In the United States an opioid epidemic is raging on, destroying communities, robbing towns of their emergency medical funds and destroying families. Overdose deaths are now the leading cause of unintentional deaths above car accidents and cancer. The number of people entering treatment is on the rise and the options for them are vast, but some options seem to be for the addict with ‘cheat mode’ on.
Medication assisted treatment has begun to be the more popular option when combating opioid addiction. Due to the rise in opioid addictions around the county, Between the addiction industry, psychiatrist, doctors and detoxes, more and more treatment centers now offer the enticing option of medication to help addicts wean off their dependence.
This type of treatment is meant to be a sort of ‘replacement’ therapy, as it can keep the bodies opioid level to a consistent, starving off the withdrawal symptoms and encouraging the recovering addict to continue with their therapy as they obtain their medication at their daily treatments. The medication Methadone has been around for decades but has been criticized for it’s effectiveness. Methadone has a high rate of abuse, and sometimes leads users to abandon their drug of choice for their legal medication that was meant to break their addiction in the first place.
There are two types of arguments for and against the medication assisted treatments. We will be addressing the medication Buprenorphine, most commonly known as Suboxone. Hardcore sobriety purist will say that using a medication that is similar to your drug of choice is not true sobriety. This stigma has caused tension between chronic pain patients, addiction specialists and recovery programs. This is why they may not believe you are truly sober if you are taking Suboxone of Subutex.
To the strictest recovery purist, Sobriety means to not be impaired. The word in itself sends a message of seriousness and purpose towards a stricter lifestyle, void of dependence of any kind. The medications Buprenorphine or Suboxone are classified as narcotic drugs and even is known to have a “high risk of addiction and dependence”. It is a partial opioid and it does affect the brain in similar ways narcotic opioids do. The claims of people using suboxone to get high describe a ‘light to mild opioid buzz’ during the first week of use, which then the brain becomes used to and the “buzz” goes away. Using the medication as prescribed, the highs found within the first week become smaller and smaller until it is not felt at all. Yes, once the medication is abused, snorted or intravenously used, the high can be comparable to normal opioid strength.
Contrastingly, Suboxone contains Naloxone, which blocks the effects of opioid medication, which include pain relieving receptions and feelings of well being, which then lead to abuse.
Most people agree that although a patient may be using Buprenorphine prescribed to them from a doctor, they are indeed in recovery from addiction and should be considered sober. The controversy becomes a problem when a heroin addict comes out of detox and begins using Suboxone, begin going to 12 step meetings and then are told they are not truly sober because they are using a mind altering substance.
If we were to be this standard, then some argue that those who smoke cigarettes (nicotine), drink coffee (caffeine) or use anti-depressants are also not sober. They are all mind altering legal drugs, but the medications similar to Suboxone are held to an unfair standard.
When this standard is applied to newly recovering addicts, it can actually damage the sobriety path and in turn lead to relapse. To be fair, Buprenorphine and Suboxone are meant as short term treatments and are to be worked into a treatment program that eventually leads to tapering off their dosages until it is no longer prescribed to them. In exception are those with chronic pain who cannot function normally without a form of pain medication. Even in that case, Suboxone is a good alternative to other more addictive opioid medications such as Hydrocodone and Fentanyl.
In other words, “In someone gets cancer, we prescribe them chemotherapy to fight their disease. These radiation treatments may last months until complete remission has happened. Essentially, the same thing occurs with opioid addiction. Medication-Assisted Treatment, like Suboxone, is their chemotherapy. It rids their brain of the craving and obsession to return to illegal or narcotic drug usage until they are stable enough to enter ‘remission’. In fact, most Suboxone prescribers require 12 step attendance or some form of therapy in accordance with medication to prepare the person for their post-addiction life” – Martin Seligman PhD