The Opioid Epidemic's Cure

The opioid epidemic. One can not turn on the news, or go through the internet without coming across it. For many of us, the opioid epidemic is something that has affected someone that we know and love, and likely, ourselves. For many years, motor vehicle accidents were the #1 killer via injury to Americans; however, in the past few years, drug overdose deaths have far surpassed car accidents and guns as the runaway leader, with more than half of those due to opioid pain medications and heroin. The latest numbers suggest nearly 50,000 American die due to drug overdoses a year, and the CDC states that 91 Americans die daily due to opioid overdose. As of 2013, hydrocodone (Vicodin) was the #1 prescribed medicine to patients on Medicare. Think about that statement for a minute.

The path down the rabbit hole of addiction is terribly simple, and often starts as a result of injury or accident. A story from a recent patient (paraphrased a bit to ensure further confidentiality):

It started with going to the dentist due to my really bad teeth. He gave me a month's worth of Percocets because they hurt so much [over 35% of opioids are obtained from a prescriber]. I was supposed to take up to 3 a day. They made me feel good. He had no problems writing refills for me whenever I asked. Soon enough, 3 a day became 6, then 12, then up to 20. The DEA eventually shut down the dentist because he was writing scripts for everyone. So my supply got shut down. I started asking around, and found out my brother had a supply, and I ran through those soon enough [over 50% of illegally obtained opioids are from a friend or family member]. We both needed some, and we hardly had the money to buy them off the streets with a few weeks after selling everything that wasn't bolted down in the house. Next thing you know, my brother and I were doing heroin because it was cheaper and easier to get.

The above story is not uncommon. I have heard variations on it dozens of times. What is different about the opioid epidemic which separates it from most other substances is just how universal it is, especially on a socioeconomic level. This is not something that is happening in the inner cities. It is happening in the suburbs and the farms as well. It is actually targeting white Americans more so than any other racial group, contrary to popular opinion, killing whites at more than double the rate than blacks of Latinos. And with addiction comes a lot of loss. Loss of friends. Loss of job. Loss of car. Loss of family. Loss of self.

So what can be done to break the cycle? Abstinence is one answer; however, it has a terrible track record. Over 90% of people who decide to detox and go cold turkey relapse. These people are more than twice as likely to die from an accidental overdose compared to those who have not. Enter medication-assisted treatment. For the longest time, methadone was the answer. With methadone however, there are plenty of drawbacks. Getting into a clinic took months. Users needed to be directly observed by the clinician taking the methadone daily. And the stigma was overbearing and unwarranted.

Buprenorphine/naloxone (Suboxone) entered the picture in the early 2000s. Suboxone is a combination of two medications and works as a partial opioid agonist and an opioid blocker in one. What does that mean exactly? It means that Suboxone will fulfill the body's physical need for opioids caused by the addiction, will not give the opioid "high", and at the same time prevent misuse and abuse by precipitating withdrawals if someone attempts to crush it up and inject it. With Suboxone, it is a take home medication that can be filled at any pharmacy. Compared to abstinence's over 90% relapse rate, treatment with Suboxone has a nearly 90% recovery rate. So what's the issue with Suboxone? Access.

In order for a doctor to prescribe Suboxone, they must undergo specialized training specific for Suboxone, and obtain a specific waiver from the DEA. If they qualify, doctors are limited to prescribing to 30 patients for the first year, and 100 patients after that first year, again if they qualify. Only in specific cases can a doctor go up 275 patients. Put simply, there just are not enough providers to fill the need. Luckily for you, Dr. Mirza has met all of the above requirements and is a firm believer in the life changing medication-assisted treatment with Suboxone. He has worked with countless patients and seen dramatic and fulfilling recoveries from addiction. He is non-judgmental, understanding and compassionate, and will work with you in order to help you achieve the best version of you.