Drug Deaths in the US are Rising Faster Than Ever
Overdoses are now the leading cause of death of Americans under 50; expert says there is a treatment plan that can save them
It is becoming the new norm. Drug overdose stories are flooding the media daily. According to the NY Times, drug overdoses are now the leading cause of death for people under 50 years of age, likely exceeding 59,000 in 2016. This is the largest annual jump ever recorded in the country, and this data estimates that deaths rose 19 percent over the 52,404 recorded in 2015.
It also suggests that this problem will only worsen in second half of 2017.
These numbers are just one part of the national epidemic that is opioid addiction. It’s a crisis that’s poised to worsen as illicitly manufactured drugs, such as fentanyl, continue to flood the market.
Yet despite this deepening crisis, some of the most effective treatments against opioid use disorder are not yet in wide usage. Dr. Carrie Wilkens, Ph.D., Co-Founder and Clinical Director, Center for Motivation and Change says “there are a number of evidence-based medication-assisted treatments (MAT’s) for opioid use disorders that support long term recovery and significantly reduce overdose risk. Yet the traditional drug and alcohol treatment industry has been shockingly slow to support their use.”
Dr. Wilkens is referring to MAT’s like Buprenorphone, Naltrexone, Vivitrol and Methadone, and says “while these medications have their downsides and side effects, the evidence supporting them as effective agents against relapse and overdose death is robust.”
● Buprenorphine, which is a partial opioid agonist, meaning it activates opioid receptors in the brain but does not produce the maximal effects that full opioid agonists, like heroin, do. It does not incite feelings of euphoria, but it will produce enough effects to trick the brain into thinking it is receiving a full agonist. Consequently, buprenorphine reduces cravings for opioids and provides relief from withdrawal symptoms. It is protective in lowering overdose risk as it blocks the receptor sites in the brain that opiates would otherwise attach to. Unlike Methadone, buprenorphine can be prescribed by specially trained physicians in a doctor’s office and does not require that you attend a Methadone clinic.
● Naltrexone is a medication taking in pill form daily that blocks opioids from binding with the opioid receptors in the brain, thereby eliminating any sense of a high. The effects last 1–2 days. It is often tried before committing to the injectable version called Vivitrol in order to assess for tolerability and side effects. It is not as effective as Vivitrol for preventing relapse since one can easily stop taking it and be unblocked quickly.
● Vivitrol is naltrexone delivered in an intramuscular injection (like a flu shot, for example) which lasts for four weeks. As with Naltrexone, it facilitates abstinence from opiates by blocking the effects of opiate intoxication by blocking receptor sites in the brain. Again, it essentially blocks the euphoric effect that comes with using opioids, and therefore makes relapse less likely.
● Methadone is a full opioid agonist with a longer half-life than the opiates that people commonly misuse. Medication is administered in a methadone clinic and the medication reduces or eliminates cravings and reduces the need to use other opiates.
“There is a strong belief in this country that “a drug is a drug is a drug,” and that if you have to take a medication to recover from a drug problem, then you are not really sober,” says Dr. Wilkens. “This is despite mountains of evidence from well-conducted research studies, showing that medication-assisted treatments like buprenorphine and naltrexone save lives.”
Dr. Wilkens points out that of the 2.5 million Americans 12 years of age or older who abused or were physically dependent on opioids in 2012, fewer than 1 million received MAT’s. “Despite their benefits, MATs have been adopted in less than half of private treatment programs. Even in programs that do offer MAT options, only about a third of patients receive them.”
A recent Pew study found that only 23 percent of publicly funded treatment programs report offering any FDA-approved medications to treat substance use disorders, and less than half of private-sector treatment programs reported that their physicians prescribed FDA-approved medication.
The Center for Motivation & Change (CMC) is a unique group of dedicated clinicians and researchers specializing in the treatment of substance use and compulsive behaviors. When Dr. Wilkens founded the center with a fellow psychologist, Jeffrey Foote, in 2003, it was one of the few centers in the nation that was not tethered to the 12-step model. Wilkens and Foote had worked together in larger hospital-based treatment centers prior, where they struggled to introduce evidence-based treatments. They realized there was a need for something different and effective. As a part of their treatment methods, they educate their clients and their families on the value of seeking adjunctive care from a physician trained in prescribing MAT’s.
“We’ve had countless people come to us at CMC who have been in multiple rehabs and never once were encouraged to be on medicated assistant treatments,” says Dr. Wilkins. “Data suggests as many as 90 percent of people detoxed completely off opiates relapse within the first one to two months unless treated with these medications.”
Since 2008, drugs have been killing more Americans than car crashes. Over two million Americans are estimated to be dependent on opioids, and an additional 95 million used prescription painkillers in the past year, more than the number who used tobacco. And each year, over one million Americans are treated in substance abuse facilities.
Dr. Wilkens says there is hope for those hooked on opiates, but there must be greater awareness of the treatment options available.
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