CINCINNATI - What if there was a magic pill that could eliminate all the cravings of heroin and oxycodone addicts without making them high?
There is such a drug. It's called Suboxone, and it has become the standard of care in medically-assisted recovery.
Suboxone does everything you would want such a medication to do:
- Eliminates withdrawal symptoms
- Doesn't make addicts high
- Prevents over-dose
- Blocks drugs of abuse
"If you slip, and go out and use an opiate of abuse it has no effect whatsoever. None. They don't get high, they don't get side effects, it's like they never did it," said Dr. Todd Carran of Milford's Northland Treatment Center.
Dr. Carran has no doubt Suboxone is saving lives, in part because of the "ceiling effect" that prevents overdose.
"It doesn't matter how much you take -- you can't get past the ceiling effect," Dr. Carran said. "So you could take 200 bottles of buprenorphine -- you're not going to get high. You're also not going to die."
Buprenorphine is the key ingredient of Suboxone. The other component is naloxone, added to prevent injection abuse.
Buprenorphine is a prescription painkiller manufactured by the British pharmaceutical giant Reckitt Benckiser (read a statement from the company at http://goo.gl/6m3Zz ). There is a generic version of buprenorphine made in Columbus, but Reckitt Benckiser is still the primary producer of the drug, and the only company combining it with naloxone to make Suboxone.
The drug was approved for the treatment of opiate addiction in the United States about a decade ago. It is quickly replacing methadone as the preferred medication to treat addiction. Methadone is a liquid opiate dispensed in a clinic, and it can get patients high.
Suboxone is a pill or a gel strip the patient can take at home, with no opiate-like side effects. It acts like an inoculation against heroin and oxycontin, because it blocks those drugs from having any effect.
You may not have heard of Suboxone or buprenorphine before, but you're paying for it with your tax dollars.
Ohio's Medicaid program, administered by the Ohio Department of Job and Family Services, paid $21,400,000 to pharmacies last year for Suboxone prescriptions. That tax money kept more than 9,000 addicts medicated.
But one doctor on the Ohio Medicaid drug approval board called buprenorphine, "one of the fastest-growing street drugs."
The Drug Enforcement Administration has labeled it, "a heroin substitute," and, "a primary drug of abuse."
While an addict can't overdose on buprenorphine alone, it can be deadly if taken with benzodiazepines or alcohol. The DEA reported 14,266 emergency room visits linked to buprenorphine in 2009.
Most health insurance companies also cover the drug, which costs between $13 and $20 per daily dose.
That coverage is helping an Eastgate-area addict named Elaine with her recovery.
"With Suboxone, I don't get high at all," she said. "My life is gradually getting better and better, and I'm doing all the things I couldn't do before."
Elaine's heroin addiction had devastated her life. But with a single strip of Suboxone under her tongue each morning, she has been able to return to an otherwise-normal life.
"In the morning when I take my Suboxone, I know that I'll be OK for today," she said. That has allowed her to seek traditional peer-to-peer treatment as well.
Elaine's daily dose of Suboxone is enough to prevent withdrawal symptoms -- and block heroin from working -- for up to three days.
"If I did want to go get high, it wouldn't do anything," she said.
But some addicts say the withdrawal from the cure is worse than that from the disease.
"Suboxone is a long, drawn-out withdrawal process," a recovering addict named Chris said.
The 22-year-old is now rebuilding his life in a 12-step recovery program. Recalling his darkest days, Chris said the only cure for his Suboxone withdrawal symptoms was heroin.
"As soon as I was taken off Suboxone, I immediately went back to my drug of choice," Chris said.
Chris told us he bought Suboxone off the street long before he was ever prescribed it as a treatment medication.
Why would an addict buy a drug that won't get him high? Because it prevents the withdrawal pains during the days between unreliable hits of heroin or oxy.
"If something that is a miracle drug that is going to help people has a street value, it contradicts itself, and I lived that first-hand," Chris said.
Chris got his eventual prescription for Suboxone from a doctor, not a treatment facility.
Doctors are required to get special training and a permit to write buprenorphine prescriptions, and they're limited to 100 patients each. Prescriptions must be renewed monthly, requiring a $150 - $250 office visit which may or may not include counseling.
Next page: Suboxone here in the Tri-State.