Opiate addiction

Opiate addiction is ravaging many areas of our country. Unfortunately, Northeast Tennessee is one of the hardest hit regions.

Imagine a person who has been illegally taking narcotic medications but who desperately wants to stop. Having decided to make a life change, this person goes to one of the many for-profit Suboxone (also called buprenorphine) clinics in the region. To his or her dismay, the person learns that the cost of help, out of pocket, is $100 a week, or more than $5,000 a year, and no insurance applies. It could be very tempting for that person to ask the doctor for twice as much medication. That way, half the medicine can be sold on the street to pay for the next clinic visit.

I’m a practicing Ob/Gyn physician, and I see too many patients whose lives have been completely disrupted by opiate addiction. In the case of pregnant patients, one huge worry is that their babies will be born addicted to these substances. Addiction of newborn infants is called Neonatal Abstinence Syndrome, or NAS. NAS is the number one cause of admission to the neonatal intensive care unit at our local children’s hospital.

I have worked with opiate addicted pregnant women for almost a year with my department at our local medical school. I’m part of a program that seeks to help these women reduce their medication dosage in an effort to decrease the chance that their babies will develop NAS after they are born. Most of these women are highly motivated to help their babies, and it’s very satisfying to work with them. We take whatever payment the patient’s insurance provides and do not charge any additional fees. Unfortunately, the clinic stays full and there is frequently more demand for services than we can provide.

Medication Assisted Treatment (MAT) is a form of medical treatment where medication is used to control the symptoms of withdrawal that people experience when they stop using addictive drugs. For opiate addiction, methadone and buprenorphine (trade name forms are Subutex and Suboxone) are commonly used; these drugs themselves are addicting. In fact, the most common addiction I see among pregnant patients is an addiction to buprenorphine. Buprenorphine is by far the most common drug associated with NAS in our region. Stated another way, the most common drug associated with NAS is a drug designed for the treatment of drug addiction.

In the example above, I mentioned that patients sometimes sell their medication in order to afford their next visits to subutex (buprenorphine) for-profit clinics. This results in more buprenorphine on the streets, which fuels the opiate addiction crisis. In other areas of our country, patients receive their care from physicians who readily take their insurance That system is better than the one we have here in East Tennessee where existing laws requiring insurance coverage for addiction treatment may need better enforcement.

In the First District, we can start by taking a stand against a system that forces patients in our region to make inhumane choices in order to pay for their drug treatment visits. The system we currently have is bad for the human beings it is supposed to help. It also puts vast amounts of buprenorphine on the streets, making the opiate epidemic even more potent.

We can do better. For our people, for our next generation, for our communities, we MUST do better.