As much time as we spend talking about the origins of the opioid crisis, pointing fingers and assigning blame and discussing disease versus choice, if there’s one thing that most experts can agree on, it’s that a solution is within our grasp. Not a cure or a complete eradication of addiction, certainly, but an approach that can at least take a serious stab at it. There are approved methods of combating addiction: medication-assisted treatment, behavioral counseling, motivational techniques – all things that we know work, but for one reason or another haven’t been made available to everyone. In particular, the medication buprenorphine, or Suboxone, has been proven to fight withdrawal symptoms and cravings for people with opioid addictions. Unfortunately, According to a 2016 report by the surgeon general, only 10 percent of people in the U.S. with a substance use disorder get treatment, and fewer than half of treatment facilities offer opioid addiction medications.
The United States is hardly the first country to deal with these problems. France had its own heroin epidemic in the 1980s and ’90s, and it responded by expanding access to buprenorphine. In 1995, France made it possible for any doctor to prescribe buprenorphine without any special licensing or training. In contrast, in the United States, physicians must take an eight-hour training course – 24 hours for physician assistants and nurse practitioners – before they can prescribe it. There are also limits to how many prescriptions they are allowed per year.
Back to France – with this change in policy, suddenly the majority of buprenorphine subscribers were primary care physicians, rather than addiction specialists, meaning the medication was much more accessible. 10 times as many patients were able to receive medication-assisted treatment, and within four years, overdose deaths had declined by 79 percent. France also established a needle exchange program at the same time, which might account for some of the improvement.
The training is one hurdle to widespread buprenorphine prescription in this country. Another is that some doctors simply don’t want their practices to be overrun by patients with addiction. Cost is a factor, too, as many insurance companies don’t want to pay for addiction treatment. A large part of the problem is the stigma associated with addiction medication. Many people view it as simply replacing one addiction for another. While it is true that some people abuse buprenorphine, it’s still considerably safer than heroin or other opioids. It allows people to begin trying to get their lives together, dulling some of the worst side effects without providing more of its own.
Of course, there are other solutions, such as increasing access to overdose reversal medications such as naloxone and cutting back on opioid prescriptions, but it seems clear that we as a country need to take a serious look at our biases and our policy and consider following France’s example.
If you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504 to get started.
