- Posted by Alex Sweet
- On January 24, 2018
- 0 Comments
Like many individuals that I have spoken to in the past, I discovered I was completely ignorant and held a huge stigmatism toward harm reduction concepts. It wasn’t until after working in a harm reduction clinic for 3 years that I had a true understanding, and realized I was very wrong in my ways of thinking.
Methadone was introduced as a harm reduction concept for opioid withdrawal, originally aimed to help decrease the criminal acts that can be performed by people with opioid use disorder in desperation to get their next fix, avoiding withdrawal. When speaking with people with opioid use disorder, it has been reported over and over to me that the withdrawals are so intense, extreme pain and discomfort, mental and emotional misery; vomiting, shakes, sweats, restless legs leading to insomnia, Quote: “Flu like symptoms times 10”. Now take a moment to consider what you would do in that state, it is my belief that a good portion of us would do just about anything to stop or ease the symptoms – look at how many of us use over the counter products when we are ill to ease some of the aches, pains and discomfort we feel- now times that feeling by 10!
As we begin to understand what withdrawal symptoms feel like, we may now begin to understand the acts of desperation; hence Methadone as a harm reduction medication.
Methadone is an agonist that works on the opioid receptors in the brain, used in both chronic pain management and in opioid addiction treatment. In short, it makes the receptors believe that you have taken the substance, however there is no euphoric feeling from taking methadone, just relief from the symptoms. This allows the individuals to continue with their day to day task and the ability to maintain a bit of normalcy in their lives. This alone has eliminated the need to search, steal, or even commit more aggressive acts to feel some relief from the grips of the intense withdrawal associated with opioid use.
Suboxone, (Buprenorphine-Partial agonist and Naloxone-antagonist) is another more recent harm reduction medication, it is only to be started under extreme withdrawal; affliction of precipitated withdrawals (a sudden onset of withdrawal symptoms) are largely the concern when starting a client on Suboxone.
Both medications are used successfully in the treatment of opioid dependency and can effectively be used to titrate a client’s dose, until complete abstinence is achieved.
Due to the psychosocial component, physicians have taken up “Blind Dosing”, meaning that with the consent of the client, the patient slowly decreases the dosage of their prescription without any knowledge that they are being decreased, the intent is to eventually have the patient dose on “Tang” juice for 2 weeks, after which the client is then told they no longer need to be on the program, they have successfully graduated. It is up to the client at that time, if they chose, they are more then welcome to continue with the physician appts. for aftercare.
In conclusion, Methadone and Suboxone can be successfully used in the treatment of opioid dependency, however, like all treatments, it’s up to the client’s willingness to change and receive the treatment properly.