Hello, my name is Louis Fisher. I was with the Drug Enforcement Administration for 31 years. Now retired, I refuse to see my country go the way of opioid pills and heroin without a fight.
What is IntegraMedical of North Carolina?
IntegraMedical of North Carolina is a newly-formed company committed to addressing heroin and prescription opioid abuse and dependency in rural and underserved communities throughout North Carolina.
What is medication-assisted treatment (MAT)?
Medication-assisted treatment (MAT) is the treatment of heroin or opioid dependency or addiction with buprenorphine. Brand names of buprenorphine include Subutex, Butrans, Belbuca, Buprenex; brand names of buprenorphine in combination with naloxone include Suboxone, Zubsolv, and Bunavail.
What is buprenorphine and how does it work?
Buprenorphine is an opioid partial agonist. This means that, like opioids, it produces effects such as euphoria or respiratory depression. With buprenorphine, however, these effects are weaker than those of full drugs such as heroin and methadone.
Buprenorphine’s opioid effects increase with each dose until, at moderate doses, they level off, even with further dose increases. This “ceiling effect” lowers the risk of misuse, dependency, and side effects. Also, because of buprenorphine’s long-acting agent, many patients may not have to take it every day.
What is naloxone?
Naloxone is added to buprenorphine to decrease the likelihood of diversion and misuse of the combination drug product. When these products are taken as sublingual tablets, buprenorphine’s opioid effects dominate and naloxone blocks opioid withdrawals. If the sublingual tablets are crushed and injected, however, the naloxone effect dominates and can bring on opioid withdrawals.
Isn’t treating addiction with buprenorphine just trading one addiction for another?
Absolutely not! Opioid addiction is a chronic disease, the same as diabetes and asthma are chronic diseases. Treating a disease with medication is a common practice, with the ultimate goal being to control the disease and to prevent a relapse.
Will a patient have to take buprenorphine forever?
In some cases, yes, the same as a diabetic has to take his or her medication forever. Some patients, though, do enter treatment with the ultimate goal of completely eliminating opioids from their life. With proper care, these patients can achieve that goal.
How will this help my community?
The benefits to your community are many. Heroin and prescription opioid abuse often lead to higher crime levels, a higher incidence of HIV and hepatitis-c (from needle sharing), higher death rates (often—and unfortunately—among teenagers), and higher unemployment. Buprenorphine, when compared with methadone, has a lower potential for abuse and doesn’t require a daily clinic visit by a patient. The SAMHSA Evaluation of the Impact of the DATA Waiver Program, published on March 30, 2006, indicates that, when used as prescribed, buprenorphine often allows the patient to continue or return to work.
Some additional conclusions from the SAMHSA report:
“…reports of street acquisition [of drugs] … at 6 month follow up … had dropped 87 percent from baseline; 80 percent of patients denied obtaining any drugs from the street in the prior 30 days.”
“Dealing or selling drugs decreased 82 percent over the study period, with 16 percent of patients reporting such activities at baseline, dropping to 3 percent at 6 month followup. This decrease was even more dramatic during the first 30 days of treatment, but the longer 6 month outcomes suggest a more stable outcome.”
“Prescription fraud—that is, obtaining prescription drugs illegally (through stealing prescription pads, forging or changing a prescription, seeking drugs from multiple physicians or pharmacies)—decreased 89 percent from 10 percent of patients reporting such activities at baseline to 1 percent at 6 month followup.”
“Other criminal activities decreased 79 percent, from 10 percent at baseline to 2 percent at 6 month followup, with even greater short-term (30-day) improvements. Other criminal activities include property crime (such as robbery, shoplifting, and stealing cars), fraud (such as forging checks, credit card fraud, identity theft, and scams), and violent crimes (such as armed robbery, assault, rape, and murder).”
How do I get a MMU to my community?
What does a MMU need? Where does it park?
Our mobile medical units are fully self-contained. We prefer to park and set up in a location convenient for patients, ideally in a church or public venue parking lot. Police stations, fire stations, and town halls also work nicely.
Some of the information included on this page was reproduced from the SAMHSA website.
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