Category Archives: Suboxone Clinics

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

Suboxone Benefits Overshadowed By Fear and Judgment of Bangor City Council

progressSuboxone is medically approved to treat opioid addiction and withdrawal in the United States, and opioid replacement therapy is a documented, evidence-based best practice. That being said, the city council of Bangor, Maine voted 7-2 against the expansion of opioid treatment services in Bangor that would allow existing treatment programs to offer additional Suboxone (buprenorphine) services to addicted people seeking treatment.

Council members were quoted as saying that Bangor had done more than its fair share of helping the addicted population, referencing the fact that many people travel from outside the area to participate in one of Bangor’s three opioid treatment programs.

This moratorium on expanding Suboxone will leave many to struggle with their severe addictions while viable opioid treatment services could be made available to help them. However, the Council wanted more time to consider whether the expansion of opioid treatment would be a good idea for the city. The temporary ban generated considerable dissension once again showcasing that fear & judgment are still barriers to treating people suffering with addictive disorders.

Progress has most definitely been made over many years with the nationwide adoption of opioid replacement therapy. Nonetheless, people continue to fear and judge those things which they do not understand. Simply put, this is human nature. I reflect on past years in which family members and other non-treatment professionals came to visit our facilities, became acquainted with our staff, and gained a real understanding as to what treatment is about.

Consistently, nearly all of these individuals experienced a change of heart and a new understanding. Some of them never considered that addiction would affect their family. Understanding addiction is something that a majority of individuals may not care to understand … until they have to. This, too, is human nature.

In any event, progress often has a way of moving forward despite impediments and naysayer opposition. If the need is there, then energy will collect and eventually be channeled toward fulfilling that need. Suboxone and methadone are such excellent medications when used appropriately. They meet an important need. It’s sad to say, but sometimes a problem has to “hit home” before a person comes to a new understanding.

The five Bangor Council members that voted against expanding Suboxone may have never faced addiction, or the loss of a loved one, or the desperate fear & pain that an addict lives with after years of being sick. One can’t help but question the motivations and “critical thinking” of people who would vote against modern medicine and saving lives. Progress will continue, but closed minds must first be opened.

Methadone Treatment and Recovery

methadone-recovery-2Recovery is for everyone and anyone with a genuine desire for change. Treatment in a methadone program offers the potential for change, and a new path which can lead to a much improved life.

In the field of addiction recovery, there are a multitude of methadone treatment programs all across the country. These programs vary considerably one to another, and this is a result of treatment philosophy, staff experience & qualifications, funding availability, and the underlying structure and operation of the methadone clinic itself.

Some methadone treatment programs are for profit and some are non-profit. Both can deliver high standards of client care and ethical treatment of their clients. "Good" treatment programs are generally identified as being so by their own clients. Conversely, if a particular methadone program is "not so good", their clients will recognize it immediately and the word will get out very quickly.

What makes a "good" methadone program? From most clients' perspectives, it is these things:

  • checking-in and receiving their medication in a timely fashion
  • being shown courtesy and respect by staff
  • feeling like the clinic is staffed by sincere, committed professionals
  • being treated as an individual instead of a number
  • paying reasonable fees for the service provided
  • rules, regulations, and expectations are clear and are enforced fairly
  • being heard & supported … when there is a problem

What is a "well run program" from a clinic perspective? These are important …

  • has clear policies and operating procedures
  • staff are professional, accountable, and self-motivated
  • there is a culture of respect & consideration shown for all staff and clients
  • costs & expenditures are carefully tracked and managed
  • the program of treatment is designed and delivered with integrity
  • documentation of services is consistently completed in accordance with standards
  • services are funded on a consistent basis (otherwise, the clinic will close)

Methadone treatment, and opioid addiction recovery, are not radically different from other substance abuse treatment programs or models of change. The underlying addictive disorder is fundamentally very similar. What separates opioid addiction from some other addictions is the overwhelming physical dependency that can develop with opioids and the associated withdrawal syndrome.

The cognitive-behavioral changes, and eventual psychological growth, that occur in opioid addiction recovery are exactly the same as in any other addiction recovery path. The essential difference is the utilization of opioid replacement medication to thwart the terrible physical withdrawal symptoms that derail recovery year after year. Methadone and suboxone, when used properly, are highly effective in helping addicted persons move forward with their personal recovery. Methadone treatment … and recovery! They go hand-in-hand, and are not mutually exclusive.

Safety and Security With Methadone

methadone-safetyIf you are currently a client in a methadone clinic, then you have most likely heard treatment staff emphasize the importance of safety with methadone and the necessity of carefully securing take home methadone doses. Methadone is a powerful medication that is tremendously helpful to recovering individuals. It is also potentially lethal in the wrong hands and consequently must be deliberately safeguarded.

There is a recently published article on Bloomberg regarding methadone being diverted and then taken by someone who later died from an overdose. This turn of events has led to newly proposed legislation in five states (Maine, Indiana, Minnesota, West Virginia, and Pennsylvania) that would further tighten regulations regarding the operation of methadone clinics and their award of methadone take home medication to their clients.

The reported misuse of methadone, and associated deaths, was allegedly tied to several private, for-profit clinics that operate in these states. One of the criticisms of the private, for-profit clinics was that they are not providing "enough services". This is intended to mean that the clinics in question were not providing sufficient education & counseling support or adequate monitoring of those who receive take home methadone.

It is critically important that all methadone clinics (both private and publicly supported) implement thorough measures to educate clients on methadone safety concerns as well as institute monitoring protocols like 24 hour callbacks and random drug testing. 24 hour callbacks require take home recipients to return to their home clinic within 24 hours and to produce their methadone take home doses for count and inspection by the clinic's medical staff.

It is also important that methadone clinics only award take home medication privileges to those clients who have achieved certain progress milestones such as successive months of clean urinalysis, attendance to required counseling sessions, the absence of criminal charges, and demonstrated appropriate behaviors & attitude toward staff and peers at the clinic.

When individuals intentionally divert methadone doses or mishandle methadone through lax practices (such as leaving it sitting out in plain view), they put others at risk and ultimately undermine the delivery of methadone services in the community. In other words, the mistakes of a few can negatively affect everyone. This also erodes the community's confidence in methadone as a life-saving medical treatment.

In the end, it is the shared responsibility of all methadone clinics and their clients to insure that methadone is taken as prescribed, and safeguarded from diversion. When proper precautions are not honored, tragedies will occur. This will lead to state legislators taking matters into their own hands with additional laws & regulations that may keep worthy individuals from receiving a valuable privilege. Take home medication is so very beneficial to honest, hard-working individuals in recovery. It frees them to seek employment, hold a job, care for family, and to more easily meet many other important responsibilities in their lives.

Time Limits on Methadone Programs

methadone-servicesThere is growing interest from a number of entities in regard to America’s opioid addiction problem, methadone treatment, suboxone treatment, and the always important funding considerations that accompany these subjects.

This interest is coming from hospitals & the larger medical establishment across the country, your local community, the Federal government’s Medicaid services division, your State’s Division of Health and Human Services who allocate state dollars for opioid treatment, private insurance companies, employers, and the list goes on and on.

The nationwide costs and consequences of addiction are enormous. The cost of treating addiction is also very large. However, research has proven repeatedly that addiction treatment produces undeniable cost benefits. In other words, treating addiction saves money in the long run by helping addicted individuals arrest their disease and become functional again. For many of the entities listed above, it’s all about the dollars. And more specifically, saving dollars when it comes to treating addiction.

The U.S. economy has been hit hard and we have a growing number of people depending on entitlements and public assistance. This, of course, creates a scenario in which more and more people are relying on a “government pie” whose slices keep getting cut smaller and smaller. The recent reductions in funding for public addiction programs have caused some agencies to close their doors … while other agencies simply had to cut back on the services they are able to offer their addicted clients.

An important consideration, which may become a hot topic soon, is how much counseling a methadone or suboxone patient can receive. Or, how long he or she can remain on their opioid replacement medication before public assistance funding begins to stop. Medicaid and State dollars presently help to fund the treatment for many opioid addicted clients in programs. There are currently more people in need of opioid treatment than there are funds available to pay for that treatment. So inevitably, patients may find themselves needing to help pay for their treatment.

I would not like to see patients be pressured to taper off of methadone before they are ready. Experience has shown us that gradual tapering, initiated & paced by the client, is the most successful means of coming off of methadone or suboxone successfully. Government public assistance is becoming more like private “Managed Care Organizations” with every passing day. As this paradigm continues to evolve, we may possibly see time limits of some sort imposed on methadone & suboxone maintenance clients. Some may view this as reasonable and necessary since such limits and caps are already applied to recipients of other health care services.

If time limits are ever applied to one’s length of time on methadone or suboxone, we will likely see clients increasingly picking up the funding for their opioid treatment. This happens everyday around the country in private, self-pay methadone clinics. In the end, we know that opioid replacement therapy works. It’s been proven! The availability of Medicaid and State funding is a great benefit to many people across the country. How this might change in the years ahead will bear close observation.