Suboxone Abuse Worries Officials in Vermont

Abuse of Suboxone, a drug used to treat addiction, is a growing concern among Vermont corrections officials.

The Burlington Free Press reports that the drug, prescribed on an outpatient basis for addiction to heroin and prescription painkillers, such as oxycodone, is being diverted by the very people it was designed to help. People have tried to smuggle the drug into the state’s prisons in a variety of creative ways, including a ballpoint pen stuffed with powder from Suboxone tablets, and a poster decorated with children’s fingerprints that were sprinkled with Suboxone powder.

Vermont Corrections Commissioner Andrew Pallito told the newspaper that Suboxone is the most common form of an illegal drug seized as contraband within the state’s correctional facilities.

According to the article, Suboxone (buprenorphine and naloxone) was dispensed in Vermont at four times the national rate in 2010. Some doctors in the state have recently stopped dispensing the drug, because they are concerned patients need more help in addressing their addiction than simply giving them a pill. Many patients who need Suboxone treatment also have mental health issues, they say.

Vermont Health Commissioner Harry Chen, who is a doctor, told the newspaper that Suboxone must be administered as part of a comprehensive treatment plan, which includes both mental health counseling and ways of detecting abuse.

In May, The New York Times reported that smuggling of Suboxone into prison is a nationwide problem.

14 Responses to Suboxone Abuse Worries Officials in Vermont

  1. Barbara Kashinski | July 27, 2011 at 2:20 pm

    This is nothing new to those of us working in the field. I have known for a while that simply giving a Suboxone prescription from a Doc’s office is not an effective treatment for substance abuse. The use of Suboxone must be tied to comprehensive treatment as methadone treatment – required UDS testing, required monthly counseling visits. Suboxone, just like Methadone, can be an effective tool in treating substance abuse if comprehensive counseling services are provided along with the prescription.

  2. Dr. Salim Abud | July 27, 2011 at 4:01 pm

    The article misses 2 important points: 1) diversion is occuring for self-medication not abuse purposes, and 2) Vermont cut back to same on $$$, not because of they all of a sudden realized that just giving a pill wasn’t sufficient.

  3. Robert Charleston | July 28, 2011 at 4:54 am

    Suboxen can be used as a multi diagnosis aid to treat for depression, opiate withdrawl, and moderate to severe chronic pain finding a doctor who will precsribe this medicine for those reasons besides opiate withdrawl is difficult because I would think there would be a liability issue the MDs are to be concerned about. I do not have the funds to be treated with suboxen for my diagnosis(s). I have been incarcerated. I have a major history of opiate addiction due to an L-5 fusion, also a history of drug abuse, along with major depression. I really would like to see the full potential of treatment be able to be used with this medicine. This medicine most likely keeps the prison systems, establishments from going into riots and unstable social norms within the system. The good has to be pulled out and the benefits revealed of this medicine that keeps a calm within the system.

  4. Whitney O'Neill | July 28, 2011 at 10:27 am

    Since we prefer to incarcerate rather than treat addiction as the public health crisis that it is, these inmates are clearly trying to self-medicate. There is a clear bias to this article; many have found long-term recovery through the use of medications such as Suboxone. We are missing a vital opportunity to treat those suffering from addictive disease and offer them a way out of the cycle of recidivism. This is a waste of not only resources but precious lives.

    • Robert Charleston | July 28, 2011 at 9:53 pm

      Whitney, I could not have said it better. Even on the streets regular Joe’s who don’t have the money for treatment from Suboxen end up self-medicating themselves to treat what this medicine helps. Like most of my friends who take Suboxen we most of the time when we are on it for a period of time it just makes you feel normal again.

    • C. Quartararo | October 19, 2011 at 1:17 pm

      I agree that if used correctly Suboxone has huge positive effects to someone who truely needs help with opiate addiction. My husband and myself were both perscribed loratab pain pills for years for pain issues due to injuries received from a terrible car accident. We both became sick of the side effects of the pain pills and felt as if they were destroying our lives…plus we have 5 children who love and depend on us to be 100% at all times. We are both currently in a suboxe program with counseling from a local christian center. Our lives are so so great now…Suboxone in combination with support from our counselors and family has changed our lives for the better. It really saved us from a downward spiral in our lives that the painkillers were causing.

  5. Carrie Foley | July 29, 2011 at 7:22 am

    As a substance abuse/mental health professional treating inmates in a county jail/DOC environment, it becomes increasingly evident that some jails and most prisons allow drug dealing to exist within the walls. And not for self-medication purposes, for the most part–unless you consider illegal drug use ‘medicating’ an addxn. Many of our county jail prisoners refer to our own jail as a ‘maximum security’ facility and can hardly wait to be sentenced and sent to prison, where they know they get any substance of choice as long as they can arrange someone outside the prison to make payment arrangements. Suboxone is certainly effective for many addicts as prescribed by trained physicians if the addict is in an overall treatment program–but look at the rates of Rx for methadone (and consequent street availability) now that many physcians feel competent to prescribe it for pain. We are a long way from giving physicians adequate training and required in-services to actually BE competent in assessing, prescribing and monitoring (much less referring) patients with substance use issues, not to mention mental health issues in general. But when corrections officials and privatized medical services use Haldol and illegal drug dealing as chemcial physical and behavioral restraints, there certainly can be no effective rehabilitation of prisoners, which we espouse as the goal of incarceration.

  6. ChrisKelly | July 29, 2011 at 3:02 pm

    Why dont the prisons in Vermont provide subs to those prisoners who have opiate addictions? There is an entire organization set up to accredit In JAil addiction treatment units….this is done as a matter of human rights in most european countries. To deny this medical care to prisoners who need it is cruel and unusual punishment.

    I beleive that Reckett, the manufacturers of SUBUTEX and SUBOXONE will sell the meds at a discount to jails and prisons. Wake Up Vermont!!

  7. Kim Johnson | July 29, 2011 at 3:09 pm

    Maybe if prisons did a better job treating opiate addiction there would be less smuggling of medication.

  8. Thomas L. Haynes, MD | July 31, 2011 at 7:37 pm

    Diversion of Suboxone is surely a problem, but not only in correctional facilities. Diversion to the street occurs in part because the Federal government limits the number of opioid dependent patients being precribed Suboxone or Subutex to 100 per practitioner. This irrational restriction causes the very thing that the medication is designed to prevent: illegal use of drugs. This unsupervised use is not only illegal, but also dangerous. Many patients who see me prefer to get their Suboxone through legal channels. Yet I am limited by the government in how many patients I can help with this medication. By restricting the legitimate route of supply, the “black market” is encouraged. We need to see this artificial limit lifted, at least for those of us who are Board Certified in Addiction Medicine and are dedicated to the treatment of this disease.

  9. notwhatyouthink | August 1, 2011 at 10:51 am

    The issue with treatment is the addicted has to be buying what we are selling “treatment”, and so many times, the addict is looking to stop withdrawals not engage in any type of meaningful treatment or behavior change. That’s work and sometimes painful. It is so much easier to chemically induce feeling good rather than feeling good because of real substantive change. When the tolerance of opioids become so high the addict can no longer can get high, they are using to function and not be sick. This motivates the addict to seek opioid replace therapy, which is a good thing and a starting point. However, this in no way means they are looking for treatment or real behavior change. They are looking to not be sick to function. As long as they hold on to “old ways” and acting, thinking, and behaving like addicts the only thing different is they can make through the day without withdrawals. In terms of the prison system putting prison on drugs, I think this is counter productive. The best way to clear up an addicts mind is to get them off drugs and let the brain heal not numb them through out their prison stay. I would have no problem with slowly tapering prisoners off opioids to prevent horrible withdrawals but to keep than on a maintenance dose their whole prison stay is a disservice. To be released from prison physical dependent, with no money, no job, and heading back to the old neighborhood, just does not sound like a good idea to me. I say taper them, treat them, encourage them, and hope for the best.

  10. Angel Gonzalez | August 3, 2011 at 10:53 pm

    Last time I checked, bup diversion published studies revealed that it was predominantly related to attempts to self treat, many times because of lack of access to treatment.

  11. Doug | February 7, 2012 at 12:03 pm

    Wow. I feel “normal” (whatever that is) only because I quit cocaine and stayed away from it for the past couple of decades. Can we please get away from the notion that feeling normal means not feeling bad? Abstinence and a balanced lifestyle will heal most self-inflicted wounds to the brain. Taking a pill to feel “normal” is ludicrous. Giving a pill to keep someone from feeling the effects of their drug use is enabling. I work in drug courts and addictions treatment. We have clients on legal opiates nodding off in outpatient treatment groups. Keeping someone high throughout prison sounds like crappy public policy and job security for correctional officers, because these folks leave prison jonesing for their next fix, and that is the slippery slope that leads to the revolving prison door. As many of you noted, taking a pill is not recovery.

    • Rachel Z | March 6, 2012 at 11:24 pm

      I agree with you. Suboxone is not the solution. It’s sold by dealers because addicts found they can get extremely high taking Suboxone and any cheap benzodiazepine with it. The effect is like mixing a pint of vodka with a three or four sleeping pills. Recovery isn’t found in a pill and it never will be.

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