There is a popular drug called Nalaxone that is used to treat heroin overdose. Recently there is a bit of controversy regarding this medication, both in the policy regarding its use as well as the pricing of it, and how those factors are affecting opiate addiction.
If someone uses too much heroin they can overdose and potentially die from it. Administering Nalaxone can prevent this death from happening. So now some people are worried that having this drug readily available to counteract overdose is going to encourage people to abuse opiates more aggressively. In other words, if the addict knows that a “cure” is available in case of overdose, they are more likely to take larger amounts of opiates in order to get high. That is the fear anyway.
But is this a logical reason to limit access to Nalaxone? In the New York Times http://www.nytimes.com/2016/08/07/opinion/sunday/treating-heroin-addicts.html?emc=eta1&_r=0 they stated that “We would never refuse an EpiPen to someone experiencing a peanut allergy for fear that it would encourage him to eat peanut butter.” So why would we limit access to Nalaxone in the hopes that it will cause heroin addicts to “shoot dope more conservatively?” That seems unreasonable.
Now the other side of the controversy is the escalating cost of the Nalaxone. In Consumer Reports http://www.consumerreports.org/drugs/cost-of-opioid-rescue-drug-naloxone-becoming-unaffordable/ they say that “Evzio auto-injectors (which work similarly to an EpiPen and rapidly deliver a single dose of naloxone) went from about $625 to almost $4,000 for a two-pack.” Why the sudden price increase?
Opportunistic marketing. The manufacturer probably saw what EpiPen was doing in terms of increasing their prices, and figured that they could follow suit. If you have a life saving product that really has no competitors, you can increase your price a great deal and people are still going to have to purchase it.
So we have two opposing forces here: One side wants to see widespread access to this life saving drug in the face of rising prices, and the other side would like to limit access to the drug in order to force heroin addicts to use drugs more responsibly. Where does the real truth fall in all of this, and what is the ultimate answer?
If history is any indication then there will likely be some harsh blow back in terms of the price hike. This will likely result in enough bad press to make the drug manufacturer reconsider their marketing strategy. So it would not be surprising for the price to get lowered again quickly to a more reasonable amount.
I tend to believe that the behavior of heroin addicts is not going to be as affected by the availability of Nalaxone as what people are thinking. I think that people who are trying to escape from reality by getting high are not going to take this medication into consideration as much as some people are fearing. Addicts are going to do what they are going to do, and I believe that it would be beneficial to have this life saving medication available rather than not. Another factor that could come into play might be the use of medications such as Suboxone in helping to treat heroin addicts. Suboxone is an anti craving medication that also contains Nalaxone in it, which helps to prevent the abuse of the medication.
Opiate addiction has escalated so much in the last decade or so that the substance abuse treatment community has been scrambling to try to treat the new “epidemic.” Many addicts, especially teens and younger people, are getting hooked on prescription pain pills before eventually seeking out an alternative on the streets. When they eventually hit the streets to find a replacement for their expired opiate prescription they often find that heroin is several times cheaper than buying pills on the black market. In other words, they could pay about 60 dollars for 30 more pain pills, or they can buy a 20 packet of heroin that will actually go further than the pills would for them. Faced with such economic realities, what would the normal drug addict choose?
And so the demand for opiate addiction solutions has skyrocketed. Treatment centers do what they can to detox addicts and introduce them to programs such as Narcotics Anonymous, but in many cases it seems that the physical component of opiate addiction demands a different kind of solution. Or rather, maybe it just demands a more comprehensive solution, in the form of medication assisted treatment. This is where medications such as Suboxone can come into play, which are a supplement to recovery. It is important to realize, however, that medication assisted treatment cannot be your only solution in recovery.
Addicts are quickly learning this as they try to take the “easier, softer way” in just using a medication such as Subuxone and expecting that it will effectively cure them of their addiction. Although it can help to minimize cravings, the medication by itself is never going to be enough to completely absolve a person of their addiction. At the core you are still an addict, you are still going to have addictive behaviors, and there is still going to be a serious threat of relapse even if you are taking a medication that helps with addictive cravings and urges. The solution is to use the medication as a supplement to your recovery strategy, not as the primary focus. You still have to engage in therapy, go to 12 step meetings, tap into your peer group in recovery, avoid toxic relationships, and so on.
In other words, you need to look at all of the negative factors in your life that could lead you to relapse, and make a comprehensive plan to address all of those issues. For example, a single toxic relationship could lead a struggling addict to relapse, even if they have everything else in their recovery figured out and are also on a medication such as Suboxone. It only takes one point of negativity to lead a person to relapse, and this is why addiction recovery has to be such a huge part of your life. You must dedicate all of your energy into working your recovery into all areas of your life, and medication assisted treatment is just one of those aspects.