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Sun Sep 15, 2019, 12:24 PM

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 we’d 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 country’s 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

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Response to StevieM (Original post)

Sun Sep 15, 2019, 12:34 PM

1. And everybody had access to doctors and Medicare care for this, unlike here.

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Response to SharonAnn (Reply #1)

Sun Sep 15, 2019, 02:56 PM

5. Suboxone treatment plus therapy is now covered under Medicaid in most, but not all states. .

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.

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Response to emmaverybo (Reply #5)

Sun Sep 15, 2019, 03:05 PM

6. Buprenorphine is not addictive. Is it covered under Medicare/Medicaid?

How come no one knows about Buprenorphine in the US?

Why are we still pushing ineffective methadone treatment?


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Response to SunSeeker (Reply #6)

Sun Sep 15, 2019, 03:13 PM

7. Well, sorry, but it can be. People will need to be weaned off. This I understand on good authority

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.

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Response to emmaverybo (Reply #7)

Sun Sep 15, 2019, 03:20 PM

10. But we know methadone is addictive AND ineffective. Why are we still using that shit?

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.

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Response to SunSeeker (Reply #10)

Sun Sep 15, 2019, 04:48 PM

11. Agree. America is only more recently open to suboxone. In earlier days not only was suboxone not

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 1930’s 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.

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Response to SunSeeker (Reply #6)

Sun Sep 15, 2019, 03:14 PM

8. Because America is the greatest country in the world and better than everyone else

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.

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Response to StevieM (Original post)

Sun Sep 15, 2019, 01:48 PM

2. Let's do it! Why are we so flipping lackadaisical about making our world better????

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Response to StevieM (Original post)

Sun Sep 15, 2019, 01:57 PM

3. Another way to reduce deaths

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.

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Response to StevieM (Original post)

Sun Sep 15, 2019, 02:48 PM

4. Also, our methadone clinics are a racket

And we need profit first before we can heal anyone.

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Response to StevieM (Original post)

Sun Sep 15, 2019, 03:19 PM

9. Bupenorphine is a much safer way to treat chronic pain than opoid narcotics

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Response to StevieM (Original post)

Mon Sep 16, 2019, 12:54 PM

12. Buprenorphine/suboxone does cause a physical dependence after time

So you need to be weaned off similar to opioids, but it doesn’t get you high and physical dependence is not addiction. Moreover you can’t get high on other opioids while on suboxone. It’s not the perfect solution but many times better than what else is available.

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