When someone like Dr. Marvin D. Seppala speaks up about addiction treatment, people listen. Living in a world in which the possibilities of success with Suboxone programs are questioned, it’s refreshing and promising to hear that Dr. Seppala, who once promoted only abstinence-based therapies, now gives his full support to the benefits of Suboxone or buprenorphine.
Dr. Seppala earned his medical doctor degree at the Mayo Medical School and completed his residency in psychiatry at the Mayo Clinic. His career has been devoted to the study and treatment of addiction, and he serves now as the Chief Medical Officer at the world-famous Hazelden Clinic in Rochester, Minnesota.
With the past success of abstinence-based therapies, Dr. Seppala was shocked by the increasing numbers of men and women falling victim to opioid addiction. He had always believed that getting straight without the help of medication was the only way to sobriety. But he opened his mind to change when he began supervising Suboxone programs and saw the astounding successes it yielded.
His decision to support Suboxone programs as a successful treatment method came about from witnessing the differences in two patient groups whose recovery he watched closely. At a satellite Hazelden clinic in Beaverton, Oregon, he supervised a group of patients taking Suboxone as they became sober and embraced their new lives. He also watched as another group in residential, abstinence-based therapy in the Rochester clinic completed their treatment, left Hazelden, and then relapsed.
He put aside his own prejudices against Suboxone programs and accepted that if it was working in the Oregon patients, it was necessary to try it at the residential clinic.
Cultural Objection to Suboxone Programs
As he tried to convert other professionals to his way of thinking, he wondered: How do you bring about organizational or cultural change? Seppala re-educated his staff so that they opened their minds and their hearts like he did to the idea that Suboxone programs constitute a viable treatment modality. They began accepting that Suboxone programs might be an alternative road to recovery, a way that would bring about lasting and comfortable sobriety in the lives of the people they were there to help.
He and the team realized that people who had to get straight without any help from medication could stay straight while they were in residential treatment—miserable and dreading the idea of going back out into the world. They stayed straight only because they had no alternative. But when they left the shelter of residential treatment, the pull of opiates led them right back to their addiction, using the same drugs in the same quantities as before their treatment.
But he felt there was much good in the recovery management techniques that they were already practicing, and he believed there was a way to combine the best of both programs. In fact, he realized that participation in group therapy and 12-step meetings could be the best way for clients to learn how to handle the stigma against Suboxone programs that existed a few years ago and continues today.
Three Opioid Treatment Medications
Today Seppala recognizes methadone, Suboxone or buprenorphine, and Vivitrol as three accepted forms of medication-assisted treatment, but his focus has been on Suboxone and Vivitrol. The Vivitrol actually prevents the brain from binding with any opioid that a person might ingest, whether they take it as a pill, snort it, or shoot it up. Seppala admitted his own high level of surprise in its undeniable success in the reduction of cravings and prevention of relapse.
Seppala cites the success at recovery that has been documented by published research, although he does worry that people will keep trying to abuse it and that they will also divert it. He identifies side effects as respiratory depression, especially for those who are also using alcohol or benzodiazepines. Someone can experience sleepiness or dizziness, and liver problems can also occur. Headaches, nausea, and sweating can happen while in a Suboxone program, especially in those who need dose adjustments.
Since his success with the Oregon clients back in 2009, right up to President Obama’s State of the Union address in January 2016, Seppala continues in his belief in and support of buprenorphine treatment for opioid addiction. And while Suboxone programs were initially promoted as a short-term form of medication-assisted treatment, he now believes that longer therapeutic treatment is necessary. As Christine Vestal in The Washington Post reports, people who remain in treatment for at least a year are twice as likely to maintain recovery as those who receive only short-term therapy.
Roadblocks for Suboxone Programs
Why don’t all addicts have access to a Suboxone program if Seppala and other addiction treatment specialists are correct in their beliefs? Seppala has identified these roadblocks to successful access to treatment:
- The stigma remains a roadblock. Too many people continue to believe that taking Suboxone or methadone to overcome a heroin or pain pill addiction is just immoral, that the person is simply substituting one addiction for another. They refuse to recognize what the experts have stated or accept that addiction is a disease that requires treatment just like hypertension, diabetes, or asthma. 12-Step Programs, in particular, have difficulty accepting medication-assisted treatment because of potential conflicts with their beliefs about recovery.
- The insurance companies continue to deny coverage for medication-assisted treatment as much as they can get away with. They won’t cover all three accepted medications, or they put limits on the length of time that someone can remain in treatment.
- Big companies that run residential treatment centers oppose medication-assisted treatment centers because they don’t want admissions at their facilities to drop.
Not enough physicians are sufficiently educated about the benefits of Suboxone programs. Once the education spreads to physicians not just at big university centers but even in small outlying private medical offices, more physicians may come to embrace Suboxone as a legitimate treatment option.
Many doctors who have learned about Suboxone programs continue to oppose it because they want the patients receiving it to participate in mandatory counseling and addiction education programs. If someone with an addiction doesn’t learn about the experiences that drove them to use opiates in the first place, they are unlikely to maintain long-term recovery.
Right now, the government requires medication-assisted treatment centers to offer counseling, but it does not mandate that clients must participate in that counseling. It’s up to the individual clinics to decide whether or not they will enforce mandatory attendance in counseling. But even when a client fails to show up for appointments, program staff are reluctant to drop them from their treatment rosters, because they know they are sending them back out into the world of addiction.
If you have had doubts about the success available through Suboxone programs, put those doubts aside and call your local Suboxone treatment provider for an appointment. Like Dr. Seppala, it’s time to open your hearts and open your minds, because Suboxone programs open up a whole new world of possibilities.