Monthly Archives: September 2014

Methadone Maintenance For Opioid Treatment

methadone-and-opioid-treatmentOpioid Treatment is a category that includes several different interventions or approaches relating to opioid use disorders. People sometimes mistake opioid treatment for “opioid detox” when they are technically two different processes.

Opioid detox refers to the process of helping an opioid addicted individual discontinue their use of opioids and be medically monitored as the body withdraws from them. In a supervised setting, a person is typically assisted through a short-term opioid detox (3-10 days) by the administration of various medications used to manage withdrawal symptoms like clonidine (to guard against high blood pressure), vistaril (to reduce nausea and anxiety), and even buprenorphine (to minimize the severity of the opioid withdrawal process).

There are also variations on an opioid detox referred to as a taper. A taper often occurs on an outpatient basis and involves a more gradual reduction in dosage of either methadone or buprenorphine (suboxone) over time. This taper may take as long as 90 days and allows the individual to adjust more comfortably due to the slower, milder reduction in dosage that occurs over a coarse of weeks or months.

Maintenance is the term which refers to maintaining an individual for a significant period of time on either methadone or buprenorphine (suboxone) to allow for stabilization on the opioid replacement medication. Since opioid addiction introduces dramatic brain chemistry changes in conjunction with strong physical dependency and cravings for opiates, many people find that they need a substantial period of stabilization on methadone in order to have a realistic chance at building a personal recovery. Numerous individuals have decided that they will utilize methadone for only a few weeks with the intention of tapering off of it very quickly. This strategy is prone to failure and tends to end in dramatic relapses back to heroin and other illicit opioids.

Methadone maintenance for most opioid-addicted persons involves receiving methadone for a year or more. This length of time dramatically raises the probability of successful physical stabilization and necessary thinking, behavior, and lifestyle changes which lead to long-term drug abstinence and sustained, productive living. Put very simply, when people attempt to rush through the process of stabilization & recovery, they sabotage their chance of experiencing real success. For that reason, maintenance is a therapeutic process which should be regarded as a one year commitment or longer, and tapering off of methadone or buprenorphine should not be rushed. Bear in mind that not all individual situations are exactly the same and there are unique exceptions.

There are many different factors that play into how long a person needs to remain on methadone or suboxone maintenance. This is highly individualized depending on the length and severity of one’s opioid abuse history, one’s present medical status and general state of health, the availability of social & emotional supports, and the presence of any co-occurring psychiatric disorders like depression.

There is considerable misinformation about methadone tapering and a bit of fear-mongering that often occurs around the topic. People that generally taper successfully off of methadone or suboxone are individuals that have invested time in counseling and personal recovery growth, and who have developed a good working relationship with their doctor or treatment staff. These individuals approach tapering as a gradual goal and are allowed to halt or slow down their taper as needed. This allows their body time to adapt to the somewhat lower dosage. It also allows them to proceed slowly and carefully such that any anxiety or fears can be successfully identified and managed.

Choosing The Right Direction: Detox – Methadone – Suboxone

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.

 

BHG Offering Methadone and Suboxone in Memphis

bhg-logoTennessee is a leading state in the incidence of opioid addiction and opioid overdose. This is most likely a direct result of Tennessee being ranked one of the country’s leading states for the prescription of opioids as well as benzodiazepines like xanax and klonopin.

The CDC (Centers for Disease Control and Prevention) report that 46 people die every day in the United States from overdose on prescription painkillers. They also have documented that 259 million prescriptions for opioids were written in 2012 alone by U.S. healthcare providers. This stunning proliferation of opioids has sparked national concerns about opioid addiction and why painkillers have been made so readily available.

In Tennessee, Behavioral Health Group (BHG) have responded to the crisis by providing opioid treatment in a variety of Tennessee cities. They currently operate three clinics in Memphis: Memphis North, Memphis Mid-Town, and Memphis South Treatment Centers under the BHG banner.

BHG also have clinics in Knoxville, Nashville, Jackson, Paris, Columbia, and Dyersburg. The company’s locations all provide suboxone (buprenorphine) in addition to methadone to aid opioid addicted individuals in their effort to cope with powerful opiate withdrawal symptoms. BHG provide various forms of supportive counseling to their patients in conjunction with their medication-assisted treatment model.

While local and federal governments work to address the rise in opioid addiction, it remains very important that addicted individuals seek and find effective treatment as soon as possible. Those interested in participating in opioid treatment often have questions about the process of enrolling in treatment and what it is actually like receiving methadone or suboxone in a clinic setting. Methadone.US offers helpful information on our site for prospective patients that provides an overview of the opioid treatment enrollment process.