Category Archives: Opiate Withdrawal

Behavioral Health Group (BHG) Specialize in Opioid Addiction Treatment

bhg-logoBehavioral Health Group (BHG) is a leading provider of opioid addiction treatment services with programs presently covering eight U.S. states. BHG provide both maintenance and detox services in an outpatient setting and utilize a variety of FDA-approved medications for the treatment of opioid addiction such as methadone and buprenorphine. Buprenorphine is the active ingredient in Suboxone.

The company currently has 37 treatment center locations in Colorado, Kansas, Kentucky, Louisiana, Missouri, Oklahoma, Tennessee, and Texas. BHG operate in accordance with a number of core values that define their services, to include: character, enthusiasm, compassion, teamwork, and perseverance.

The organization’s website states that they incorporate best practices into their treatment approaches and use outcome-based metrics to consistently improve their service delivery. BHG has achieved full accreditation among their various facilities which means that they meet or exceed quality standards of care as determined by the Joint Commission on Accreditation of Healthcare Facilities.

Medication-assisted treatment is the industry standard for helping those with moderate to severe opioid addictions who have not responded well to traditional forms of therapy. BHG treat both the medical and behavioral aspects of addiction to opioids via medication to alleviate opioid withdrawal symptoms and team-based behavioral counseling used to address a patient’s psychological dependency on opioids.

If you are interested in opioid treatment with BHG, they provide an online inquiry form that you can quickly complete and submit through their website at www.BHGRecovery.com.

For prospective patients living in the San Antonio, Texas community, you can obtain more information on BHG services by visiting the Methadone.US page for San Antonio.

New Opioid Treatment Medication Prepares for Market Release

bunavailSoon to be released is a new oral buprenorphine based product called Bunavail. Bunavail is manufactured by Biodelivery Sciences and is a combination of buprenorphine and naloxone. It is a thin film formulation that is designed to adhere to the inner cheek where it quickly dissolves and is absorbed into the mucosal lining of the mouth.

The medication is touted as delivering about twice as much active ingredient into the patient’s bloodstream compared to sublingual suboxone. Bunavail is scheduled to be released in the third quarter of 2014. A press release by the company mentions that the medication will compete with other products in the $1.7 billion dollar opioid dependency treatment market.

Bunavail is a new advancement in drug delivery technology according to the press release and is reported to produce less constipation than other competing buprenorphine products. Patients can also speak freely while the medication dissolves.

With an estimated 2 million plus people addicted to opioids in the United States, new medication alternatives are welcomed.

Biodelivery Sciences is described as a specialty pharmaceutical company with a focus on pain management and addiction treatment. The company is based out of Raleigh, North Carolina. Bunavail’s FDA approval was announced on June 6, 2014.

Click here for more Information and Articles on Buprenorphine

Heroin Addiction In College Life

addiction-in-collegeWithin the last year, Methadone.US wrote about the resurgence of heroin addiction in corporate America and in particular areas of the Northeast United States. However, opioid addiction is not exclusive to the Northeast and is surfacing across the entire country. This emerging epidemic has gained the attention of numerous government personnel as well as local community leaders.

There are thousands of colleges and universities in America. While substance abuse on college campuses is nothing new, the growing heroin problem is. Alcohol, marijuana, and cocaine have been ever-present throughout colleges for decades, but opiates historically have been a second tier drug of abuse … until now.

A recent¬†article on DrugFree.org has highlighted efforts being made at the University of Rochester and the University of Vermont to more actively screen for opioid abuse among the students enrolled there. It is anticipated that the number of college students using heroin will rise in correlation with the general heroin epidemic which has already infiltrated the state of Vermont and other parts of the country. Vermont’s Governor Peter Shumlin is on record as having recognized that the state is experiencing a genuine crisis with heroin addiction and associated overdose deaths.

According to the DrugFree article, Yale University officials have also reached out to students to share the school’s caution and concern that some students may not fully understand the danger and potency of the drugs being secretly distributed on college campuses. University representatives are trying their best to get ahead of the problem before things spiral out of control.

Heroin has become the new “cheaper” substitute for those who have developed a dependency on prescription opiates but who no longer have access to them. Unfortunately, it has become a practice among many colleges to keep drug problems out of the news for fear that it will tarnish the school’s reputation.

This tendency to keep things “quiet” often works against connecting addicted people with the professional help that they may need. Every college should be working hand-in-hand with local addiction treatment organizations and professional addiction counseling centers since most colleges and universities are not sufficiently staffed to deal directly and effectively with complex addiction treatment issues. Credit should be given to those schools that are being proactive in their desire to educate students before tragedy strikes.

Information For Families on Opioid Addiction Treatment

Methadone Dosage Increases

methadone-increaseWhen a new client joins a methadone program, they go through a process called induction. Induction is the initial delivery of a methadone dose and the subsequent increases in dosage over the next 1 to 2 months as the medical team help get the client stabilized & comfortable on a dose of methadone that effectively eliminates their painful opioid withdrawal symptoms.

Induction is historically a high risk span of time since there is an increased risk of accidental overdose with methadone. It is extremely rare that overdose occurs during induction especially if clients are abstaining from other illicit substances during the induction process.

Therein lies the dilemma. Some clients become impatient with the process of methadone induction and will supplement their methadone dose with other unapproved opiates or benzodiazepines. This is dangerous and actually undermines the benefit of what methadone can achieve for the patient.

To help the treatment team determine the level of methadone increase to provide a patient, they use the Clinical Opiate Withdrawal Scale, or COW Scale. This is a withdrawal assessment tool that helps the clinical or medical team determine the prevalence and severity of opioid withdrawal symptoms. The scale produces a score based on the client’s reported symptoms and the team’s observation of withdrawal symptoms. The higher the COW scale score, the more severe the symptomology and thus a greater justification for allowing a higher dosage increase.

Some clinics are known to take clients up 10 mg at a time. Many physicians consider this high risk and too rapid of an increase. Note that methadone is a slow acting, long lasting opioid agonist with a much longer half life than heroin and most other prescription opioids. What this means is that methadone stays in the system much longer and builds cumulatively over time. So the actual effect of a dosage increase is not immediately felt and may take 1-3 days before the full effect of that dosage increase is realized.

With an impatient client, they may receive a dosage increase but not feel the immediate relief they were hoping for. Consequently, they may use additional unapproved opiates that then mix with the methadone increase that is still being absorbed into their system. This puts the client at risk of overdose.

Many clinics use 5 mg increases every few days while some clinics adjust each requested increase in accordance with the COW Scale score. For example, a client may receive several 5 mg increases because they have moderately severe withdrawal symptoms, but then receive a 3 mg increase days later and possibly a 2 mg increase days after that as the symptom severity begins to diminish. This more cautious approach reduces the risk of overdose while still addressing the client’s unresolved physical discomfort.

A well-managed methadone induction is tailored to the individual client’s needs, and the client’s safety is always the chief concern. Methadone dosage increases are provided only to alleviate measurable physical withdrawal symptoms or closely associated anxiety, restlessness, or psychological distress from withdrawal.

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.

Repairing Life After Opioid Addiction

methadone-recovery-1Addiction is an uphill battle. We have heard this said many times before. Many who found themselves in the midst of a personal opioid addiction were swept along on a nightmarish roller coaster ride with seemingly no brake pedal within reach.

Fortunately, addiction recovery is real, and people do get off of the roller coaster ride to hell. This is accomplished in a variety of ways with one method sometimes being the decision to try opioid replacement therapy such as methadone or suboxone.

Once off the roller coaster, individuals have an opportunity to survey their surroundings, to reflect on what has happened in their lives, and to begin moving along a better, safer path. Inevitably, facing the consequences of one's past becomes part of this gradual recovery process as does repairing the damage that occurred.

It is important to remember that change does not happen overnight, and repairing one's life happens step-by-step a little each day. There is a popular saying in recovery circles that is profound in its wisdom. It's "progress, not perfection". What this means is that no one is perfect, and that chasing perfection is perhaps an unrealistic goal. The goal should be "progress". This … is achievable. In repairing one's life and in living a new life of recovery, pursuing "progress" is enough.

Another insightful saying is this … "A journey of a 1000 miles begins with the first step". Once you have committed to sobriety and living your life in a better way, you have already taken several steps in the right direction on your new journey. You do not have to reach your destination in 24 hours. The journey itself is a huge part of your personal healing & personal growth.

Repairing one's life after opioid addiction will require several things of you. One is to cultivate patience with the world. The world often moves at a different speed than we do, and it is in our best interest to adjust to that rather than to try and control the speed of the world around us. This will require patience. Patience can grow. We can develop patience through mindfulness, prayer, therapy, and in other ways.

Also important to repairing one's life is trying to live with a sense of purpose. We must be committed to something, or someone, in order to live with a sense of purpose. In active addiction, the daily purpose was to get by without becoming sick, and that defined many addicts' focus day after day. Life loses its purpose when one is reduced to chasing drugs to avoid being dope sick.

Recovery offers so much more in terms having a new and improved life purpose. I can't tell you what that should be. But for some, it's being a good son or daughter, or a good spouse or parent. Or regaining a renewed sense of pride in their job, or "giving it away" and helping another addict or person in need, or volunteering to help a child learn to read, or mowing the yard of an elderly neighbor who can't do for themselves as well anymore.

Your purpose may not be known yet. But you can certainly discover what is really important to you once you get off the roller coaster ride of opioid addiction. As always, recovery is a choice. No one can force it on you. But it is there, available to you … when you are ready. Call your local clinic today. Ask a friend to help you find local resources. Choose to take your first step.