For Painkiller Addicts, Suboxone Means Freedom, Dependence

By ABC News

Nov 8, 2011 7:00am

ABC News’ Dr. Mirjana Jojic reports:

The first-ever large-scale study to look at treatment options for prescription painkiller addiction has shown that these treatments – much like painkillers themselves – can be a double-edged sword.

The psychological effects of painkillers are one of the reasons 5.3 million American abuse them, according the National Institute on Drug Abuse. Researchers at McLean Hospital, a Harvard Medical School affiliate, conducted the first large-scale study to look at treatment options for this growing problem.

“What made this study different was the population,” said Dr. Roger Weiss, lead author and chief of the division of alcohol and drug abuse at McLean Hospital. “This is the first study that focused exclusively on people dependent on prescription opioids, not heroin.”

Tooth extractions, chronic pain, illness and other painful surgical procedures are the major reasons Americans are prescribed painkillers. These medications, branded Percocet or Vicodin, are classified as opiates, and in addition to pain relief, they can produce the same feelings of euphoria and relaxation as heroin does.

The study took 650 people addicted to prescription pain medications and treated them with buprenorphine and nalaxone. This combination, marketed together under the trade name Suboxone, safely mimics some of the effects of opioids, while reducing drug cravings, helping to control withdrawal and preventing the same “high” if patients were to abuse opioids while on Suboxone.

Half of the study participants were also given intensive individual addiction counseling. Over the 12-week trial period, 49 percent of participants had success with Suboxone in that they were able to maintain sobriety for a large portion of the study, regardless of counseling.

“This was an ideal population to treat – short history of opiate use, high employment rate and most [people] had never sought help, so they weren’t dealing with many failed attempts,” said Weiss of the success of Suboxone.

However, despite their initial improvement, when participants were weaned off Suboxone, 90 percent went back to using prescription pain medications.

Weiss and colleagues concluded that Suboxone was effective in reducing prescription drug abuse in the short-term and could be safely administered to patients in an outpatient setting with relatively short weekly medication management visits. However, the likelihood that participants would relapse on pain killers if they stopped Suboxone was extremely high.

“This study is a cautionary tale,” Weiss advised, and stressed that future studies should focus on how long people should take Suboxone to increase their chances of staying sober.

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