Perspective on Addiction: sugar and opioids

My perspective on Cycle of Addiction:

Diabetes type 2 (sugar addiction)
  1. Real need: Whole Foods & appropriate physical activity
  2. Craving from needs unmet: hunger
  3. Easy substitute: simple carbohydrates
  4. Brief relieve from hunger
  5. Craving recurs from needs unmet: hunger
  6. Go to 3.
Opioid crisis (opioid addiction)
  1. Real need: wholefood, appropriate physical activity, ability to pay attention to what is important & self-compassion
  2. Craving from needs unmet: pain & suffering
  3. Easy substitute: opioids
  4. Brief relieve from pain & suffering
  5. Craving recurs from needs unmet: pain & suffering
  6. Go to 3.

I believe we need a system solution that supports solutions at an individual level.

I see each patient encounter as a valuable opportunity to engage patient in a conversation on the nature of addiction; whether it is to sugar or opioids or anything else for that matter.

I then enrol them in our weekly “physician-led self-management education groups” to continue our journey of awareness and wellness.

I have ran this group for over a year now.  It has proven to be an effective way to help my patients.  

There has been many stories.  John’s story stands out (fiction name).  He has eliminated the substitutes in his life (street drugs, alcohol, cannabis and tobacco) and replaced it with what he truly need (wholefood, appropriate physical activity, improve ability to pay attention to what is important & self-compassion through practice of BAM)

For type 2 diabetes, John’s HbA1C was 11.5 on SGLT, DDP4 and metformin. His last HbA1C was 5.6.  This type results is not uncommon in my patient population.  According to a study published in Lancet, “at 12 months, almost half of participants achieved remission to a non-diabetic state and off antidiabetic drugs. Remission of type 2 diabetes is a practical target for primary care”

John meditates daily with his wife and eats 400 grams of non-starchy vegetables per day.  He enjoys great relationships with his wife, daughter and his grandchildren.  We hope to collaborate and share our perspectives in our community on the importance of vegetables in our diet.

The case of Type 2 diabetes.


Annual health care cost per Canadian = $6604
Annual health care cost per Canadian with diabetes = $26416
Difference per year = $19812
Even though I don’t have the numbers for opioid crisis, I believe they are also staggering.

It appears to me there is plenty of money to be saved if we can all target the real need for awareness and self-management rather than direct most of our attention to the substitutes or substitute it with a yet more costly substitute.


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