After years of surging overdoses, some of the officials and medical practitioners most deeply involved in the fight against opioids hope that they finally have the tools, the funding and the public support needed to get the epidemic under control, the Pittsburgh Post-Gazette reports. “I have some cautious optimism,” said Debbie Dowell of the U.S. Centers for Disease Control, at the annual conference of the American Society of Addiction Medicine, which ended Sunday in San Diego. Even as fentanyl and carfentanil have killed more and more people in some states, a few have begun to reverse the trend. The epidemic is an opportunity to “change the way addiction medicine is treated across the board,” by integrating it with the broader medical community, said William Compton of the National Institute on Drug Abuse. “It truly is a remarkable time right now.”
The key tool is buprenorphine, known by the brand name Suboxone, which is becoming available in new forms, including some that quench the craving for opioids for months. Buprenorphine, an opioid, is often combined with naltrexone, which prevents other opioids from binding to the brain’s receptors. Treating one opioid with another has been controversial since the introduction of methadone for that purpose in the 1950s. Many advocates of complete drug abstinence view methadone and buprenorphine with skepticism. Few cities have more heroin-fighting experience than Baltimore. Fifteen years ago, overdoses climbed, but the city “achieved a really dramatic reduction in heroin-related overdose deaths with expansion of buprenorphine and methadone,” said Yngvild Olsen of the Institutes for Behavior Resources, a drug treatment center. Now, when someone shows up at a Baltimore hospital with an opioid overdose, they get a dose of buprenorphine, introduction to a “peer recovery coach” and an appointment the next day at one of 25 “fast track” treatment sites.