Written by Jane Ellen Stevens in ACE STUDY, ADVERSE CHILDHOOD EXPERIENCES, CHILD TRAUMA, COMMUNITY PREVENTION PROGRAMS, SOLUTIONS
He says: Addiction shouldn’t be called “addiction”. It should be called “ritualized compulsive comfort-seeking”.
He says: Ritualized compulsive comfort-seeking (what traditionalists call addiction) is a normal response to the adversity experienced in childhood, just like bleeding is a normal response to being stabbed.
He says: The solution to changing the illegal or unhealthy ritualized compulsive comfort-seeking behavior of opioid addiction is to address a person’s adverse childhood experiences (ACEs) individually and in group therapy; treat people with respect; provide medication assistance in the form of buprenorphine, an opioid used to treat opioid addiction; and help them find a ritualized compulsive comfort-seeking behavior that won’t kill them or put them in jail.
This “he” isn’t some hippy-dippy new age dreamer. He is Dr. Daniel Sumrok, director of the Center for Addiction Sciences at the University of Tennessee Health Science Center’s College of Medicine. The center is the first to receive the Center of Excellence designation from the Addiction Medicine Foundation, a national organization that accredits physician training in addiction medicine. Sumrok is also one of the first 106 physicians in the U.S. to become board-certified in addiction medicine by the American Board of Medical Specialties.
Sumrok, a family physician and former U.S. Army Green Beret who’s served the rural area around McKenzie, TN, for the last 28 years, combines the latest science of addiction and applies it to his patients, most of whom are addicted to opioids — but also to alcohol, food, sex, gambling, etc. He sees them in the center’s two outpatient clinics: his clinic, which the Center for Addiction Science has taken over as its rural clinic, and another that opened recently in downtown Memphis.
Since he first sat down in the early 1980s to write a research paper to describe the symptoms of the newly named post-traumatic stress disorder in Vietnam veterans – “problems with the law, having trouble sleeping, anxiety, divorce, sleep troubles, substance use disorders, depression, anxiety, cognitive and chronic pain issues” — Sumrok has pieced together the ingredients for a revolutionary approach to addiction. It’s an approach that’s advocated by many of the leading thinkers in addiction and trauma. Surprisingly, it’s a fairly simple formula: Treat people with respect instead of blaming or shaming them. Listen intently to what they have to say. Integrate the healing traditions of the culture in which they live. Use prescription drugs, if necessary. And integrate adverse childhood experiences science: ACEs.
“My patients seem to respond really well to this,” he says.
ACEs understanding changes practice
Learning about ACEs more than two years ago was a big turning point for his understanding of addictions, explains Sumrok. “I was working in an eating disorders clinic and someone told me ‘90 percent of these folks have sexual trauma’. I remember thinking: That can’t be right. But that was exactly right. Since I’ve learned about ACEs, I talk about it every day.”
He also practices it every day, by integrating ACEs assessments for all patients in his clinics. He currently has about 200 patients who are addicted, most to opioids (heroin and prescription pain relievers, including oxycodone, hydrocodone, codeine, morphine, and fentanyl). “I’ve seen about 1,200 patients who are addicted,” he says. “Of those, more than 1,100 have an ACE score of 3 or more.”
Sumrok knows that score says a lot about their health and ability to cope: ACEs comes from the CDC-Kaiser Permanente Adverse Childhood Experiences Study, groundbreaking research that looked at how 10 types of childhood trauma affect long-term health. They include: physical, emotional and sexual abuse; physical and emotional neglect; living with a family member who’s addicted to alcohol or other substances, or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s incarcerated, and witnessing a mother being abused. Subsequent ACE surveys include racism, witnessing violence outside the home, bullying, losing a parent to deportation, living in an unsafe neighborhood, and involvement with the foster care system. Other types of childhood adversity can also include being homeless, living in a war zone, being an immigrant, moving many times, witnessing a sibling being abused, witnessing a father or other caregiver or extended family member being abused, involvement with the criminal justice system, attending a school that enforces a zero-tolerance discipline policy, etc.
The ACE Study is one of five parts of ACEs science, which also includes how toxic stress from ACEs damage children’s developing brains; how toxic stress from ACEs affects health; and how it can affect our genes and be passed from one generation to another (epigenetics); and resilience research, which shows the brain is plastic and the body wants to heal. Resilience research focuses on what happens when individuals, organizations and systems integrate trauma- informed and resilience-building practices, for example in education and in the family court system.
The ACE Study found that the higher someone’s ACE score – the more types of childhood adversity a person experienced – the higher their risk of chronic disease, mental illness, violence, being a victim of violence and a bunch of other consequences. The study found that most people (64%) have at least one ACE; 12% of the population has an ACE score of 4. Having an ACE score of 4 nearly doubles the risk of heart disease and cancer. It increases the likelihood of becoming an alcoholic by 700 percent and the risk of attempted suicide by 1200 percent.
High ACE scores also relate to addiction: Compared with people who have zero ACEs, people with ACE scores are two to four times more likely to use alcohol or other drugs and to start using drugs at an earlier age. People with an ACE score of 5 or higher are seven to 10 times more likely to use illegal drugs, to report addiction and to inject illegal drugs.
The ACE Study also found that it didn’t matter what the types of ACEs were. An ACE score of 4 that includes divorce, physical abuse, an incarcerated family member and a depressed family member has the same statistical health consequences as an ACE score of 4 that includes living with an alcoholic, verbal abuse, emotional neglect and physical neglect.
Subsequent research on the link between childhood adversity and addiction corroborates the findings from the ACE Study, including studies that have found that people who’ve experienced childhood trauma have more chronic pain and use more prescription drugs; people who experienced five or more traumatic events are three times more likely to misuse prescription pain medications.
Keywords; addiction, adverse childhood experiences, ACE Study
This is a shortened version. To read the full article go to https://acestoohigh.com/2017/05/02/addiction-doc-says-stop-chasing-the-drug-focus-on-aces-people-can-recover/
Thank you for this insight. What a great article. Are there clinics in the New England or New York are a that follow the ACE approach?