Dr. Bryan Wood and Family

More and more, the national dialogue on mental health and addiction recognizes that co-occurring disorders, that is, both mental illness and addiction, afflict a large percentage of sufferers. Some individuals take alcohol or drugs to medicate their symptoms of anxiety, depression or other mental illnesses; sometimes the damage done by alcoholism or drug abuse causes mental illnesses; and sometimes the cause is difficult to pin down, but the correlation is apparent. Although accepted practice and treatment (by most) for mental illness includes prescription medications, a debate rages on about using prescription medications in the treatment of addiction. Methodone has been around for years, but there are many objections to its use. There are also other drugs whose side effects can be quite pronounced. Suboxone, a relative newcomer on the scene, has shown some promise.

Dr. Bryan Wood, founder of the SelfRefind Clinics based in Kentucky, has had good results helping people with this medication.

 Hi, Dr. Wood. Can you elaborate a bit on your own background and Suboxone’s genesis?

 I would like to clarify right off the bat that I am not a ‘spokesman’ of Suboxone. I don’t speak for the company of Reckitt Benckiser. I do speak for treatment of opiate addiction through the use of Suboxone. I am listed as a TA (Teaching Advocate) for Reckitt and educate the public and other health care providers about opiate addiction therapy, specifically on the best practice behaviors using Suboxone. I spent over eighteen years being the medical director of various Emergency Departments in Oklahoma City and central Kentucky.

I was looking for a better answer for the treatment of opiate addiction than what 40 years [approach based on] abstinence and 12-step [programs] provided. My research led me to buprenorphine and I have not looked back.

Buprenorphine (Suboxone) was made available as an outpatient office-based treatment option by the DATA waiver of 2000.  Over the last 7-plus years it has developed a progressively more enthusiastic following among addiction treatment providers because of its rapid efficacy and excellent treatment outcomes.

What does Suboxone do? How long does it take before you see results?

Buprenorphine binds to the same receptors in the body and brain that full opiate agonist medications do (like OxyContin, Percocet, Lortab, Vicodin, Demerol, etc). As a partial agonist (it partially stimulates the receptors where usual opiates fully stimulate them), it does not produce the same euphoria or somnolence. The effects of full agonists are like throwing gasoline on a small fire; this results in a tremendous increase in flames. Partial agonist activity is like squirting cologne on the same fire; this provides a much less significant response. Suboxone has an extremely long “half-life” so it works longer than 24 hours. It simply keeps the opiate addict from developing physical withdrawal symptoms. This soon leads to elimination of almost all cravings. Just feeling normal all day, every day, sounds simple, but it frees the addict from these horrible cycles of craving and withdrawal that monopolized their lives. This allows them to pursue life unshackled from addiction.

It is exciting and rewarding to have a front-row seat to their successes. Typically patients feel dramatic improvement in their physical symptoms in the first 12 hours, complete resolution of physical withdrawal in 24 hours, and after 2-3 days feel fully “normal,” often for the first time in many years.

What kinds of trials have been done and what have been the results? Of particular interest are the long-term success rates.

 Numerous trial studies have been done in many countries and many settings like heroin addiction treatment programs, methadone clinics, drug courts, multiple other criminal justice settings, university based clinical trials, and private clinician office based trials, just to name some. The results vary, of course, but consistently buprenorphine based treatment FAR surpasses other modes of treatment for addiction.

It would be hard to state long-term success rates for Suboxone because it has only been available for 7-8 years now and is only now starting to gain ground with wider use by DATA-waived physicians. We do unequivocally know, however, that the longer a patient remains in treatment, the better their long-term success. We know those that complete an established treatment program have much better outcomes. We also know the more trust a patient has in their treatment program, the more their long term recovery will be significantly enhanced. Buprenorphine shows dramatic improvement over past standard interventions in all of these areas mentioned. Those studies that contrast treatment with buprenorphine to control groups show fantastic outcomes for the buprenorphine participants compared to the control groups.

What have been the results of using Buprenorphine at your clinics?

 SelfRefind has been in existence since October 2007, so we would be hard pressed to state any long-term outcomes. We are a maintenance clinic (maintain patients typically from 1.5-2 years and then taper as they tolerate to ‘drug free’). If one takes the view of ‘reduction in harm,’ our consistent success rate is about 73-75%.  That is the number of people that remain consistently in our program. Our patient satisfaction remains quite high in the 94-95% arena. We take a strong patient-centric view of addiction and treat them as we would wish to be treated. We have many successful ‘graduates’ of our program, but we remain proud of every patient who persistently seeks sober living. These folks are steadily returning to the lives they once led before their disease got the better of them. They are reclaiming loving parenthood, becoming dependable workers again, redeveloping the interpersonal relationships damaged from the disease of addiction, and they may hold their heads high as they struggle on the same roller coaster of life the rest of us do.

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In Part, 2 we will continue our discussion with Dr. Wood.

Bryan Wood, M.D. is the founder of SelfRefind, a series of clinics dedicated to treating individuals suffering from opioid addiction. He is a teaching advocate for Reckitt Benckiser, the manufacturer of the Suboxone, a medication that treats opiate addiction. SelfRefind is the largest provider of Suboxone in the U.S., with more than 45 affiliated physicians, and the organization takes pride in treating patients with love, compassion, and respect. Dr. Wood is based in Kentucky.

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From Psych Central's website:
Helping Pillbillies Stop Using Hillbilly Heroin: Dr. Bryan Wood, Part 2 | Therapy Soup (April 8, 2010)

Rush Limbaugh TV Show – American Spectator (April 30, 2010)

From Psych Central's website:
America The Addicted | Therapy Soup (May 17, 2011)

America The Addicted | http://cnc.cz.cc (May 17, 2011)

    Last reviewed: 6 Apr 2010