Meperidine - Treatment for Habitual Users

Treatment for Habitual Users

Meperidine is a highly addictive, Schedule II opioid narcotic. A high potential for addiction usually means that long-term use is risky. Long-term use may be measured as years of continual use, or as a repeating cycle of periods of use interrupted by times when the drug is not being used. The longer a narcotic drug is used, the more likely it is that a person may need help to quit using it. People who become addicted to drugs like meperidine or other prescription painkillers are less likely than users of street drugs to seek assistance in withdrawing from taking the drug.

When an opioid is suddenly discontinued after a long period of use, serious and uncomfortable withdrawal symptoms generally occur. Most people who manage to overcome an addiction to meperidine do it on their own, but many cases require professional help. Symptoms of physical withdrawal from meperidine may include restlessness, pain in bones and muscles, insomnia, diarrhea, a runny nose, chills with goose bumps, and involuntary leg movements. Symptoms of psychological addiction include becoming severely depressed and having an almost uncontrollable craving or desire for the drug.

For a chronic addiction, meaning drug use and addiction that has lasted more than a year, methadone may be used in a medically supervised withdrawal process. (An entry on methadone is also available in this encyclopedia.) Methadone is another opioid. It is used in progressively smaller doses to help users break free of addictions to more powerful drugs. Methadone helps reduce withdrawal symptoms, including the craving of another opioid, and it has fewer side effects than other opioids.

An Alternative Treatment

Since 2002, drug treatment specialists have experimented with a new drug called buprenorphine (BYOO-preh-NOR-feen). One day it might replace the use of methadone to treat withdrawal symptoms. Early results are promising, but access to the drug is still strictly limited by government control.

Researchers are hopeful that buprenorphine can help people break free of addiction to opiates such as heroin and codeine, and to opioid pain pills like Demerol, Vicodin, and OxyContin. Also known by the names Suboxen and Subutex, the drug has similar effects on the body as methadone but it is not as addicting as other opiate or opioid-like drugs. Controlled doses of buprenorphine help people withdraw from their addiction to drugs like heroin and Vicodin without some of the complications of methadone treatment. Doctors who have used buprenorphine consider it a successful treatment option and they wish more patients could benefit from it.

According to federal law, only doctors who earn special certification from the Drug Enforcement Administration (DEA) are allowed to prescribe buprenorphine. In addition, the law specifies that each certified doctor or group practice is limited to treating thirty patients at a time with the drug. By early 2005, only 4,850 of 600,000 U.S. doctors—fewer than 1 percent—had earned certification to dispense the drug. Of those, only 1,500 had treated patients with it.

Cost of Abuse

At between $300 and $350 per month for treatment, buprenorphine is expensive, and many insurance companies will not pay for it. However, people with pain pill addictions often spend more than $300 every month to support their habits. Plus, the true cost of addiction can include the breakup of a marriage or family, the loss of a job, and a criminal record.

What is the best balance between controlling access to the drug and making it available to all who need it in a treatment setting? The DEA wants to maintain close restrictions on the use of buprenorphine to prevent a possible new drug abuse "epidemic." Doctors who use it to treat patients with opioid addictions want to be able to help more people, and sooner, rather than later. While the waiting lists grow, doctors and other addiction treatment professionals will have to work with federal lawmakers to figure out how to best use this resource.