Opioids are prescribed in the US mainly for pain control. This includes medications like Codeine, Percocet, Vicodin, Oxycodone, Dilaudid, and many other branded and generic drugs. Chronic use of these medications, even when used appropriately, can lead to opioid dependence.
Opioid dependence is characterized by "an individual's inability to stop using the opioid despite the fact that stopping its use would be in his/her best interest." Criteria for the actual diagnosis of opioid dependence have been developed by the World Health Organization, and are widely used by physicians in office practice.
The complications of long term opioid use are numerous and, besides physical dependence and addiction, include liver dysfunction, constipation, nausea, respiratory depression, and many more.
Opioid dependence can lead to opioid abuse, a much more dangerous condition with many medical and legal adverse outcomes.
What do you do when it's time to get off the opioid pain medication, and you can't do it because of drug dependence?
The newest trend is to use Suboxone. Suboxone is a two-component medication which contains buprenorphine (itself an opioid) and naloxone. It works primarily by preventing withdrawal symptoms and controlling the craving for the opioid medication. It allows you to remain active in daily life activities such as work and family functions. The medication is taken daily, and comes in a wafer form which dissolves rapidly under the tongue.
Physicians have to go through specific training to become certified in the administration of Suboxone.
I am now certified to prescribe Suboxone. The advantage of having an Internist manage Suboxone therapy is that general medical issues and opioid dependence issues can now be treated in the same office setting in an integrated manner.
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