A recent Herald-Leader editorial supported using Suboxone (buprenorphine and naloxone) to treat opiate addiction. The editorial claims that with more taxpayer-funded Suboxone, opiate abuse and overdoses will decrease.
Unfortunately, recent history demonstrates otherwise.
Suboxone prescriptions are rising dramatically within Kentucky — from approximately 5.6 million doses in 2011 to 11.6 million doses last year. Statistics from the Cabinet for Health and Family Services reveal that Medicaid alone paid approximately $27.6 million for buprenorphine products last year in Kentucky. It was the No. 2 drug in Medicaid costs last year.
If more Suboxone equated with fewer overdose deaths and decreasing opiate dependence, we might have more to show for the nearly 34 million doses of Suboxone peddled within Kentucky since 2011.
Instead, opiate abuse abounds and our citizens continue to die.
Moreover, even though Suboxone is now widely available, it has not slowed the rising prevalence of opiate addicted babies. Hospitalizations for addicted newborns continue an alarming climb — from approximately 29 in 2000 to well over 700 in 2011. Nearly 824 addicted infant hospitalizations were identified in 2012.
The editorial also stated that if used as prescribed, "the substitute drugs enable users to function normally, hold a job, go to school, without the impairment and craving that drive abusers to crime and other risky acts."
Unfortunately, Suboxone is frequently abused. The real world is flooded with medication diverted from legitimate sources, long-term offenders who often test positive for Suboxone smuggled into jails, and hapless defendants who repeatedly report long-term opioid maintenance with no real path toward sobriety.
The Food and Drug Administration recognizes these risks and warns, "Buprenorphine, like morphine and other opioids, has the potential for being abused and is subject to criminal diversion." Moreover, the FDA also cautions that Suboxone "may impair the mental or physical abilities required for the performance of potentially dangerous tasks such as driving a car or operating machinery." Why? Because Suboxone is a narcotic.
The concern that Suboxone is frequently diverted is well founded. From July 2014 through April 2015 Kentucky administered 191,201 drug tests to criminal defendants in drug court. Of those, 2,695 were positive for the illegal use of Suboxone and methadone — the very same dangerously addictive drugs which the Herald-Leader suggests are currently insufficiently available.
Taxpayer costs of medically assisted treatment using Suboxone far exceed the costs of the drugs. Defendants using opiates such as Suboxone and methadone must undergo expensive drug testing to ensure the opiates are within therapeutic levels.
Cheaper stick tests are insufficient because such tests don't tell the court or probation officers whether the defendant is using the opiate as prescribed. Drug testing in Kentucky's drug courts currently ranges from a low of $127,000 up to $239,000 monthly, meaning laboratory testing of many hundreds or thousands of extra samples is not viable with current budget constraints.
Taxpayer funded intoxicating drugs are not the answer. Instead, we need restraint and non-addictive forms of medically assisted treatment, such as Vivitrol (naltrexone). Since Vivitrol does not produce a high and has no street value it is not diverted. Using Vivitrol will not prolong dependence because it is not an opioid. Coupled with counseling and drug testing, Vivitrol works without taxpayer supported prolonged addiction.
In a short time, my research and experience have convinced me that Vivitrol may be a much needed fit for some opiate addicts. Our families, neighbors and communities need a real alternative to addiction — whether that addiction is to street drugs or to the medication prescribed to treat such addiction. No one should be satisfied with maintaining addiction, no matter the drug.