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Harvard Health Blog
Opioid addiction: Long-term treatment for a chronic condition
- By: Glen Buchberger, MD, Contributor
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I been a addict since 1991 ,I have tryed to get help from various sources of which not one of them were any good , methadone is worse than the heroin so no good ,I begged to go to a rehab and was successful in getting a placement only for social services to refuse funding, I went onto subutex and found it was good and worked for me until I went away for a long weekend and missed picking up my dose for the third day so was put onto daily pick up and made to sit in the pharmacy like a child to which I said stick it up ya arse for a year I was picking up weekly and was doing bloody good ,no relapse,but by putting me back on daily pick up put me in places and situations that are not good for me,waiting in waiting rooms with many other junkies who were not interested in getting clean and soon as they get out they want to go score , chemist everyday mixing with the same people I spent a year getting away from ,can’t hold a job down coz have to go chemist everyday can’t get on and live or go away for a week or so and be normal and clean so I blew them out as I feel these so called agency’s are only interested in makeing there books look good so they get more funding its a joke none of them are interested in really helping you as that will put them out of work ,so now I’m still a addict but I buy subutex off the street and fly to Spain or anywhere hot and stay for a month and I’m clean within the first week of being there no heroin or substitute then within a week of being back home I’m hooked again ,I find its the best way for me as if I don’t get away I will end up dead or in the gutter ,it might not work for everyone but it works for me soon as I wake up and I feel the rattle is coming its time to get on a plane and start to live a little well that’s my story
Excellent article on the benefits of integrating science and full service treatment programming. Given the relative costs of treating addiction, over a lengthy period of time, it would make sense, for treatment to be provided in the patient home community. For decades, the Johnson Inst. convinced us that the patient needed to be removed from their environment for 28 days (since that is how long it takes to completely eliminate alcohol from the system). A questionable measure of how and how long treatment should be provided, but it has become the norm, with others, suggesting that inpatient treatment, really, needs to be provided for 90 days to be successful.
How about, if we flipped the treatment field upside down and recognized that the environment is not the problem, the individual is. Thus, we treat the individual, in their home community, offering a full spectrum of ambulatory detox (where appropriate), day IOP, PHP and evening IOP. Simultaneously, the family would participate in the patient’s care from day one, throughout the duration of the various levels of care and finishing with a year of aftercare. Costs would plummet, patients would be integrated into support groups, that can give them hope that there really is life after discontinuing alcohol or drugs. If the patient does relapse, the connections with peers, counselors and family are all right there in the community and the patient’s chronic disease can be treated with MAT, Psychiatric intervention, medical intervention and outcomes skyrocket.
A secondary gain, would consist of the virtual elimination of the corruption that has come to rule every aspect of today’s patient care. There just isn’t enough money, and all outpatient providers, would by necessity be contracted with insurers (in network) and the out of network providers would pack up their vans, their sober living homes and, hopefully, many go to prison for the illegal activities that have become so prevalent in the field that I joined thirty six years ago.
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