opiate, painkiller addiction, suboxone

There have been a number of leaps forward in the diagnosis and treatment of people suffering opioid and painkiller addiction and use disorder. The DSM-5, the diagnostic manual for mental health disorders, has revamped diagnostic criteria, and the DEA is allowing a number of new treatments to be done in a primary care doctor’s office. These changes are allowing much greater access to safe and effective treatment for opioid use disorder.

The new functional MRI machines have shown us both structural and functional changes in the brain that occurs as the result of drug use and abuse. Opioid use quickly changes the brain. Opioids are known for physical dependence, with tolerance and withdrawal, and for the long-term debility that results from their chronic use. Two things happen in the brain of a person with a physical dependence on opioids when they come off the drug: they have short-term withdrawals that are quite unpleasant, and they have cravings, a result of the brain changes. Many times, withdrawal can be managed with assistance in detox centers. But the cravings can last a life-time, and are what is usually responsible for relapse.

The receptors in the brain, once they have had opioids attached to them, are switched on and never switch off. We have two choices for treatment. We can block the receptors with other drugs, or we can put a safer opioid in the system to fill the receptors. Some of the new treatment options do both.

Treatment for opioid use disorder always includes medication, because we know through science that only with medication is long-term remission possible for the vast majority of people. The current medications include methadone, naltrexone, and buprenorphine.

Buprenorphine is an opioid with the ability to both partially block the receptors and fill other receptors with a safer drug. Buprenorphine does not have the intoxicating effects of other opioids, but does block the cravings very effectively. This drug, in the solo formulation, can also be used to prevent relapse during pregnancy. Prescribing and administration can be done with a special license in primary care offices, and is an option that allows a person to continue to work and care for children and otherwise resume normal life.

Naltrexone is available as an injection, and it acts to block the receptors. Methadone is also an opioid, and is administered as part of a structured treatment program. It can be used to treat an opioid addiction in the presence of chronic pain.

Detox alone is only treating half of the problem. Medication started at the end of detox to keep a person off the drugs is needed for long-term remission. The medications we have now are safe and effective in the long run. Consider speaking to the doctors at FirstCare Medical Center about your opiate, painkiller addiction, and treatment with suboxone in poughkeepsie, kingston, highland, new paltz, newburgh.

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