OPIOID MEDICAL CURE BUPRENORPHINE RESEARCH IS SMOKESCREEN FOR DIVERSION AND MISUSE FUELING EPIDEMIC
Attention-distracting report focuses on prevalence of the least likely cheat for urine drug tests, ignores cheats that work, ignores replacement of clinical contact and drug screens by phone access to opioids
by Clark Miller
Published September 6, 2024
All it takes now is a phone call, extremely convenient for opioid users that medical dispensers have been relieved of providing clinical contact and monitoring of patients at risk in America’s opioid crisis.
Just a phone call to get prescriptions for one of the most abused, diverted and otherwise misused opioids on the street (see “The bupe economy” in this post), prescribed by America’s medically licensed practitioners of addiction medicine.
And it’s working! In ways we can attribute to America’s top addiction experts, healthcare and public health institutions, and expert media reporting.
Just check the trends in provision of the gold standard cure to at-risk opioid users.
Unfortunately, it’s working and having effects in predictably perverse and lethal ways.
But let’s not get distracted.
Back to the report in America’s top medical journal.
As reported on here,
New research finds that patients who spike their urine with buprenorphine to cheat adherence testing are more likely to be positive for non-prescribed opioids, highlighting the need for best practices in this setting. “Spiking suggests that treatment is not working — especially in patients continuing illicit drug use. Detecting spiking allows clinicians to adjust or intensify the treatment plan,” said lead author Jarratt Pytell, MD, of the University of Colorado School of Medicine, in a statement. (JAMA Psychiatry)
Right.
Good God this is tedious.
But let’s break it down.
patients who spike their urine with buprenorphine to cheat adherence testing are more likely to be positive for non-prescribed opioids
You don’t say!
highlighting the need for best practices in this setting
AI had to write that. It’s less than human.
What setting is that? Now that opioid abusers can hook up for their bupe by phone call? How about a stern medical warning about the spiking, letting users know that it’s easily detectable, so they can get smart and use the drug screen cheats that aren’t detectable and work?
allows clinicians to adjust or intensify the treatment plan
No actual suggestions? C’on, what comes to mind?
Not sure how to use your own urine, by freezing and saving it, or someone else’s?
No problem, help is everywhere. Where there’s a need . . . and incentive, or reward.
There is no more common, easily available prescription drug on the streets than bupe, it’s value, remarkable variety of uses, and stability in street and prison economies of illicit drug use – as consumable, commodity, and currency – described here, and here, and here (scroll down to “The bupe economy”).
A user prescribed bupe or anyone not concurrently using other opioid or drugs of abuse can take Suboxone for a few days, save some urine, freeze if needed, then, with the aid of easily available cheat devices, keep it at body temperature and ready to hand over as a specimen that will pass with flying colors – therapeutic levels of buprenorphine and nothing else of concern.
But why bother with all of that? That’s sooooo pre-pandemic, so unnecessary, now that clinic visits and drug screens are history, anachronism in the new world of no-barrier provision of opioid cures by phone call.
The concerns and premise of the JAMA study and its conclusions and interpertatinos are moot, of little relevance, because things have changed. The database for the JAMA study ran from 2017 to 2022 – that is, heavily skewed and weighted to periods prior to COVID, prior to dramatic loosening of clinical standards and practices designed to pass bupe out as quickly as possible: by forgoing clinical contact with patients, then opening up bupe prescribing to medical professionals with no training or experience providing substitute opioids to problem opioid users.
Urine drug screens, with some exceptions including in probation and parole systems, have beome a moot point, a thing of the past with bupe prescriptions filled by phone call.
There were effective cheats all along, now they’re rarely needed with elimination of clinical contact and responsible and ethical monitoring of patient wellbeing and safety, patients at high risk of overdose and death in American Medicine’s opioid crisis.
It was predictable that all measures of problem, high-risk opioid use would continue to surge over the new period of reckless prescribing, including buprenorphine-involved overdose deaths.
See this post for an explanation of the graphic including the projected values.
Things have changed, including acceleration of the lethal crisis now post-pandemic and as more and more of American Medicine’s gold standard cures are dispensed to diseased brains.
But not the assurances from America’s most trusted addiction and medical experts regarding the effectiveness of their gold standard and “miracle molecule” cures. Or the use of public healthcare funds for those cures.
Those things haven’t changed.
Or the continued exposure, driven by incompetence and malfeasant practice, of vulnerable Americans to predictable harm and death in the face of obvious risks.
Harm obvious to anyone who wants and is not afraid to see. That hasn’t changed either.
