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(Archive April 2016) Letters to the Editor: Drug Replacement Therapy

Dear Editor,

Drug Replacement Therapy is an unrealistic aspect of treatment for addicts seeking recovery. One very important aspect is considering how dosage is acquired for each individual.  The means in which dosage is considered is based on a few simple questions. Answers to questions such as: number of years addicted, type and amount of opioids used, frequency of use, method of use, and health state, are considered factors for clinicians to determine proper dosage. A primary concern with these questions is that they all point to the honesty of the client. 

This is a very concerning issue because being on drugs for drugs means the client can still overdose. Even if the medication is given legally they can be triggered by not enough or too much of the drug prescribed. To base treatment on factors that are results of an addict’s word, while using or in the detox process, is very irresponsible and therefore makes dosing an extremely difficult task. 

According to a an article published in 2014 in The American Journal on Addictions (Ferri, et al), when discussing results of relapse related to treatment of buprenorphine, states that in the period of 5 months 50% of patients had relapsed at least once with 23% never returning to treatment.  This statistic was based on a daily maintenance dose of 20mg. 

Another statistic from the same source states: “And third, that buprenorphine may not be the best agent for treatment of patients with severe opioid dependence who may require further mu-receptor stimulation beyond the ceiling effect of buprenorphine to alleviate cravings. This is contrary to what has been observed with methadone maintenance, namely that higher doses tend to be more effective in achieving retention and abstinence,” when referring to the three most likely factors in relapse. Once again proving that more factors need to be considered before administering a dose.

With all this, I encourage you to educate yourself and others on the legislature relating to addiction and possible options for recovery that do not include more drugs. Proper funding of more halfway houses and treatment facilities that do not condone drug replacements would be ideal and allow much more effective results. Get involved in the communities around you and help bring awareness to the support needed for programs that help people already and have been proven to work, but just don’t have the resources needed to extend their reach. Please do not shy away from the border-line malpractice concern of this drug replacement façade and instead, push towards a generation of healthy recovery through information centers, halfway houses, and twelve-step fellowships, etc.

Sincerely,
Kyle Cole

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