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Suboxone offers relief for some opioid addicts

Montana Standard - 10/7/2018

Oct. 07--According to many observers, the current opioid epidemic, which refers to the misuse of both prescription and non-prescription opioids across the country, is a result of pharmaceutical companies reassuring the medical community in the late 1990s that patients would not become addicted to opioid pain relievers.

As such reassurances increased the rates healthcare providers began prescribing these drugs, dispense rates peaked on average nationally in 2012 at 81.3 prescriptions per 100 persons, according to the Centers for Disease Control. While the national opioid prescribing rates dropped to 58.7 prescriptions per 100 people in 2017, recent data from Butte-Silver Bow and Anaconda-Deer Lodge counties show this rate hasn't changed much locally since the epidemic broke out.

CDC data collected in 2016 found there were 96 opioid prescriptions per 100 people in Anaconda-Deer Lodge County and 98.6 prescriptions per 100 people in Butte-Silver Bow.

About a month ago, Shawn Keltner of Helena, asked his wife to tear up one of these prescriptions, which a dentist had reportedly given him despite being informed that Keltner was on Suboxone.

"I remember thinking, 'You don't really know what Suboxone is, do you?'" Keltner said. "I feel like even in the medical community doctors are naïve about opioid addiction sometimes."

A bottle of Lortab is what got Keltner addicted to opiates in the first place.

About 20 years ago, Keltner had a really bad headache that sent him to the emergency room. The doctor sent him home with Lortab, which sat on a table in his home for months. Keltner said a friend of his kept asking if he could have some of the medication, but Keltner refused.

Then, after a bad day, Keltner said he decided to see if a couple of the pills would take the edge off.

"It was a cure-all for me," Keltner said, looking back on that day. "But I didn't know it would soon take me handfuls of pills to get back to that first feeling."

For the next two decades, he moved around Montana and California, chasing his addiction. When it got harder to get scripts from physicians, his addiction grew more severe. He spent these years in and out of prison for various crimes and drug-related thefts, which made obtaining drugs from other addicts a lot easier, Keltner said.

Around 2004, Keltner tried Suboxone for the first time when it was a relatively new treatment. He was on a program that allowed him to take the medication free for one year. But after that, he was on his own and had to stop taking the treatment because he couldn't afford it.

"That was the best year I'd had in a long time," Keltner said. "They wanted $8 a pill, and I had to take three pills a day. I couldn't pay that. So I started using again right away because the withdrawal was so terrible."

Keltner said he tried to tough it out, but after five or six days without the Suboxone, his addiction started over again. He said his relapse started with prescription medications again, then heroin and meth.

However, Keltner never forgot how good he felt the one year he was on Suboxone. He said he sought out other clinics and doctors that could help him in Helena, Kalispell and Missoula, but there were either no openings or it was too hard to commute.

Then, in 2014, Keltner called Dr. William Reiter's office in Anaconda. (See related story.) Two years later, he finally got in to see him and was prescribed Suboxone again.

"It's not a miracle drug and it's not a cure-all, but it takes the mental obsession away so I can focus on what I need to stay sober," Keltner said.

Reiter has prescribed Keltner Suboxone for about two years.

Because of Keltner's relapse after he stopped using Suboxone around 2005, he said he was initially nervous about getting off of the medication completely. However, he recently said he is working with Dr. Reiter now to slowly taper down every four months and isn't as nervous anymore. Right now, Keltner is taking 8 milligrams every day, a significant decrease from the 24 milligrams he started with.

"A lot of people never go off of it," Keltner said. "I have no end time in mind. But I am willing to try to get off of it after this year, as long as I know I have Dr. Reiter on my side."

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