On Tuesday, Dr. Joseph D’Orazio came in to speak to our class. Dr. D’Orazio has been at Temple University Hospital since July of 2016. He is trained in emergency medicine as well as toxicology: unintentional overdoses and suicide attempts, medication complications, environmental poisons, etc. He is now board certified in addiction medicine, and runs a program to start patients on medication assisted therapy.  He is a doctor at Temple Trust Clinic, Trust standing for “Temple Recovery Using Scientific Treatments.” One of the people I met while crowdsourcing was an employee at this clinic.

Dr. D’Orazio discussed the importance of person first terminology, and how language makes a big impact on patients, whether it be positive or negative. We learned of a new term: positive drug screen, which is a preferred alternative to “dirty urine,” which is clearly dehumanizing and has a negative connotation. I also learned of the term “person who uses IV drugs.” He said that most people in medicine view patients with substance use disorder as someone with an ethical issue or a weakness, instead of seeing it and treating it as a valid illness. They also don’t qualify a reocurrence of use and the nature of the disease, but as a weakness. Not surprisingly, we found out that support and success rates are lowest among patients with low socioeconomic status, lack of family and social support or with significant psychiatric comorbidity.

We learned about the functions of the frontal lobe and the nucleus accumbens, and how dopamine plays a role in how an addiction develops. We also learned that some people have abnormal dopamine release to begin with, and that could contribute to them developing substance use disorder, but there are multiple ways of developing, including the presence of underlying mental health issues, and genetic predispositions. We looked at a lot of statistics and graphs about the opioid problem in Philly, and I understood better how so many people end up stuck in Kensington and living without homes, because of the progress of their disorder and how it affects other aspects of their lives. Learning about the nuerological side of drug use, as well as how they are made, sold and saught after helped me understand more about why this has become such an epidemic. Apparently, this is the biggest epidemic of our lifetime, and 4 times as many die from overdose in Philadelphia than from homicides, which is really a lot to process.