Tag Archives: Suboxone

Med Conference: Buprenorphine Effective for Addiction Treatment

Attendees at a presentation during Hospital Medicine 2018 learned that the drug buprenorphine is appropriate to prescribe for hospitalized patients with opioid use disorders. The same medication is also effective for treating the acute pain experienced by patients being treated using buprenorphine.

Significant Increase in Drug Overdose Deaths

Dr. Anika Alvanzo, from John Hopkins Medicine, made a presentation at the conference. She referred to the significant increase in drug overdose deaths over the past 20 years. The number of fatalities jumped from three percent per year between 2006-2014 and 18 percent per year in the years 2014-2016. Dr. Alvanzo said that a large number of these deaths can be linked to increased use of synthetic opioids.

Types of Prescription Pain Medications

While some people refer to opioids to describe all types of prescription pain medications, they differ in the way they are made.

• Opiates are natural pain medications that are derived from opium. The opium is extracted from the opium poppy and is used to make medications such as morphine and codeine.
• Synthetic opioids are manufactured by humans and include methadone and fentanyl.
• Semi-synthetic opioids are a hybrid made from making chemical modifications to opiates. Drugs in this category include oxycodone, hydromorphone and buprenorphine.

Buprenorphine Availability a Bridge to Treatment for Opioid Use Disorders

Dr. Alvanzo stated during her presentation that there are currently three medications approved by the Food and Drug Administration (FDA) for treating opioid use disorder: buprenorphine, naltrexone and methadone. She went on to say that when buprenorphine is prescribed to patients on discharge from hospital, it “significantly increases” the likelihood that the patient will seek professional treatment. Approximately 75 percent of patients were in treatment one month after discharge.

The doctor urged her colleagues attending Hospital Medicine 2018 to consider getting their buprenorphine certification so that they can order the drug within the hospital and at discharge for patients. She referred to buprenorphine availability as a “bridge to treatment” for opioid use disorders patients.

Buprenorphine for Addiction Treatment

States Expanding Access to Buprenorphine for Addiction Treatment

Buprenorphine for Addiction TreatmentThere continues to be a high demand for medication-assisted treatment (MAT) for opioid addiction. To date, however, states like Ohio only haveabout two percent of doctors that have completed the training necessary to prescribe or dispense buprenorphine. This is the main ingredient in the addiction treatment drug Suboxone, and other similar medications.

Plan to Double Healthcare Professionals Providing Buprenorphine

The state is planning to double the number of healthcare professionals certified to provide Suboxone (and other addiction treatment medications) to patients over the next 18 months. The federal government has provided $26 million in grant funding under the 21st Century Cares Act so that more healthcare providers can get training. Under existing law, doctors, as well as nurse practitioners and physician assistants (PAs) can dispense buprenorphine.

Waiver to Treat Patients for Opioid Addiction

Under the Drug Addiction Treatment Act of 2000 (Data 2000), doctors can apply for a waiver allowing them to treat patients with buprenorphine in their office, clinic, a community hospital or “any other setting where they are qualified to practice.” To qualify for a physician waiver, a doctor must be:

• Licensed under state law
• Registered with the DEA (Drug Enforcement Administration) to dispense controlled substances
• Agree to treat a maximum of 30 MAT patients during the first year
• Qualify to treat MAT patients, either by training or by professional certification

A doctor who has completed at least eight hours of classroom training focused on treating and managing patients with opioid use disorders can qualify for a waiver. The new training program for medical professionals is 1.5 days of classroom instruction, and participants are expected to continue their education through online courses and seminars.

Medication-Assisted Treatment Growing in the United States

The National Institutes of Health Studies says that MAT is a very effective method for treating opioid addiction. Studies conducted in 2014 revealed improved long-term recovery rates over traditional treatment methods, though it often takes finding the perfect balance for each individual as to how long they stay on the medication. Ideally, they would work toward being off of it in 2 years or less, and many people seek to use Suboxone for short-term tapering to simply ease opiate withdrawal symptoms.

Many Patients Receiving Treatment for Opioid Addictions Still Being Prescribed Painkillers

Opioid AddictionsA new study conducted by researchers at Johns Hopkins Bloomberg School of Public Health revealed a major problem with prescribing practices in several states throughout the country. It was discovered that many patients who were receiving prescriptions for buprenorphine to treat their opioid addictions were also receiving prescriptions for prescription painkillers at the same time.

According to information from eleven states, two in five patients that were using buprenorphine were also being prescribed prescription painkillers. Additionally, it was discovered that 66% of people who had completed treatment were also being prescribed painkillers within 12 months.

This shocking discovery only serves to highlight the obvious need for better prescribing practices, prescription drug monitoring programs and more education for doctors. “Policymakers may believe that people treated for opioid addiction are cured, but people with substance abuse disorders have a lifelong vulnerability, even if they are not actively using. Our findings highlight the importance of stable, ongoing care for these patients,” commented Dr. G. Caleb Alexander, study author.

Many experts agree with Dr. Alexander. Treatment has been found to be one of the most effective ways to overcome an addiction to opiates. However, many people struggle to find a treatment facility that is right for them. This is made even more difficult by the potential changes being implemented surrounding the Affordable Care Act, which helped increase access to treatment for more people.

There are many successful ways of treating opioid addiction, and using burprenorphine (Suboxone) as an aid to reduce withdrawal symptoms and cravings has proven to have multiple benefits. What this study shows is that the healthcare system in America has a long way to go to help fix the opioid crisis that appears to be continuing to escalate.

Federal Government Urging Medical Treatment for Addicts

whondcpssIt used to be common that someone enrolled in a drug and alcohol treatment facility would undergo significant amounts of counseling, but receive no medication for their disease. This was especially true for those people who were coming off of heroin. Many treatment facilities have a longstanding policy against prescribing medication like Suboxone or methadone for heroin withdrawal and treatment. According to several reports, the Federal government is attempting to change this by requesting that facilities who receive public funds begin providing heroin addicts with medication as part of the withdrawal and treatment process.

Heroin withdrawal is arguably one of the biggest reasons why it is so difficult for addicts to abstain from using the drug for extended amounts of time. The painful, flu-like symptoms make it difficult for a person to transition from the addiction into recovery. Vomiting, insomnia, body aches and severe cravings combine to make heroin one of the most difficult drugs to come off of safely. Oftentimes a heroin withdrawal can last several weeks, making it tough for therapists and counselors to commence with the processes needed for effective treatment and sobriety.

Methadone and Suboxone were created as an answer to the heroin withdrawals and as long-term replacement therapy. Both drugs are administered to addicts that are trying to achieve sobriety. The drugs block the opiate receptors in the brain and prevent the addict from feeling the painful withdrawal symptoms. When administered by a doctor and monitored by medical staff, the drugs can be effective in helping someone make it through the first few weeks of sobriety. However, methadone and Suboxone are dangerous if not taken under medical supervision, and even it is people can still remain dependent on those synthetic opioids and require further treatment if they want to get off all drugs.

Throughout the years, addicts have found ways to abuse the drugs, making treatment providers weary of advocating the medications as part of a successful treatment protocol. The Federal government aims to change this. By suggesting that treatment facilities that receive Federal aid begin to prescribe the medications as part of their withdrawal procedure, the government is acknowledging that heroin abuse is severe enough that medication is warranted. However, intense monitoring of the drugs would be necessary so as to ensure that addicts are not abusing the drugs and prolonging their addictions.