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St. Joe's is a nationally award-winning health care provider, offering excellence in the areas of Cardiovascular, Orthopedic, Cancer, Women's Health, and Pulmonary care. We take great pride in earning the trust of the community and in being the health care provider of choice for North Oakland County residents and their families. Discover Award-Winning Care For a referral to a St. Joe's physician or more information, visit stjoesoakland.org or call 800-372-6094. 2159570 56 November 30 • 2017 jn continued from page 54 health person's life. Without that next fix, the person will experience withdrawal symptoms. Keeping withdrawal in check becomes more important than any other commitment in the addict's life. "What the addict has to do to get the next dose often has more anti-social conse- quences than the drug dependency itself." And if he doesn't get that next dose? A person would suffer withdrawal symptoms, which an addict avoids at all costs. Addicts feel compelled to find the next dose and that search replaces social, occupa- tional and recreational activities. Everything revolves around avoiding withdrawal. TREATMENT METHODS Opiate-use disorder is treated with methadone-assisted recovery. A dose of methadone can last for 24 to 100 hours. During that period, the client does not have to worry about with- drawal and can begin to focus on the rest of life, including job, interactions with people and concern for mental health. As the client rebuilds the network of life, he or she can begin to taper off the use of methadone. The patients also need intensive counseling. "We do compassion-based therapy," Gomez says. "Compassion differs from pity. Pity lets us off the hook. Compassion makes demands. It means that we have to say, 'Let's figure out how to make this better.'" Even with counseling and metha- done, Gomez reports that "the recov- ery rate stays at about 50 percent. The client has to be ready to overcome the addiction for this treatment to work." The long course of treatment and the uncertain results frustrate observ- ers. While ER physicians and emer- gency medical technicians generally work to stabilize their patients in cri- sis, addiction medicine physicians and counselors like Gomez work with the patient over the long term to help him or her change. This also involves a change in the way the public perceives the disease of addiction and the way individuals struggling with the disease are per- ceived. Sometimes patients get written off. People who make policy want to punish. Maybe long prison sentences will prove effective. Yet Gomez asks, "If it were your son or wife or daughter, would you write them off so easily?" Gomez, speaking as a drug rehabili- tation counselor and also as a rabbi, says, "The first rule for treatment of opiate-use disorder comes right from the Mishnah. 'Hillel says: Do not judge your fellow until you have stood in his place' (Avot 2:4). We have not experi- enced what the patient has, and we should not judge the patient." Feinberg Consulting in West Bloomfield provides case man- agement for people coping with addictive drugs and for their families. When people come in looking for treatment recom- mendations, "we do a thorough assessment that provides the information necessary to make appropriate recommenda- tions," says Steve Feldman, COO at Feinberg Consulting. But sometimes, he says, the situa- tion calls for a dramatic intervention. "Recently, we coached a family on inviting their relative to come to a meeting about the crisis in the fam- ily," Feldman says. "He attended. The other family members each shared a letter they had written him, sharing their thoughts about him and about how he had changed — not to blame or shame him, but, please, please, to get him to accept help. He did decide to enter a residential facility in another state." Feldman explains that helping the individual also means helping the family and the whole support sys- tem. "By the time we get a call about someone in crisis, there has usually been a breakdown in the whole sys- tem. Intervention means finding an alternative to the road the person is now on. A person addicted to drugs or alcohol is on a road that leads to pain and misery and destruction." At first, Feldman notes, the family response is likely to be, "It is not so bad; we do not need to do anything today." "The disease wants that response," Feldman says. "It thrives in shadow. We illuminate options. There is an alternative to the pain and misery of active addiction." Feldman travels the country to learn about treatment alternatives. "Each treatment center has its own strengths and specialties," he says. "We try to vet the facilities from a clinical and an ethical standpoint. We want to know which facility would be a good fit for which client. Some specialize in working with clients of a certain age; some work exclusively with male, or female, or gay, lesbian, or transgender clients; some with clients who suf- fer only from addiction, and some with clients who have mental health issues." Finding the proper facility is diffi- cult and confusing to navigate on your Steve Feldman