Posted on 12/31/2016 7:24:13 PM PST by DBCJR
For years, Oklahoma lead the nation in prescription painkiller abuse according to SAMHSA.
Oklahoma and the nation set out to do something but it was almost totally "supply-side", regulatory and law enforcement oriented to reduce the supply of opioid tablets on the street. These measures were much needed but they did nothing to help the estimated 245,000 prescription painkiller abusers in Oklahoma, nor prevent new entries into the problem, "demand-side". Demand-side interventions are treatment and prevention initiatives. Why are demand-side interventions important?
Addiction to opiates is the most powerful addiction. If you shut off supply dramatically, without demand interventions, you have a massive population very sick and desperate. It was entirely predictable what would happen, a shift to heroin, a major game-changer for the worse. Look at what happened to the supply and street price of OxyContin during this time:
When the supply of OxyContin was cut in half the street price of OxyContin rose 5 fold! What would people do? Heroin was cheap and easy to get. The Mexican Drug Cartel was very accommodating. They built tunnels across the border with robotic rail constantly going 24/7. A million dollar investment nets $20 million the first year.
This greatly and abruptly changed the landscape of opiate addiction. So much so that in 2010 ABC 20/20 ran a series, The New Face of Heroin Addiction:
Unfortunately, the traditional treatment, according to SAMHSA is only 6-10% effective with opiate addiction. Medication Assisted Treatment (MAT) improves those odds substantially. However, the vast majority of MAT is administered, as a prominent marketing campaign states, "in the privacy of a doctor's office", for a 30 day script for a a partial agonist buprenorphine drug like Suboxone. The doctor recommends getting counseling and not using other drugs. Does an addict do that? A Harvard study shows when these aspects of treatment are not included success rates fall back to to traditional treatment levels.
In addition, buprenorphine drugs are only appropriate for low to intermediate opiate dependency but methadone, a full agonist, is for intermediate to heavy dependency. Why? Because buprenorphine plateaus at 32 micrograms. Before that level it is actually more effective than methadone but after that methadone becomes far more effective.
In other words, in intermediate to heavy dependencies, buprenorphine fails to manage withdrawal and cravings effectively. And most of the time the person affected is not getting counseling or subject to clinical accountability. What happens? More often than not, the addict hits a low spot, begins to relapse, and uses the buprenorphine when they cannot get the drug - or sells it to get the drug.
Listen to what our former clients say about the difference in treatment:
Advanced Recovery offers evidence-based best clinical practices to obtain the best results. http://AdvancedRecovery.co
“My cousin in OK once told me her two teenage sons did “Karaoke” several times a month.”
I observe that a teenager caught with alcohol has the book thrown at them,while a teen caught using heroin is coddled.
Heroin is easier to get, in some cases its cheaper.
My hypothesis is that if you want to put a dent in future heroin addicts? Let teens escape with something less addictive. Let teens drink beer.
The level of vice taxation is such that there are alternatives that are cheaper.
You are correct, it cuts across all socioeconomic strata. No profession is immune religious, medical, law enforcement, etc.
Prevention initiatives need to be expanded on all levels. Medication Assisted Treatment needs to be funded and accepted by the criminal justice system. But it needs to be done right or it becomes part of the problem. Done correctly it improves outcomes 9 fold over traditional treatment. It’s not perfect but a huge difference.
Then inform us of the inaccuracies with cited sources.
>On some level, the people who matter don’t want it stopped.
Bingo. It’s also why the left is freaking out over the Philippines president, they’re terrified that he’s succeeding and everyone will find out how easy it is to stop drugs.
Many cities now have Veterans courts...It is a year long diversion program that mandates treatment for substance abuse ( or other mental health problems). It is very successful where other programs have not been. the courts work VERY closely with the VA treatment team and the results are good.
I would refer you to SAMHSA.... the leading national governmental research organization on substance abuse...that publishes the latest evidence based research on treatment; yet cost the patient extra money.
below is a publication on opioid treatment..with medication assisted treatment.
The evidence based research now states that Buprenorphine tx (suboxonne) in a medically supervised program is the number one treatment for opioid use disorders. It is not considered that “abstinance” based treatment is effective in opioid use disorders. Of course, to handle all the other issues an addict faces , supportive interventions ( housing, 12 step programs, counseling) are helpful—albeit those who are on MAT —medically assisted therapy—very often do fine without other treatments, which are often not providing any additional benefit.
that is where I disagree with the source of this article.
The VA around the country now has substance abuse clinics who have Buprenorphine medically assisted clinics that are providng help and hope to many veterans. We need to get the word out.
http://store.samhsa.gov/shin/content//SMA12-4214/SMA12-4214.pdf
Is this text a paraphrase? I can't find it in your 358-page link.
Yes, this is a paraphrase..of the latest information in my study of this treatment.
WILL LOOK FOR ANOTHER LINK.
Most of your posts are very negative.
If you are interested in learning more about addiction tx, I suggest you go to the samhsa webiste. It has hundreds of articles re research.
You’ve been here since november of 2016. How about posting some information you’ve found about whatever the topic is that you’re interested in.
Thank you. This article refers to SAMHSA CSAT. I would refer you to Treatment Improvement Protocol 43 for the components of a proven effect MAT program. Also, I would refer you to The National Alliance of Advocates
for Buprenorphine Treatment chart in a Washington Dept of Education article (see figure 7) chart depicting buprenorphine plateauing in effectiveness at a 32 microgram dose http://depts.washington.edu/hivaids/spop/case2/discussion.html
For intermediate to heavy dependency methadone, a full agonist, is indicated.
And what has this to do with treating opiate addiction?
For about 4 years running Oklahoma lead the nation in prescription painkiller addiction.
70-75% if following SAMHSA CSAT Treatment Improvement Protocol 43
Sad.
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