Maria is a 63-year-old woman with a history of polysubstance abuse.
“I used to do heroin every day for 32 years,” she says. While heroin was her drug of choice, she also dabbled in cocaine, alcohol, pain killers, and other drugs. She battled Hepatitis C, a result of her drug habit. Yet, for 10 years, until about a year ago, she says she was clean until a variety of personal issues caused her to relapse.
Motivated by her daughter and her grandchildren, Maria got help. After undergoing inpatient detox, she started an outpatient treatment program with the Addiction Medicine department at SBH Health System that includes the use of suboxone and individual and group counseling.
“She’s done extraordinarily well. She’s a star,” says Dr. Jonathan Samuels, medical director of Addiction Medicine. “She takes her medication, has had clean urine [screenings] and attends group therapy. It also helps that she has a stable family.”
Maria is one of about 50 patients in SBH’s suboxone treatment program, which is offered as an alternative to its long-standing methadone maintenance treatment program (MMTPs). Approved by the FDA in 2002 and offered by SBH since 2014, suboxone – a drug produced through the combination of buprenorphine and naloxone and administered in sublingual strips – offers certain benefits over methadone.
With methadone, some patients complain of feeling sedated. It can cause dry mouth and has a high sugar content, both of which contribute to a high rate of dental caries and periodontal disease. Overdose is a real possibility. As such, methadone patients require more frequent monitoring and may often need to be seen on a daily basis to receive their medication.
Patients like Maria who use suboxone can be given a month-long supply of the drug. “It’s virtually impossible to overdose on suboxone alone – although when combined with alcohol or benzodiazepines it does remain a risk,” says Dr. Samuels.
Patients beginning the suboxone regimen typically undergo an initial period of close observation and dosage adjustment with frequent urine toxicology screens before receiving monthly home supplies.
Dr. Samuels speaks positively about the use of suboxone, but is candid about the uphill battle faced by addicts who, as a rule, often relapse. Not every suboxone patient, he says, has been as successful as Maria.
“It works for me,” says Maria. “I feel beautiful and I don’t feel like using.”