A deeper look inside Suboxone clinics and the double-edged drug

TRI-CITIES, TN (WJHL) -Suboxone. It’s meant to help wean people off opioid-dependency, with the promise of a bright light at the end of the dark tunnel of addiction.

But left in the wrong hands, without proper oversight, it can be prescribed chaos.

“It’s strongly abused. Heavily abused. One of the most abused prescription narcotics we have in this county,” Carter County Sgt. Harmon Duncan said in April, when News Channel 11 tackled Suboxone’s intended use versus growing abuse in the Tri-Cities.

News Channel 11 delve deeper in this report by going inside a Suboxone clinic and inside the lives of two recovering addicts – on flip sides of the double-edged drug.

“I was a drywall man,” Sam Campbell said. “And I injured myself.”

“After I had him, (her now 12-year-old son) they prescribed me pain pills,” Amy* said.

Both paths were paved similar enough for Amy and Sam, pain killers taken with innocent intentions – to feel better. But soon, both began feeling lost without them.

“I was selling everything I had at the end,” Campbell said.

“I am addicted – it hit me. And since then, it’s just been a downward spiral,” Amy said.

They’re two addicts, working to reclaim their lives at different mile markers on the road to recovery.

Amy is now five months clean.

“It’s really hard,” Amy said.

And Campbell –

“Four years sober,” Campbell said.

Suboxone has played a role in each of their journeys. But thatis where the road split.

“It just cleared my mind up,” Campbell said.

“I wish I never would have put the first one in my mouth,” Amy said. “Every time I’m getting high off of it, I would crave everything I could get – everything!”

“I withdrew off of Suboxone so many times… And you do withdrawal severely from it. Anybody that says you don’t, if they were to take them themselves for any period of time and try to stop, they would know,” Amy told News Channel 11.

Suboxone is the brand name for a combination of buprenorphine, which is an opiate, and naloxone.

“Naloxone is added so that people do not take the Suboxone tablets or the films and inject them,” Sarah Melton, an Associate Professor in the Department of Pharmacy Practice, at East Tennessee State University’s Bill Gatton College of Pharmacy said. “Naloxone would make them go into withdrawal.”

Because of that, Melton says Suboxone is less likely to be abused than pure buprenorphine, which being sold under the brand name Subutex.

“That IS a primary drug of abuse,” Dr. Tom Reach, of Watauga Recovery Center told News Channel 11. “It is injected, and it’s very commonly injected up in Appalachia, up in the hill country in Eastern Kentucky and Southwest Virginia. I think Subutex is as bad a problem in those areas, as would be morphine or hydrocodone or oxycodone, because it’s an injectable drug.”

While Suboxone’s risk for abuse may be lower than Subutex, you wouldn’t know it talking to local law enforcement.

“Suboxone’s the most common one out there. It’s – again, it’s like buying M&Ms. Any doctor will prescribe it, it’s easy to abuse, and if the doctor won’t prescribe it they’re cheap, they’re $20 a pill in the street. My specialty is really methamphetamine. Most of the methamphetamine raids I have, we’ll find suboxone or oxycodone there, if they’re in one, they’re in all of them,” Sgt. Duncan said.

“I crave it more than any drug I’ve ever done,” Amy said.

In Amy’s experience trying two different Suboxone clinics in Johnson City, “You do not get individual care. I believe they’re worried about getting your money, they do not drug test like they’re supposed to, they do not taper like they’re supposed to,” Amy said.

Federal numbers indicate Tennessee has the highest number of doctors prescribing the drug per capita in the southeast, southeast, aside from Kentucky.

“We have some of the highest overdose rates from opioids in the country,” Melton said. “And we need access for these patients to get appropriate treatment. And I think that’s why you have seen so many clinics open recently, but again the important thing is, we must have comprehensive components for our patients to really get better. The medication alone really isn’t the best way to go.”

“Every treatment program that is done appropriately and has the best outcomes, have their patients doing counseling with a Certified Substance Abuse counselor, they have group meetings with support for their patients, they require their patients to go to Narcotics Anonymous, Alcoholics Anonymous, or a faith-based recovery program, such as Celebrate Recovery. In addition, the patients are going to get urine drug screens, breath alcohol tests, and they’re not going to be prescribed other controlled substances, like benzodiazepines. And their prescribers are going to be using the Controlled Substance Database on a regular basis, to make sure they’re not accessing other prescription medications that may have the potential for addiction,” Melton told News Channel 11.

But reality is falling short of that standard of care in some clinics.

“Both times I was prescribed Klonopin, a benzodiazepine. Everyone I know did,” Amy said. “The benzos that were prescribed with it, I – I was just as addicted to that as I was the Suboxone because, especially when they’re mixed. When you mix the benzodiazepines with the Suboxone, they’re intensified. It makes them feel stronger.”

Tipton told News Channel 11 when the women she sees come to Families Free, “Many times when women are prescribed about 4 Suboxone and 3 Klonopin a day, from what they have told us when they come into treatment. So most of the women take two, and sell the other two. We have an incredible amount of Suboxone that is on the streets in Johnson City and really, all over the region now. So it is diverted many times, they do alter the way that they take the medication, I think that happens more often with Subutex.”

“In essence, they are in active addiction, go to a treatment clinic and receive an opiate and a benzo. So, they are left to manage these two controlled substances on their own with very little other services or treatment to go along with it,” Tipton said of what she’s seen.

Only federally authorized doctors can prescribe buprenorphine. Currently, there is a 100-patient limit for each physician. Visits to Suboxone clinics average $100 per week, many times cash only, not including the cost of medication.

“There is a lot of money involved in this,” Tipton said.

According to the New York Times, Suboxone generated $1.55 billion in 2012, trumping the sales of medications like Viagra and Adderall.

Dr. Reach stands by the drug’s benefits. He knows firsthand the power of what he calls the “soul-swallowing, life threatening disease” of addiction.

“Back in the 90’s, I ended up getting involved in hard drugs. And I ended up losing my medical license,” Dr. Reach said.

Suboxone came on the market in 2002, after Dr. Reach got sober. But fearing its stigmatization, he invited us to his clinic, Watauga Recovery Center in Johnson City. Dr. Reach’s practice is a strong advocate of the 12-step program.

“Treating addiction is the solution, not the problem,” Dr. Reach said. “Lumping everyone who prescribes this medication into one category and painting a broad brush, is missing the significance of the fact that it is the most effective treatment for narcotics addiction. It’s saving lives. It’s changing people’s lives.”

Campbell is one of Dr. Reach’s patients, and knows that better than anyone.

“Oh my gosh, I, I wouldn’t be here today. I’d be dead I definitely would have been a goner a long time ago,” Campbell said. “I was able to take 10-15 Percocet 10’s a day, and I’m not PROUD of it. I’m ashamed of it. But that’s part of my healing process.”

“I didn’t have a car for three years. We’d WALK because of addiction,” Campbell said.

Campbell is still on Suboxone, which he credits for now having car, his family by his side, food on the table, and a hunger to live the life he thought he’d never get back.

“I wouldn’t be here to spend the next few years of the rest of my life. Hopefully I’ve got a few more,” Campbell said.

“Have we just traded one drug for another? Or have we treated the disease of narcotics addiction with an appropriate medication? And THAT’S the question people have to answer,” Dr. Reach said.

*Families Free Director Lisa Tipton request that we conceal Amy’s identity, as she’s currently in one of the organization’s recovery programs.

Copyright 2014 WJHL. All rights reserved.

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