Tri-County Community Services provides care to thousands of residents in Taos, Colfax and Union counties, an increasing number of whom are addicted to heroin and prescription painkillers. In response, officials at Tri-County are introducing two new opioid addiction treatment medications in coming weeks - Suboxone and Vivitrol.
Each drug represents a different form of treatment - the former falling under the category of "opioid replacement therapy" and the latter being used to suppress the effects of opioids on the brain, in part, as a means of addressing the underlying causes of addiction.
The U.S. Food and Drug Administration approved Suboxone, the commercial brand name of the combined chemicals buprenorphine and naloxone, in 2002. The medication itself is an opioid, but unlike certain prescription painkillers and heroin - a cheaper alternative - Suboxone only partially activates the part of the brain that responds to opioids. According to clinicians, Suboxone reduces overdose death because the drug's effect is less powerful than painkillers or heroin. In addition, the effect is longer lasting, softening and drawing out the spiking euphoria heroin users experience and easing the plunging lows that follow, clinicians say.
After varying periods of treatment that can range from one month to more than one year, some patients have claimed to feel stabilized as the euphoric effects of the drug flatten out and then dissipate, allowing some to re-enter a life relatively free of addiction, according to American Addiction Centers.
But as with most prescription medications, there are also drawbacks.
Aside from the FDA-mandated list of possible side effects, including stomach pain, vomiting and constipation, one of the major concerns surrounding the drug is its potential for abuse. In some cases, Suboxone has become a kind of replacement addiction for patients, according to federal experts. And in the hands of a user without a tolerance to opioids, as little as 2 milligrams can be fatal. Although the added chemical, naloxone, serves to lessen the effect of opioids on the brain, it does so only partially - meaning that there may be a heightened risk of overdose among those who choose to abuse the medication or other drugs while in treatment.
Given its form - typically in paper-thin dissolvable strips - the drug has carved out a corner of the illegal drug market all its own as a highly concealable opioid. Suboxone has become a popular form of contraband in jails, including the Taos County Adult Detention Center, where strips have been slipped or dissolved into books and letters, according to jail officials and police.
Naltrexone, the active chemical in Vivitrol, helps some patients overcome addiction by blocking the effects of opioids on the pleasure center of the brain, according to the FDA. The drug is typically administered in the form of an injection once per month for either six months to one year and was approved for use among qualified patients in 2010.
Taking the drug effectively causes immediate withdrawal, bringing underlying problems that have been suppressed by drug abuse to the surface. Therefore, it requires a stable environment for a patient - ideally combined with adjunctive therapy administered by a service provider.
Vivitrol is an expensive option, with injections costing about $1,500 apiece.
One potential drawback is that, because the drug suppresses the effects of opioids on the brain, patients who sustain serious injury may find during treatment may find pain medications to be ineffective. The barrier the drug creates, however, can be overridden - but only with very high doses of opioids, which can be fatal under some circumstances.
Though Vivitrol is a newer medication, early longitudinal studies performed by the FDA have shown that patients are "more likely to stay in treatment and refrain from using opiates and other types of illicit drugs."
The new medications will first be made available at Tri-County's Taos office, then will be rolled out at offices in Clayton and Ratón. "It will be directed and supported by a medical doctor who will be physically located at our main campus in Taos and they will physically go to Ratón and Clayton monthly," Dr. Rodney Gross, executive director at Tri-County, announced last week.
Officials at the nonprofit are hopeful that the new drugs will provide new, effective treatment options for addicts in Northern New Mexico - a region that continues to be one of those most affected by what the U.S. Centers for Disease Control has identified as a nationwide opioid "epidemic."