Southampton - Fortunately, those afflicted with narcotic (opioid) addiction have another option to help them choose to live successfully with what is all too often an illness that prematurely ends lives. I personally know of four young men whose lives were tragically and suddenly taken from our local community due to this horrific plague of narcotic abuse. Expensive brief and intense programs to achieve a "rapid detox" generally fail within 30 days for the vast majority of people struggling with narcotics. For most patients, there is no cure for what is a lifelong cursed relationship with opioids.
Intense outpatient counseling with or without medication is one of the best options for most patients. However, the disease is one of frequent relapses despite every known intervention, including the newer option of outpatient treatment with buprenorphine (brand name Suboxone), with which I am most familiar.
Buprenorphine, like methadone, is a long-acting opioid, taken by mouth for patients with narcotic addiction, and is designed to keep a patient comfortable and out of withdrawal, but not causing a high. Buprenorphine intervention is somewhat similar to methadone treatment, and has been shown to give similar long term outcomes, but at much less of a hassle to the patient. Methadone clinics often close their doors to new and desperate patients due to long waiting lists. Those fortunate enough to get accepted into such clinics are initially required to go daily, often needing long commutes, something rather inconvenient for most. Clinics are funded by our taxes, and methadone costs pennies. Patients on methadone are known to abuse the drug to get high, by using higher doses, and even by injecting the medication. Patients on methadone may also easily get high and overdose from other opioids while taking methadone.
Buprenorphine is taken usually once daily, under the tongue, in the form of a fast-dissolving film, or as a tablet. It is usually combined with another medication, naloxone, to prevent the patient from getting high in the event the medication is abused by being injected. The cost of one tablet or film is about $7, much less expensive than street drugs. This prescription medication is covered by health insurance plans. Most patients take two or less daily. Patients taking more than four a day will usually feel unwell, unlike methadone whose daily dose can be more dramatically escalated. Most importantly, patients who take their buprenorphine, are choosing life, because when they take this medicine, they are unable to get high nor overdose from other opioids. They will quickly get their lives back, while still taking an opioid for their chronic addiction, but they will not be getting high from the medication.
Buprenorphine treatment usually is started in a physician's office, by a physician specially certified to prescribe this medication. The initial visit will be for two to three hours, with the patient arriving in withdrawal, after a trying but tolerable period of 12 to 24 hours without narcotics. Patients are advised to come with a friend or family member and not to drive themselves for that first visit. The medication is given in carefully controlled amounts during this initial "titration," along with supplemental medication as needed to promote patient comfort.
Subsequent visits are much simpler, and are scheduled quickly at longer intervals, until patients may be seen on a monthly basis. Patients should expect to be treated with the same respect and confidentiality as all other private patients seen by the treating physician. Random drug screens will be done, and patients will be urged to complement the medical treatment with attendance in a professional counseling program. AA and NA meetings are strongly urged as well.
Unfortunately, buprenorphine, like methadone, is no panacea. Patients too often do not follow the treatment, and may even sell their medication for money or trade the medication for street drugs, including more dangerous narcotics. It is common for patients suffering from narcotic abuse to attempt to convince themselves and their friends and loved ones that they no longer require counseling nor medical treatment, only to end up relapsing, too often with fatal consequences. Unfortunately, there have also been dozens of deaths of a certain limited group of patients taking buprenorphine, because these people had mixed their prescribed medication along with high doses of tranquilizers ('benzos') at the same time. Taken alone, as prescribed, buprenorphine is a very safe and effective option for those with narcotic problems, allowing them to Choose Life, and To Succeed!