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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.

Repairing Life After Opioid Addiction

methadone-recovery-1Addiction is an uphill battle. We have heard this said many times before. Many who found themselves in the midst of a personal opioid addiction were swept along on a nightmarish roller coaster ride with seemingly no brake pedal within reach.

Fortunately, addiction recovery is real, and people do get off of the roller coaster ride to hell. This is accomplished in a variety of ways with one method sometimes being the decision to try opioid replacement therapy such as methadone or suboxone.

Once off the roller coaster, individuals have an opportunity to survey their surroundings, to reflect on what has happened in their lives, and to begin moving along a better, safer path. Inevitably, facing the consequences of one's past becomes part of this gradual recovery process as does repairing the damage that occurred.

It is important to remember that change does not happen overnight, and repairing one's life happens step-by-step a little each day. There is a popular saying in recovery circles that is profound in its wisdom. It's "progress, not perfection". What this means is that no one is perfect, and that chasing perfection is perhaps an unrealistic goal. The goal should be "progress". This … is achievable. In repairing one's life and in living a new life of recovery, pursuing "progress" is enough.

Another insightful saying is this … "A journey of a 1000 miles begins with the first step". Once you have committed to sobriety and living your life in a better way, you have already taken several steps in the right direction on your new journey. You do not have to reach your destination in 24 hours. The journey itself is a huge part of your personal healing & personal growth.

Repairing one's life after opioid addiction will require several things of you. One is to cultivate patience with the world. The world often moves at a different speed than we do, and it is in our best interest to adjust to that rather than to try and control the speed of the world around us. This will require patience. Patience can grow. We can develop patience through mindfulness, prayer, therapy, and in other ways.

Also important to repairing one's life is trying to live with a sense of purpose. We must be committed to something, or someone, in order to live with a sense of purpose. In active addiction, the daily purpose was to get by without becoming sick, and that defined many addicts' focus day after day. Life loses its purpose when one is reduced to chasing drugs to avoid being dope sick.

Recovery offers so much more in terms having a new and improved life purpose. I can't tell you what that should be. But for some, it's being a good son or daughter, or a good spouse or parent. Or regaining a renewed sense of pride in their job, or "giving it away" and helping another addict or person in need, or volunteering to help a child learn to read, or mowing the yard of an elderly neighbor who can't do for themselves as well anymore.

Your purpose may not be known yet. But you can certainly discover what is really important to you once you get off the roller coaster ride of opioid addiction. As always, recovery is a choice. No one can force it on you. But it is there, available to you … when you are ready. Call your local clinic today. Ask a friend to help you find local resources. Choose to take your first step.

Methadone Clinics Have Good Intentions

legaldomains_1A new methadone clinic in North Haven, Connecticut recently opened called APT. Lynn Madden, who is the acting CEO of APT Foundation, has made a concerted effort to connect with the local community in order to help citizens understand that methadone clinics can be operated safely and discreetly with no adverse effects to the surrounding neighborhood.

The clinic currently has about 800 patients. An article by the New Haven Register documents the comments of local residents and businesses who all report that the clinic has been good for local business and has resulted in no problems or increase in crime.

The article goes on to explain how the clinic is actually situated in close proximity to a large community development, but positioned such that neither is really aware of the other. This demonstrates how some clinics are expertly planned and managed.

At Methadone.US, we wrote two years ago about a New York City methadone clinic that is housed in a downtown church and serves many hundreds of clients per day. This clinic there is so private and quiet that local businesses did not even know it was in operation for years just across the street.

This type of well run facility and seamless community integration provides good evidence that the fears and criticisms of methadone naysayers are largely unfounded.

Lynn Madden of APT was quoted as saying that New England has a very high rate of addiction to opioids. We know that this phenomenon is increasing across the country, and consequently will demand more attention, and funding, in the years ahead if we are to adequately address the opioid addiction problem.

APT seem to have a good strategy for dealing with the unfortunate stigma that still exists around methadone. The key is education, outreach, and clinics staffed with professionals who are adept at explaining the benefit of drug treatment to the local community. Treatment solves problems. Treatment saves lives, reduces crime, and restores economic productivity on both a personal/familial level and a community level.

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.