Let’s be clear, you do get high off of methadone and it is addictive. So, is methadone treatment just substituting one drug addiction for another? Does the Federal government authorize methadone use because the billion-dollar drug war is obviously failing and legalizing heroin/opiates is politically untenable? Should people who are addicted to opiates – whether they’re doctors, lawyers, teachers, construction workers, or unemployed, mentally ill, or criminally involved individuals – have the same choices for treatment? After years of inconclusive, and chair throwing debate, King County will increase the opportunities to use Suboxone (Buprenorphine) as an alternative choice to methadone for treatment of opiates.
King County funds the use of methadone for substance abuse treatment. It is even dispensed in our jails. The goal for treatment is that between 1-2 years of treatment people become stable enough to eliminate their need for daily Methadone. While some people are able to achieve this, many require ongoing opiate substitution therapy with methadone to remain stable in their recovery.
But an opportunity for change presented itself with King County’s adoption of a tenth of a percent increase in the local sales tax to increase the array of mental health and substance abuse services. In government jargon this funded a plan is known as the Mental Illness and Drug Dependency Action Plan (MIDD). We moved to adopt two new strategies that specifically identify Suboxone as a viable option for the treatment of clients with an opiate addiction.
Strategy No: 1a (2) – Increased Access to Substance Abuse Outpatient Services for People Not On Medicaid ”Funding will be increased to County contracted outpatient treatment agencies and OST programs to provide treatment services for low-income individuals from King County. Low-income individuals are defined as having income of 80% of the state median income or less, adjusted for family size. Specific service components include intensive outpatient treatment and outpatient treatment as well as daily doses of methadone or an alternate OST such as suboxone.”
Strategy No: 15a – Drug Court: Expansion and Enhancement of Recovery Support Services ”Access to suboxone treatment. A medication approved for the treatment of opiate dependence. Currently, opiate dependent clients receiving methadone must go to a limited number of Federally approved methadone treatment facilities. Opiate dependent clients can receive suboxone instead of methadone and receive services in traditional outpatient agencies and physician offices. This change will provide more patients the opportunity to access treatment.”
King County is also partnering with and supporting Harborview Medical Center. They applied for a grant proposal to the Substance Abuse Mental Health Services Administration (SAMHSA). King County and Harborview want to expand capacity and enhance services for non-methadone assisted treatment of opioid dependence in low-income and indigent patients. If funded, King County has committed significant matching funds to this project. Harborview Medical Center (HMC), proposes to expand their Suboxone assisted program by 45 slots to serve, over three years, a total of 225 low-income and indigent patients.
This project is intended as a pilot project and will enhance the coordination of multiple systems for this population. A Community Advisory Committee with representation from Washington State, King County, Harborview, and Suboxone program patients will be convened and guide the planning, implementation, and evaluation of the project to assure its sustainable integration into the wider addiction treatment system. Successful applicants of this grant will be notified later this fall.
As a friend of mine told me, the best addiction is each and every new day of sobriety.
- A Stepped Care Strategy Using Buprenorphine and Methadone Versus Conventional Methadone Maintenance in Heroin Dependence: A Randomized Controlled Trial, Psychiatry Online
- Is methadone too dangerous for opiate addiction? British Medical Journal
- After the Storm. Developments in Maintenance Treatment Policy and Practice in Sweden 1987–2006
- Related articles, Pub Med
- Related information, American Journal of Psychiatry