The battle against opioid addiction in America is being fought every day, and many are fighting hard to create more opportunities for treatment and recovery. With more awareness being raised across the country, many are turning to medication-assisted treatment (MAT) methods as a way to address illicit opioid abuse and overdose. One of the most commonly known medications used in MAT is Suboxone.
MAT programs can be very helpful as a harm reduction strategy that gives people struggling with addiction a chance to avoid harmful withdrawals. However, addiction specialists also recognize that MAT alone is not an adequate substitute for comprehensive addiction treatment.
Furthermore, medications like Suboxone can be useful, but only to an extent. This drug may help to curb withdrawal symptoms from opioids like heroin or prescription painkillers, but it is also a powerful narcotic that can cause its own symptoms of dependence and withdrawal. Some people have tried to utilize Suboxone to get off of other drugs, only to find themselves dependent on this medication. So how do you stop using Suboxone?
More About Suboxone
Suboxone is a medication primarily for helping people stop using other opioids. The medication is a combination of two drugs:
Most people do not realize that Buprenorphine is itself an opioid. This semi-synthetic opioid medication is different from other opioids because it is a partial opioid agonist. What this means is that its maximal effects are less than full agonists such as heroin or methadone.
However, it still creates feelings of euphoria and respiratory depression. With chronic use, this opioid can still cause physical dependence.
This medication is used to block the effects of opioids, especially when it comes to opioid overdose. It is added to the Buprenorphine to attempt to decrease the risk of misuse. Due to the nature of this medication, if someone takes Naloxone while still experiencing the effects of an opioid it can cause them to go into sudden withdrawal.
The makers of Suboxone do warn that it can be abused in a manner similar to other opioids, both legal and illicit. They issue a number of other warnings for those considering using the medication, including:
- Injecting Suboxone may cause serious withdrawal symptoms.
- Suboxone film can cause serious, life-threatening breathing problems, overdose and death, particularly when taken intravenously in combination with benzodiazepines or other medications that act on the central nervous system.
- One should not drink alcohol while taking this medication, as it can lead to unconsciousness or even death.
Some of the adverse effects of Suboxone use include:
- Numb mouth
- Painful tongue
- Redness of mouth
- Disturbance in attention
- Irregular heartbeat
- Sleep problems
- Blurred vision
- Back pain
These are only a few examples. Some circumstances may lead to further complications, including someone being pregnant or living with severe hepatic impairment. You should discuss any decision you make to start or stop using Suboxone with a healthcare professional.
5 Steps to Stop Using Suboxone
Speak with a medical professional
If you have a Suboxone prescription, do not stop taking it without speaking to a healthcare professional first. Abruptly discontinuing a MAT program can not only cause you a great deal of discomfort, but it can be very dangerous. Trying to quit without medical assistance also creates the risk of relapse and overdose.
This is why safe medical Suboxone detox is such an important element of any addiction treatment program.
Before you decide to stop using Suboxone, speak with your personal physician or a medical addiction specialist in order to decide what is the safest and most effective way to move forward.
Taper vs Cold Turkey
When someone goes ‘cold turkey’ to stop using Suboxone, they essentially discontinue without any kind of medical support. Again, we remind you that this can be extremely dangerous and is always counterproductive. A better choice is to develop a plan with a medical professional that utilizes a gradual taper or even medications to assist with withdrawals.
Health experts recommend gradually reducing doses of buprenorphine. Typically, you can lower your dosage over a period of three weeks or more, reducing the doses by 10%-20% each week. The best way to decide how to do this is by working with a medical professional.
Get comprehensive addiction therapy
Another crucial aspect of addiction treatment is the opportunity for comprehensive addiction therapy. Individuals have a much better chance to stop using Suboxone for the long-term when they address the underlying issues that lead them to use opioids in the first place. Sometimes, drug use stems from emotional issues, trauma, or behaviors that are self-destructive. When people avoid addressing these issues, they become vulnerable to relapsing as a means to cope with them later.
Therapy not only helps people uncover the root cause of their pain, but it also teaches people new, healthy ways to cope with these issues.
Build a support group in recovery
Once someone has started the recovery process, a huge part of staying on the right path is to build a support group. It is very difficult to try and stop using Suboxone or any other drug all on your own. Having friends, family or mentors provides people with the resources to reach out to when they are struggling.
When trying to overcome addiction, it can be difficult for some to relate to people who do not understand addiction. Thankfully, there are support groups all over the country that offer assistance to each other while dealing with a specific issue. Most people know of 12-Step programs and other support groups for alcohol or drug addiction.
Participate in aftercare programs
Another useful element of treatment is aftercare. While support groups are extremely helpful, another way to stay involved in the ongoing process of addiction recovery is to get involved in aftercare programs. Many treatment providers will have programs in place to support those who have completed the inpatient levels of care, such as residential treatment, and are ready to transition back into everyday life.
When you stop using Suboxone, it is a good idea to stay connected with those who can offer support and guidance.
When a lot of people hear about medication-assisted treatment, they think it is an easy way out of addiction. Some people automatically assume that you can trade an addiction to heroin or Oxycodone for a dependence on Suboxone or another drug and everything will be fine. However, with MAT programs the goal should never be to rely on a medication for the long-term.
Medication-assisted treatment does make a difference. For some people, the fear of withdrawal symptoms keeps them using far more potent and dangerous drugs. Because they do not want to experience the pain, they keep using. Sometimes, this leads to death. So giving someone the chance to reduce the risk by using a prescription medication might keep them alive long enough to get treatment. But that is the important thing- to get the treatment.
Medications like Methadone and Suboxone are only supposed to be one piece of a more comprehensive treatment plan. They are intended to act as a short-term tool to help people ease their discomfort and avoid suffering while they try to give up drugs. MAT programs are only really effective when they are accompanied by therapy and other means of treatment. So if you want to stop using Suboxone and start recovering, seek out a rehab program that wants to help you heal.
Holistic addiction treatment is specifically designed to treat the entire person, not just the addiction. This kind of approach offers a variety of opportunities to develop new coping skills, learn more about addiction and the impact of drugs on the body, and experience innovative treatment modalities to heal the mind, body and spirit. For over 20 years, Palm Healthcare Company has been a leader in providing holistic addiction treatment. If you or someone you love is struggling, please call toll-free now.
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Eminem; Marshall Bruce Mathers III; The Real Slim Shady, is not just an icon in rap who had an unfathomable impact on hip-hop culture. He is also a man who has endured a lifetime of public controversy, private conflict, personal loss and emotional pain. Not only does this make his music career that much more powerful, but it makes his journey through addiction and recovery that much more gripping. With Eminem celebrating 10 years of sobriety this month, we take a quick look at the story of sober Slim Shady.
Eminem Celebrating Sobriety
A few days ago, between his headlining sets at this year’s Coachella, 45-year-old Marshall Mathers took to social media to share a message with his fans. On Instagram Slim Shady posted a photo of his ten-year medallion on Saturday, April 21. The circle, marked with an ‘X’ for the Roman numeral ten, is a token he received to commemorate a decade of continuous sobriety. To caption the image, he wrote:
“Celebrated my 10 years yesterday”
In just 2 days’ time, the image had already garnered over 1.7 million likes and over 33,000 comments. He wasn’t the only one utilizing his social status to share that powerful moment. Fellow rap artist and friend in sobriety Royce Da 5’9” also took to Twitter to give the real Slim Shady a shout out for his recovery milestone, writing:
“Happy sobriety birthday to my mentor @Eminem… Keep fighting the good fight homie… I love you for life”
Eminem has also shared moments of his journey through recovery with other famous sober peers, including Sir Elton John. The post prompted many fans on social media to congratulate Mathers on his anniversary. Others shared how he had helped inspire many others in recovery.
The last ten years have not been easy for Slim Shady, but it seems they have been worth it.
A Quick Look at a Legend
Long before Eminem got sober, he was a household name and best selling artist. Over his whole career, he has had a truly incredible list of accomplishments, including:
- 10 number-one albums on the Billboard 200
- Five number-one singles on the Billboard Hot 100
- 4 million albums sold in the US
- 220 million records globally
- He is among the world’s best-selling artists of all time
- He is the only artist to have eight albums consecutively debut at number one on the Billboard 200
- Winner of 15 Grammy Awards, including Best Rap Album
All of this, not to mention successful clothing lines, the creation of his label Shady Records which helped launch artists like 50 Cent and Yelawolf, and his own Sirius XM Radio channel, Shade 45. He gave us such gifts as D12 and Slaughterhouse, while also inspiring countless other artists.
Eminem isn’t only known for his music, but also for the controversy surrounding him. Whether it was the ugly battles with his mother, ex-wife, or the legal trouble he was conflicted with publically, it all fueled an image of a man who lived in a courtroom fighting painful scandals. He used the pain in his creative process, and the world was given a lot of angry, violent, and even poetic moments.
The Academy Award-winning film 8 Mile, which he starred in, made him the first rap artist to ever win the award for Best Original Song with “Lose Yourself”. Followed by various other film and entertainment ventures.
Oh, and don’t forget the Marshall Mathers Foundation, which aids disadvantaged youth.
The list just goes on and on. There is not enough time here to cover the truly immeasurable impact Eminem has had on not just hip-hop culture, but on the overall culture in America.
Getting to 10 Years
Slim Shady has always been pretty public about his struggles with addiction to prescription drugs. It is laced in his image over the years and is a prominent subject of his music. Back in 2002, a fellow artist said he had been trying to straighten out, but while working on 8 Mile he was introduced to Ambien and this prescription took him deeper down the path. When talking about working on his album Encore, Slim Shady once said he would “just go into the studio and goof off [with] a pocketful of pills”.
In 2007, Eminem suffered from an accidental methadone overdose after his addiction had spiraled out of control. At one point he revealed that he was taking up to 60 Valium and 30 Vicodin pills a day. After adding Ambien to the mix, he made his way to methadone by the end of his substance abuse. In 2011 when interviewed about the overdose, he stated:
“The doctors told me I’d done the equivalent of four bags of heroin… They said I was about two hours from dying.”
In a 2011 New York Times interview Slim Shady said,
“I used to get pills wherever I could. I was just taking anything that anybody was giving to me.”
Following that near-death experience, the Detroit rap legend chose to attend an addiction treatment program in Michigan. However, he ended up relapsing short of a month out of the hospital.
He reported that his star status made rehab difficult for him to focus on himself. Instead, he chose to detox at a hospital and dove into counseling and therapy. He credits his children, including his biological daughter Hailie, and two adopted daughters Lainey and Whitney. He also gives credit to exercise, saying that running helped him find a healthier high that helped him sleep.
When looking at his story, it is absolutely remarkable the impact that Slim Shady had had on the world of hip-hop or just music in general. He has been described by many as one of the greatest artists of all time, with billions of fans all over the globe. To hear about the life he lived; through poverty, depression, desperation, and addiction, to be a living legend only speaks to the inspiration in his experience, strength and hope. We celebrate the path Eminem walks and the work he has done over the years to make it this far.
Thank you for sharing, Slim Shady.
It can be a real inspiration to see some of the most successful people are recovering alcoholics and addicts. It reminds us that we all can suffer the same way and that we all have the same chance to build a better future. The more heroes we have every day that step up and share their message of hope, the more hope we may have that people seek the help they desperately need. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
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Support for Medication-Assisted Treatment (MAT) has continued to grow in recent years as the opioid epidemic in America has put a mounting strain on the country. While the numbers of overdoses and opioid-related deaths have steadily climbed to devastating heights there has been more effort to explore treatment options. A better understanding of the medical and mental health aspects of addiction has become a priority. Stigma has slowly begun to carry less weight while advocates push for more effective and supportive routes to care for recovering addicts. One thing people have turned to heavily is medications like Suboxone of Methadone in attempts to steer away from more illicit and dangerous substances like heroin or fentanyl.
The application of medication in treatment can be very useful. It is a strategy that can help with the preservation of life by helping people stay off more unpredictable and life-threatening substances. However, some would say that if used for long-term this form of treatment is still relying on the idea of substitution. Often times these drugs have their own very harsh withdrawal symptoms, especially with extended use.
Taking a look at the more popular drugs used for medication-assisted treatment, one may ask- can you quit medication-assisted treatment with no withdrawals?
Understanding Medication-Assisted Treatment
Medication Assisted Treatment is the use of anti-craving medications to try and help address issues related to drug dependence, withdrawal, and relapse. The more common medications used in MAT include:
But MAT is also utilized alongside comprehensive therapy and other forms of support. Experts and advocates for addiction recovery, including the Substance Abuse and Mental Health Services Administration (SAMHSA), insist that maintenance medications alone are not sufficient enough treatment.
Advocates for medication-assisted treatment will compare MAT to someone taking medication for diabetes or asthma, with the belief that maintenance drugs are an essential part of staying healthy. However, others in the world of addiction recovery still believe it is possible to be healthy in recovery without the prolonged use of powerful medications.
The truth is the answer may not be the same for everybody. Different treatments may be more useful for different people. No one should be ashamed of the method they use to get help. But we also want to look at how some drugs used in medication-assisted treatment might make things more complicated for certain people.
Looking at the most popular maintenance drugs for opioid addiction, of course, we find Suboxone. To better understand Suboxone withdrawals, we first have to know what it is. This popular brand name is used to identify a prescription medication that contains active ingredients:
- Buprenorphine- a narcotic opioid medication
- Naloxone– an opioid blocker that impedes the effect of opioid medications
This medication functions as a partial opioid agonist and diminishes cravings as well as prevents other opioids from reacting to the brain’s opioid receptors. Taken in low doses for short periods of time, the drug can be helpful in curbing opioid withdrawal symptoms while tapering off without too many residual effects.
The tricky part comes when someone uses Suboxone for an extended amount of time as a replacement for heroin or other opioids.
Sometimes this can lead to its own form of recreational use and physical dependence. Even the U.S. Drug Enforcement Administration reports that Suboxone is commonly susceptible to abuse. It is still a powerful drug.
Suboxone Withdrawal Symptoms
While Suboxone and other maintenance drugs may be a preferred tactic for going ‘cold turkey’ off of heroin or other opioids, the drug itself still has the power to cause its own set of withdrawal symptoms. These symptoms can include:
- Irritability or agitation
- Difficulty sleeping
- Profuse sweating
- Runny nose
- Frequent yawning
- Stomach pain or cramping
- Dilated pupils
- Nausea and vomiting
- Changes in mood
Not to mention precipitated withdrawal, when the ingredients in this medication can actually induce the onset of unpleasant symptoms rapidly, if not immediately, for someone actively engaged in opioid use.
Methadone is a long-acting opioid medication utilized since the 1970s to try and help people get off of heroin. It is typically used today under strict medical supervision because the drug is very potent and has a high risk of addiction. In fact, a 2012 National Survey on Drug Use and Health found that approximately 2.46 million people reported to using methadone for a non-prescribed purpose at least once.
According to another study, in 2009 methadone was responsible for 1 out of every 3 opioid overdose deaths.
Because of the risks, a gradual taper should be utilized to wean someone off of methadone. Often times doctors will prescribe another detox medication to help with this process, with the tapering to be done under medical supervision.
But as with trying to quit heroin or other powerful opioids ‘cold turkey’, trying to abruptly discontinue methadone can bring on intense withdrawal. This includes physical and psychological symptoms such as:
- Runny nose
- Tearing or watery eyes
- Muscle aches
- Joint pain
- Abdominal cramps
Many of these symptoms are similar to the symptoms of withdrawing from heroin or other opioids. So in a sense, this drug can create similar withdrawal symptoms as the drugs it is supposed to be used to treat.
Quitting Medication Assisted Treatment
Is it possible to quit medication-assisted treatment- yes, there are always other options for getting comprehensive care and lasting recovery without the prolonged use of these medications. Even relapse prevention is possible without relying on medications to fight cravings.
Can you quit medication-assisted treatment with no withdrawals? Well, that may be a process. It depends on a number of factors, such as the specific maintenance medication and the length of time using it. For example, someone who has been using methadone for years could probably have a much harder time getting off methadone than someone who used another medication for a month or so to help get off opioids.
Safety is crucial when deciding to quit MAT. Quitting medication-assisted treatment without a taper or other forms of medication can cause intense withdrawals. It is not suggested that someone try to quit MAT ‘cold turkey’ or without consulting a doctor for help with changing the dosage and slowly tapering off the drugs.
Again, just because it isn’t heroin or fentanyl doesn’t make it harmless.
MAT or Detox?
Medication-assisted treatment holds a lot of value, but the question becomes whether or not it is the kind of sustainable solution you want. Recovery isn’t one-size-fits-all. Medication-assisted treatment can be helpful in saving someone’s life who cannot stop using drugs. But is it something that will completely eliminate cravings and withdrawals, or will it just postpone these symptoms?
Remember, these are still powerful narcotic drugs that have a high risk for abuse. Some people end up using medication maintenance for life. Others will use it for a short period of time, with a detox period afterward. Either way, it is your choice; how long do you want to rely on substances, and to what extent?
Other models believe in providing holistic treatment and personalized therapy after a detox period, helping to reduce and remove chemical dependence and build a foundation for personal recovery.
Using medication to help with the painful and often overwhelming symptoms of withdrawal from opioids and other drugs can be essential to a smooth and healthy transition. In fact, with a safe medical detox, each individual is given an initial assessment to see what medications will be helpful in making this phase of treatment comfortable and safe. This can include medications for anxiety, mood disorders, physical pains and various other side-effects of substance abuse.
And when it comes to some of these medications, it can sometimes be necessary to continue using them.
The biggest difference is whether narcotic maintenance medications like Suboxone or methadone become a long-term prerequisite to recovery, or if they are used to help someone who is sick get better so that the real healing can happen.
Palm Healthcare Company believes in providing a safe medical detox to allow for a comfortable and healthy transition from active drug or alcohol use. Our facilities utilize an experienced and professional medical staff who help to monitor each individual’s progress and provide effective medical support for lasting recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help.
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The Big Pharma industry is still in the hot seat, and this week another lawmaker is adding a new name to the roster of drug makers to be investigated for shady marketing practices. Alkermes, the company behind the opioid treatment implant Vivitrol, is now being investigated for how they market their product.
Background on Vivitrol
Vivitrol is another name given to the generic drug Naltrexone. Originally approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcohol dependence in 1994, Naltrexone eventually became approved for the treatment of opioid dependence. The medications primary use appears to be blocking the opiate receptors in the brain. It’s intended so that someone using heroin or other opiate-based drugs cannot experience the drugs high.
The Vivitrol shot is made by Boston-based biotech Alkermes. This medication stood out from other Naltrexone medications because Vivitrol is an injection given every 4 weeks with a monthly doctor visit. It is time released for longer lasting relief, instead of being a pill taken once a day.
Supposedly Vivitrol is intended to further help by reducing cravings for opioids. However, Naltrexone and Vivitrol have been refuted by many for having any notable effect on opioid cravings.
Enter Senator Harris
Kamala Harris is a Democratic California Senator who has announced she will be part of launching a new investigation into the sales and marketing practices of the makers of Vivitrol. According to the senator, Alkermes allegedly worked to increase sales of their opioid treatment medication through two questionable strategies:
“Aggressively” marketing Vivitrol to officials in the criminal justice system
Senator Harris says that Alkermes pushes for judges and lawmakers to use their product. The company even provided free samples, which resulted in Vivitrol being actively implemented in 450 treatment programs across 39 states.
Lobbying efforts by federal and state lawmakers
In her statement, Harris also alleges that the company has spent millions of dollars in direct appeals to government officials. Meanwhile, they were contributing to numerous congressional campaigns.
Due to the drug companies marketing, Vivitrol raked in well over $69 million dollars in the third quarter of 2017.
In her statement Senator Harris says,
“We are at the height of a crisis, and companies are taking advantage of pain in order to profit”
“We must hold these companies accountable for their deliberate actions that magnify the opioid epidemic and drive up the cost of drugs for Americans.”
The senator even quoted the chief of addiction medicine at Stanford University School of Medicine, Dr. Anna Lembke, who said,
“Alkermes has taken unethical drug promotion to new depths by enlisting judges, law enforcement personnel, and legislators to favor Vivitrol over proven treatments. Alkermes’ actions undermine public health.”
Which seems like some pretty strong words. In the midst of the opioid crisis, it might be fair to say we should use every resource we can get. However, the Big Pharma enterprises still need to be put in check when it comes to overlooking more effective treatments.
In fact, a 2011 review of studies suggested that Naltrexone was not significantly superior to placebo, and the authors believed there was no sufficient evidence to support Naltrexone therapy for opioid dependence.
One reason Senator Harris seems to have Vivitrol in the crosshairs seems to be that the pharmaceutical company made a habit out of promoting Vivitrol as a more effective treatment than other maintenance drugs, such as Suboxone or Methadone, even though there is no substantive data to support this claim.
As part of the investigation, Harris contacted Richard Pops, the Alkermes Chairman, requesting the company provide data and communication. At the moment Alkermes is disputing the allegations. Senator Harris appears to be calling their bluff, as she was requested that Alkermes submit:
Alkermes has also been asked to turn over any materials provided to participants or speakers for Alkermes since 2010. They’re being asked to disclose amounts paid to the company by various associations, including:
American Society of Addiction Medicine
National Institute on Drug Abuse (NIDA)
Partnership for Drug-Free Kids
Any studies presented to these groups are also to be turned in.
In their own statement, Alkermes states they are “focused on ensuring that patients, healthcare professionals, and criminal justice officials are educated on Vivitrol, and believes that patients should have access to all medications.”
There is no telling whether or not this investigation is going to turn into a witch hunt or if it will blow the lid off of even more bad behavior from Big Pharma. While other drug companies that can be connected to the opioid crisis are already facing lawsuits and others even criminal cases for racketeering and fraud, the Vivitrol producers might find themselves on the chopping block sooner rather than later.
There is already much disagreement about whether or not the Vivitrol treatment is really effective in the first place. Some say the medication helped save their life. Many others have horror stories of uncomfortable side-effects made worse by cravings. Either way, pharmaceutical companies still need to be held accountable for their marketing methods, especially when they seem a little suspect.
For now, this is all a request. Only Republican Senator Ron Johnson has the power to issue subpoenas on behalf of the Homeland and Governmental Affairs Committee.
When talking about the most effective treatment programs for addiction, we should also remember that maintenance drugs like Suboxone, Vivitrol and others are not exactly a solution. While they can be effective in keeping people alive and helping to overcome their sickness, the real healing does not come from magic pills or implants. The real transformation comes with developing the understand and the tools to take care of yourself. If you or someone you love is struggling, please call toll-free now.
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While the nation is still struggling to find the right strategy to climb out of the opioid crisis in U.S. it seems many are holding onto the idea that Big Pharma is going to save us from the destruction they helped create. While we can agree that evidence-based medical assistance in recovery is a useful tool, some seem to think that the only fix for a pill problem is more pills, or in this case, more needles.
Just recently, after President Trump declared the opioid crisis a “National Health Emergency”, the advisory committee to the U.S. Food and Drug Administration (FDA) voted 18-1 that a new injectable drug called RBP-6000 could benefit addicts and the lower of two doses studied had an “acceptable” safety profile.
So what does this mean for the opioid epidemic efforts? Is Indivior a miracle injection that is going to make the epidemic more manageable, or is it another kind of Methadone or Suboxone that is just keeping people hooked?
What is RBP-6000?
For a little background, RBP-6000 is an experimental drug designed to help fight America’s growing opioid addiction crisis. It is described as a sustained-release buprenorphine. It is designed to be delivered once a month as a subcutaneous injection. The compound solidified once in contact with bodily fluids and releases buprenorphine over time.
If approved, it will be the first monthly injectable buprenorphine treatment. When creating the drug the manufacturers studied two dosing regimens.
In one, 300 milligrams were given once a month for six months.
In the other, two doses of 300 milligrams were followed by four doses of 100 milligrams.
According to reports, there was only a minute difference in effectiveness between the two doses, and they drug company acknowledge that the higher dose of RBP-6000 caused more side effects. Looking closely into some of the reports from the research, some side-effects include:
Injection site pruritus
Upper respiratory tract infection
While these side effects were not noted in an extremely high percentage of those tested, they are still relevant to consider until there is more extensive data available. So far, the report says the safety profile is consistent with that of Suboxone.
So RBP-6000 is like Suboxone using the delivery of Vivitrol; another injectable drug used to try and block the effects of opioids.
Big Pharma Making Big Moves
This is one sign of how Big Pharma is stepping in to make a buck off of the opioid epidemic yet again.
Indivior is the company behind RBP-6000. It was originally part of Reckitt Benckiser as the Buprenorphine division but has since split off to be a specialty pharmaceutical company. Indivior already sells Suboxone Film, a product which combines buprenorphine and naloxone. Suboxone is a maintenance drug widely used in America to try and curb the effects of opioid addiction and withdrawal, but Suboxone is known to have its own side-effects and withdrawals. Some even attest that Suboxone is itself addictive and very difficult to get off of.
Two months ago the share prices for Indivior took a deep hit after a U.S. court ruling clearing the way for a generic rival to Suboxone Film. So, with new competition on the way in the Suboxone market, Indivior put a renewed focus on another maintenance drug to bring to market.
Some analysts already expect that RBP-6000 could capture around 30% of the broader buprenorphine market. Some believe this new form of injectable buprenorphine could generate annual sales of around $700 million by 2021.
Jefferies sees potential sales of $1.3 billion by 2025.
So now the push for this new drug is boosting its sales prospects as competitors threaten revenues from Suboxone sales.
To learn more about why Suboxone isn’t the easier answer some people think it is, download our FREE E-BOOK
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Waiting for FDA Final Ruling
This endorsement on behalf of RBP-6000 comes less than a week after FDA Commissioner Scott Gottlieb announced the agency’s plans to promote extensive use among opioid addicts of less harmful opioids such as methadone and buprenorphine, the active ingredient in RBP-6000.
However, some of the FDA panelists still would like to see more data about which patients should be given the higher dose. Other panelists say they would like to have it available, even though they lack of data supporting any additional benefit of higher doses. So even though the drug is shown to have side-effects in higher doses, and there is limited information on how these side-effects impact the individual, the FDA is considering to let this drug pass the grade.
The FDA’s decision is set to be made by November 30th, although typically the agency follows the recommendations of its advisory panels. So it may very well already be a done deal.
Why It Matters
Again, with respect to the importance of offering alternatives to particularly dangerous opioids like heroin or fentanyl. It is important to have resources for the purpose of preserving of life. Keeping people alive long enough to get help is crucial. But we also have to see that this is not a miracle cure.
Methadone, Suboxone, and Vivitrol may serve a purpose for some in a certain capacity. However, these drugs are not an adequate substitute for comprehensive addiction treatment. Each one of these methods should be accompanied by a holistic treatment plan that addresses all aspect of addiction, including emotional and mental health.
Drugs like RBP-6000 may help subdue the more serious symptoms from the physical side of addiction, but they can also present their own risks.
It is important to offer safe medical assistance, but we have to remember that these Big Pharma companies are not selling us instant cures to opioid addiction. This isn’t even the first time we have seen a new drug come out to try and treat the opioid problem from companies that are closely related or directly responsible for narcotic medications that helped fuel the issue.
Remember, there is not a quick fix for this problem. We cannot prescribe our way out of the problem. It is going to take better treatment resources beyond more medications.
Drugs like RBP-6000 from Indivior are not necessarily a bad thing, but they also may not be the kind of treatment people should focus on. Instead, there are safe medical treatment options that offer holistic resources and mental health services. A lasting recovery begins with effective treatment. If you or someone you love is struggling, please call toll-free now.
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Narcan is a brand name for the opioid overdose antidote Naloxone hydrochloride. Technically speaking, the opioid antagonist is a synthetic congener of Oxymorphone that is structurally different in that the methyl group on the nitrogen atom is replaced by an allyl group. In the past couple years Narcan has gradually become a household name. With the opioid epidemic in America continuing to ravage many communities across the nation, Narcan has become one of the first lines of defense. For some people, while they know now what this powerful substance is, they are still unsure how to use Narcan to stop an opioid overdose.
NOTE: All instructions in this article come from the Harm Reduction Coalition website. You can also look for Narcan/Naloxone training in your area. Different brands may provide more specific instructions. Be sure to real labels and warnings on Narcan or Naloxone kits.
How to Use Narcan: More about Narcan
Narcan works by blocking the effects of opioids and can actually reverse an overdose in order to get medical attention to someone who is in need. The life-saving opiate antidote is used for the complete or partial reversal of opioid depression, including respiratory depression. An opioid overdose can cause breathing to slow down or stop completely, putting someone’s life in immediate danger. Some examples of opioid overdoses Narcan may be used to reverse include the drugs:
One major plus is that Narcan has no euphoric effects and cannot get someone “high” so abuse is not an issue. The overdose antidote is essentially harmless if there are no opiods present in someone’s system. If given to a person who has not taken opioids, there will be no effect. Narcan can still be effective when alcohol or other drugs are present with opiates. However, some of the incredibly potent synthetic drugs such as Fentanyl and carfentanil have shown to be somewhat resistant to Narcan treatment, meaning those overdosing due to carfentanil require extra doses to be stabilized.
Administration to opioid-dependent individuals may cause symptoms of opioid withdrawal, including:
- Fast heart rate
There are other measures that can be taken to help ease these symptoms as well.
How to Use Narcan: Intravenous Infusion
The most rapid onset of action is achieved by intravenous administration, which is recommended in emergency situations. Narcan may be diluted for intravenous infusion in either:
- Normal saline
- 5% dextrose solutions
2 mg of Narcan mixed in 500 mL of either solution provides a concentration of 0.004 mg/mL. Narcan should not be mixed with preparations containing:
- Long-chain or high molecular weight anions
- Any solution having an alkaline pH
No drug or chemical agent should be added to the mixture unless its effect on the chemical and physical stability of the solution has first been established. To use the injectable Narcan:
- If the person is not breathing perform rescue breathing for a few quick breaths.
- Use a long needle (called an IM or intramuscular needle) which about 1 – 1 ½ inch. NOTE: If there isn’t a big needle, a smaller needle is OK and inject under the skin, but big needles are better.
- Remove the pop off orange top from the vial
- Draw up 1cc (1cc=1mL=100u) of antidote into the syringe
- Inject into a muscle, the best being thighs, upper, outer quadrant of the butt, or shoulder. NOTE: Inject straight in to make sure to hit the muscle.
- After injection, continue rescue breathing 2-3 minutes.
- If there is no change in 2-3 minutes, administer another dose and continue to breathe for them.
NOTE: If the second dose of naloxone does not revive them, something else may be wrong— either it has been too long and the heart has already stopped, there are no opioids in their system, or the opioids are unusually strong and require more naloxone (such as Fentanyl or carfentanil).
For more information, you should be able to find instructions in the Narcan kit, or inquire when picking up a Narcan kit about any opportunities to receive more in-depth training.
How to Use Narcan: Nasal Spray
Another resource that has helped make huge progress in fighting opioid overdose death rates is the Narcan (or Naloxone) nasal spray kit. The variation has made training people to administer the overdose antidote much easier and much less dangerous. Without needles, the nasal spray system helps eliminate the issue of blood contamination.
According to instructions posted through the Harm Reduction Coalition, there are about 5 steps for how to use Narcan with nasal spray.
- If the individual is not breathing perform rescue breathing for a few quick breaths.
- Attach the nasal atomizer (applicator) to the needleless syringe and assemble the glass cartridge of naloxone.
- Tilt the head back and spray half of the naloxone up one side of the nose (1cc) and half up the other side of the nose (1cc).
- If there is no breathing or breathing continues to be shallow, continue to perform rescue breathing for them while waiting for the naloxone to take effect.
- If after about 3 to 5 minutes there is no change, administer another dose of naloxone and continue to breathe for them.
NOTE: If the second dose of naloxone does not revive them, something else is wrong—either it has been too long and the heart has already stopped, there are no opioids in their system, or the opioids are unusually strong and require more naloxone (such as Fentanyl or carfentanil).
Regardless of if you use an intravenous Narcan kit or a nasal spray kit, Narcan should never be used as substitute for emergency medical care. In the event of an opioid overdose one should always call 911 right away, even if the individual wakes up. Narcan can wear off between 30-90 minutes, while the effects of the opioids can last much longer. It is possible that after Narcan wears off the overdose can return.
Also look into Narcan training programs in your area.
How to Use Narcan: Get More Help
When someone has to be revived from an opioid overdose it can be a pretty clear cut indication that something needs to be done in order to help them stay safe.
Another difficult aspect of how to use Narcan is that naloxone can cause uncomfortable opioid withdrawals. Because Narcan blocks the action of opioids in the brain, people can wake up feeling withdrawals practically immediately and try to use again. Of course this could result in another overdose.
Beyond administering Narcan to save someone’s life, take this as an opportunity to seek resources and start a conversation about getting them the help they need. Preserving life is important, but saving a life by changing a life can make a world of difference. There are empowering and innovative addiction treatment programs that specialize in addressing this chronic, progressive and fatal substance use disorder. After surviving an overdose presenting someone with the opportunity to get treatment may be the best chance they get.
Holistic addiction treatment allows people who were once hopeless build the foundation of hope again. If you or someone you love is struggling with substance abuse or addiction, please call Palm Healthcare Company. We want to help.
CALL NOW 1-888-922-5398