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Drug Detox, Not Suboxone, Is The Doorway To A Real Solution For Opiate Addiction
Police seizures of the opiate addiction maintenance drug buprenorphine are skyrocketing in Baltimore, MD, and according to officials it is typical of a national trend. Under publicly funded “addiction maintenance” programs, addicts are being prescribed what they call “bupe” to ease withdrawal symptoms and quiet their cravings for heroin, OxyContin and other opiates. But many are selling their prescriptions on the street rather than transitioning to a permanent cure through drug detox and drug rehab.
The Baltimore Sun reported this week that trade in illicit bupe prescriptions in that city are rising dramatically, with more addicts every day using the drug to get high. Confiscated illicit buprenorphine was out the roof compared to the growth in methadone seizures in 2007, the Sun article says — the same year that local and state government began spending millions to treat opiate addicts with it. Baltimore City’s police lab saw a 214 percent increase in bupe cases over 2006, and at the County lab, there was a 106% increase, the Sun reported. Meanwhile, oxycodone cases rose less than 7 percent, and methadone cases actually decreased.
Known by the trade name Suboxone, it is a formulation of buprenorphine and another drug, naloxone. Buprenorphine was originally developed as an opiate painkiller, but has seen service in drug detox and addiction maintenance programs for several years as well. Buprenorphine can cause drowsiness, vomiting and respiratory depression like other opiates, but less so than many others, and can result in dependence and the need for drug detox. Naloxone, on the other hand, counteracts the action of opiates, and is used alone to counteract life-threatening central nervous system shutdowns caused by opiate overdoses. In Suboxone, the two drugs are supposed to free opiate addicts from the dangers of street drugs, needle sharing and drug-related crime more safely than the more commonly used — and widely abused — addiction maintenance drug methadone.
Buprenorphine can trigger a high, but the problem is, addicts are crushing and injecting or snorting the pills to get high, rather than using them as prescribed. The practice also rapidly releases the naloxone which brings on withdrawal symptoms, and taking Suboxone with other opiates can also trigger withdrawal. And when mixed with other depressant drugs such as benzodiazepines and antipsychotics, Suboxone can be deadly. Hospital emergency wards — and coroners — too often see the results of such mistakes.
Drug detox statistics have risen right along with the expansion of methadone abuse for years. The increasing bupe abuse will surely see a corresponding rise in drug detox statistics as well. Real freedom from any addiction is found through drug detox and drug rehab, not continued addiction. And down deep, addicts know it.
Nevertheless, bupe is becoming favored by proponents of addiction maintenance over the more common methadone, even though it is more expensive. But now bupe has joined methadone as a serious problem among addicts. And whereas methadone is often provided one dose at a time at clinics, private doctors can prescribe months-long supplies of Suboxone — putting a lot of bupe on the street at one time, setting up the illicit street sales, and leading to more addicts needing more drug detox than ever.
The Sun article went on to say that federal officials responsible for promoting Suboxone, who long played down its potential for misuse, are changing their tune. Federal officials might request warning labels, better detection methods and better training for doctors.
However, few addicts on maintenance programs ever make it into drug detox and rehab. Many addiction counselors, drug detox specialists and even the public consider maintenance programs to be counter-productive because they don’t end addiction, they validate and support it. Lawmakers and politicians at all levels are saying maintenance programs fuel more addiction and crime, and that public money might be better spent on more drug detox and drug rehab programs.
Expanding the availability of drug detox and drug rehab programs would be good, but improved training for doctors (and maintenance program workers should be included too) should beef up the ability to help convince individual addicts to make the decision to try for a real recovery through drug rehab, beginning with a medical drug detox program that really works.
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