...Comparison of Methadone and Suboxone in Opioid Treatment Program Julien Nougarou Upper Iowa University Abstract Addiction to opioids is a common problem throughout the world. Maintenance treatments such as Methadone and Suboxone are effective in lessening the desire to consume illicit drugs, but they are not perfect options for drug treatment as each has negative effects, too. In this paper, both the positive and negative effects of the drugs Methadone and Suboxone will be determined and evaluated in order to better ascertain the better treatment. It was concluded that the effectiveness of each treatment can only be determined on a case-by-case basis, as the factors of success are often dependent on the patient receiving the treatment. There are various criticisms for both modes of treatment, but no other means of treating opioid addiction have yet to be found. There are improvements that could be made for both treatments, but regardless of improvements each mode of treatment is risky as there is no miracle cure for opioid addiction. Introduction In 1864, The New York State Inebriate Asylum, the first in the country, opened in Binghamton, NY. It was the first of a growing network of inebriate asylums that treated alcoholism and addiction to drugs such as opium, morphine, cocaine, chloral, ether, and chloroform. Today, when talking about opioid addiction and dependency treatments, two controversial but efficient treatments stand out from the lot: Methadone and Suboxone...
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...A Combined Approach: Seeking an Effective Method to Treat Opioid Addiction Jason Yarborough SOC 490 Dr. C. T. Rowley September 16, 2012 A Combined Approach: Seeking an Effective Method to Treat Opioid Addiction Background Addiction treatment approaches can take many forms. From Alcoholics Anonymous meetings to long term inpatient rehabilitation programs, there are many different choices available to those struggling with addiction. Understanding the nature of each type of addiction and determining the best course of treatment for the individual is important to ensure success. For opioid addiction, maintenance based programs, though controversial, show high rates of treatment retention, reduction in criminality, gainful employment, and improvement in health; offering an alternative to those who have not had success in abstinence based programs. Addiction is a challenging and complicated health issue. It affects people physically as well as mentally and socially, impacting nearly every aspect of life. Families can be torn apart. The effects of addiction can cause a person to lose employment and fall into poverty. Health issues such as HIV and hepatitis can affect addicts who share needles, or engage in prostitution to obtain drugs. The greatest consequence of addiction is death. The Center for Disease Control and Prevention states, “Drug overdose death rates in the United States have more than tripled since 1990 and have never been higher.” The negative consequences...
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...compiled by the Agency for Healthcare Research and Quality. The rise may be attributed in part to increased maternal drug misuse and addiction, as well as to greater legitimate use of medication to treat pain and depression. Further, more careful surveillance for symptoms associated with maternal drug use have turned up more affected babies. About 1% of pregnant women report recreational use of opioid painkillers like Oxycontin, according to the National Household Survey on Drug Use and Health, a number that has stayed constant since 2003. The new treatment guidelines, appearing on Monday in the journal Pediatrics, recommend that pregnant women addicted to prescription pain relievers or heroin should be maintained on either methadone or buprenorphine (Suboxone, Subutex). These recommendations are in line with prior consensus documents from the National Institutes on Health and World Health Organization. MORE: The ‘Oxycontin Baby’ Scare The authors state that the alternative to maintenance — active or passive detoxification — is “associated...
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...infection after the implementation of NSP programmes.30-32 Analysis of ten years of programme data in a prison in Spain showed a 71% return rate on distributed needles. 32 In Kyrgyzstan, needle sharing was shown to decrease from 20 to 8% after introduction of a needle exchange programme.30 Opioid substitution therapies Opioid substitution therapy (OST) with methadone is a “feasible option in a wide range of prison settings”. 33 OST programmes have been “effective in reducing injection drug use and associated needle sharing and blood borne infections in prison settings”.33 OST also helps reduce risk of overdose deaths upon release when community linkages are included in the programme.33 In a randomized clinical trial (n=116) comparing outcomes between prisoners using methadone versus buprenorphine persons using the latter stated a higher a higher degree of interest to continue treatment at release and were more likely to continue treatment after release. Staff administering treatment noted the increased time burden in preparing for, dispensing, and monitoring ingestion of buprenorphine tablets (15 min/day/inmate) versus liquid methadone 1-3min/day/inmate) decreasing the number of persons that can be seen per day. 34 The use of OST in prisons has been associated with a “reduction in drug use and high risk harmful behaviour.” 33 Delays in implementing such programmes in prisons may negatively impact prisoner health outcomes.35-42 Studies that include opinions of prisoners regarding OST...
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...As one prescription drug abuser in his early 20’s explained: Once people (pill brokers) know you take them prescription opioids, they’ll start calling you. “Oh, it’s this time of the month.” Then they wait for that person to get their script. They know exactly in their head what day the script’s getting ready to come so they got the patterns down. Pill brokers and dealers reported congregating in open air drug markets typically strip mall and pharmacy parking lots, and outside methadone clinics to buy, sell, and trade prescription drugs. These markets were reported to involve a variety of transactions, including the purchase of prescription drugs for cash, as well as trades for crack and heroin. Pill brokers also reported the purchase of used fentanyl patches from nurses who have stolen them from pain patients or from disposal containers in hospitals. Some individuals frequenting the drug markets also barter their oxycodone for other opioids or benzodiazepines, typically alprazolam. Doctor Shopping focus group participants indicated that even in a small state like Delaware, doctor shopping appeared to be fairly easy. The vast majority of abusers reported obtaining medications through doctor shopping, and most reported frequenting at least four physicians in order to obtain sufficient amounts of their desired medications. Occasionally clinics and hospital emergency rooms were reported as locations for doctor shopping as well. A heavy user stated: Another focus group member...
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...Review Starting Step III opioids for moderate to severe pain in cancer patients: Dose titration: A systematic review Palliative Medicine 25(5) 424–430 ! The Author(s) 2010 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269216310386280 pmj.sagepub.com ˚ Pal Klepstad Pain and Palliation Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Intensive Care, St Olavs University Hospital, Trondheim, Norway Stein Kaasa Pain and Palliation Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Palliative Care, St Olavs University Hospital, Trondheim, Norway Petter C Borchgrevink Pain and Palliation Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Center for Pain and Complex Disorders, St. Olav University Hospital, Trondheim, Norway Abstract The European Association for Palliative Care recommendation for starting morphine for cancer pain is dose titration with immediate release (IR) oral morphine given every 4 h with additionally doses for breakthrough pain. As part of a EU 6th framework programme to revise the guidelines we review the evidence regarding starting treatment and dose ...
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...I S S N 1725 - 5767 Travel and drug use in Europe: a short review 1 THEMATIC PAPERS Travel and drug use in Europe: a short review Travel and drug use in Europe: a short review emcdda.europa.eu Contents 1. Introduction 2. Travelling and using drugs Young people Problem drug users 3. Examples of drug-related destinations 4. Prevalence of drug use among young travellers Young holidaymakers in Europe Young backpackers Young clubbers and partygoers 5. Risks associated with drug use while travelling Health risks Risk related to personal safety Legal risks Risks related to injecting drug use Risks to local communities 6. Potential for prevention interventions 7 Conclusions . Acknowledgements References 3 4 4 4 6 9 9 10 11 13 13 14 14 14 15 17 19 21 22 Travel and drug use in Europe: a short review emcdda.europa.eu 3 1. Introduction Recent decades have seen a growth in travel and tourism abroad because of cheap air fares and holiday packages. This has been accompanied by a relaxation of border controls, especially within parts of Europe participating in the Schengen Agreement. As some people may be more inclined to use illicit substances during holiday periods and some may even choose to travel to destinations that are associated with drug use — a phenomenon sometimes referred to as ‘drug tourism’ — this means that from a European drug policy perspective the issue of drug use and travel has become more important. This Thematic paper examines travellers...
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