Category Archives: Opiate Addiction

Prescriptions for Opiates

opiatesThere are many legitimate and appropriate uses for opioid medications. Opioids are excellent at managing acute or chronic pain for back injuries, post-surgical recovery, dental work, and other medical conditions that generate unbearable pain.

For those who may become physically dependent upon opioids, their difficult journey often does not begin with a chase for euphoria or a “drug high”, but with a short-term prescription from their physician for a pain killer … in order to minimize the pain and discomfort from a recent surgery or injury.

How the brain & body respond to opiates varies from one person to the next. Some individuals have a very high tolerance for pain and may need relatively less pain relief medication than someone who possesses a high sensitivity to pain.

If an individual takes pain medication for a long enough period of time, they may run the risk of developing a tolerance to the medication such that only higher doses of it are effective at reducing pain. As the person begins to increase their use of the pain medication, a physical dependency begins to set in resulting in withdrawal symptoms when the opioid relief wears off. The only thing that will eliminate the uncomfortable withdrawal symptoms is taking more of the pain medication. And thus, a vicious cycle sets in.

It is important to consider than no one starts out intending to become addicted. Unfortunately, many prescribing physicians do not explain to their patient the potential for developing an addiction to opioids. In fact, there is general consensus emerging that pain prescriptions are too readily given out. Many admissions to methadone clinics include individuals whose opioid dependency began with a legitimate prescription for pain medication. It is important that both doctors and patients share responsibility in addressing the potential for addiction with opioid medications. We do not want to discourage the appropriate use of pain medications. They are extremely effective at helping people manage their pain and be able to function. But education is critical if we are to help individuals adopt the proper caution & awareness in regard to potential opioid dependency.

Doctors and Methadone

factsHow doctors view methadone is becoming a hot topic. A friend recently informed me that the TV celebrity doctor, commonly known as Dr. Drew, was against methadone and had publicly made negative comments about the medication. I was disappointed to learn of this because Dr. Drew has a fairly large national audience who follow his opinion on medical matters. I then noticed that Dr. Jana Burson (a well-educated and experienced opioid addiction professional) had written on this topic, and herself questioned why Dr. Drew had made derogatory comments in regard to methadone. Dr. Burson knows firsthand how incredibly beneficial methadone is to those suffering with chronic opioid dependency. If a physician deserves a national audience & voice on this topic, it is Dr. Jana Burson, not Dr. Drew Pinsky.

Physicians typically seem to fall into one of two camps: either those who are educated on addiction and modern addiction treatment approaches, or those who are not. This may seem like a simplistic analysis, but is surprisingly accurate. Sadly, in my experience, physician critics of opioid replacement therapies often jump to conclusions that stem from personal bias or opinion based on very limited exposure to methadone and its benefit to the recovering community. Methadone is not “alternative medicine”, or some unproven sideline drug that one must obtain via the black market in a third world country.

Methadone is the leading medically-approved pharmaceutical treatment intervention for opioid addiction in the United States. There is no medical “speculation” on methadone’s success in the treatment of opioid addiction. It is a proven method of saving lives and restoring quality of life for a large subset of those who are addicted to opioids. These are not hyped opinions, but are medical facts that are beyond dispute. That any “physician” would reject methadone as a legitimate treatment for opioid addiction … is professionally irresponsible, and suggestive of medical incompetence in the area of treating drug addiction.

Methadone has been in widespread use in America for over 40 years. The number of addicted individuals whose lives have been saved and/or improved (through the medically supervised use of methadone) is well documented. SAMHSA (the United States Substance Abuse and Mental Health Services Administration) publish evidenced-based Treatment Intervention Protocols (known as TIPS manuals) that are available to treatment centers all across America. They have several such manuals, published and widely distributed, that are specifically dedicated to treating opioid addiction with methadone and buprenorphine (suboxone). SAMHSA also maintain a U.S. government website listing all of the methadone clinics in the USA and U.S. physicians approved to dispense buprenorphine for the treatment of opioid addiction. Why do they list these? So that suffering people can find help for their addictive disorder.

Perhaps Dr. Drew should interview actual patients in methadone treatment programs. Then interview the staff of professionals (including dedicated, knowledgeable physicians) that work in these facilities. Then interview the families of methadone patients that regained their sons, daughters, mothers, and fathers. Then read the evidenced-based literature & research available (through SAMHSA) on the beneficial use of methadone in treating opioid addiction.

That might require Dr. Drew to walk off of the TV production set, out of the celebrity limelight … and into the everyday real world. It’s a place where people like Dr. Jana Burson work for many years, with thousands of opioid addicted people, using medical interventions that are proven and effective. Dr. Drew would do well to have a sit down conversation with professionals like Dr. Jana Burson. This might allow him to replace negative personal bias … with medical fact. Only then, would he be equipped to speak to the public about methadone and opioid addiction. Until then, he is just part of the TV & celebrity noise … where drama, ratings and sensationalism … are cherished over the truth.

Drug Rehab for Teens

rehab-for-teensTeen drug abuse is a persistent problem in America, and unfortunately, is on the rise again. With recent State and Federal budget cuts, funding across the country for adolescent drug treatment has dwindled. There are far fewer drug rehab facilities today than there were just 5 years ago. Locating inpatient and outpatient teen rehab programs has become a challenge for parents and adults seeking local teen drug treatment resources.

RehabForTeens.org is a new online information center which provides general information on teen substance abuse and contact information for a variety of teen drug rehab programs across the United States. The site was launched in January 2012 and will undergo periodic updates to keep people informed on the availability of teen rehab programs in each U.S. state.

RehabForTeens.org describes the different types of drug treatments available for teenagers and offers a blog from the unique perspective of parents as well as drug treatment professionals. Drug rehabilitation for teens has emerged as a very important social topic with so many young people facing tough choices on a daily basis.

Methadone Used With Newborn Babies

methadone-babyThere is a fascinating article in The New York Times which explores the use of methadone and buprenorphine in treating babies born addicted to opioids. While this is often an emotionally-charged subject, it is a very important topic and points to the benefit of methadone in relieving suffering and in stabilizing one’s health through the elimination of painful opioid withdrawal.

The article explains the dilemma that hospitals face when an opioid addicted woman is pregnant. Depending on the type and length of her opioid use, her baby may be born with an opioid dependence. And the newborn could begin experiencing painful withdrawal symptoms within 1 to 5 days.

The Times article addresses the use of methadone (or buprenorphine) in alleviating a baby’s suffering. Prior to birth, methadone has also been used to reduce the chance of miscarriage and the probability of in utero seizures. Many doctors have little to no experience with this type of treatment, and are consequently apprehensive about taking on the risk of treating an opioid addicted mother-to-be.

As of yet, there is no single universal protocol which has been established for treating newborns with methadone. However, several medical centers have been working in this area using a combination of medications such as methadone, phenobarbital, clonidine, and buprenorphine.

Early indications suggest that it is hard to predict which infants will need opioid replacement medication. To determine which babies may be experiencing withdrawal, nurses use a checklist of symptoms and assess each baby every few hours … if the baby has been identified as “at risk” due to the mother’s opioid addiction.

The Times article goes on to speak about the growing opioid addiction in America and the need for medical professionals to further educate themselves on available treatment options. We all need to remain solution-oriented, and to address this problem straight on in a constructive fashion. Thankfully, opioid addiction is a treatable illness, and opioid replacement therapy is a viable option for coping with this growing epidemic.

Methadone and buprenorphine are the best interventions we have at present for treating opioid addiction. Without them, many addicted persons would remain lost in their addiction for years on end. And babies born to addicted mothers would needlessly suffer. With time and good public education on opioid replacement, more people will find their way into a life of recovery.

Effective Medical Treatment for Opiate Addiction

nihMethadone treatment has been in existence in the United States since the 1960’s, and it became fairly well-established in the 1970’s particularly in the larger metropolitan cities where heroin addiction was more pervasive. In the 1980’s, methadone clinics continued to emerge across the country since they successfully helped opioid addicted individuals experience dramatic improvement in their lives.

During the 1990’s, this expansion continued and the efficacy of methadone treatment became further substantiated through research. Eventually, full endorsement occurred by the U.S. National Institutes of Health (NIH). In November of 1997, the NIH converged to make a formal, consensus statement for this purpose:

To provide health care providers, patients, and the general public with a reasonable assessment of the effective approaches for treating opiate dependence.

A 12 member panel, assisted by 25 experts, had coordinated a study. Various professional fields were represented including psychology, psychiatry, family medicine, behavioral medicine, epidemiology, plus participants from the general public. This group shared with the world their conclusions in a single, definitive, all-encompassing statement, which read:

Opiate dependence is a brain-related medical disorder that can be effectively treated with significant benefits for the patient and society, and society must make a commitment to offer effective treatment for opiate dependence to all who need it. All opiate-dependent persons under legal supervision should have access to methadone maintenance therapy, and the U.S. Office of National Drug Control Policy and the U.S. Department of Justice should take the necessary steps to implement this recommendation. There is a need for improved training for physicians and other health care professionals and in medical schools in the diagnosis and treatment of opiate dependence. The unnecessary regulations of methadone maintenance therapy and other long-acting opiate agonist treatment programs should be reduced, and coverage for these programs should be a required benefit in public and private insurance programs.

This endorsement further validated what many addiction professionals had known for years, that methadone maintenance was an extremely beneficial therapeutic intervention. As time rolled forward into the new millennium, 2000 and beyond, methadone clinics continued to be established in areas where no opioid treatment had previously existed, including America’s smaller rural areas and modest-sized towns.

Today, methadone and buprenorphine (suboxone) treatment are more readily available than ever. A major focus of many opioid treatment programs is to now treat a client’s co-occurring disorder(s) either within the OTP clinic itself or though a local referral to another mental health provider/specialist. A substantial number of addicted individuals suffer from depression, bipolar disorder, generalized anxiety or panic attacks, attention deficit hyperactivity disorder (ADHD), or other psychiatric illnesses which can be successfully managed once properly diagnosed.

While some communities are reluctant to embrace methadone treatment & methadone clinics, this can change with education & time. Treatment changes lives for the better, and allows addicted individuals to become more responsible and more productive. It was highly beneficial that the NIH publicly recognized the validity of methadone maintenance. This was a positive, and justified, large step forward in advancing help for opioid addicted people everywhere.