Abstinence Kills: Why Opioid Addiction Treatment Must Change

• Over 40% of Americans know someone who died of a drug overdose.

• Drug overdoses kill more Americans, ages 18 to 45, than car accidents and cancer.

• Fatal overdoses increase drastically after an addict is totally abstinent for even a week or two.

Many books have been written about addiction and recovery or healing from addiction. However, healing takes time. Stopping drug use is not enough. Studies show that up to 90% of people who manage to stop using opioids like fentanyl may relapse. The problem is that opioid relapses can come with high rates of fatal overdoses.

YOU CAN'T HEAL FROM ADDICTION IF YOU'RE DEAD.

People recently released from jails and prisons are 10 times more likely to die of overdoses, the number one cause of deaths among recently released inmates. Why? Because they were forced into abstinence. Studies also suggest that people finishing drug-free rehab programs may even have higher rates of fatal overdoses than untreated opioid addicts. Fatal overdose rates also surge 6-fold for people who discontinue treatment with methadone or buprenorphine (suboxone, subutex, etc.). These groups are also abstinent.

The first 80% of this book focuses on how to keep opioid addicts alive as they learn how to heal from their addiction. Along the way, this book also shows how our understanding of addiction has been shaped by mindsets that were developed over the previous century for a different chemical: alcohol. These strategies, including abstinence, can work for alcohol, but are not appropriate for opioids. For example, abstinent alcoholics do not die if they relapse, but abstinent opioid addicts do.

This book offers insights for how to understand addiction, why addicts make the "choices" they do. This book discusses why opioid addiction needs to be treated as a disease. It looks at the evidence for the medical approach as well as 12-step programs.

Addiction is a medical disease, but human beings are spiritual beings who may need spiritual help. This book argues that both medical and spiritual approaches are valid, but they belong on parallel tracks. They may be headed in the same direction but must remain separate tracks.

The final section of the book proposes a new model for understanding addiction as an emotional phenomenon. People fall into addiction for emotional reasons, they stay in addiction and relapse into addiction due to emotions, but they also find their way to sobriety through their emotions.

Simon Feng, MD, whose messages on TikTok have been going viral, has 40 years of clinical experience as a physician. He started out as a family physician, but his practice has been focusing on the treatment of addiction and chronic pain for the past two decades.

PEOPLE ARE TALKING ABOUT ABSTINENCE KILLS:

The book I was looking for. A message that needs to be heard
"When I dove back into addiction medicine after a brief foray into it 8 years prior, I was looking for not just technical advice but something on its philosophical foundations. After 3 years I found Abstinence Kills. Dr. Feng masterfully appeals to both doctors and the addiction community at large, using sound reasoning to defend his approach, which, while unorthodox to some, is really common sense when you stop and think about it. This book will save lives. It's a message that needs to be heard." (Bruce Thomas, MD)

I thought I understood addiction, but I was wrong.
"I have friends whose children died from accidental overdoses. I thought addiction was a choice made by weak, selfish people. Now I see that it's a disease, and we have to treat it like a disease. I appreciate the clear way Dr. Feng explains things." (M. Levine)