Heroin Treatment Options: Suboxone

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SPRINGFIELD, Mo. — As part of our examination of opiod and heroin addiction in the Ozarks this week,  we’re looking at treatment options. Today we take a closer look at buprenorphine commonly called “suboxone.”

A woman we are calling “Clair” started experimenting with opiates at the young age of 15.
By 18, she was using heroin heavily on a daily basis.

Clair says, “A lot of addicts, you wouldn’t know. It’s just normal people, running away from something. I was looking for the energy and just looking for the escape, I guess.”

Clair was spending up to $90 a day on the drug. “I didn’t steal and break into people’s houses. I didn’t live on the street or anything like that. It was really private.”

Help came in the form of her doctor– who wrote her a prescription for Suboxone. And while it’s a constant struggle,  she’s now 6 months drug free. 
She’s 24 years old.

Mercy Hospital Pharmacist Terry Barks tells us, Suboxone is a mild opiate,  made to reduce cravings and help with withdrawal symptoms.
“You get the mild stimulation from it, but you don’t get the euphoria. You don’t get the high. But, it’s enough to take the edge off the cravings.”

Ultimately, the goal is remission.

Mercy Addiction Specialist Christine Saxton says, “It’s kind of a two fold. The negative affects of the withdrawals and losing the positive affects of the high, makes it very common for people to relapse.”

“It just takes a lot sometimes to even get out of bed. I think for an addict— it’s hard,” Clair admits.
Saxton says,  “We know this is a chronic disease. We know it makes life-long changes. There are changes, permanent changes in that brain functioning.”

Dr. Melinda Campopiano is a Medical Officer at SAMHSA’s Center for Substance Abuse Treatment.
She tells us,  there’s a lot of good that comes from taking Suboxone.  “Just getting on Buprenorphine reduces mortality by half. They’re risk for HIV is reduced by half.”

Clair says, “It gives you time to get your life straight and not have to worry about withdrawing and feeling, I guess feeling like crap.”

But unfortunately, no drug is perfect.  There is a dark side, too.
“People need to recognize that if they have saboxone in their possession, they need to keep it secure, because being a drug of abuse potential, they could be targeted for theft.” Barks warns.

Experts say when a person needs the medicine and can’t get it legally, they’ll take matters into their own hands and hit the streets.
“There’s definitely some evidence that that is the pattern,” says Dr. Campopiano.  “People who are trying to control their drug use or trying to get treatment can’t access it will try and get the medication illicitly.”

Clair says, “The only people who I’ve met who buy Suboxone off the street are people who are trying to get better, who don’t have insurance or can’t find a doctor who will prescribe it to them.”

And while it’s possible to abuse almost any drug, medical professionals say, getting high off Suboxone is next to impossible.
“If they take another opiate, the Naloxone will block the effect of it. It’s just a waste of time and money,” says Barks.

Clair says, “If you use it like you’re supposed to, someone like me who had an intense addiction, can’t get high. It just doesn’t happen, cause you already have a tolerance.”

There’s also a cap on Suboxone. At first, providers can treat up to 30 people at a time the first year.
And up to 100, following that.

Providers must be registered and have special training through the Drug Enforcement Agency and Substance Abuse and Mental Health Services.

But there’s not on drugs like Hydrocodone and Codine.  Doctors have unlimited prescriptions when it comes to those, says Dr. Campopiano.
“But many providers are finding that, especially if they’re the only ones in their community that’s providing treatment. They are overwhelmed by the demand.”

She says, there’s a need for more registered providers in our communities.
Providers, like the doctor who helped save Clair. “I don’t think I’d be here without him.”

Dr. Campopiano tells us patient limits were defined in the statute by Congress back in 2000, all under the Modified Controlled Substance Act.
But now, they are trying to change that.

Health and Human Services has a “Notice of proposed rule making” in the Federal Register for public comment.
They are proposing a new higher limit for specially-qualified providers, raising the limit of Suboxone prescriptions to 200.

Public input can be submitted until the end of the month. Once they move forward, we could see changes come early Fall or Winter.    

Read more on the proposed rule here. 

Too see all of our reports on The Quiet Epidemic, click here.

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