Methadone is FDA-approved for pain management and the treatment of opioid addiction. Methadone is a relatively safe and highly effective medication when used exactly as prescribed. It is currently in use in the United States and around the world following years of conclusive research on methadone’s efficacy and safety.
It is important for patients receiving methadone to know that it can interact with other central nervous system depressants like alcohol and benzodiazepines such as xanax, klonopin, valium, and librium as well as similarly acting non-benzodiazepine agents like ambien (a popular sleep aid). When methadone is mixed with these other medications, there is an increased risk of sedation and loss of consciousness. In extreme cases, individuals mixing methadone and other CNS depressants have gone into respiratory failure.
For those who have chosen to receive methadone in an opioid treatment program, they will discover that a proper dose of methadone not only eliminates opiate withdrawal & cravings, but will also block the euphoric effects of any other opiates. This is typically a positive side effect in that it discourages illicit opiate use or supplementing with street drugs like heroin. Since methadone binds so well to the brain’s opiate receptor sites, any other opiates that are ingested have no means of creating a euphoria or a high since the body’s opiate receptors are occupied by methadone. This removes the incentive to misuse other opiates and can facilitate the process of recovery. I was ordered by his neuropathologist to treat panic attacks. I began to drink them in half, and then I kiss the pill for the night. I drank a tablet of hours at 8 pm – after half an hour I sleep with a child). The effect is very classy: nothing is interesting, nothing is needed, there is no emotion – everything a person needs is just morally tired.) She accepted Klonopin for about four months. The effect was. Somehow I just did not care about panic attacks). They did not care anymore.
There are instances in which a patient’s physician has prescribed a benzodiazepine for anxiety management while also prescribing methadone. Such decisions should always be accompanied by a thorough discussion with one’s doctor of the potential risks & complications. There are other, safer alternatives for treating anxiety such as Buspar and cognitive therapy. These other options should be considered when a patient is already receiving methadone. In addiction treatment, the use of benzodiazepines for anxiety is typically monitored carefully through increased random urinalysis testing and medication counts.
Posted in Benzodiazepine, Buprenorphine, Drug Safety, Heroin, Methadone, Methadone Blog, Methadone Clinics, Methadone Maintenance, Methadone Safety, Prescription Drugs, Suboxone
Tagged alcohol, klonopin, overdose, xanax
Soon to be released is a new oral buprenorphine based product called Bunavail. Bunavail is manufactured by Biodelivery Sciences and is a combination of buprenorphine and naloxone. It is a thin film formulation that is designed to adhere to the inner cheek where it quickly dissolves and is absorbed into the mucosal lining of the mouth.
The medication is touted as delivering about twice as much active ingredient into the patient’s bloodstream compared to sublingual suboxone. Bunavail is scheduled to be released in the third quarter of 2014. A press release by the company mentions that the medication will compete with other products in the $1.7 billion dollar opioid dependency treatment market.
Bunavail is a new advancement in drug delivery technology according to the press release and is reported to produce less constipation than other competing buprenorphine products. Patients can also speak freely while the medication dissolves.
With an estimated 2 million plus people addicted to opioids in the United States, new medication alternatives are welcomed.
Biodelivery Sciences is described as a specialty pharmaceutical company with a focus on pain management and addiction treatment. The company is based out of Raleigh, North Carolina. Bunavail’s FDA approval was announced on June 6, 2014.
Click here for more Information and Articles on Buprenorphine
Somewhat of a surprise was the recent ruling that the state of Massachusetts cannot ban the powerful new painkiller, Zohydro, from being prescribed in the state. The manufacturer of Zohydro, Zogenix, had argued that the ban was not constitutional and must be reversed.
The state governor, Deval Patrick, had announced his intention to make Zohydro unavailable since the manufacturer’s initial plan was to provide it without a tamper-proof component to deter abuse and potential overdose.
Judge Rya Zobel ruled that the state of Massachusetts had exceeded its authority in banning the drug, and she consequently implemented a preliminary injunction temporarily reversing the ban. The governor expressed disappointment that the public’s safety concerns were not sufficient to halt the sale of Zohydro, but he stated he would pursue other channels for addressing the widespread opioid abuse problem that is continuing to grow in the state and across the country.
Opioid pain medications have become a primary drug of abuse for a number of age groups. Deaths by opioid overdose now surpass deaths by homicide and motor vehicle accidents in numerous states.
While Zohydro may be an effective pain management medication, it will very likely be sought (and purchased illegally) by those with severe opioid addictions trying to avoid daily opioid withdrawal sickness. Sadly, overdose deaths will result from the use of this medication in similar fashion to the problems that surfaced when oxycontin hit the market. Please keep yourself informed, and if you are suffering with opioid addiction and withdrawal sickness, seek treatment immediately. There is opioid detox, methadone medication assistance, and private physicians using suboxone to help patients cope with their addiction.
The State of Massachusetts is experiencing dramatic levels of opioid abuse and their Governor, Deval Patrick, is sharply focused on addressing the problem. A compelling Boston Globe article has highlighted the growing problem with heroin and other opiates across the state noting that 185 people died of heron overdose between November 2013 and February 2014.
Also mentioned in the article was the state’s plan to increase funding for drug treatment by $20 million and to prohibit the sale of Zohydro, a highly potent prescription painkiller that has drawn much attention and criticism due to its ability to potentially worsen the opioid epidemic in America.
Governor Patrick has declared the opioid abuse problem a public health emergency and is taking active measures to increase the availability of naloxone to Massachusetts public workers so that they can intervene to save the lives of those experiencing an opiate overdose. Naloxone is a powerful opioid antagonist that reverses the effects of opioid overdose within minutes. Numerous overdose victims have been saved in recent years as a result of medical personnel or bystanders having access to naloxone.
The state also intends to crack down on the over prescription of pain medication and will be requiring physicians and pharmacies to participate in the prescription monitoring program. Participation was previously only voluntary, but will now be mandatory. Prescription monitoring reduces the prevalence of “doctor shopping” and also the diversion of prescription medications to the street where they are resold at a premium.
While naloxone can save lives by reversing the effects of opioid overdose, methadone also saves lives by removing the desperate daily struggle to avoid opioid withdrawal. This daily struggle often leads to premature death or long term incarceration. Suboxone (buprenorphine) provides the same medication-assisted support which allows those lost in addiction the ability to stabilize and move forward again. It is important to emphasize that medication-assisted treatment should always incorporate long term counseling and recovery-building since addiction is not just a physical dependency problem. The psychological component of addiction is what is addressed through counseling and therapy.
Receiving 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. Tramadol is an analgesic, belongs to the group of opioids. It’s a remedy, so Tramadol cannot be bought without a prescription. I was pricked at the hospital when they did not help NSAIDs, with pain caused by a hernia of the vertebral disc.
According to the instructions, the action of the remedy occurs within 15-30 minutes and lasts for 6 hours. Once, with especially severe pain, it was enough for a couple of hours. But overall the remedy is really strong, and sometimes it’s just a rescue.
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