Posts Tagged ‘hazelden to use buprenorphine’

Hazelden Advances into the Twenty-First Century

In last week’s edition of Alcohol and Drug Abuse Weekly, I read that Hazelden’s addiction treatment center now plans to add medications to the treatment they provide for opioid addicts. Presently an abstinence-based, 12-step recovery center, Hazelden plans to have three treatment tracks available for opioid addicts: one offering buprenorphine (Suboxone), one offering naltrexone, and the traditional non-medication program that is now provided.

Better late than never.

Naltrexone, as an opioid block, isn’t controversial, since it is an opioid antagonist and therefore gives no opioid sensation. However, it will block any other opioid from acting on the brain. I call naltrexone the “anti-opioid.” It’s useful as an insurance policy for opioid addicts because if they relapse while on it, they won’t feel any opioid effect. For patients struggling with opioid withdrawal, this medication will not help, and in fact may make their withdrawal worse. Frankly, I thought Hazelden was already using naltrexone.

Their chief medical officer, Dr. Marvin Seppala, said Hazelden decided to use medications to treat opioid addiction in response to the public health crisis of opioid overdose deaths. Now more common than fatalities in car crashes, Hazelden feels opioid overdose deaths, “Demand up-to-date, evidence-based treatment protocols that offer the brightest promise of recovery.”

He says using the buprenorphine will help stabilize patients so that they can better engage in counseling and 12-step recovery. He says the patients will be watched and monitored closely, and will be in outpatient treatment settings while they are on buprenorphine. He also says, “Ultimately, we’ll have people come off these medications.”

I have mixed feelings when I learned all of this.

Predominately, I feel happy and relieved. Finally, a respected big-name, 12-step abstinence based treatment center is going to use medication that’s been proven to prevent overdose deaths. Hazelden is taking a huge step by moving away even a little bit their anti-medication dogma. Hopefully their action will influence the rest of the treatment field that has so far rejected medication-assisted treatment for opioid addicts.

True, Hazelden’s press statement said they didn’t look at buprenorphine as a long-term solution, and set complete abstinence as the goal for opioid addicts, but it is movement movement in the right direction. They should be praised.

On the other hand…the cynic in me raised an eyebrow as I read the article. Really? Up-to-date??  I think not. Suboxone, approved in 2002, was available as of 2003. That’s nearly ten years ago. How many addicts have died because of the addiction treatment establishment’s anti-medication biases, which prevented them from endorsing buprenorphine as a viable option in a timely fashion?

I have buprenorphine (Suboxone) patients who say they wouldn’t be alive if not for this medication. Many of these folks cycled in and out of 28-day treatment programs, good ones, but that path didn’t work for them. Most weren’t told about buprenorphine as a treatment option by these addiction treatment programs. Most learned about buprenorphine from other addicts. That’s sad, and unprofessional.

Change is hard. Once an abstinence-only treatment provider myself, I know how hard it is to take a step back, and say wait a minute…here’s some real proof that this new method may be better, though it goes against my present mindset. But if doctors and other professionals treating addiction want to be taken seriously, we have to constantly re-evaluate what we are doing, to see if we are up-to-date with best practices. We must keep an open mind and a willingness to change. That’s important in all of medicine, but especially true for addiction medicine, where things change rapidly.

After all, isn’t an open mind and a willingness to change what we ask of our patients?

Kudos to Hazelden for taking a step forward.

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