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PostPosted: Sat Jan 30, 2016 9:15 pm 
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Hi guys.

I was reading this article a couple of weeks ago about abstinence based recovery vs medication assisted recovery, and one big caught my attention.

http://www.smh.com.au/national/icecold-withdrawal-or-slow-release-20150731-gioxxd.html

Quote:
David Best, associate professor at Victoria's drug and alcohol research centre Turning Point, says there is already an over-reliance on drug replacements that condemn people to a "living zombie land".

"While they are not committing a lot of crime and not spreading a lot of disease, their physical health and their mental health, their quality of life and their wellbeing deteriorate," he says.

Best points to a 2011 UK study of 300 opiate-addicted doctors, which found only one received drug replacement.

"Poorer people in community treatment programs get told methadone is evidenced-based practice," he says. "It seems to me that methadone is underclass management by a middle-class professional group who are nervous about their cars getting broken into and their brothers and sisters getting hepatitis and AIDS."

Instead of being medicated and forgotten about, Best argues people addicted to drugs - be it alcohol, heroin or ice - need help building new social networks, reuniting with their families and finding meaningful activities and safe housing.


I'm really looking for that 2011 UK study. I can't seem to find it anywhere. It looks incredibly interesting, basically saying that doctors are very happy to prescribe patients drugs like methadone and Suboxone, but aren't willing to take it themselves if they're addicted to opioids.


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PostPosted: Sat Jan 30, 2016 11:59 pm 
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This is a different study, but similar, in the US in 2009. Haven't seen the one you are looking for-

https://addictionandrecoverynews.wordpr ... 11/page/2/


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PostPosted: Sun Jan 31, 2016 10:47 pm 
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Thanks heaps for that. Seems similar things are happening in the US. So why is there this double standard, ie doctors refuse drug-replacement for themselves while recommending it for their patients? Seems dodgy to me.

I found a link in that article that brings me closer to the study I'm looking for. But that one was equally as enlightening wonderstruckmum.

http://recoveryreview.net/2014/05/doctors-addictions-double-standards/


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PostPosted: Mon Feb 01, 2016 6:38 pm 
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It never ceases to amaze me how far people go to find conspiracies. Must be exhausting, surrounded by so many people planning against you!

There have been a couple studies over the past 20 years that are pulled up, over and over, by the anti-med treatment folks-- the people who run the $30,000 per month treatment programs like the one I was forced to attend. The couple studies show ONE YEAR sobriety rates of 50% to 70% in doctors, 'proving' that residential treatment works. TeeJay, you're the first person I've ever heard of use those arguments to say that doctors get some special benefit-- although I guess the studies you quoted came up with the thought before you did...

If any of you want the treatment that doctors have to use, you are welcome to it. It is out there. The Board told me I had two choices-- Rogers in WI or Talbott. I chose the closer, cheaper one. Understand that to get my license back, I needed the full blessing of the program I attended. The program is 'open ended'-- i.e. I was there for over 3 months, and probably would still be there if not for the 9/11 attacks (I was released the day after the attacks; I wonder if they just got sick of holding me there when everyone else went home!!).

I paid over $60,000 to be there-- that's just for the 90 days. I had to remortgage my house, and sell the cottage on a lake that we bought for 150K a few years earlier. But the costs did not stop there-- not by a long shot. I was required to be in group AND individual therapy for 6 years--- twice per week for the first 3 years, then once per week after that. I was drug-tested twice per week at my expense- including the more costly tests that looked for fentanyl-- for six years.

After about 5 years, I ate a poppy-seed muffin and was tested later that day. I had 170 nanograms of morphine per cc of my urine-- so I was called the next day. I had to appear before the Board, in front of 30 people with microphones, answering questions.

TeeJay--- all of this is available to you. Sell your house like I did, and go and get it. You will have a 50-70% chance of staying clean-- for a year. Gosh-- look what the system is keeping you from!

Obviously I have a bit of anger about this issue. Most states will not allow a health professional to work while taking medications that treat addiction. I have worked with several nurses, residents, and doctors, trying to help them get their licenses back while on Suboxone. THEY ALL LOSE.

All those stupid articles listed above should be entitled 'doctors and nurses not allowed to use the treatment for addiction that actually works.' THAT would be far more accurate.

Look up the Mayo clinic article and editorial--- you will find it if you google 'mayo clinic study showing doctors shouldn't work on Suboxone.' The study was ridiculous--- it took people NOT on opioids, and put half of them on opioid agonists and half of them on buprenorphine. These people were NOT tolerant to opioids. Both groups were F'ed up, obviously-- so the study concluded that buprenorphine would impair docs. That stupid 'study' is widely quoted, anytime a doc asks to work while taking Suboxone.

I'm just amazed that people are so eager to see themselves as 'missing out', that they would twist this situation around completely backwards....

want that special 'doctor treatment'? Just pull out your wallet and go. But it wasn't the music therapy I paid 10 grand for that got me better.... or the 'psychodrama' bullshit for another 10 grand... or the 'feelings work'.... or the 'art expression therapy' where I molded a couple pots. It was the SIX YEARS when I had to commute an hour to be a first-year resident again, then after working all day, sit in a lab until they could call in a male worker from home, because all testing had to be witnessed from 'skin to cup'... and then drive home, hopefully by 7 or 8 PM. After doing that for six years, knowing that any slip would cause my kids to lose their home, I learned to stay clean.

THAT'S what you're missing out on. Scandalous!


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PostPosted: Mon Feb 01, 2016 7:33 pm 
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Thanks for taking the time to respond Dr. J. But I think you've seen my post as attacking the fact that doctors get special treatment for addiction. That is not what I meant to convey at all.

I only wanted to find out whether it was true that doctors never seem to end up on Suboxone and methadone themselves. It wasn't a personal attack or even conspiratorial. Despite the cross communication you did answer my question though. Seems doctors aren't allowed to be on Suboxone to practice medicine.

But that leads to another question. That is, why do the medical boards not allow doctors to be on Suboxone because of its potential to lead to impairment, but still allow doctors to prescribe it to professions where impairment can cause immense harm, like train, truck and taxi drivers?

Edit - I think I found the impairment study you speak of.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538407/


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PostPosted: Mon Feb 01, 2016 11:10 pm 
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Oh wow. So unfair. But I kind of figured something like forbidding MAT to doctors might be what was happening. Awhile ago I read an article. Maybe you were even mentioned in it? Can't recall. It was about how someone noticed the high rate of addiction among anesthesiologists relative to other physician specialties and got an idea and researched it. Turns out that anesthesiologists are pretty constantly exposed to tiny amounts of fentanyl and maybe some other opiates that are vaporized in the air close to the patients they treat as they bend over the patients. So really their employer is in a way causing the addiction via the working conditions. Seems like there should be a way to file workmen's comp claims and get THEM to pay for all the treatment, not blame you and put you through all that hell and guilt and financial turmoil. Anyway, that's what it looks like to me.

My sister is an internist in WI. She didn't know anything about opiates or Suboxone until my daughter's troubles began. Together we read the big SAMSHA book and spent time trying to understand what it's all about. Now she finds that it's become pretty useful knowledge as when she's on call all kinds of people turn up at the hospital on Suboxone or opiates or both and most often she is the only person working there who knows anything at all about the topic. Not many health professionals know much about it. And a lot of times what they know is wrong. There needs to be a massive effort to educate medical professionals about this topic so they can work together to come up with a plan to deal more effectively with the epidemic.

I am SO grateful that this treatment is available to help my D in her recovery. I don't think she would have been able to make it out of the pit otherwise. She goes to many NA meetings because she finds the mutual support of other recovering addicts very helpful. Her observation is that among the younger people there, the ones who have accumulated any clean time at all and are doing well are pretty much all on Suboxone, though many don't advertise it because of worries about how some of the 'old timers' will react.

In general I find the widespread aversion to Suboxone treatment very frustrating and disheartening. The guy my daughter ran off with during her 'dark days' last year has travelled a different path than hers since they parted. He has legal troubles and was orderd into detox by his PO who figured out he was still using. At that point my D came home and committed herself to recovery with the help of Suboxone. The guy spent some time in the hospital and then got clean in jail and after a month or so PO allowed him out of jail into an abstinence based rehab. After 6 weeks of that he got moved to a 6 month program in a sort of combo rehab/sober living place that is also abstinence based where he is now. He has been brainwashed to think he can make it without medication and plans to try it, though his dozen plus abstinence based rehabs over the years never took. I looked into the place he is at now. It seems so great. Beautiful, spacious, well appointed. The guys work during the week with lots of meetings and therapy after work and have fun outings on weekends. You know, river rafting, rock climbing, museums, everything you can think of. Pictures on FB of happy guys spending healthy time recovering together in nature. Etc. But when you google the name of the place, you also hit several obituaries because relatives of the dead direct that donations be sent to this place. By cross checking I found for example one guy who died less than 3 weeks after celebrating his completion of the 6 month program. It's so sad. My D is convinced that this will be the fate of her friend.


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Dr. Jeffrey Junig, M.D., Ph.D.

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