We have learned a lot about addiction treatment over the past couple years as more and more research has been poured into the disease state. We know that 220+ million opioid prescriptions are written each year for pain management, we know that statistically 5% (potentially more) of these patients will develop an addiction.
We know that addiction doesn't discriminate and is not an issue of moral upbringing or character but rather a physical change in the brain. Neuro genetic studies show a mutation in the mu receptor in opioid addicted individuals. People with this mutation will very likely become addicted with any exposure to opioids. Some patients without this mutation when taking opioids will complain of nausea and being sick , describing the symptoms as "being allergic" to the medication - an adverse effect, most take opioids to relieve pain but when not in pain do not desire the medication, but about 9% will state they never really felt bad but once exposed to opioid feel the best they ever have and crave more opioid - that is the people who become addicted. Diabetics are born with a genetic predisposition to diabetes. Type 2 over time and with weight gain (Carb Addiction) develop diabetes. We don't shun them!
The addiction causes blindness, kidney failure, heart attack, stroke, neuropathy, obesity, hypertension and 35 % of the population is affected
causing one of the greatest costs to the health care system!
We know that 16,000 people die every year from overdose of prescription pain relievers. That's 46 people every day. And we know that no one starts out with the hopes of becoming an addict. But we are also learning through our research that the best choice for patient recovery and healing from addiction is by combining responsible medication assisted treatment (aka buprenorphine) with ongoing counseling. Diversion has been a problem in the past but we now know that patients don't require excessive amounts of buprenorphine and they certainly don't need to be maintained on higher doses of it as that leads to a greater opportunity for diversion. Buprenorphine treatment is NOT a magical treatment for the opioid addict. It is a partial agonist to the mu receptor that will keep a patient from experiencing withdrawal symptoms and having those cravings that constantly occupy the addict's mind. Buprenorphine buys the patient TIME to get their life back together. People assume that when a patient buys suboxone or any form of buprenorphine off the street it's because they are getting a euphoric high from it when in fact they are taking it to AVOID the withdrawal symptoms that come with not using heroin or prescription pain medications. They use it so they don't feel like they're DYING. A patient can reclaim their life with buprenorphine treatment when it is used responsibly and Kentuckys new laws and regulations are helping to outline an appropriate therapeutic treatment course for patients suffering from addiction while red flagging clinics for irresponsible buprenorphine treatment. Not everyone taking Suboxone or any form of buprenorphine treatment is abusing it. We dont shame the patients desperately trying to release themselves from the strong holds of addiction. I suggest we celebrate the success stories of those who have taken that route and now lead healthy, sober, productive lives. Those who are able to hold down a job now, those who have their relationships back on track, are no longer resorting to violence and crime and those who serve as a positive influence on their children. A negative publicity only fuels the problem because patients don't know where to turn and feel like a failure when they can't handle the real world outside of abstinence based programs.
In reference to the cost of buprenorphine treatment...what is the cost of NOT prescribing! Street drugs cost lots of money. Where do you think money is obtained by one who is destitute from addiction and a $600.00 a day drug habit? Crime is even more expensive as is the loss of human life. Approximately 60% of the IV drug users are positive for Hepatitis C and %5 are positive for HIV. This also adds on to the cost of treating addiction. Hepatitis C costs $75,000 just for the medication to treat and a total of $100,000 per patient for the remaining lab, follow-up, and physician /hospital costs. HIV costs $386,000.00 alone for drug treatment during the life time of the individual. Who picks up the tab? The tax payer in the form of Medicaid.
We at LWR-Wellness operate with the goal of HEALING not JUDGING the patient and educating their family and support system. I'd encourage readding the article "Dying to be Free" written in the Huffington Post and visit www.OutTheMonster.com to get the real story on what addiction looks like.
YouTube the story of Marin Riggs at http://youtu.be/yWWONh9xGvk or Tyler Campbell at http://youtu.be/j-9Z0pXbtvI to understand WHY people would utilize buprenorphine treatment as opposed to abstinence based rehab facilities.
Things are evolving in this disease state and I can see a positive stand in Kentucky Legislature and the Kentucky Board of Medical Licensure that will lead the way for the rest of the nation. Great things are happening and we have success stories to prove it if we can just get everyone to understand and shed some light on what addiction really is.
L. William Roberts, M.D., FACP