http://wlos.com/news/local/paths-to-recovery-treating-opioid-use-disorder-without-the-stigma
ASHEVILLE, N.C. (WLOS) —
In the United States, some 900,000 doctors prescribe the pain killers responsible for creating so many opioid addictions, but less than 4 percent of doctors have the training or license to prescribe one of the “Paths to Treatment.”
A News 13 investigation found a local doctor fighting to change those numbers. He’s working to train more medical professionals to prescribe Suboxone, an opioid used to treat withdrawal symptoms, but it has a ceiling effect — lowering the risk of misuse.
Family physicians prescribing Suboxone say it could change the stigma around getting medication-assisted treatment.
“People are going to be judgmental,” said Paul.
That’s the stigma around opioid addictions. To shield his kids, Paul asked News 13 to disguise his identity and not use his real name.
“I wouldn’t think that anybody on my cul-de-sac or any of my neighbors would think that I had been, in my mind, a very serious drug addict for a lot of years of my life,” he said.
Years ago, Paul had traded a pain killer addiction for methadone.
“I was high all the time. I just didn’t come down,” he explained.
It became obvious he needed an alternative.
“I was asleep in class. My mind couldn’t process things,” Paul said.
That’s when his family doctor suggested Suboxone.
“I feel that it’s important for people to know that your neighbor very well may be on Suboxone, and that’s OK. That it’s something, that it’s a lot better than the alternative,” he said.
It also breaks that stigma by waiting for treatment here, next to you, in the family physician waiting room.
“They’re waiting there to see me for a follow up for high blood pressure, or diabetes, but then some of them are waiting to come in and get their Suboxone,” said Dr. Blake Fagan, a family physician with MAHEC.
Dr. Blake Fagan became certified to prescribe Suboxone after one of his patients overdosed in the Emergency Department.
“A lady that I had delivered two of her kids, at the time she had an 8 and a 10-year-old, she rolled into the ER dead from an overdose. It just changed my life. It would be wonderful if we were graduating more addiction specialists that were psychiatrists, but we’re just not pumping those out in the United States or North Carolina,” Fagan said.
Fagan’s mission is now to encourage anyone who prescribe medication to incorporate Suboxone into their normal primary care in an effort to increase the numbers. It’s an additional 8 hours of training to prescribe Suboxone. Training that’s also happening in the OB-GYN’s office.
“Being able to have a safe environment for women to disclose that, ‘Hey, I’m pregnant and struggling with addiction, and I’m using, and I need help’,” said Family Nurse Practioner Melinda Ramage with MAHEC.
Project CARA prescribes Suboxone through MAHEC’s OB-GYN office.
“Just like the blood pressure medicine I prescribe for high blood pressure, they also come with some risks for that pregnancy, but what we have to look at is that bigger picture. What is the best way to keep mom safe and healthy,” said Ramage
News 13 asked how Suboxone is different than methadone for a pregnant mom or anyone else.
“That medicine is built that if you were to take more than you should have, you don’t die. That’s the beauty of the medicine. It’s very hard to overdose on that medicine,” Dr. Fagan said.
Which is why patients can take it at home, and go longer between doctor visits after they’re started.
“It takes a lot of visits at the beginning, but one of the incentives for them is to really stick with our program,” said Dr. Fagan.
But, just like methadone, there’s the danger of it being abused. Robert Lee Davis was arrested in October during a traffic stop when officers found he had substance believed to be crack cocaine and Suboxone, but no prescription for it.
Still, taken as prescribed, some patients say the payoff can be life-altering.
“It just made it an overall pleasant experience when you have somebody that cares about your overall well-being from top to bottom, not just one aspect of it,” said Paul.
Paul’s using his sobriety to go back to school and mom, Dana Ashe, feels if more doctors and rehab centers were prescribing Suboxone, her daughter may be alive today.
“If she had been on Suboxone as part of her treatment coming out of there, her tolerance wouldn’t have been zero. She wouldn’t have been craving. She wouldn’t have been sick from the withdrawal. She probably wouldn’t be dead,” she said.
Dana Ashe questions why more detox facilities don’t prescribe medication assisted therapies, like methadone or Suboxone.