LESSON 3: COUNTER MEASURES
[Note: This posting is a continuation of a report on
the development of a civics unit of study.
This unit is directing students to formulate informed positions on the
opioid epidemic. It is being developed
in real time. Writer wants to express
gratitude to Wikipedia for identifying the bulk of the research this blog has
used in the development of this unit.]
Development of this
unit of study has brought this blog to the point of reporting what a third
lesson might look like. Hopefully, due
to implementing the previously reported second lesson (see previous posting, “First
Two Lessons in a Unit about Opioids”) the student has a well-rounded view of
what the opioid epidemic is in terms of how it effects individuals in the
on, as a possible homework assignment leading to a third lesson can be for
students reviewing a list of factoids and insights concerning counter measures
available to help addicts. The student
can be handed a list of such counter measures for the various opioid drugs that
have been developed. Overall, counter
measures take the form of prevention strategies, prescribing counter drugs such
as methadone, behavioral therapies – such as 12-step programs – and individual
and group therapies.
in the form of counter measure factoids, are a sampling:
Among either doctor-prescribed or doctor-regulated treatment
regimens there are both medical and behavioral components. They count on various drugs – kratom,
naloxone, methadone, or buprenorphine – and then combine it with behavioral
treatments including individual and group therapies, residential treatments,
and 12-step programs.
Between the years 2003 and 2011, the use of buprenorphine has
increased 40%. More recent figures are needed.
Buprenorphine comes in various forms including an implanted form
called Probuphine. The implanted form
Accompanying counter measure insights are:
Methadone, the most used counter drug, is itself a long-acting
opioid. As such it can function to
replace heroin with just a single daily dosage by attaching chemically to the
opioid brain and spinal cord receptors.
This leads to activating the brain and spinal cord in such a way as to
diminish symptoms, reduce cravings, and suppressing highs that heroin and other
opioids induce. The aims, of this
regimen, are to taper off the dependency the user has under a controlled
environment and to increase the likelihood of avoiding a relapse. Since, it is a controlled regimen, the
patient needs to pick up daily dosages from a methadone clinic. This is not feasible for all addicts or it
adds to the possibility of patients being stigmatized since their treatment is
subject to a level of public viewing.
To meet the challenges of opioids, there has been two overall
approaches: medical and behavioral. What is better? It depends on the addicted person.
Growing in popularity is a treatment that uses
buprenorphine. Administered like
methadone, in terms of usage, but it’s under a much less controlled
regimen. Yes, there is the need for a
prescription to attain this drug, but less regulated demands. Patients receive month-long prescriptions, so
there are no daily visits to clinics.
The claim by its advocates is that it is safer than methadone and its
use aims at reducing or quitting the use of heroin or other opiates. In addition, it is credited with eliminating
cravings and withdrawal symptoms but not inducing a euphoric high among
patients. And lastly, since there are
less clinic or doctor visits, costs are cut drastically.
Again, this is a sampling of factoids and
insights. For a more complete list, the
reader is encouraged to visit previous posting, “General Counter Measures among
Related Groups,” August 18, 2018. Also, soon
there is going to be a special posting that will list all the factoids and
insights this unit highlights.
If a list of factoids and insights is
distributed before student arrive to class, the teacher can launch a discussion
on the possible political forces at play when opioid policy is considered. For example, representatives of the opioid
industry worked to make that industry’s interest known within the federal
government and worked to secure “friendly” policy positions. While not included in the above list, there
are a couple of factoids regarding this factor in the referred to previous
posting and in the posting to come.
Students, in terms of this factor,
should be able to identify these industry interests and pass judgement
regarding their functionality in meeting the crisis and their morality
regarding affected federalist values.
More specifically, the question students can address is: is the general welfare of the commonwealth prominent
among these corporate leaders’ thinking when considering the related activities,
Another factor is the relative
effectiveness of the reported counter measures.
This might lead to students speculating and being assisted in their unit
assignment of investigating the local availability of counter resources.
During this class time, the teacher can request students to voice opinions and
to back up their opinions with stated factual or insightful information they
have been given. This last effort
advances student skills in building reasonable and effective arguments.
To round-off the instructional portion
of this unit, is to suggest here that a two-day lesson be next. This two-day effort could consist of
students, who are arranged into groups, investigate one of three aspects. The three are: production and distribution, demographic factors,
and governmental reactions. The next
posting will develop this two-day lesson.
 The writer
also wants to state that where possible, he has checked the sources and has at
times added to the listed research.
 Ibid. AND
Jennifer C. Veilleux, Peter J. Colvin, Jennifer Anderson, Catherine York, and
Adrienne J. Heinz, “A Review of Opioid Dependence Treatment: Pharmacological and Psychosocial Intervention
to Treat Opioid Addiction,” Clinical
Psychology Review, vol. 30, no. 2, March 2010, 155-166, abstract accessed August
23, 2018, https://www.sciencedirect.com/science/article/pii/S0272735809001421
 L. W. Turner,
Stafan P. Drszewski, R. Mojtabai, Daniel Webster, S. Nesbit, R. S. Stafford,
and G. Caleb Alexander, “Trends in Buprenorphine and Methadone Sales and
Utilization in the United States, 1997-2012,” Value in Health, May 2013, abstract accessed August 23, 2018, https://www.valueinhealthjournal.com/article/S1098-3015(13)01627-6/fulltext?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1098301513016276%3Fshowall%3Dtrue
Medication Formulations Could Quickly Make a Difference for Treating Opioid
Addiction,” National Institute on Drug Abuse, August 22, 2017, accessed August
23, 2018, https://www.drugabuse.gov/about-nida/noras-blog/2017/08/new-medication-formulations-could-quickly-make-difference-treating-opioid-addiction
 David W. Dixon
and Ryan P. Peirson, “Opioid Abuse Treatment and Management,” updated June 21,
2018, accessed August 23, 2018, https://emedicine.medscape.com/article/287790-treatment
Schwartz, “My View: New Approach Needed
for Opioid Epidemic,” Portland Tribune,
July 25, 2017, accessed August 23, 2018, https://pamplinmedia.com/pt/10-opinion/367132-248727-my-view-new-approach-needed-for-opioid-epidemic-
 This concern will be more fully addressed
in a future posting that looks at governmental reactions. The history
already reported makes mention of industry policy as with the case of Purdue
 It is also a good opportunity to check on students’
progress in accomplishing unit assignment.
Students can be told that the unit test will consist of them reporting
their findings. For that test, they will
be able to use their notes.