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Photo by National Cancer Institute on Unsplash.

Medication assisted treatment faces roadblocks in opioid addiction fight

In light of the decriminalization of hard drugs in Oregon, medical providers are calling on New Mexico to improve access to medication assisted treatment for substance abuse disorders for all populations across the state.

A recent study published in the Journal of Substance Abuse Treatment found that “buprenorphine and methadone in particular reduce fatal opioid overdose rates by 50–70%, reduce illicit drug use, increase treatment retention and improve psychosocial outcomes.”

While the D.A.R.E. campaign enthusiastically warned students about the dangers of drug use in the late 90’s, “pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers,” according to the National Institutes of Health.

In 2017, almost 1.7 million people in the United States suffered from an opioid use disorder (OUD), and the following year 63% of drug overdose deaths in New Mexico involved opioids.

However, the medical community has found a proven solution to help people suffering from addiction in the form of medication assisted treatments. The Substance Abuse and Mental Health Services Administration states that prescriptions of buprenorphine or methadone “relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body.”

Dr. Valerie Carrejo, an associate professor at the University of New Mexico School of Medicine and program director for the Addiction Medicine Fellowship, said that she couldn’t “speak highly enough of the success (she’s) seen … treating patients with OUD and using medications has been the most successful way to help people.”

Carrejo said that on the “neurobiological side of it, drug use changes the makeup of the brain … and medication puts it back in balance, similar to how someone with depression needs to take antidepressants to rebalance their brain chemistry.”

Emily Kaltenbach, the senior director of resident states and New Mexico for the Drug Policy Alliance, addressed public concerns about illegal sales of buprenorphine in an interview with the Daily Lobo.

She said that buprenorphine is being sold on the streets because people across the state have limited access to the medication and are “pushed to purchase their own treatment from the underground market.”

According to Kaltenbach, buprenorphine is one of the most common forms of contraband in jails because people receiving medication assisted treatment are forced to come off their medication and must seek out treatment by other means.

“It’s unconscionable that we would not allow someone to continue their medication in a jail based setting,” Kaltenbach said.

Both Kaltenbach and Carrejo likened the prescription of buprenorphine or methadone to prescriptions for other diseases, the latter stating it should be treated “just like diabetes, obesity or heart disease.”

Across the pond, Switzerland has taken a more intensive approach to people suffering from OUD. In 1994, the country legalized heroin-assisted treatment (HAT), which allowed the prescription of pharmaceutical-grade heroin. The legalization saw staggering results, with a decline in new heroin users, a drop in drug overdoses by 64% and a drop in HIV infections by 84%.

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While pharmaceutical-grade heroin was legalized for use in HAT programs in Switzerland, Carrejo pointed out that in the United States, heroin’s classification as a schedule I controlled substance prevents it from being used in therapeutic settings.

Another treatment option in the U.S. could soon be the prescription of the narcotic hydromorphone for people with severe OUD, a step already taken by pilot programs in Canada.

One such four year program in British Columbia prescribes hydromorphone tablets and provides “wrap-around services, such as peer support, medical care, mental health support and a personal support plan.”

In New Mexico, the Drug Policy Alliance is currently trying to launch a hydromorphone pilot program of its own that would implement the prescription use of hydromorphone in clinical settings. Kaltenbach said that early research in the U.S. has shown that “hydromorphone works even better than (pharmaceutical-grade heroin) and doesn’t have the same federal obstacles.”

When asked about the public support of such a program, Carrejo was hesitant and said it depends on what part of New Mexico would be considered.

“There’s a lot of resistance in parts of our population … that believe that addiction is a matter of willpower,” Carrejo said.

Regardless, Kaltenbach remains hopeful that New Mexico can eventually follow the Oregon model, which would lead to “fewer people in jail and prisons who have a dependency on opiates.”

As the scope of treatment options continues to expand, Carrejo left New Mexicans with the humanistic reminder that those suffering from substance abuse deserve empathy and respect as they battle their disease.

“Normalizing (people with OUD) goes back to helping that pregnant mom when she’s addicted and treating her like a human as she brings a new human into this society,” Carrejo said.

Shelby Kleinhans is a freelance photographer and beat reporter at the Daily Lobo. She can be contacted at news@dailylobo.com or on Twitter @BirdsNotReal99

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