Political discussion and ranting, premised upon the fact that even a stopped clock is right twice a day.
Tuesday, August 03, 2004
Addiction As A Public Health Problem
To one who has long argued that addiction should be viewed as a public health issue, and that we should remove the impediments to researching treatments and medications for addiction, this sounds like progress.
As one who holds rather strong opinions on this subject, and who has witnessed firsthand the devastation inflicted by chronic opiate addiction, I am clapping my hands at the "progress" buprenorphine signifies.
To summarize, current regulations on methadone distribution make it nearly impossible for an addict to seek treatment while trying to maintain a normal life. For instance, there are far less clinics available than the user population requires. Many addicts seeking treatment have to drive an hour (one way) to the nearest clinic, which may only be open for a five or six hour window due to the constant underfunding of these clinics. Current regulations in most states dictate that a client must be in treatment for a minimum of three months before he or she is eligible for take-home privileges, so the individual usually ends up spending just as much time attaining the methadone as he or she once spent engaging in drug-seeking activities (hardly conducive to the end-goals of treatment).
Furthermore, even though buprenorphine is classified as a "Schedule III" substance (Methadone is placed in "Schedule II" which is subject to much tighter regulation than "Schedule III" substances), doctors must have a special license from the DEA to dispense buprenorphine. Obtaining this license is a rather lengthy process, exemplified by the fact that, in southeast Michigan, only three physicians are currently licensed to prescribe buprenorphine. An additional requirement of buprenorphine maintenance treatment is that a physician may only treat a maximum of twenty patients at any given time. That means that, until more physicians obtain this license, there are long waiting lines to receive care from currently licensed physicians.
In short, while buprenorphine offers a small step for the future treatment of opiate addiction, it certainly does not represent a giant leap. Far more barriers to treatment must be removed before practitioners will see any decrease in addiction and/or relapse rates where opiate addiction is concerned.
As one who holds rather strong opinions on this subject, and who has witnessed firsthand the devastation inflicted by chronic opiate addiction, I am clapping my hands at the "progress" buprenorphine signifies.
ReplyDeleteTo summarize, current regulations on methadone distribution make it nearly impossible for an addict to seek treatment while trying to maintain a normal life. For instance, there are far less clinics available than the user population requires. Many addicts seeking treatment have to drive an hour (one way) to the nearest clinic, which may only be open for a five or six hour window due to the constant underfunding of these clinics. Current regulations in most states dictate that a client must be in treatment for a minimum of three months before he or she is eligible for take-home privileges, so the individual usually ends up spending just as much time attaining the methadone as he or she once spent engaging in drug-seeking activities (hardly conducive to the end-goals of treatment).
Furthermore, even though buprenorphine is classified as a "Schedule III" substance (Methadone is placed in "Schedule II" which is subject to much tighter regulation than "Schedule III" substances), doctors must have a special license from the DEA to dispense buprenorphine. Obtaining this license is a rather lengthy process, exemplified by the fact that, in southeast Michigan, only three physicians are currently licensed to prescribe buprenorphine. An additional requirement of buprenorphine maintenance treatment is that a physician may only treat a maximum of twenty patients at any given time. That means that, until more physicians obtain this license, there are long waiting lines to receive care from currently licensed physicians.
In short, while buprenorphine offers a small step for the future treatment of opiate addiction, it certainly does not represent a giant leap. Far more barriers to treatment must be removed before practitioners will see any decrease in addiction and/or relapse rates where opiate addiction is concerned.