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New Proposed Rules Create Barriers to Buprenorphine

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On Jan. 30, 2023, the Biden Administration announced it would end the COVID public health emergency, which could mean new issues regarding telehealth and Medication-Assisted Treatment when the order ends in May this year. MAT, especially buprenorphine, was expanded to online access for most people with opioid use disorder, giving greater access to desperately needed treatment for people in rural areas. Now, it appears that access to buprenorphine may be trickier than it seemed before.

The expansion has saved lives, and there have been repeated assurances by HHS, DEA, SAMHSA, and even the Biden Administration that telehealth buprenorphine patients won’t lose access to treatment. The truth, however, is murkier than it seems. It appears the DEA wants to put much stronger limits to telehealth treatment in place, which could cause unsurmountable access barriers for people who can’t go in person to get their meds prescribed.

What Will the Proposed Rules Do for MAT?

The new proposed rules, treatment advocates say, could cause more harm than good. While they say they’re not stripping access to treatment, the rules would make treatment much more difficult for vulnerable demographics. Patients will be required to have in-person exams and will not be able to continue to a fully virtual telemedicine care regimen. Patients already taking MAT will not be exempted; if their care began at a virtual clinic, they now would need to meet a treatment provider in-person to continue their care.

There seems to be little scientific reasoning behind this; unlike other treatment drugs, buprenorphine is a partial opioid agonist. It is less likely to be abused compared to other opioids due to its unique pharmacological properties and the way it is prescribed. Buprenorphine has a "ceiling effect," which means that after a specific dose, taking more medication does not produce any additional effects, making it less likely to be abused.

Increasing MAT Access Can Only Be a Good Thing

Many medical and professional societies have advocated for increased access to MAT, including buprenorphine. The American Society of Addiction Medicine (ASAM), a professional society representing physicians, clinicians, and other healthcare professionals specializing in addiction medicine, has long argued for increased access to MAT to improve treatment for opioid addiction. The American Medical Association (AMA), the largest professional association of physicians in the United States, has supported efforts to expand access to buprenorphine as part of a comprehensive approach to addressing the opioid epidemic.

Other doctor organizations have recognized the importance of increasing access to buprenorphine to help combat the opioid epidemic and improve the treatment of opioid addiction. The American Academy of Family Physicians, American College of Physicians, and American Osteopathic Association have written letters or papers supporting increasing access to buprenorphine.

Hundreds of organizations signed a paper asking the Biden Administration to make the emergency act telehealth provisions permanent last year; however, the DEA seems to have other thoughts about drug and MAT safety and administration.

Hopefully, the DEA will listen to these organizations and create a rule that’s fair and flexible so that patients can get the treatment they need with the fewest barriers possible.

Getting Help for Addiction

If you or somebody you know in recovery is interested in sober housing options, we’ve got space in our safe, sober, friendly community. Learn more about your options and how our programs work by giving us a call.

Medication-Assisted Treatment is considered the gold standard of treatment for opioid use disorder. Experts say the medication, alongside appropriate treatment, and peer support groups is backed by science. MAT can help individuals begin to live substance-free while quelling withdrawal symptoms and cravings. But how well does it work for people who use fentanyl, a drug that is 50 to 100 times the potency of morphine?

Opioid Use Disorder and Fentanyl

Fentanyl is a highly potent drug that is typically used by experienced drug users. Many people who are exposed to drugs in a medical setting end up misusing them. Some people misuse prescription drugs after surgery. Others start out with recreational opioid use, such as OxyContin pills sold online or on the street. Eventually, addiction becomes costly, and people may move up to more potent drugs. Many people who use heroin, Oxycontin and other opioids decide to try fentanyl, a much more potent drug.

Fentanyl addiction is dangerous and deadly. People can quickly become physically addicted, experiencing intense withdrawal symptoms if they cannot use an opioid. Withdrawal is the top reason many people resist getting sober from opioids. People who use fentanyl will have stronger withdrawal symptoms than those using a less potent drug.

Deciding on MAT Dosage For Fentanyl Users

When a person gets sober from opioids and enters a detox program, they are assessed by a clinician for detox symptoms.  Yes, MAT can be successful for people addicted to higher-dose opioids.  People who have used high doses of drugs such as heroin have still found relief and freedom from cravings using treatment drugs such as methadone, Suboxone or Naltrexone.

A doctor or nurse practitioner will help administer MAT and assess a patient for symptoms after they’ve been sober for 24 hours. There may need to be adjustments to the initial dose. All dosage decisions are made between the healthcare provider and the patient. Some patients will stay on MAT for the duration of their inpatient treatment. Others will stay on it indefinitely. The CDC has said MAT is safe to use for years. For this reason, most sober housing programs treat MAT like they do most medications.

Sober Housing and MAT

People who are sober and meet the requirements of sober housing programs often are on medication. MAT isn’t a big deal; programs are more about focusing on recovery. If you’re interested in sober housing, our program offers community, safety, and recovery in a serene and vibrant environment. Give us a

Addiction Is a treatable disease, and trust-building with loved ones is integral to the healing process. For some couples, it makes sense to seek couples therapy and strengthen their relationship. Couples therapy offers a space and time for romantic partners to work on their issues with a facilitator.

People who struggle with substance use disorder often have trouble in their relationships. After all, addiction is a disease of the brain. As a person becomes dependent on a substance, the way they act and think may change. The brain is focused on making its reward system happy rather than being a reasonable and responsible family member.

Why Couples Therapy?

Addiction is a disease that can leave much damage in its wake. It’s hard for partners and other loved ones to watch as somebody spirals out of control. They may try to help their partner only to be “shut out” or lied to.

Addiction is a family disease, and everyone in the addicted person’s life is affected by it. For some families, many false notions of stigma are still attached to the idea of addiction. People may be hurt or overwhelmed when their loved one admits there’s a problem.

Families, love, and emotions are complex. Addiction recovery helps the addicted person begin to rebuild their lives and stay sober. Therapy helps everyone adjust to the new changes and find ways to build trust together. A therapist can help facilitate difficult conversations about commitment, fears, sadness, anger, and past hurts that must be addressed.

Addiction Education In Couple’s Therapy

It’s essential to seek out a therapist that understands and works with families who live with a person with substance use issues. Many treatment centers and sober living communities have access to therapy for couples to work together.

Educating family members is also a big part of family therapy. Understanding that addiction is a disease of the brain, but it’s treatable is essential. Families need education about addiction's physical, mental, and emotional effects. They also need to learn more about recovery in general.

Couples may have experienced financial issues, job loss, arrests, and other wreckage. Sorting through and acknowledging the hurt with a professional can help couples build a healthier relationships.

Consider A Sober Living Community Post-Treatment

For many people, even married couples, treatment is just the beginning of a long journey toward long-term sobriety. After treatment, a sober living home can offer the community and support structure to start living life in early recovery. Learn more about your housing options by contacting us at 760-216-2077.

Many people who decide to get sober use tools like Medication-Assisted Treatment to reduce withdrawal symptoms and help them focus on their recovery. Sublocade is a Medication-Assisted Treatment option many people prefer because it’s only administered once a month. It is prescribed and administered by medical professionals for people with opioid use disorder who want to stay sober.

What Is Sublocade?

Sublocade contains the drug buprenorphine and is administered monthly in a medical provider’s office. For many people, it’s a safe and responsible way to go about their lives while getting relief from withdrawal symptoms and opioid cravings.

Sublocade works best when the person taking it also gets counseling via drug treatment or one-on-one therapy. This can help newly sober people gain insight into themselves and understand their addiction. Opioid use disorder is manageable, but Medication-Assisted treatment is only part of managing it. Getting therapy can also help somebody learn new coping skills and learn to live a more authentic, happy life drug-free.

How Often Is Sublocade Needed?

People prescribed Sublocade need to get the injection monthly in a healthcare provider’s office. Most treatment providers will start patients with a 300mg dosage and eventually will be weaned down to a lower dose, usually 100mg. Some people will stay on 300mg longer if their healthcare provider deems it necessary.

People can use Sublocade as MAT for as long as the doctor approves. Some people will get an injection for months, while others may need to stay on it for years.

Sublocade Injections Increase Sobriety Success Rates

According to the manufacturer, in one clinical study, people treated with Sublocade were fourteen times more likely to complete their treatment programs and stay sober. 28% of people who got therapy/treatment alongside their MAT stayed sober for at least 24 months.

In the study, the group that was given a placebo only had a 3% success rate over the same period. While some people did relapse in the more successful group, everyone who stayed sober for at least 80% of those 24 months did so with the help of Sublocade.

Consider Sober Living

If you or somebody you love needs a safe space to lay their head, sober living may be the healthiest choice. Living in an environment where people work toward positive change can be inspiring and help you stay focused on your goals. Learn more about our communities by calling us at 760-216-2077.

For many people with opioid use disorder, Medication-Assisted Treatment (MAT) such as Suboxone or Vivitrol is a lifeline to long-term sobriety. While MAT is not the best option for everyone, thousands of people across America have used it in one form or another to help put distance between themselves and their last use of illicit drugs.

Becoming Familiar With MAT

MAT is considered an important tool for people with opioid use disorder. The recovery community has not necessarily embraced it as the go-to tool for addiction recovery, mainly due to worries about its safety. Many people who got sober without the aid of MAT may have reservations about its use. However, the FDA has recently recommended the use of agonist or partial agonist medications (methadone, buprenorphine) to support abstinence. Through this endorsement, more treatment centers have decided to add MAT as a tool for people new to recovery.

Like all treatment tools, MAT is an option, but it’s not the only way people can get and stay sober. We’re fighting a deepening opioid crisis, and treatment providers, as well as their clients, deserve to have as many tools at their disposal as possible. MAT definitely can provide a life-saving function for people who suffer from opioid dependence and addiction.

It is the role of the treatment providers and medical professionals to learn the facts about how medications work and find ways to support long-term recovery for individuals using these medications. This education on MAT includes those who run sober homes and housing programs for people in recovery.

According to data from 2018 gathered by the National Institute on Drug Abuse (NIDA), 128 people in the United States die from opioid overdoses every day. Medication-Assisted Treatment has helped thousands of people beat those odds by reducing cravings and assisting individuals to put more time between themselves and their drug of choice.

Guidance For Treatment Providers, Sober Housing, And Others

New guidance has been released by NIDA to help addiction treatment providers understand the ins and outs of prescribing and helping people use MAT as a part of their overall treatment plan.

While all treatment providers and sober housing professionals have their own programs that help them build a safe community, this information is vital to assisting professionals to make the right choice for their clients to begin their journey in recovery.

The guidelines brief attached can help sober living homes and other providers understand where MAT fits into an overall treatment plan. While MAT is still new to the sober housing community, it has been safely used in treatment facilities for a number of years. Understanding what role it can play will help housing communities draft their own policies based on science and information on treatment outcomes.

Download the guide here.

 

 

 

 

 

 

 

About the National Association of Recovery Residences (NARR):

NARR's mission, according to their website, is "to support persons in recovery from addiction by improving their access to quality recovery residences through standards, support services, placement, education, research, and advocacy."

 

About By the Sea Sober Living

Now, more than ever, it’s important to have people in your life who support your recovery. Sober living situations are a great way to rebuild your life and adjust to working on your new goals. Learn more about how our sober home can help you in your recovery. Call us at 760-216-2077 to learn about housing options.

As a person in recovery from addiction, you’ve gone through a lot of struggles just to stay sober. It’s not easy to fight against a substance use disorder. Treatment and therapy can help you cope with the transition from addiction to recovery. But what about when you have to spend most of your time in the “real world”? Will you be able to return to your career, or find work at all when you’re newly clean and sober? This can be quite a challenge for some people. But it’s a fact of life that everyone needs to have money to cover life expenses, such as shelter, food and other necessities.

Explaining Gaps in Employment

A lot of people in recovery feel they must explain gaps in employment on their resume. After all, you may have quit a job and gone on a bender, or simply remained unemployed for months or years because your addiction was in control. When addiction is control, a person may steal, show up late or not at all, or otherwise exercise poor judgement that leaves them unemployed.

A poor work history isn’t something that you can gloss over. If you want to resume a career and have a troubled work history, you may have to humble yourself with a job that pays your bills even if it isn’t your dream job.

It’s best to be honest about any mental health issues and your addiction/recovery up front. While you may feel there is stigma attached to your recovery, honesty is always best when you’re starting a new relationship with a potential employer.

If You Have a Criminal Record

Nowadays almost every employer does a background check when choosing who to hire. You should be prepared to admit this upfront and explain the ways you have made amends.

It’s true that if you have history of drug or alcohol-related offenses, you’re less likely to be offered interviews or a job. Be honest about your struggles and explain how you’re overcoming them.

Taking Different Jobs

We all live in the real world where it’s important to be realistic. If you need a job to pay the bills, then you need to humble yourself and take a job even if it’s not in your chosen field.

You can work a job while showing your dedication to the career you want. This means volunteering, getting more education, and working on getting a significant amount of sober time.

If you can’t find the job you want, or you keep getting turned down, it’s time for you to consider upgrading your skills. It’s important that you stay sober and always make that priority. If you stay sober, and continue to work, future employers will see your dedication and stability.

There are hundreds of free classes with certificates you can use to improve your resume while working a job outside of your field. Try classes from Alison.com or Coursera. Most of them are free!

Of course, asking around at 12-step meetings for job leads, guidance or other help can give you a leg up when it comes to job hunting. Never be afraid to ask for help, you’ll one day be able to pay it forward.

Living Sober

Are you looking for some extra support or a way to live with your recovering peers? Consider sober homes. Living with others who have similar goals can help you stay focused and safe from triggers. Give us a call at 760-216-2077 to learn more about your options.

Active addiction can derail your life, no matter who you are or where you come from. Getting clean and sober is a welcome relief to anyone who has struggled with the extreme ups and downs of a substance use disorder. For most people, however, the problems of addiction aren’t left behind. As the saying goes, “Wherever you go, there you are.” Just because you’ve removed the substance abuse from your life doesn’t mean that you’re completely healed and done with recovery. Much work will remain when you leave your treatment center, and it’s up to you to get that work done.

Plug Into a Support Network

Above all else, your recovery must come first when you’ve graduated from treatment. This means that as soon as you leave treatment, it’s up to you to create a support network. This could mean starting an aftercare program, seeing a therapist, or going to groups for your substance use disorder.

You will also need to build support from the 12-step meetings you go to. Finding a sponsor that you like and trust is an important step that you hopefully completed while in treatment. Once out, this person can be a lifeline to meetings, events, and coping tools you need when you first get clean and sober. If you don’t feel comfortable with your sponsor at first, give it some time. There’s nothing wrong with getting a new sponsor if the one you initially chose isn’t a perfect fit.

 

Consider Recovery Housing

Not everyone is ready to go to their old home when they get sober. Some people just feel safer around others in recovery, and others may not want to go home to a household full of triggers where people drink and use drugs.

It’s time for you to do what helps YOU stay sober. If this means taking time to transition to your new life, then consider a sober housing situation. Sober housing is a great way to test your wings in recovery but still have discipline and accountability to others who understand what you’re going through.

If you’re interested in your sober living options, you’re in the right place. We also have aftercare programs to help you if you need them. Take the time to relax and settle down in a structured environment that still makes time for fun. Our sober living environment was built to give you a solid foundation as well as teaching you how to enjoy life in your newfound recovery. Give us a call to learn more about your options at 760-216-2077.

Hillary Clinton's team seems to be placing a higher level of attention to substance use disorders, formerly known as addiction and alcoholism, with the heroin and methamphetamine epidemic in rural America. Seems like awareness is at senate level and permeating the verbiage of the candidate, hoping that their words get placed into action. What's great is that, apart from using google hangouts (pretty tight to be staying current and involving multiple brainstorming), their focus is on decriminalizing lower drug offenses, placing a priority for mental health and attention to treatment rather than incarceration. Great step guys. Now go do it.

http://www.nytimes.com/politics/first-draft/2015/06/01/hillary-clinton-focuses-on-drug-addiction-after-learning-scale-of-problem/?_r=0

Sober Living San Diego


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Manziel enters rehab. The timing with the superbowl seems like a perfect storm of celebration, media and gossip. I guess its not until it happens in the NFL that more attention is given to substance use disorders than even the entertainment industry (Whitney Houston, Robin Williams and Hoffman?) Big noise for a month...did we learn something from it? Thats its an epidemic? That its not only affecting 'big names' but also regular people? The Movie Studios with Hoffman had him do detox (as little as a week), only to have the pressure of money getting him back to work. If they relapse, whos to blame? Agents? Managers? Studios? Now we have the NFL. This will be a great opportunity to see how we view recovery and the time it takes for someone to 'heal' before they get back to the field. Will he get back after rehab? Will there be a time period where Manziel's needs are met before football is even mentioned? Heres to an amazing athlete who deserves not only a short term attention, but care for long term and attention to the family. Oh, yes. And an opportunity to educate the viewers. Ball is on your court NFL.

http://espn.go.com/nfl/story/_/id/12267487/johnny-manziel-cleveland-browns-entering-rehab-improve-himself

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Hmmm....so you mean there is a high probability that youth's on their phone all the time might also be misusing substances. Interesting. Thoughts? I wonder if the people making the tests have an issue with it and how they came about studying it. I mean, who are the individuals who placed so much value in it, and by value I mean money. How much is facebook and twitter worth? I wonder if what were studying to understand is more a reflection of what we value and if their is a contradiction of what we want as opposed to what we are creating. Perhaps a bit too deep, but I personally wouldn't get too overwhelmed into studying the disorder of social media as opposed to understanding the torn social dynamics, specifically generational value and appreciation gaps. Those I have yet to see studied.

http://www.huffingtonpost.com/2014/12/13/social-media-addiction_n_6302814.html

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