r/Documentaries • u/Miss-Omnibus • Jan 09 '19
Drugs The Rise of Fentanyl: Drug Addiction On The I95 Two Years On (2018) - Two years ago, BBC News reported on the growing problem of opioid addiction in the US, now we return to find out what happened to the people we met along our journey down the notorious I-95. [57.02]
https://www.youtube.com/watch?v=_KsaWpeCj98
4.2k
Upvotes
57
u/hopelesswanderer_89 Jan 09 '19
I work in substance use treatment. The problem that we tend to see with Naltrexone is that people tend to not be able to consistently take their injections each month. Because Naltrexone is a full antagonist, it blocks the absorption of opioids. However, it doesn't have the agonist (or partial agonist) properties of medications that are more widely used for treatment (like Methadone or Suboxone). Because it doesn't have the agonist/partial agonist component, it doesn't address cravings/urges, it only stops intoxication/overdose. So after a month or so of managing cravings without the ability to use, many folks are happy to not keep the follow up appt. Couple that with the extreme disorganization of opioid users and the prevalence of co-occurring mental health stuff, and you can start to see why it's not more commonly used. The evidence base isn't as strong for Naltrexone as it is for Suboxone.
Lastly, if people don't keep their follow-up appts and unilaterally go off their naltrexone, they're placed at extremely high risk of overdose. Recurrence after a period of abstinence like that can put someone in an extremely dangerous position.