Over the past decade we have seen an alarming rise in the misuse of opiates, both in prescription form, such as oxycontin, percocet, morphine, vicodin, as well as street drugs like heroin. Here in Oregon, with the closure of many methadone clinics there are fewer options for treatment of opiate abuse than ever before. To fill this void, The American Society of Addiction Medicine has worked diligently to find alternative, effective treatments for opiate addiction and in October 2002 the drug, Buprenorphine, received FDA approval for this purpose.
In clinical studies, Buprenorphine has proven effective in minimizing the extremely painful side effects of opiate withdrawal without patients feeling either euphoria or sedation. It is also virtually impossible to overdose on Buprenorphine.
Since June 2003, staff physicians at Serenity Lane have been treating opiod-addicted patients with Buprenorphine. Since then, hundreds of patients have taken advantage of this therapy. Opioid addiction is a complex disorder, and while this therapy does indeed make initial treatment more tolerable, there is still need to treat all aspects of the addiction. To be considered for this treatment, patients must be motivated and are required to participate in our residential program, with follow up in outpatient and recovery support.
Buprenorphine is a synthetic medication that has both opiate and “anti-opiate” properties. When administered to the patient undergoing opiate withdrawal symptoms, it rapidly reduces and often eliminates those symptoms within an hour. Previously, withdrawal meant 3 – 6 days of severe muscle aching and spasm, profuse sweating, abdominal cramping and diarrhea. With Buprenorphine these symptoms are essentially avoided, while the patient is gradually tapered on decreasing doses of the medication over a period of one to several weeks (depending on such variables as the duration and intensity of the patient’s previous dependency, physical health, and degree of motivation).
Buprenorphine’s opiate-like properties allow it to be substituted for the patient’s previous addictive opiate medication(s), while itself providing essentially no sedation, euphoria or other ‘dangerously reinforcing’ effects. In addition, larger amounts can be taken (even overdoses) with no increased effect and no reduction or loss of consciousness. (In this respect it is distinctly safer than methadone, which has historically been used in similar settings.)
Notably, while Buprenorphine is being used, no other opiate will have any effect — oxycontin, morphine, even heroin cannot replace it from nerve receptors, thus minimizing, to some degree, the risk of sudden or impulsive return to opiate use.
Finally, one great advantage of this medication in the treatment setting concerns use of the patient’s time. Instead of 3 – 6 days bedridden in anguish, patients instead can almost immediately begin attending recovery groups and practicing the non-pharmacologic techniques of stretching, deep-breathing, visualization and meditation, which become dramatically more effective in the slowly detoxing, non-sedated, newly motivated patient.
One of the obstacles to patients seeking treatment for opiate addiction, has been the debilitating withdrawal – the prospect of which is so abhorrent that the addict would rather break the law and seek the drug than commit to a treatment program. Now that we can offer such patients a significantly more comfortable, manageable detox experience, we are confident we’ll see better recovery rates and continuing success stories with this group.
For more information on Serenity Lane’s treatment options for opiate addiction please contact our staff physician at: