Heroine maintenance works just as well and of course methadone (whether it's more or less addictive is not so clear) is often on the black market and results in deaths. I am objecting to calling a preferred officially marketed addictive drug as treatment while one that is not on the accepted economic market (deemed illegal) is demonized. Perhaps the real policy issue is why so much unhappiness is extant in our society that leads so many to seek escape.
So we probably have some degree of overlap, because I do run into this issue. I think that methadone and buprenorphine have properties which give them significant advantages in addiction treatment, but I still find that there are circumstances where it’s useful to prescribe other opioid medications, particularly for patients who are in pain. I would agree that the carveout for a couple of medications as MAT is an irrational regulatory decision.
And I would also agree that the “deaths of despair” paradigm is more informative than looking at things in terms of the pharmacology of any one specific drug of abuse. The despair that leads people into drug use is more of an issue than the drugs themselves. I use this particular term because I watched the authors of the deaths of despair book present to an audience of opioid experts at NIH, one of whom took the mic to sneer at them and ask why anyone should bother concerning themselves with the deaths of white men.
Glad to hear that you as I am is concerned by the state of our country which creates so much unhappiness with its divisive politics and lack of care about those who have fewer means to create safety nets to provide soft landings.
Heroine maintenance works just as well and of course methadone (whether it's more or less addictive is not so clear) is often on the black market and results in deaths. I am objecting to calling a preferred officially marketed addictive drug as treatment while one that is not on the accepted economic market (deemed illegal) is demonized. Perhaps the real policy issue is why so much unhappiness is extant in our society that leads so many to seek escape.
So we probably have some degree of overlap, because I do run into this issue. I think that methadone and buprenorphine have properties which give them significant advantages in addiction treatment, but I still find that there are circumstances where it’s useful to prescribe other opioid medications, particularly for patients who are in pain. I would agree that the carveout for a couple of medications as MAT is an irrational regulatory decision.
And I would also agree that the “deaths of despair” paradigm is more informative than looking at things in terms of the pharmacology of any one specific drug of abuse. The despair that leads people into drug use is more of an issue than the drugs themselves. I use this particular term because I watched the authors of the deaths of despair book present to an audience of opioid experts at NIH, one of whom took the mic to sneer at them and ask why anyone should bother concerning themselves with the deaths of white men.
Glad to hear that you as I am is concerned by the state of our country which creates so much unhappiness with its divisive politics and lack of care about those who have fewer means to create safety nets to provide soft landings.