The United States is currently facing a devastating public health crisis due to widespread opioid abuse and overdose deaths. Prescription and illicit opioids such as oxycodone, hydrocodone, heroin, and fentanyl have destroyed lives and torn families apart. According to the Centers for Disease Control and Prevention (CDC), over 450,000 Americans have died from an opioid overdose between 1999-2019. In 2020 alone, over 93,000 people fatally overdosed, primarily due to the synthetic opioid fentanyl.
What Are United States Of America Suboxone?
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and others. Opioids work by binding to opioid receptors in the brain and body to reduce the intensity of pain signals reaching the brain. However, they also induce feelings of euphoria and are highly addictive.
Opioids have legitimate medical uses and are often prescribed for conditions requiring management of severe acute or chronic pain, like that caused by injuries, surgical procedures, cancer, and more. However, Suboxone as opioid prescribing began to significantly rise in the late 1990s, so did rates of misuse, addiction, overdoses, and unintentional deaths.
The Rise Of Prescription Opioid Misuse And Heroin Epidemic
Many experts believe the rise in legal access to prescription opioids helped fuel the current crisis. Between 1999-2010, opioid prescribing in the US quadrupled. As more people were exposed to prescription opioids, more began misusing them by taking them for recreational purposes or in a manner other than prescribed. This included taking higher than recommended doses, taking someone else’s prescription, or continuing use long-term despite treatment of initial condition ending.
By the 2010s, the crisis had evolved into twin epidemics – one of prescription opioid misuse and another involving heroin and synthetic opioids like fentanyl. Some people who misused prescription opioids transitioned to heroin due to it being cheaper and easier to obtain than prescription pills. Fentanyl arrived on the scene in the mid-2010s, making the crisis deadlier. Often mixed with or sold as heroin, it has contributed to surging overdose deaths.
The Role Of Medication-Assisted Treatment In Opioid Use Disorder
As the overdose crisis intensified, treatment methods like medication-assisted treatment (MAT) gained greater prominence. MAT involves the use of medications like methadone and buprenorphine (brand name Suboxone) to help manage withdrawal symptoms and cravings in those with opioid use disorder. When combined with counseling and behavioral therapies, MAT has proven highly effective for both treatment and long-term recovery.
Suboxone is a partial opioid agonist medication approved by the FDA specifically for the treatment of opioid dependence. It contains buprenorphine, which binds to opioid receptors but is only a partial agonist instead of a full agonist like opioids. This makes it less likely to induce euphoria or overdose and more effective for tapering opioid tolerance. It also contains naloxone to discourage intravenous misuse. When taken as prescribed, Suboxone reduces cravings and risks of relapse without producing the dangerous respiratory depression effect of full agonists.
Widespread Access And Utilization Of Suboxone
Suboxone has been made more widely available since the 2000s as part of broader efforts to expand access to MAT. The Drug Addiction Treatment Act of 2000 allowed qualifying physicians to prescribe buprenorphine for opioid addiction outside of specialty addiction clinics. The Affordable Care Act brought addiction treatment under mental health and substance abuse parity provisions, boosting coverage for MAT medications like Suboxone.
As a result, the number of providers able to prescribe buprenorphine skyrocketed from around 4,000 to over 58,000 between 2003-2017, vastly increasing access across rural and urban communities nationwide. Likewise, the number of patients receiving buprenorphine treatment for opioid dependence grew tremendously during this time. In 2017 alone, over 1.6 million people received treatment with Suboxone or other formulations.
While concerns exist around diversion of Suboxone to illicit s, most experts agree it has played a critical role in treatment response to the crisis. Many lives have been saved through use of buprenorphine, especially in preventing fatal overdoses during periods of relapse. Expanded access to medications like Suboxone has given hope to those unable or unwilling to engage in treatment through abstinence-based models alone. It offers a path to long-term recovery for opioid addiction that more closely resembles chronic care management models used in other diseases.
Challenges And Criticisms Of Suboxone Treatment
However, Suboxone treatment is not without its challenges and critics. Some providers have been accused of over-prescribing and not maintaining proper controls to prevent diversion. As a Schedule III controlled substance, it holds risks of misuse or abuse in its own right when obtained illicitly. Reports of babies being born opioid-dependent due to Suboxone use in pregnancy have raised concerns. Questioning of its use beyond 1-2 years also continues as long-term efficacy remains unclear.
Cost barriers also persist. While Medicaid expansion under the ACA increased coverage, premiums and out-of-pocket costs remain prohibitive for some. Limited availability of treatment is another barrier, especially in underserved rural regions. Lack of coordinated care with psychiatric medications can undermine Suboxone’s effectiveness when co-occurring mental illnesses are not adequately addressed. Stigma also discourages some from pursuing MAT or staying in treatment programs.
Addressing these challenges will continue strengthening Suboxone and expanding access to effective treatment. Educating the public on its benefits for long-term recovery compared to short-term detoxification models can normalize treatment as a chronic medical condition like hypertension. Improving provider training on risk mitigation strategies will enhance safety. Integrating buprenorphine prescribing into general medical settings could boost capacity. Most experts agree that further investing in equitable access to evidence-based MAT like Suboxone treatment should be a national priority during this crisis.
The opioid epidemic ravaging the United States represents one of the worst public health crises in modern history. As the dual problems of prescription misuse and illicit drug overdoses evolve, medication-assisted treatments offering an alternative path to long-term recovery have taken on increased importance. Though not without limitations, formulations like Suboxone that combine buprenorphine with counseling support have demonstrated effectiveness treating opioid use disorder at scale. Expanding access to Suboxone through integrated healthcare models holds potential to both address current treatment shortfalls and mitigate future epidemic growth. Continued research refining best practices will strengthen medication-assisted treatment’s