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I went to a conference where virtually every public and community health agency in the area where I live was represented. There is a change...

Showing posts with label naloxone. Show all posts
Showing posts with label naloxone. Show all posts

WHAT IS SUBOXONE? WHAT IS SUBUTEX? WHAT IS MAT & OBOT?

Suboxone is the name of a combination medication: buprenorphine and naloxone. I comes in different strengths. It is made into "films" that get absorbed in your cheek or tablets that get absorbed under your tongue. It is confusing to hear since when you hear naloxone, one thinks of the naloxone used to reverse opioid overdose.  It is all in the properties of each medication. When in film or tablet form AND absorbed via cheek or under tongue, the buprenorphine is the stronger of the two medications, when absorbed through the GI tract. The naloxone properties are different and it is weak in the GI tract and doesn't interfere with the buprenorphine combining with the opiate receptor site, in fact it might help it stick better. But, if misused and abused, and given nasally or IV somehow, the naloxone is stronger and prevents the buprenorphine from adhering to the opiate receptor site. The naloxone takes over the site and nothing else can enter since this med is very strong when given through nose or IV. Strange, but that is how it works in a nutshell.  That is why buprenorphine is usually given as a combination medication. To minimize abuse and prevent harm.

Subutex is a brand name for buprenorphine alone without any naloxone. It used to be that pregnant women received Subutex to minimize any chance of miscarriage. But nowadays, since it is only a danger if abused, Suboxone is often given to pregnant woman with the proper education on the chance of miscarriage if abused. Subutex might also be used for those switching from methadone to Suboxone. It makes for a smoother transition. I heard Subutex is becoming a more popular med in general for treatment but I am not certain on the actual facts. If it is true, then the only reason would be to get more people into treatment.

As I said in a previous post, suboxone is good for those with short history of opioid abuse, with the daily use not too great. If you experience cravings despite all else becoming stable then you need methadone.

Besides cravings, the biggest complaints I have heard from those who tried Suboxone Treatment is that they could not fall or stay asleep. Some complain of a constant headache. Others, it was muscle cramps in their thighs and calves. As with all narcotics constipation is the #1 complaint.

With the Opioid Crisis, Suboxone is becoming a focus point for treatment. Doctors take a course and become certified. Medication Assisted Treatment (MAT) or Office Based Opioid Treatment (OBOT) is what it is being called and you will be hearing a lot more about this. They are generally Suboxone Treatment. Some states already have many physicians participating. Physician participation does vary by state or area. All medication is given by an RN and the patient is assessed and progress monitored properly. Since it is office based, the stigma of a clinic is not there to interfere with any progress. It is a great way to help those newly addicted and a great way to get someone in treatment. As with any treatment program, there is drug testing and addiction counseling or group addiction counseling. It won't work unless you change your thinking AND your behaviors. If Suboxone doesn't work, there is methadone. Still treatment just different med for different needs. The downfall of methadone are the rules: so far, only a hospital or clinic setting may dispense methadone for addiction. I feel a change coming in the near future....


What is Naloxone?

This is an excerpt from SAMHSA's Opioid Prevention Toolkit,

*I underlined and did bold on pertinent info. After the SAMHSA paragraphs I summarize it all...

      " Opioid overdose-related deaths can be prevented when naloxone is administered in a timely manner. As a narcotic antagonist, naloxone displaces opiates from receptor sites in the brain and reverses respiratory depression that usually is the cause of overdose deaths.7 On the other hand, naloxone is not effective in treating overdoses of benzodiazepines (such as Valium®, Xanax®, or Klonopin®), barbiturates (Seconal® or Fiorinal®), clonidine, Elavil®, GHB, ketamine, or synthetics. It is also not effective in overdoses with stimulants, such as cocaine and amphetamines (including methamphetamine and Ecstasy). However, if opioids are taken in combination with other sedatives or stimulants, naloxone may be helpful. Naloxone injection has been approved by the United States Food and Drug Administration (FDA) and used for more than 40 years by emergency medical services (EMS) personnel to reverse opioid overdose and resuscitate persons who otherwise might have died in the absence of treatment.8

FACTS FOR COMMUNITY MEMBERS
Naloxone does not have the potential for abuse. It reverses the effects of opioid overdose.9 Injectable naloxone is relatively inexpensive. It typically is supplied as a kit with two syringes10 These kits require training on how to administer naloxone using a syringe. The FDA has also approved an intranasal naloxone product, called Narcan® Nasal Spray, and a naloxone auto-injector, called Evzio®. The intranasal spray is a pre-filled, needle-free device that requires no assembly. The auto-injector can deliver a dose of naloxone through clothing, if necessary, when placed on the outer thigh.  Prior to 2012, just six states had any laws that expanded access to naloxone or limited criminal liability.11 Today, 42 states and the District of Columbia have statutes that provide criminal liability protections to laypersons or first responders who administer naloxone. Thirty-nine states and the District of Columbia have statutes that provide civil liability protections to laypersons or first responders who administer naloxone. Thirty-eight states have statutes that offer criminal liability protections for prescribing or distributing naloxone. Thirty-three states have statutes that offer civil liability protections for prescribing or distributing naloxone. And 42 states have statutes that allow naloxone distribution to third parties or first responders via direct prescription or standing order.

https://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA16-4742

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**What it means:  Naloxone is a medication that is prescribed by a doctor. This medication has been used for many years in hospitals when needed for patients post surgery if having an unfavorable reaction to anesthesia and pain medication. These medications slow down breathing. If your breathing is not providing enough oxygen to your brain and your heart, your brain will be damaged and your heart will stop. Naloxone is a special medication that can instantly reverse this situation! Miracle med!! Before the opioid crisis, this medication was given IV in hospitals. Now, you can get a prescription for naloxone that can be given by spraying in one nostril (close the other one) or by injection *thru the clothes* eliminating precious time unclothing the person (it will even tell you what to do). 42 states allow "third parties" (such as clinics) to give out naloxone by a "standing order", which means you don't need to personally see a doctor to get it. Just show up at the appropriate clinic and ask for it. No questions. 39 states have a law in effect that protects whoever calls 911...no arrests, no searches, if you call 911 to save a life. So please, call 911 for anyone in need. Don't drop someone off at an Emergency Room! Parents, friends, get a prescription for naloxone and carry it with you. No incrimination when asking for a prescription. You CANNOT harm someone if you give it and they don't need it. It just won't do anything. No side effects. But, if they need it...you saved a life and there is no better feeling than making a difference! One thing to remember, once given during an overdose, the person might need a second dose after a 30-60 seconds if no response. Why? It is because of the super duped drugs out there....carfentanil......making the drugs more potent and deadly. That is why naloxone always comes in packages of 2. Like  I said, it can't hurt and if needed will save a life. After receiving naloxone the person will start breathing and then will be in withdrawals. So, give the spray or injection then call 911 right away! Don't wait to see how it works. They will need intervention for their drug use and this is the perfect opportunity. Plus they need a medical evaluation to ensure they do not need any other medical care.