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Why are Insurance Companies Focusing on Maintenance Drugs?

Why are Insurance Companies Focusing on Maintenance Drugs?

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Justin Mckibben

Addiction is not an easy problem to address. It is a complex issue with many variables, so of course there is no simple answer to fix it. There is no one-size-fits-all solution; no monopoly on the right kind of treatment. It is understandable that there is a degree of effectiveness with utilizing any medical means available to try and address addiction, but are maintenance drugs really the answer?

Surely medication assisted treatment is useful, and it helps a lot of people. Most inpatient treatment programs utilize some form of medication to ease withdrawal symptoms and other side-effects of long-term drug use. The detox period of treatment usually focuses on medically assisting someone struggling with drugs in this transition.

However, is getting people off of one drug by making them dependent on another really the best case scenario? It seems now insurance companies are putting more effort into using maintenance drugs to treat addiction. Is this really a better strategy?

Maintenance Drugs

Firstly, let us make a clear definition of what maintenance drugs are. Typically, the definition of maintenance drugs is along the lines of prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines.

Examples of common maintenance drugs are medications such as:

  • Fluticasone and salmeterol (Advair Diskus) which is used to treat asthma
  • Insulin glargine (Lantus) used to treat diabetes

If you consider these examples the point is that people use these medications to “manage” their illness, not to overcome or remedy it. So looking at the issue of addiction, there are some well-known maintenance drugs, specifically concerning opioid addiction.

These medications can be effective, but they also present a level of danger themselves. Even though doctors prescribe them to combat withdrawals, they actually can create their own devastating withdrawals, especially with long term use.

Aetna Aims for Maintenance Drugs

Aetna is one of the nation’s largest insurance companies. In a recent Aetna report, the company is prepared to remove a major restriction for patients seeking maintenance drugs for opioid addiction. The change is set to begin this coming March. Aetna is the third major health insurer to announce such a shift in policy in recent months, now in league with Anthem and Cigna insurers.

To be more specific, this insurance company will stop requiring doctors to seek approval before they prescribe particular medications that are used to combat withdrawal symptoms. One of these medications is suboxone, a well-known medication that many people use to fight opiate addiction.

The common insurance practice is known as “prior authorization”. The reason they are seeking to eliminate this policy is because it sometimes results in delays of hours to days before a patient can get the medications.

This new approach to regulation of maintenance drugs impacts all its private insurance plans, an Aetna spokeswoman confirmed.

Advocates of Maintenance Drugs

Addiction treatment advocates to support having expanded access to maintenance drugs. Dr. Corey Waller, an emergency physician who chairs the American Society of Addiction Medicine’s legislative advocacy committee, states:

“It’s a first-line, Food and Drug Administration-approved therapy for a disease with a known mortality. [For] every other disease with a known mortality, the first-line drugs are available right away.”

Essentially, the idea that parity laws require insurers to cover addiction treatments at the same level as other kinds of healthcare means these kinds of medication should be available for immediate access. This should be the same for all forms of addiction treatment.

Opinion: Treatment over Maintenance

While many would argue that maintenance drugs are a form of treatment, it is still a relevant argument that maintenance drugs are also imperfect and could actually be harmful if they become the cookie-cutter answer implemented by most insurers.

While harm reduction is understandable, and maintenance drugs can help people struggling with heroin or other dangerous opioids avoid other serious risks, the fact is many maintenance drugs include their own side-effects. Some often become subject to abuse themselves.

For instance, suboxone can be useful as a harm reduction tactic, but it can also be abused. Many people who have used suboxone as a long-term solution have found themselves battling suboxone withdrawal symptoms. The dangers of suboxone are very relevant.

The same, if not worse, has often been said about methadone maintenance drugs. While they may keep someone alive to get treatment, there should still be a strong emphasis on treatment itself. Maintenance drugs are most effective when part of a program. They are not a substitute for a treatment program.

Treatment should focus on finding solutions, not prolonging the suffering. Drug and alcohol addiction treatment should come from a holistic approach that addresses more than just physical ailments. Holistic treatment focuses on providing extensive and personalized therapy, combined with physical and emotional heal. If insurance companies want to focus on combining rational medical resources with comprehensive treatment, then this could be a great thing. However, if the focus becomes a quick-fix drug option opposing a full recovery through treatment, it only adds to the danger.

Maintenance drugs have support from the recovery community, but typically they must be accompanied by therapy and other means of treatment. Maintenance drugs are just that- drugs. They are often powerful narcotics, and are true to their title- “maintenance,” not a permanent solution.

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My Last 100 days as an addict

My Last 100 days as an addict

Many people (in and outside of recovery) believe that an addict has to “hit their bottom” before they are ready to get clean. I don’t think that is the case for everyone, though. Don’t get me wrong, things had gotten pretty bad for me, especially in my last 100 days as an addict in active addiction. But, I am certain that I was headed for way worse had I not gotten help when I did.

My last 100 days of active addiction…

It is hard to write about this but, not because of any emotions I may have been feeling; in fact I was quite numb by the end of my run. I say it’s hard to write about because my memory is a little hazy. Go figure…years (about ten) of substance abuse really takes its toll on your brain and, especially memory, or at least in my case it has. The good news, I have learned, is that the damage is not permanent; drugs don’t actually “fry” your brain like many believe.

The last 100 days of my addiction would put us somewhere around May-ish of last year.  Let’s see, what was I doing? I was holding down a pretty decent job as back-up head teller in one of the top five largest banks in the country. That means I had control over large sums of money on a daily basis. And I never stole any. Yet. I was living with my mom because I couldn’t afford my drug habit. I mean, my own apartment.

When I wasn’t working, I was constantly on the hunt for my next drug. The thought of being dope sick terrified me. Years ago, I had sought help in the form of a methadone program without really researching what it was that I was getting into. And just as ignorantly, after about 8 months on the junk, I up and decided to quit. Cold turkey. Yes, you read that right. Two months of being dope sick was a big enough lesson, I thought, to keep me from ever going back out. It wasn’t. I didn’t have recovery in my life then and it was just a matter of time before I started using again.

But I digress…last 100 days…OK.

Working at the bank, living with moms, spending all of my money, time, and energy on getting drugs. I started buying Suboxone off the street to keep me from getting sick. That was holding the opiate withdrawals at bay but, like a good addict, I sought out other ways of getting high. I started shooting cocaine and crack. I would abuse my Ambien prescription, taking sleeping pills when I couldn’t get my hands on the other stuff. I was desperate to not be stone cold sober – to keep from being aware of myself and my feelings.

Several key events had occurred leading up to and during my last 100 days of being an addict that eventually led me to the front door of a treatment center. One profound experience was my birthday weekend, in early March. It involved me “celebrating” with a number of different substances which then resulted in a trip to the emergency room via ambulance. The hospital staff didn’t know what was wrong with me. I was forthcoming with everything that I had taken but my blood tests indicated a different and more alarming problem. Nurses evaluated me for signs of stroke. At 32, I thought, I’m way too young have had a stroke. I was kept in the hospital overnight for observation. I found out that my tox screen indicated that I had almost every drug in my system. As an active addict, my motto was always “Go Big or Go Home.” At first, I thought it was funny that I had managed to hit virtually every panel of the drug screen. But in the following days, intense feelings of guilt and shame began to eat away at me. I didn’t want anyone to know what happened. If anyone casually asked me how my birthday was, I was hit with yet another pang of shame.

Around this time, my father mentioned the idea of treatment to me. This pissed me off. He was hardly in my life, who was he to say what I needed? I didn’t speak to him for 2 months. During that time, though, it was if a seed had been planted in my mind. I started to realize that banging dope in the bathroom at work and smoking crack in gas station bathrooms wasn’t “partying.” It was problematic, to say the least.

I toiled over the decision to get help. At one point I decided: either go to treatment or kill myself. It had really become that black-and-white for me. In what many people call a “God moment,” I had a moment of clarity: I would go to treatment. Once I had made the decision to get help, I felt a sense of relief and calm wash over me. I was weightless. It was a knowing, a certainty, that I was going to be alright.


If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135

Drug Withdrawal Symptoms

Drug Withdrawal Symptoms

Drug withdrawal symptoms are what many addicts and alcoholics fear most. They feel like your body is screaming at you to get it what it needs, which is the substance! And in a way, that is exactly what your body is doing. Drug withdrawal symptoms occur because your brain works a lot like a kind of spring when it comes to addiction. Drug and alcohol are brain depressants that push down the spring and suppress the production of neurotransmitters like noradrenaline.

When you stop using drugs and alcohol, all the weight comes off the spring, and your brain rebounds by producing a surge of adrenaline that can cause drug withdrawal symptoms. Not only that, but your brain used to produce “feel good” chemicals on its own but since you have been giving it synthetic feel good chemicals it has become lazy and doesn’t make them anymore. So when you stop giving it synthetic feel good chemicals, it takes a minute for your brain to wake up and start making them again, and it isn’t very happy to do so initially.

Drug Withdrawal Symptoms are not created equal

Every drug is different. Some drugs produce severe physical drug withdrawal symptoms and severe emotional drug withdrawal symptoms. These drugs are the usually the most feared by addicts to stop. They are alcohol, opiates and tranquilizers such as valium and Xanax.  Other drugs that produce less severe physical withdrawal symptoms, but still have an emotional withdrawal are cocaine, marijuana and ecstasy. Every person’s experience with drug withdrawal symptoms is a little different. For instance, you may experience little physical drug withdrawal compared to the person with you in drug detox. This is because drug withdrawal symptoms are dependent on how much, how long and the individual person.

What are the emotional drug withdrawal symptoms?

  • Anxiety
  • Restlessness
  • Irritability
  • Insomnia
  • Headaches
  • Poor concentration
  • Depression
  • Social isolation

What are the physical withdrawal symptoms?

  • Sweating
  • Racing heart
  • Palpitations
  • Muscle tension
  • Tightness in the chest
  • Difficulty breathing
  • Tremor
  • Nausea, vomiting, or diarrhea

Some drug withdrawal symptoms are dangerous and could potentially be fatal. These drug withdrawal symptoms are usually associated with the use of alcohol and tranquilizers. Suddenly stopping alcohol or benzodiazepines can lead to seizures, strokes, and heart attacks in high risk patients. A medically supervised detox is highly recommended for anyone who is addicted to alcohol or benzos because a medically supervised drug detox can reduce the risk and dangers of the drug withdrawal. Some of the dangerous drug withdrawal symptoms associated with alcohol and benzos are:

  • Grand mal seizures
  • Heart attacks
  • Strokes
  • Hallucinations
  • Delirium tremens (DTs)

But what about opiates?

Drug withdrawal symptoms from opiates such as heroin, OxyContin, and morphine are extremely uncomfortable, no doubt, but they aren’t fatally dangerous unless they are mixed with other drugs. Heroin withdrawal on its own, by itself, does not produce seizures, heart attacks, strokes or delirium tremens. A medical drug detox is not a necessity for opiate withdrawal but it is still highly recommended. A medical drug detox can help ease almost all of the discomfort due to the drug withdrawal symptoms. If you are in need of a medical detox, Palm Partners Treatment Center can help. Contact us today at 800-951-6135.

Dangerous New Drug: Nucynta

Dangerous New Drug: Nucynta

Apparently in the eyes of the makers of Nucynta there aren’t enough drugs on the market to take care of, well, pretty much anything, including pain. Nucynta is one of  the newest opioid analgesics to hit the market. This means that, yes Nucynta provides pain relief that is comparable to other more well-known opioid analgesics such as hydrocodone and oxycodone. Nucynta though, is meant to have more tolerable side effects. But that hasn’t stopped many people from finding themselves with Nucynta addiction.

What is Nucynta?

Nucynta or Tapentadol, was approved by the United States FDA for the treatment of moderate to acute pain, and in 2011, the extended release formula of the drug known as Nucynta ER, was approved by the US FDA for the treatment of specific types of moderate to severe chronic pain. Because Nucynta not only helps to combat pain but also helps with norepinephrine reuptake inhibitor, Nucynta has the possibility of helping with many off-label uses including chronic pain and certain mood disorders. The mixture of an opiate and a serotonin-norepinephrine (SNRI) reuptake inhibitor is meant to make the opiate more effective.

Nucynta addiction

Nucynta has many adverse effects including an addiction potential. Many of the side effects of Nucynta are similar to those of oxycodone and morphine. Nucynta has been shown to cause less nausea and dizziness than morphine though. Nucynta can impair physical and mental abilities and with regular use can result in dependence which can lead to a Nucynta addiction. Someone who has a Nucynta addiction will experience Nucynta withdrawal symptoms just as they would if they had any other kind of opiate addiction.

Nucynta can be abused either by crushing, chewing, snorting or injecting it. Using Nucynta in this way can easily lead to an overdose and potentially death as well as a Nucynta addiction. Nucynta addiction overdose is not very common but it can happen. Nucynta can suppress breathing and this can cause overdose and death. Nucynta overdose is more likely to happen if it is taken with other drug such as alcohol. Alcohol has been shown to increase the effects of Nucynta making it much more dangerous. Signs of a Nucynta overdose can include hypotension, coma, respiratory depression, and somnolence.

Someone who has a past history of addiction is at a much higher risk of abusing Nucynta and is at a higher risk of using Nucynta with other drugs and alcohol; and is therefore also at a much higher risk of developing a Nucynta addiction.

Nucynta addiction looks just like an addiction to any other opiate. Many Nucynta addicts will use the same methods to get the drug that they would use to get morphine or oxycodone. Nucynta addiction can cause a person to doctor shop, medication seek, and buy the drug on the street. The potential this drug has for a Nucynta addiction is part of the reason it is classified as a Schedule II narcotic with oxycodone and morphine.

Once a Nucynta addiction has formed in order for the individual to get off the drug they have to go through the withdrawal process. Withdrawal symptoms due to a Nucynta addiction can be really unpleasant and just as with any other opiate withdrawal it is recommended that a Nucynta addict seek professional medical help.

Nucynta addiction withdrawal symptoms can include but are not limited to:

•             Anxiety

•             Sweating

•             Trouble sleeping

•             Tremors

•             Diarrhea

•             Hallucinations

Treatment for a Nucynta addiction usually begins with detox where the individual will be given suboxone or will slowly taper off the medication just as if they were detoxing from oxycodone. Luckily for anyone with a Nucynta addiction treatment is available and no one has to be stuck in it. If you or your loved one is in need of Nucynta addiction treatment, please give us a call at 800-951-6135.

Drug Detox in Arlington

Drug Detox in Arlington

If you or your loved one is in need of drug detox in Arlington, please give us a call at 800-951-6135.

You should consider going to a drug detox in Arlington if you find yourself using alcohol and/or drugs and, even though it’s gotten to the point that you want to stop, you simply cannot. You’re realizing that it’s more than will power and find yourself experiencing withdrawal symptoms that are anywhere from uncomfortable to downright frightening. Programs for drug detox in Arlington and everywhere in the country exist because withdrawal is a sign of drug dependence: a medical condition that needs to be treated medically.

What is a Drug Detox?

A drug detox is a program that helps you stop taking the drug or drugs that you are physically dependent upon in a safe way. The program usually lasts from four to ten days, depending on the drugs you were taking, for how long you were taking them, and the amount of the drug or drugs you have been taking.

A Drug Detox in Arlington will:

Evaluate: Upon entering a drug detox program, you will be tested to see which substances are in your system. This is not something that you will get in trouble for; a drug detox is a medical treatment program that is treating you for a condition: drug dependence. Clinicians at centers for drug detox in Arlington also evaluate you for potential co-occurring disorders, dual diagnosis, and mental health and behavioral issues.

Stabilize: After being evaluated, you will be given certain medications; depending on the drug or drugs you were abusing, in order to ease your withdrawal symptoms. This is the detoxification process. You will be monitored by medical staff so as to ensure that you are safe and as comfortable as possible.

What to Expect at a Drug Detox in Arlington

Drug detox in Arlington consists of a schedule of medication to treat your withdrawal symptoms that will gradually taper you off over your stay. You will have your vitals checked a couple times of day: morning and night. You will be given your medication(s) on a set schedule and you will be provided meals. Throughout the day, you will attend groups or meetings and have ample downtime so that you can rest and so that your body can begin to heal. The medical personnel at the drug detox in Arlington will routinely check your vital signs and overall health to make sure you are comfortable and the detox is proceeding safely.

Going to a Drug Detox in Arlington is a Good Idea

Medical detox treatment at the drug detox in Arlington is a safe, medically monitored drug and alcohol detox treatment program. You will be in a tranquil and serene setting with outstanding services and amenities. The staff at drug detox in Arlington is caring and competent and is qualified to assist in making you feel the comforts of home. Arlington, Virginia is close to the nation’s capital, Washington D.C., and there are many things to see and experience in this area of the country. There are national and historic parks and landmarks. Nearby are the shopping districts of Crystal City, VA and Georgetown in Northwest D.C.

If you or your loved one is in need of drug detox in Arlington, please give us a call at 800-951-6135.












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