Recovery

When I was asked about medical issues in our community, my first thought was opioid use disorder (OUD). It is so pervasive in our society, but I feel even medical providers do not have a good understanding of it. I have been providing medication-assisted treatment for the last three years, and I want to share my experience.

First, let me describe OUD. Many people envision a heroin junkie on the streets, but in reality, it can affect anyone. The criteria that define OUD is using more opioids than anticipated for a longer period of time, with an impact on daily life. This can take the form of having cravings, or withdrawal symptoms, worrying about running out or getting that next dose, or using opioids when it is dangerous. It can cause difficulties with work and with relationships. There are many people out there who are physically dependent on opioids who do not have OUD, but when it starts to impact your life it becomes OUD.

There are three medication treatment options for OUD, including methadone, naltrexone, and buprenorphine. I use buprenorphine (with or without naloxone) in my practice. It has many trade names, the most common is Suboxone. It is typically a tablet or a film taken daily, but it also comes in a monthly injection. It works by making your body think you have enough opioids in your system, so it is very helpful for cravings. It is also useful for pain, but it is most commonly used for OUD. It does not have the same risks of overdose as traditional opioids and therefore has fewer restrictions. I find that it gives my patients the time to get counseling or other services to help with the underlying cause of their OUD.

Getting on to buprenorphine, like the other medication treatments, does take guidance from a provider. The most important thing about transitioning is that you cannot change straight from opioids to buprenorphine. It can cause sudden onset of withdrawal. Instead, with the help of your provider, you will stop your usual opioids and wait until you are in moderate withdrawals—for example sweaty, nauseated, or irritated. Then we start the buprenorphine, and the withdrawal symptoms will stop within a few minutes.

Some people see getting help as a sign of weakness, but I see asking for help as a sign of strength. It can be really scary to admit that you need help. My patients have been able to get their lives back after their opioid use—they have been able to maintain their jobs, have successful pregnancies, get treatment for underlying anxiety and depression, and address their other health concerns. It makes a difference, and you deserve it.