Many physicians don’t want to offer opioid maintenance. They’re happy to refer out, to an addictionologist or psychiatrist with training.
In terms of a comfortable detox, Suboxone was a success. In terms of a return to opiate use, it was a failure.
We should remember the proposal isn’t actually about a way to get addicts off drugs; it’s a way to facilitate use.
Reliable stats on relapse can be hard to come by, but return-to-heroin rates appear to run above 80% (and in some cases, higher).
The fewer services you provide, the fewer staff you need, and the more likely you are to have a healthy profit margin.
It also suggests that the ‘return to heroin’ rate among former maintenance clients may be even higher.
Experience tells us that almost all of the wide variety of treatment strategies and models are around because they work well for someone.
We haven’t corrected any identified physical deficiency. We’ve simply substituted a medical opioid for an illicit one.