There may be widely recommended medicines for treating opioid addiction, but one-third of primary care physicians believe the treatments are no more effective or safe than other approaches, such as counseling or a 12-step recovery program, according to a new survey.
Of three treatments that are approved by the Food and Drug Administration for combating what is known clinically as opioid use disorder, just 7.6% of physicians reported prescribing buprenorphine and only 4% prescribed injectable naltrexone. (A third medicine, methadone, can be only dispensed for treating addiction as part of specialty treatment programs).
Moreover, a mere 20% of the primary care physicians expressed interest in treating patients with opioid use disorder, according to the survey of 336 primary care physicians, which was published Monday in the Annals of Internal Medicine. Yet previous studies have indicated the drugs are effective, leading the National Academies of Sciences, Engineering, and Medicine to endorse their use in a report last year.
I had a roommate who became addicted to heroin while in high school. He went to various rehab programs, and at age 25 was attending regular Alcoholics Anonymous (A.A.) in effort to stay clean of heroin. One of the major points he wanted me to know about his past experiences was to avoid taking Suboxone (Buprenorphine / Naloxone). He said it was a HORRIBLE drug and that the withdrawal from Suboxone was 10x worse than the withdrawal from heroin. I will never forget that conversation with my old roommate.
The bottom of page 37 in the report that you reference, “Medications for Opioid Use Disorder Save Lives”, states that “buprenorphine’s withdrawal syndrome may be less severe” than methadone or heroin withdrawal; but I have to take such strong issue with that statement based on my friends anecdote.
The report later goes on to say roughly that particular drugs and drug doses are more, or less, suited for different types of people and that more research/focus needed to go into this area. I agree with this point and think that pharmacology can have its place in drug abuse treatment. However, high standards in this area should be in place to prevent people from transferring one addiction (heroin) to another addiction (buprenorphine / nalaxone). I do not blame primary care physicians or other medical providers for not being comfortable with prescribing addictive drugs like suboxone. Especially not after the same or similar drug companies recommended PCPs to overprescribe opioids, which is what originally introduced that person to the effects of opioids.
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