ScienceDaily recently did an article called Doctor’s Offices Can Help Stem Abuse Of Oxycontin, Other Narcotic Painkillers, summarized as, “a new study shows how doctor’s offices and clinics can identify patients who may be diverting or misusing narcotic painkillers such as OxyContin, and steer them to help, while preserving access to the drugs for patients who truly need them to control their pain.”

To me, this sounds like a really nice dream with a ton of potential for failure, lawsuits and a growing mistrust between doctors and patients. Doctors don’t want to go to jail for unwittingly helping someone sell their medication or abuse their prescriptions. On the other hand, people need to manage their pain and for every person who misuses the drugs they are prescribed, there is another one who has a legitimate need for the painkillers and still others who aren’t getting a dose high enough or a medication strong enough to handle their pain.

Do what did they come up with to better police the prescription drug situation? A “policy that logged and carefully screened all patients who were receiving the drugs for non-cancer pain,” as well as a contract of sorts between prescribing doctors and opioid painkiller receiving patients that both are required to sign. The study showed that 35 percent of the 167 patients that received opiates either turned in dirty drug tests that revealed the use of illegal street drugs or turned up on state prescription records showing that they were receiving multiple opiate prescriptions from various doctors simultaneously. Recipients of OxyContin or oxycodone were twice as likely to abuse their prescription as recipients of other opiate drugs.

The study author is Jennifer Meddings, MD. She says, “Many of us in the clinic were surprised at what we found, because a doctor’s job is first and foremost to trust the patient as they tell us about their pain, but in order to confront this issue and protect our ability to prescribe these drugs to the patients who truly need them, we need to have a uniform approach for all patients.”

If they can come up with a way to effectively help those who are abusing pain medication rather than simply turning them away, belittling them or reprimanding them, then this could be the beginning of something great. The threat of abuse from patients who are drug-seeking as well as legal repercussions for the prescription abuse of their patients are turning many young would-be doctors away from a field that is already severely lacking in qualified professionals. However, strict regulations can turn those who are legitimately in need of pain management to illegal sources for their medication, which only increases harm.

I don’t envy the position that the medical community is in. Anyone have any ideas on how to handle this problem?

There are a number of blogs out there written by women who are married to addicts, mothers of  junkies or otherwise connected (and deeply scarred by) someone else’s addiction. Among my favorites are The Junky’s Wife, Married to an Addict, Married to My Ex, and Mother to an Addict. Whether or not the writer is still married, suffering from codependency or her own addiction issues or living with multiple family members who are addicts and alcoholics, each of these blogs have one thing in common: they are honest. Each one expresses frustration, anger, betrayal, real love, confusion, the best intentions and the worst outcomes. In short, each one gives a very real portrayal of what it’s like to love someone who is married to addiction.

Even if the addict in your life is aware of their problem, open to treatment and even attempting treatment with methadone maintenance or a Suboxone detox, their troubles—and yours—are far from over. Relapses can and do still happen. These may be one-time slips or binges that last for days and they can be even more dangerous than maintaining a regular habit because the body’s tolerance is different than the addict remembers. Overdose in these situations is exceedingly common, especially for those who are addicted to opiates and prescription painkillers. Mixing drugs is always a dangerous thing in any context and for those who are on a maintenance or medical detox program, a relapse almost always means the introduction or re-introduction of a different drug or drugs into the system.

Feeling like a cop in your own home is never pleasant. Addiction usually comes with quite a bit of lying, even in the bold face of evidence supporting the opposite assertion and this can take quite a toll on any relationship. It’s difficult to rebuild trust, to constantly question whether or not someone is high when they say they’re tired or if that $20 you can’t find is merely lost in a jeans pocket somewhere or was stolen by your loved one. For the writers of these blogs, they handle these issues by blogging about it and find support through their readers, creating an online support group that’s available 24 hours a day.

Note: I’m aware of the fact that all of the blogs I picked out were written by women. I actually searched out similar blogs penned by men who love female addicts, but found none. Do they exist? Most likely. It certainly happens in life often enough. If anyone knows of any blogs in this category penned by men, by all means, let me know!

There seems to be a little confusion about the difference between the two “nal-xone” drugs, naltrexone and naloxone. Two very different drugs, the similar names are confusing but what makes it worse is the fact that both are related to the treatment of drug and alcohol abuse. Hopefully this will clear up the misconceptions.

Naltrexone

Naltrexone, like naloxone, is an antagonist that binds to opioid receptors and blocks the effects of opiates. However, naltrexone is used primarily in the treatment of alcohol addiction in an effort to reduce the craving to drink. Its generic name is naltrexone hydrochloride, but it’s sold under the brand names Revia and Depade. An extended release formula is also sold as Vivitrol.

After detox off of opiates or alcohol, naltrexone may be prescribed to help people stay off the sauce—in any form. It effectively blocks any opiates from binding to your opiate receptors so if you do try to get loaded while you’re taking it, it won’t work. You won’t get high at all. But for some reason, it’s rarely prescribed to people who suffer solely from opiate dependence but rather to those who need help fighting the urge to drink. With studies to back it up, it works well to prevent relapse and decrease the severity of relapse when it does occur. For those who need help with opiate addiction, a better medication is Suboxone, which combines buprenorphine and naloxone.

Naloxone

Sold under the brand name Narcan, naloxone is injected into a muscle when overdose on an opioid-based drug occurs. Whether you overdose on a prescription painkiller like Fentanyl, Vicodin, Dilaudid, Darvon or Darvocet, Norco or OxyContin or you overdose on a street drug like heroin or morphine, naloxone stops the overdose dead in its tracks (no pun intended).  It works by heading straight to the opiate receptors and knocking off any opiates that are there, which stops the respiratory depression they cause and the subsequent overdose. It doesn’t work for benzodiazepines like Valium, Xanax, Valium, or Klonopin, nor does it work for stimulants like methamphetamine and cocaine.

Naloxone stays active in the system, blocking opiates from binding to your opiate receptors for 30 minutes to 90 minutes. When it wears off, the opiates that caused the overdose are still in your system and their effects will kick in again and, possibly, slam you right back into an overdose. This brief reprieve, however, can be what you need to keep you from dying before you get emergency medical help.

A few things you should know:

- Naloxone won’t let you give a clean drug test.
- Naloxone is effective in fighting an overdose even if you hit a vein.
- Naloxone is ONLY meant to be delivered with a needle in the event that someone is dying.

Suboxone

If you are addicted to opiates and taking Suboxone to detox off of your drug of choice, then you are taking naloxone. Suboxone is a combination of buprenorphine and naloxone, and it comes in a pill that you take by dissolving it beneath your tongue. The naloxone remains dormant unless you should try to abuse the Suboxone by dissolving it in water and inject it. If you do this, the naloxone will kick in and prevent you from experiencing any of the relief that the buprenorphine provides for those trying to avoid withdrawal symptoms.

So hopefully that clears that up! Any questions?