Category Archives: Opiate Treatment

21st Century Cures Act

opioid-treatment-fundingThe U.S. House of Representatives just passed a sweeping reform, called the 21st Century Cures Act, that will infuse $1 billion in new funding earmarked for opioid treatment and prevention services.

It has taken several years of alarming statistics on the national opioid epidemic, but Congress has responded. This USA Today article provides an overview of the numbers. In addition to the $1 billion for opioid services will be another $4.8 billion for cutting-edge research around treating Alzheimers, cancer, traumatic brain injury, and other medical issues.

The bill received enormous bipartisan support and passed 392-to-26. In 2016, death by drug overdose surpassed death by car crashes and gun fatalities. The public outcry for government intervention has been steady. With so many families having been affected by addiction issues, the new funding allowance should open doors for opioid treatment particularly in rural areas where opioid services have been severely lacking.

Methadone remains the #1 medication-assisted treatment option. Buprenorphine medications are; however, making a big impact in the treatment field with a wide variety of buprenorphine-based formulations coming to market. In addition to the familiar suboxone film, are probuphine (a buprenorphine implant), subutex (an uncoated buprenorphine tablet), and bunavail.

Buprenorphine Implant for Opioid Addiction

buprenorphine implantThe FDA has approved a new implantable drug called Probuphine. Probuphine contains the partial opioid agonist, buprenorphine, which is used to suppress the opioid withdrawal symptoms that interfere with daily life.

The implant is the size of a matchstick and is inserted under the skin in the forearm area. It steadily releases a dose of buprenorphine which has been scientifically proven an effective treatment for eliminating opiate withdrawal symptoms in a number of people physically dependent on opioids.

With heroin and opioid overdose deaths at an all time high in the United States, this new alternative offers one more beneficial path for anyone struggling with opioid relapse and chronic withdrawal. Importantly, Probuphine only treats the physical withdrawal from opioids such that the underlying psychological factors of addiction must still be treated through counseling and other support approaches.

The Wall Street Journal has an extensive article on this new medication and the historically important role of methadone and oral buprenorphine. In the article, Nora Volkow (director of the National Institute on Drug Abuse) is quoted as saying:

Scientific evidence suggests that maintenance treatment with these medications in the context of behavioral treatment and recovery support are more effective in the treatment of opioid-use disorder than short-term detoxification programs aimed at abstinence.

Over 47,000 people died in the U.S. of drug overdoses in 2014. A majority of these were attributed to heroin and prescription painkillers. With continued coverage in the media and ongoing community discussion, more answers and helpful interventions will hopefully see the light of day.

Methadone Information | Suboxone Information

Heroin and Prescription Drug Epidemic

senate-bill-drug-treatmentThe growing problem around opioid addiction continues to receive coverage in the media, and it has become a topic of discussion on the campaign trail because candidates are being approached throughout the country by concerned families and citizens.

Marcia Taylor, President of Partnership For Drug Free Kids, provided testimony in January to a Senate Judiciary Committee on the need to increase funding for drug prevention and drug treatment. Proposed for consideration is the CARA Senate Bill which stands for Comprehensive Addiction and Recovery Act. CARA would allocate funding for drug treatment and prevention resources with a goal of getting more addicted individuals into treatment, and better educating both parents and teens on the dangers of recreational opioid use.

CARA would also address the need to distribute naloxone across the U.S. to aid in the fight to reduce deaths from opioid overdose. Local law enforcement would be trained on the administration of naloxone. Prescription drug monitoring programs would also receive increased support under CARA.

Methadone and Suboxone have become familiar interventions for anyone knowledgeable on opioid addiction issues. Most state-funded opioid treatment programs in the United States are currently full and have waiting lists of addicted people who are eager to participate in medication-assisted treatment.

In America, there has been a notable expansion in recent years of treatment programs who utilize methadone or suboxone to help patients. While many of these programs are private self-pay, Medicaid presently pays for methadone-based treatment approaches in a number of U.S. states. The number of private pay programs currently outnumber state-funded and Medicaid-funded programs by a substantial margin.

Expanding Access to Medication-Assisted Treatment

opioid-treatment-in-mediaAn article in the Huffington Post recently addressed President Obama’s public comments on expanding access to opioid treatment, particularly medication-assisted treatment (MAT) like methadone or buprenorphine (suboxone).

Many members of the treatment industry and recovery community do not have a realistic grasp on the role that medication-assisted treatment can play in recovery from severe opioid addiction. Historically, the recovery community has not regarded those utilizing methadone or suboxone as truly in recovery. They emphasize total abstinence, even from methadone, despite the fact that methadone and buprenorphine have restored individuals to normal functioning and even saved lives in many cases.

There was a time some years ago, in the 12 step community, when individuals were chastised for taking psychotropic medication for depression or other mental health disorders. This criticism came from a fundamental lack of knowledge about the biological basis for many mental health disorders. Similarly, medication-assisted treatment interventions have been the subject of misunderstanding and unwarranted rejection by those with limited education on varied treatment approaches.

As America’s opioid problem continues to grow, we need real solutions rooted in medical science and research. At this point in time, medication-assisted treatment has been in use long enough to clearly demonstrate its usefulness in facilitating personal recovery from addiction.

In 2015, we saw numerous local and national political figures rally around families that have been impacted by heroin overdoses and the heartbreaking loss of loved ones. Opioid addiction has finally come into focus within the mainstream media, and even current Presidential candidates have begun to address this as an important issue which commands attention and a solution.

More: Question and Answers on how methadone works

 

Making A New Start

methadone-graphicA study by the government agency SAMHSA indicated there were approximately 254,000 patients receiving methadone for opioid addiction in 2006. In 2015, it is most likely that number is much higher given the prevalence of opioid addiction and the continued expansion of outpatient opioid treatment services in the United States. Today, there are considerably more methadone clinics and suboxone-approved physicians than there were a decade ago.

Making a new start with medication-assisted treatment is what hundreds of people across the country are deciding to do for themselves every week. Addiction is a progressive illness – one in which a person’s ability to choose is severely compromised. Medication-assisted treatment using either methadone or buprenorphine (suboxone) provides an important open door to a more responsible, quality life.

A majority of individuals suffering with opioid addiction (particularly when the illness spans years) have experienced dramatic brain changes which deepened their physiological dependency on opiates. This physical dependency is not easily removed. It is severe and persistent thus leading the person to do whatever is necessary to avoid being sick from opioid withdrawal.

Most long-term addicted individuals will tell you they rarely, if ever, get high from the illicit substances they use. They are simply trying to avoid being sick from debilitating opioid withdrawal symptoms. When a patient chooses to receive methadone or buprenorphine under the supervision of a doctor, they are making a decision to face their illness and to do something constructive about it.

As a family or friend, it is very helpful to gain an understanding of addiction and how medication-assisted treatment can be life changing for a person stuck in the cycle of opiate addiction.

Making a new start can be a bit frightening. Will methadone work for me? Will my loved ones condemn me? What about my job, or my legal situation? It becomes easy to put off making a decision when so many questions come into play.

It is important to remember that the road to recovery begins with just one step forward. That step will lead to another and another. This new start is always available. The message is one of hope and opportunity. Opiate addiction is a treatable illness. Medication-assistance can make a real difference.