‘Tragic result’: Some use opioid treatment drug to get high

6:27 p.m Tuesday, Nov. 21, 2017 Local

A treatment drug widely-prescribed to help Medicaid recipients get off opioids is being manipulated, sold on the street and used as barter in area jails, according to addiction treatment advocates.

“The tragic result is that many addicts are selling their Suboxone script, using part of the cash as a monthly stipend and then purchasing much less expensive heroin or some other drug of choice,” said Burt Dhira, owner of Phoenix Recovery Centers with locations in Dublin and Newark.

Suboxone is the most-widely prescribed treatment option for addicts to safely withdraw from opioids. But it has become controversial. The thin strips that dissolve on the tongue are seen as too easy to divert and misuse, causing groups like the Ohio Addiction Treatment Council to argue for Medicaid to pay for other treatment options.

Suboxone is a combination of the opioid buprenorphine and the opioid-blocker naloxone. By minimizing the effect of the naloxone, dealers have been able to add to the local drug supply.

Suboxone strips are purchased by drug dealers for as much as $1,200 for a one-month supply, Dhira said, and sold on Dayton-area streets for $10 to $15 a pop. Often the sellers are addicts on Medicaid who got a Suboxone prescription from their local treatment clinic, he said.

As a result, drug dealers are profiting off Medicaid, which is funded by state and federal tax dollars, according to Dhira.

More than a quarter of the addicts interviewed for a study by the University of Kentucky’s Center on Drug and Alcohol Research said they’d sold, traded or given away the Suboxone they were prescribed.

Most people who are using Suboxone without a prescription are doing so to self-medicate and avoid withdrawal, medical professionals say.

Push-back from the medical, treatment and law enforcement communities about Suboxone led to changes in the state’s 2018 Medicaid preferred drug list.

The list specifies which medicines are automatically covered by Medicaid and which ones require prior authorization from a doctor. The list was initially drafted to make Suboxone the exclusive preferred treatment addiction treatment, which was a huge potential boon to the company that makes it.

That struck some treatment experts as odd because Attorney General Mike DeWine and 41 other attorneys general across the country are suing Suboxone-maker Indivior for allegedly driving up profits by illegally delaying the entry of a generic drug into the market.

Suboxone is still on the preferred list, but another treatment drug — Zubsolv — was added earlier this month. Although Zubsolv is similar to Suboxone, it is sold in a pill form that law enforcement officials say is more difficult to conceal.

Dhira called the move is a step in the right direction, but he’d like to see all FDA-approved treatment options covered by Medicaid without prior authorization. Medicaid pays for about half of all medication assisted addiction treatment in Ohio.

“One treatment is not good for all in this fight that takes the lives of nearly 80 Ohioans every week,” he said.

Manipulating treatment drugs to remove their opioid-blocking properties is dangerous, doctors say, particularly when they are combined with other street drugs.

It can be diverted and used by people with opioid use disorder the same as any other opioid,” said Dr. Michael Dohn, Medical Director of Public Health Dayton & Montgomery County’s outpatient drug addiction treatment center.

Staff Writer
Major Kirk Keller hold up a envelope to the light that was sent to an inmate in the Greene County Jail, Friday, Nov. 17, 2017. It appears to have a strip of Suboxone, an opioid addiction treatment drug, hidden inside the seal, just next to his right thumb. KATIE WEDELL/STAFF

The other drug added to the preferred list for 2018, Zubsolv, is a tablet that dissolves under the tongue and is also a combination of buprenorphine and naloxone. The body is able to more effectively use the buprenorphine in Zubsolv, according to addiction experts, so the tablets contain a lower dose of active ingredients and it is harder to abuse. It’s also harder to smuggle into a jail because it looks like a small pill.

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