Treating Opiate Addiction with Opiates – The Good, Bad and Downright Ugly

Treating Opiate Addiction with Opiates – The Good, Bad and Downright Ugly

There is nothing new about treating opiate addiction with other addictive drugs. That is a sad fact and one which has always been questioned by medical professionals and lay people alike. However, in recent years newer drugs have been added to the list of acceptable pharmaceuticals used in the treatment of addiction and this has raised more than a bit of concern.

While the use of methadone dates back more than half a century to treat addiction to opiates such as heroin, newer drugs are now in use and these are added to the list of controlled substances to beware of. Many people are alarmed at some of the facts which are being underplayed in the media.

For a better look at some of the controversy, check out information found on the Recovery Resource Center website. In the meantime, let’s take a look at treating opiate addiction with other opiates to get a glimpse at the good, bad and sometimes downright ugly of this sometimes questionable practice.

Methadone Sets the Stage

Most people are familiar with methadone which was developed in the 1930s by German scientists as a synthetic analgesic (pain reliever) with properties similar to morphine. The effects are also similar to those of morphine and other such narcotics and there was a good bit of initial success with the drug as a pharmaceutical. However, in the 1960s as heroin addiction reached epidemic proportions, doctors began using methadone to help wean addicts off heroin, but even then, results were questionable.

Like heroin and other narcotics, methadone was also addictive, so that should have raised red flags right then and there. It is possible to overdose on methadone and since its properties are similar in scope to drugs like heroin and morphine, it has just as high a street value as those other addictive substances. Since 1947 when the drug was first introduced to the United States, methadone has been the most widely used MAT (Medication-Assisted Treatment) drug for opiate addiction. The FDA claims that it is not giving drugs to drug addicts, but many treatment centers believe otherwise. Bear in mind that methadone is an opiate.

Buprenorphine Gets FDA Approval in 2002

Now, some half-century later a new opiate has entered the controversy. In 2002 the FDA approved the use of buprenorphine for use in MAT. In-depth information on buprenorphine can be found on the SAMHSA, Substance Abuse and Mental Health Services Administration, government website but it is clear that this is another potentially dangerous drug. By some accounts, the buprenorphine family of pharmaceuticals can be even more lethal than methadone for a few obvious reasons.

One of the main fears with the use of drugs in this family is the fact that, unlike Methadone, which must be administered by a treatment center for addiction, these drugs can be prescribed by a general practitioner for use in the treatment of addiction. That, in and of itself, is scary to a growing number of people. The buprenorphine drugs include:

  • Bunavail
  • Suboxone
  • Zusolv
  • Buprenorphine

Bunavail is a compound formulation of buprenorphine and naloxone and it is administered as a buccal film. This means it is placed on the inside of the mouth along the cheek for absorption. Suboxone is a combination of the same two compounds but this particular drug is administered in a sublingual film which means it is placed under the tongue for rapid absorption. Zubsolv is the same combination administered as a sublingual tablet.

Why These Opiates Are Used in MAT

Now then, at this point, you are probably asking yourself why on earth would doctors prescribe other addictive substances to treat addiction to opioids like heroin and morphine along with others in the family such as oxycontin. That is a very good question and one which has raised more than a few eyebrows upon looking at a few statistics.

First of all, the ‘logic’ behind using these drugs in MAT is because they are supposed to have a lower potential to be misused, which is questionable. These drugs all have a high street value which means they are, indeed, being misused as an illicit substance. However, the big ‘selling point’ is that they diminish the physical effects of dependency on the opioids which include cravings and withdrawal. They are also said to be less likely a cause of overdose.

A Few Statistics to Be Aware Of

One of the most startling statistics is that methadone remains high on the list of causes of death by overdose on prescription opioids. According to the CDC, 2017 saw OD deaths averaging 47 per day and methadone featured prominently on the list of substances they itemized.

Putting this in perspective, in 2017 the top 5 drugs that caused overdoses were listed as:

  1. Fentanyl
  2. Prescription drugs such as oxycontin
  3. Heroin
  4. Cocaine
  5. Methamphetamine

Now then, take a look at that list and you’ll see that prescription opioids are second on the list with fentanyl being first. What is alarming about that is the fact that fentanyl is a pharmaceutical and, until recent years, not manufactured as an illicit street drug. It could be argued that the two leading causes of death by overdose would be pharmaceuticals!

Know Your Options

In the end, it is imperative that any addict or concerned family member should understand that there are options. Yes, these drugs can help to save lives because they are not as deadly as opioids like heroin or fentanyl, but they can be abused as well.

It isn’t always a matter of substituting one drug for another, but more a matter of feeding an addiction with another addictive substance. There is still a great deal of controversy in the press as well as the medical community, so it really is important for anyone to understand the various options in treatment.

Maybe MAT – medically assisted treatment – is the best course in the very beginning, but maybe it shouldn’t be a long-term solution. The best advice you can be given is to do the research before committing to any treatment program of any kind. There are options, so arm yourself with the latest information so that you aren’t setting yourself up for failure. You do have a choice you know! So take the time to learn your options. Your life depends on it.

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