Punjab – firefighting mode
During Hope Trust’s tour of Punjab recently, we studied the methodologies being adopted by local medical facilities while dealing with heroin addiction.

Punjab in India is facing an unprecedented drug epidemic. The problem is acutely affecting the very social fabric of the state. Psychiatrists and physicians are overwhelmed by the huge demand and are in a fire-fighting mode. In such a situation, the medical professionals are responding by medical interventions such as detox. Detox is the first stage in addiction treatment. If not followed up by a comprehensive rehab program, the addict has a high chance of relapse. Therefore, after medical detox, the client needs to get admitted into a rehab program. Unfortunately such rehabs are few, if any, in the state. Several rehabs have cropped up which are not professionally run and many are fly-by-night operators that are exploiting the situation.

Suboxone and Buprenorphine – benefits and dangers

Suboxone and Buprenorphine are being extensively used by psychiatrists for detoxification of addicts. The question is: does it work?

Suboxone is a synthetic drug – an opioid that’s active ingredient is Buprenorphine and Naloxone and can be an effective drug for detoxification of opiate addiction.

However, Suboxone - a synthetic analgesic opioid - is highly addictive, and can be more than or as addictive as the drug or opiates the addicts are trying to be freed from.

The most beneficial and safest method for using Suboxone is to get in a detox and rehabilitation program, or hospital inpatient detox center or doctor that offers 1 to 2 weeks of Suboxone under medical supervision. Ideally, the individual should be immediately transferred into a comprehensive inpatient treatment center to rehabilitate the physical, mental, emotional, social and spiritual aspects of the drug addiction in a holistic program, while being kept away from the tempting environments. Suboxone does not provide these benefits - it’s only designed to address the physical part (detoxification) of a complex opiate addiction by alleviating withdrawal symptoms, but when not taken correctly can further complicate even the physical aspect of the addiction.

Suboxone works well during the detox stage – minimizing the uncomfortable effects of the withdrawal process. This is ideally accomplished within one week. If the drug is taken for a longer period, the addict faces the danger of causing an addiction to Suboxone itself – a type of substitution addiction. Oxycontin addiction can be as devastating as heroin abuse. Nevertheless, one week of low to moderate doses of Suboxone shouldn’t cause a physical dependence.  It is critical to taper the dose especially toward the second half of the week and/or any time the individual discontinues taking opioids. That being said, the Suboxone should not be stopped abruptly, since that can cause a return of some pains and aches of the withdrawal symptoms.

After detox

At this stage, the addict is vulnerable and may trade one drug by another and become addicted to Suboxone/ Bupernorphine. Opiate addicts are very sensitive in this area, and if they are still going through withdrawals, they will more than likely search for more drugs to relieve the pain caused by opiate withdrawal.

Therefore, it is very beneficial to go straight to an appropriate drug rehab centre. The rehab can address the post acute withdrawal symptoms such as irritability, lack of concentration, insomnia which usually triggers a relapse in early recovery. Moreover, the drug rehab can assess for any co-occurring psychiatric issues such as depression and bipolar disorder. The drug rehab can then initiate an individual plan to address all areas of the person’s life – the physical, mental, social (relationships), emotional and spiritual areas. That is the best and proven way to long-term sobriety.

The goal of addiction treatment

The goal of any drug addiction treatment program is to have a drug-free life and develop tools to prevent relapse. These tools are essentially spiritual in nature – a change in attitudes, developing positive qualities such as compassion, tolerance, patience, humility, open-mindedness and honesty. These qualities help in alleviating daily stress which is the major trigger for relapse. These qualities also help in making the individual a productive member of society.

So, addiction recovery starts with detox – during this stage drugs such as Suboxone may be employed – then going through a holistic rehab program and maintaining clean status by bringing about a significant change in the individual’s personality.