Not every prescription drug addict starts out abusing drugs. Very often, the addict starts as a patient who is prescribed a pain killer after a surgery or a particularly harsh illness. Unfortunately, some of these patients will become dependant on these drugs, either due to persistent pain or because they are predisposed to an addiction. Others start taking addictive medicine because of a sleep disorder or anxiety condition. No matter how it starts, however, addiction to prescription drugs runs a typical course.

When we think of prescription drug abuse, we most often think of addiction to Vicodin or, more recently, OxyContin. These opiates are highly addictive painkillers that provide the user with a sense of well being. As the person develops a tolerance to the drug, he must ingest increasingly larger doses, or move to increasingly more addictive substances, in order to achieve the same high. Hard core addicts will often resort to snorting or shooting the medicine, once taking a pill orally fails to produce the necessary rush.

Addiction to prescription drugs happens fast. It also has a powerful grip. Withdrawal symptoms for prescription drugs are particularly harsh and addicts will take drastic measures to ensure that they never have to experience those feelings. Because the addict will often need increasingly large doses of drugs in order to avoid withdrawal, the cost of a prescription drug addiction can be staggering. Addicts often spend up to one hundred dollars a day in order to obtain these costly drugs.

Once a person who is addicted to narcotics is no longer able to obtain a high enough rush from the prescription drugs, he often moves to heroin as it provides a greater high. However, heroin is also much more expensive. Because the person is an addict, work often suffers and the flow of money eventually dries up. What’s left is a drug addict who is unable to afford his fix. At this point, treatment is the only option.

Some drug addiction treatment professionals adhere to the belief that true recovery can only be achieved if an addict completely eliminates addictive substances from his life. This often results in a “cold turkey” approach to kicking a drug habit. Others, however, believe that recovery is most effective when the addict is kept comfortable during withdrawal and the recovery period. This often results in the addict being placed on a different drug regimen. Problems often arise with this method of addiction treatment, however, when the addict becomes addicted to the drug used to treat the original addiction.

Heroin addiction is historically difficult to treat and “cold turkey” cessation of heroin or narcotics is incredibly dangerous. Medical professionals have developed a way to wean these addicts off the drugs in a non-painful way. For decades, the drug methadone had been used to treat addiction. However a new drug, Suboxone (buprenorphine or “bupe”), has been shown to be effective at treating drug addiction.

Suboxone was introduced in the US in 2002 and has been used in place of methadone. Unlike users of methodone, however, those who take bupe are limited in the strength of the high they can achieve, and do not experience the slowness or cessation of breathing that those on methodone experience. Doctors believe that these characteristics make bupe less addictive, and less deadly, than methadone.

When it was introduced in France years earlier, bupe reduced the number deaths from drug overdoses by over eighty percent. Public health officials around the US were hopeful that it would produce similar results here.

Suboxone is much easier to administer than methadone, making it more attractive to public health agencies. While methadone users must visit a clinic every day to drink their dose, creating de facto gatherings of former drug addicts all over the community, Suboxone is prescribed by a doctor and obtained at a pharmacy once a month. Suboxone also does not cause users to nod, like those on methadone do. This makes Suboxone users better able to function at work.

While Suboxone and methadone have been embraced by the public health community as a viable treatment, private practitioners are not convinced that it is the best way to treat drug addiction. In essence, users of these substances bounce from one drug of choice to the other and, in order to truly recover from addiction, some believe that addicts must cease taking drugs, period.

Although heroin addiction is on the rise among young people in the US, not all medical professionals have embraced Suboxone as the preferable alternative to methadone. First, U.S. federal law requires doctors to take a day-long course and pass a test prior to being able to prescribe it. Also, methadone is big business – for-profit methadone clinics would be put out of business if Suboxone were to replace methadone as the addiction treatment drug of choice. Thus, the methadone industry is working hard to ensure that Suboxone stays at the fringes of drug addiction treatment.

http://www.huffingtonpost.com/lloyd-i-sederer-md/addiction-recovery-a-new_b_595448.html
http://www.suboxonerehabtreatment.com

Suboxone for Drug Addiction Treatment – Underappreciated or Unwelcome? is a post from: Drug Addiction Treatment

Peter Hermann of the Baltimore Sun writes that John and McCracken were postdoctoral fellows at the University of Maryland School of Medicine, working in labs on the same floor, studying the effects of drug addiction. However, they grew marijuana inside their home and used narcotics purchased over the Internet from a Philippine pharmacy that shipped pills hidden inside stuffed animals.

"These are two brilliant people who made a stupid error in judgment," Woessner said in a telephone interview Wednesday. Woessner said she doesn’t think McCracken injected her daughter or forced her to do drugs.

"He loved her and she loved him," she said. "I know this. They’re humans, just like all of us. We all have our faults. Just because drugs is what they studied doesn’t mean anything. Addiction is addiction, no matter what we do, what race we are, what occupation we have."

Baltimore police have charged McCracken, 32, with several drug violations, and a department spokesman said federal authorities have expressed interest in pursuing the case. McCracken is free on bail and declined to comment when reached at his home on Wednesday.

McCracken told police, according to court documents, that he and John "thought they could control the morphine and buprenorphine" and that he thought marijuana should be legalized.

Dr. Donald Jasinski, chief of the center for chemical dependency at Johns Hopkins Bayview Medical Center, said it should come as no shock to see doctors or other medical professionals addicted to drugs, especially those who study narcotics and are around the chemicals daily.

"Anybody who handles drugs thinks they know how to control it," he said. "Perhaps the highest risk group for opiate dependency is doctors."

Buprenorphine is commonly used to ease heroin addicts off the drug, and is prevalent in Baltimore and other cities as an alternative to methadone.

Jasinski said doctors "who you think would know better" sometimes like to experiment like everyone else. "How many people try to quit smoking and know that it’s bad for them and want to quit but can’t?" he said.

Woessner said she was angry to discover that lab workers, despite being around controlled drugs and narcotics that would be illegal on the street, were not tested for drug use. Such testing, she said, could have alerted authorities and helped her daughter get treatment before she died.

Karen A. Buckelew, a spokeswoman for the medical school, said drug tests are administered to "certain employees as required by law," but she confirmed that workers in the lab where John and McCracken worked were not monitored regularly.

Woessner described her daughter as a "superstar" and said "everything she did, she did well." She started playing softball at age 7 and continued on a team in Baltimore. She played the clarinet in her high school band and embraced the Native American heritage of her father’s family. She graduated from high school early and enrolled in Cornell University at the age of 17, majoring in biology.

She met McCracken at Wake Forest University as they worked toward doctorates in their shared field of interest, drug addiction. She earned a doctorate in physiology and pharmacology.

She moved to Baltimore in 2006. McCracken left the University of Pittsburgh three months ago to join her. John worked on projects involving schizophrenia and drug use, and last year led a neuroscience discussion on "This is your brain on drugs."

Woessner said she met McCracken several times and that she regarded him as "polite, intelligent, articulate" and someone "who loved my daughter." They planned to live together for a year before marriage, and, she said, McCracken would have made "a perfect son-in-law."

McCracken told authorities that he and John injected themselves with buprenorphine and morphine. Police said they had turned their unkempt house into an indoor marijuana farm, with grow lights and fans vented with aluminum dryer hoses. Police said they found pills in bags, at least 20 bongs, 30 marijuana plants growing up to two feet high and more packed and stored in Mason jars.

According to court documents, McCracken gave police a detailed account of what happened Sunday, saying he and John soaked two buprenorphine pills in water before filtering them and filling two syringes each with 1 mg doses of the drug. He said John, who has asthma, injected first and immediately had trouble breathing. He helped her use her inhaler, and then dialed 911.

She got to the hospital at 6 p.m. and died 49 minutes later. McCracken said he didn’t get a chance to shoot up because John had already gone into distress. Police found her syringe in the living room of the house.

McCracken told police that he didn’t think John overdosed, but instead injected a bad batch of drugs. Police said results of toxicology tests to determine how John died are pending.

Woessner said she met with McCracken on Tuesday and described him as "very upset, because they were playing, they were doing what couples do. This was not an intentional thing."

However, she does not want him at her daughter’s funeral on Saturday. She said some relatives are angry with him and with what happened, and she wants the service to be a place "where I hope to celebrate her life."

Woessner repeated that she doesn’t blame the boyfriend but said, "I say to God, ‘I hope that Clint can someday find some peace with this.’ "

Post-Doctoral Student Studying Drug Addiction Dies After Injecting Buprenorphine is a post from: Drug Addiction Treatment

Dr. Sack explained that Suboxone is one of two forms of the medication buprenorphine, which was originally developed to treat pain. Suboxone binds to the opiate receptor in the brain and suppresses pain in the same way that opiate drugs like morphine, heroin, and other opiates do. However, as the dosage increases, Suboxone blocks the opiate receptor and doesn’t allow it to be stimulated. Unlike Subutex, the other form of buprenorphine, Suboxone contains naloxone, which blocks the effects of opiates when injected intravenously.

Put simply, Suboxone acts like other opiates but blocks the level at which someone can experience euphoria, making it impossible for someone to get high from other opiates like OxyContin, heroin, codeine, morphine, and Vicodin. This way, clinicians can use Suboxone to block the withdrawal symptoms without having to worry about the client relapsing. In addition, the naloxone prevents people from getting high on Suboxone by injecting it rather than taking it sublingually.

Dr. Sack explained that 25 to 30 percent of Promises clients are dependent on opiates and that about two-thirds of those clients also abuse other drugs. At Promises, Suboxone is usually used for 3-4 days, but can be used for up to 14 days depending on the severity of the dependence. Once a person starts exhibiting withdrawal signs, he or she is given Suboxone and the withdrawal symptoms are stopped within 12-15 hours.

When asked if Suboxone itself is addictive, Dr. Sack said, “Drugs that have the greatest addiction potential have short half-lives and are absorbed quickly into the brain. Suboxone has a very long half-life and takes a while to reach the brain, so it has a much lower addiction potential. People can and do take Suboxone recreationally, but doctors just need to manage people to make sure they use it correctly. In addition, the euphoric feelings that come with Suboxone are much less intense than other opiates because of its long half-life, so people are less likely to abuse Suboxone.”

Suboxone is approved for maintenance like methadone, but Promises doesn’t use it this way. “For most people who are dependent on opiates and other drugs or alcohol, the goal of recovery is to be off drug completely, so staying on methadone or Suboxone for maintenance kind of defeats the purpose,” Dr. Sack said. He acknowledged that some opiate users will benefit more from maintenance treatment but that the ultimate goal is to get them off of drugs completely.

The advantage of using Suboxone instead of methadone is that if someone does use street drugs while taking Suboxone, it’s very unlikely for that person to overdose. In addition, methadone can only be dispensed from a methadone clinic, and patients must visit the clinic every day to get their dose. Suboxone, however, can be prescribed by a physician.

Of Suboxone’s efficacy, Dr. Sack said, “Data shows that buprenorphine is 50-100% more effective than other available treatments such as clonidine, and that a higher percentage of people who use buprenorphine complete their withdrawal. For maintenance treatment, the results are similar to methadone in that about 60% of people who are given maintenance treatment with buprenorphine stay on the treatment and don’t use illicit drugs while they’re on it.”

Suboxone: Safe, Comfortable Withdrawal from Opiates is a post from: Drug Addiction Treatment

Buprenorphine is a medication that virtually stops withdrawal symptoms from opiate drugs such as heroin, methadone, Vicodin, OxyContin, codeine, and morphine. Many people find it extremely difficult to recover from opiate addiction because the withdrawal symptoms are so severe, so buprenorphine ameliorates the process.

At Tompkins, opiate-dependent prisoners are started on buprenorphine about one month prior to their release date, given a 30-day supply as they leave, and then linked to a licensed provider for continuing care. New inmates can also be given the drug to help with detoxification when they first arrive. The facility’s mental health director, Dr. John Bezirganian, started the program a few years ago.

Tompkins County is the only jail outside of New York City to offer such medication-assisted therapy, and the only one in the state to use buprenorphine. Rikers Island in New York City offers short-term detoxification treatments with methadone, a drug used to help wean heroin addicts off the drug. However, methadone is controversial due to its addictive nature.

Buprenorphine, however, is not addictive. No matter how much one takes, he or she will only get 20-30 percent of the effect of a full dose of heroin or morphine. In addition, if a person taking buprenorphine tries to take heroin or another opiate, he or she won’t be able to get high. Unlike methadone, buprenorphine has no street value and can be prescribed by a primary care physician. (People using morphine must go to a licensed dispensary every day to get their dosage.)

Dr. Bezirganian said he manages many of the buprenorphine cases himself, both in jail and in the community, and that it seems to be effective. Though not all inmates prescribed the treatment continue with it upon their release, many of them do, and Bezirganian said he believes it have saved more than one life.

“It’s a highly risky time when people leave a jail. If they return to their environment, there is a high risk of accidental overdose, and relapse in general,” Bezirganian said. “This way, at least they have a shot at choosing recovery.”

In November 2006, the New York State Commission on Correction notified county sheriffs and jail administrators of new federal regulations permitting easier administration of buprenorphine, and said that safe and effective opioid withdrawal treatment in jail is part of the generally recognized standard of adequate medical care. However, Tompkins is the only jail that provides this therapy.

The Human Rights Watch report said that the other 56 New York counties could correct this problem immediately, adding that punishment for drug use in New York State prisons is severe and out of proportion to the seriousness of the offense.

Prisoners who may be drug dependent are punished for symptoms of a chronic, relapsing disease,” it said. “Drug dependence treatment is withheld from prisoners who may need it as part of the disciplinary sanction.”

New York Prison Lauded for Opiate Addiction Treatment Program is a post from: Drug Addiction Treatment

When you are in the grip of heroin, it seems like you’ll never be free of it. Heroin addiction is one of the most difficult drugs to overcome, it’s true, but that doesn’t mean it’s impossible. You do need to be prepared for a long haul. And you do need courage and conviction.

What Happens in the Body With Heroin Addiction

Just why it’s so hard to overcome heroin is easy to see when you look at what the drug does to your body. Over time, your nervous system has adapted to accommodate chronic use of the drug. When heroin first infiltrates your body, your brain’s natural chemistry reacts with heroin’s toxins to create the feeling of heroin euphoria. Other effects include a feeling of heaviness and inability to move, dizziness, nausea, change in skin temperature. You feel tired, and the world seems to no longer exist around you. In effect, you are incapable of functioning either mentally or physically.

Heroin also damages the central nervous system, and may also cause short- and long-term harm to the respiratory and cardiovascular systems. Many users overdose and die from the drug’s toxic effects, while others suffer severe and permanent damage.

A University of California study of 581 male heroin addicts monitored over 30 years (1964 to 1994) found alarming results. After 30 years, more than half (284) of the original participants, had died. Causes of the deaths: 22 percent died from overdose, 15 percent of chronic liver disease, and 20 percent from suicide or homicide. Of the remaining 43 percent of the deaths, the causes were AIDS, cancer or cardiovascular diseases. What about the 297 addicts still alive after 30 years? The sad truth is that 43 percent of them were still using heroin.

You’ve Made the Decision to Enter Detox – Now What?

Just by entering detox you’ve made a powerful first step. You may have finally hit bottom, due to a combination of physical and emotional consequences of the effects of heroin. Perhaps you had an intervention and that’s why you arrived at detox. The point is that you’re here. Now what?

Some of the immediate effects of detoxification from heroin are those you’re already quite familiar with. Every time your high wore off and you didn’t get your fix right away, your body started to feel some of the withdrawal symptoms. You may have even tried to quit cold turkey – not a good idea, as you well know if you’ve tried it.

Physical withdrawal symptoms include: a 3- to 5-day period of intense anxiety, insomnia, flu-like symptoms, cramps, chills, sweating, diarrhea and goose bumps. Muscles start to tighten and twitch, leading to involuntary spasms or kicking. Psychological cravings for the drug become almost unbearable, impossible to fight. Peak withdrawal symptom severity occurs about 24 hours after termination of the drug, and can last a week or more. Without medication to manage the withdrawal symptoms, the pain can be excruciating. But unless other medical problems exist, detox itself is not life-threatening.

Detoxification under medical supervision alleviates the discomfort of heroin withdrawal, managed by administration of medication – if the patient chooses this method. Using medication, the effects can be minimized or even prevented. Drugs used include methadone, clonidine and buprenorphine drugs like Subutex or Suboxone.

Rapid Detox Using Anesthesia Not Recommended

Among the many methods for detoxification that have been proposed or used, rapid detox using anesthesia sounds like a great idea. You’re given an anesthetic, and when you wake up, you’re clean of heroin. That’s not necessarily true. In a study conducted by psychiatrists at the Columbia University Medical Center and New York State Psychiatric Institute at Columbia found that detoxification under general anesthesia is unsafe and ineffective. The procedure can lead to risk of death, seizure and increased stress. Separate studies found other risks, including delirium, attempted suicide, abnormal heart rhythm, and kidney failure.

Detoxification with buprenorphine, while slower than with anesthesia, is less expensive and more effective.

Bottom line: there’s no single, magic pill or treatment that will erase years of chronic heroin abuse overnight. Medically-supervised detoxification, weaning your body safely off the drug, is absolutely necessary.

But detox is only the start of your recovery.

After Detox

The most important factor in determining your overall chances of a successful recovery occurs after the drug has been purged from your system. In fact, drug rehab following detox from heroin can last from 3 to 6 months in a residential program. Your therapy will consist of a number of personalized treatment methods, including individual psychotherapy, group counseling sessions, fitness and nutrition, dialectical training therapy, cognitive-behavioral therapy (CBT), family treatment, alternative therapies, relapse prevention and more. Life-affirming activities include yoga, acupuncture and exercise.

During rehab, you will learn to identify, analyze and understand the triggers that promote drug use and learn new ways of thinking and acting that do not involve drugs. You will also learn new coping skills to deal with stress. You will have the support of individuals trained to help you, and they will deal with you as an individual, basing your treatment on your needs.

Following your drug rehab treatment program, you will be encouraged to continue receiving support and help through continuing counseling, perhaps in outpatient treatment, and to attend recovery support groups such as Narcotics Anonymous. You need to build a new life away from the people and situations that were associated with your drug abuse. By continuing your counseling after you leave drug rehab, you will further strengthen your skills in better understanding and dealing with the underlying issues that caused you to find heroin so attractive in the first place. You now know that heroin is a dead-end path. You’ve chosen to follow a new route, to chart a new life, one that, prior to entering detox and drug rehab, you couldn’t even begin to imagine.

Yes, recovery from heroin addiction is a long road. But it is one that is well worth traveling to arrive at the future you want for yourself: clean and drug-free.

Heroin Addiction: The Long Road Home is a post from: Drug Addiction Treatment

One dose of buprenorphine remains active in the human body for as long as 48 hours, which provides a longer duration than morphine. This is one of the qualities that make this drug ideal for helping opioid addicts to break free of their addiction. Since the drug remains in the body for 48 hours, it also ensures that the withdrawal symptoms that people experience are significantly decreased.

Buprenorphine requires sublingual (under the tongue) administration on a frequent basis. Drug administration should always be supervised by a substance abuse treatment professional, and doses must be strictly monitored. Federal regulations require this in order for treatment centers and medical facilities to be able to administer the drug at all.

There are some side effects that can occur along with the use of buprenorphine. They range from moderate to severe, and it should be pointed out that this drug can, in some cases, produce fatal side effects. The most commonly occurring side effects include the following:

• Headache

• Drowsiness

• Dizziness

• Vomiting

• Decreased libido

• Constipation

• Respiratory depression

Respiratory depression is the side effect that presents the most serious problems with the use of buprenorphine, as it can be fatal in some people. Unfortunately, there is no way to correct or treat this problem should it develop.

While undergoing buprenorphine treatment, all patients are regularly monitored to see how their livers are functioning, as some adverse effects can be caused by using this drug.

Even though buprenorphine is used to treat people with opioid addictions, the possibility does exist for an addiction to the buprenorphine itself to develop. The types of dependencies that can develop include both physical and psychological. People who are considering undergoing treatment with this drug should be aware, however, that instances of people becoming addicted to buprenorphine are quite rare.

Often times, one of the primary questions that people have is whether they should choose buprenorphine or methadone as a treatment option. Both of these drugs are routinely used for short-term and long-term treatment of opioid addiction. Dosing requirements may be a bit better with buprenorphine simply because of the drug’s ability to remain in the body for 48 hours, thereby offering longer-term effects. With buprenorphine, patients typically only have to receive a dose every other day, while methadone requires daily dosing.

Buprenorphine also has an advantage regarding the total amount of treatment time that is required to successfully complete a detoxification program. With buprenorphine, treatments generally last for a few months, while with methadone indefinite or sometimes lifelong treatment is necessary.

It is very important that buprenorphine be administered in an inpatient treatment facility, particularly one that specializes in substance abuse treatment. Inpatient treatment programs not only offer patients detox programs, they also offer treatment or rehabilitation programs that are designed to help people learn healthier ways of living. Some of these treatment programs include counseling, diet and exercise, massage, acupuncture, and group therapy.

The purpose in these additional treatments is to give patients a better chance of maintaining success by giving them the tools they need to lead lives that are free of substance abuse. If patients learn how to be healthy and happy (physically and emotionally) then they will be far less likely to have a relapse.

Resource:  Suboxone Treatment

Sources Used

1. Buprenorphine Detox and Treatment. http://www.addictionsearch.com/

treatment_articles/article/buprenorphine-detox-and-treatment_24.

html. Accessed 19 June 2009.

2. Buprenorphine. http://www.answers.com/topic/buprenorphine-hydro

chloride. Accessed 19 June 2009.

Buprenorphine is a post from: Drug Addiction Treatment