NPR has a story about Vivitrol, one of the three FDA-approved drugs to treat opioid addiction. The other two are methadone and burenorphine—both of which are opioids themselves and can also be abused. Vivitrol promotes itself above its competition/alternatives claiming that it is a nonaddictive treatment.
Opioid addiction is a chronic, relapsing brain disease that affects people psychologically and physically. Effective treatment programs often focus on both aspects of addiction through counseling and medication.1,2 VIVITROL is the first and only non-addictive, once-monthly medication that, when combined with counseling, is proven to help prevent relapse to opioid dependence, after detox. VIVITROL blocks opioid receptors in the brain while you work with the psychological aspects of counseling.2,3
The company that sells Vivitrol, Alkermes, has realized that an important market in which to expand is the market where so many addicts end up—our justice system. Vivitrol has begun marketing and sales-pitching judges—judges who can make Vivitrol a part of court ordered treatment programs.
The argument worked for Judge Lewis Gregory, who heads the city court in Greenwood, Ind. About a year and a half ago, Gregory didn't allow participants to start on addiction medications while in the program. "We were failing miserably with the heroin population," he says.
At the time, Gregory was only familiar with buprenorphine and methadone. Both are opioid medications that can prevent withdrawals, reduce cravings and ultimately help people maintain a stable recovery. When they are properly prescribed and administered, patients don't get a euphoric feeling or a "high."
He received a packet of Vivitrol literature (sales pitch), followed by a phone call from an Alkermes sales representative. Judge Gregory decided this was as good a shot as anything else he was trying. What’s important to understand here is that there is no one way to treat addiction. What works for one person doesn’t work for another, and for some, sadly, nothing ends up working. What’s terrifying is that the opioid epidemic is so pervasive, and our government officials are so bigoted and inept at handling it, this has left open our justice system to act as medical professionals—which they are not.
Dan Mistak, an attorney with Community Oriented Correctional Health Services, says courts should allow all medication options and let doctors make treatment decisions — including whether or not someone should use medication in their recovery.
"We rely on outside experts all the time in the judicial system. We don't ask a judge to come in and be an expert in arson," for example, he says. "This is a responsibility that a judge doesn't want."
There have been medical specialist reviews done of treatment programs offered under various drug court policies, which should be reviewed by the legal system, and specifically judges making these court-ordered decisions. But leaving the “education” of judges on medicine and drug treatment up to pharmaceutical salespersons is a recipe for disaster.
I wonder if we can imagine what might happen if big business was allowed to dictate drug treatments? Oh, right—the opioid epidemic.
Be kind, for everyone you meet is fighting a hard battle.
—(either) Plato, Philo, or Ian MacLaren