Erin’s latest article on the newest dangers posed by opioids, and especially Fentanyl, demonstrates the ever-changing face of substance use disorders. Equally, the treatment field has finally begun to embrace the need for the inclusion of medications to enhance outcomes. For many years, the treatment field was committed to abstinence only as a lone strategy, neglecting the fact that each patient (and drug) has unique medical, psychiatric, and withdrawal variables that demand addressing if the patient is going to have the very best chance of moving into a life of recovery.
In 2004, we received compelling studies from the National Institute of Addiction and other federal agencies for treatment providers to include the use of Medication-Assisted Treatment in the treatment of opioid addiction. At that time, pharmaceutical companies and regulatory bodies were demanding that all doctors and hospitals more aggressively attend to the treatment of pain by aggressive use of opioid-based medications like Vicodin, Oxycodone, and others. Hospitals and doctors were being sanctioned for not giving patients in pain opioids, even when the physician felt that the patient was at high risk of addiction. More and more patients were finding that their efforts to come off of the pain medications were throwing them into severe withdrawal that included insomnia, sweating, anxiety, and other highly uncomfortable symptoms.
Simultaneously, there was a discovery of opioid blockers like Suboxone (Buprenorphine and Naloxone) that precluded the patient from getting high on opioids but also gave them relief from withdrawal symptoms. More and more studies were showing greatly enhanced outcomes by using Suboxone as a means of withdrawing the patients off of full agonists like Hydrocodone or even heroin. Many people had shifted to heroin, in an effort to stave off the painful withdrawal effects, as regulatory bodies had now changed their position and were placing tremendous pressure on healthcare providers to rarely prescribe opioids.
The good news is that more recently, a new medication called Sulocaide has come onto the market that is an injectable, 30-day slow-release opportunity for patients to gradually reduce their use of opioids and enhance becoming involved in support groups like AA/NA and treatment, while their families could begin to understand what had happened to their loved ones.
Despite the ongoing dangers that continue to ravage the country from Fentanyl, we are increasingly seeing addiction as a healthcare problem and not an issue of the individual’s character or morals. With more agencies working together, such as law enforcement, medicine, schools, and other social assistance, we can continue to find ways to reduce the epidemic that continues to ravage our first responders.
