I work with many patients in family practice and mental health, but I also have many patients, as well as family and friends, who are in recovery from addiction. Suboxone is not the answer [Advisor Forum, May 2016]. Suboxone has become a crutch for many. What was supposed to be short-term relief to help opiate addicts withdraw from opiates has become a growing epidemic in and of itself. Many tell me that they have been on this drug for 3, 4, and even 8 years. They also tell me that this medication is harder to quit than the opiates it was supposed to help them stop using in the first place. Suboxone has become the methadone of this decade. I saw a 44-year-old patient yesterday who has been on methadone for 12 years because he had back surgery. We are always looking for a quick fix, and it just does not work. Suboxone can be injected, despite what we are told by pharmaceutical companies. There is no easy answer, but this is not it. It is trading one drug for another. It seems physicians at times have become legal drug dealers (this is opinion, not fact), charging $200 each visit to these patients because insurance does not cover their visits. I do not know what the answer is, but this certainly is not it. 

Obviously, I have strong feelings about this issue due to the handling of the medications and the patients involved. Patients with chronic pain cannot get the medications they need in this country now. Addicts are dying more on the streets today than ever before, and people are also not getting the correct treatment they need.—SALENA STEADE, FNP-BC, Mobile, Ala. (213-2)

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These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.