The latest buzzword in the media about the “fight” against the opioid epidemic is Buprenorphine, better known as Suboxone, Subutext and a variety of other pharmaceutical formulations. One of the measures that the Department of Health and Human Services has implemented, which it claims will combat the growing problem of opiate addiction, is the ability for doctors to prescribe more buprenorphine to more patients. Is this “solution” to opioid addiction really a solution? Or are we one more time missing the mark – with addicted teens and young adults paying the consequences?
Lack of Effective Treatment
When working with a teen or young adult who has only begun using opiates recently, placing them on a long-term drug replacement protocol effectively cripples them, and perpetuates the cycle of their dependence on an opiate in order to get by.
It goes without saying that a lack of effective treatment for teens struggling with substance abuse issues can result in severe emotional and physical consequences. Most drug-addicted teens never receive any form of addiction treatment. The Centers for Disease Control and Prevention (CDC) recently officially classified the opioid abuse problem as an opioid epidemic. While Suboxone is often utilized as an opioid addiction treatment, the reality is that drug-replacement therapy doesn’t offer a solution for long-term recovery. The number of teens struggling with opioid addiction increases every year. In order to effectively treat teens suffering from opioid addiction, it is imperative that the treatment methods employed are not only unique to teenagers, but are sustainable in the long-term.
What Kind of Treatment is Appropriate for Teens and Young Adults?
The developing adolescent brain leaves teens with substance abuse issues extremely vulnerable. Not only are the neurological effects of drug abuse more impactful on the developing teenage or young adult brain, but the environmental influences that make it difficult for young people to maintain recovery have to be addressed. Addiction affects brain development and normal brain maturation in teens. These developmental issues can lead to lifelong consequences. That is why it is imperative that teens struggling with substance abuse issues receive the help they so desperately need. 90 percent of drug-addicted teens never receive addiction treatment. This scary fact is compounded by the new trend for those that do receive treatment to be dispensed buprenorphine as a long term addiction solution. Addressing adolescent drug use is a critical matter. When teens receive addiction treatment at the first sign of trouble, they have a significantly higher chance at recovery and overall better health. Giving someone another opiate with the expectation that they will be taking it indefinitely does not constitute treatment. While this method of treating opiate addiction may have its merits when dealing with long-term opiate addicts where harm reduction is the best that can be hoped for, crippling teens and young adults by creating an institutionalized dependence on a new opiate does the opposite of treating the problem.
This mentality arises out of the fact that most treatment protocols are geared towards older adults. Teens and young adults struggling with substance abuse issues have a unique set of needs that differ from the individual needs of drug-addicted adults. Teenagers rarely enter addiction treatment programs voluntarily. They are still in a crucial stage of development both physically and emotionally. They deal with a totally different set of pressures than older adults – both internally and externally. The most effective treatment programs for teens are long term, and address the family as a unit. Family involvement in the treatment process offers the best chance at success from drug-addicted teens.
Why Is Drug-Replacement Therapy A Bad Idea For Teens?
While questioning the decision to heavily rely on suboxone or methadone replacement therapy is a highly unpopular stance to take in much of the treatment industry, the fact of the matter is that some teens who are being prescribed these drugs are being more harm than good.
Methadone treatment is a form of drug-replacement therapy often used in adults suffering from opioid addiction. Methadone treatment, like Suboxone, requires daily dosing to prevent the individual from going into withdrawal. This requires daily visits to a clinic. Suboxone does not require a daily clinic visit, but still necessitates a daily dosing. While the argument is that these drugs lower the rates of addicts experiencing fatal relapse, neither of them addresses the root of the addiction or gives young people struggling with opiates a way out.
Suboxone Treatment for Teens: The Good and the Bad
So what exactly is Suboxone and why is it being talked about so much? Buprenorphine treatment, like Methadone, is a form of drug-replacement therapy. Suboxone is a combination of buprenorphine, an opiate substitution that helps to eliminate cravings, and naloxone, a drug that blocks the euphoric effects experienced from opioids. While Methadone is not recommended for teens, many mental health professionals recommended Suboxone to teens. This is because if the drug is taken as prescribed, it can take away opiate cravings and reduce the ability of a user to get high. The problem is, it doesn’t offer a long-term solution for recovery. There are both advantages and disadvantages in treating an individual suffering from opioid addiction with the drug. While it has it’s application very early on in the treatment cycle and may be the best option when working with an older addict for whom abstinence is not an option, without addressing the underlying causes of addiction in the first place, a substitute opiate can only do so much good.
The Good: The active ingredient, Buprenorphine, helps reduce withdrawal symptoms and craving associated with opioid addiction. The active ingredient, Naloxone, eliminates the “high” experienced from opioids. It helps stop the illegal use of heroin and prescription opioid medications in the short term.
The Bad: Suboxone is a drug replacement treatment; it requires daily dosing to be effective. It is habit-forming and can lead to dependence, tolerance, withdrawal symptoms and addiction. Physical dependence develops with continued use, even when taking the medication as prescribed. If mixed with other drugs or alcohol, the result can be fatal. There are also many instances of Suboxone abuse. Addicts employ alternative routes of administration in order to achieve a “high”. These methods can lead to overdose and death. Individuals who have been prescribed the drug are often unable to stop taking it. This leads to unintended long-term use and serious withdrawal symptoms.
A Day in The Life of a Suboxone Patient
The other thing that a Suboxone prescription does not take into account is the behavior of the user. The following is the direct account of an individual who was treated with Suboxone therapy for 2 years as a young adult. Names have been omitted to protect their privacy.
“When I was 20 years old I was prescribed Suboxone to deal with my heroin addiction. I had been using heroin and other opiates heavily for about a year at this point, and had never attempted to get sober using any other methods. I was scared of withdrawing, so I reached out to my parents and they agreed to get me in to see a doctor who would prescribe me Suboxone. They had no experience dealing with addiction at this point, and to them, anything that offered a way out for their son who was using heroin, sounded like a good idea.
Without anything other than an initial doctor appointment – no therapy, no clinical assessment, no inpatient stay, no requirements whatsoever outside of a monthly drug test – I left my first doctor’s appointment with a daily prescription for 16 milligrams of Suboxone. This was not coupled with any required therapy. I was forced to visit the doctor’s office once a month to take a drug test and show I had no other opiates in my system in order to keep my refills coming. The doctor strongly suggested that I join his partner outpatient program, which I would eventually do, but I faced no other obstacles in getting my insurance to fill a prescription for 60 of the strongest Suboxone pills on the market.
One thing that I never hear in the media is the fact that a lot of people use Suboxone to get high. If you don’t have a pre-existing tolerance to opiates, the drug is really, really strong. Like, get you high for a whole day strong. Because of this, I spent the next two years selling my Suboxone.
I would take the Suboxone for a while, then decide I wanted to get high and stop taking it. Within a day or two I would be able to get just as high as before off of heroin. I could sell my Suboxone to afford the heroin that I wanted. The whole time, my insurance was footing the bill. Then, when I wanted to stop using heroin, I would just start taking the Suboxone again and wouldn’t have to deal with the withdrawal. It was a really cushy set up that last for two years until I finally got sober.”
As dramatic as this story is, it very common in the field of recovery. A solution to teenage and young adult opiate dependence has got to be holistic.
Address the Real Problem
If the nation is going to address the opiate epidemic, there are a lot of things that could and should be done. Hiding behind an increased ability of doctors to prescribe a medication is not one of them. Recovery from addiction requires a holistic, comprehensive approach if it is going to be long-term or sustainable. While Suboxone has it’s applications, relying on it as the sole solution for teens and young adults does more damage than good. Do you have any experience dealing with a long-term Suboxone prescription? Let us know about it in the comments section below.