“If somebody has a heroin dependence and they did not have the possibility to be offered methadone or Suboxone, then I think it’s a fairly tall order to try and get any success. There have been so many papers on this -- the impact of methadone and Suboxone. It’s not even controversial. It’s just a fact that this is the best way to wean people off an opioid addiction. It’s the standard of care.”
--Dr. Bankole Johnson, professor and chair of the Department
of Psychiatry at the University of Maryland School of Medicine
In other developed countries, the standard of care for opiate addiction is known as "medically assisted treatment." Under a doctor's supervision, people with addictive disorders are prescribed medications like methadone, buprenorphine and Suboxone, which remove the cravings associated with opiate addiction.
In the United States, by far the most common form of treatment is based around the concept of strict abstinence. Advocates of the abstinence model consider the use of Suboxone or methadone to be tantamount to using heroin itself.
(Ryan Grim and Ariel Edwards-Levy. "Science Be Damned: Americans Prefer Broken Method Of Heroin Treatment, Survey Finds." The Huffington Post. February 23, 2015)
According to the The HuffPost/YouGov poll, 50 percent of Americans chose the abstinence option, and just 19 percent favored the use of synthetic opiates. Another 32 percent were unsure. Forty percent of people said that synthetic drugs like Suboxone or methadone are more dangerous than helpful, because "it’s more important to get people off drugs entirely, even if that means recovery is more difficult."
The poll also found that most Americans are uneasy about the idea of having a clinic dispensing drugs nearby. Fifty-eight percent of respondents said they'd be somewhat or very uncomfortable with having a methadone clinic in their neighborhood, while just 26 percent said they'd be very or somewhat comfortable.
In a Perfect World
If the country were not in the grips of a destructive opiate epidemic, if people were not becoming addicted to opiates like heroin in alarming swells, and if people were not dying of opiate and opiate-related deaths in record numbers, strict abstinence may be the logical preference of treatment.
In times of overwhelming health hazards, we must respond with the most effective, most medically sound care. And, right now, that is medically assisted treatment with synthetic drugs. Saving lives becomes the bottom line as an epidemic rages. As difficult as it may be to acknowledge treating substance abuse with another substance, we have to act quickly to stop unnecessary deaths.
I think God can save an addict. I think abstinence can save an addict. And, I think even prison can save an addict.
In the vast majority of cases nothing but medically assisted treatment can save opiate addicts. The value of a single life saved with medically assisted treatment can only be measured in worth by the value of that life to his or her loved ones. I know many of these loved ones who thank God for methadone, buprenorphine and Suboxone, and I know many others who lost a precious family member before medically assisted treatment could be effected.
Ask yourself ...
"If my loved one could be saved from certain death by medically assisted treatment, would I want to put that person on methadone, buprenorphine, or Suboxone?"
That, unfortunately, is the only pertinent question for many in the real world in which we live. Until we find another method of treatment that is more effective and less invasive -- physically and morally-- than using these substances, we must save lives and trust that each life saved will find a productive future. I truly believe this is God's will.