Category Archives: Opiate Treatment

Access to Addiction Treatment

methadone31Many state-funded addiction treatment services have undergone gradual cuts during the last 15 years. With the rising opioid addiction crisis in America, better access to opioid treatment is definitely needed.

There are a number of private clinics and outpatient treatment centers opening their doors in most every state. These private clinics are meeting a need for services that are often absent in more remote areas of the country.

Some new opioid treatment providers are smaller, independent methadone clinics while others are part of a larger network such as those owned by Acadia Healthcare, Behavioral Health Group (BHG), or Colonial Management Group.

They all have one thing in common, and it is that they provide their patients with medication-assisted treatment (MAT). MAT is scientifically proven to be more effective than other forms of abstinence-based treatment.

Medication assistance typically utilizes methadone or buprenorphine-based products to alleviate a patient’s chronic opioid withdrawal. Without medication-assistance, patients often face either a detox admission or they struggle on in a daily effort to secure opiates so as to prevent the return of withdrawal sickness.

People ready for opioid treatment may find that their local methadone clinic is full, or that their nearest clinic is just too far away to access on a daily basis. For some patients, suboxone/buprenorphine may be the best solution since a prescription can be obtained for several weeks of medication before a return visit is required.

Access to treatment is currently on the radar of national healthcare officials and government legislators, many of whom have received numerous letters and calls from families requesting more funding for treatment, and better access. Media coverage has also been much improved during the past 3 years in part due to the widespread opioid crisis and its broad impact.

Supporting local opioid addiction treatment services is important for every community. It ultimately saves lives, reduces crime, and promotes recovery so that addicted patients can work and function.

21st Century Cures Act

opioid-treatment-fundingThe U.S. House of Representatives just passed a sweeping reform, called the 21st Century Cures Act, that will infuse $1 billion in new funding earmarked for opioid treatment and prevention services.

It has taken several years of alarming statistics on the national opioid epidemic, but Congress has responded. This USA Today article provides an overview of the numbers. In addition to the $1 billion for opioid services will be another $4.8 billion for cutting-edge research around treating Alzheimers, cancer, traumatic brain injury, and other medical issues.

The bill received enormous bipartisan support and passed 392-to-26. In 2016, death by drug overdose surpassed death by car crashes and gun fatalities. The public outcry for government intervention has been steady. With so many families having been affected by addiction issues, the new funding allowance should open doors for opioid treatment particularly in rural areas where opioid services have been severely lacking.

Methadone remains the #1 medication-assisted treatment option. Buprenorphine medications are; however, making a big impact in the treatment field with a wide variety of buprenorphine-based formulations coming to market. In addition to the familiar suboxone film, are probuphine (a buprenorphine implant), subutex (an uncoated buprenorphine tablet), and bunavail.

Buprenorphine Implant for Opioid Addiction

buprenorphine implantThe FDA has approved a new implantable drug called Probuphine. Probuphine contains the partial opioid agonist, buprenorphine, which is used to suppress the opioid withdrawal symptoms that interfere with daily life.

The implant is the size of a matchstick and is inserted under the skin in the forearm area. It steadily releases a dose of buprenorphine which has been scientifically proven an effective treatment for eliminating opiate withdrawal symptoms in a number of people physically dependent on opioids.

With heroin and opioid overdose deaths at an all time high in the United States, this new alternative offers one more beneficial path for anyone struggling with opioid relapse and chronic withdrawal. Importantly, Probuphine only treats the physical withdrawal from opioids such that the underlying psychological factors of addiction must still be treated through counseling and other support approaches.

The Wall Street Journal has an extensive article on this new medication and the historically important role of methadone and oral buprenorphine. In the article, Nora Volkow (director of the National Institute on Drug Abuse) is quoted as saying:

Scientific evidence suggests that maintenance treatment with these medications in the context of behavioral treatment and recovery support are more effective in the treatment of opioid-use disorder than short-term detoxification programs aimed at abstinence.

Over 47,000 people died in the U.S. of drug overdoses in 2014. A majority of these were attributed to heroin and prescription painkillers. With continued coverage in the media and ongoing community discussion, more answers and helpful interventions will hopefully see the light of day.

Methadone Information | Suboxone Information

Heroin and Prescription Drug Epidemic

senate-bill-drug-treatmentThe growing problem around opioid addiction continues to receive coverage in the media, and it has become a topic of discussion on the campaign trail because candidates are being approached throughout the country by concerned families and citizens.

Marcia Taylor, President of Partnership For Drug Free Kids, provided testimony in January to a Senate Judiciary Committee on the need to increase funding for drug prevention and drug treatment. Proposed for consideration is the CARA Senate Bill which stands for Comprehensive Addiction and Recovery Act. CARA would allocate funding for drug treatment and prevention resources with a goal of getting more addicted individuals into treatment, and better educating both parents and teens on the dangers of recreational opioid use.

CARA would also address the need to distribute naloxone across the U.S. to aid in the fight to reduce deaths from opioid overdose. Local law enforcement would be trained on the administration of naloxone. Prescription drug monitoring programs would also receive increased support under CARA.

Methadone and Suboxone have become familiar interventions for anyone knowledgeable on opioid addiction issues. Most state-funded opioid treatment programs in the United States are currently full and have waiting lists of addicted people who are eager to participate in medication-assisted treatment.

In America, there has been a notable expansion in recent years of treatment programs who utilize methadone or suboxone to help patients. While many of these programs are private self-pay, Medicaid presently pays for methadone-based treatment approaches in a number of U.S. states. The number of private pay programs currently outnumber state-funded and Medicaid-funded programs by a substantial margin.

Expanding Access to Medication-Assisted Treatment

opioid-treatment-in-mediaAn article in the Huffington Post recently addressed President Obama’s public comments on expanding access to opioid treatment, particularly medication-assisted treatment (MAT) like methadone or buprenorphine (suboxone).

Many members of the treatment industry and recovery community do not have a realistic grasp on the role that medication-assisted treatment can play in recovery from severe opioid addiction. Historically, the recovery community has not regarded those utilizing methadone or suboxone as truly in recovery. They emphasize total abstinence, even from methadone, despite the fact that methadone and buprenorphine have restored individuals to normal functioning and even saved lives in many cases.

There was a time some years ago, in the 12 step community, when individuals were chastised for taking psychotropic medication for depression or other mental health disorders. This criticism came from a fundamental lack of knowledge about the biological basis for many mental health disorders. Similarly, medication-assisted treatment interventions have been the subject of misunderstanding and unwarranted rejection by those with limited education on varied treatment approaches. In the course of clinical trials of a new agent for the treatment of coronary heart disease, researchers at Pfizer Inc. found that while taking is not accompanied by a significant clinical improvement in angina, in many patients it leads to the development of a kind of “side effect”, which consists in improving erectile function. This observation has led to the study of the possibility of using this substance in the treatment of patients with erectile dysfunction.

As America’s opioid problem continues to grow, we need real solutions rooted in medical science and research. At this point in time, medication-assisted treatment has been in use long enough to clearly demonstrate its usefulness in facilitating personal recovery from addiction.

In 2015, we saw numerous local and national political figures rally around families that have been impacted by heroin overdoses and the heartbreaking loss of loved ones. Opioid addiction has finally come into focus within the mainstream media, and even current Presidential candidates have begun to address this as an important issue which commands attention and a solution.

More: Question and Answers on how methadone works