Rx for Drug Addiction -- Backed by Federal Dollars & Doctors -- Raises Hopes & Questions

Jan 24, 2017

Evidence is growing that certain medicines can ease cravings for drugs and alcohol and improve people's lives. And the medical community, backed by substantial federal funding, is promoting these drugs, calling them life-savers in many cases. But there are skeptics: Some who feel this approach merely replaces one addiction for another and others who fear this is just another profit-making venture of so-called "big pharma."


GUESTS:

  • Molly Rossignol - Family Doctor and Addiction Specialist at Concord Hospital.
  • Eric Spofford - Chief Executive Officer, Granite Recovery Centers.
  • Rachel Boersma - Director of Nursing for Aware Recovery Care of New Hampshire, based in Bedford.
  • Joseph Harding, Director of the Bureau of Drug and Alcohol Services at the New Hampshire Department of Health and Human Services. 

Highlights from this conversation:

Addiction treatment is ramping up in New Hampshire after bipartisan work in the legislature for more funding, and enormous efforts at the local level. 

There is growing interest in "medication-assisted treatment" (MAT), which is the use of certain medications to reduce or eliminate drug cravings, symptoms of withdrawal, and the high opioids provide. Advocates say this approach must be accompanied by therapy and other services.  The state, meanwhile, with federal dollars, is promoting more widespread use of MAT. 

Doctor Molly Rossignol of Concord Hospital says that these opioid-based medications (known as buprenorphine) can be extremely effective and are backed up by hundreds of studies.   

"The vast majority of outcomes are positive," she said. "Always there can be side effects of medications but  the preponderance of people who use these medications correctly have a good outcome."

That word "correctly" is key.  

And for Eric Spofford, CEO of Granite Recovery Centers, there are too many people who misuse the drugs, even selling them on the streets.   In trying to overcome his own addiction, Spofford took both Suboxone and methadone.  "There was definitely a sense I had opioids in my system. I was not sober. I was not in my right mind... Suboxone became a crutch. We all had prescriptions. We used them. We sold them. They were $10, $15 a piece on the street." 

Dr. Rossignol said, however, that addicts may be buying Suboxone because they are looking for ways to get better and not necessarily to continue their addiction to opioids. 

For one listener who emailed and asked to remain anonymous, medication-assisted-treatment has been a lifeline: 

I have been addicted to opiates actively for 25 years I've been in 3 impatient treatment programs and four to five outpatient programs. Have faced legal problems and almost lost my marriage. 

But with counseling and medication (Suboxone) the last 10 years. I've changed professions and I am a master technician a productive member of society, own my own home, pay my taxes, and I am a good husband and father. So, however you cut it -- being dependent on medication,  somebody else making a profit -- I don't really care. My friends and family are happy and so am I.

Another listener who asked to remain anonymous said in an email that Methodone was a lifesaver:

Those who say patients like myself abuse it... and walk around like zombies are misinformed. After four years, I went from a heavy heroin user on 95 mg to completely sober.

Jeff, from Westminster, Vermont, had a very different experience and continues to struggle with addiction:

So I've been an active drug user for at least 20 years now, and I tried Suboxone. I was prescribed it through the doctor for a while, and then I got off [Suboxone] and tried to do the normal addict thing, tried to do it on my own, and it just seems that I'm 38 years old now and I've been fighting this my entire life. It just seems like I can never be sober...I've been to treatment three or four times and it just seems like an endless battle that never ends, and the more I try, the harder it gets...It's a depressing thing.

Jeff says Suboxone helped manage his addiction, but that it was far from perfect: 

It's just like another hook. You get on that and you get used to taking that and then in the morning you wake up, and you don't have anything, and you feel naked, and you feel like panic mode. And then you get some Suboxone and you can handle a couple of days and then it starts over again... it just seems like an endless battle, it never ends. 

Spofford's own story of addiction started when he was 14 years old:

A buddy of mine who I'd been friends with since elementary school came over with Oxycontin. I had no idea what it was.  We crushed it up, split it in half, sniffed it and that was the first time I ever got high on opiates, and it changed my life forever. In a year, at 15 years old, I found heroin. My habit started to get worse and worse and worse and pretty soon it became too expensive to keep up with Oxycontin. Heroin is cheaper. It’s also more available and I stuck a needle in my arm at 15 and I rode that road until I was just about 22. 

Spofford said he has been sober for ten years and celebrated that anniversary last December.  Granite State Recovery Centers allow only limited use of Suboxone, he said, a five to seven day dose that can help mitigate the debilitating symptoms of withdrawal.  

That kind of limit can be frustrating for doctors and others who feel that there should be a greater allowance for long-term use, given the documented effectiveness of the drugs. 

Exchange listener Sharon said Methodone and MAT has saved hundreds of thousands of lives, allowing people to become stable, functioning members of society. 

I just wanted to point out. These people on these medications that are using them correctly, which is the majority of them, are not addicted to these medications. There’s a difference between addiction and dependence. They are dependent on Methadone or buprenorphine -- 

just like a person who is on insulin for diabetes. 

For more information about MAT and opioid addiction treatment, read coverage by David Armstrong at STATNews:

https://www.statnews.com/feature/opioid-crisis/dope-sick/

https://www.statnews.com/2016/09/28/opioid-addiction-fight/