Could Avoiding Addiction be as Simple as Postponing Substance Use?
By Joan Goodchild
The data on addiction growth in Massachusetts is clear: substance abuse, particularly when it comes to opioids, is increasing.
According to the state’s Department of Public Health, in 2000, about one-third of admissions to substance abuse treatment centers and programs were opioid related. By 2015, opioid-related admissions had increased to more than half, overtaking alcohol as the No. 1 reason people seek treatment.
Despite the growth, there are still underserved areas in Massachusetts when it comes to addiction specialization and treatment.
That is where Dr. Ruth Potee comes in. The western Massachusetts native attended medical school and trained at what was then Boston City Hospital. Upon returning to the area where she was raised, Potee found the availability of treatment options for residents in the area to be scarce.
“At Boston City Hospital, addiction was part of what I did. It was a normal part of care,” said Potee. “And when I moved to Franklin County, I remember asking ‘Who’s taking care of people with addiction?’ The answer was ‘nobody.’”
Now as a family physician and addiction medicine specialist at Valley Medical Group in Greenfield, she is focused on the fight against the disease of addiction. Potee says approximately one-third of the patients she sees are struggling with addiction of all kinds. And she works to spread the message that as a significant segment of the population struggles with addiction, it should not be viewed with stigma.
“Addiction is not a moral failing or a mark against your character or the result of having been brought up by bad parents,” she said. “It is a true disease, like all chronic diseases. Much like diabetes is a disease and a disorder, we need to look at addiction that way, too.”
Stopping addiction early
Potee’s goal in working to combat addiction is to encourage more dialogue and communication around the disease. She hopes parents, grandparents and the community in general will gain more confidence to have frank discussions around the topic. She regularly presents at schools and community spaces around New England to educate parents about addiction and the adolescent brain; an area that she believes needs special attention.
“All addiction is a pediatric disease,” said Potee. “It starts when the brain is developing. If you ask people who struggle with addiction when was the first time they began using substances, they will almost always say age 12, 13 or 14.”
Which is why Potee feels it is crucial to educate this age group and their parents now. As Potee notes, addiction in adulthood could be avoided simply by delaying use of substances until the mid-twenties age range.
“If we could hold off on using substances until the brain is developed, until 22, 23, you won’t [perhaps] develop an addiction,” said Potee.
This piece of information startling, but encouraging. Postponing use of any drugs and alcohol until adulthood can actually stop addiction? It sounds so simple, doesn’t it? That’s because it is, said Potee, but also complicated by society.
“The legal drinking age is 21,” she noted. “But we know there are many young people who start much earlier than that with peers. But kids should know their predisposition to addiction, because genetics play a huge role. They should be told if there is addiction in their family history. They should know that as much as basic health information like their height, or weight, or not to a lot of drink soda. Those are the kids that need to be informed and truly delay substance use in childhood and adolescence.”
Potee explained that addiction takes root in adolescence due to the process of synaptic refinement in this stage of life. The brain at this age, she said, is clipping back many electrical connections in the brain.
“Adolescence is about developing an ordered brain and addiction gets in the way. And then people’s lives go off the rails later in life.”
She said another factor that can influence later risk for addiction is childhood trauma, such as a bad divorce, abuse, or loss, which sets up pathways in the brain where using a substance feels better.
“The pressures teens are under are extraordinary,” said Potee. “A lot of teens will turn to drugs or alcohol because they are desperate to feel different than they feel right now.”
One bit of good news is that despite an increase in overall opioid abuse in the state, teen substance abuse itself is actually down. A number of national organizations that monitor teen substance abuse find a continued long-term decline in the use of many illicit substances, including marijuana, alcohol, tobacco, and the misuse of prescription medications, among this age group. This is encouraging, said Potee.
“I don’t want people to feel hopeless and feel there’s nothing that can be done when it comes to this issue. This generation has the lowest use of substances in decades,” she said. “I spend a lot of time telling my kids they are doing a great job avoiding drugs and alcohol, because they are.”