Drug developers condemn Texas judge’s anti-science abortion ruling

Over 400 biopharma leaders are calling for the ruling to be reversed.

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If the judge with no science/engineering training wants to "do science" can we let the scientists/engineers with no judicial training do law?

Hi, academic working in drug policy here. Drug court judges have been requiring people to engage in 12-step 'treatment' for decades as an alternative to staying in jail (12-step has a 5-7% success rate for opioid users and increases the risk of death for the 93-95% of people for who it doesn't work) because it 'feels better' than stuff with an evidentiary base (buprenorphine treatment has an 80%+ success rate but is dismissed because 'it just swaps one poison for another'). So yeah, welcome to the world where judges play medical professional except with tens of thousands of patients' lives at stake.

 

[spasm]

To be fair, let me add a personal experience: at least talk about the buprenorphine/naloxone combo, Suboxone; buprenorphine, by itself is an unbelievably strong opioid. I know this because I'm an ex-opiate addict who did use Suboxone as part of getting clean. Once, before the regulations made it no longer possible, my two year old kid was in the hospital, and I was about to go into screaming withdrawals -- so they gave me 8mg of buprenorphine. Not bup/naloxone, just straight buprenorphine.

I've never been so high, so long, in my entire life. It was glorious and miserable both -- glorious because, hey, I'm high as a fuckin' kite; miserable because I literally just wanted Suboxone so I could corral the other kids. I didn't want to be a gooey mess in the corner, I just needed to not be in acute opiate withdrawal. I needed to watch the other two kids while my first wife dealt with the doctors. I, pretty emphatically, did NOT need a high on par with Dilaudid, which is where Buprenorphine left me.

I do wish we'd expand access to Suboxone, though -- it's very expensive, and the people who need it most are extremely unlikely to be able to afford it. Parts of me think it should be like condoms at the health center -- want a handful? Grab a handful. The other parts of me think it should be like a methadone clinic -- just show up every morning, dose up, get on with your day. It surely shouldn't cost a psychiatric visit plus a couple hundred bucks for a months supply. (In 2009, I paid $300/month to the doctor and about $500/month to the pharmacy.)

(13 years clean of opiates; 5.5 years clean of alcohol. It takes some serious work to be clean of either. Did the work, got the postcard, now I'm an upstanding citizen who pays taxes and participates in my community. I miss boutique Gin. Everything else? Meh. I had just started getting in to small-distillery gins whenever I got sober. Certainly don't miss it enough to end up back on the vodka for breakfast plan.)

Of the people who tried to get sober with me 5.5 years ago, two of them are still non-drinkers. Two. Out of ~200. I'd guess that your claimed 5-7% success rate is significantly higher than reality. I'd guess closer to 1%, but that's from the perspective of alcoholism and addiction, not from the perspective of drug policy. You're working with data, I'm working with a life of anecdotes, so you're probably right; it just doesn't feel like 12 step programs do MOST people right.


That said, Suboxone used right is probably the best tool there is for opiate addicted people to get clean.

Oh, for sure, I agree with everything you're saying, particularly the 'hand it out like condoms' bit, because all the evidence backs that. I was using 'buprenorphine' as shorthand for a couple of treatment regimens, most prominently suboxone, just because my post wasn't really about drug treatment modalities rather the way judges get inappropriately involved in treatment decisions for people who use drugs. I figured the general Ars readership isn't down in the details of drug treatment, but as always I stand corrected Glad to hear you're doing well!