Category Archives: Addiction Recovery

Subutex and Methadone in Treatment of Opioid Addiction

Recovery from opioid addiction initially centers around physical stabilization: specifically the management of opioid withdrawal. This is an essential step for the vast majority of opioid addicted people seeking help. Research has shown a 90% failure rate for opioid treatment programs that do not offer medication assistance.

Methadone was the original medication FDA-approved for treating opioid addiction although Subutex has been recently introduced into opioid treatment programs around the country as a viable alternative. Subutex is effective especially for milder levels of opioid dependency.

Subutex is a brand name version of buprenorphine, the partial opioid agonist that reduces withdrawal symptom sickness. Most patients are familiar with “Suboxone” which is a popular buprenorphine-based film that is dissolved under the tongue and is taken once per day. It differs from Subutex in that it contains naloxone so that it cannot be easily abused intravenously.

A number of methadone clinics began offering subutex in the past few years in an effort to expand treatment options for patients. Because subutex can be abused, it is typically administered daily in the clinic by a nurse where it can be supervised.

If you are considering entering a treatment program for opioid misuse, you may want to ask about the variety of medications utilized by the clinic or physician. Some patients have successfully transitioned from methadone to subutex while others enter the program starting with subutex. This is a decision best made in conjunction with your treating doctor who can formulate a treatment plan based on your history of opioid use.

Billions To Be Allocated In Fight Against Opioid Crisis

The national budget proposal for the 2019 fiscal year includes a request for $13 billion in funding for opioid treatment and related services. This linked Newsweek article states that $3 billion would be allocated in 2018 and another $10 billion in 2019.

Many opioid treatment programs across the country are currently able to add patient slots when additional funding is made available. The opioid crisis has flooded many clinics that are already at maximum census due to limited State and Medicaid funding.

A number of private pay clinics have opened in recent years as the need for medication-assisted treatment increased. If a substantial allocation of government funds becomes available, opioid treatment services will finally come into sharp national focus as scores of people finally obtain the help they need to stabilize and to recover.

In treating opioid addiction, research has shown that traditional abstinence-based programs which do not utilize medication assistance have a failure rate of 90%. Medication-assistance is a critical factor in helping opioid addicted people move into sustained recovery. The proposed $13 billion earmarked for opioid treatment services can make a huge difference all across the U.S. Methadone or buprenorphine (suboxone) coupled with counseling and drug testing comprise the gold standard of care in treating opioid addiction.

Opioid Treatment Making A Difference

There is a great article in the Bismarck Tribune about the expansion of methadone services in Fargo, North Dakota. Fargo, like most other areas of the country, was impacted in recent years by numerous opioid-related overdose deaths.

The article reports that Cass County had 31 overdose deaths in 2016, but that number was reduced to 15 in 2017, due in part to the increased availability of naloxone (the medication that reverses opioid overdose).

While local ambulance calls have decreased in relation to opioid overdoses, the problem of opioid addiction remains a widespread and primary concern in the community.

The Tribune story reveals that more local residents are now enrolled in opioid treatment and are receiving the life-saving medication, methadone. Treatment that combines medication-assistance and counseling is the industry standard in quality care for those addicted to opioids.

The new Fargo-based clinic is reported to have 164 active patients currently enrolled in the methadone program. The clinic director, Mark Schaefer, is quoted as saying that while enrollment has been rapid, there remain many people in the local area with untreated opioid addiction.

The availability of treatment is making a difference. And medications like methadone, buprenorphine, and naloxone are providing a much needed solution to America’s opioid crisis.

Achieving Stability in the Recovery Process

Opioid addiction is one of the more challenging substance use disorders to confront and manage because of its physical dependency characteristics. Once the process of physical addiction has taken hold, avoiding daily withdrawal becomes a high hurdle.

Because of this daily dilemma, it becomes difficult to remain focused on other aspects of recovery. It’s the law of “first things first” that applies when tackling any problem. There is a natural order and sequence which must be followed when trying to solve a complex task. Opioid addiction recovery is no exception.

Obtaining relief from opioid withdrawal symptoms is a very important first step in addressing opioid addiction. This is why medication-assisted treatment is specifically identified as a medical best practice. Science and years of exhaustive research have proven (not just suggested) that treatment coupled with medication-assistance offers the greatest probability of long-term success when trying to overcome moderate to severe opioid addiction.

Fortunately, more people are becoming aware of the need for buprenorphine, methadone, and other medications that can play a vital role in stabilizing an opioid addicted individual at the onset of their personal recovery.

Historically, efforts to come off of opioids in a detox setting have been often unsuccessful because many detoxes used insufficient medications to alleviate withdrawal symptoms. Consequently, patients would typically begin to get sick in 1-2 days with their withdrawal symptoms becoming intolerable. This can lead to patients abandoning the detox effort and a quick return to illicit opiates.

However, the tide is turning. As the American opioid crisis continues to impact families and U.S. society, many more physicians, lawmakers, and government representatives are gaining a quick education on the enormous value of medication-assisted treatment. Methadone is at the forefront of this new awareness as is buprenorphine-based products like Suboxone.

Appropriate medications used responsibly and under a doctor’s supervision provide stability, hope, and opportunity.

Methadone Availability

Imagine trying to medically manage advanced diabetes with no insulin or grand mal seizures without anticonvulsant medication.

Modern medicine has raised our standard of living and sustained life in ways that people could not have imagined just 100 years ago.

In the cases cited above of diabetes and epilepsy, medication functions as a miracle intervention that saves the patient from suffering and death, and allows him or her to lead a full and productive life.

Science is clearly instructing us that addiction is a treatable illness which can at times be successfully managed with medication assistance, similar to the stabilizing role that insulin plays in the life of the diabetic patient.

A critical element of opioid addiction is the physical dependency which leads to debilitating opioid withdrawal symptoms. For many individuals, the persistence and severity of opioid withdrawal leads them to chronic failure in any effort to recover. With the assistance of methadone (or buprenorphine), many of these people will finally be able to cope with their illness by having their withdrawal symptoms alleviated.

The value of relief from opioid withdrawal is monumental. It is often the first major step toward being able to face one’s addiction. Medication assistance is good science, and it opens a door that was likely closed for many years. The value of having a new start is priceless. We only have one life. It is worth saving. Whether it’s diabetes, epilepsy, heart disease, or addiction – specific medications can help a patient restore their quality of life.