Abstinence-Based Treatment or Buprenorphine?
Many people struggling with opiate addiction seek help in outpatient counseling and then in residential treatment as necessary. Others try medication assisted treatment, utilizing drugs like buprenorphine. Both of them are opiates, but they are more stable than heroin. They can help the addict who cannot resist his urges or withstand the withdrawal cravings. However, many experts believe that buprenorphine comes with its own set of problems that prevent a person from getting clean and standing on his own two feet once again.
Everyone has to make his or her own choice for the type of recovery he undertakes, but it’s important to understand what buprenorphine will not do: It will not allow you to deal effectively with your feelings so that you can get to the bottom of your need to use drugs in the first place.
There have not yet been long-term studies surrounding the use of this drug. It’s true that a couple buprenorphine formulations were approved by the FDA in the year 2002, including the well-known Suboxone, but they really weren’t widely used until 2006 and later. The available studies addressed short-term use of the drug and basically were funded by the drug’s brand-name manufacturer. That in no way indicates any shortcoming on the part of the manufacturer, but doctors and substance abuse professionals still have so much to learn about its long-term use.
Buprenorphine is more powerful than most opiate pain relievers. As a side effect it circumvents the brain’s ability to regulate emotions. A person using it may become emotionally erratic and find he cannot respond appropriately to stressful situations. Incidental problems include loss of libido and, in the long term, loss of hair, but those are minor concerns.
This emotional dysregulation is the primary concern among treatment professionals for those who seek help for opiate addiction. Most people develop their addiction in the first place because of some emotional difficulty in their lives. It may stem from family problems such as physical, sexual, or verbal abuse. The children of addicts grow up confused, not knowing how to deal with the world when they were co-opted into caring for their parents. Some people become addicted as a way to self-medicate a mental health issue such as depression or bipolar disorder. That’s why counseling is so important.
Substance abuse treatment must address all aspects of a person in order to get him well again and on the road to recovery. A residential treatment center evaluates many dimensions of a person, including his biomedical health, emotional and cognitive conditions and complications, his acceptance of the need for treatment, family functioning, developing a support network, and various aspects of aftercare planning. The fact is that most doctors who are licensed to dispense buprenorphine do not offer treatment in all those areas.
Some psychiatrists, including board-certified psychiatrist Dr. Steven Scanlon, believe that many of those physicians become licensed because they see buprenorphine treatment as an easy way to make a buck. An office visit costs a couple-three hundred bucks. The patient pays it and walks away with his monthly supply of buprenorphine. He doesn’t take away anything in terms of understanding his addiction or healing the rifts in his life.
Dr. Scanlon also warns us that while pain pill detox might take just a month or so in residential opiate treatment, buprenorphine digs into a person’s brain and it takes many months, plenty of money, and about 10 various medications to get off it. He says that many people give up detoxing from buprenorphine because it just takes so long.
So you make the choice. There are residential rehab clinics with a wide variety of treatment modalities available to help you through detox and change your life. Drug free or drug slave—it’s up to you.
