Category Archives: Medication Assisted Treatment

Reducing Risk of IV-Related Infections

drug-safetyOne of the risks associated with the progression of opioid addiction is the increased probability of an addicted person moving to injectable heroin as a last resort in dealing with opioid withdrawal. In the early years of methadone’s adoption in treatment centers, it was used primarily to help heroin addicted individuals detox from heroin and eventually remain heroin free.

While heroin is definitely resurfacing, the opioid epidemic of recent years has primarily been about prescription opioids taken orally. Following this pattern of use, users eventually discover that crushing and snorting pills is a more efficient means of getting an opioid into their system. Injecting is typically the last step in this progression of the disease of addiction.

But with injection comes a variety of new risks and health problems such as skin abscesses, localized infection at the site of injection, as well as hepatitis C (a viral infection of the liver) and HIV infection acquired through needle sharing with infected persons. A recent story in the news highlighted a sudden increase in HIV infections in Scott County (Indiana) in conjunction with the rise of opioid addiction there and injectable drug use.

Indiana’s governor has temporarily approved the use of needle exchange programs to help reduce the risk of virus transmission resulting from the use of dirty needles. The story indicated that the number of documented HIV infections had risen month over month. The county is presently trying to locate over 100 people who may have been exposed to the HIV virus in connection with injecting opiates.

Methadone and other medication-assisted treatments have been conclusively proven to reduce heroin/opiate relapse and injection drug use. For many individuals trapped in a daily cycle of perpetual drug abuse, the risk of acquiring a deadly infection increases with every day that they are not in treatment receiving help.

Treatment leads to recovery, and recovery leads to dramatic lifestyle change. Many patients who choose methadone as a tool in their personal recovery never go back to injecting drugs. This obviously is a life saving choice.

Using the data from the long-term and serious studies, we must admit that 60% of men using the drug on a daily basis normalized their erectile function; they had no symptoms of the diseases and felt healthy. It is interesting that after 2 years of use, this indicator remains almost unchanged. This suggests that there is no tachyphylaxis. The data of a large-scale study show that the patients taking PDE5 every day are less concerned with the time of action of the drug, the speed of the effect and spontaneity of sexual activity. The patient doesn’t think about whether the pill will work.

Someone recently stated “If you’re dead, you can’t recovery.” This is a rather blunt way of expressing a profound and meaningful truth. Addiction does rob loved ones, friends, family, and neighbors of life, health, and happiness. Recovery has the ability to restore all of these. Let us keep our minds and hearts open about the value of medication-assisted treatment. It is making a real difference for numerous people around the world.

Maine’s Governor LePage May Undermine Opioid Addiction Treatment

Maine2Paul LePage, the governor of Maine, has announced that he is considering ceasing state-funded support for methadone. As an alternative, Maine is proposing that patients prescribed methadone be switched to a more affordable suboxone option as part of a $727,000 state budget cut. The story is here.

This is an indefensible decision with dire medical implications for opioid addicted patients currently receiving methadone. It equates to government officials making medical decisions that will negatively impact the health and well-being of thousands of people.

Representative Drew Gattine (a member of the Health & Human Services Committee) is quoted as saying the proposal shows a lack of understanding of the societal costs of addiction throughout the state of Maine.

Methadone and suboxone are both effective medications, but offer very unique characteristics and applications depending on the severity & chronicity of a patient’s opioid addiction. Buprenorphine (the actual opioid agonist contained in suboxone) has a much lower ceiling effect than does methadone meaning its effectiveness would be insufficient for a potentially large percentage of stable methadone patients on 60mg or more of methadone daily. Many patients on a moderate to high maintenance dose of methadone would not have their opioid withdrawal symptoms managed by even the maximum dosage allowed for suboxone – which is generally around 32 mg per day.

For a politician to, in essence, prescribe inappropriate medical treatment for a diagnosable medical condition is a huge state liability. The repercussions are alarming. Hopefully, the local medical establishment and other state officials will step in before irreversible damage is done. Methadone works. This cannot be denied.

Methadone has a long, proven track record of medical efficacy and cost effectiveness. Maine, in particular, has suffered in recent years with a severe opioid addiction epidemic. Reducing access to appropriate medical treatment like methadone will likely result in overdose deaths across Maine and an explosion of condemnation for the governor and his office.

Medication-assisted treatment (MAT) for opioid addiction is not a fad. It is scientifically proven effective and endorsed by multiple state & federal regulatory agencies as well as ASAM.

SMC Recovery Offering Affordable Opportunity in Scottsdale

smc-recovery-2SMC Recovery based in Scottsdale, Arizona opened an outpatient addiction treatment program late last year. SMC provides a Medication-Assisted Program utilizing methadone and an Intensive Outpatient Program. Both treatment modalities are endorsed by SAMHSA as best practices in the field of addiction treatment.

Methadone programs across the USA cover a wide range of prices sometimes as high as $15.00 per day. However, SMC Recovery have implemented one of the most affordable rates in the country at just $55.00 per week. This is an outstanding value for anyone who has been struggling with opiate addiction and it is one of the most competitive rates we have learned of anywhere in the country.

Prospective patients are often unable to get started with outpatient methadone treatment because the cost is just too high for them. SMC Recovery have lowered this barrier considerably. We were informed by their staff that this price will most likely be active over the next year consequently providing numerous Scottsdale area patients an excellent opportunity to see if methadone treatment is beneficial in addressing their addiction problem. SMC’s program offers counseling & support in addition to methadone dosing.

For more information, visit the SMC Recovery website or contact their staff at: 1-480-998-HOPE (4673).

Methadone or Suboxone

addiction-is-treatable-2A common question among those seeking help is whether methadone or suboxone is the best choice for opioid replacement therapy. It reminds me of the age old debate … which is better, Ford or Chevy? Methadone has been used in opioid addiction treatment for about 45 years. Suboxone has been available to the public for 12 years. Each of these medications has been shown, through conclusive research, to be highly effective in eliminating opioid withdrawal. Both methadone and suboxone achieve a similar outcome, but with subtle differences. [view our comparison chart]

When opiate withdrawal symptoms are no longer a daily preoccupation and source of anxiety, individuals are free to invest their energy & time in productive, meaningful activities. Avoiding withdrawal sickness is the single greatest driver of continued opioid use, and often pushes an individual to desperate measures to maintain a supply of opiates so that they will not get sick.

People unfamiliar with addiction sometimes believe that an addicted person “just wants to get high”. To the contrary, most people with a chronic opioid addiction are just trying to get by, to get through the day without becoming sick all over again. Opioid withdrawal sickness is an exhausting roller coaster ride that rarely slows down long enough to allow an individual to escape. Their relief from opioid withdrawal sickness is typically short-lived, and they then begin feeling sick all over again. Quite a vicious cycle.

This is why suboxone (buprenorphine) and methadone are so valuable as a medical treatment for opioid addiction. These synthesized opioid replacement medications have a slow onset, long duration of action. This means that they don’t quickly spike to maximum levels in a person’s bloodstream like heroin. They reach maximum benefit several hours after they are taken. They then remain active in a person’s system for more than 24 hours and consequently keep painful withdrawal symptoms away. With no fear of being sick, a person can finally live their life and refocus their time where it needs to be: work, school, family, home, etc.

Methadone is a full opioid agonist whereas buprenorphine (the active ingredient in suboxone) is a partial opioid agonist. Because suboxone is a partial agonist, it is somewhat less susceptible to causing overdose and is considered easier to taper off of as individuals lower their daily dosage. As a result of methadone being a full opioid agonist, it is typically more effective with severe, long-term opioid addictions. Suboxone has a peak benefit at 24-32 mg per day whereby higher dosages than this will not produce additional withdrawal relief. However, methadone has no such “ceiling effect” and much higher dosages can be utilized as needed to eliminate a patient’s opioid withdrawal.

Family Support of Methadone Treatment

methadone-treatmentWhen patients enter treatment for opioid addiction, their families are usually relieved yet apprehensive. They may have seen previous recovery efforts not be sustained and their loved one return to active substance use. So, families often learn to be cautiously hopeful.

With methadone treatment, there is a new component in the recovery process with the addition of medication assistance. Whether it’s methadone or suboxone, families become curious as to how their loved one will handle this new medication. As most readers know, there is considerable misinformation and misunderstanding about what methadone can accomplish. This leads a patient’s family supports to sometimes have a wary attitude toward methadone or suboxone.

I would like to share two stories that illustrate how family attitudes can shift. The first patient we’ll call Mary to maintain her anonymity. Mary was a local realtor who had developed an opioid dependence. She had been able to conceal her addiction from her parents, but finally reached a point where it became evident that something was seriously wrong. She told her parents that she was entering “treatment” and would be attending counseling. They supported this decision, but were unaware that Mary’s treatment would include opioid replacement therapy.

Mary had one relapse early in treatment, but made the necessary adjustment and remained drug free for the next 12 months. Methadone worked extremely well for her eliminating her opioid withdrawal and erasing her fear of being sick. Through counseling, her coping improved and her perspective on living a full life returned. She blossomed before everyone’s eyes with improved mood and energy, mental focus, and a renewed spirit. She interviewed with several real estate agencies and was hired by a prominent national realty company. Mary was both excited and grateful.

After this first year, she approached our staff and asked for assistance in telling her parents that she was in “methadone” treatment. She was concerned that they may not understand how important a role it had played in her success and she wanted some back-up from professionals who could answer all her parents’ questions. Mary was also considering a switch from methadone to suboxone with the intention of tapering down off suboxone over several months.

Her parents came to the treatment center and met with Mary, myself, and our nurse. Mary reviewed her progress with her mom and dad and then told them that she had been receiving methadone each day as part of her treatment. She explained how it had assisted her and then asked staff to help elaborate. Her parents listened as we discussed how methadone was an approved medication and had been successful for many years in helping opioid addicted people change their lives. Mary’s mother responded saying “We knew something was working for her. We are so grateful she found you. We have no problem with the methadone and we will support Mary with this.” We went on to discuss her thoughts on transitioning to suboxone and how this might be accomplished. Her parents talked that day about the huge change they had seen in their daughter since coming into treatment and how much it meant to them to see her happy again and getting well.

After the meeting, Mary literally beamed with relief that her parents had been understanding and so supportive. Within the next month, she switched to suboxone and began tapering down over the next four months eventually becoming medication free. Methadone and counseling became the roadmap to safety and sobriety for Mary. It also stabilized her to the point that her skills and abilities as a real estate professional could again be used to build a new future for herself by generating significant income.

The next case example is about a woman we’ll call Sarah. Sarah came to our agency seeking methadone treatment after several years of heroin addiction that had recently worsened. Amazingly, she was still working full-time although she was exhausted and emotionally depressed. She began treatment and within three months barely resembled the person that had been admitted to our program. She gained weight. The light returned to her eyes and her smile. Her mental clarity improved dramatically, and both staff and patients remarked how her personality had surfaced. Sarah had been fatigued and depressed for so long that it was as if she was buried inside herself covered by layers of pain, and tired from the battle of fighting her addiction.

We watched her come back to the person she truly was. We discovered that Sarah was actually a human dynamo and a very capable person who had been struggling under the massive weight of a chronic heroin addiction. As she progressed through treatment, she met many milestones of success. In due time, she informed her parents that she had been receiving methadone and explained to them how helpful the medication had been. I had a phone conversation with Sarah’s mom who lived in another part of the state. She explained that she did not know much about methadone, but was very appreciative for what we had done for her daughter. As a great job opportunity had surfaced in the hometown of Sarah’s parents, she relocated to their town and transferred her treatment to a clinic there.

Two months after Sarah moved, we received a huge fruit basket in our office from her parents thanking us for being a support to her and informing us that Sarah was doing beautifully.

These are true stories and examples of methadone’s beneficial role in recovery as well as illustrating that family fear can be replaced by understanding & family support. These examples show a stark contrast between what a person looks and feels like when they first arrive vs. how far one can go once they become stable on methadone and moving forward on the path of recovery.

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