Monthly Archives: May 2012

Prescriptions for Opiates

opiatesThere are many legitimate and appropriate uses for opioid medications. Opioids are excellent at managing acute or chronic pain for back injuries, post-surgical recovery, dental work, and other medical conditions that generate unbearable pain.

For those who may become physically dependent upon opioids, their difficult journey often does not begin with a chase for euphoria or a “drug high”, but with a short-term prescription from their physician for a pain killer … in order to minimize the pain and discomfort from a recent surgery or injury.

How the brain & body respond to opiates varies from one person to the next. Some individuals have a very high tolerance for pain and may need relatively less pain relief medication than someone who possesses a high sensitivity to pain.

If an individual takes pain medication for a long enough period of time, they may run the risk of developing a tolerance to the medication such that only higher doses of it are effective at reducing pain. As the person begins to increase their use of the pain medication, a physical dependency begins to set in resulting in withdrawal symptoms when the opioid relief wears off. The only thing that will eliminate the uncomfortable withdrawal symptoms is taking more of the pain medication. And thus, a vicious cycle sets in.

It is important to consider than no one starts out intending to become addicted. Unfortunately, many prescribing physicians do not explain to their patient the potential for developing an addiction to opioids. In fact, there is general consensus emerging that pain prescriptions are too readily given out. Many admissions to methadone clinics include individuals whose opioid dependency began with a legitimate prescription for pain medication. It is important that both doctors and patients share responsibility in addressing the potential for addiction with opioid medications. We do not want to discourage the appropriate use of pain medications. They are extremely effective at helping people manage their pain and be able to function. But education is critical if we are to help individuals adopt the proper caution & awareness in regard to potential opioid dependency.

Doctors and Methadone

factsHow doctors view methadone is becoming a hot topic. A friend recently informed me that the TV celebrity doctor, commonly known as Dr. Drew, was against methadone and had publicly made negative comments about the medication. I was disappointed to learn of this because Dr. Drew has a fairly large national audience who follow his opinion on medical matters. I then noticed that Dr. Jana Burson (a well-educated and experienced opioid addiction professional) had written on this topic, and herself questioned why Dr. Drew had made derogatory comments in regard to methadone. Dr. Burson knows firsthand how incredibly beneficial methadone is to those suffering with chronic opioid dependency. If a physician deserves a national audience & voice on this topic, it is Dr. Jana Burson, not Dr. Drew Pinsky.

Physicians typically seem to fall into one of two camps: either those who are educated on addiction and modern addiction treatment approaches, or those who are not. This may seem like a simplistic analysis, but is surprisingly accurate. Sadly, in my experience, physician critics of opioid replacement therapies often jump to conclusions that stem from personal bias or opinion based on very limited exposure to methadone and its benefit to the recovering community. Methadone is not “alternative medicine”, or some unproven sideline drug that one must obtain via the black market in a third world country.

Methadone is the leading medically-approved pharmaceutical treatment intervention for opioid addiction in the United States. There is no medical “speculation” on methadone’s success in the treatment of opioid addiction. It is a proven method of saving lives and restoring quality of life for a large subset of those who are addicted to opioids. These are not hyped opinions, but are medical facts that are beyond dispute. That any “physician” would reject methadone as a legitimate treatment for opioid addiction … is professionally irresponsible, and suggestive of medical incompetence in the area of treating drug addiction.

Methadone has been in widespread use in America for over 40 years. The number of addicted individuals whose lives have been saved and/or improved (through the medically supervised use of methadone) is well documented. SAMHSA (the United States Substance Abuse and Mental Health Services Administration) publish evidenced-based Treatment Intervention Protocols (known as TIPS manuals) that are available to treatment centers all across America. They have several such manuals, published and widely distributed, that are specifically dedicated to treating opioid addiction with methadone and buprenorphine (suboxone). SAMHSA also maintain a U.S. government website listing all of the methadone clinics in the USA and U.S. physicians approved to dispense buprenorphine for the treatment of opioid addiction. Why do they list these? So that suffering people can find help for their addictive disorder.

Perhaps Dr. Drew should interview actual patients in methadone treatment programs. Then interview the staff of professionals (including dedicated, knowledgeable physicians) that work in these facilities. Then interview the families of methadone patients that regained their sons, daughters, mothers, and fathers. Then read the evidenced-based literature & research available (through SAMHSA) on the beneficial use of methadone in treating opioid addiction.

That might require Dr. Drew to walk off of the TV production set, out of the celebrity limelight … and into the everyday real world. It’s a place where people like Dr. Jana Burson work for many years, with thousands of opioid addicted people, using medical interventions that are proven and effective. Dr. Drew would do well to have a sit down conversation with professionals like Dr. Jana Burson. This might allow him to replace negative personal bias … with medical fact. Only then, would he be equipped to speak to the public about methadone and opioid addiction. Until then, he is just part of the TV & celebrity noise … where drama, ratings and sensationalism … are cherished over the truth.