MONROE — Sobriety for someone in the grip of addiction comes in fits and starts, strides and stumbles.
Just like the treatment of any other disease or illness, Dr. Teresa Jackson said, medicine can provide relief and aid recovery. She wants the modern push by addiction treatment to follow in the ancient tradition of the Hippocratic Oath’s maxim, “First, do no harm.”
Jackson is part of the growing ranks of addiction treatment professionals who replace one drug with a prescription and regular monitoring. She prescribes patients the appropriate medication, such as methadone or buprenorphine, to help curb their addiction through a safe detoxification from alcohol and drugs. The Snohomish County Jail offers a similar process of medication-assisted detoxification.
“Most folks need help to stop drinking and to stop using opiates,” said Jackson, who recently joined The Recovery Center at EvergreenHealth at Monroe.
She knows the challenges intimately, given her own past drug abuse and recovery.
In 2011, the former surgeon had her Arizona medical practice restricted for five years because of concerns about performing surgery while impaired. She was diagnosed with drug and alcohol abuse and tested positive for anti-anxiety, antidepressant and opiate medications a few days after a March 2010 incident.
“I had a problem with substances and I went to treatment,” Jackson said, adding that she was monitored until 2016 in Arizona and was interviewed and drug tested to obtain her license in Washington earlier this year.
Through treatment, she became sober. During that time of recovery, she was given the opportunity to work in detoxification and wanted to help people struggling with substance use disorders, the medical term for what is commonly called addiction. That led the 45-year-old to her second career. Her new role is on the back end of the sobriety path, helping people out of addiction and into recovery.
“It felt very rewarding to help others,” Jackson said.
“I don’t feel ashamed of my past. I’m proud of what I overcame.”
There are many people to help. According to the 2016 National Survey on Drug Use and Health, an estimated 20.1 million people 12 and older had a substance use disorder.
A one-week count of overdoses highlights the effect in Snohomish County. From July 17-23 last year, 37 overdoses related to opioids were reported, three of which were fatal.
In an ideal environment, Jackson said, patients realize they want to stop using, enter into a facility to comfortably and safely detox from substances, get treatment through medicine and therapy, and return as “a happy, healthy productive member of society.”
“The reality is, sadly, not the ideal,” she said.
According to a 2016 report from the U.S. Surgeon General, only about 10 percent of people with a substance use disorder receive specialty treatment.
A lot of patients make it to the detox phase and stay for a few days for in-patient treatment, Jackson said. But when they return home without proper support to stay sober, many relapse. The rate of successful treatment through medicine is statistically low, well below 50 percent. The National Institute on Drug Abuse reported that drug addiction patients relapse between 40 percent and 60 percent once treatment ends.
But it’s better than a cold-turkey alternative. Patients in medication-assisted treatment have a lower risk of relapse or overdose and a higher likelihood of escaping addiction than those in abstinence-only treatment, which is the complete cessation of drug and alcohol use.
Critics question the nature of replacing abuse of one chemical for reliance on another. The difference, Jackson said, is in the results.
For opioid-use addiction, she said people can remain physically dependent on medications. But addiction is partly defined by the intense craving for the drug or the bad behaviors to sustain the substance abuse. Patients taking medicine have shown Jackson progress: a person getting their chemical-dependency prescriptions from a doctor, seeing the doctor regularly and taking their medications as prescribed.
A key finding of the the 2016 surgeon general’s report was that “an insufficient number of existing treatment programs or practicing physicians offer these (Food and Drug Administration)-approved medications.”
One such medication is buprenorphine, an opioid. It has side effects just like its cousins Vicodin and oxycodone and fentanyl. But it can help with withdrawals and curb cravings, both of which can cause patients to suffer if untreated.
“If someone has never experienced it, it’s very difficult to explain to someone,” Jackson said.
Her profession might become better understood in the coming years. Micah Matthews, the Washington Medical Commission’s deputy executive and legislative director, said medication-assisted treatment is a “relatively new” subspecialty. There are 74 physicians with such a specialty known in the state, seven of whom practice in Snohomish County.
At the Monroe in-patient/out-patient facility, Jackson joins a staff of two other physicians board-certified in addiction medicine, 14 nurses, 14 chemical dependency counselors and a social worker.
All of that is part of the response to the opioid crisis in Snohomish County.
In theory, addiction treatment colleagues could work themselves out of the profession. In reality, the prevalent disease means the eight detox beds available for patients each day are used every day.
“Any facility that provides detox for patients is going to stay full in our society,” Jackson said.
But she also knows that with every stumble, there presents itself the hope of a new stride to get sober with a little doctor-prescribed medication. All she has to do is recall her own recovery.