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Moises E. Quinones, M.D. ("Dr. Q") has over 36 years treating substance use disorders. "Dr. Q" is Board Certified Fellow of the American Board of Addiction Medicine (ABAM), member of the American Society of Addiction Medicine (ASAM). American Board of Internal Medicine (ABIM) and Board Eligible by the American Board of Emergency Medicine  (ABEM).  

"Failing to prepare is preparing to fail."   -Benjamin Franklin

Is addiction a disease or a set of deeply entrenched habits or both? Professor Peter Cohen in the Netherlands said, "maybe we shouldn't even call it addiction.Maybe we should call it bonding. Human beings have a natural and innate need to bond, and when we're happy and healthy,we'll bond and connect with each other, but if you can't do that,because you're traumatized or isolated or beaten down by life, you will bond with something that will give you some sense of relief.  Now, that might be gambling, that might be pornography,that might be cocaine, that might be cannabis, but you will bond and connect with something because that's our nature. That's what we want as human beings."

There is compelling evidence that our behaviors surrounding Substance Use disorder (SUD) have more to do with seeking connections in our lives than drugs. Why do many say they take drugs to "feel normal?" Substances give us the feeling of being connected. Consider why alcohol is called a "social lubricant." Consider the following 14 minute You Tube video by Johann Hari entitled "Everything You Thought You Knew About Addiction is Wrong."  

Who or what addiction is, who or what caused it is not as important as; what to do about it.  Much has been made of the changes to brain circuitry in addicted individuals. However, our brains are constantly changing and new circuits are constantly being formed. Scientists who study brain changes know behavior can change our brains as much as many medications. We now know that we make new brain cells (neurons) and "re-wire" our brain's circuitry (neuroplasticity) both from behaviors as much as substances. But when it comes to understanding certain things about the brain such as consciousness, linguistics and spirituality even the best scientists in the world are humbled with how much we have yet to learn.

Brain researcher George Koob MD: "Remember, psychology is biology. Whatever changes occur in the way we think and the way we do things are ultimately conveyed by some neurochemical change in the brain. Let me give you a very powerful example. My colleagues up at UCLA, Jeffrey Schwartz and Lou Baxter, have been studying Obsessive-Compulsive Disorder, which is generally considered to be an anxiety disorder but has some similarities to addiction. They can do PET scans on people with Obsessive-Compulsive Disorder and show deficits in certain parts of the brain. They can reverse those changes in the obsessive-compulsive patients by treating them with Prozac. But they can also reverse those changes completely with a behavioral therapy that they have developed to treat the condition without drugs. So both the behavioral therapy--a form of psychotherapy--and drugs, when they treat the patients effectively, make the same change in the brain. Is it psychological or is it biological? It's both. And it doesn't matter. You can get the same results either way."

Addiction is also a disease and/or a condition of More. The treatment for addiction is  MORE; more healthy motives, choices, support, coping, acceptance, accountability, connections, rewards, gratitude and learning; all of which lead to growth and freedom. I'n not a fan of big-pharma and their pills, when coping skills and tweaking out minds and hearts produce long lasting healthy effects.  

I believe Medication Assisted Therapy (MAT) is a window of opportunity to address the psycho-social-spiritual challenges at the core of our dependence. Addiction is too complex just to throw medication at it and expect a cure. MAT is not Medication As Therapy. MAT, whether with an opiate blocker; Vivitrol®/Revia® or a partial-opiate agonist; Buprenorphine (Suboxone®, Zubsolv®, Bunavail®, Sublocade®, Probuphine®), is only a stabilizing measure to address the deeper roots of our SUD.

While QMC highly values and encourages the use of 12-step facilitated programs because of their sound principles and compelling success, we recognize that recovery does not come in a box or a one size fits all. The principle of  sound guidance, support, counseling and accountability (HONESTYprove to be essential ingredients to a sustained remission from this devastating condition. What these principles look like in the patient's life may vary widely. If you're just looking for pills and thrills instead of skills, you may not be ready for recovery and you may want to keep looking. 

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Ultimately, Suboxone is a great help to people who have nowhere else to turn. But its greatest benefit is in helping people be receptive to real addiction treatment. When you suffer from addiction, the substance or process that caused the addiction is only secondary. The reason it’s so easy to move from one addiction to another is because addiction itself is the problem. Once you become addicted, your mental processes change, and you become more prone to compulsive behaviors in the future.

This is why Suboxone alone will not make you overcome addiction. It can release you from the grip of your particular substance of choice, but until you truly understand the nature of your addiction and develop strategies for recognizing and avoiding compulsive / unhealthy behavior in the future, you will not have truly overcome your addiction.

Suboxone exists as a great way to bring you back from the brink and make you much more receptive to the real addiction treatment you need. But it is, ultimately, a painkiller. Like any painkiller, it treats the uncomfortable symptom, not the problem.

Addiction is the problem. Opioids are the symptom. To truly get your life back, you have to treat both, and with the right treatment and persistence, you will get your life back.

THANK YOU for trusting me to care for you at this important time of your life.  I look forward to working with you.         Dr. Q