WEEK 9 discussion 1 responses to two colleagues SOCW 6443 Read a selection of your colleagues’ postings. Respond by Day 5 to of your colleagues’ posts by: The two colleagues post I chose are posted with this Extending your colleague’s Discussion with additional support for the stance Offering a different psychotropic drug treatment than your colleague and supporting its use with evidence Refuting the use of the selected medication and providing evidence to support your stance from the Learning Resources and other scholarly sources RE: Discussion 1 – Week 9 A medication that is used in the treatment of substance abuse is buprenorphine, also known as suboxone. Buprenorphine is used for the treatment of individuals dependent on opiods. The abuse of opioids, such as prescription medications, has risen greatly over the years. Opioid abuse leads to overdose, human immunodeficiency virus, and hepatitis (Welsh & Valadez-Meltzer, 2005). Buprenorphine works by blocking opioids, reducing effects such as withdrawal and cravings. When used with opioids, this medication prevents opioids from binding, reducing the effects that individuals would seek in using opiods (Velander, 2018). In individuals with opioid use disorder, individuals who were using buprenorphine had a retention rate of 75% as well as having a negative drug urinalysis of 75% as well, indicating the positive benefits of buprenorphine. Buprenorphine has also shown to reduce mortality rates, and result in individuals being sober and employed after 18 months (Velander, 2018) However, buprenorphone has side effects. These side effects include hypotension, a lower seizure threshold, vomiting, dizziness, headache, and sweating for example (Kumar, Viswanath, & Saadabadi, 2020). The controversy that surrounds buprenorphine is the idea that it is just a substitution for drugs with another drug. Considering that individuals may have to remain on this drug for years, or even indefinitely, there is a misconception that individuals are simply taking a drug that is legal. Buprenorphone itself can also be abused, as it does still have some addictive potential, although it is mild. This can be abused by crushing the pill and snorting the powder or using it intravenously. However, this can be addressed if prescribed in a formula where it can only be taken sublingually (Kumar, Viswanath, & Saadabadi, 2020). Buprenorphine is not only beneficial for opioid use disorder, but for other issues such as hepatitis C and HIV. Velander (2018) states “Suboxone would likely be more widely accepted as a medication if analogous treatments were available for other addictions. However, no partial-agonist treatment or similarly effective medication is available for alcohol or cocaine use disorders” (p. 25). Perhaps over time, the stigma that surrounds using the use of a medication to treat substance abuse disorders can decrease over time. Additionally, with more research, other treatment options that do not require the use of long-term, or even for life, medications can be discovered. References: Kumar R, Viswanath O, Saadabadi A. Buprenorphine. [Updated 2020 May 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459126/ Velander J. R. (2018). Suboxone: Rationale, Science, Misconceptions. The Ochsner journal, 18(1), 23–29. Welsh, C., & Valadez-Meltzer, A. (2005). Buprenorphine: a (relatively) new treatment for opioid dependence. Psychiatry (Edgmont (Pa. : Township)), 2(12), 29–39. RE: Discussion 1 – Week 9 Methadone Use in Treatment (MAT) for Opiate Dependence Methadone is one of the most widely used drugs in Medication-Assisted Treatment (MAT) for opiate dependence. However, the use of Methadone is perceived as giving drugs to drug addicts. This perception is driven by the increased number of deaths, emergency department visits, and increased economic costs related to prescription of opioid use and overdose. Between 1999 and 2010, the use of MATs such as Methadone has been associated with more than 16,561 overdose deaths, which is way higher than 3036 deaths implicated in the use of heroin (Volkow et al., 2014). Additionally, in 2007, MATs overdose cost the healthcare system an estimated $72.5 billion in terms of substance-abuse treatment admissions (Volkow et al., 2014). These figures have exacerbated the misguided belief that the use of Methadone is equivalent to merely replacing an addiction with another addiction. Contrary to this misguided belief, Methadone is proven to be effective in promoting recovery in patients with opiate addiction. However, proper prescription and monitoring are required to ensure Methadone’s effectiveness in reducing the risk of overdose (Lichtblau, 2011; Volkow et al., 2014). Methadone use does not only promote patient retention in treatment, but it also improves social functioning and lowers the risk of contracting infectious diseases through the avoidance of injectable drugs. Several barriers in the healthcare system have contributed to the underutilization and misuse of Methadone and the proliferation of the notion that the drug merely replaces an addiction with another. Lack of enough qualified prescribers has contributed significantly to the improper use of Methadone and its failure in treatment (Volkow et al., 2014). Besides, most health practitioners prefer the use of the abstinence model leading to the underutilization of Methadone and other MATs. Medicaid programs also act as a barrier to the effective utilization of Methadone through policies and regulations that limit dosages prescribed and promote the use of therapies first. The use of methadone in treatment for opiate dependence is not like giving drugs to individuals experiencing drug addiction. The negative impacts associated with methadone treatment are attributable to a lack of proper prescription and monitoring and underutilization due to barriers in the health care system (Preston et al., 2017). Methadone is effective in relieving narcotic craving, preventing withdrawal, and blocking the euphoric effects. References Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning. Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology for therapists (8th ed.). Oakland, CA: New Harbinger. Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014). Medication-assisted therapies—tackling the opioid-overdose epidemic. New England Journal of Medicine, 370(22), 2063-2066.
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