiction.
genetic link to addiction. Familial addiction Inhaled, snuffed, or injected toxins have a
can skip a generation and can show up in much greater addictive result.
one sibling while not in others. The genetics
of addiction are not well understood at this
And let me add one other anecdotal obserpoint. I have met people who after their first vance. As I met with and spoke to countless
alcoholic drink had an intense desire for families, the one thing that seemed constant
more - immediately. This is a challenging was that the one child with the substance use
disease for certain.
disorder was the one child that always seemed
to have an issue with self-esteem. Sometimes
So how does a person actually develop an this child was an introvert but other times
addiction? It is simply through a change in the child was an Eagle Scout, captain of
the chemicals that are already in our brains the cheer squad, star football player... the

1 http://www.health.harvard.edu/newsletter_article/how-addiction-hijacks-the-brain

N E PA

VITAL SIGNS

successes didn't always negate the fact that
the child had low self-esteem. Sometimes
these strong accomplishments were just a
cover-up for how the child really felt.
So, once I had a child tell me that on the
morning of his first day in high school -
while waiting for the bus - a junior in high
school approached him and asked him if he
was nervous. He went on to say that if he
wanted to calm down he had just the thing for
him - for free. We all hope our child would
turn this offer down - but, are we sure? We
need more research in the field of addiction.
We need to stop the bias and stigma attached
to this disease. If we didn't link addiction to
"bad parenting" maybe we would diagnose
it earlier in our children and help with the
treatment before it is out of hand.
Ten years ago I wrote an op ed for the
paper - heroin use was escalating and we saw
overdose deaths in our young bright children.
There was an outcry from communities concerning the problem and then it went away. Or
did it go away? I don't think so. It did not go
away - we just stopped paying attention to
the crisis. Now we are facing a true epidemic
with countless deaths and destroyed dreams.
We cannot turn our heads away again and
we cannot say that it is someone else's child.
We need to join forces and save our children,
wives, husbands, mothers, fathers, brothers,
sisters, grandparents, friends, etc.
KAREN E. ARSCOTT, D.O., M.Sc.,
specializes in Neuromuscular Medicine.
She is Associate Professor in Clinical
Medicine at Geisinger Commonwealth
School of Medicine. Since 2008, she
has been a leader with the Northeast/
Central Pennsylvania Interprofessional
Education Coalition.

http://www.health.harvard.edu/newsletter_article/how-addiction-hijacks-the-brain

Table of Contents for the Digital Edition of NEPA Vital Signs - Summer Fall 2017