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Myths on drugs easing addiction
Craig F. Walker/Globe Staff
By Felice J. Freyer
Globe Staff

For Mike, a white-collar worker, a medication restored his life after 10 years of shooting heroin. For Amy, a homeless woman, it started her on a still-incomplete journey to recovery. But as a Globe story highlighted on Thursday, there is lingering resistance to treating addiction with drugs. Here are five common myths contributing to the stigma.

Myth #1: People who take buprenorphine or methadone to treat addiction are merely substituting one addiction for another and aren’t truly sober.

Such statements reflect a misunderstanding of addiction. By definition, addiction involves more than taking drugs regularly — it includes a compulsion to pursue drugs despite life-destroying consequences.

Methadone and buprenorphine (known by a brand name, Suboxone) are opioids and they do create physical dependence. But dependence is not the same as addiction; it doesn’t involve behavioral impairments. Patients who want to stop taking buprenorphine or methadone need to taper down their dose very slowly to avoid withdrawal symptoms.

Doctors say that people taking these medications are in fact sober, if they are taking an appropriate dose.

Myth#2. Buprenorphine is sold illegally on the street and smuggled into prison, so it can’t be a legitimate medication.

Addiction specialists say that buprenorphine has street value primarily because it eases the symptoms of withdrawal, which are terrible. Addicted people want to have it when they can’t get heroin or want a break from heroin. If people had easier access to buprenorphine in doctor’s offices and prison infirmaries, advocates say, they wouldn’t need to turn to the black market.

You can’t get high on buprenorphine alone, unless you haven’t taken any opioids in a long time, and even then it’s not much of a high.

Myth #3: Drug companies, which have been blamed for starting the opioid epidemic, are now making billions pushing a different set of opioids as a solution.

Buprenorphine and methadone are not blockbuster drugs for their manufacturers. Methadone is a decades-old generic that is very inexpensive. Buprenorphine comes in many different formulations, including generic versions, so that no single manufacturer is pushing it. The main proponents of these medications are physicians who have seen them improve patients’ lives, including many physicians with no ties to pharmaceutical companies.

Myth #4: Vivitrol is a better choice for everyone because it’s not an opioid and doesn’t cause dependence.

Vivitrol, or injectable naltrexone, is a newer medication that works well for some people. It’s a shot into the buttock that blocks the effects of opioids for three or four weeks. But it doesn’t have as long a track record as buprenorphine and methadone, and some specialists worry that it merely delays overdoses instead of preventing them, because people have no tolerance for opioids after being on Vivitrol.

Still, plenty of people find Vivitrol a lifesaver.

Bottom line: Each of the three medications for addiction works for some people, and none works for everyone.

Myth #5: Many people taking medications for addiction continue to take other drugs to get high, showing that the medications don’t work or make things worse.

No, it shows that addiction is complex and recovery is a process, sometimes a long one.

Some people, like the white-collar worker in the Globe story, find that medication is enough to get back on track. For others it’s more complicated. Even with medications blocking the effects of heroin and fentanyl, some still want to get high, so they’ll mix in other drugs. They may be homeless, jobless, or suffering from mental illness, and see no path to sobriety despite the medications.

But as long as they’re taking medication, addicted people are much less likely to die of an overdose. As addiction specialists like to say, a dead person can’t recover.

Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer