Category Archives: Suboxone Physicians

Pregnancy and Opioid Treatment

pregnancyWhen a woman is pregnant and addicted to opioids, she faces extraordinary stress and very often a wave of judgment from those around her that is emotionally painful and difficult to deal with. The criticism of others is understandable since no one wants to see an unborn baby placed at risk through the mother’s drug use. But this cauldron of angry emotion and public condemnation often overwhelms a pregnant mother, who may already feel guilty, and it pushes her further into isolation and inaction. This isolation only places the mother and unborn baby at greater risk of overdose and possible miscarriage.

Fact: It has been thoroughly researched and the findings conclusive that pregnant opioid-addicted women have a much better chance of carrying their baby to term and having a healthy baby when the mother is receiving medication-assisted treatment. Every day, addicted mothers receiving methadone or buprenorphine give birth to healthy babies that thrive and develop normally.

Methadone and buprenorphine (Subutex) are very different medications compared to heroin and painkillers like oxycodone. Heroin and painkillers manufactured for break-through pain act quickly, but also dissipate quickly. For those with an opioid addiction, this momentary relief from opioid withdrawal does not last long and they are back out there again desperately trying to find more heroin to avoid becoming sick.

With methadone or buprenorphine, mothers are medically stable and able to avoid debilitating cycles of withdrawal as well as the dangerous drug-seeking behaviors and lifestyle that put them and the baby at risk. A woman is already in a state of increased vulnerability when pregnant. If lonely, isolated and forced to go to the street to find dope or pills, she will find herself in dangerous situations and exposed to a drug culture that values money over human life.

This harsh reality is what some women face as they struggle to survive while carrying an unborn child. If in treatment at a methadone clinic or under the supervision of a caring physician who utilizes buprenorphine, the pregnant woman can start the process of personal recovery. She can avoid becoming sick from opioid withdrawal and avoid taking grave risks just to avoid that withdrawal. She can receive emotional support and medical assistance to maximize her health and that of the unborn baby. She can better prepare herself to be a good mom once the baby is born.

There are those who may indignantly exclaim “But the baby will be born addicted”. The reality is that it is much safer for a baby to be born to a mother receiving methadone or buprenorphine than for the baby to be repeatedly exposed to adulterated street heroin and combinations of drugs riddled with unknown contaminants. Think about that. Technically, the baby may be born with some physical dependency, but this is successfully managed all the time by medical professionals across the country. Buprenorphine has been found to have a milder withdrawal syndrome and is utilized successfully in helping infants comfortably detox. Methadone is successfully used for this purpose as well.

It is important to also make a distinction between “addiction” and “dependency”. They are not the same. “Addiction” encompasses the persistent craving for opiates, the mental preoccupation with securing them, and the inappropriate behaviors and lifestyle aberration that develop as people lose control over their ability to choose. “Dependency” can occur with anyone who has been using an opioid for a sustained period of time. Someone who has become “dependent” can readily taper off of the medication and will not be necessarily driven to obsess over drugs or desperately seek them. A baby who is born temporarily dependent on methadone or buprenorphine can be successfully tapered off of the medication. Obviously, a baby does not meet the definition of “addicted” so to use that term is technically inaccurate and misleads the public.

Finally, methadone and buprenorphine are safer for the baby. It’s ultimately about helping that unborn baby to develop normally in the womb and to be born alive, healthy, and with maximum opportunity for a good life. Chances are that the mother will indeed be that baby’s primary caretaker for a long time. It is much better that she be introduced to recovery and various avenues of support through methadone or buprenorphine treatment than to be left on her own with no support, little guidance, and struggling to find dope on a daily basis.

 

Opioid Addiction Spiking in Guilford County North Carolina

policeGuilford County is the third most populated county in the state of North Carolina. Located within Guilford County are the cities of Greensboro and High Point – both of which are experiencing a surprising increase in opioid addiction and related overdoses.

The High Point Enterprise news reported that the High Point Vice and Narcotics unit has begun to make a favorable impact on the problem with multiple arrests of those trafficking heroin locally. The article documents that 70 reported High Point opioid overdoses have occurred thus far in 2014 with 9 of those ending in death. Six people were arrested the week of July 14 and are being held on multi-million dollar bonds for their roles in selling or trafficking heroin. To emphasize the local impact, the HP Enterprise reported that 7 overdoses occurred within a 24 hour period on May 16, 2014.

Just 15 miles away in the neighboring city of Greensboro, Rhino Times covered the local explosion in heroin addiction much of which has been driven by individuals turning to heroin when they could no longer obtain prescription opioids like oxycodone. Rhino Times interviewed the Director of Guilford County Emergency Services, Jim Albright, who stated that a particularly strong strain of heroin hit the streets of Greensboro in late April, 2014.

Over the weekend of April 25, the Guilford County EMS responded to an avalanche of calls in response to people overdosing on the new potent version of heroin. Mr. Albright is reported to have identified that 21 overdoses and 5 deaths occurred just in that one weekend. Due to the potency of the drugs, some victims were found with a needle still in their arm.

Highlighted in the article was the life saving properties of Narcan, a drug that quickly reverses the dangerous overdose effects of opiates. Narcan can be administered by injection or squirted into the nasal cavity. As it is absorbed into the body, it restores breathing to those that have overdosed. Narcan is now kept in first responder vehicles, firetrucks, and ambulances. Visit Alcohol & Drug Services for more on Narcan and opioid overdose prevention kits.

For information on methadone as a treatment for opioid addiction, click here.

Methadone and Treatment Are Valuable Resources

action-methadone-assistanceSince the launch of Methadone.US, hundreds of thousands of visitors have searched the site and located important treatment resources to help them deal with a chronic opioid addiction. The city pages on Methadone.US list both methadone clinics and local buprenorphine (suboxone) physicians.

While the federal government maintains a similar database of medication-assistance providers, we focus on making this site convenient and easy-to-use for patients, families, medical professionals, and anyone interested in finding help for addiction problems.

We have some recent clinic additions to Methadone.US in the cities of Salt Lake City, Dallas, and Cincinnati. There are an increasing number of clinics around the country, and in larger metropolitan areas there are often numerous facilities available to serve the much larger population. To highlight local treatment programs, we offer Featured Clinic Listings for those methadone treatment providers who wish to profile their services to a larger number of prospective patients who are visiting their city’s page on Methadone.US.

A very exciting aspect of opiate-specific recovery is the growing recognition among medical professionals nationwide that opioid addiction is an actual illness and that it can be successfully treated with medication-assistance. For too many years, there has been a rush to judgment when it came to opioid addicted people who would present sick and in need of care. Recently, the problem with opiates has become so widespread that those in society who thought they could never be affected by it have come to realize that addition is an equal opportunity disease.

The “story” is in the real recovery of people who begin medication-assisted therapy and who then go on to change their lives, resume work, get ahead financially, reconnect with their family, and live a better, high quality life that is not compromised by constant medication seeking.

Methadone and treatment have value because they change lives and save lives. It’s not a hard concept to grasp and not controversial when evaluated from a factual, objective point of view. More good news is that opioid replacement therapy is not going away. It is an effective, proven intervention that is based on actual science and extensive research, and it has been deemed a best practice by the U.S. Substance Abuse & Mental Health Services Administration. That is quite an endorsement. Methadone and treatment … valuable resources that make a lasting difference in the lives of many people.

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.