Ronald and Cherie Santasiero explore the opiate-abuse crisis among teens in the United States and offer specific strategies for treatment and prevention.
Written by a married couple who share a medical practice specializing in opiate addiction treatment and counseling, the book is clearly intended to support and promote their practice and specific approach. The Santasieros are candid about the fact that they strongly advocate the use of Suboxone (buprenorphine combined with naloxone) for detoxification and as substitution therapy, a methodology that, in their analysis, too few physicians are using. (They are careful to state that they “do not have any connection or financial ties to Reckitt-Benkeiser,” the drug’s manufacturer.) The reasons, they say, are manifold: stringent federal and state regulations about the use and dispensation of Suboxone; a prejudice on the part of doctors and therapists that any sort of substitution therapy is counterintuitive for addicts; and a general unwillingness on the part of physicians to bring addicts into their practices and offices. Their discussion of these barriers is fascinating and compelling, as is their physiological analysis of how Suboxone works within the brain. Written in layperson’s language but not dumbed down, the biochemical conversation makes a strong case for the theory that many opiate addicts—particularly teen addicts—are naturally deficient in an essential brain chemical, the neurotransmitter known as GABA, gamma-amino butyric acid, and that with opiate use, they are essentially self-medicating. Suboxone, they believe, is a dramatically safer way to replace that neurotransmitter during recovery, especially coupled with counseling, holistic supplements and lifestyle changes, including diet and other self-care measures. The nonbiochemical chapters of the book are somewhat less evenhanded. The opening chapter is a horror show of a case study—a cautionary tale of an addict named Michael that is as grim and transparently foreboding as Go Ask Alice. And the chapters on counseling and prevention, somewhat in conflict with the book’s earlier argument that addiction is largely biochemical in cause and is not anyone’s fault, take a dim and slightly sanctimonious view of modern parenting practices. But overall, the book is an intelligent, thorough overview of addiction with a reassuring proposal for a treatment regimen that has helped many and has the potential to help many more.
Well worth a read for anyone dealing with or wishing to prevent an opiate addiction in themselves or a loved one.