Drug treatment for drug addiction

It’s an approach that research evidence and many in recovery say makes sense — but one that some advocates say has it all wrong.

One of the most effective ways of treating those suffering from opioid addiction is with drugs. There are two types of drugs used. Methadone and a newer drug, buprenorphine, are opioids that substitute for the drugs someone with an addiction problem craves, but don’t produce a high. A different type of drug, naltrexone, blocks the brain’s opioid receptors, making it impossible to get high from opioids.

The Globe’s Felice Freyer dives into the issue of treating drug addiction with drugs in today’s paper. She drives home both the effectiveness of the approach — and huge stigma attached to it — by profiling “Mike” a young Financial District suit who swallows a buprenorphine tablet each morning before grabbing his briefcase and heading off to blend in with the downtown crowd.

She says Mike, who doesn’t want his last name used and is photographed only from behind, “faces a double stigma — against addiction and against the medication that enabled him to overcome it.”

He originally went to the renowned Hazelden Betty Ford Foundation clinic in Minnesota, which at the time, in 2011, used an abstinence-only approach that relied on the 12-step program pioneered by Alcoholics Anonymous. He relapsed soon after.

Those given drug treatment with methadone or buprenorphine have much lower rates of relapse or overdose than those who attempt addiction recovery without medication. But not everyone supports the approach. “If I’m taking an opiate every day, how am I sober,” one leader of a recovery group tells Freyer.

A Quincy doctor she speaks with falls in a middle ground, prescribing buprenorphine for some patients, but warning that it has a “dark side,” with some patients unable to wean themselves off it. “The death rates are going down, but it’s not a life worth living,” the doctor says.

One of the biggest debates over medication-assisted addiction treatment has to do with US prisons, where sometimes a third or more of inmates arrive with an addiction problem. While neighboring Rhode Island is the one state in the country that makes all three drug treatments available to inmates, Massachusetts only makes naltrexone, which is administered through an injection, available to prisoners.

Dr. Warren Ferguson, an addiction specialist at the University of Massachusetts Medical School, writes in CommonWealth about a patient who was forced to detox “cold turkey” from methadone when he landed in a county jail where he was not provided the treatment.

“Eliminating methadone without proper planning wreaks havoc on the mind and body,” writes Ferguson, who thinks such a forced withdrawal by correctional facilities “should be illegal.”

He may have powerful company. The Justice Department informed state officials in March that it was investigating whether stripping inmates of such treatment when they land behind bars violates the Americans with Disabilities Act.

That was welcome, if surprising, news to Ferguson and others who have called on the state to make methadone and buprenorphine available to inmates. A provision that would have mandated that was pulled out of the final version of the recent criminal justice bill passed on Beacon Hill.

“I never thought something like this would come out of the Trump administration,” Ferguson told the Globe in March when news of the Justice Department inquiry broke. “I was like ‘Wow, this is the best thing I’ve heard in a long time.’”

MICHAEL JONAS


BEACON HILL

State Reps. Geoff Diehl and Jim Lyons continue their call for impeachment of Essex Superior Court Judge Timothy Feeley over his sentencing of a heroin dealer. (Boston Herald) A Globe editorial calls their attacks “nothing short of an assault on judicial independence.”

MUNICIPAL MATTERS

Members of the Quincy Conservation Commission, following a hearing with Boston officials requesting a permit to build a new Long Island Bridge, said they need more information on the environmental impact of the rebuilt span before they can decide on whether to issue the permit. (Patriot Ledger)

Rockland Selectman Deirdre Hall is taking a temporary leave from the board until an investigation into allegations made by her of inappropriate behavior by the town administrator is complete. Hall, who also has withdrawn from the race for state representative, said she and her family have been subject to attacks and rumors on social media since the allegation came to light. (Wicked Local)

Brockton’s city-owned golf course took in more than $1 million in revenues last year for the first time in its 91-year history. (The Enterprise)

WASHINGTON/NATIONAL/INTERNATIONAL

House Speaker Paul Ryan is the latest Republican to dismiss President Trump’s claim that an FBI  “spy” infiltrated his campaign, a sign of growing resistance among GOP congressmen to Trump and some of his policies and claims. (New York Times)

Stephanie Clifford, the porn actress who goes by the name Stormy Daniels, has filed suit against her former attorney claiming he was a Trump “puppet” who colluded with Trump lawyer Michael Cohen to get her to falsely deny her affair with Trump. (Washington Post)

David Koch, one of the two billionaire brothers who used their oil-fueled wealth to push conservative candidates and causes, is stepping aside from the business and political operations of the family business because of declining health. (New York Times)

Former Boston mayor Ray Flynn offers a tribute to Holocaust survivor Steve Ross, whose story is told in a new book. (Boston Herald)

ELECTIONS

Donald Trump has become a central figure in races across Massachusetts, from the contest for governor to battles for state rep. (Boston Globe)

Unofficial returns in California show that Democrats qualified for the November ballot in all seven hotly contested congressional races despite fears that the large number of candidates in the nonpartisan primaries would split the vote and give Republicans the top two slots. (U.S. News & World Report)

Actress Jennifer Lawrence urged voters in Maine to support a ballot question that would mandate ranked-choice voting.

BUSINESS/ECONOMY

The building commissioner in Lenox sent notices to 56 homeowners ordering them to stop offering short-term rentals or submit to an inspection to ensure compliance with regulations covering lodging houses or bed and breakfasts. The building commissioner said a directive from the Baker administration requires that inspection agencies and health departments “treat online home rental services for transient guests as a lodging house or bed and breakfast establishment.” (Berkshire Eagle)

Joan Vennochi decries Boston developer Don Chiofaro’s proposed 600-foot tower that would go up next to the New England Aquarium, saying it would make a mockery of a state law that aims to limit waterfront construction to no more than 155 feet.

EDUCATION

School choice is booming on the Cape with some districts thriving from the influx of students while districts losing students say their budgets are being decimated. (Cape Cod Times)

Lincoln-Sudbury Regional High School is still waiting for funds that the state has withheld because it forms were not filed properly. School officials say a software glitch prevented the forms from uploading. (MetroWest Daily News)

HEALTH/HEALTH CARE

At least 25 people have died of overdoses in Fall River through May this year with nearly 400 people treated for overdoses by emergency responders, putting the city on a pace to far exceed last year’s totals. (Herald News)

Jonathan Bush, the founder and chief executive of athenahealth, resigned amidst multiple allegations regarding his personal conduct and a possible takeover bid for the Watertown company. (Boston Herald)

TRANSPORTATION

Lynn Mayor Thomas McGee brings transit advocates Rick Dimino of A Better City and Al Raine of AECOM to town to make the pitch that greater investment in the MBTA and more transit links between Lynn and Boston are needed. (Daily Item)

ENERGY/ENVIRONMENT

Boston Mayor Marty Walsh will announce a new renewable energy buying initiative among cities at the first International Mayors Climate Summit today at Boston University. (Boston Globe)  Mary Skelton Roberts of the Barr Foundation urges the mayors to focus on transportation as they seek to reduce carbon emission and minimize climate change. (CommonWealth)

A group of stakeholders in western Maine gave their blessing to a new transmission line crossing over instead of under the Kennebec Gorge in return for a $22 million mitigation package. The transmission line would be paid for by Massachusetts electric ratepayers under a procurement to bring hydro-electricity from Quebec into New England. (Maine Public Radio)

CRIMINAL JUSTICE/COURTS

With officials debating whether sex offender Wayne Chapman should be released from prison, the Salem News digs into the data to understand why and how sex offenders are released from jail. The Herald reports that about a third of those sex offenders being held under civil commitment were successful in recent years in petitioning for release. Gov. Charlie Baker’s proposed reform would establish a five-member review board to decide on release, not the current system of two psychologists, with a judge or jury settling the matter if the board members aren’t in agreement. (Boston Herald)

MEDIA

The Boston Globe tells a judge that it needs former employee Hilary Sargent to share any information she has about editor Brian McGrory sending her inappropriate and sexually suggestive text messages. The Globe and Sargent are headed to court today. (CommonWealth)

Two new studies show that communities that lose their local newspapers experience increased municipal costs driven by spending that is unchecked by watchdog journalism. (Media Nation)

Bill Littlefield is retiring as host of NPR’s “Only a Game” after 25 years. (Boston Globe)