Addiction Specialist Says Opioid Treatment Needs a Dramatic Overhaul
Dr. Simon Feng says abstinence kills
INDIANAPOLIS , May 6, 2025 /CNW/ -- Dr. Simon Feng says America needs to dramatically change the way we treat opioid addiction. Feng says abstinence or an "all or nothing" approach is unnecessarily costing lives. In fact, fatal overdoses increase drastically after an addict is totally abstinent for even a week or two. It's an urgent issue. Drug overdoses from the opioid fentanyl kill more Americans between the ages of 18 to 45 than car accidents and cancer.
Feng graduated from the University of British Columbia in 1984 and practiced as a family doctor for 30 years. After seeing his patients become addicted to painkillers, he began focusing on addiction medicine and became a certified addiction specialist a decade ago. He currently practices in Indiana.
"You can't heal from addiction if you're dead," said Feng. "Studies show that up to 90 percent of people who manage to stop using opioids like fentanyl may relapse, with high rates of fatal overdoses."
Feng says stopping drug use isn't enough - brains need time to heal, and protection from fatal overdose during healing is essential. Feng is the author of the newly published book "Abstinence Kills -- Why Opioid Addiction Treatment Must Change." In it, Feng offers insights into why addictions happen and proposes a new framework for understanding addiction. The book is available on Amazon.
The roots of addiction medicine began a century ago, developing mostly around alcoholism. Today, the nation faces an epidemic of a different addiction–opioids, specifically fentanyl. Opioid and alcohol addictions are very different, especially regarding how they kill. Alcohol is sipped or chugged over time and an addict usually passes out before consuming a fatal dose, but drugs are taken all at once and fatal overdose is common. Feng says these two addictions need different treatment approaches. Alcoholics do not die of relapses, but opioid addicts do.
Feng says opioid abstinence results in a rapid loss of tolerance and carries high risks of fatal overdoses with relapses. Feng says abstinence frequently kills opioid addicts who fall off the wagon because they take the amount they used at the height of their addiction, not understanding it will now take far less to kill them with the loss of tolerance.
"I believe it is terribly misguided to think that 'an addiction is an addiction, is an addiction,'" Feng says. "This perspective is comparable to believing that 'a cancer is a cancer, is a cancer' because all cancers are due to the same problem of unregulated cell growth. If that were true, we should be able to treat all cancers the same. No, it would be ridiculous to apply the same treatment for leukemia, breast cancers and skin cancers."
Feng says one of his goals is to get addiction medicine accepted as conventional medicine. Addiction medicine is currently recognized as a medical specialty. However, many people, including other medical specialists, think of addiction medicine as a "fringe" specialty, treating addiction medicine like a "second-class citizen" of medicine.
"Doctors also need to hear my messages, not just the general public," said Feng. "The medical community needs to look at opioid addictions in a new, modern light to save lives. Instead of abstinence, we should be treating opioid addictions with medications like Buprenorphine and Methadone. These medications reduce mortality, cut medical and legal complications, and restore addicts to society."
The book also proposes a new model for understanding addiction as an emotional phenomenon. Feng says people fall into addiction to find relief from negative feelings; they stay in addiction and relapse into addiction due to emotions. Thus, emotions may also provide keys to sobriety. Feng has developed a Growth Model to help addicts. However, Feng says addiction must be primarily treated as the medical disease it is, with medication, and spirituality can be addressed on a parallel track.
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.
Contact: Kate Shepherd
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SOURCE Dr. Simon Feng
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