opiate detox

How does Suboxone work?

Sunrise uses Suboxone for opiate detox.  You'd probably like to know how it works, without getting into all the fol-de-rol about agonists, antagonists, mu opioid receptors and all that.

Buphrenorphine (Suboxone's just a stage name) doesn't quite act like other drugs.  It stimulates one place in the brain the same as heroin, methadone, oxycodone and the other opoid (opium-like) drugs, but it has the opposite effect on most of the other receptor sites that opiates use where, instead, it neutralizes the opiates' effects.

In addition to buphrenorphine, Suboxone contains a drug called naloxone.  It is also an opiate antagonist, and it enhances the neutralizing effect of the  buphrenorphine.

What this all boils down to is pretty simple, once you get past the neurology and chemistry: Suboxone's neutralizing effects get the drugs out of the system, while its stimulating effect eliminates withdrawal symptoms.  If you give someone a dose of naloxone alone, it throws them into immediate and severe withdrawal.  However, the two drugs working together allow us to detox from our opiate of choice, and allow it to happen in relative comfort.

Completely changing our brain chemistry around can never be symptom-free, and if you've ever done an opiate detox “cold turkey,” you know that it's one of the most miserable experiences imaginable.  No one wants to go through that again.  With Suboxone, you don't have to.  Along with the medical and emotional support of a first-class detox facility, Suboxone treatment makes the early stages of recovery from opiate addiction physically and emotionally more comfortable, removing one of the biggest obstacles to getting clean and sober.

Medical Schools To Offer Residencies In Addiction Medicine

An article published July 10th in the New York Times heralds a much-needed addition to addiction treatment, aimed at making it a recognized specialty like surgery, endocrinology, obstetrics, etc.

In a move that recognizes addiction as a disease, rather than simply a psychological or moral problem, the program will provide a one-year residency in addiction medicine for doctors who have complete their basic training and are aiming for a specialty. They will spend their residency studying addiction and its connection with heredity, brain chemistry, and psychological issues while treating a broad variety of addictions ranging from alcohol and prescription drugs to nicotine.

According to Nora D. Volkow, of the National Institute on Drug Abuse, the prior lack of this kind of education for doctors was “a gap in our training program…a very serious problem.”

The American Board of Addiction Medicine (ABAM), formed in 2007 to address the issues surrounding medical training in addiction, expects to accredit 10 to 15 additional institutions this year.  Those currently accredited are:

Boston University Medical Center
University of Florida College of Medicine
St. Luke’s-Roosevelt Hospital in New York
New York University at Buffalo School of Medicine
University of Maryland Medical System
University of Cincinnati College of Medicine
University of Minnesota Medical School
University of Wisconsin School of Medicine and Public Health
Marworth Alcohol and Chemical Dependency Treatment Center in Waverly, PA
and the John A. Burns School of Medicine at the University of Hawaii

Kudos to these institutions, ABAM, and the people in the medical and other professions who worked long and hard to accomplish this great stride forward in the understanding and treatment of addiction.

Pride: An Excuse To Avoid Detox And Treatment

Pride is one of many obstacles that can get in the way of our decisions regarding detox and treatment. Drug addicts and alcoholics are loaded with it.  We don't want to admit that we couldn't handle our own problems our own way.

But that's usually false pride.  As is the case with so many forms of denial, the real issue is fear: fear of being labeled an alcoholic or addict; fear of losing the prestige that we may have accumulated; fear of the process of detox, treatment and recovery itself — but, most of all — fear of having to live without the crutch of alcohol or other drugs to get us through life.  Let's look at those one at a time.

Fear of being labeled an alcoholic or addict; fear of being “found out.”

For some reason, many of us imagine that no one outside our immediate circle of family and friends has noticed our addiction.  Think about it.  How likely is it that we wouldn't notice someone we worked or socialized with if they had a problem with drinking or drugging? We  might make excuses for them to protect our own behavior, but the fact is that we'd know long before they did.

There is no reason to think that other folks don't know about our problems.  Bosses notice work quality, absences, long lunches, coming in late and the other ways that we accomodate our using.  Later on they may notice other things like discrepancies in expense accounts, clients not seen, and so forth.  Bosses are in the business of evaluating employees.  Of course they notice that stuff!

Our kids notice our failure to participate in their lives; our spouses the disintegration of a partnership into much less than it could be.  Other family members notice the decline of our participation in family events, changes in our personalities, booze on our breath.  They may remark on our tendency to hang with the drinkers in the family and avoid the social or non-drinkers. Same with our friends. Bottom line: we're not very good at fooling folks.  Not good at all.

Loss of prestige

We really have a choice here: we can either go to detox and treatment, attend a 12-step group, get our act together and regain our ability to function at a high level, or we can continue to allow things to deteriorate to the point where we blow our standing in the community ourselves.

Fear of the process

Detox and treatment were a walk in the park 21 years ago when I did my stint, and things have gotten better since.  A medically-monitored inpatient detox is as close to pain-free as it's possible to make a process like that.  For me, treatment was like a vacation from troubles and care, with the additional benefit of being among people — staff and other clients — who understand where we're coming from, won't judge us, and will help us on the road to recovery and getting our lives back.  I didn't want to leave.

That leaves us with our biggest fear of all, giving up our best friends.

If we don't think alcohol and other drugs were our best friends, we need to think again.  “Who” did we go to when we were feeling down?  What was our refuge from problems?  What was the one thing that we made sure we always had nearby?  What did we choose, while forsaking most of the people in our lives?

Right.

Giving up the drugs is scary.  There is no question about it.  But continuing the life we have while using is scary too.  There is one big difference between our friend and recovery.

Recovery will let us live a life that may be better than we even hoped. Our friend will take everything from us, and then kill us slowly and painfully.

Your choice.