Criminal charges before and after initiation of buprenorphine maintenance

I would have thought this was a softball in support of buprenorphine. But, no:

Among subjects with prior criminal charges, initiation of office-based buprenorphine treatment did not appear to have a significant impact on subsequent criminal charges.

The paper gets a little says that this lack of effect includes drug charges. I’m no fan of buprenorphine maintenance and even I’m surprised.

6 Comments

Filed under Controversies, Harm Reduction, Policy, Research, Treatment

6 responses to “Criminal charges before and after initiation of buprenorphine maintenance

  1. I often wonder why so many doctors that WE know, here in Washtenaw County are so generous with their Suboxone prescriptions? And I was under the impression THEY worked for Dawn Farm & one of them sits on the board? I could be wrong, but [names removed by editor], and a couple of other area doctors are rather heavy-handed with their Suboxone scripts, aren’t they? I recently talked with an employee of the Suboxone parent company & he said [name removed] is one og the leading Suboxone prescribers in the midwest, maybe even the nation. And doctor [name removed] is VERY pro-Suboxone, prescribing it to many, MANY local recovering addicts. Yet I’m consistently told Dawn Farm is now ‘anti-Suboxone.’ I reserve the right to be wrong, so I’ve been wondering for some time now how this plays out with these doctors, who to my knowledge, are affiliated with Dawn Farm.

    • We’ve had frank conversations with all the doctors you mentioned about the issue. Some are on the same page, others disagree with us. That’s going to happen within a community of practitioners.

      This is also something that’s evolving. At least a couple of them are considerably more skeptical of Suboxone than they were just a year or two ago. Some used to prescribe Suboxone for maintenance and have stopped, others continue. Further, even those who are most comfortable with Suboxone support our practices because they argue that Suboxone makes sense as an adjunct to low intensity outpatient services but would have no place in a residential setting.

      That said, these guys volunteer, or have volunteered for us, and have helped thousands of addicts with no or little pay. However, Dawn Farm’s Suboxone practices are determined by Dawn Farm’s leadership team.

      • Ernie M

        Ah, that seems to shed more light on it. There’s probably more I could have said in my post, but it wasn’t appropriate in a public setting like this, you know what I mean. BUT, I would love to discuss this, & other ‘cutting
        edge’ issues, with you in person, Jay. And I haven’t really seen you in a fairly long time, but since subscribing to your posts here I realize that we have a lot of interests in common, that would probably bore many people! LOL, I’ll give you a call sometime & see if we can meet up for a cup of coffee or something!
        I think you are spot on saying that there are evolving feelings/theories about Suboxone. Who knows how people, especially doctors, may view it in five years time, considering the huge change in opinion from five years ago! I’ll go ahead & say what I’ve been thinking: It would appear that it is the almighty dollar that dictates individual views on Suboxone, prescriber wise. I’ll be upfront: What I see, and many others I’ve talked to about this EXACT SAME ISSUE see (trust me Jay, it’s discussed A LOT at A.A. meetings around here & with A.A. members outside of meetings here) are area doctors one one hand saying (I’m gonna’ dumb it down here), “you are not sober if you’re on Suboxone maintenance,” but then they are prescribing Suboxone left & right & forcing patients to attend A.A. mtgs! Some of these doc’s are the highest Suboxone providers in the state! It’s baffling. I have a friend, a female A.A. member, who just the other day told me that she WILL NOT sponsor women on Suboxone b/c they are too much to deal with & they just are not sober if they are on that medication. I pointed out to her that she’s been on anti-depressants for 20 years, sober for twelve years, and no one questions her sobriety.

  2. Bryan

    The hard truth here is that people in recovery can’t be treated as a single group. Doctors obviously weigh the risks vs. potential reward of the drug before prescribing, but patients are unique. I think in a policy debate like this it can be really dangerous to say that “because Suzy is on medication XYZ her recovery isn’t as real as Bobby who takes nothing.” AA has a pamphlet on the place of medication within the fellowship and it essentially says that if an alcoholic is upfront and honest with his/her physician about their alcoholism it (medication decisions) lie in the hands of the patient and prescriber. I have run afoul of some closed-minded aa’s who have tried to run me out of the fellowship where I live in Phoenix, and it was because I admitted to a sponsor that an addictionologist had me on a medication (not bupe), and the advice I was given by my prescriber was to “keep it to myself” because without going to medical school and seeing my chart most people wouldn’t understand. I hate having secrets in AA, but going to meetings and working the steps are the most important things in my life. I’d probably be dead in a week without AA. I would really caution people from venturing too far into the medical arena, and especially in undervaluing the importance of recovery in people who are on any medication.

  3. Ernie M

    Well put, Bryan. We are mos def on the same page. It is amazing how so many people who, just a few years ago were panhandling to get cash to buy their next fix and/or drinking mouthwash & rubbing alcohol to calm their tremors, are now posing as medical experts and freely giving unsolicited advice on who is “not really sober” as well as creating rules where there were none before. It’s dangerous & counter productive. Many folks end up having to “keep it a secret” (medication intake in general) in order to avoid having “Bob the retired drunk” tell you that you are not really sober.

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