After taking office this year, Maine Gov. Janet Mills pledged to make the opioid epidemic a top and immediate priority for her administration. One of the governor’s pledges was to expand access to medication-assisted treatment, including Suboxone.
Suboxone is the brand name for a prescription medication used in treating those addicted to opioids. It contains two active ingredients, buprenorphine and naloxone. The medication blocks the opiate receptors, reduces a person’s withdrawal symptoms and calms the urges to use heroin or prescription opioids.
In recent years, Suboxone has become the preferred treatment for combating opioid addiction. It’s not perfect, but it’s one of the fastest ways we can reduce harm and open a pathway to recovery for those with opioid use disorder.
Mills recently followed through with supplemental spending to the state budget that removes time limits for Medicaid patients being treated for substance use disorders with medications, including Suboxone. The final two-year budget was just signed by the governor on Monday.
Maine will also get help from the federal government in the form of $2.3 million in additional funding to address the opioid problem in the state. The grant is largely aimed at expanding access to medication-assisted treatment options including Suboxone.
The problem of Suboxone being diverted
As more Suboxone is prescribed legitimately, more is also diverted to the secondary street market – until it isn’t. Once the medication is more easily accessible, there won’t be a reason for the widespread diversion.
I previously wrote about my personal experience with Suboxone and admitted that I had bought and sold the medication illicitly, but I think the issue of diversion deserves more attention. Suboxone being sold and used on the street is one of the most common objections I get when it comes to expanding access.
To arrive at this argument, you must first assume that because someone addicted to drugs would purchase Suboxone on the street, they are using it to get high. In my experience, this just isn’t the case.
For a period of more than a year, I had a legitimate prescription for Suboxone. Although I was forced to pay cash for the doctor’s visit, the medication was covered by my employer’s health plan. Without this coverage, it would have cost me hundreds of dollars more each month to fill my prescription.
For many months, I split my prescription with another user. Like me, he had previously misused opioids but was now solely using Suboxone to fight off withdrawals and gain some normalcy back in his life.
The only real difference in our treatment plans was that I purchased my medication from a doctor, and he purchased his from me. When it’s easier and faster to obtain Suboxone on the street than through a doctor, we know we have a serious access issue.
We shouldn’t care about diversion
When I first used the medication, I was amazed to find that something could completely take away my withdrawal symptoms within 15 minutes. I didn’t feel high; I felt normal for the first time in years.
Being so accustomed to living on the roller coaster between being high on heroin and sick in withdrawal, I had forgotten what it was like to just feel all right.
Suboxone’s effects are far less potent than those of heroin. It doesn’t make sense for a heroin user to seek it in order to get high.
It’s also nearly impossible to overdose on Suboxone. When we consider this fact alone, we should be encouraging its use if even only as a means to reduce harm and save lives.
Suboxone and medications like it are not what brought us to our current situation. It’s being used to – at the very least – reduce harm and risk of overdose. The alternative is using a potentially deadly substance like fentanyl.
Access to medication-assisted treatment has dramatically improved in recent years, but those with substance use disorder still often face obstacles when seeking treatment. Doctor’s appointments, waiting rooms, provider stigma, patient limits, government certificates and time limits can often be avoided with a quick text to a friend.
We need to focus on continuing to increase access so that those with substance use disorders don’t believe they are better off buying their Suboxone on the street.
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