In this video, Pantea Farahmand, MD, of NYU Langone Health Grossman School of Medicine in New York City, reacts to the portrayed of teen addiction in the HBO series “Euphoria,” and explains treatment options for those with an opioid addiction.
The following is a transcript of her remarks:
Though I have not watched the whole series, I have watched clips of [“Euphoria” character] Rue and her struggle with addiction, and I thought it was very well done.
Coming off of opiates is very physically unpleasant. You become sweaty, your muscles will cramp, you might have vicious vomiting, headaches, and while all of this is going on, you have the most intense cravings to use opiates. So you will have definite highs, definite lows, and seeing her go through that was really important for anyone who’s considering using drugs to see, and for those who have loved ones experiencing addiction, it is helpful for them to see.
When it comes to treating an opiate use disorder, we like to have a multifaceted approach. So this includes medications, therapy, support groups, families, churches, community, anything you can get on board. However, not including medications in particular with an opiate use disorder is a missed opportunity.
This is an unfortunate thing; aa [Alcoholics Anonymous]/N / A [Narcotics Anonymous] are wonderful. They are wonderful organizations. However, they both actually traditionally say ‘no’ to medications, and you’ll hear things that are very stigmatizing about medications. I’ve been watching “Dopesick” as well, and they have one of the people praying, and they’re really glamorizing, you know, just abstinence-based programs. The reality is that they’re helpful, but when you’re craving, you are going to use, and if your tolerance is gone, if you’re not using regularly and you go back to using as much as you did before, that is death.
With adults, they’ve done studies where people who are on Suboxone [buprenorphine-naloxone] and methadone versus no medication, the success rate is 97% versus 3%. In kids, the success rate on something like methadone and Suboxone is 73%. Every time a person uses an opiate, they’re at risk of getting an infection or passing away. Not saving them as soon as possible and giving them access to these medications is really a missed opportunity to save a life.
It absolutely can be challenging to get medications to those that are under the age of 18. The reason being is providers, families, communities add a lot of stigma to the aspect of medications, and you’ll hear things like, ‘You’re just replacing one addiction with another addiction.’ And the science backs up the fact these medications are life saving. However, because of the stigma, sometimes providers who aren’t trained in addictions, or who don’t see a lot of individuals with addictions, will not prescribe.
Shows like “Euphoria” can absolutely help reduce stigma. Any access to media and kids’ attention and family’s attention is a great opportunity to teach people about the evidence-based treatments and reduce [lack of] treatment acceptance. It can also reduce stigma associated with the sorts of people that have addictions. There is an identity often associated with substance use, as those who have moral problems or are rule breakers or are doing things that are illegal in general. This is not the case. Addiction is a medical condition, and it’s very challenging to beat.