From Pill Mills to Counseling Centers

In the first part of this  post I am going to summarize an article by Kristen Gwynne on the drug Suboxone that appeared in the online site Salon on August 22, 2012 (click here). It appears that the pain clinics, or “pill mills,” which wildly over-dispensed OxyContin (generic name oxycodone) in Portsmouth and Scioto County are being replaced by “counseling centers” that will be dispensing Suboxone to people addicted to opioids ( a synthetic drug resembling opium), of which the most popular  and deadly one in Portsmouth was oxycodone (OxyContin). The name Suboxone suggests to me that it is a substitute, not only pharmaceutically but financially, for oxycodone. Suboxone and oxycodone are pharmaceutical cousins, but Suboxone is less toxic.  Taking the less toxic Suboxone is supposed to make the withdrawal from the more toxic opioides like oxycodone easier. But as Gwynne points out there are serious problems with Suboxone. She interviewed Joe, a 23-year-old recovering addict who has been using Suboxone for three years. For much of that time he has been self-medicating with Suboxone, which he buys on the black market because the cost is cheaper than it would be if he were seeing a doctor and visiting a clinic. Joe says that if he were seeing a doctor and visiting a clinic,   a 90-day treatment program would cost him  $35,000. Because he doesn’t have insurance, or $35,000, he turns to the black market, where it is cheaper. But finding a doctor to treat him would not be easy in any case. Seventy-five percent of doctors qualified to prescribe Suboxone are limited to treating 30 patients a year, and twenty-five percent are allowed to treat 100 a year. Joe has been dependent on Suboxone five times longer than he was on OxyContin, so there is a dependency problem with Suboxone at least for some addicts. The owner of the new counseling center in Portsmouth is quoted as saying Suboxone is not addictive. That statement is not true.

The title of Gwynne’s article on Suboxone is “Doctors and Dealers Battle for Addicts.” Will that be the situation in Scioto County and in Portsmouth in particular? Is there already, a competition between doctors and drug dealers for addicts? Is there already a black market for Suboxone? 

 Lysol, Clearasil, and Suboxone

A British conglomerate, Reckitt-Benckiser (RB),  originally developed Suboxone.  Many of the cleaning, polishing, and other household products in the American homes are manufactured by RB, which hadn’t had  much experience with pharmaceuticals. RB originally manufactured Suboxone in pill form, but the U.S. Food and Drug Administration notified them that an alarming number of children were being poisoned by the drug. Reckitt-Benckiser made the drug child-proof by producing Suboxone in strips, which are placed under the tongue, where the drug is slowly absorbed into the blood stream. Since the law requires bottles with dangerous drugs to have child-proof caps, the question arises just how kids were getting access to the pills. The only answer that I can think of (Reckitt-Benckiser didn’t provide an explanation on their website: click here) is that the child-proof caps on medicine bottles in households with drug- addicted adults were not always put back on once they were taken off, nor were they likely put back in the medicine cabinet, if they had even ever been put there. This problem serves to remind us that drug-addicted people do not, probably cannot, act responsibly, even when the safety of children is concerned.

In God We Trust. All Others Pay Cash

The doctors and pill mills of Scioto County did a cash only business with oxycodone. Will it be the same  in Portsmouth with Suboxone? If so, we can  expect that addicts, some of whom will be attracted to Portsmouth because of Suboxone dispensing “counseling centers,” will turn to breaking into homes and cars to help pay for the drug, as they did with oxycodone. Because counseling centers, like the pill mills, will be bringing money into the city, the tendency will be to scrutinize them less closely, especially if they are advertising in the Daily Times and the Community Common, but the price the community may have to pay for the kind of patients, or customers, counseling centers attract will in the final analysis be much too  high, even higher than the $35,000 Joe couldn’t pay every ninety days.

   

                     You put Suboxone under your tongue and what do you get,

                     Ninety days older and $35,000 in debt.

                     St. Peter don’t open those Pearly Gates 'cause I can’t enter, 

                     I owe my soul to the counseling center.

A sub-lingual Suboxone strip