Addiction Treatment Gap Is Driving A Black Market For Suboxone

Months in prison didn’t rid Daryl of his addiction to opioids. “Before I left the parking lot of the prison, I was shooting up, getting high,” he says.

Daryl has used heroin and prescription painkillers for more than a decade. Almost four years ago he became one of more than 200 people who tested positive for HIV in a historic outbreak in Scott County, Ind. After that diagnosis, he says, he went on a bender.

But about a year ago, Daryl had an experience that made him realize he might be able to stay away from heroin and opioids. For several days, he says, he couldn’t find drugs. He spent that time in withdrawal.

“It hurts all over. You puke, you get diarrhea,” Daryl says.

Full story at npr.org

Too Few People Who Survive Opioid Overdose Get Medication-Assisted Treatment

A new study concludes too few people who survive an opioid overdose receive medication-assisted treatment that will reduce the chance of another overdose.

The study included more than 17,500 adults who survived an opioid overdose and found only about one-third received either buprenorphine (Suboxone), methadone or naltrexone (Vivitrol), HealthDay reports.

Among people who did receive one of these medications, most did not stay on the drug for a long time, the researchers report in the Annals of Internal Medicine. The researchers found 17 percent used buprenorphine, with a median use of four months; 11 percent used methadone, with a median use of five months; and 6 percent used naltrexone, with a median use of one month.

Full story at drugfree.org

Although their introductions as treatment are different, two top medications for opioid addiction are equally effective

With opioid addiction officially declared a public health emergency in the U.S., medical intervention to treat the illness is increasingly important in responding to the epidemic. Now, a new study concludes that two of the top medications available for outpatient, office-based treatment, once initiated, are equally safe and effective in curtailing opioid use, relapse, treatment drop-out and overdose.

Researchers in the Departments of Psychiatry and Population Health at NYU School of Medicine, who led the study sponsored by the National Institute on Drug Abuse (NIDA) and published online November 14, 2017 in The Lancet, conclude that extended-release naltrexone (an opioid antagonist marketed as Vivitrol) demonstrated similar safety and clinical effectiveness to more commonly prescribed buprenorphine-naloxone (an opioid agonist marketed both generically and as Suboxone).

However, the study also points out differences that have previously been known: Patients being treated with naltrexone must detoxify before it can be administered. (This is commonly referred to as the “detox hurdle.”) On the other hand, buprenorphine allows individuals to transition relatively seamlessly from opioid use to medication maintenance without needing to detoxify.

Full story at Science Daily

Inadequate Access to Addiction Treatment Leads to Suboxone Black Market

Inadequate access to opioid addiction treatment programs has led to a thriving black market for Suboxone, the drug that helps patients overcome their addiction, experts tell The Wall Street Journal.

More than 36,000 doctors are certified in the United States to prescribe Suboxone and other buprenorphine-based medications. Until last year, those doctors were limited to prescribing the drugs to 100 patients each. Last year, the Obama Administration increased that number to 275, and began allowing physician assistants and nurse practitioners to prescribe the drugs.

Full story of Suboxone thriving on the black market at drugfree.org

Mindfulness May Help Patients Reduce Suboxone Dose, Pilot Program Suggests

The practice of mindfulness, or paying attention “on purpose” to the present moment without judgment, may be helpful for people trying to reduce their dose of the opioid medication buprenorphine/naloxone (Suboxone), according to Zev Schuman-Olivier, MD, Medical Director for Addictions and Executive Director for the Center for Mindfulness and Compassion at the Cambridge Health Alliance.

Dr. Schuman-Olivier is co-leading a mindfulness-based group for individuals prescribed Suboxone to treat their opioid use disorder, who want to reduce the amount of medication they take, come off of it completely, or come to a place of acceptance with their medications. Of the first five people who participated in the program, three have reduced their buprenorphine dose, and two have been able to stop taking it completely with no relapse for six months with the help of another non-dependence forming addiction medication, naltrexone.

Full story of mindfulness and patients reducing opioid use at drugfree.org