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Is the Baltimore addiction treatment industry maintenance happy?

Is the Baltimore addiction treatment industry maintenance happy?

June 9, 2014
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Since the 1980’s the city of Baltimore has been known as one of the cities with the worst illegal drug problem, most notably heroin. For years Baltimore was known as the “heroin capital” of the United States. Rising to prominence during the 1980’s during America’s crack epidemic, the drug problem in Baltimore has grown steadily ever since.

Former Baltimore Mayor Kurt Schmoke first attempted to combat the cities drug epidemic, attempting to look at drug addiction as a health and a community issue rather than a criminal issue. Mayor Schmoke pushed treatment for addiction and even broached the idea of decriminalizing drugs locally (an idea he was bashed in the media for even considering.) Later on, Baltimore and it’s drug problem was made famous (infamous?) by the HBO miniseries “The Corner” and then, of course, in the groundbreaking show “The Wire”. Even now, when someone from out of town mentions Baltimore there are typically three things that are mentioned as references: local sports teams the Orioles and the Ravens, steamed Maryland crabs and heroin.

Baltimore has an opiate abuse problem. Herion, OxyContin and other forms of narcotics are the “drug of choice” from the Inner Harbor all the way out to the suburbs of Baltimore County and Harford County and even the more rural Carroll County. Addiction doesn’t discriminate between class, race, religion, gender or geographic area. Baltimore and it’s surrounding areas have a drug problem and the options for substance abuse treatment are limited and unfortunately much of the local “treatment” philosophy is flawed.

One of the major local issues surrounding drug treatment in the Baltimore area is a mindset of medication maintenance for opiate addicts. While the havens of addiction treatment and recovery that exist in communities around the country such as Southern California, Arizona, Minnesota and South Florida (just to name a few) have progressed to models of holistic, comprehensive treatment, Baltimore still seems stuck in the 1980’s, proclaiming the benefits of methadone maintenance as treatment. Furthermore, since the introduction of opiate medications such as buprenorphine and Suboxone, Baltimore and the surrounding areas have taken up the charge of medication maintenance models of drug treatment. Ideas like long term Suboxone maintenance as effective treatment pervade much of the local addiction treatment industry.

Baltimore Seems to be Pushing Methadone & Suboxone Maintenance

A local online Google search turned up 214 doctors in the Baltimore area with the ability to prescribe buprenorphine, and that’s just within the Baltimore city limits. That doesn’t include the doctors in the surrounding counties. While progressive areas have sought to utilize medication in conjunction with addiction treatmen, through protocols like opiate detox or short term taper programs, Baltimore still seems stuck on the idea that prescribing an opiate addict Suboxone on a long term basis is actually treatment. While more progressive areas of the country utilize these drugs to eventually get a patient drug free and abstinent, many in the local substance abuse treatment industry seem content to keep narcotics addicts on these drugs as long as possible, some for the rest of their life. Let’s not even mention that drugs like Methadone or Suboxone simply treat the physical withdrawals symptoms of an addict, therefore not truly treating the underlying addiction issues. Maintenance is simply trading one illegal maintenance drug like heroin for one legal maintenance drug like Methadone, or one legal maintenance drug like OxyContin for another legal maintenance drug like Suboxone. A good question is: Has anyone that takes a maintenance philosophy have ever seen an addict on long term Methadone or Suboxone attempt to get off those drugs? The detox is horrifying, often much longer and more intense than a heroin or prescription narcotic withdrawal.

Baltimore seems to be maintenance happy. Throwing people suffering from opiate abuse issues on long term narcotic mediation maintenance is not treatment. It does not get to the core issues of the disease of addiction. Comprehensive treatment examines all aspects of a patients life and addiction: physically, mentally, emotionally, spiritually, their living environment, their family structure, their behaviors, their choices, their belief systems, their personality. Quality comprehensive treatment examines all these areas, meets the patients where they are at, then challenges and treats the patient in order to help them begin their journey of recovery and offering the necessary follow up to support them in that recovery. Does that type of treatment sound like Methadone or Suboxone maintenance?

Baltimore was hit with a heroin epidemic in the 1980’s and 1990’s. More recently, the prescription pain killer epidemic has grown exponentially and moved further outside the city. Due to the decline in local recovery homes and halfway houses (they are non-existent in Baltimore County), the ability to help opiate addicts on an outpatient basis for treatment is limited because these patients don’t have safe, sober living environments to go to while getting treatment. Furthermore, based on managed care, most insurance companies don’t cover much time in a residential or inpatient rehab and some even require a patient to “fail” several times at an IOP treatment center before authorizing benefits for an inpatient drug rehab. Because of this, it seems the local area has the mindset of “success rates” of people not using heroin or other opiates are greatly improved by putting them on a medication maintenance program like long term Methadone or Suboxone maintenance. And while “success rates” may show that patients have stayed off heroin for an extended period of time while on these drugs, what these rates don’t account for is how many other substances the patient is abusing, what their quality of life is, have they treated the underlying illness and the associated behaviors and are they truly happy?

Comprehensive treatment is necessary to overcome addiction. All aspects of a patient’s life must be examined and treated. Medication plays an important role in the treatment of addiction but it cannot be the only component that is used and it certainly cannot be seen as the treatment itself. Baltimore and the surrounding areas in Maryland seem to be of the mindset that medication maintenance is an innovative approach to drug and alcohol treatment, while the majority of addiction treatment in America abandoned that philosophy years ago. Those suffering from substance abuse in Baltimore deserve the opportunity to receive high quality, comprehensive addiction treatment in order to cultivate a sustainable recovery and not simply be thrown into a model of “harm reduction” as an after thought because the mindset is “opiate addicts always relapse so let’s at least keep them from overdosing.” This mindset does not help addicts recover. It does not help addicts recreate their lives. This mindset must be abandoned and in it’s place must be offered high quality, comprehensive drug and alcohol addiction treatment for the residents of Baltimore and the surrounding areas.

If you or someone you know is suffering from a drug and alcohol addiction and needs treatment please call us for help. Maryland Addiction Recovery Center offers the most comprehensive addiction treatment in the area. If we aren’t the best fit, we will work with you to find a treatment center that fits your needs. Please call us at (410) 773-0500 or email info@marylandaddictionrecovery.com. For more information on all of our alcohol and addiction treatment services and resources, please visit the web site at www.marylandaddictionrecovery.com.