Category Archives: Suboxone Physicians

Doctors and Prescriptions For Pain Medication

oxycodone-prescriptionReceiving increased attention across the country are concerns about prescription pain medication and to what extent prescribers are using caution and due diligence in administering them.

In addition to opioid addiction treatment centers that often employ methadone, pain management clinics also utilize methadone as well as other beneficial but potentially addictive opioid medications such as hydrocodone for breakthrough pain. Often, in addition to painkiller prescriptions, pain management physicians will prescribe powerful benzodiazepines like Xanax and Klonopin to manage patients’ stress and anxiety symptoms.

The potential problems which can emerge from these medication combinations is fairly extensive. First, uninformed patients can develop a rapid physical dependency on pain meds if not properly educated. Patients also run the risk of accidental overdose when combining powerful drugs like methadone, oxycodone, and xanax. There is a serious risk to the community when a physician overprescribes because powerful pain medications and benzodiazepines have a premium “street value”, and are often diverted and sold to naive, inexperienced users who can easily overdose and die.

A recent article in DrugFree.org cited several State congressional bills being considered which would require physicians treating pain management to receive special education in the prescribing of opioid medication. Pain management clinics have been identified in the last few years as a major source of diverted opiate medications making their way to the black market. The article points to two states, Pennsylvania and New Jersey, that have set-up task forces to explore methods for reducing their states’ presciption drug abuse problems.

For recovering people, pain is a real life circumstance which should be dealt with humanely and sensitively without judgment. From child birth to surgery to cancer treatment, anyone can experience debilitating pain. Managing that pain may require strong medication that carries some risks. While every adult bears obvious responsibility for knowing what they put into their body, it makes sense that doctors would undergo specialized training in regard to the use of opioids to treat pain. This not only provides the physicians themselves with a reduced liability risk, but helps to increase the chances that those receiving strong medication are more thoroughly educated on the benefits and important cautions around use of prescription painkillers.

For information on suboxone-approved physicians, read: Suboxone Doctors

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.

Drug Addiction, Methadone, and Suboxone

suboxone-articleAn article was brought to our attention by Dr. Dana Jane Saltzman, a New York City physician who specializes in the treatment of opioid addiction. Dr. Saltzman uses suboxone in her private practice to help those seeking recovery from a severe opioid habit.

The article was posted in The Village Voice and attempted to depict the duality of opioid replacement therapies. This duality stems from the highly therapeutic & legitimate uses of suboxone (buprenorphine) contrasted against the attempts of some addicts to create a black market cottage industry with the medication selling it illegally online via Craigslist, Facebook, and other social media.

In the world of medicine and addiction treatment, selling suboxone is certainly criminal, and also behavior characteristic of someone who is not grounded in recovery. Many medical & clinical treatment professionals across the country have endeavored for decades to provide safe, effective treatment to suffering addicts. When FDA-approved opioid treatment medications are misdirected and sold on the black market, all varieties of abuse and exploitation occur ending in overdoses and a deepening of damaging social stigma about medications such as suboxone and methadone.

The Village Voice article plays it straight up the middle with perhaps some emphasis on the growing underground market for suboxone targeted to those who want to bypass the cost or inconvenience of signing on with a suboxone-approved physician.

Individuals who attempt to treat their own addiction with opioid replacement therapy are going to fail a high percentage of times. First, most  have no medical basis for understanding the complex nature of opioid addiction in the brain, and they can even deepen their addiction through the inappropriate use of opioid replacements. Addicts often go with what feels right opting for their own intuition as opposed to following proven best practice protocols like those employed in structured treatment programs supervised by suboxone-approved doctors.

Addicts who treat themselves with street suboxone or methadone are also completely missing the counseling component of recovery which addresses the underlying psychological factors that drive addiction. Taking street suboxone without counseling is akin to taking diabetes medication while eating doughnuts. In other words, the individual makes their complicated dilemma even worse.

There are some generic equivalents of suboxone in development which may make opioid replacement therapy more accessible to the larger population. Suboxone and methadone have a definite place in addiction treatment. It is critical however that early recovering addicts receive quality counseling so that they can better understand how to cope with relapse patterns and develop the skills necessary to successfully manage the disease of addiction. Addicts treating themselves with medications acquired on the street will remain stuck in a vicious cycle of addiction.

True recovery requires humility and commitment to higher principles. Chasing shortcuts to recovery creates more pain and wastes valuable time that would be better invested in real solutions.

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.

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.

Joining the Methadone.US Online Database

methadone-graphicGreetings and happy 2013 to our site’s visitors, U.S. methadone clinics, suboxone physicians, and addiction treatment providers across the country! Methadone.US was successfully launched in 2011 and quickly developed surprising traffic to our website as many hundreds of individuals searched online daily for local opioid treatment services and discovered Methadone.US.

Our goal was to humanize opioid addiction treatment and to help educate the public on the value of methadone and suboxone, and to further legitimize opioid replacement therapy. This goal is being achieved every day as evidenced by our hundreds of thousands of visitors, numerous emailed comments & stories, and people taking our online opioid addiction assessment.

Methadone.US features individual pages for cities across the United States, and we are now providing a showcase featured spot at the top of every city page for local methadone clinics & suboxone doctors to list their services. If you are a treatment professional looking to reach and serve clients, then feel free to join Methadone.US and have your clinic or practice clearly profiled at the top of your city page. As an example, you can view two of our new additions here: Matrix Center in Wichita, KS and American Treatment Center in Newport News, VA.

Opioid addiction treatment is going mainstream. This is a good thing because it simply helps those suffering with addiction find the help that they need, and to begin the process of recapturing their quality of life. As Methadone.US enters its third year, we would like to thank all those who believe that addiction recovery is possible, and that methadone & suboxone are beneficial tools in that process.

Many people in our society, from all walks of life, are struggling today with a debilitating opioid addiction. They deserve help. They are ready for change and they need only to connect locally with good treatment services. Fortunately, the internet is making that connection more possible with every passing day. Thank you for visiting, and for supporting, Methadone.US in reaching that worthwhile goal.