Despite being the go-to drug for treating opioid addiction, more pharmacies are yet to stock it. But, why is it so? At the age of 29, Louis Morano already knows what exactly he needs, as well as, where to find it. Morano has had seven stints in opioid addiction rehab over the last 15 years. As such, he decided to visit a mobile clinic parked on a Kensington neighborhood corner in Philadelphia. This is the geographical heart of the overdose crisis of this city. The mobile clinic is often referred to as a “bupe bus” by the locals.
Buprenorphine is known for treating opioid addiction withdrawal symptoms and curbing cravings. Suboxone is among the common names that are used in regards to drugs that have it. This drug combines naloxone and buprenorphine.
Buprenorphine is among the three medicines approved by the FDA for use in combination with cognitive behavioral therapy as the gold standard for treating opioid addiction. Morano is one of the many people that Google ‘rehab near me’ (check AddictionResource) when cravings and opioid withdrawal symptoms become unbearable.
Prevention Point
Morano has used Suboxone in the past. He says that he was purchasing it from a dealer in the street and used it to go through a workday where heroin use wasn’t allowed. The drug enabled him to avoid or prevent sick withdrawal feelings. As such, he knows the feeling that the drug brings, though it has not been his prescription. Morano thought of the drug as his crutch. However, he is now committed to recovery. Buprenorphine is, therefore, very important to him. “I can no longer do this,” says Morano. He needs a medical report.
The bupe bus is simply a Prevention Point project. This is a syringe-exchange program in Philadelphia only. It’s part of the efforts by the city to expand access to medication-assisted opioid addiction treatment.
According to the Centers for Disease Control and Prevention, 2.1 million individuals in the U.S were suffering from at least one opioid use disorder associated with prescription opioids in 2016. In the same year, 262,000 people had an opioid use disorder associated with heroin. A common treatment for opioid use disorder is medication-assisted treatment. This is a treatment that combines the use of buprenorphine, naltrexone, and methadone with behavioral therapies and counseling.
Morano is the first in the line of many patients. After a while, the bus opens its heavy doors and Dr. Ben Cocchiaro calls Morano inside. The dual squeezes in a small exam room. They discuss the help Morano might get towards his recovery from buprenorphine. The doctor tells Morano that if he uses the medication as instructed, he might be more successful in his recovery this time. Dr. Ben also advises Morano to be open to the idea of seeing his therapist more often. Morano gets instructions for taking the medication. The doctor makes a call to a pharmacy to get Morano a prescription.
Research on Buprenorphine Use
Up to now, the focus of research on buprenorphine access barrier has been on the fact that few medical service providers can write its prescriptions. The federal laws require doctors to apply for and get a special waiver to prescribe buprenorphine. This waiver is given by the Substance Abuse and Mental Services Administration only.
For a doctor to get this waiver, they must undergo training for eight hours. Initially, the doctor is allowed to prescribe this drug to a maximum of thirty patients only at a time. These constraints make many doctors not to even bother getting the waiver.
Consequently, the numbers of people using the terms, ‘rehab near me’ are increasing by the day. Many individuals want to get treatment for opioid addiction but there are limited doctors to provide it.
People that are actively involved in addressing this crisis not that some pharmacists hinder opioid users from getting buprenorphine. Dan Ventricelli from the Philadelphia College of Pharmacy says they can write many prescriptions for individuals. However, if no pharmacists and pharmacies are willing to fill medication, do it consistently, and hold open conversations with patients during their treatment process, the community pharmacy might end up having a bottleneck.
The Street Use of the Remedy Frustrates Pharmacists
A patient may search ‘opioid rehabs near me’ and contact a specialist for help but some pharmacists may be hesitant for several reasons. For instance, there is an independent pharmacy owned by Richard Ost a few blocks from the Kensington bupe bus. This pharmacy was the first to stock buprenorphine in the neighborhood. However, Ost noticed that customers weren’t using this medication as instructed. Instead, they sold it.
Buprenorphine is a partial agonist for opioid. That means it is essentially a low-grade opioid. Once a person takes it in a tablet or pill form, it’s unlikely to have similar euphoria feelings with heroin. However, it can cause similar feelings if injected or dissolved.
Many individuals purchase the drug for a similar reason as Morano did. They use it to avoid withdrawal symptoms between the time of injecting fentanyl or heroin. But, some purchase it when they want to stop using opioids without professional assistance.
The SUPPORT for Patients and Communities Act extends the privilege to prescribe buprenorphine in office settings to Certified Registered Nurse Anesthetists, Certified Nurse Midwives, and Clinical Nurse Specialists until October 1, 2023.
Unfortunately, the illegal Suboxone market tempts and targets people that want to stay sober. So, people may search ‘opioid drug treatment center near me’ and find a facility to help them. But, illicit drug dealers may try to talk to these people when they see them come out of pharmacies that sell the medication. These can try to trade or buy Suboxone from recovering patients.
Buprenorphine can Save Lives
Pharmacists and doctors have different training on how long prescription for buprenorphine should continue before a patient is tapered off the drug some medical service providers prescribe it as a long-term treatment. Pharmacists can consider longer treatment courses as intensifying long-term dependency risk.
But, when a patient has withdrawal and buprenorphine is not provided quickly, it’s highly likely that they will turn back to fentanyl or heroin. A person in withdrawal is sick and they want to recover. They need urgent help which can’t be gotten via medication-assisted treatment. However, this help can be gotten just a block away very cheaply and quickly.
Near the Prevention Point’s bupe bus is the Pharmacy of America. This is dispensing buprenorphine to Philadelphia patients reliably. Anthony Shirley, the head pharmacist here, says he is comfortable filling scripts from the doctors at the Prevention Point.
In a nutshell, many opioid addicts that want to recover from their addiction Google ‘drug clinic near me’ when in need of urgent help. These need buprenorphine urgently and if it’s not availed, they turn to the addictive opioids. Pharmacists like Shirley have made providing buprenorphine to such patients their job.
