Category Archives: Naloxone

Opiate Abuse Epidemic Addressed by Massachusetts Governor

massachusettsThe State of Massachusetts is experiencing dramatic levels of opioid abuse and their Governor, Deval Patrick, is sharply focused on addressing the problem. A compelling Boston Globe article has highlighted the growing problem with heroin and other opiates across the state noting that 185 people died of heron overdose between November 2013 and February 2014.

Also mentioned in the article was the state’s plan to increase funding for drug treatment by $20 million and to prohibit the sale of Zohydro, a highly potent prescription painkiller that has drawn much attention and criticism due to its ability to potentially worsen the opioid epidemic in America.

Governor Patrick has declared the opioid abuse problem a public health emergency and is taking active measures to increase the availability of naloxone to Massachusetts public workers so that they can intervene to save the lives of those experiencing an opiate overdose. Naloxone is a powerful opioid antagonist that reverses the effects of opioid overdose within minutes. Numerous overdose victims have been saved in recent years as a result of medical personnel or bystanders having access to naloxone.

The state also intends to crack down on the over prescription of pain medication and will be requiring physicians and pharmacies to participate in the prescription monitoring program. Participation was previously only voluntary, but will now be mandatory. Prescription monitoring reduces the prevalence of “doctor shopping” and also the diversion of prescription medications to the street where they are resold at a premium.

While naloxone can save lives by reversing the effects of opioid overdose, methadone also saves lives by removing the desperate daily struggle to avoid opioid withdrawal. This daily struggle often leads to premature death or long term incarceration. Suboxone (buprenorphine) provides the same medication-assisted support which allows those lost in addiction the ability to stabilize and move forward again. It is important to emphasize that medication-assisted treatment should always incorporate long term counseling and recovery-building since addiction is not just a physical dependency problem. The psychological component of addiction is what is addressed through counseling and therapy.

Heroin Addiction in Charlotte, North Carolina

methadone-blog-picAs has been widely documented in recent news media, heroin addiction is on the rise in the United States and does not appear to be slowing down anytime soon. From densely populated metropolitan cities to rural America, opiates are finding their way into schools, places of employment, and the upper socio-economic strata.

A well-written piece is just out in Charlotte Magazine profiling an intelligent 21 year old man by the name of Alex Uhler who succumbed to the pull of heroin, and sadly died of a fatal overdose. His story clearly illustrates a number of complex issues around addictive disease: the shame associated with being addicted, the extent some will go to conceal their addiction, and that it is an illness which impacts all people regardless of race, money, intelligence, or status.

The article addresses the increased presence of heroin in Charlotte, NC partly in response to the crackdown on, and scarcity of, prescription opioids. The extensive piece, by Lisa Rab, speaks to the emergence of opioids in professional work settings and schools, and touches on the frequency of co-occurring disorders alongside the addiction such as clinical depression, ADHD, and bipolar disorder.

Naloxone is also highlighted in the article sidebar as it has gained notable acceptance as the leading antidote for opioid overdose, and has been already documented to have saved hundreds of lives just in recent years. Naloxone can be administered by any bystander to an overdose victim. There are injectable and intranasal versions of the medication available at this time.

A local law enforcement official was quoted as saying that Charlotte’s drug problem cannot be eradicated by merely arresting drug dealers because there is always another up-and-coming dealer waiting on the sideline to take that vacant spot. The official said that society must stem the demand for drugs. Only then can we make our communities safer.

Medication-assisted treatment should most definitely continue to be funded and promoted as our society endeavors to save people from chronic opioid addiction. Many individuals have needlessly died when their lives and safety could have been restored through enrollment in an opioid treatment program. Methadone, buprenorphine (suboxone), naloxone and naltrexone are highly beneficial medications and act as a critical bridge in the addiction recovery process.

While Charlotte has a number of methadone clinics and buprenorphine-approved physicians, funding for opioid treatment remains a substantial obstacle for a number of people. Methadone is the most affordable option although various formulations of buprenorphine (suboxone) are becoming more cost-effective.

For more on opioid addiction, see Opioid Addiction in the United States

Zubsolv For Treating Opioid Dependence

zubsolve-methadoneDr. Jana Burson made a recent post about the newly FDA-approved medication for treating opioid dependence called Zubsolv. Zubsolv is manufactured by a Swedish pharmaceutical company, Orexo.

Zubsolv is a new sublingual (tablet dissolved under the tongue) formulation of buprenorphine and naloxone that is taken once daily to eliminate opioid withdrawal symptoms. As an alternative to suboxone or methadone, Zubsolv was approved in July 2013 as a medication which may be prescribed by physicians for the maintenance treatment of dependency on opioids.

The medication is meant to be taken in conjunction with counseling so as to help the patient learn the necessary skills for avoiding opioid relapse. The sublingual tablet is designed to dissolve in about 5 minutes when held under the tongue.

New products such as Zubsolv bring additional choices to those suffering with opioid addiction. As new products enter the market, there is an improved chance that once costly opioid replacement medications may come down in price and become more readily available to individuals who could not afford them.

The primary ingredients in Zubsolv are buprenorphine and naloxone so it is similar to a Suboxone formulation although promoted by the manufacturer as having a better taste, being a smaller tablet, and dissolving more quickly. Note that suboxone is now offered in a thin film formulation that also dissolves more rapidly than the original suboxone tablets.