Tuesday, January 8, 2013

Addicted to Painkillers? Effective Treatments are Available


Abuse of opiate-based prescription painkillers (Oxycontin, Vicodin, Percocet, etc.) is on the rise among both adolescents and adults. These medications can easily cause addiction, and the incidence of accidental overdose and death is increasing at an alarming rate. Trying to get off of these drugs can be a difficult journey. When trying to kick the habit, people experience a myriad of severe withdrawal symptoms that can include nausea, vomiting, diarrhea, muscle aches, sweating, and chills. My patients often say they “feel like they want to die” when going through withdrawal. While withdrawal symptoms are severe, they usually pose no medical risk to the patient. However, due to the severity of the symptoms, many people cannot make it through withdrawal on their own.


Fortunately, an extremely effective treatment option is available for opiate addiction. Specially certified doctors can prescribe a drug called buprenorphine during an office visit to assist the detox process. Taking buprenorphine allows a person to stop taking opiates without experiencing withdrawal symptoms. In addition, buprenorphine takes away the cravings for opiates, blocks the ability to get high on opiates, and is not fatal on overdose.   After taking buprenorphine for a period of time, a person can taper off of buprenorphine without experiencing the severe symptoms associated with opiate withdrawal. Additionally, buprenorphine treatment can be managed in a doctor’s office without the need for inpatient “rehab”.

There are two approaches for buprenorphine treatment—a quick detox and maintenance mode. With a quick detox, a person takes buprenorphine for a short period of time (two weeks to a few months) and then tapers off of it. With maintenance mode, a person takes a maintenance dose of buprenorphine for a longer period of time (six months or more) before tapering off of the drug.  I usually recommend the maintenance mode for my patients, particularly for those people whose drug habit has lasted longer than a year. Being on a maintenance mode of buprenorphine affords people the opportunity to make the changes necessary in their lives to allow them to stay off of drugs. They have the opportunity to get their work situation and finances in order, repair relationships and regain trust, get new friends who do not take drugs, and generally learn how to live without drugs. Once their life is in order, a person can then taper off of buprenorphine and be well prepared to stay drug-free. I have found that the relapse rate with a quick detox is much higher because they have not had time to make the changes necessary to support a drug-free life. Studies have shown that the longer you take buprenorphine, the greater the chance of maintaining abstinence permanently.

If you are interested in buprenorphine treatment, you should contact your primary care doctor. Alternatively, you can visit www.buprenorphine.samhsa.gov for a listing of doctors authorized to prescribe buprenorphine in your area. This website will also provide you with more information about buprenorphine.

You should be aware that there are other treatment options available for opiate addiction such as Naltrexone, Vivitrol, and Methadone. However, I generally recommend buprenorphine treatment for most of my patients because it manages withdrawal symptoms and cravings, it is a relatively easy treatment plan to follow, and it has a higher success rate.

As I mentioned earlier, it is possible to detox from opiates on your own without medical assistance. Withdrawal symptoms are severe and scary, but generally do not pose any medical danger for most people. However, certain medical conditions (pregnancy, heart problems, etc) can make the withdrawal process dangerous and may require monitoring or assistance from a doctor. If you are considering doing this on your own, please consult with your physician to make sure it is safe for you.

4 comments:

  1. The medication is a true life saver. The Buprenorphine gave me the only real chance to kick my opiate addiction which was the direct result an injury. I have to say though that if you are unsure about the medication or which Dr to use please at least do one session with dr Weiner and then make your decision. I believe you'll find his knowledge and genuine kind and caring demeanor will help you decide to stay in his care. I've seen him for 6 or 7 years and couldn't imagine seeing anyone else ever.

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    1. So sorry I didn't see the notification that you had commented on my blog so it was never published. Here it is. I appreciate it.

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  2. I see my comment was removed. I thought that it might inspire someone on the fence to move forward. I guess not. Tom C.

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