To the editor:

I applaud the Carroll County commissioners who voted down providing Medication Assisted Treatment to those jail inmates not already in a MAT program. Just because the "standard of care” (as Jerry Knirk stated in his Oct. 11 column) is treating one opiate with another synthetic one, sometimes we have to dig deeper into the issue.

Knirk ends with the supposition that Carroll County is opening itself up to civil liability in the event an opiate-addicted inmate dies because the county is refusing to provide the standard of care of MAT for an inmate with opiate use disorder.

On the contrary, I happen to believe that he and other state lawmakers who currently promote the use of drugs such as Methadone and Suboxone that results in people’s long-term use of, addiction to and direct or indirect death will by reversing their legislation and policies toward MAT and one day be restricting and warning the public just like what happened with prescription opiates.

Suboxone (a combination of buprenorphine and naloxone) was introduced in 2003 in the U.S. for patients detoxing from opiates and going through withdrawal. In other words, its intended purpose was not for long-term use. In fact, many users say getting off Suboxone is harder than Oxycontin or heroin. The withdrawal symptoms are also worse, lasting weeks and months rather than days and includes psychological issues in addition to physical ones. How did a drug that was supposed to relieve withdrawal symptoms become the “standard of care” for opiate addiction? (Follow the money.)

On July 11, the Department of Justice issued a little-known press release: A global consumer goods conglomerate and maker of Suboxone, Indivior, agreed to pay $1.4 billion to resolve potential liability suits under federal investigation for the false marketing of the drug. Oxycontin has its place in pain medicine, no doubt. But we saw how it led to an addiction crisis. Are we seeing the same thing with Suboxone?

Statistics say MAT reduces crime, recidivism and illicit drug use. But someone on 60-100 mg of methadone or 16-24 mg of suboxone or a combination of suboxone and marijuana — another legalized form of harm reduction — can be anywhere from impaired to disabled, in other words — you can get high.

The goal in recovery is optimal health and wellness. Let’s not start by giving in to a flawed “standard.”

Knirk warns us that withholding MAT from an incarcerated person with an established or new diagnosis is indefensible. OK, so you put them on Suboxone for their established sentence and then what? Put them on parole for the rest of their life in order to monitor their state-sponsored MAT program?

Many people, including those leaving jail and prison, don’t have the insurance, benefits, money, transportation, family support, primary care provider or motivation to follow through on a treatment plan that can support MAT.

So what happens? They use illicit Suboxone or other drugs on the street. They use heroin. For those post incarceration, they have more of a chance if they never used Suboxone in jail. Period.

Let’s spend the money on dynamic abstinence-based treatment in jail and on re-entry programs post-incarceration.

To me, it is indefensible to put "standard of care" above quality of life. To me, MAT just stands for “More Addiction and Trouble.”

Beth Dyer

Jackson

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(2) comments

dicktilton

Beth Dyer's lengthy comments regarding MAT programs boil down to, "Just say no." Qualified addiction specialists disagree. Too many uninformed people still want to punish addicts- even if their only crime is drug use. Unless we start treating addiction as an illness, we will continue to have desperate addicts committing crimes to get drugs. Supervised addiction programs- including Methadone treatment- can be effective in keeping addicts from committing violent crimes to score drugs. We need to be pragmatic in our approach. Affordable, legalized, controlled drugs may well be key to reducing the horrific costs of addiction-related violence in our communities.

marspike7

Interesting perspective Beth but I am not quite sure where you are getting your information from.

“People released from jail or prison are at increased risk of death, especially in the first four weeks after leaving incarceration. The prime driver is drug overdose, including opioid overdose death. While opioid agonist therapy — buprenorphine or methadone — has been shown to substantially reduce death rates from opioid overdose in the general population, these treatments are rarely available in jail or prison settings. But they could have a big impact. A British study found that prison-based opioid agonist therapy was associated with a 75% reduction in death in the first four weeks after release. In Rhode Island the post-release overdose death rate dropped 61% within a year after the state implemented an MAT-in-corrections program (offering buprenorphine, methadone, and naltrexone).”

Yes Indivior was sued but it was because they were trying to keep generic Suboxone out of the market.

In 2010 the UK changed its drug policy from MAT to abstinence based and as a direct result death rates from overdoses skyrocketed.

I know many, many people who have had their lives restored and given back to them because of Suboxone.

I am one of them.

No medication is perfect but Suboxone saves lives.

You can’t treat the dead.

Kind regards,

Mark

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