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Moving to Overcome Opioid Abuse

Like many of her health care colleagues in a variety of disciplines, Dr. Mona Gupta, a Raleigh-based psychiatrist, is deeply challenged by a major epidemic of opioid abuse.

Dr. Mona Gupta

“It’s a very common event,” she reports. “A person gets pain medication for relief of back pain, for example, and all of a sudden they feel a sense of euphoria: ‘Wow, I feel great!’ And too often, people who would not typically be considered drug addicts do in fact become addicted to mind-altering substances.

“Over time, I’ve brought together a team in my office who are professionally and emotionally equipped to offer major, effective support to people who are dealing with opioid addiction.”

Naltrexone, she explains, “is an example of a drug used to prevent people who have been addicted to certain drugs—opiates—from taking them again. It is used as part of a complete treatment program for drug abuse. It’s also used effectively in other ways—such as weight loss and to deal with alcohol addiction.

“The ingestible form of Naltrexone is given once a month, and there simply are not a lot of providers offering this option for their patients.
“I have patients come in who are clearly depressed and anxious, and we often begin a familiar process. ‘OK, how many drinks are you having every night?’ They may reply, ‘Not really sure; maybe three or four beers.’ But when we dig a little deeper, we often find they were drinking until they passed out—because that’s how they deal with their emotions. That’s just one of many paths to seeking physical, mental, and emotional pain relief.”

Signs and Symptoms of Opioid Addiction

There are many signs of inappropriate opioid use, notes Dr. Gupta. A partial list includes:

  • Unusual sleepiness or sleep disturbances
  • “Lost” or stolen prescriptions or medication
  • Frequently missing appointments unless receiving a renewed prescription is expected
  • Irritability
  • Drug hoarding during periods of reduced symptoms
  • Injecting opioids intended for oral use
  • Lack of interest in social events

And more.

A National Epidemic

These kinds of transactions around drug issues, Dr. Gupta notes, “are becoming more common—and drug use and abuse is truly a national epidemic affecting nearly two million people. Over half a million people are addicted to heroin, for example.

“I have counselors in the office who are dedicated to helping patients relieve and overcome substance abuse. My doors are open to these patients; we have a commitment to reach out to these patients so they do not necessarily have to go to a methadone clinic or to a physician’s clinic. They can actually come and see a psychiatrist. That is one of the things we do: We treat addiction. And we are aware of, and connected with, all of the resources in our area that are available to these patients. We’ve developed strong referral relationships with a great variety of treatment options.

“In addition, because my mother is also a psychiatrist, practicing in Florida, with her assistance, I have on a number of occasions been able to refer patients for specialized treatment in Fort Lauderdale or West Palm Beach. Thanks largely to my mother, I have these connections.

“Sometimes, when it comes to alcohol and opiate issues, you can’t offer effective treatment on the fly. The treatment process has to be medically monitored, because coming off some of these addictive substances can be high-risk. Improperly done, it can make the patient very ill. So moving a patient into a setting where there are major, effective resources available is sometimes a good option.”

A Team Effort

And, notes Dr. Gupta, “having a substance abuse therapist in my office is most helpful—she is intimately and thoroughly aware of all of the treatment options available to our patients. Getting the most effective treatment for each patient is really a team effort.

“And there is the issue of our office—quite important for some patients. We have office space in a big, beautiful white building—and there are no signs that say Addiction Center. A person may come into our main entrance to see their dentist, get treatment for sleep apnea, or seek relief of anxiety or substance abuse. It’s a quiet, private setting for clients and practitioners.”

Healing Path

The daughter of two physicians—her father is a gastroenterologist, her mother a psychiatrist, both still practicing in Florida—Dr. Gupta felt led at an early age to be in the healing arts.

She went to Nova Southeastern University College of Osteopathic Medicine, in Florida, emerging as an osteopathic physician “with holistic interests and tendencies. The term osteopathic physician is still an unknown to many of my patients. I explain that osteopaths attend four years of medical school training just like medical doctors, and are ‘real, licensed’ doctors in all the states and dozens of foreign countries, both for medicine and surgery.

“And it’s true that osteopaths emphasize the importance of the musculoskeletal system, holistic medicine, proper nutrition, and environmental factors in maintaining good health. Osteopaths are known for using a hands-on approach to medicine and frequently manipulate or palpate as part of diagnosis and treatment.”

After her Nova training, Dr. Gupta completed her four-year residency in psychiatry at the Baptist Medical Center at Wake Forest University in Winston-Salem, NC.

Dr. Gupta has an eclectic practice, working with adolescents and adults no matter the nature of their health issues. “I work with such challenging problems as bipolar disorder and schizophrenia to scores of people who are challenged by events in their lives. I really do empathize with patients who are dealing with such every-day issues as anxiety, questions of self-image, depression and perhaps health challenges. Every one of us has a period in our lives when we are challenged and need support and guidance.”