February 27, 2009
FOR IMMEDIATE RELEASE

EASING OPIATE RECOVERY DETOXIFICATION AND MAINTENANCE

Thom Montgomery, Ph.D. CADC

BUPRENORPHINE - The Advanced Advantage

Dedicated to using the latest in science based treatment approaches, Brookside Institute is one of the few clinics whose Medical Director is authorized to treat patients addicted to opiates with Buprenorphine as a detoxification assist: the advantages of Buprenorphine are many. A person may be safely engaged in the detoxification regimen while fully participating in the treatment program.

Among addictive drugs, opiate withdrawal has proven the most difficult. From the heroin addict to the new breed of prescription drug addict, the problems of withdrawal remain the same. For treatment professionals, therapists and doctors, the opioid dependent patient has been among the most distressing, and has represented an unacceptable high relapse risk. Patients have traditionally been hospitalized in most cases, and even if they have completed detoxification, have lost valuable time.

Suboxone® - Brookside Institute's Choice

Buprenorphine is a semi-synthetic narcotic; Suboxone® is a sublingual formulation that is a combination of Buprenorphine and Narcan. Taken sublingually Buprenorphine is absorbed through the mucus membrane, while Narcan is not. Because of its composition and safety, the Brookside Protocol™ utilizes Suboxone® as opposed to Subutex®, which has a high potential for misuse.

For many prescription drug and heroin addicts, suffering from the pain of the original injury or the fear of medical treatment has been compounded by the painful discomfort of withdrawal by methods which, rather than easing the pain, create intensified pain levels.

It is estimated that acute and chronic pain are serious problems for up to 30% of the population. It is claimed that 50 million people are disabled with chronic pain, that more than 550 million work days are lost each year, costing the economy more that $50 billion dollars annually.

Some 15% of today's medical patients suffer from a dependency to pain killers; this fear of withdrawal becomes increasingly important. We recognize that all patients who are physically dependent on prescription pain killers as well as other opiates such as heroin became dependent through no fault of their own. Their disease is a chemical imbalance that requires expert medical treatment in a safe, humane and effective environment.

Opiates imitate and are chemically almost identical to the body's own pain management drugs, endorphins, thus opiate addicts in withdrawal experience greater pain than the average person. Unable to tolerate their own pain and unable to complete the detoxification process, the opioid dependent individual often returns to drug use.

Past methods of assisting in treating the symptoms of withdrawal have not proven overall effective for many.

Suboxone® Detoxification, Maintenance and Treatment Program - The Process

Patients applying for Brookside Institute's Suboxone® detoxification, maintenance and treatment program are first evaluated for their level of addiction or abuse by our Medical Director. Once the applicant patient is deemed appropriate for the Suboxone® regimen, an initial treatment plan is formulated. Suboxone® will be administered only once withdrawal has begun.

Because Suboxone® is administered in pill form, the ease of administration increases compliance with the regimen. Buprenorphine may also be dispensed for take-home use, adding to it's attraction as both a detoxification and maintenance medication. The primary active ingredient in Suboxone® is Buprenorphine, while the other ingredient is Naloxone, which discourages diversion and abuse.

The management of withdrawal from opiates takes from three to seven days, and patients report a more comfortable detoxification that under any other regimen experienced, accompanied by a greatly diminished craving for opiates. Patients wishing to continue on a maintenance program may safely do so, as approved by our Medical Director. It is a mandatory part of the treatment program that each patient be reenrolled and actively participating in a full treatment program, including group and individual counseling. Suboxone®'s success rate is directly linked to appropriate counseling.

What is Buprenorphine?

Chemically, Buprenorphine [Suboxone®] is a man made opiate agonist medication that has recently been approved by the FDA for the treatment of opiate addiction. It also provides hope for any heroin addicts currently being treated in a methadone maintenance program as a viable alternative.

By offering a method of nearly pain free withdrawal from opiates, including heroin, methadone, oxycontin, Vicodin and other prescribed drugs, which are opiate based, Buprenorphine frees the patient to focus on other primary issues of recovery.

Many persons are unaware that prescription pain relievers such as oxycodone and codeine are opiate based. It is extremely important that they be withdrawn from their pain medication once the condition mandating it has passed. Sudden "cold turkey" withdrawal is dangerous. For most prescription drug dependent patients, methadone is not a viable alternative. It is certainly not an effective tool to assist in detoxification.

Preventing most withdrawal symptoms, Buprenorphine may be used to safely and comfortably withdraw from any form of opiate.

This permits the patient to cease using the opiate to which he or she is addicted in a much more comfortable, less distressing manner. However, only a doctor who is qualified in the use of Buprenorphine can determine if it is a good choice for a patient who is addicted to opioid pain relievers.

For the Patient on Methadone

Buprenorphine is also a much more effective tool for the individual addicted to heroin than is methadone. The most common form of heroin treatment today consists of methadone maintenance - a program in which the addict moves to a safer, less constricting drug - but still, a drug which requires regular doses for a lifetime. Some methadone clinics offer a 21 day "comedown", but few such clinics offer the counseling required for effective recovery - resulting in most patients returning to the maintenance regimen.

Trained in Buprenorphine [Suboxone®] methodology, Brookside Institute's Medical Director notes that a person currently being treated with methadone can safely switch to Buprenorphine with minor withdrawal symptoms. For many heroin and prescription opioid addicts, this represents a much more dignified method of beginning recover.

It should be noted that because the two drugs are very different, patients will have varying levels of satisfaction with the results. It is important to note that patients can also switch from Buprenorphinie to methadone, so that, unlike methadone maintenance, the individual does not have to feel trapped. Few patients have ever made the reverse switch back to methadone.

Working with other Professionals

Brookside Institute is glad to work with any professional in resolving the difficult issue of appropriate and effective withdrawal from opiates, and in providing a foundation for ongoing recovery.

Used in assisting opiate withdrawal since its first application in 1973, Buprenorphine has been recognized by the FDA as a useful adjunct to treatment. It is, however, strictly regulated.

At the present time Suboxone® is one of only two Schedule III, IV, or V substances to have received Food and Drug Administration approval for opioid addiction treatment. Thus, it is the most effective opioid medication that may be prescribed or dispensed outside an opiod treatment program setting.

While Suboxone® itself is an opioid, and can produce typical opiate effects and side effects, such as euphoria and respiratory depression, even at the most, these effects are less than those of heroin and methadone.

Given at low doses, Suboxone® produces sufficient effects to allow opioid-addicted individuals to discontinue the dependence on opiate drugs without experiencing the most painful withdrawal symptoms. Side effects are minimal, and organic damage is not known to occur.

Special Training Needs and Brookside's Professional Availability

While not every physician can treat patients with Buprenorphine, one advantage of the medication is the fact that it can be used in any outpatient clinic, as well as in an inpatient setting. Its convenience is emphasized by the fact that treatment of opioid dependence is not confined to any particular setting.

Brookside Institute's Medical Director is one of the few doctors authorized and to utilize Buprenorphine. By the terms of the regulatory code, 21 U.S.C. 823(g), prescription use of Suboxone® in the treatment of opioid addiction is limited to physicians who meet certain qualifying requirements, are specially licensed and have notified the Secretary of Health and Human Services (HHS) of their intent to prescribe this product for the treatment of opioid addiction.

Satisfactory monitoring of treatment compliance and efficacy (in terms of abstinence from other opiates) is performed by means of frequent urine screens for both Buprenorphine and other drugs of abuse is vital for those addicts in treatment who have a need to prove total abstinence from drugs of abuse to an employer or to the justice system.

Brookside Institute provides a full program of treatment. We have found that simply being withdrawn from a drug does not provide recovery. The older methadone clinics have learned through years of practice, that while replacing the drug with a synthetic substitute may reduce the more drastic effects of the drug, simple recution of harmful effects does not lead to full recovery.

The preferred method used at Brookside Institute to provide full recovery options during and following Buprenorphine detoxification, is Cognitive Behavioral Therapy [CBT]. This is a method of therapy or counseling which emphasizes a "start where you are" philosophy, rather than lengthy, time consuming, analytical approaches.

Each clinician at Brookside Institute is trained in CBT techniques allowing each patient to quickly address the issues which have previously thwarted recovery. Improvements in behavior are often rapidly noted by family, friends and employers. The rewards for all concerned are intensified.

Additionally, the use of the latest in brain wave analysis techniques, identifying the areas of the organic brain which may be functioning below effective levels, maximizes the patient's opportunities for full physical and psychological recovery.

Working with referring professionals and within the recovery community at large, Brookside Institute works to provide the latest in recovery methods for the highly problematic opioid dependent patient, as well as the full range of chemical dependencies and their concomitant co-occurring disorders.

Contacts:
E. Keith Owens, Director
Brookside Institute
Phone: (949) 679-7425
Fax: (949) 679-7428
owens@brooksideinstitute.com
Brookside Institute