People with opioid addiction are illegally purchasing a medication that's prescribed to treat opioid addiction.
Many are doing it to self-medicate. Some are trying to get high.
“Never craved opioids at all when I was on it. That was the great thing about it,” said Tamara Courtney of Damascus, Ohio.
Courtney, who is a few weeks in recovery from her addiction to painkillers, is talking about Suboxone, which she bought illegally for $20 a dose when she was seeking drugs on the streets. “It was instant relief from withdraws,” she said.
The drug is a bit of a paradox. It is an FDA-approved opioid medication that works to silence the craving of opioids, without the high.
Suboxone is a trade name for the generic medication buprenorphine combined with naloxone to prevent heroin or fentanyl or prescription painkiller cravings, euphoria and, ultimately, overdose.
Street diversion has been a problem for years: Some of those who are prescribed buprenorphine products follow doctors' orders and take it as they should. Some take it improperly or not at all, then sell leftovers to people who can't find a legitimate way to get the medication. Or to drug-seekers trying to get high.
Dr. Mina “Mike” Kalfas, a certified addiction expert in Northern Kentucky, said the diversion of Suboxone to the streets makes it difficult for prescribers who treat opioid addiction with it.
“It muddies the water,” Kalfas said.
Kalfas is beginning to use a recently approved injectable buprenorphine for some patients. It can help those who waver on taking their medication properly, he said. If it turns out to be effective for a lot of people, Kalfas said, it also might reduce the amount of the drug that's diverted to the streets.
And, as doctors prescribe more buprenorphine products for opioid addiction, there's a chance that could prevent some street purchases, said Kalfas.
He thinks much of the misuse today comes from people trying to self-treat addiction.
That’s how Carah Ross of Montague, Prince Edward Island, Canada, used it when she was in active addiction.
“I’m now legally on Suboxone but purchased it on the streets to try to kick dope,” said Ross. “I am on a low dose and don’t get high from it. And it’s a blocker, and you can’t get high on it.”
“Mostly people who can’t get into a clinic will do this or who have gotten cut off their script, or who are traveling,” she said.
Ross was addicted to heroin and fentanyl and has been in recovery for more than three months.
There are those get the drug illegally because they don't like the stigma of being seen at an addiction services clinic.
A father of three who lives in Johnstown, Pennsylvania, shared that he used to buy diverted Suboxone to self-treat.
Why? "I did not want any of my co-workers or anyone see me going to a clinic." He also didn't have insurance at the time, so he couldn't afford to purchase it at a pharmacy.
Kyndra Rivas of Houston said she was prescribed Suboxone to help her stay in recovery.
“When I had a script for it, a lot of my ‘friends’ would want to buy a strip (dose) to get through the day because they couldn’t get their other fix and didn’t want to be sick,” Rivas said.
She says she got high from it, although it wasn't the same kind of euphoria other drugs brought for her.
When she lost her insurance, Rivas could not afford her prescription, so she stopped using it. “I was OK for a couple of days when I ran out, but then I got extremely sick.”
She ended up in an emergency room for a life-threatening bowel condition, she said.
Usually, people become dependent on buprenorphine products, Suboxone or otherwise, and go through withdrawal just like with any other opioid when they stop taking it. They need to be carefully weaned from the medication to control the symptoms of withdrawal if they are going to end treatment with it, doctors say.
Kevin Claypool said he took Suboxone for nine months, and when he stopped, he experienced withdrawal symptoms coupled with an anxiety that he'd never had before.
“It is by far – by far – harder to get off Suboxone and Subutex once you get on it,” said Claypool, of Mesa, Arizona.
The Ohio State Highway Patrol’s records on buprenorphine-type seizures show a sharp increase since 2013 but a relative leveling off after that.
In Greater Cincinnati, police have arrested several people in the last two months with Suboxone. In two cases, drugs were found after unrelated investigations.
One man, arrested by Harrison Police on June 18, was charged with possession of buprenorphine and naloxone and drug abuse instruments. Police were investigating a domestic violence call.
On the same day, a woman from Glencoe, Kentucky, was charged with having Suboxone and heroin.
She was a passenger in a car that was pulled over for a traffic offense. After police ran her name it turned up open warrants. Cincinnati Police found the drugs and needles in her purse and bra after searching her.
The most common advice doctors and lawyers give for those who are prescribed the drug is what they'd tell anyone: Keep it in its original packaging with your prescription label.
