We Speak Methadone (and buprenorphine)

A NAMA Recovery Forum for Medication Assisted Treatment patients, family and advocates. (Issues or Questions about registration and/or the forum? Email zac@tnmethadone.org OR sapphirematthews@gmail.com)
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 Post subject: Obama Administration Makes Big Announcement Addressing Heroi
PostPosted: Fri Sep 18, 2015 9:05 am 
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http://www.huffingtonpost.com/entry/oba ... e8b0ccf192

The Obama administration is hoping that reducing some of the barriers to Dr's prescribing Suboxone/Subutex to patients is going to help this heroin epidemic.

I personally don't feel it's a step far enough. We need lower clinics prices for people who's clinics don't accept insurance and who can't claim it back, and more government acceptance of MMT as an effective treatment option.

MMT has been considered the 'gold standard' of treatment for opioid addiction, so why are the government not reducing barriers to people's access to that?!

As we know, buprenorphine does not work for everyone, and people need to know there are other options out there. The administration (in fact every administration) seem unwilling to endorse MMT as a form of treatment, whether that's because they feel that might upset some more conservative voters, I don't know, but the mere fact that they are endorsing bupe and not methadone is yet again increasing the stigma surrounding methadone.

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 Post subject: Re: Obama Administration Makes Big Announcement Addressing H
PostPosted: Thu Sep 24, 2015 4:35 pm 
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The fact that the PRESIDENT is evening DISCUSSING MAT is a huge step... but we have to keep pushing. Overall I think things are headed in the right direction, though. But I'm with you. It's only METHADONE Maintenance Treatment that the National Institutes of Health has deemed the "gold standard treatment" and it's only METHADONE Maintenance Treatment that the Centers for Disease Control & Prevention (CDC) has said is the "most effective treatment" for opioid addiction.

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 Post subject: Re: Obama Administration Makes Big Announcement Addressing H
PostPosted: Fri Sep 25, 2015 6:03 am 
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Well, if even such lauded bodies as the CDC and NIH are saying that MMT is the 'gold standard' for opioid treatment, I would really wish that more people in charge would be pushing methadone as much as they are currently pushing bupe.

Perhaps it's because the public don't really know what bupe is, and the fact that the pharma companies say that it 'blocks' use of opiates makes them think it's superior to methadone, which we all know is a marketing gimmick, and doesn't really have a grain of truth in it.

Bupe has it's place, as many people do very well in BMT, but methadone remains the most effective treatment and should be advertised as widely as possible, and endorsed by the government at state and federal level.

With the heroin epidemic that's currently underway, this drastically needs to happen, as lives need to be saved!!!

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 Post subject: Re: Obama Administration Makes Big Announcement Addressing H
PostPosted: Wed Sep 30, 2015 12:05 pm 
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You're right, and you make valid points. My concern with lifting or raising the buprenorphine prescribing cap is numerous... there just aren't any regulatory requirements in place right now to stop bad docs from becoming "buprenorphine mills." Things like drug testing, referring to counseling, etc. are all "recommendations" right now for Bupe doctors... and "recommendations" are optional. I saw a Bupe doc in Savannah, TN that meets "patients" in church parking lots... writes each and every patients a Rx for 3 8mg Suboxone OUT OF HIS TRUNK... no drug testing, no referrals to counseling, NOTHING... and he can LEGALLY do that for up to 100 patients. So until we make these basic "recommendations" actual REQUIREMENTS I'm afraid we'll do more harm than good and great more and more stigma around buprenorphine. Imagine if that doc in Savannah, TN could do that for an UNLIMITED number of patients?! Or even for 300 patients?! So I agree we need to expand access, but NOT until we make the "recommendations" (things all the good doctors are already doing) actual REQUIREMENTS under the law. AATOD spoke to this some in one of their recent policy papers as well: http://www.aatod.org/policies/policy-statements/increasing-access-to-medication-to-treat-opioid-addiction-increasing-access-for-the-treatment-of-opioid-addiction-with-medications/

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Comprehensive Opioid Treatment Programs
Program Director | Counseling Solutions Treatment Centers - Chatsworth


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 Post subject: Re: Obama Administration Makes Big Announcement Addressing H
PostPosted: Fri Oct 02, 2015 7:07 am 
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As regards the Bupe cap, I really do agree with you on that. If Dr's have too many patients, they just can't possibly hope to give them all the care and attention that they need. It's all very well for people that are stable and just need to get a script, but for those that need more attention and are not stable, it could be quite dangerous.

People seem to have the erroneous opinion that bupe is pretty harmless compared to methadone, when in fact it's still a strong analgesic in it's own right. Part of the fault lies with the drug companies and the way that they've marketed Suboxone/Subutex, and partly with some drug treatment professionals, who, possibly because they're getting incentives from pharmaceutical companies, are promoting bupe over methadone.

In some states, the incidences of child ingestion of bupe outweighs the ingestions rates of methadone hugely, yet we only hear about the methadone ones in the media, another example of the bias against methadone.

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 Post subject: Re: Obama Administration Makes Big Announcement Addressing H
PostPosted: Thu Oct 08, 2015 8:32 pm 
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Unfortunately almost all the talk about "expanding access" is talking almost solely about raising/lifting the buprenorphine prescribing cap. There's a lot of really good sounding language out there being used and being preached that is ultimately behind some ideas that aren't so great.

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Zac Talbott, CMA
Email | zac@tnmethadone.org

Chief Operating Officer | Counseling Solutions Treatment Centers
Comprehensive Opioid Treatment Programs
Program Director | Counseling Solutions Treatment Centers - Chatsworth


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 Post subject: Re: Obama Administration Makes Big Announcement Addressing H
PostPosted: Fri Oct 09, 2015 8:19 am 
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Ugh, not so good then. I am of a mind with you as regards that, I'm just not sure that it's the best move forward, and could actually hurt some people more than help them.

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