Opioid Crisis

As most of you know I have been on the front lines of addiction for several years. Approximately 7 years ago while I was on the Cardiac Surgery team, I watched a young man slowly die from multi-organ failure, he was 23. He had had 3 heart valves replaced and 2 years prior he had 2 valves replaced. His valves were destroyed from infection from injecting heroin. I will never forget his mother staring out the window contemplating the soon to come grave loss she would endure. On one hand I was angry that in excess of a million dollars of taxpayer money was being spent on him, on the other I was profoundly saddened by impending pain his mother would experience and by the loss of this young life that had potential.

​When I was on an orthopedic service I was the one called to go to the ER and evaluate patients. One too many times I admitted soft tissue infections (abscesses) as well as infected joints all related to injecting heroin (muscling heroin). Many a late night we went to the operating room to wash out joints and drain and wash out huge abscesses from heroin use. The end result is 6 weeks as an inpatient with a pic line and IV antibiotics and sometimes multiple trips the the operating room. The expense is astronomical!

I did the training required for a DEA waiver to prescribe Suboxone in November of 2017 with the push of my girlfriend who is an internist and was experienced in prescribing Suboxone. We were going to do it together. Life paths changed and I went to work part time for a Suboxone clinic. I learned a lot from that experience. I learned how people alter their urine, I learned about the "whizinator" (look it up), I learned words like mexi's (fentanyl) and diversion (selling medication). From the experience I have decided to pursue providing the injectable form called Sublocade as well as Vivitrol. I have been told it is an absolute pain as far as getting the insurance company to pay for the medication. Alas, pain upfront or pain later, meaning constant monitoring, drug tests and pill counts or one injection every 28 days. 

Is Suboxone a cure? No, it is a bandaid on the problem. I don't have answers as to how to beat addiction, but I do know if we can stabilize people on medication we can decrease the impact of addiction on families and our healthcare dollars.

If you have a loved one or friend of a friend please try to get them help and be sure to watch Dr. Montes The Neurobiology of Addiction on Youtube.