New Maintenance Drugs Enter Market as Demand Rises

By May Wilkerson 09/21/15

The demand for medications like Suboxone and naloxone have skyrocketed.

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The United State’s growing problem with opioid painkillers and heroin has spurred a new market for maintenance drugs.

Maintenance drugs, like methadone and Suboxone, are opioid-based medications prescribed to help people ease off painkillers or heroin in order to help them function in their daily lives. For decades, the vast majority of recovering opioid addicts were treated with methadone, also known as Dolophine.

A downside of methadone is it must be dispensed under supervision at a clinic. In recent years, more alternatives are being introduced into the addiction treatment market as demand rises.

In 2002, Suboxone, the brand name for buprenorphine and naloxone, received federal approval, and has become a popular alternative to methadone. Suboxone and other, newer drugs, are more convenient as they can be taken at home. Doctors who prescribe these drugs must be certified by the DEA and complete an eight-hour training course.

With opioid addiction rampant across the country, these doctors and drugs are in increasingly high demand. Dr. Brent Boyett runs an addiction treatment center in the small town of Hamilton, Ala., and is one of just two dozen board-certified specialists practicing in the state.

Boyett is also a dentist and family doctor, but 40% of his patients are now seeking treatment for addiction. "As far as we know, there is no known cure for opioid dependence," says Boyett.

His aim is to help his patients function and avoid relapse. In recent years, he has participated in clinical trials for new maintenance drugs like Bunavail, which is transmitted through the inside of the cheek, and Zubsolv, which dissolves under the tongue.

Physicians like Boyett believe in treating opioid addiction as a lifelong problem. Ultimately, the goal is to wean patients off maintenance drugs, but he says some patients do better with lifelong maintenance than without. "Once the brain becomes damaged by drugs, there is a 90% relapse rate," he says.

But maintenance treatment remains controversial in the medical community. Some doctors are opposed to the medications, seeing them as a “crutch” or simply an alternate addiction. Like painkillers, maintenance drugs can be abused. Doctors who prescribe them typically supervise their use carefully, asking patients to save all wrappers and packaging to ensure accountability for all medications.

Despite the risks, Boyett sees maintenance drugs as a useful and sometimes necessary tool. "Buprenorphine will no more cure for your addiction than insulin cures diabetes," he said. "What you are trading is chaos for control. You are trading an out-of-control situation for a life that has stability."

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May Wilkerson is a writer, comic and Managing Editor @someecards. Co-host of the podcast Crazy; In Bed w/alyssalimp. She is also the top Google result for "insufferable lunatic." Follow this insufferable lunatic on Twitter.