A Recent Open Label Pilot Study

Opioid addiction is so prevalent in the healthcare system because of the countless number of hospital patients being treated for chronic pain. While opioid analgesics have beneficial painkilling properties, they also yield detrimental dependence and addiction. There is a legitimate need for the health care system to provide powerful medications because prolonged pain limits activities of daily living, work productivity, quality of life, etc. (Taylor, 2015). Patients need to receive appropriate pain treatment, however, opioids need to be prescribed after careful consideration of the benefits and risks.

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

America has a major problem with opioid addicts, and many facilities are helping the addicts by providing safer options to taking the drugs their bodies crave. Methadone clinics are places where people addicted to opioids can receive medicine-based therapy. Opioid use, drugs such as heroin, morphine, and prescribed painkillers, has increased in the US with all age groups and incomes. People become addicted to these drugs when they are prescribed, recreationally used with other addicts, or they are born addicted. Many health institutions are addressing this issue with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted

Substance abuse disorders have been considered a major epidemic by public health authorities during this century. Most recently, those who use, and abuse opioids have been in the spotlight. The growing number of overdoses, deaths, and individuals who are identified as opioid abusers has, of late, been the subject of media attention. Now coined “The Opioid

There are three predominate forms of Medication Assisted Treatment (MAT) that have proven effective in combating opioid use disorder. Methadone, buprenorphine, and naltrexone have all shown to be effective in the treatment of substance use. When prescribed and monitored properly, MAT has been shown to reduce illicit drug use and reduce the rate of accidental overdose. However, while as many as 2.5 million people are suffering from substance use disorder, less than 40% have access to MAT

Opioid abuse, misuse and overdose is a problem in The United States. You can’t turn on the TV or read a newspaper without some mention of the epidemic. This issue has caused the practice of prescribing or taking narcotic pain medication to be looked at under a microscope. Patients are fearful to use some necessary pain medication, because they may become addicted. Other patients who genuinely do have pain and need medication are having a tougher time obtaining the help they need. The problem of abuse and addiction is tough to solve since for some people the medications are the only way they can function and live a semi-normal life. A patient with pain may be hesitant to visit the doctor and

The National Center on Addiction and Substance Abuse provides guidelines and recommendations to healthcare providers in terms of how to screen for an addiction. Opioid addiction is screened primarily through patient interviews involving both specific and open ended questions about their lifestyle, mood, and drug use. A psychiatric exam may also be administered to look for psychological factors indicating an addiction such as depression, anxiety, and other psychological symptoms related to addiction and withdrawal. Withdrawal is evaluated by gradually taking a patient off opioids and if symptoms of withdrawal are found the severity of the withdrawal itself is then evaluated.2 If a patient is diagnosed with an addiction to opioids then the transition to tertiary prevention, or treatment will occur. However, treatment will only occur if early detection and screening techniques are utilized fully by healthcare provider otherwise it is likely an overdose will kill the opioid

Objective: This study compared the effectiveness of methadone, Subutex, and Suboxone in reducing illicit drug use during treatment for opioid dependency and retaining patients for the duration of treatment.

Naloxone is added to buprenorphine for the treatment of opiate dependence and to prevent intravenous diversion [11]. However, the efficacy of buprenorphine is not affected by the combination because the half-life for buprenorphine is

Physical dependence to a substance is a state of adaptation that is manifested by specific signs and symptoms of certain drugs that can be produced as a result of abrupt cessation, rapid dose reduction, decreasing blood level of the drug, or administering an antagonist. Dependence is a normal physiologic consequence of extended opioid use, and by itself, is not the same as addiction.¹ To treat this state of reliance, opioid agonists, such as methadone and buprenorphine-based regimens, have been the mainstays of therapy. While they are both long-acting and bind to opioid receptors in the central nervous system, they differ in their mechanism of action and how they are perceived by the general population. This consult’s objective is to evaluate current literature that is available regarding the differences in outcomes and efficacy between methadone and buprenorphine-based treatment in opioid-dependent patients.

Addiction to opiates is developing and continues to be a large problem in many countries. Substitution for such opiates in pharmacotherapy has shown to reduce the use of illicit drugs and the potential criminal behavior that is associated with taking opiates (Merrill J, Alterman A,

Out of the 60 participants 14 were women, 42 came from treatment settings, 18 came from criminal justice settings and 5 did not attend the follow-up 6-month interview. During the 6-month treatment trial, 95% of the participants used opioids on one or more occasions while the other 5% reported completely refraining from using opioids during treatment. The average frequency of opioid use was 24 days during the entire 6-month period. The overall frequency of opioid use was reduced from an average of 2.4 (using the 0-3 frequency scale) before Naltrexone implantation to 0.9 after 6 months of treatment. Heroin was the most commonly used opioid among the 60

The negative stigma surrounding opioid addiction is not only dangerous and harmful but promotes marginalization to the individuals who are carrying the burden of these negative labels. It can cause them to be misdiagnosed as well as be given improper treatment. (National Pain Report, 2015). In addition, it may discourage those individuals from seeking help. Narcan has been proven to be effective at reversing the effects of an overdose and has been credited in reversing 10,000 overdoses from 1996 to 2010. In Boston, Massachusetts police officers started carrying Narcan and were able to respond to 591 overdoses and reverse 491of them. (The Marshall Project, 2015) Narcan is slowly becoming available to be purchased over the counter. Rhode Island is one of those states, and it is imperative to disseminate this information to the people of Rhode Island. Lastly, a multidisciplinary approach addressing the further training of those at the clinical level and the criminal justice level. Physicians along with law enforcement will be required to complete education on overdose prevention, drug addiction, and the effects of the opioid antagonist Narcan. This action plan will arm the public with insight and further the knowledge of just how damaging the opioid addiction is, not only on a state level but a national and global level. Further, data and evidence will convince

Vivitrol is an intramuscular, extended-release formula of naltrexone (XR-NTX), which is given once monthly to detoxified opiate dependent patients who wish to abstain from opiate use. Vivitrol is also used to treat alcohol dependent patients, but this paper will focus on its effects on opiate addicted patients. Naltrexone is an opioid receptor antagonist, which blocks the euphoric effects of heroin and prescription opiates by binding to opiate receptors in the brain and blocking the action of the neurotransmitters. The Vivitrol injection releases naltrexone slowly over the course of 4 weeks. The time-release system works by encasing the naltrexone in biodegradable microsphere-polymers, which break down at different rates to maintain therapeutic levels of naltrexone over a 4-week period. Vivitrol suppresses effects such as euphoria, pain relief, sedation, physical tolerance, and physical dependence. This medication, like other extended release injections, is designed to address patient medication-noncompliance. It is recommended that patient have no opiates left in their system for a period of 7 days before starting a Vivitrol regimen. Vivitrol is generally well tolerated with few adverse side effects. One study found the most common side effects to be pain at the injection site, nasopharyngitis, insomnia, and hypertension (Syed, 2013).

Some addiction psychiatrists have cautioned against the rising excitement concerning Vivitrol. “Naltrexone buys you a month, but if you stop taking it and you haven’t developed coping strategies you may relapse,” said H. Westley Clark, a retired former director in the Substance Abuse and Mental Health Services Administration. “People do recover from opioid dependencies, but often to do so they also need to deal with other issues in their lives” (Tabachnick, n.d).