Opioid dependence is a national problem. There are some terrific resources to help you better understand your alternatives for treatment and recovery. Please look through some of selected documents and links below.
The federal government has set up an agency to address substance abuse issues generally, and opioid abuse specifically. Its called the Substance Abuse and Mental Health Services Agency (SAMHSA) and its website contains some helpful information. Below is a link to a brochure they developed for family and friends, some results from their latest surveys, and a new website they developed to help people better understand Medication Assisted Treatment.
The National Alliance of Advocates for Buprenorphine Treatment (NAABT) has a website with a lot of educational material to help understand opioid dependence and addiction. It also includes some excellent materials that help to explain how Suboxone and buprenorphine treatment works. Please see the links below to some of the key pages.
Naloxone (Narcan, Evzio) is a prescription medication that will reverse an overdose to opioids. The State of Maryland has been very aggressive at promoting the accessibility to naloxone. Please take a look at the Behavioral Health Administration's website to learn more about naloxone. Ask your MATClinic doctor for a prescription.
For those who are interested in more details and a peek behind the curtain of diagnosis and treatment, please feel free to explore some of the topics and sites below:
Opioid Use Disorder: Providers diagnose patients when they come in to MATClinics for their intake. Whether formally or informally, they will ask prospective patients questions in order to make a diagnosis. Those diagnosed with Opioid Use Disorder are good candidates for Medication Assisted Treatment. The American Psychiatric Association publishes a manual of psychiatric diagnoses, one of which is Opioid Use Disorder. Click here for a link to the underlying document that helps providers assess patients.
Who can prescribe buprenorphine? In order for health care providers to write prescriptions for buprenorphine based medications for the purpose of treating Opioid Use Disorder, they need to take special training courses that qualifies them for waivers from the DEA. For Doctors, the training is eight hours, for Nurse Practitioners and Physicians Assistants, the training is 24 hours. Typically that training is accomplished through online courses. There are a number of groups that provide waiver training including the American Academy of Addiction Psychiatry (AAAP), buppractice.com funded by the National Institute on Drug Abuse (NIDA), and the American Society of Addiction Medicine (ASAM). In addition, many addiction conferences offer live training courses, or partial live and online training. If you want some insight into the topics that are covered in these trainings, you can download an example of the first module here.
How can I see further behind the curtain? The Substance Abuse and Mental Health Services Administration (SAMHSA) has funded a website that provides resources and mentoring for buprenorphine prescribers, called the Providers' Clinical Support System for Medication Assisted Treatment, or PCSS-MAT. There is lots to explore and it will give you a good understanding of how the medical profession implements Medication Assisted Treatment. Here is a link to their podcasts, a link to webinars and specific buprenorphine training, a Frequently Asked Questions section, and a nice news summary of the latest in opioid addiction medical news.
Treatment Improvement Protocol: In February 2018 SAMHSA published Treatment Improvement Protocol 63, a comprehensive guide for medical providers about how to treat Opioid Use Disorder. Much of the information in the TIP can be found elsewhere, but it puts all of that information, research and guidance in one document. The intended audience is treatment providers, but patients and family members will find much of the information helpful. At the least, it might raise questions that you can discuss with your provider.
Co-occurring mental and substance use disorders: Approximately 45% of patients seeking substance use disorder treatment have also been diagnosed with a co-occurring mental health disorder (National Survey of Substance Abuse Treatment Services). This is sometimes called comorbidity and it is often difficult to tell cause from effect. Opioid abuse can bring about symptoms of other mental illnesses and mental illnesses can often lead to drug abuse (National Institute on Drug Abuse). In some patients, the severity of their mental illness may be beyond the expertise of MATClinics professional staff to address effectively. MATClinics have strong relationships with a wide range of mental health professional service providers and will work with patients to get them into behavioral health treatment environments best suited for their needs.
Genetic predisposition for Opioid Dependence: Over the last few years, there has been a lot of discussion around the links within families to opioid use and abuse. While there are indications that some people may inherit a genetic predisposition to addiction, the evidence is not quite as clear. Many genetic studies "of opioid use suggests significant heritability of drug use behavior, however the evidence from molecular genetic studies is inconclusive." (Genetics of Opioid Dependence: A Review of the Genetic Contribution to Opioid Dependence, 2014). The science will likely improve over time, but its important to remember that regardless of how you may find yourself abusing opioids, the need for a combination of medication and behavioral health support remains the same.