SUBOXONE ASSISTED TREATMENT
501 (c) (3) Non-Profit Corporation
(A Subsidiary Of Medical Assisted Treatment)

OCTOBER 2007

   

MARKET RESEARCH OPPORTUNITY FOR PATIENT ON SUBOXONE®

If you are currently taking Suboxone and over 18, you may qualify for a market research survey that will pay you $75 for your time and opinion.

If you are interested in participating, please call:

Angela Glass, Senior Project Manager at Curtis Analytic Partners
1-800-836-1684 - Ext. 100

What you can expect when you contact Curtis Analytic Partners:
Curtis Analytic Partners (CAP) is a market research company that specializes in patient research. They will ask you some screening questions and then, if you meet the criteria for the study, they will provide you a link to an online survey.

Any personal information you share will be kept strictly confidential
.


         The Big Hurt:  New Hope For Kicking The Pain Pill Habit

Most doctors would have labeled Laura Nelson an addict. 

Back pain led doctors to prescribe a pain killer twice as strong as Vicodin; then, she couldn't kick the habit. 

Her trouble started a couple of years ago as she was struggling to recover from a second surgery for ruptured discs. Vicodin, a hydrocodone painkiller, wasn't working.  Twice the pain landed her in the emergency room.

Doctors prescribed Norco, which helped, but she realized she was hooked on it when she tried to stop taking the medication.

"My body was used to having it," says Nelson,39 a former Oakland resident who now lives in San Jose." If I didn't get my prescription filled for the weekend, I'd  be laid up in my bed feeling miserable.  It was twenty times worse than the flu.

On bad days she took as many as 10 Norco.

Nelson consulted two doctors, both of whom suggested she take a weaker narcotic, she says.  Realizing this wasn't a permanent solution, Nelson did some research and found out about buprenorphine, a drug that suppresses opiate withdrawal symptoms and has an antidepressant effect.  Essentially, it could relieve the flulike symptoms she experienced when she stopped taking Norco.

Nelson searched for a doctor offering the treatment and found Dr. Richard Gracer, founder and director of the Gracer Medical Group in San Ramon.

Realizing Nelson was desperate for immediate help, Gracer's staff scheduled a same-day appointment .  The doctor started her on Subutex, a buprenorphine pill that dissolves underneath the tongue.

Hours later, back at work , Nelson felt wonderful for the first time in years.

"It worked that fast," she says . "I'm not exaggerating when I say it saved my life."

Nelson was addicted to painkillers.  She had become part of the growing trend of prescription drug abusers in the United States. 

More than 13 percent of the U.S. population-31.2 million teenagers and adults -said they have misused prescription painkillers at least once, according to a 2003 National Survey on Drug Use and Health.  About 4.7 million of them have misused opiate pain killers, ranging from morphine to codeine. 

The problem is exacerbated by prescription drug sales on the Internet, the availability of painkillers such as Vicodin and the fact that doctors are more comfortable prescribing these painkillers than they were when only stronger drugs were on the market, Gracer says. 

Gracer doesn't view a patient with a prescription drug problem as being a conventional addict. "You have to differentiate between physical dependency amd addiction.  "Addiction is behavior-based," he says.  "Most with prescription drug problems are just normal people who got hooked when they got it from their Doctor."

Prescription drug abuse is a major reason why Gracer has made addiction recovery his business. A specialist in interventional pain management, Gracer has spent 30 years as a doctor. Then in 2002, he started taking a closer look at a relative new drug, Prometa. 

For people addicted to alcohol, cocaine and methamphetamine, Prometa helps alleviate post-acute withdrawal syndrone and cravings, as buprenorphines does for opiates . 

Gracer was also alarmed by the low success rate of traditional addiction treatment programs-which some experts put as low as 5 percent and others as high as 20 percent.

While Gracer recognizes these treatments, such as 12-step programs,work for some people, they often fail to target "hidden" addicts.  Hidden addicts are largely employed, middle-class people who would never consider entering a methadone clinic or addiction recovery center. Gracer notes that they comprise 15 percent of the population.

"A lot of middle-class people, like executives, aren't going to get up in a public forum and say they are an addict.  They're not comfortable with that," Gracer says.  'And a lot of people aren't even in a place yet to believe it themselves." 

The real turning point came when Gracer met a patient who bought Norco of the Internet and was taking up to 50 pills  a day.

In 2005, he launched Gracer Behavioral Health Services.  And earlier this year, he outlined his approach in his book, "A New Prescription To Addiction." 

"The reason I wrote the book is because I wanted to make a change,"says Gracer. "I  wanted to show people a good way to do it. Not the only way, but at least the waty that really seems to work."

Gracer's program combine using drugs that eliminate cravings and withdrawal symptoms with counseling, nutritional guidance and alternative approaches, such as acupuncture and chinese herbal remedies. 

Gracer estimates that he has had success with two-thirds of the 50 patients he has seen so far. 

Take Allen a recovering alcoholic who lives in Sonomo County and asked that his last name not be published. 

A drinker for 30 years, Allen was consuming a half bottle of vodka a day.  Nearing his 50th birthday, he sought help from his personal doctor , who suggested he look for a program in the phone book. 

That didn't work for him.

"Most are religious-based, and I'm not religious," he says. "Putting my problems on the table was not the way to go for me. I wanted to deal with this on my own." 

So in 2004 he went to Gracer for the Prometa treatment, which is administered intravenously for three consecutive days,then again three weeks later for two days.  Today, he still meets with program director Steve Peterson, a licensed clinical social worker and certified alcohol and drug abuse counselor.  But he hasn't had a drink since taking Prometa.

"Sometimes I think about it," he admits,"especially when I go fishing off the coast or go to Mexico.  I think how it would be to join my friends, but iknow for my own health, I can't drink again." 

Low self esteem and not having a supportive family are barriers to recovery. "People who don't believe they can change and don't," Peterson says.  "When you can believe you can change, that's a very empowering feeling. That's what we emphasize."

Gracer is not the type to buy into the negative.

in 1978, he fractured a neck bone in a car accident.  Traditional treatments failed to work. Relief arrived only after a physical therapist trained in Europe manipulated his spine.

But he's also a scientist, and initially he was skeptical of the Prometa plan. 

"There were a couple of times when we'd get a really messed up meth-head, and I would tell  Steve Peterson ,"If it works for this guy,I am a believer."  he says. "In  the beginning the data wasn't there yet,so we were skeptical.  But we've seen too much now.  I officially believe because I have seen it work."

Reference: http://www.insidebayarea.com   
Ann Tatko-Peterson   

     Buprenorphine Program Succeeding

Sixty-five percent of opiate addicts taking part in in a buprenorphine trial in Maryland stayed in treatment for at leat six months, officials said.

The Associated Press reported that Baltimore health officials called the results encouraging, although they noted that the 90-day retention rate in methadone programs is more than 80 percent.

The $1-million Baltimore buprenorphine  project has enrolled 269 addicts, and similiar programs are being established elsewhere in
the state.

 

What are the principal differences between methadone and buprenorphine? 

Although overall methadone maintenance therapy has been successful, it is associated with a number of problems, including limited patient and community acceptance.  Therefore methadone is not ideal for all patients .  Buprenorphine was first considered as a possible alternate to methadone in 1978 (Jasinski et al) and further studies confirmed its use as a successful maintenance therapy for opiate addicts. (Bickel et al. 1995, Schottenfeld et al. 1997, Fischer et al., 1998). However, due to the lack of withdrawal symptoms it is now considered more as a detoxification therapy rather than a maintenance therapy.  It may therefore either be used alongside methadone, or instead of methadone.  Unlike methadone, which may be used for life, buprenorphine may be used only for a short period of time for detoxification. (Ford et al.2004) 

The principle difference between buprenorphine and methadone from Euromed's perspective appears to be presentation of the drug.
Buprenorphine is presented as a white  tablet whilst methadone is usually presented as a green liquid. It may therefore be possible to adulterate urine more easily with buprenorphine compared with methadone which will turn the urine greem. 

For opiate withdrawal its primary benefit is the lack of withdrawal effects, when compared to other opiates such as heroin (Fischer et al. 1999). This can also be seen as a disadvantage since there is some evidence to indicate a high drop out rate for those addicts on buprenorphine compared to methadone during the early stages of treatment (Fischer et al. 1999)

  Is it possible to abuse buprenorphine?

 When buprenorphine is used as prescribed, by placing it under the tongue, it produces less stimulation and physical dependence than full agonist medications like methadone. The "high" effect of buprenorphine peaks at lower level in comparison with methadone  and other full agonist medications, no matter how much of buprenorphine is used, thereby reducing its abuse potential. 

There were reports of misuse of buprenorphine when injected into the body in Europe. To circumvent the illicit diversion of the medication it is combined with naloxone, an opioid antagonist.  As long as the medication is used as prescribed by placing it under the tongue only buprenorphine will be absorbed.  However, crushing the tablet and injecting it into the body causes the absorption of naloxone into the body, which will trigger a precipitated withdrawal effect  and the person becomes very sick.  

How do I find physicians who are trained to prescribe buprenorphine?

I would like to recommend the http://www.turntohelp.com. I think you will  really like it because you can type your zipcode in and it asks you within how many miles would you like to locate one capable of prescribing buprenorphine. If you have any trouble at all locating a physician then please let us know immediately and we will assist you.  We are here to help you and we want you to know that you are not all alone. You are going to need support and we will be here for you. We are not here to judge you but just to help you get back on track with your life.  

Leading Toxicologist warns aginst New Drug of Abuse

Professor Alison Jones said benzylpiperazine was a "new drug of abuse" which could have serious clinical effects -similar to those of ecstasy to which it is structurally related.

The findings appear in a paper co-authored by Professor Jones in the prestigious international medical journal-The Lancet.

In the paper Professor Jones from the University of Newscastle and her toxicology colleagues, from Guy's  and St Thomas' Hospital in London and St Georges' Hospital London Drug Testing Laboratory, show for the first time the presence of a new drug of abuse.

Professor Jones said while benzylpiperazine was prohibited in Australia , the drug was readily available in the united Kingdom.

The drug is currently unrestricted in the United Kingdom.  Its availability and detection in patients in the united Kingdom who have come to harm, raises significant issues of clinical problems and access," said Professor Jones.  Now in Australia, Professor Jones has joined the University of Newcastle and to the Hunter Medical Research Institute as Professor of Medicine and Clinical Toxicology.  She is also a clinician at the Newcastle Mater Hospital and responsible for providing education and toxicolgy advice to clinicians. 

###,
An internationally recognized researcher in the field of toxicology, Professor Jones has expertise in the clinical aspects of drugs of abuse, analgesic poisoning, antidote use  and chemical toxicology.  Profesor Jones intends to conduct research into drugs of abuse in the Hunter region, where use of the methamphetamine (ICE) is prevalent  and with colleagues through out Australia.

Editor's Note: I like to try and bring you articles that will broaden your horizon.  I wasn't even familar with benzylpiperazine.   I did some more research on the medication and I will share my knowledge with you.  

 

Clubbers Snap Up New Legal High
Drugs From Same Class as Viagra Marketed As Alternative to Ecstasy

David McCandless

A new breed of stimulant drugs from the same class as Viagra but with similar effects to ecstasy are being sold through British shops and websites. The drugs, known as piperazines and marketed as p.e.p pills, are fuelling a boom in the "legal highs" trade as people search for safer, cleaner alternatives to illicit drugs that do not carry the risk of conviction.

Vendors of legal highs are always on the lookout for substances to boost sales, especially since the sale of fresh magic mushrooms was outlawed this year. Piperazines appear to be filling this void. The pills contain a blend of the stimulant benzylpiperazine (BZP) and other less potent chemicals from the piperazine family.They are becoming increasingly popular as a legal alternative to ecstasy's active ingredient, MDMA, mainly because users say they appear to work.
"I was quite surprised that a legal high could be so potent. Most usually just give you a bit of a hot flush," said Peter, 32, who has tried the pills several times. "It was a good party buzz with an ecstasy-like rush. I was up all night, feeling good, jabbering away."

"We're selling quite a lot of them," said Kieran Wilson, the manager of Spiritual High, the Middlesbrough-based company which packages and distributes the stimulant and which claims to have sold hundreds of thousands of pills. "We sell to around 150 headshops around the country, and website retailers on top of that. So we do have quite a big base for it."

The company markets a range of p.e.p pills at £5 for two or £180 for a tray of 72. Each offers a different blend of piperazines and different effect. "Stoned" is described as mild, mellow and giggly, while "Twisted" gives a "loved-up feeling with a trippy edge".

Synthesised from the pepper plant, BZP was originally used as a worming treatment for internal parasites in cattle.Taken on its own,it acts as a mild stimulant, about 10% the strength of normal "speed" or amphetamine. It causes wakefulness, euphoria and increased vigilance. But when it is mixed with other piperazines, the effects become more euphoric,even psychedelic, lasting up to eight hours. Unlike Viagra, however, BZP does not appearto have an effect on sexual performance.

Question Marks

The bulk of Britain's supply is imported from New Zealand where they are packaged as a "drug harm minimisation solution". They contain vitamins and antioxidants to reduce side-effects and ease hangovers.  Users  Are told to take no more than three at a time.
In the 80s the drug showed promise as an antidepressant, but it was subsequently shelved. Clinical evidence seems to suggest no ill effects from use. Owing to a lack of recent research, however, question marks remain over interaction with antidepressants such as Prozac and over-the-counter medicines. Those who are allergic to pepper are advised to avoid the drugs.

Worldwide there has been a single reported death associated with BZP. In Zurich in 2001 a 23-year-old took two BZP tablets alongside ecstasy and drank more than 10 litres of water in a 15-hour period. She later died from hyponatremia or water poisoning, a common cause of ecstasy-related deaths. The role of BZP was unclear.

http://www.Erowid.org

More to come later.  If any of you have information on BZP then we would appreciate you sharing it with us.  I like to try and keep everyone abreast of what is happening especially with all the illicit medication.

Until next month please take care and if you have any questions then just post them and we will see they are answered. We have a Suboxone Forum that is really growing and we would love to have you in attendance.  You can listen to others and learn a lot. We know it is not easy and if we can provide anything at all to help you then let us know.  

Thanks to all of you who have joined with us and helped to make Suboxone Assisted Treatment a  friendly place to visit.  We couldn't have done it all without your help and visits. You all have been wonderful in your patience with me and in sharing with others about your Suboxone Pharmacotherapy.  We thank you for all your help and in pointing the ones to us that you knew needed more information than you could supply.

 Until, next month, know we are here for you. You can call us anytime you like and if you lack money then please send us an e-mail with your phone number and the best time to reach you and we will call you at our expense. We want you to call and we will assist you in any way we can. Sometimes, it just helps to talk with someone who understands what you are experiencing. We stay open 24/7 simply because we care.  Write me at:
changeyourlife@SuboxoneAssistedTreatment.org

Editor/Publisher: Deborah Shrira     Date: 31 October 2007