For those of us touched by the death of a loved one from a drug overdose, I know which option I would choose if given the option of a few years of life on Suboxone* or death.
In our practice we have seen many individuals in the throes of opiate addiction and withdrawal transform almost overnight after buprenorphine induction. While it is not a magic pill, it can be the first step toward healing from an addiction–giving the patient and their family members time to work on the psychosocial issues that may have precipitated the addiction in the first place. This medication absolutely saves lives. As addiction medicine practitioners, we commend the Huffington Post for bringing up this important topic for discussion. For over a decade, Dr. Kornfeld at Recovery Without Walls has championed the use of buprenorphine and often been met with reluctance from some traditional workers in the addiction treatment community. However, as explained in the article, the statistics show that recovery from opiate addiction is achieved far more often if addicts are given medication assisted therapy.
We have long known that the system to treat addiction has been separate from the structure of the medical and scientific community and we are seeing this problem develop as a lethal failure. We hope to see changes within the healthcare system to make this life saving treatment more widely available. More physicians need to obtain certification from the federal government to prescribe Suboxone. State-funded and private health insurance agencies need to make the process of obtaining coverage for these medications easier. Longer office visits with practitioners and psychotherapy sessions needs to be covered by insurance agencies so that the recovering addict can address other stressors that contribute to relapse.
The Huffington Post article is focused mostly on treatment in Kentucky, however, our own state of California is certainly affected. We would propose that medication based treatment should be part of the standard of care within residential programs. If a practitioner should choose not to treat an opiate addict with a maintenance medication, there should be a justifiable reason for withholding that treatment. Just as if you were to choose not to treat a diabetic, a justifiable reason, such as attempts at dietary change or exercise, must be made clear. This paradigm could apply in the case of opiate addiction, but many of the current methods in treatment centers rely on moralizing and willpower more than what has been scientifically shown to lead to recovery.
The brain of an opiate addict is often changed by the drug. Cravings are unbearable and the physical and psychological reactions to stress are heightened. Maintenance medications allow recovering addicts the time to slowly regain normal function. Contrary to some individuals quoted in this article, maintenance medication does not necessarily mean forever. Many addicts will take Suboxone for 6 months to several years, but good addiction medicine providers understand that tapering is always the goal.
When speaking about providing Suboxone to recovering opiate addicts, healthcare providers, individuals in the justice system, and others in the treatment community must set aside the stigmas associated with this illness and embrace this life saving treatment. The greater availability of this medication under the supervision of a physician results in fewer deaths which seems to us to be the truly moral choice.
*While we use the trade name Suboxone, most of the buprenorphine, including buprenorphine combined with naloxone, is available as a generic medication.
Posted by Cara Eberhardt, Patient Care Coordinator
Read the Huffington Post article here.
Find us on Facebook here.