Dear Colleague Letter 12-6-2012 Final Rule Modifying Buprenorphine Dispensing Restrictions in OTPs

National Alliance for Medication Assisted Recovery

Press Release

Contact Persons:
Joycelyn Woods, Executive Director, edirector@methadone.org
Roxanne Baker, President, president@methadone.org
Phone/Fax: 212-595-NAMA


The National Alliance for Medication Assisted Recovery ‘s (NAMA Recovery) purpose is to represent the interests and rights of patients receiving Medication Assisted Treatment (MAT). While NAMA Recovery commends the Center for Substance Abuse Treatment for attempting to equalize Buprenorphine in Opioid Treatment Programs (OTPs) with Office-Based Opioid Treatment (OBOT) prescribing physicians our concern is it will have a negative effect on OTP patients creating a two tier system. We suggest that this is an opportunity to normalize medications within the OTP.


Both methadone and buprenorphine should have an induction period so that dose adjustments can be made and to insure that patients are taking their medication daily. At the end of thirty (30) days if patients have negative toxicology and are showing progress that take home medication be started for responsible patients prescribed methadone and buprenorphine. Without these adjustments patients prescribed methadone will be impelled to switch to buprenorphine with often disastrous results (i.e. inadequate dosing, opioid pain medications are difficult to prescribe).

Including buprenorphine as a medication prescribed in OTPs will most certainly increase diversion of buprenorphine and this in turn results in increased stigma which is already occurring and more restrictive policy.

Unfortunately it is very probable that those receiving methadone at OTPs will pay the price for any diversion from OTPs whether buprenorphine or methadone.

We recognize that the services offered in OTPs make them uniquely qualified to treat addictive disorders. NAMA Recovery urges caution to insure that the goals of this Dear Colleague letter are met in making MAT more available and to adjust the policy to make a fairer OTP system.

Since its beginning methadone treatment has been demonstrated to be the most effective treatment for opioid addiction, resulting in the termination of opioid use and of criminal behavior. In spite of this success, methadone treatment is often disparaged as a “substitute drug” by those who ignore the positive benefits that it has clearly brought to society. These attitudes negatively impact on opiate treatment programs in a variety of ways, but it is the methadone patients themselves who are particularly stigmatized and harmed. With the advances of science and introduction of buprenorphine it was hoped that the stigma and prejudice directed at patients and programs would change. As the premier international advocacy organization for Medication Assisted Treatment (MAT) the National Alliance for Medication Assisted Recovery* (NAMA Recovery) will actively respond to the issues that affect the daily lives of MAT patients and work towards the day when they can take pride in their accomplishments.


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Walter Ginter to Receive Vernon Johnson Award

Faces and Voices of Recovery and Hazelden's Center for Public Advocacy invite you to join us at an evening reception recognizing the outstanding contributions of Walter Ginter, Project Director of the Medication-Assisted Recovery Services (MARS) Project. He is the leading face and voice of medication-assisted treatment and recovery in the US.

Wednesday, June 27, 2012, 6:00 - 8:00 pm

Carnegie Institute for Science

1530 P Street NW

Washington, DC 20005

Emmy-award winning reporter and anchor Pat O’Brien, who will be one of the hosts of the 2012 Olympic Games, will be joining us as we salute the extraordinary contributions of the country's most influential recovery community leaders to the growing movement to promote the reality of recovery from addiction.

Host Committee Co-Chairs*
Fmr Congressman Patrick Kennedy Co-Chair One Mind for Research	Carol McDaid Capitol Decisions
Host Committee Members
Johnny Allem DC Recovery Community Alliance	Franni Frankin Aquila Recovery
Ann Barnum The Health Foundation of Greater Cincinnati	Christopher Kennedy Lawford Author
Tim Cheney Chooper's Guide	Former Congressman Jim Ramstad
Tom Coderre Rhode Island State Senate	Mike Sime Hazelden Foundation
Laurie Dhue Veteran Broadcast Journalist Founder of Laurie Dhue Media, NYC	Stuart Smith Foundation for Recovery RICAREs
* Organizations listed for identification purposes

Faces and Voices of Recovery and Hazelden’s Center for Public Advocacy have joined together to host America Honors Recovery honoring the legacies of Joel Hernandez, Vernon Johnson and Lisa Mojer-Torres. All contributions to the America Honors Recovery awards event will go to Faces & Voices. To find out more about this year’s honorees, please click here.

NAMA-R Announcement 6/4/2012

National Alliance for Medication Assisted Recovery

435 Second Avenue

New York, NY 10010

http://www.methadone.org/

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Stop Stigma Now: Small Organization Rises to Raise Funds for Methadone Treatment PR Campaign

ATForum, Spring

Stop Stigma Now, a small group of retired opioid treatment program (OTP) providers has a big—and honorable—goal: eradicating stigma against the methadone treatment field. It began about five years ago with the closure of the Mount Sinai Narcotics Rehabilitation Center in New York City, recalls Joycelyn Woods, project coordinator with the National Alliance for Medication Assisted Recovery (NAMA Recovery).

The physician and administrator who led that program got together and started talking about the fact that the stigma situation isn’t any better than it was in 2007. “It’s worse,” said Ms. Woods. “Nobody is going to do anything about it unless we do something about it ourselves. I had hoped for a long time that the federal government would do it—they have the money and the resources.”

Sy Demsky, the former administrator at Mount Sinai (he retired shortly before the closure), and Philip Paris, MD, the physician, helped organize the Stop Stigma Now group. “Their idea is to raise money from new sources and create a huge PR campaign,” said Ms. Woods. One suggested way of raising money was to ask OTP patients—each of whom would contribute one dollar. “The programs have to decide whether to cooperate. This could be impossible to manage,” she said.

This leaves Stop Stigma Now in a difficult position—doing something very important, without adequate funding to make it happen. With prescription opioid abuse rampant, OTPs and state substance abuse agencies seeking to address this are faced with new zoning restrictions or outright prohibition based on prejudice or unfounded fears.

“We wish to let the public see our patients as the successes so many of them are,” Dr. Paris told AT Forum in an e-mail. “Our patients are dependent on their medication, not addicted,” he said. “They are not substituting methadone for their street drug. Instead, methadone helps to correct the illness induced by years of using heroin or abusing pain medications.”

Stop Stigma Now attended the AATOD conference in Las Vegas, prominently passing out buttons and letting the addiction treatment field know about their work. “We were received warmly with a show of support by many of the leaders in the field,” said Dr. Paris. “We received many pledges for future financial support. That is very important if we are to be able to widen our anti-stigma message.”

To find out more about Stop Stigma Now, and to make a donation, go to Go to www.stopstigmanow.org

Posted ATForum May 29, 2012
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In My Own Words Essay Contest Winners

NAMA Recovery is proud to announce the 3 winners of the MAT In My Own Words Essay Contest.

The winners were:

1st Darlene DeMore (PA)
2nd Louis Buchhold (CA)
Ian Christenson (MN)

The winners will receive: 1st-$500, 2nd-$250, 3rd-$100.

We are proud to announce that a recordbreaking 128 individuals
from across the US and the UK submitted essays.

And even more proud that so many of you bravely shared your story.

Here Are the Essays

First Place
MEDICATED ASSISTED TREATMENT
A New Beginning
Darlene DeMore, Pennsylvania

Medicated Assisted Treatment (MAT) has supported my recovery from addiction in ways I never expected. Early in recovery my only concern was not feeling sick and having a place to sleep other than the ground or a park bench. When I became pregnant, I was terrified that I would not be able to take care of my child. MAT allowed me to become well, function normally and raise a beautiful, healthy daughter.

I am commonly asked why I have been on methadone maintenance for 14 years and my reply is because it works for me. Sadly MAT is misunderstood and stigmatized in our communities. What most people do not realize is that my medication is only a fraction of what my recovery is about. As with anyone in recovery, I needed therapy, family support, positive people and finding my passion in life. MAT is just that, assisted treatment. It’s a medication I take to treat my disease of addiction. Using drugs was only a symptom of other things I needed to learn how to cope with to be successful.

I continue to be committed to recovery because when I allowed myself to be open to the process and accept my disease I was free. Free to be a loving mother of two, free to contribute to my community, free to share my recovery experiences and free to be a woman I am proud of, honored to be, and will continue to become.

# # #

Second Place
ATTC Essay
Louis Buchhold, California

I’ve been sober for 11 years/6 months. I could have never imagined I could experience even one day free from alcohol/drugs back then. In 8-long years I have never been able to get longer than 30-days sober, being in/out of AA, therapy, and having tried to kill myself. Then I met a psychistrist who saw past that homeless, unemployable, degenerate hope-to-die alcoholic – to a person gripped by a terrible disease with a medical solution.

At that time in 1999 Naltrexone was new. I had tried all the other clearly non-effective recovery methods, what harm could a trial be? MAT moved me for the first time to stop dissociating when triggered. I found myself being completely present, able to stop the addictive process. I got 60-days, after which, like an alcoholic/addict, my self-will tested this MAT by drinking/using. The medication worked. I stayed present and able to be recovery-committed since, knowing it is possible.

I continued taking Naltrexone for 2-years. I went off when I had built enough behavioral tools and support to ensure my ongoing recovery. I continue to live each day only 24-hours at a time, knowing thay I can return to drinking and using tomorrow. If it wasn’t for MAT I would not be here to tell my story. I am grateful that there are medical options to help oeople struggling when all else has failed them.

# # #

Third Place
IN MY OWN WORDS…
Medication Assisted Treatment (Buprenorphine / Suboxone)
Ian Christenson, Minnesota

Suboxone saved my life. I’ve been clean and sober since that day 5 years ago when I walked into my doctor’s office beaten down by my addiction and finally asked for help.

At 30 years of age, after 15 years of drug addiction I started Suboxone. I had been attending 12 step groups but after years of heroin and pill addiction, numerous drug treatments, and chronically relapsing I had to do something different. The decision was difficult. Suboxone is controversial and I feared the judgments of others in recovery.

Medication-Assisted Treatment is a BIG part of my recovery but staying sober depends on more than just medication. I do service work, go to meetings, stay away from drugs/alcohol, and surround myself with supportive people.

Medication-Assisted Treatment is the best decision I had made in a long time. I know I wouldn’t be where I am today without the help from my doctors and the MAT program.

Suboxone has stopped my cravings and preoccupation with getting high. My life is no longer controlled by being high, lying, feeling miserable, then starting the cycle again.

I’m 100 % committed to my recovery. Even though some days are still hard I know I can make it though the tough times. I now have a good job, a house, and a family. Besides all that, I now have something I never thought I could, sobriety and true happiness. I owe a lot of that to MAT.

# # #

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