Opioid dependence, A.K.A. addiction to pain pills, kills thousands of young people in the US every year. Those who have read my columns on the topic at my blog, forum, or at my PsychCentral site probably have a good sense of my attitude toward Suboxone: While it would be wonderful if people could stop using opioids completely, in reality the relapse rate after treatment is over 90%. And frankly, not treating people with such a fatal condition is, in my opinion, a shameful way to practice medicine.
Suboxone has unique properties. People who are taking Suboxone as prescribed become tolerant to the effects of the medication, and within a week they look and feel completley normal. They are not ‘on’ anything, anymore than a person with hypertension is ‘on’ blood pressure medication. Although while medications for hypertension reduce the risk of cardiovascular disease to a varying degree, Suboxone has a more direct and constant effect, by blocking the effects of heroin or pain pills.
Some people will cite the several studies of physicians in residential treatment as proof that such treatment can work. The problem with that logic is that physicians’ situations are different from that of most people. Addicted physicians go through longer periods of residential treatment, for example; my own residential stay was longer than three months. After discharge, physicians are monitored by the board, including weekly or even twice-weekly random drug testing, for five years or more. Physicians are required to attend AA and psychotherapy group meetings for years, and their attendance and participation are monitored as well. Recovering physicians are not allowed to take psychoactive medications without prior approval from the board, including over-the-counter cold medications. Alcohol, of course, is off the table (literally). Any violation of the rules risks losing the medical license that was worked very hard for. In other words, residential treatment can work in certain situations— with intense monitoring, and when faced with the constant, real threat of losing everything. But most patients are not in such a position when they enter residential treatment, making a maintenance agent valuable, and often necessary.
There are regional shortages of doctors who will prescribe Suboxone. I assume that many doctors are busy enough to pass on taking an extra certification course, and some doctors may be turned away by the stigma associated with opening their offices to people struggling with addiction. At any rate, it can be very difficult to find a doctor, and that is why I created this directory. I will add updates as things change, and people are welcome to comment with the names of places I am missing. Use the directories to find a doctor near you. And before you go, check out the search button; it pulls blog posts and forum messages from people who have been or are in your shoes.