Suboxone Assisted Treatment
Wishes All The Fathers
"Happy Father's Day"
July-Updates 2009


Greetings!  Summer has finally arrived. Yes, we still are having many rainy days in Georgia but they are becoming warmer.  It is about time for warm weather but I prefer the cooler weather but then, who am I? I believe I am unique and I deserve the best life has to offer and I am hoping all of you feel the same way about yourself. You need to let go of any guilt you are holding onto and forgive yourself.  Yes, I said "Forgive Yourself!" Guilt can and will destroy you. I'm asking all of you Fathers, present yourself with the "Gift Of Forgiveness" on Father's Day.   

Need any help trying to pay for your Suboxone? 
I have some information to help you. You can no longer print the application to apply for Rx-Assistance out on your own printer but the help is still available. First, you need to check with your physician and see if He has a slot open because they can only accept three patients at a time... If He doesn't you might want to look around for one who does. If you locate one then you must let Him know you would like to apply but now it is the Doctor who must call for the application and obtain the required information from you and send it in.  If you would like to talk to a Nurse about it at Reckitt-Benckiser, they can be reached from 9:00 am - 8:00 pm Monday -Friday at (877)-782-6966.        

I have the information located on my website if you would like to look at the criteria and understand more fully how it works. Please click on the URL address and it will take you to the information. If you have any questions at all please do not hesitate to call us with them. We are on call 24 hours every day. We are here to answer your questions and supply the support you need to get started.  If you can't afford to call, you just let us know and send us your number and the best time to call and we will call you.  I bet you thought you were out there all alone and no one cared. It isn't true because someoone does care about you. We can be reached at (770) 428-0871 (office) and (770)-527-9119 (Cellular) .  If you need me to call you, send me an e-mail to Please read over the information on the URL  before giving us a call.  It should answer most all of your questions.   

Opioid Dependence

Opioid dependence is a medical condition, which is difficult to control due to compulsive drug use and craving, leading to drug seeking and repetitive use even in the face of severe negative health and social consequences.  Opioid dependence (mostly heroin) is a complicated condition that has both metabolic and psychological components and, partly due to its illegality, is currently associated with severe morbidity and a high risk of death.

Opioid dependence is a problem that exists in most countries today.  Heroin use has become increasingly common in North America sice the 1960s and in Europe sice the 1970s.  In Europe, the epidemic first ocurred in the sixties in the West, followed by the South in the eighties and, today, most countries in the Central and Eastern European Region, Newly independent states (NIS) and Russia have growing populations with opiate dependence. Furthermore, opiate use and dependence seems to be increasing in other regions, where traditionally it was less prevalent, including (Southeast) Asia, China, South and Central America and even Africa.    

Reports by the United Nations Office on Drugs and Crime (UNODC) and the World Health Organization (WHO) have shown, that there has been a global increase in the production, transportation and consumption of opioids, mainly heroin. The worldwide production of heroin has more than doubled or even tripled since 1985.  Evidence from national surveys and other data sources suggests that the prevalence of heroin use is general populations is relatively low. Globally, it is estimated that 13.5 million people take opioids, including 9.2 million who use heroin. In 2002, UNODC estimated a total of 185 million users of illegal drugs and 1.3 billion smokers and 2 billion alcohol users (UNODOC, 2003). However, in many countries (notably those in Europe), the majority of people seeking treatment are primarily addicted to opiates. 


Treating Opiate Addiction With Replacement Therapy

* Medications currently available to treat addiction to heroin, OxyContin and other prescription opiates are called replacement therapies.
This treatment can improve the health of addicted people and reduce the harmful impact of taking illicit drugs.
* Methadone is a long-established replacement therapy.
* A relatively new medication, buprenorphine, has been shown to be effective in helping opiate-addicted people.

New scientific understandings of brain chemistry are paving the way for significantly improved treatments for people who are addicted to heroin, opium, legally manufactured pain relievers such as morphine, OxyContin, Vicodin and Dilaudid and other opiate drugs.

Such improvements can't come a minute too soon. Twelve- to 17-year-olds are the fastest growing group of people in the United States experimenting with such drugs. And opiates are highly addictive - one half of all people who use them recreationally will need formal substance abuse treatment related to this experimentation.

Opiate abuse can bring about significant and long-lasting chemical changes in the brain. These changes cause a person to experience intense cravings and negative emotions when they try to stop. Because of this altered chemical state of the brain, the majority of opiate-addicted people who recover require medication in order to correct these changes, much as a diabetic requires insulin to maintain a more normal blood sugar level. The most commonly used medications for opiate addiction in the United States are methadone and buprenorphine. Health professionals call treatment with such medications replacement therapy.

A common misconception about replacement therapy is that this treatment is really just substituting one drug of abuse for another and that people who utilize medications in treatment of opiate abuse are not really in recovery. This idea fails to recognize that recovering from opiate abuse is not a matter of will power or moral re-examination. It is a physical illness most effectively treated by using medications such as methadone and buprenorphine to assist the person in regaining physical stability and then helping the person address other psychological and spiritual needs.

People with significant opiate addiction are unlikely to recover without some form of replacement therapy as part of their treatment. On the other hand, replacement therapy alone is not nearly as effective as combining it with other treatments such as counseling and self-help groups.

Addiction is a chronic illness like heart disease, high cholesterol or high blood pressure. Persons with these chronic diseases are prone to relapse. The affected person deals with the symptoms associated with their condition throughout the lifespan. Even in the best of circumstances the symptoms of a chronic disorder may reappear periodically. This is particularly true during periods of stress or when a person doesn't closely follow medical recommendations.

Unfortunately the failure to think of addiction in these terms has negatively affected the health of many opiate-addicted people. This type of thinking often leads patients to be discharged from treatment if they relapse. But the approach in the treatment of other chronic medical disorders, such as diabetes or heart disease, is to continue to work with patients even when they do not do well in order to improve long-term treatment outcomes.

As we continue to learn that addiction is similar to other chronic illnesses, treatment programs are beginning to adopt new ways of working with patients, sometimes called the harm reduction approach. Harm reduction approaches emphasize the need to shape treatment toward the individual needs of the patient as opposed to forcing the patient to adapt to the demands of the treatment program's definitions of recovery. Harm reduction is nothing more than:

* using practical treatment approaches to reduce the negative consequences of drug use,
* encouraging retention in treatment and
* improving the long-term health and general recovery of each addicted person as well as promoting public health goals.

Important Facts About Replacement Therapy

 *  Replacement therapy is not short-term; your friend or family member will need to remain on the medication for years in order for it to be effective.
*  Patients receiving methadone will initially need to be present at the program on a daily basis, although as they become more stable the daily visits may take only a few minutes.
*Methadone patients can earn the ability to take home some dose of medication over time if they stop the use of drugs and do well in treatment.
*  Patients on replacement therapy, particularly methadone, may encounter travel restrictions, making it difficult to visit family or take vacations.
*  Methadone and buprenorphine are treatments for opiate addiction and will typically not stop the abuse of other drugs.
*  Replacement therapy is not a "magic bullet" and patients usually have to engage in counseling, mutual help groups, or other forms of treatment to fully recover.
* Methadone side effects such as sedation, sweating, constipation and weight gain usually go away after a person  has been on the medication for a short time.
*  In clinical practice it has been observed that buprenorphine produces few side effects, with headache being the most common. Unfortunately this side effect does not usually fade with time.
*  Clinical experience indicates that Buprenorphine can make some psychiatric symptoms worse and methadone may be a better choice in that situation.

Five Things To Know About Methadone

1. Methadone allows people to function normally by stopping withdrawal symptoms, eliminating craving for opiates, blocking opiate induced euphoria, and correcting the neurochemical abnormalities in the brain caused by opiate addiction.
2. Methadone maintenance is the most effective treatment we have for opiate addiction.
3. Methadone is the most cost-effective treatment for opiate addiction.
4. Participation in a methadone treatment program significantly reduces a person's risk of HIV and Hepatitis C infection.
5. Methadone is the most widely used treatment for opiate addiction in the United States.

Five Things  To Know About Buprenorphine

1. The use of buprenorphine allows people to function normally by stopping withdrawal symptoms, eliminating craving for opiates, blocking opiate induced euphoria, and correcting the neurochemical abnormalities in the brain caused by opiate addiction.
2. Buprenorphine is a safe medication with a low risk of overdose and very few side effects.
3. Buprenorphine can be prescribed by a personal physician in their office and allows patients to recieve up to 30 days of medication at a time once they are stable.
4. Buprenorphine can be prescribed for young people with shorter histories of opiate addiction allowing intervention early in the addictive cycle.
5. Buprenorphine is regulated differently from methadone, making it more like other prescription drugs. This allows the person to more easily adapt the medication into his or her lifestyle and reduces the negative attitudes often associated with methadone.

Five Important Questions To Ask Your Replacement Therapy Doctor

1. What are the risk and benefits to me of methadone and buprenorphine and how will you know if one of these medications is the best one for me?
2. What are your program rules for continuation in treatment if I should relapse or be unable to stop my drug use?
3. Will I have input into my treatment plan that addresses my needs as an individual?
4. What happens if I become unable to pay for treatment?
5. Do you have referral relationships with specialty care providers if I need treatment for HIV, Hepatitis C or become pregnant?

© 2007 Home Box Office, Inc. All Rights Reserved.

I have received many calls from frustrated patients unable to taper off their replacement therapy.  Many of you have contacted us wanting  more information concerning it.  Personally, I don't like the word replacement therapy, I prefer pharmacotherapy but I wasn't consulted. (Ha!) Seriously, I remembered the above article and thought it would serve a two-fold purpose.  I am asking all of you to take the time and read through it carefully and if you still have questions, we will be happy to discuss them with you.  

You will need support from your family and friends.  I'm not saying it can't be done alone but I believe you have a better chance of succeeding if you have a support system.  We realize all of you may not have a family and access to a lot of friends therefore we have made our help available to you.  We don't want you to feel as if you are a bother.  We are advocates.  We chose to be here for you. We want you to take advantage of the help we offer and allow us to be there for you.     

If you really must withdraw from methadone, it is best to do so very slowly. You should not withdraw from more than 10% of your dose per week at doses over 100 mg. That is, if you are on 150 mg, you could probably safely lower your dose to 135 mg. Once you get down to doses under 100 mg, you probably won't want to drop more than 2 mg per week until you get down to 50 mg. Then I would say you should drop only 1 mg per week or 2 mg every other week. Of course, not everyone is the same, and some people can drop more quickly. Others might not be able to drop this fast.

And by all means, if you put yourself on a schedule but find that you don't feel well, stop dropping and stabilize until you feel better. You may even want to go up a few milligrams until your body adjusts. Don't decide that you want to be completely off methadone by the next season coming up because your body might not listen to you. It might tell you that you shouldn't be completely off until next year--or the year after. Before you even attempt to withdraw, ask yourself why you want to do so. If it is because your counselor or your parents or your significant other wants you to, forget it. You won't be successful.

You must be the one who wants it, and you need to have all your affairs in order. That means you need to be working or doing something that you like to do, your finances should be in order, and you shouldn't have any issues you haven't dealt with. If you are ill or under stress, you absolutely do not want to try to withdraw at this time.

Until Next Month...Stay Clean! If you need us at 770.527.9119 anytime, day or night. Next month, I will include some tables for tapering off Suboxone and much more valuable information. Knowledge is Power.

Happy Father's Day! Forgive yourself and let go of all the guilt and shame. You can't move on with your life until you forgive yourself.   

Happy Father's Day!

 Deborah Shrira,Editor                                   July 2009