A study published a year ago by Dr. Michael Ferri and others evaluated potential for relapse by studying 62 patients receiving Suboxone treatment for opiate addiction. It may not seem like a very large sample to constitute a scientific study, and the researchers admit that continued study is recommended. But think about what this means for you: What are your chances of relapse? How will you know the signs?
Dr. Ferri chose patients receiving Suboxone treatment rather than methadone treatment because he believed that Suboxone treatment available in a doctor’s office provides a greater level of privacy than does methadone administered in a clinic setting. He also felt that individualized treatment plans are more often created in the setting of a doctor’s office.
What Is the Best Setting for Suboxone Treatment?
Whether or not that is actually true or if it’s just a prejudice of Dr. Ferri’s is up for debate. Keep in mind that many physicians pursue a license to write prescriptions for Suboxone simply because they see it as an additional revenue generator for the practice. When a doctor first becomes licensed to prescribe generic buprenorphine or its brand name equivalents, he can only treat 30 active patients at a given time, even if he has multiple practice locations. Once he reaches the one-year mark, he is permitted to maintain an active patient roster of up to 100 patients. Now think for a minute about what you pay for a visit to your Suboxone doctor: Consider how much money can be made if the doctor has 100 patients who pay that amount every week. If there are no expenditures for drug screens or counseling, the doctor has quite a lucrative payday.
Like anything there are always some people who do a good job and then there are some bad eggs that decide to limit their practice to Suboxone treatment without really caring about the patients. You can tell if you’re going to one of those doctors by the way you’re treated in his office.
The quality of a good medication maintenance therapy clinic that offers either methadone or Suboxone treatment proves itself by the efforts of the staff to interact with the patients they serve. Are the patients encouraged or even required to attend counseling sessions with the counselors? Can family members at some point participate in treatment? Are there special groups for women’s issues, for example, activities for the clients, or support group meetings available?
Description of the Research
Nevertheless, in Dr. Ferri’s study, the doctors performing the research were not themselves providing Suboxone treatment but accessed the electronic records of people who had been treated by other doctors. Ferri’s group used statistical ranking techniques to analyze those who had relapsed versus those who had not. Some of the conditions factored into play included refusal of the insurance to pay for Suboxone treatment, patients who took their Suboxone and also abused other drugs, and patients who suffered from emotional or mental health disorders in addition to their addiction. The researchers included patient ages and the length of their prior opiate abuse in the study.
Patient demographics showed 4 percent more males than females; half married and half not; 15 percent more had private insurance than public insurance such as Medicaid; 20 percent more were employed than unemployed; 15 percent more had a history of intravenous drug abuse, as opposed to just pills or snorting medication; 15 percent more had tried residential treatment unsuccessfully; and one-third of them had emotional or mental health disorders.
The single highest indicator that a person receiving Suboxone treatment might relapse was the person’s use of alcohol at the same time he was taking Suboxone. Following that, the patients who relapsed most often were taking a higher dose of Suboxone, 24 mg, as opposed to a lower dose of 16 mg or less. People who experienced difficulty with mental health disorders had the same risk of relapse.
What It Means
The doctors did not find that just taking a larger dose of Suboxone by itself indicated a high risk of relapse, but they did find a higher percentage of those people were also more likely to be abusing alcohol or benzodiazepines. The study also suggested that people with anxiety or depressive disorders might unintentionally seek to alleviate stress or fearful emotions by seeking to increase their doses of Suboxone. If that sounds like you, you may do better on methadone than Suboxone treatment.
These statistics are not an automatic guarantee of relapse for anyone who is in Suboxone treatment on a high dose or with a mental health disorder. However, if you know you are stressed out or depressed, you should accept your doctor’s recommendation to go into therapy, or talk openly with your counselor about your feelings if you haven’t already shared them. And if you’re taking Suboxone while continuing to use alcohol or other drugs, you should recognize that you are putting yourself at high risk of failure.
Part of your recovery is being open to suggestions and attending all your therapy sessions. Medication-assisted opiate treatment requires more than just a dose of medication. Suboxone treatment can work wonders for you. It can be the vehicle that transports you to a new and better life.
