PDT Staff Writer
Orman Hall, Director of the Ohio Department of Alcohol and Drug Addiction Services (ODADAS), said the state has a protocol that allows for longer use of Suboxone as a treatment for prescription drug abuse.
In a recent Times story, Scioto County Counseling Center Director Ed Hughes and the Counseling Center’s Medical Director Dr. Terry Johnson said they believe the maximum use for Suboxone in their treatment protocol is two weeks — long enough to keep the patient from being sick when the come off of a drug such as oxycodone.
Hall says ODADAS has a different protocol.
“The general approach that we are taking with Medication-Assisted Treatment (MAT) is, based on our protocol, that no one gets more medication than what they need, because Suboxone has a ceiling effect, and if people are dosed at a level that is higher than what they physically need, there is a high probability that it is going to be diverted and used inappropriately,” Hall said.
“So our low-dose protocol is really about making sure that people have just the amount of medication that they need. But we also believe that it is important for people to have access to medication for as long as they need to be in a stable recovery. It is my understanding with outpatient services the Counseling Center is actually using the department’s (ODADAS) low-dose protocol, and there isn’t a two-week limit to the amount of time that people can receive medication. I think that they are just applying that (two-week maximum) to those persons who are in residence. That’s a little bit of a nuance, and we are certainly going to take a look at the practice that they are engaging in. But for the majority of their clients that are receiving outpatient services, they are doing precisely what the department is recommending.”
Hughes was not reachable for comment by phone Thursday afternoon.
Hall said ODADAS has work to do to make sure everyone is in alignment with the protocol.
“One of the things we all agree on is, medication without treatment isn’t effective,” Hall said. “Where we may disagree is that for most people that are opiate-addicted, treatment without medication is, from our perspective, not likely to be effective either for most people. Everybody is different. There may be some highly-motivated people, or some people who have failed in treatment previously that can be in stable recovery without medication. I certainly wouldn’t want to exclude that population. But statistically, based on the data that we’re looking at in national studies, it appears to us that medication is necessary for most people that are opiate addicted, and again, many of them will need it for an extended period of time — while they are in treatment — in order for them to have a reasonable chance of being in stable recovery.”
Hall said national studies show the potential for relapse without medication is between 80 and 95 percent, based on analysis of looking at relapse data without medication assistance. He said because of that data, ODADAS has taken a “strong stance” of supporting Medication-Assisted Treatment.
“With that said, we understand there is a significant problem around diversion, and that there are misinformed physicians that are not using medications in a manner that is consistent with helping people to be in recovery,” Hall said. “And it is also our understanding that there may be a significant presence of those types of practitioners in the southern part of our state.”
Hughes and Johnson also warned of just such activity by saying there are Suboxone clinics in surrounding states that may be looking to locate in Scioto County that may be simply handing out prescriptions for Suboxone without adequate treatment programs.
“We are currently in the process of trying to understand the scope of the diversion problem that is taking place in our state, and we will be addressing that in the near future,” Hall said.
Stacey Frohnapfel-Hasson, Chief of the Division of Communications and Workforce Development for ODADAS, said the concern for misuse of Suboxone still exists and is being monitored by their agency.
“There still is the education roadblock in terms of using high doses over extended periods of time that could definitely lead to addiction,” Frohnapfel-Hasson said. “And we’re trying to attack that on the education front, so that we don’t create another generation of individuals addicted to these narcotics.”
Frank Lewis may be reached at 740-353-3101, ext. 232, or at firstname.lastname@example.org.