[(Chaos) x (Suboxone + J Addict Med + Am Soc Addict Med + Like Minded Docs + Addiction Medicine + Spiritual Interventions + 12 Step Recovery Programs + Drug Testing)]

Suboxone → buprenorphine + naloxone
ASAM → American Society of Addiction Medicine
LMD → Like Minded Docs


I. Suboxone – ProPublica: http://projects.propublica.org/checkup/drugs/2017

At a glance: this drug in 2012

413K
Medicare Part D Claims

$147M
Retail Cost


Suboxone Cost by State – Top 10 –
State Claims Cost
Massachusetts 51,132 $15M
Pennsylvania 26,679 $9.16M
New York 24,069 $9.03M
Michigan 19,746 $7.72M
Florida 19,403 $7.59M
Ohio 18,201 $6.22M
Kentucky 17,427 $5.66M
Tennessee 16,108 $5.49M
California 15,232 $6.03M
Texas 14,8 $5.88M

Complete list via ProPublica: http://projects.propublica.org/checkup/drugs/2017


Top 10 prescribers of Suboxone: names & cities not included in this blog post – available via ProPublica –
Provider Medicare Claims State
Internal Medicine 2,583 Alabama
Psychiatry 1,329 Massachusetts
M.D Specialist 1,08 Indiana
Psychiatry 898 Massachusetts
Family Medicine 861 Michigan
Addiction Medicine 852 Michigan
Family Medicine 825 Alabama
Emergency Medicine 743 Tennessee
Specialist 681 Vermont
Adult Medicine 671 Pennsylvania

Complete list via ProPublica: http://projects.propublica.org/checkup/drugs/2017


Database – Buprenorphine / Suboxone

Ramirez, Jorge H; Langan, Michael (2015): Buprenorphine database – January 29, 2015. figshare.
http://dx.doi.org/10.6084/m9.figshare.1297654




II. J Addict Med + ASAM

“The September issue of our Journal of Addiction Medicine” –S. Gitlow.

Inaugural issue of the journal of addiction medicine. - PubMed - NCBI


– Database –

Ramirez, Jorge H; Langan, Michael (2015): Database: ASAM & Journal of Addiction Medicine. figshare.
http://dx.doi.org/10.6084/m9.figshare.1297644

Database  Journal of Addiction Medicine   ASAM - Google Sheets


American Society of Addiction Medicine (ASAM)

1. Economic data:
http://projects.propublica.org/nonprofits/organizations/133177396
http://www.guidestar.org/organizations/13-3177396/.aspx
http://nccsweb.urban.org/communityplatform/nccs/organization/profile/id/133177396/

2. Information not available:
http://www.propublica.org/special/how-much-money-do-groups-receive-from-industry

3. Publications: available in the figshare database. http://dx.doi.org/10.6084/m9.figshare.1297644




III. Like Minded Docs (LMD) + Spiritual Interventions + 12 Step Recovery Programs

Like Minded Docs   Chaos Theory and Human Pharmacology


MeSH: Spiritual Therapies

http://www.ncbi.nlm.nih.gov/mesh/68026443
Mystical, religious, or spiritual practices performed for health benefit.
Year introduced: 2002

Tree Number(s): E02.190.901

MeSH Unique ID: D026443

Entry Terms:

  • Therapies, Spiritual
  • Spiritual Healing

See Also:

All MeSH Categories

Analytical, Diagnostic and Therapeutic Techniques and Equipment Category

Therapeutics

Complementary Therapies

Spiritual Therapies

– Faith Healing
– Homeopathy
– Magic
– Medicine, African Traditional
– Meditation
– Mental Healing
– Occultism
– Radiesthesia
– Shamanism
– Therapeutic Touch
– Witchcraft
– Yoga


I just found that 12-step interventions have not been introduced to the Medical Subject Headings (MeSH):

http://www.ncbi.nlm.nih.gov/mesh/?term=%22twelve+step%22+or+%22twelve+steps%22+or+%2212-step%22+or+%2212-steps%22+or+%2212+step%22+or+%2212+steps%22

That’s not surprising considering the fact that only a small number of papers about 12-step therapies have been published on academic journals: 1046 PubMed articles since 1974 (first publication)

1st PubMed search query (January 24, 2014): “twelve step” or “twelve steps” or “12-step” or “12-steps” or “12 step” or “12 steps”
http://www.ncbi.nlm.nih.gov/pubmed/?term=%22twelve+step%22+or+%22twelve+steps%22+or+%2212-step%22+or+%2212-steps%22+or+%2212+step%22+or+%2212+steps%22

2nd PubMed search query (January 24, 2014): (“1974/01/01″[Date – Publication] : “3000”[Date – Publication])
http://www.ncbi.nlm.nih.gov/pubmed?term=(%221974%2F01%2F01%22%5BDate%20-%20Publication%5D%20%3A%20%223000%22%5BDate%20-%20Publication%5D)

Approximately one thousand articles (not related to 12-step therapies) per a single paper matching search terms related to 12-steps recovery programs.

Performing a more specific search query: 653 results (“twelve step” OR “twelve steps” OR “12-step” OR “12-steps” OR “12 step” OR “12 steps”) AND (alcohol OR alcoholism OR addiction OR “drug abuse” OR “substance abuse”)
http://www.ncbi.nlm.nih.gov/pubmed/?term=(%22twelve+step%22+OR+%22twelve+steps%22+OR+%2212-step%22+OR+%2212-steps%22+OR+%2212+step%22+OR+%2212+steps%22)+AND+(alcohol+OR+alcoholism+OR+addiction+OR+%22drug+abuse%22+OR+%22substance+abuse%22)

Less than one paper related to 12-step interventions for addiction recovery per one thousand articles about other topics (not 12-step interventions).

What is the evidence supporting the safety and effectiveness of 12-step programs?

Ramirez, Jorge H; Langan, Michael (2015): Database: Twelve Step Rehabilitation Programs. figshare.
http://dx.doi.org/10.6084/m9.figshare.1297665

Analysis in progress…




 IV. Addiction Medicine

 1. ProPublica: Treatment Tracker –  The Doctors and Services in Medicare Part B –

http://projects.propublica.org/treatment/

2. DISRUPTED PHYSICIAN 101.2: “ADDICTION MEDICINE” IS A SELF-DESIGNATED PRACTICE SPECIALTY UNRECOGNIZED BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES–(AN AMA CENSUS TERM INDICATING NEITHER TRAINING NOR COMPETENCE)

“Addiction Medicine is currently not recognized by the American Board of Medical Specialties (ABMS).  It is still a a Self-Designated Practice Specialty and the American Board of Addiction Medicine is a Self-Designated Board.  So too is the American Academy of Ringside Medicine and Surgery, the American Academy of Bloodless Medicine and Surgery and the Council of Non-Board Certified Physicians.  But these Self-Designated Boards do not have the multi-billion dollar drug and alcohol testing and treatment industry supporting them. Addiction Medicine has deep pockets, and if the November 2014 issue of the Journal of the American Medical Association (JAMA) is a harbinger of what’s to come, this self-designated practice specialty currently being certified by a self-designated Board and bereft of anything resembling the educational and professional standards for quality practice in a particular medical specialty or subspecialty as defined by the ABMS, the American Council on Graduate Medical Education (ACGME) and the Institute of Medicine (IOM) may soon robber baron its way into acceptance by the Medical Profession.

One thing is for certain.  When society gives power of diagnosis and treatment to individuals within a group schooled in just one uncompromising model of addiction with the majority attributing their very own sobriety to that model, they will exercise that power to diagnose and treat anyone and everyone according to that model.  The birth of Addiction Medicine as an ABMS accepted discipline is sure to be a success for the drug and alcohol testing and 12-step treatment industry, but its spawn is sure to be an inauspicious mark on the Profession and Guild of Medicine and a bane of society for years to come.” –Michael L. Langan.




 

 

V. Drug Testing

Ramirez, Jorge H; Langan, Michael (2014): Drug testing database. figsharehttp://dx.doi.org/10.6084/m9.figshare.1270272

The Inquiry concludes that there is no justification for drug testing in the workplace as a means of policing the private behaviour of employees, or of improving performance and productivity. It suggests that although drug testing does have a role to play, particularly where safety is a concern, investment in management training and systems is likely to have a more positive impact and to be less costly, divisive and invasive. Drug Testing in The Workplace — IIDTW

However, independent report said that drug testing could, at most, have only a “limited impact on safety and performance”, and that testing the general workforce was a “costly and divisive” way of managing employees, and was an “inappropriate use of managerial power”.

The report said that drug testing could be beneficial in sectors where safety or public trust were an issue, but added that the practice had “no role in the majority of workplaces, and should never be used simply to investigate the private lives of staff.” —Drug Testing at Work ‘to increase’ — The Guardian (2004)

Featured Photo: Suboxone tablet – both sides by Supertheman

  5 comments for “[(Chaos) x (Suboxone + J Addict Med + Am Soc Addict Med + Like Minded Docs + Addiction Medicine + Spiritual Interventions + 12 Step Recovery Programs + Drug Testing)]

  1. January 30, 2015 at 2:06 pm

    Reblogged this on Disrupted Physician.

    • Johanna Ryan
      February 5, 2015 at 1:53 pm

      I’m not familiar with “Like-Minded Docs” except through their website. But as a thirty-year member of AA, and a patient of American psychiatry for close to forty years on and off, I share some of their fears and concerns. Behind the sudden intense interest in the failures and shortcomings of twelve-step programs (which I believe are more the fault of the for-profit treatment industry than of AA) and the tidal wave of criticism of their failure to use “promising new drugs” is an old, crafty and multibillionaire force. Yep, PhARMA.

      These days I see people coming into our AA group fresh out of “rehab” and on cocktails of four or five medications. They are on Seroquel, and Effexor, combined with Campral or Baclofen or Neurontin or Lyrica which are supposed to manage their cravings. They are increasingly on benzodiazepines. Some are on TWO benzodiazepines. Some are also on amphetamines (Adderall or Vyvanse) to help them “tolerate the sedation.” They disappear pretty fast, back into “rehab.” They become weaker and less confident, convinced that “my brain makes me an addict.” It’s scary. There was a time thirty years ago that AA members were too doctrinaire anti-psychiatry and anti-drug. That was the 80s. In the 2000s, no one dares breathe a word against “what your doctor prescribed” even when it’s manifestly toxic.

      The largest “rehab” in my community, Alexian Brothers Behavioral Health, is a major contract research organization for drug company clinical trials. It’s not surprising that down on the “substance abuse” unit you can hardly walk without tripping over the atypical antipsychotics.

      By no means do I reject buprenorphine for pain-pill and heroin addicts (and by the way most of our current crop of heroin addicts got addicted to Pfizer, Purdue and Eli Lilly opiate products). I also know, as an atheist, that there’s a serious problem in the “Twelve Step” treatment industry. But PLEASE look into all sides of this question, and don’t be made an inadvertent shill for something much, much worse. I lost a friend last year to a massive overdose of muscle relaxants from the pain specialist and benzodiazepines from the addiction psychiatrist. Not a drop of alcohol in him, the tox report said. But he was real, real dead.

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