Blog: Why Drug Test

“Every so often one of my established office-based buprenorphine (Suboxone) patients gets a little rebellious about being asked to take drug tests. They feel since they’ve been doing so well for so long, they no longer need urine drug tests. They say things like, “Don’t you trust me by now?” But it’s not about them or their character. It’s about the disease of addiction. I tell them some abbreviated form of the following:

  • Patients in treatment don’t always tell me when they’ve relapsed.
  • It’s good medical practice.
  • There’s a gold mine of information in relapses.
  • Drug screening benefits the patient by giving them accountability.
  • Drug screening also shows them I’m serious about their recovery.
  • It’s the standard of care.

Source: JanaBurson – August 31, 2013

Drug Addiction Relapse Infographic: The Revolving Door

relapse-the-revolving-door_0“One of the persistent challenges of fighting addiction is the risk of relapse, or the full return to an addictive lifestyle after an attempt to quit.”

This new infographic visually shows:

  • Rates of Drug Addiction Relapse vs. Chronic Illness
  • What Triggers a Relapse?
  • Relapse Rates by Drug
  • Factors Most Likely to Trigger Relapse
  • Demographics of Substance Abuse Treatment Admissions

Source: – June 8, 2013

Stress & Addiction: Research Identifies How Stress Triggers Drug Relapse

Recent research from Brown University could pave the way for new methods of treatment for those recovering from addiction. Researchers identified an exact brain region in rats where the neural steps leading to drug relapse take place, allowing them to block a crucial step in the process that leads to stress-induced relapse.

Prior research has established that acute stress can lead to drug abuse in vulnerable individuals and increase the risk of relapse in recovering addicts. But the exact way that stress triggers the neural processes leading to relapse is still not clearly understood. The Brown study provides new insights on how stress triggers drug abuse, and could lead to more effective treatments for addiction. “

Source: – March 11, 2013

Harsh Cameron Douglas Sentence Sparks Appeal, Support

Not offered drug treatment, Douglas relapsed while in prison and was caught in possession of a small amount of heroin and Suboxone.

But, unusually, Douglas was also prosecuted for drug possession by a prisoner, and even more unusually, he was hammered hard at sentencing. Federal District Court Judge Richard Berman nearly doubled his original drug trafficking time, sentencing him to an additional 4 ½ years in prison. Prosecutors had asked for at most an additional two years.

“Tacking on more prison time for a person who is addicted to drugs because they relapse behind bars goes against fundamental principles of medicine, inflicts unnecessary suffering and undermines both safety and health,” said Dan Abrahamson, director of legal affairs for the Drug Policy Alliance.  “Such a response only fuels the vicious cycle we see daily across the country of drug-dependent persons being imprisoned while sick, coming out sicker, and then returning to jail even quicker — at huge expense to everyone.”

Source:  – May 21, 2012


Research Study: Technique Rewrites Addicts’ Memories

 Researchers in China have developed a technique that rewrites the memories of drug addicts to lessen their association with pleasure and help prevent them from relapsing.

The study’s findings may be a useful addition to existing treatments for recovering addicts, who are vulnerable to relapse even after undergoing rehabilitation programs which include “extinction procedures” to help patients control cravings

Source:  Healthcare Today – April 17, 2012

Retention in Opioid Agonist Treatment after Prison Release Reduces Re-incarceration

Opioid agonist treatment (OAT) in prison and after release might influence the risk of re-incarceration. This prospective cohort study linked data on OAT and incarceration among 375 men with heroin use originally recruited in 1996–1997 for a randomized controlled trial of OAT in prison in New South Wales, Australia. Participants were followed through 2006.

  • During 9+ years of observation, 331 participants engaged in OAT 1081 times, with a median of 2 episodes per participant (mean length of engagement, 156 days); 58% started OAT in prison.
  • Ninety percent of participants were re-incarcerated after the first incarceration.
  • Engagement in OAT at the time of release had no effect on re-incarceration.
  • Post-release retention in OAT was associated with a one-fifth reduction in the number of re-incarcerations.

Comments: This study affirms that retention in OAT following release is associated with reduced re-incarceration among former prisoners with opioid dependence. Although other investigations have shown that initiating OAT prior to release maximizes post-release treatment retention, the current study suggests active linkage to ongoing treatment is an essential component. Continuing or initiating OAT during incarceration is necessary but not sufficient to optimize post-release outcomes among opioid-dependent inmates; correctional systems and treatment providers must also provide transitional assistance to ensure that former inmates reach OAT programs after release.

Published In: Alcohol, Other Drugs, and Health: Current Evidence a project of the Boston Medical Center issue January/February 2012. Access checked 3/12/12. Peter D. Friedmann, MD, MPH

Original Source: Larney S, Toson B, Burns L, et al. Effect of prison-based opioid substitution treatment and post-release retention in treatment on risk of reincarceration. Addiction. 2012;107 (2):372–380.

What Vietnam Taught Us About Breaking Bad Heroin Habits

One theory about why the rates of heroin relapse were so low on return to the U.S. has to do with the fact that the soldiers, after being treated for their physical addiction in Vietnam, returned to a place radically different from the environment where their addiction took hold of them.

“I think that most people accept that the change in the environment, and the fact that the addiction occurred in this exotic environment, you know, makes it plausible that the addiction rate would be that much lower,” Nixon appointee Jerome Jaffe says.

For additional coverage of this topic see the two-part blog The “Lee Robins Study” and Its Legacy available at: and

Source: National Public Radio – January 2, 2012

Study: Benzodiazepine Use by OTP Patients May Indicate Untreated Anxiety

A recent study based on an anonymous survey of methadone patients in a Baltimore, Maryland opioid treatment program (OTP) found that more than half of benzodiazepine users attending group meetings had started using these drugs after entering methadone maintenance (MM) treatment.

The authors caution that their study results should not be used to make clinic policy, or to change operations. This article could be helpful to OTPs as they try to deal with the issue of benzodiazepine abuse.

“The study findings suggest that most methadone programs do not address co-occurring anxiety problems,” the authors concluded. Further study is needed “to develop effective treatments that will simultaneously target addiction symptoms, anxiety disorders,” and misuse of benzodiazepines.

The authors noted that benzodiazepine misuse increases the risk for relapse and overdose.

The study, Benzodiazepine Use and Misuse Among Patients in a Methadone Program, by Kevin W. Chen et al, is published in BMC Psychiatry, May 19, 2011. The article is available for free download at:

Site last updated July 17, 2014 @ 5:55 pm