$1,400,000,000 - Was that to pay for the damage done by the thoroughly disgraced Sackler family’s marketing of Oxycontin? No, their company was Purdue Pharma. This settlement was about abusive marketing of the opioid drug Buprenorphine, commonly known and dispensed in the Medication Assisted Treatment (MAT) business as “Suboxone”.
In April of 2019 Indivior PLC, a subsidiary of Reckitt Benckiser Group (RBG) that has now been separated, was indicted for “engaging in an illicit nationwide scheme to increase prescriptions of Suboxone”. That trial begins in May of 2020. However, in the meantime RBG settled any liability they potentially had for the actions of their orphaned subsidiary (Indivior PLC). RBG determined $1,400,000,000 to be the amount they were willing to pay to avoid any greater liability at trial.
So, what is Indivior PLC potentially guilty of? Overly aggressive marketing of MAT pharmaceuticals. The indictment alleges “Indivior’s marketing scheme was highly successful in fraudulently converting thousands of opioid-addicted patients over to Suboxone Film” and for using an internet and telephone program to “connect patients to doctors it knew were prescribing opioids to more patients than allowed by federal law, at higher doses, and in a careless and clinically unwarranted manner”.
Medication Assisted Treatment programs utilizing Suboxone, and Methadone too, appear to be useful in providing a bridge to long-term recovery from addiction. Especially when the bridge is built on a foundational array of mental health and social services. And if the bridge ultimately arrives at a healthy exit ramp leading to lifelong involvement with autonomous groups and societal institutions that develop mindfulness, spiritual wellbeing and freedom from addiction. However, while these opioid-based pharmaceuticals are ostensibly dispensed as a remedy for addiction, in reality more and more people are abusing them and becoming full-on addicted to them every day.
What leads to the conclusion these “remedies” are actually addictive? As the olde saying goes “the proof of the pudding is in the tasting”. Just ask any patient who attempts not dosing with Suboxone or Methadone for a day or two. The physical withdrawal symptoms are as bad or worse than those related to kicking Heroin and Oxycontin. A week or longer in a medical detoxification unit is required to safely exit the clutches of these opioid drugs. Plus, the Substance Abuse and Mental Health Services Administration (SAMHSA) documented results from the 2018 National Survey on Drug Use and Health revealing approximately 256,000 people in the USA misused Methadone and 718,000 misused Buprenorphine (“misused” meaning abused). And the FDA found that Suboxone was the “primary drug” in 420 reported deaths across the United States.
Unfortunately, there is a long and sordid history of pharmaceutical manufacturers marketing opiate and opioid drugs to cure addiction to the opiate and opioid drugs they had previously marketed. Originally, Opium was prescribed by physicians for pain relief. Then Morphine was developed and marketed as, among other things, a cure for the subsequent outbreak of Opium addiction. Heroin was synthesized from Morphine and marketed by Bayer as a non-addictive substitute for (the surprisingly unexpected) Morphine addiction crisis that of course had ensued. Methadone and Buprenorphine are just the latest incarnation in pursuit of an easier, softer, way out of the quagmire that is opiate and opioid addiction. In recognition of the lucrative irony involved in production and marketing of these opioids comes a devastatingly sarcastic, if not precisely accurate, slogan --- “Suboxone, brought to you by the makers of Oxycontin”.
So, is there a way out of this recurring nightmare? At Vegas Stronger we know there is. Beyond Methadone and Buprenorphine, a third medication has been recognized and approved for use in Medication Assisted Treatment and Recovery (MAT-R) --- Naltrexone. While Buprenorphine and Methadone are opiate-based solutions, replacing one addictive drug with another and subject to diversion on the black market, Naltrexone stands alone as containing no mood or mind altering substances. People in MAT-R programs utilizing Naltrexone are, in fact, free from the effects of having any opioids in their system. They are abstinent and recovering.
There are some in the MAT business who cast aspersions on abstinence based programs. Even though abstinence based recovery programs are helping literally millions of people recover today and have been successfully, continuously and increasingly doing so for the last 85 years. Many of these professional nattering nabobs of negativity hang their skepticism on the claim that abstinence based treatment is not “scientific”. Yah, as if! As if science over the years had done admirably well at serving up remedies to suffering addicts! Not so much.
However, that said, we’d all have to agree on the validity of scientific studies published in the Journal of the American Medical Association. The December 2017 issue of JAMA published an article titled Effectiveness of Injectable Extended-Release Naltrexone vs Daily Buprenorphine-Naloxone for Opioid Dependence A Randomized Clinical Noninferiority Trial, JAMA Dec. 2017 Volume 74, Number 12; Lars Tanum, MD, DMSci. The conclusion was that in the randomized clinical trial, treatment with intramuscular extended-release naltrexone was as effective as oral buprenorphine-naloxone in reducing the use of heroin, opioids, and other illicit substances.
Naltrexone is an antagonist; it simply blocks opioid receptors in the human brain. As a result, cravings are reduced and no opioid “high” can be achieved. At Vegas Stronger our guiding principle is that an optimal solution exists for opioid addicts to be restored to productive and fully self-actualized membership in society. That is the wholistic combination of non-opioid based MAT (Naltrexone) with a diversity of traditional Recovery pathways (MAT-R). These pathways include Psychosocial Therapy, Safe Housing, Occupational Training and participation with autonomous groups and societal institutions that emphasize mindfulness and spiritual wellbeing while cultivating the desire to help others find their way out of addiction.
There is no “one size fits all” approach. We recognize MAT utilizing opioids has carved out a niche in the treatment field. But we believe every person who suffers from the disease of addiction, sooner or later, ought to have an opportunity to experience complete freedom from addiction.
The lie is dead, we do Recover.