“Addiction experts say Suboxone is so effective in treating opiate addicts it can dramatically transform people in a matter of weeks”. In Doc’s Fight to Lift Restrictions, a good point is made on State’s ability to curb opiate addiction. Most state backed low-cost or free prescription programs for suboxone in replacement drug therapy is severely limited, effectively missing an opportunity to drastically reduce the financial and social impact of opiate addiction. Tucson Arizona’s COPE Community Services has stated that its use of suboxone is limited to 100 addicts, deferring many other addicts to the lower cost methadone which is not as effective. Methadone, albeit, very effective at harm reduction when used properly, is quite addictive and its users can be more prone to relapse back to street drugs. Talk continues about Generic Suboxone drastically cutting the sale price of its active ingredient, buprenorphine, but people are still waiting. The point is that readily accessible replacement drug therapy will put a large dent in the ugly business of opiate addiction. That’s something States can’t afford to ignore.
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September 26, 2010 at 10:16 pm
keif
awsome. very positive story.
October 1, 2010 at 5:21 pm
susan lea
Our local methadone clinic gives Suboxone to patients instead of methadone as long as the patient has $2000 to spend. Most addicts don’t have much money at all, much less $2000. So they have two choices; cold turkey or methadone. If you are poor you are more likely to “get clean” in jail than in a treatment center. Suboxone treatment would cost the state a lot less than what it now spends on incarceration. Let’s hope a generic is available soon.
October 2, 2010 at 6:10 pm
Tom at Recovery Helpdesk
I’m not sure what you mean when you say methadone is “quite addictive.”
Addiction refers to a compulsive and maladaptive pattern of drug use that continues in spite of negative consequences. Methadone patients are not addicted. They are using a prescribed medication as intended in order to enjoy the recovery benefits.
Are methadone patients physically dependent on the medication in the sense that they would go into withdrawal if they abruptly stopped taking the medication? Yes. But the same is true of a long list of medications including some blood pressure medications –and, of course… buprenorphine (Suboxone/Subutex).
Buprenorphine and methadone effective forms of harm reduction. But they are also both effective recovery supports.
There are differences between methadone and buprenorphine that may make one a better choice than the other for a particular person. But the post seems to suggest that methadone is bad and buprenorphine is good.
Both cause physical dependence, but not addiction when taken as prescribed.
Both have similar relapse rates if treatment is terminated prematurely.
Both are very important and effective treatments for opiate dependence.
October 2, 2010 at 9:12 pm
Bill Ford
Always respect your work Tom. As for this question, all I can say is when someone is “addicted” to an opiate and seeks methadone to transfer their addiction to a legal opiate so they can normalize their life, are they not still addicted?…and to a drug which is one of the strongest opiate drugs.
You are in the treatment business, Tom, so I don’t want to over talk you. How does one really differentiate between addiction one day and physical dependence the next just for switching from heroin to methadone. I am sure the patient’s attitude evolves tremendously, given the space to do that and I appreciate the medical explanation that could apply to many using methadone responsibly. I’ve seen it used badly as well and when it is; its deadly.
I don’t think methadone is bad at all in respect to harm reduction. The point of the piece is how hard it is for addicts to get suboxone at will. Fact is, methadone is much easier to get started on in most public treatment clinics. No matter how you cut it Tom, treatment is a tough business when our own government stands in the way of making it accessible and high cost treatment centers make treatment so exclusionary. Addicts should be very thankful to methadone in that regards. It has made a difference in many lives and that’s what is most important. So, don’t get me wrong. I am not against methadone.
October 23, 2010 at 8:58 pm
Tom at Recovery Helpdesk
I agree with you that in some places methadone is easier to get than Suboxone. But this isn’t true everywhere. We have a 1 to 1.5 year waiting list at the methadone clinic near where I live. Suboxone treatment is hard to get too, but easier than methadone. I’m sure we both agree that it is in everybody’s interest to make both forms of treatment available on demand for those who need it.
On the methadone vs. heroin issue. Keep in mind that methadone is a slow acting opiate which makes it much different than heroin which is a fast acting opiate.
When a person takes the same dose of methadone every day, the long-acting, stabilizing methadone molecules occupy the opiate receptor sites in the brain and prevent withdrawal, prevent cravings, block the effects of rapid acting, destabilizing heroin molecules –all without making the methadone patient feel high.
It is very possible to use opiates every day and not be addicted, even though you are physically dependent.
Most people who are prescribed opiates do not become addicted. This includes tens of thousands of people who are prescribed methadone for pain.
The same is true of most people prescribed methadone for treatment of opiate dependence. They are physically dependent on the medication, but they are taking the medication as prescribed and experiencing the benefits of recovery rather than the negative consequences of addiction. They aren’t getting high from their methadone and aren’t using other opiates. So describing them as “addicted” to methadone just isn’t accurate.
The idea that methadone patients are “trading one addiction for another” is very damaging because it creates stigma, discourages people who would benefit from methadone treatment from trying the treatment, and creates barriers for people in methadone treatment.
It’s especially discouraging when someone “get’s it” when it comes to Suboxone but not when it comes to methadone.
October 25, 2010 at 12:14 am
Bill Ford
Geographic differences! “Hard to get” is a common theme so far. I do understand that non-addicted people are generally able to stop opiate use at will as long as they follow their prescription. When someone takes prescribed opiates after surgery for an extended period, I understand, they should also be ok when they stop, but not always as I have seen. Some step over the line. Regarding recovering addicts on methadone, they get sick if they stop the methadone without weaning from it. If you say that is dependence, I can respect that. Sure!, they don’t get high on the methadone if not abused, but showing up early every morning for a daily dose, is a hard program for the young addicts. How many times do they relapse? As far as stigma, I think you know what we are up against. Addicts certainly are no stranger to stigma. I suspect, they would accept replacement drug therapy at whatever social cost they had to pay. it should be a dignified process like going to a doctor, which it is not always, maybe not often enough. The stigma and limitation that the public effects on the subject is most damaging to possibilities in recovery. In my opinion, the condition of addiction achieving the status of a legitimate disease and warranting medical intervention at will, is key.