Every time you turn around, there is another story about marijuana reform in America. Regardless of which side of the argument you stand, you consistently read new headlines to ponder regarding how cannabis is making its way into the mainstream. In many states, reform has been embraced with open arms and surprising public support. However, there are also cases where marijuana reform is being faced with strong opposition. Now, you can consider New Hampshire as one of these instances. This week, a House committee voted to approve a new marijuana legalization bill.
Due to the notably high rates of opioid overdoses in the state of New Hampshire, many are contesting marijuana legalization. The Granite State has been hit pretty hard by the ongoing epidemic, and many officials feel that pushing for legal cannabis will only make the drug problem worse.
Government Officials Pushing Back
Governor Chris Sununu is just one of many officials in New Hampshire trying to put a stop the marijuana legalization. They insist that the issue isn’t only concerning cannabis, but also opioids and other drugs.
It is understandable that people are hesitant to embrace drug reform policies in an area that has one of the highest per capita death rates due to opioid overdose in the country. Citizens and communities all over the state have suffered, while money and resources have been pouring into efforts to combat overdose deaths. Therefore, opponents of marijuana legalization are insisting it is too risky to consider easy access to any drug at this point.
Governor Sununu states,
“When we are dealing with opioids as the single biggest health crisis this state has ever had, you are going to tell me legalizing more drugs is the answer? Absolutely not.”
Many still argue that marijuana is a gateway drug and that by allowing recreational access to cannabis they will be effectively increasing the rate of opioid abuse. This is instigating a further national discussion about whether or not marijuana use is a gateway to opioid abuse.
Sununu may be a Republican, but the opposition to legalization is not exclusively partisan. In fact, both New Hampshire Senators, Senator Jeanne Shaheen, and Senator Maggie Hassan, are Democrats that express their own opposition to marijuana legalization. Sununu even has the state commission on alcohol and drug abuse against the legislation.
Additionally, plenty of residents also support the push back. Many believe New Hampshire should focus on addressing the opioid crisis before considering cannabis reform. Ronald G. Shaiko, who is studying public policy and social sciences at Dartmouth College in Hanover, New Hampshire, says that many residents feel that the government hasn’t responded well enough to the opioid epidemic. Therefore, most are skeptical about adding more drugs into the mix.
Marijuana Legalization VS Opioid Addiction
Proponents of cannabis reform do not dismiss the opioid crisis, but instead, argue that increasing access to marijuana could actually reduce rates of opioid overdose. This is a movement that has also begun gaining ground in recent years. State Representative Renny Cushing, who is sponsoring the legalization bill, stated:
“What we’ve come to understand is that marijuana in many instances is an exit drug, not a gateway drug.”
Legalization supports point to a 2018 study that shows an association between daily marijuana use and remaining in medication-assisted treatment (MAT) programs. Additionally, a 2014 study found that states with medical marijuana had lower death rates from opioid overdoses. Some states are now encouraging marijuana use instead of opioids or making opioid addiction a qualifying condition to receive a medical marijuana prescription.
New Bill Barely Passes
Even with a bipartisan message of caution, the new legislation to establish recreational marijuana in New Hampshire appears to be moving forward. Advocates for the new bill believe that Governor Sununu is fear mongering and using the opioid crisis to block the Democratic-controlled state legislature.
The New England area is known for embracing more liberal policies on social issues. Following the other states in the New England area, New Hampshire legalized medical marijuana in 2013. Then during Sununu’s administration, the state decriminalized marijuana possession in small amounts in 2017.
This new bill will make it legal for people over the age of 21 years old to possess, consume, buy and grow small amounts of marijuana. The bill also makes an effort to establish a commission responsible for licensing and regulating:
- Retail establishments
One state commission states that the tax revenue from a new cannabis industry could give New Hampshire between $15.3 million and $57.8 million a year. The financial benefits of cannabis reform have been a real selling point in many states. To put it in perspective, California:
- Taxes all sales of recreational and medical marijuana by 15%
- Made over $2.75 billion on recreational sales
- Added over 80,000 new jobs with cannabis sales
Needless to say, that is a lot of money. Some estimate the legal cannabis industry could grow to a whopping $25 billion in 2025.
Another huge selling point of the bill for many people is that it would expunge prior convictions for offenses relating to cannabis that are made legal under the new law.
The New Hampshire House Criminal Justice and Public Safety Committee approved the bill on Thursday, February 21, 2019, in a 10-9 vote, cutting it incredibly close. However, Governor Sununu has reportedly vowed to veto the bill if it reaches his desk. Meanwhile, House Speaker Steve Shurtleff believes there are enough votes in his chamber, and maybe in the Senate as well, to override a veto from the Governor.
There does not seem to be one easy answer for the cannabis debate going on in New Hampshire. For the moment, both sides seem confident in their stance. Even experts who believe cannabis may be useful in helping fight opioid addiction say that more research is necessary. Therefore, many experts insist marijuana should not be used as a substitute for other methods of MAT.
Tym Rourke, a member of the state commission on alcohol and drug abuse who oversees addiction-related programs for the New Hampshire Charitable Foundation, makes a good case for proceeding with caution. Rourke points out that while marijuana could be more or less safe for the average person, that doesn’t mean it is safe for everyone. Rourke states,
“For some people, it’s unsafe. And as we are grappling with a high volume of individuals struggling with the consequences of substance misuse, do we really want to create a system that puts another substance more into the marketplace or more into their presence?”
This is a sentiment echoed by many addiction recovery advocates. There are those who believe in studying the benefits, but many holds with the idea that even if some are able to safely use cannabis, the same may not be true for many of those with substance use disorders. Therefore, as the movement for marijuana legalization continues, we should still be aware of those who could be at risk of relapse or prolonged drug use.
Even if marijuana is legal in certain areas, there should still be support for resources that treat people suffering due to substance abuse. Even if you don’t believe marijuana is a gateway drug, it can still be risky for those in recovery. Furthermore, marijuana addiction is possible for some, even if it is not as life-threatening as heroin addiction. If you or someone you love is struggling, please call toll-free now.
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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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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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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.
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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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