How France Cut Heroin Overdoses by 79 Percent in 4 Years
~snip~
In the 1980s, France went through a heroin epidemic in which hundreds of thousands became addicted. Mohamed Mechmache, a community activist, described the scene in the poor banlieues back then: To begin with, they would disappear to shoot up. But after a bit wed see them all over the place, in the stairwells and halls, the bike shed, up on the roof with the washing lines. We used to collect the syringes on the football pitch before starting to play," he told The Guardian in 2014.
The rate of overdose deaths was rising 10 percent a year, yet treatment was mostly limited to counseling at special substance-abuse clinics.
In 1995, France made it so any doctor could prescribe buprenorphine without any special licensing or training. Buprenorphine, a first-line treatment for opioid addiction, is a medication that reduces cravings for opioids without becoming addictive itself.
With the change in policy, the majority of buprenorphine prescribers in France became primary-care doctors, rather than addiction specialists or psychiatrists. Suddenly, about 10 times as many addicted patients began receiving medication-assisted treatment, and half the countrys heroin users were being treated. Within four years, overdose deaths had declined by 79 percent.
https://www.theatlantic.com/health/archive/2018/04/how-france-reduced-heroin-overdoses-by-79-in-four-years/558023/?fbclid=IwAR26X9BWeOVqmkpiohMSialrNBgvNHmsyr6LIPqgkNHBOkHuV_mTBKEHW-I
SharonAnn
(13,772 posts)emmaverybo
(8,144 posts)Some states cover with state funds though. Some cover methadone, but not suboxone. 84 percent
of Medicare Part D and Medicare advantage plans cover suboxone,
More work to do and America came late to evidence-based treatment, but then the abstinence, 12
step, self-help and faith-based model has dominated addiction treatment. Suboxone and Methadone are addictive. Coverage is also not lifelong, but usually six to twelve months.
No expert here. Feel free to weigh in.
SunSeeker
(51,550 posts)How come no one knows about Buprenorphine in the US?
Why are we still pushing ineffective methadone treatment?
emmaverybo
(8,144 posts)from a psychiatric NP whose clinic just got approved to treat with suboxone, hence she had to get certified. And no, the clinic is not in the Bible Belt or in the least anti- harm reduction or anti-meds.
SunSeeker
(51,550 posts)Buprenorphine doesn't get you high, it just reduces the craving for heroin. I can see people being psychologically dependent on Buprenorphine for fear or relapsing, but that's not like addiction to methadone.
emmaverybo
(8,144 posts)paid for, but many legislators did not approve of it. Some rehabs would not allow patients to be on it. Further, those charged with possession, could not get deterrence if they were on
Methadone is simply better known. Ignorance, punitive attitudes, and plain old stinginess, as well as stigma all play a role in America coming late to suboxone treatment. With more acceptance, suboxone and CBT will become front-line approaches.
Alcoholism, excessive drinking, is still our number one drug problem. We are still back in the 1930s with approaches to it, and not using all treatment modalities, but prescribing a one size fits all.
By contrast, we are getting more enlightened about opioid addiction.
IronLionZion
(45,410 posts)why do you hate America?
It's profit. Companies make money by keeping people addicted to opioid pills and ineffective treatments like methadone. Pharma companies control the laws in America. In other countries, laws control their pharma companies.
Karadeniz
(22,491 posts)Bev54
(10,045 posts)I am not sure what it is like in the US but in Canada, most provinces, anyone can carry Narcan so if someone is overdosing the most immediate person can give them a shot to counter the overdose. Family members of an addict most often will have it available.
AllyCat
(16,174 posts)And we need profit first before we can heal anyone.
vsrazdem
(2,177 posts)captain queeg
(10,148 posts)So you need to be weaned off similar to opioids, but it doesnt get you high and physical dependence is not addiction. Moreover you cant get high on other opioids while on suboxone. Its not the perfect solution but many times better than what else is available.