America's Affair with Opioids: 10 Steps to Reverse the Opioid Crisis

By MD Fred Von Stieff

Physician and Addiction Medicine Specialist, Dr. Fred Von Stieff explains how we can stop fentanyl deaths and end this opioid crisis. He uses his three decades of experience and expertise to outline a strategy summarized in 10 steps that has the power to incite real change - through knowledge, prevention, and treatment of opioid addiction with t

• Language: English
• Publisher: America
• Release date: Oct 18, 2023
• ISBN: 9780983951834

MD Fred Von Stieff

Dr. Fred Von Stieff is an accomplished Addiction Medicine Specialist, board-certified addictionologist, and a world-renowned expert in the field of chemical dependency treatment. As a physician and medical director over hospital-based chemical dependency programs, he has dedicated the past three decades of his life to improving detoxification and treatment methods. By observing the mechanisms of the brain and deciphering the rules by which the brain behaves, Dr. Von Stieff has become an authority on brain chemistry, utilizing the predictable behavior of neurotransmitters to both detoxify patients in the quickest and safest manner possible, and also to set patients up for lasting sobriety. By sharing his discoveries, it is Dr. Von Stieff's hope that educating this country's leaders, doctors, influencers, and general public on practical steps to prevent and treat opiate addiction will be the key to stopping this nation's fentanyl and opioid crisis.

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What readers say about the book

"A must read for all, especially physicians, as we face America’s opioid crisis...

"Dr. Von Stieff lays out clear, practical, clinically proven strategies to truly understand, prevent, and treat opioid addiction.

"I have the privilege to witness and work with Dr. Von Stieff at the same hospital.  As an inpatient and consultation psychiatrist, I call on his expertise and guidance in complex cases.  When the intensivist, internist, and I are baffled, we turn to Dr. Von Stieff. 

When Suboxone and methadone fail, Dr. Von Stieff’s Backdoor Method works!

– Cindy Le, MD (Psychiatrist)

Dr. Von Stieff is a respected Addictionologist who has safely detoxified thousands of patients in the San Francisco Bay Area. His services are of incalculable worth especially during this fentanyl epidemic.

– Janis Laiacona (RN & Director of Nursing

at Herrick Psychiatric Hospital Berkeley)

His pioneering method, examining the brain’s balance of neurotransmitter levels throughout the stages of addiction and recovery, is truly revolutionary.

– Jeff Sandoz, PhD, LMHC, MAP

America’s Affair with Opioids

10 Steps to Reverse the Opioid Crisis

Fred Von Stieff M.D.

First Edition

Canyon Hill Publishing, San Francisco, California

Copyright © 2023 by Fredrick Von Stieff M.D.

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the author.

This edition was prepared for publishing by

Ghost River Images

5350 East Fourth Street

Tucson, Arizona 85711

www.ghostriverimages.com

Cover design by Jason Anscomb

ISBN 978-0-9839518-3-4

Library of Congress Control Number: 2023915423

First Digital Edition

November, 2023

Preface

The boom in fentanyl overdoses and deaths has ripped through the American consciousness, directing our attention to previously silent injustices and demanding action – but what actions? How can we fix the opioid epidemic in a country that makes up only about 5% of the global population, yet consumes at least 80% of the global opioid supply?

America’s unparalleled demand for opioids has incurred an extortionate cost. Since 2018, more Americans lose their lives to opioid overdoses every year, than the total number of Americans who died in Vietnam, a conflict that lasted over ten years. In 2018 some 74,000 individuals died from opioid overdoses. In 2022, that number jumped to 107,000, and that death toll climbs every year. This book is an answer to the relapse and overdose that are far too common in the saga of opioid addiction and its treatment; it is an initiative to reverse America’s opioid crisis through practical means.

I am a hospital-based physician, a board-certified Addictionologist, Medical Director, and Addiction Medicine Specialist, a Fellow of the American Society of Addiction Medicine, the California Society of Addiction Medicine, and the American Board of Addiction Medicine. I have been practicing in Northern California for three decades and detoxifying people off of opioids and other drugs since 1992.

I wrote America’s Affair with Opioids: 10 Steps to Reversing the Opioid Crisis to show how each of us – doctors, politicians, parents, patients, nurses, clinicians, teachers, pediatricians, influencers – everyone, can act to stop these opioid deaths.

To stop these deaths and see a reversal in these statistics, we need to first shift where we focus our efforts to make change – a shift from simply scrutinizing how opioids are supplied, to looking at why there is such a large demand in the first place. Understanding the basic genetics and neurochemistry behind the demand for these opioids will lead to a vital change in the methods used to treat and prevent opioid addiction.

By focusing on the demand when finding a solution for the opioid epidemic, we will answer the following questions:

Why are so many people addicted to opioids?

Why is relapse so common when trying to get off of these drugs?

Do we have the tools necessary to reduce America’s voracious appetite for opioids?

Reducing America’s demand for opioids starts with a change to the way we perceive the addicted mind and education about how these drugs affect the brain’s neurochemistry. This book will provide that insight and then expose how current treatment methods contribute to the increasing trend in mortality. Sadly many deaths caused by complications with opioids occur during relapse while physicians use today’s standard method for detoxification – prescribing alternative opioids like Suboxone and methadone and then slowly decreasing the dosage. I’ll explain in detail why in many cases that method fails.

There is a better way to treat opioid addiction, a practical method that addresses and ameliorates the neurochemical imbalances (induced or conceived) that cause the cravings. This new method is safer and faster, and uses absolutely no narcotics in the majority of cases.

Most doctors are skeptical of any new approach to this discipline. Only after they see this method in practice, witnessing its unrivaled results, is their skepticism resolved.

While Suboxone, Subutex, and methadone do have their place in the medical practitioner’s armamentarium, these drugs are unfortunately often used without sufficient discernment. Today’s standard methods of detoxification and opioid addiction treatment are in dire need of improvement. Those improvements are outlined in these pages and they will give power to this new strategy to prevent further opioid deaths.

Before opioid addiction treatment methods can freely advance, strongly entrenched misconceptions surrounding addiction must be overturned. Addiction is not just psychological. It is not simply the result of lack of will power or some personality flaw. It is a medical condition with physiological symptoms that can be treated at the neurochemical level using the mechanisms of the brain to guide treatment in a mechanical manner with a predictable outcome. If we change our standard methods of pain management and opioid detoxification, and establish a system of education, prevention, and accountability as outlined in this book, we will reverse this opioid crisis.

I have compiled crucial information through higher education, the latest findings published in medical journals, continued medical education in extensive and complex current data studies, as well as perhaps the most valuable tool of all – my own decades of experience in the field. I have synthesized, condensed, and placed this vital information within the pages of this book in a palatable form that anyone can understand and use to their benefit and to the benefit of those around them. Most influential to the contents herein is my three decades of observations and experience working in a hospital-based detoxification unit. Under constant peer review by the hospital and regulatory bodies such as the Joint Commission, I have successfully completed over 30,000 detoxifications without any inpatient hospital deaths. Utilizing that experience and the data I’ve gathered throughout these detoxifications – the ideas, the statements, and the theories within this book are this physician’s own.

Introduction

America’s Affair with Opioids was written for anyone affected by the opioid epidemic and for everyone who has a hand in shaping how we recover from this crisis. Individuals dependent on narcotics and their loved ones can benefit from this book’s clarification of why so many become addicted to opioids and how the latest scientific methodology in treatment is freeing tens of thousands from the grips of addiction. Doctors and medical staff involved in the treatment of opioid addiction, and even politicians and social workers can also benefit from the 10 steps and information that I have outlined which demonstrate how we can put this country on the path to recovery.

There are a lot of factors working against efforts to exterminate opioid addiction in this nation – factors such as profits, entrenched common medical practices, and a misunderstanding of what addiction really is. If we as a society are ever going to resolve this crisis of opioid abuse and overdose, we need to confront these obstacles to advancement. That is the focus of Part I of this book.

Part II exposes the flaws of today’s standard methods of pain management and opioid detoxification. Part III and Part V reveal how to effectively treat opioid addiction using a new scientific method that discontinues all narcotics in many cases which I call, the Backdoor Method. The focus in this new method of treatment is to safely get patients back on their own natural opioids and correct any neurotransmitter imbalances. By doing this and not just prescribing another opioid indiscriminately without some analysis of the root cause and reason for their addiction, we are eliminating cravings and chemical dependency.

Today’s common practice of routinely placing patients on another opioid often leads to patients having to then detoxify off of that medication, relapsing, and often having a fentanyl overdose. The reasons for those consistent results will be considered and explained in Chapter 4. The Backdoor Method avoids that commonplace pattern.

This book explains how and why this new method works. It reveals how these neurotransmitter systems relate to one another and react to various drugs. By showing how to carefully and correctly manipulate these systems, this book demonstrates how to put this new method into practice. This information can put a huge dent in the epidemic of opiate addiction and stop the morbidity of this largely preventable atrocity by giving doctors the tools necessary to treat this problem at its source – its physiological level.

Of course it is up to board-certified physicians to put these methods into practice. In fact, twenty years ago, this kind of knowledge would have only been made available to fellow doctors and scientists, but times have changed and pharmaceutical companies have made it their business to inform the general public about their products. Therefore, it has become imperative to also educate the general population on the various medications and method options available for chemical dependency treatment.

My first book, Brain in Balance: Understanding the Genetics and Neurochemistry behind Addiction and Sobriety, established a broad framework for treating all forms of chemical dependency. This book, on the other hand, focuses specifically on my method for treating opioid addiction, The Backdoor Method. Portions of information from Brain in Balance are reiterated herein because they provide the foundation from which the Backdoor Method is built. Included is an explanation of how the neurochemical balances within the brain of a genetic alcoholic can also drive a person to opioid dependency. While alcohol has a unique way of stimulating serotonin and dopamine, opioids are also used for their ending dopamine effect. All this fascinating science of the brain will be explained in Parts IV and V.

I have been asked why I do not publish my findings in medical journals. I have chosen instead to publish these books in order to make the information more broadly available. In doing so, I have ensured that my findings do not become disconnected pieces that fail to demonstrate how to put the information into practice. Furthermore, this book provides practical information that will enable doctors to successfully treat virtually every kind of opioid addiction, no matter how severe the case, using a proven scientific method.

I put the method I have laid out in this book into practice every day in my chemical dependency unit because it reaps unparalleled success – a significantly higher long-term success rate than what is in the literature. This is quite a feat when compared to the national average of 30 to 45% long-term success rates using other detoxification and treatment methods. Mention of this success is not meant to be self-congratulatory. Rather, it is meant to affirm the efficiency of my scientifically-based methodology that, in spite of its efficaciousness, has yet to be in mainstream practice because of the lack of availability of the knowledge herein.

After reading Brain in Balance and putting my methods of detoxification and addiction treatment into practice, physicians from all over the world, have found similar success. The information within this book is substantiated by thousands of articles found on PubMed, the sources cited in my list of references, and my own decades of research and experience as a Board-Certified Addictionologist and Medical Director over various chemical dependency units.

By unearthing the root causes of America’s opioid crisis and deaths, the irrefutable need for a shift in both how we view addiction and where we focus our treatment will be made manifest. The flaws of current opioid addiction treatment methods and pain management medical practices that lead to further addiction, relapse, and death must be addressed now. From there, we can embrace the science behind successfully resolving opioid addiction by addressing the physiological neurochemical causes that have for so long been ignored. We can also begin taking practical steps for preventative measures.

America’s Affair with Opioids: 10 Steps to Reverse the Opioid Crisis is divided into seven parts, each with their focus written at the onset. Part VI includes ideas for public policy that could initiate practical methods of prevention starting at a young age. Our youth are among those at highest risk for falling victim to opioid addiction. Part IV explains who is most at risk, adding urgency to our prevention efforts. Without a doubt, education is our most powerful weapon against this opioid crisis. Each chapter in this book delves into one of the 10 steps required to turn this crisis around. The education of doctors, medical staff, and the general public – young and old, is at the heart of each of these steps.

At the end of each chapter there is a summary of the information covered, out-lined as Key Points. Part VII of this book contains a Drug Index summarizing how various medications and drugs affect the