Which is best?

Most patients prefer the sublingual strips. While there are generic Suboxone tablets, the primary reason that patients were given prescriptions for the tablets was to save money compared to the cost of the brand Suboxone films. The Suboxone generic tablets tend to take longer to dissolve.

Suboxone brand patent rights recently expired opening the door for generic varations of the medication. This has leveled the pricing to about the same for strip or tablet. My opinion is that the strip, or film, is the better choice.

Originally published at Jacksonville Florida News

Dear Dr. Roach: Can you tell me the best way for a person to withdraw from Suboxone and how long it usually takes? My son was an opioid addict and has been on Suboxone films for four years for his recovery. He is now very gradually weaning off of it by reducing the amount he takes each week. This has been going on for months. His physician is overseeing it, and together they determine the percentage he is to reduce it by. I have since heard that this is a brutally painstaking way to do it — not that all of this hasn’t been brutal — and that he would be better off going to a hospital and going through the withdrawal there, in a much shorter time period. Also, I’ve read that four years is a terribly long time to be on Suboxone and that he never should have been on it for that long. Can you help to clarify? — Anon.

Answer: Suboxone is a combination of two medications that partially block the effect of opioids. It is an effective treatment for opioid withdrawal symptoms. However, it is not, by itself, a treatment for opioid dependency, and should be used as part of a comprehensive treatment. This is done by an expert in addiction medicine.

Suboxone can be used for short periods of time, say four to 12 weeks. I have seen patients on it for as long as a year, and have read that it may be used for longer, but four years is beyond my experience. However, that does not mean it may not be appropriate. Stopping opioids suddenly leads to withdrawal symptoms, while slow tapering generally prevents these bad symptoms. Too-rapid withdrawal may make relapse more likely.

Needle Exchange programs have not been immune to the impacts of corona virus. Discovering a article written by BlockClubChicago.com they describe the so called conditions and reality for addicts living and using on Chicago’ city streets. Here is a snippet from the articles introduction.

CHICAGO — The COVID-19 lockdown has reminded David Galorath how painful it can be to inject heroin with a dull needle.
“It sucks,” he said. “That hurts. It hurts your body.”
So in early April — with his supply of fresh syringes for his heroin use dwindling as needle exchange sites closed due to staff shortages — he attempted a dangerous do-it-yourself way to sharpen his old ones at home.
“A buddy of mine said, ‘You can do it on a nail file, one of those big ones,’” said the 41-year-old former waiter who said he perfected the technique through trial and error. “I started sharpening one, and that thing was like sandpaper.”

Government-funded needle exchange programs — such as the Community Outreach Intervention Projects’ storefront that serves Galorath — have cut services and closed exchange sites due to staff shortages and safety concerns as the virus sweeps the nation, so far killing more than 70,000 in the U.S.
In fact, the amount of needles exchanged by the Chicago program in March plummeted by more than 78% from the year before. It has left hundreds of high-risk users to fend for themselves — more likely to reuse or share needles and unable to get the help on which they have come to rely.
“Am I worried about it? Yeah,” Galorath said of the COVID-19 outbreak. “But I’m not like, overstressed because we’re all going to die of something, right?

“Hey, I’m a drug addict, dude.”

The article continues describing one aspect of a very complex and multi-dimensional subject of sourcing and sharpening needles including, how to use sandpaper to sharpen your old, contaminated needle for unsafe drug consumption. It’s not surprising there is so much uncertainty and misinformation surrounding community efforts to curb disease and infection outbreaks when you have journalism like this fine piece which you can continue reading here.

Have you ever gone to an emergency room or doctors office and seen the nurse sharpening the syringe before your flu shot? Never! Please, please do not do this! It is very dangerous, you could get tiny shards of metal in your heart or infections that will make you wish you were dead.

There are Walgreens and CVS on every corner of the city that sell 10 packs of syringes for $2-$3 please consider the cost over your drugs and the fact having an arm or leg amputated would cost alot more than the $3 you saved. Even this solution is a far cry from what I would call a “solution”, Americans are suffering, truly suffering from the vicious cycle of pain and addiction and there has to be a more informative guide than “sharpening your old contaminated needles”!

There is a better solution, that solution is seeking medical care immediately. Addicts end up in shelters, hospitals, jails, and morgues but they rarely end up in treatment getting the help they need. There is no quick fix to addiction but there are trained professionals who have helped 100s of people survive their battles. There ARE medications that can help addicts.

Medication Assisted Treatment has the highest success rate of stabilizing an individual and the lowest rate of relapse compared to alternative treatments. Patients being treated by a licensed medication addiction specialist can be prescribed Suboxone which will nearly eliminate the consequences of opiate withdrawals. Suboxone removes cravings, suppresses pain responses and prevents relapse by blocking the receptors that allow a person to get “high” off opiates. Suboxone treatment combined with some sort of human support system is going to offer a chance to rehabilitate in an otherwise hopeless situation.

There is no “one” fix to treating addiction. Similarly, there is no one treatment for high blood pressure or diabetes. However, there are certain “technologies” that work better than others. As a former 8-year heroin addict I can attest to the life saving capabilities of Suboxone and doctors like Dr. Kenji Oyasu. Suboxone allowed me to break the cycle of addiction, stabilize my life, discover a resemblance of normalcy and start the process of repairing everything I had destroyed. Each day gets better than the last. With approximately 40k people dying every year from opiate and synthetic opiates I consider myself one of the lucky ones.

Deep down inside, every addict desires to be free. No one wants to be addicted to anything, no one wants to be unhealthy, in pain, lost, depressed, anxious, unable to take care oneself, nobody wants to die slumped over in a gas station bathroom. Our friends, our family, our fellow neighbors quietly battling addiction are losing their lives in every town and city. We are a culture of technology and should look to new technology in medicine to solve problems of days past.

You may not know how to save your loved one or maybe you may not know how to save yourself but I know someone who does.

ModernMed Recovery 847-423-6800.

Tell them RJ sent you.