The War on Recovery: How the U.S. Denies Lifesaving Medications to People with Opioid Addiction
Part 5: The Battle Against Addiction Medications
In the ongoing battle against opioid addiction, one man’s advocacy for the use of buprenorphine, a common medication for opioid addiction, led to his expulsion from a Narcotics Anonymous meeting. Mark Palinski, whose life was saved by buprenorphine after years of struggling with opioid addiction, faced backlash from the leaders of the meeting who viewed the medication as no different from heroin or fentanyl.
For Palinski, buprenorphine was a godsend. It helped him overcome his addiction and freed him from the debilitating withdrawal symptoms associated with quitting opioids. However, the stigma against addiction medications like buprenorphine and methadone persists in many addiction recovery communities, leading to the exclusion of individuals who rely on these medications for their recovery.
Despite the overwhelming evidence supporting the effectiveness of medications like buprenorphine and methadone in reducing the risk of overdose and aiding in recovery, many institutions within the addiction recovery community continue to reject these lifesaving treatments. In recovery housing programs, residents are evicted for taking medication, while rehab facilities and detox centers often require individuals to abstain from medication or quickly wean off them to be admitted.
The hostility towards addiction medications stems from a long-standing tradition within Narcotics Anonymous and other recovery programs that advocate for abstinence from all “mind-altering” substances, including regulated medications like buprenorphine and methadone. This outdated mindset has created a barrier to accessing essential treatment for many individuals struggling with opioid addiction.
Despite calls for change and a growing acceptance of addiction medications in some recovery communities, the reluctance to embrace these treatments persists. The federal government has failed to enforce requirements for addiction treatment facilities to offer medication, and accreditation organizations continue to promote abstinence-only approaches.
As the death toll from the national drug crisis continues to rise, it is imperative that the addiction recovery community reevaluates its stance on addiction medications and provides support for individuals seeking evidence-based treatment. The cultural revolution in some recovery communities offers hope for a more inclusive and effective approach to combating opioid addiction. It is time to prioritize the health and well-being of individuals struggling with addiction and provide them with the resources they need to recover and thrive.
The recent government survey of over 14,000 substance use treatment facilities revealed a concerning statistic – over 40% of these facilities did not offer methadone or buprenorphine, two medications crucial in the treatment of opioid addiction. This lack of access to evidence-based medications highlights a broader issue within the addiction treatment landscape, where traditional abstinence-based programs like Narcotics Anonymous are still prevalent despite evidence suggesting their limitations.
Narcotics Anonymous, a global fellowship with over 70,000 meetings worldwide, has long been a go-to resource for individuals seeking support in their recovery journey. However, its staunch opposition to addiction medications like methadone and buprenorphine has been called into question by experts and researchers. Studies have shown that individuals who seek recovery from opioid addiction without medication-assisted treatment are at a higher risk of overdose and death compared to those who receive medication.
Kim Gannon, a Yale Ph.D. candidate in health policy and management, who was once a participant in Narcotics Anonymous, has raised concerns about the program’s influence on treatment approaches. She believes that the organization’s stance against addiction medications may have inadvertently contributed to more harm than good in the fight against opioid addiction.
Narcotics Anonymous is not the only organization with a rigid stance against medication-assisted treatment. The Salvation Army, a prominent provider of drug and alcohol abuse treatment in the U.S., enforces strict policies against methadone and buprenorphine in its rehabilitation facilities. This has led to legal challenges, with advocates arguing that denying access to these life-saving medications goes against best practices in addiction treatment.
Despite growing support for medication-assisted treatment from national organizations like the National Alliance for Recovery Residences, many addiction treatment facilities across the country continue to resist incorporating these medications into their programs. A recent survey revealed that a significant number of federally certified facilities do not offer methadone or buprenorphine, and many recovery residences in states like Florida prohibit buprenorphine.
The lack of oversight and regulation in the addiction treatment industry allows facilities to maintain outdated practices that go against evidence-based medicine. While federal guidelines suggest that sober living facilities should allow medications for opioid use disorder, this recommendation is often ignored. As a result, billions of dollars are spent each year on addiction treatment that is not aligned with current best practices.
Experts like Nora Volkow, the director of the National Institute on Drug Abuse, emphasize the importance of flexibility in treatment approaches. Patients who benefit from medications like buprenorphine should not be excluded from other forms of therapy or support groups based on outdated ideologies. It is essential for the addiction treatment landscape to evolve and embrace evidence-based practices to improve outcomes for individuals struggling with substance use disorders. In the world of recovery from opioid addiction, individuals often find themselves facing a difficult decision: whether to continue using buprenorphine, a medication that has been proven to help them, or to let go of their support systems in order to adhere to the abstinence-based approach of groups like Narcotics Anonymous (NA).
For many, the choice is not an easy one. The saying “There is no easier, softer way” is often heard in 12-step recovery circles, emphasizing the belief that recovery requires sacrifice and pain. However, when it comes to opioids, there are medications like buprenorphine that can help ease withdrawal symptoms and support individuals in quitting their addiction. One such individual is Palinski, who struggled with addiction for over a decade before finding relief with buprenorphine. He described the medication as life-changing, allowing him to focus on improving his life without feeling the intoxicating effects of opioids.
Despite the positive experiences of individuals like Palinski, organizations like NA remain unsupportive of medication-assisted treatment. The organization’s literature emphasizes a program of complete abstinence, viewing medications like buprenorphine as a form of treatment that goes against their principles. While NA allows individuals on medications like methadone or buprenorphine to attend meetings, they are not considered “drug-free” and may face stigma within the group.
The National Institute on Drug Abuse defines recovery as a process of change that leads to improved health and wellness. Many individuals in recovery argue that true recovery should be defined by overall health and happiness, rather than strict adherence to abstinence from certain substances. Palinski, for example, measures his recovery by his well-being and safety, rather than by complete abstinence from all substances.
While debates about addiction medications continue, the effectiveness of medications like methadone and buprenorphine in helping people quit illicit opioids and avoid overdose is undeniable. Public health experts highlight the harm caused by 12-step fellowships’ hostility towards these medications, but implementing full access to addiction medications in all recovery settings poses practical challenges.
Overall, the decision to continue using buprenorphine or adhere to an abstinence-based approach is a difficult one for many individuals in recovery. Finding a balance between the support provided by medications and the principles of organizations like NA remains a challenge, but ultimately, the goal of recovery is to improve one’s health and well-being, no matter the path taken. Menzies, a member of Narcotics Anonymous, expressed a sentiment that many in the recovery community can relate to: “The houses say: Enough is enough, I can’t take this anymore.” This feeling of overwhelming despair and exhaustion is all too common among those struggling with addiction, especially in the face of the current opioid crisis.
The landscape of drug addiction has shifted dramatically over the years, from the days of prescription painkillers like OxyContin to the rise of heroin and now the prevalence of fentanyl. For those battling addiction, the odds of successfully quitting cold-turkey have plummeted as the potency of the drugs they are using has increased. The younger generation, in particular, faces the challenge of quitting fentanyl, a drug that can be deadly even in small doses.
Critics of traditional recovery methods, such as Narcotics Anonymous, argue that the organization’s anti-medication stance is outdated and harmful. The philosophy of complete abstinence from all drugs, including medications like methadone and buprenorphine that have been proven effective in treating opioid addiction, may be putting lives at risk. The resistance to this philosophy has led to the emergence of alternative groups like Medication-Assisted Recovery Anonymous (MARA), which offers a more inclusive approach to recovery.
MARA meetings, unlike traditional 12-step programs, welcome the use of addiction medications and encourage open dialogue among participants. The organization’s emphasis on living a safe lifestyle rather than complete abstinence has resonated with many who feel marginalized by the strict rules of Narcotics Anonymous. MARA provides a sense of community and support for those who may not find what they need in traditional recovery settings.
Palinski, a member of MARA, has seen firsthand the difference that a more flexible approach to recovery can make. His Friday meetings attract a diverse group of individuals seeking a non-judgmental space to share their experiences and struggles. Through MARA, he has found a community that understands the complexities of modern addiction and is willing to adapt to meet the needs of its members.
As the conversation around addiction treatment continues to evolve, it is clear that one size does not fit all when it comes to recovery. Organizations like MARA are paving the way for a more inclusive and effective approach to helping those in need. It is essential that the recovery community as a whole remains open to new ideas and strategies that have the potential to save lives and bring hope to those who are struggling. The Impact of Climate Change on Global Food Security
Climate change is one of the most pressing issues facing the world today, with far-reaching impacts on ecosystems, weather patterns, and human societies. One of the most concerning consequences of climate change is its impact on global food security.
As temperatures rise and weather patterns become more erratic, agriculture is increasingly vulnerable to crop failures, pests, and diseases. This poses a significant threat to the world’s food supply, as a large portion of the global population depends on agriculture for their livelihoods and sustenance.
One of the key ways in which climate change affects food security is through changes in precipitation patterns. Droughts and floods have become more frequent and severe in many parts of the world, leading to crop failures and food shortages. In some regions, farmers are struggling to adapt to these changing conditions, leading to decreased yields and increased food prices.
Rising temperatures also have a direct impact on agriculture, as many crops are sensitive to heat stress. Heatwaves can reduce crop yields and quality, particularly for staple crops like wheat, rice, and maize. In addition, higher temperatures can create more favorable conditions for pests and diseases, further threatening food production.
Another consequence of climate change is the loss of biodiversity, which is essential for maintaining healthy and resilient ecosystems. As habitats are destroyed and species are lost, the ability of ecosystems to provide essential services, such as pollination and pest control, is diminished. This can have a cascading effect on agriculture, as farmers rely on these services to maintain productive crops.
In order to address the impact of climate change on food security, it is essential that governments, businesses, and individuals take action to mitigate and adapt to these changes. This includes reducing greenhouse gas emissions, investing in sustainable agriculture practices, and supporting farmers in adapting to changing conditions.
Furthermore, efforts to increase the resilience of food systems, such as diversifying crops and building climate-resilient infrastructure, are crucial for ensuring that communities can continue to access nutritious and affordable food in the face of climate change.
Ultimately, the impact of climate change on global food security is a complex and multifaceted issue that requires a coordinated and sustained response from all sectors of society. By taking action to address the root causes of climate change and build more resilient food systems, we can help ensure a more secure and sustainable future for all.
