Doctors see encouraging results with medication-assisted drug treatment

While some people have expressed concerns about treating drug problems with other drugs, doctors say there is a clear scientific consensus that medication-assisted treatment works well in dealing with opioid addiction.

The treatment combines the use of medication with counseling services that offer coping skills and referrals to other agencies that can handle specific issues.

Doctors Paul Racicot and Paul Friend, who are associated with LRGHealthcare’s recovery center, have been treating patients with Suboxone, a formulation of buprenorphine, for nearly two years, and Racicot says the results have been better than expected.

“Dr. Friend and I went into this and were surprised,” he said. “We didn’t have a lot of great tools for dealing with these addictions until Suboxone came on the scene.”

In the past, methadone was the drug of preference for dealing with opioid addiction, but the problem, said Racicot, is that it requires high doses.

“It’s a long-acting, dangerous narcotic, and those trying to use methadone for treatment had to go in every day, which made it hard to hold a job. There was also a certain amount of euphoria with it, causing disorientation.

“Then Suboxone came along, and patients don’t gain a tolerance and don’t have to have dose increases. It’s a very potent blocker of opioid receptors, and also brings a fair amount of pain relief with it. It’s a legitimate pain medicine people do well on,” he said. “The other fallout I never expected was almost all of our patients are able to work. Most are very excited to be working for the first time in years. It stops the cycle: They’re not committing crimes, and not going to jail.”

The recovery clinic, which includes a partnership with Horizons Counseling, of Gilford, initially operated out of the basement of Franklin Regional Hospital, but now also has a Gilford branch at LRGH Occupational Health.

“The clinic was one of the first not-for-profit medication-assisted treatment centers in the state-run by a hospital system,” Racicot said. “That meant a lot more access, especially with expanded Medicaid.”

He said, “One of the reasons Dr. Friend and I became interested in this is because, as ER and family physicians, we were seeing kids we knew, we were taking care of mother and son patients together. The big push is to break the cycle. If a child grows up in an addicted family, it’s hard for parents to be parents, and they are looking at drug and alcohol use by their children. Show me a child that’s hungry, and I’ll show you a family where there’s addiction, because with the cost of drugs, oftentimes there is neglect.”

The two doctors have relied on studies by Dartmouth-Hitchcock Medical Center in Lebanon, which found changes in brain chemistry as a result of the use of opioids. With chronic opioid addiction, Racicot said, the receptors get damaged and people need more of the drug to get the same effect.

“But there’s a certain healing with Suboxone,” Racicot said.

The drug helps to overcome the chemical deficit that develops in the brain of a person with an opioid addiction and can prevent the symptoms of withdrawal and drug craving without the feeling of euphoria that methadone produces.