As the current opioid epidemic rages around use, more people fall victim to opioid use, abuse, dependence, and addiction. From prescription painkillers to heroin, the opioid crisis threatens not only public health but also economic welfare. Opioid abuse single-handedly costs the United States an astonishing $78.5 billion every single year, accounting for the costs of health care, treatment, lack of productivity, and criminal justice.
When opioids first came into play in the late 90s, doctors and medical experts assured that prescription opioids would not be addictive, leading to many more people being prescribed opioids.
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Unfortunately, overdose rates rose exponentially, and by 2015, over 33,000 people were killed by opioid abuse and another two million people suffered from addiction. These outrageous numbers were not due to simply overprescribed opioids but also as a result of the creation of illicit synthetic opioids. Fentanyl, one of the most powerful illicit opioids created, contributed largely to the skyrocketing numbers and remains one of the most dangerous drugs ever known.
For decades, medication-assisted treatment has been a powerful tool in addiction treatment. There is an enormous variety of medications that serve different purposes. In the case of opioid use disorder, medication-assisted treatment is extremely effective and almost always necessary due to the severity that opioid addiction can spiral into. Unfortunately, medication-assisted treatment, especially in regards to opioid use, has a negative connotation and, although medications could potentially save someone’s life, the stigma surrounding medication-assisted treatment often times dissuades a patient from engaging in MAT.
Fighting Addiction Yourself is Difficult. Let Our Experts Help!
Fighting Addiction Yourself is Difficult. Let Our Experts Help!
How Does Medication Assisted Treatment Work?
By definition, medication-assisted treatment (MAT) is a method that administers medications, usually in conjunction with therapy, to aid in addiction treatment. MAT is commonly used in treating severe addictions such as alcohol, benzodiazepines, and opioids.
From blocking the pleasurable and euphoric effects of substance use and abuse, the medications used in MAT have a variety of purposes. Medications can alter someone’s chemical brain functionality, treat withdrawal symptoms, and normalize body functions among many other things.
One of the main and most noticeable differences between medication-assisted treatment and abstinence treatment is that addiction treatment progress during MAT is measured in much smaller steps than in abstinence-based treatment. With the precision and care offered by MAT programs, a patient is much more likely to succeed in their addiction treatment and overall long-term sobriety. In the case of MAT for opioid addiction, slowly tapering off of the substance is viewed as progress instead of abstinence-based treatment, which generally views every step as either success or failure.
When it comes to alcohol rehab, MAT therapy will at first be used as a treatment option to help someone through the often difficult withdrawal symptoms that accompany alcohol detox. This help keeps someone safe from certain potentially life-threatening symptoms and also allows them to get to participating in therapy sooner than they otherwise would be able to.
There are many people who are skeptical of medication-assisted treatment, typically for opioids but also for alcohol use disorders as well. They are under the impression that medication-assisted treatment merely gives someone a new addiction to replace the old one, but this is not the case. The medications being given to those in treatment are not harmful, especially compared to whatever substance they had become dependent on. The administration and dosage of these medications are also closely monitored by medical professionals.
It is always important to differentiate between medication-assisted treatment and treatment via medication. MAT involves the use of medications to aid in the treatment process, but it is important to not assume that simply taking meds will cure your addiction. Medications are only effective when used in conjunction with counseling, therapy, and other treatment methods. Assuming that taking medications will instantly lead to a sober life can often lead to relapse and ultimately the building of addiction again.
Unfortunately, there is much false information that has been spread regarding medication-assisted treatment. These myths can easily dissuade an opioid addict by providing false information and scares. Knowing what is fact and what is fiction when it comes to MAT can prevent unnecessary fear or complications in future treatment.
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The most widespread myth about medication-assisted treatment is the idea that engaging in MAT simply replaces one substance addiction with another substitute substance addiction. This is especially believable when talking about opioid addiction, as many medications that are used in MAT to treat opioid disorders are commonly viewed as addictive.
While these accusations may have some truth behind them, and while substituting substances does occur, it does not immediately “swap” the addictions. In the highly unlikely event that a patient becomes addicted to the administered medication, it should still be viewed as an improvement. Patients’ addictions generally involve life-threatening drugs, and while they may now be dependent on a different one, their lives are in a much more stable state now.
There are many other different speculations on why MAT should be avoided, and almost all of them are countered by scientific proof as evidenced by successful treatment rates. They are as follows:
Only the most extreme and severe addictions should be treated with medication-assisted treatment.
While MAT can greatly help severe life-threatening addictions such as opioid, alcohol, or benzodiazepine addiction, it does notonly benefit the more severe disorders. Medication-assisted treatment consists of the use of a wide variety of drugs, and with so many options, MAT can easily benefit almost any addiction, regardless of severity or length of use. Even milder substance use disorders, such as marijuana addiction, can be treated with MAT, further proving the usefulness of medications in addiction treatment.
Medication-assisted treatment increases the risk of overdosing.
Contrary to popular belief, MAT only helps patients in preventing future overdoses. Because a patient may go from heavy use to complete sobriety at the beginning of treatment, addicts are likely to overdose if they relapse due to a habit of taking high doses in the past. The use of medications during the early stages of treatment especially can help prevent relapse and overdose, proof that MAT is not half as dangerous as it is perceived. Common medications have the effect of causing negative side effects at even the slightest use of a drug. In alcohol addiction treatment, for example, there is a medication that causes nausea and migraines if alcohol enters the patient’s system.
Medication-assisted treatment should only be used short-term.
This is one of the most debated topics when it comes to MAT. Many people assume that medications are meant for medical detox or the beginning stages of treatment, which is an understandable point of view. It would make sense that medications should only be used short-term to avoid the swapping of addictions, however, research indicates that long-term MAT (between one to two years) has led to higher success rates and long-term sobriety after treatment.
Medication-assisted treatment and abstinence-based treatment have little to no difference in results.
This is simply a false statement. Medication-assisted therapy has been proven time and again to be successful in addiction treatment, and is commonly suggested as the first line of treatment for many addicts. MAT is supported by a number of expert scientific organizations such as:
- The National Institute on Drug Abuse
- American Academy of Addiction Psychiatry
- Centers for Disease Control and Prevention
- National Institute on Alcohol Abuse and Alcoholism
- Substance Abuse and Mental Health Services Administration
- American Medical Association
The Dangers of Opioid Withdrawal
Being very potent painkillers, opioid withdrawals are among the most uncomfortable and unpleasant withdrawal symptoms. During opioid addiction detox, withdrawal symptoms begin to show within the next six to 30 hours, depending on whether the opioid is short-acting or long-acting. After 72 hours, the withdrawal symptoms begin to peak and begin to significantly affect the addict’s health. Even the earliest withdrawal symptoms can be extremely unpleasant and can include:
- Uncontrollable shaking
These are then followed by the more severe symptoms, which can include:
- Suicidal thoughts
- Severe seizures
- Delirium tremens
- High blood pressure
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While more common in benzo or alcohol withdrawal, Delirium tremens is the life-threatening withdrawal symptoms associated with substance withdrawal that include a number of severely dangerous side effects such as intense confusion or disorientation, vivid hallucinations, constant panic and anxiety attacks, and even fatal seizures. Delirium tremens generally take three days to start and can last another three days before finally fading.
When an opioid addict engages in professional treatment, the withdrawal symptoms become significantly less dangerous. Through MAT, a patient can safely avoid things like seizures and Delirium tremens. Medications can include benzodiazepines (to counteract the severe physical withdrawal symptoms) and antidepressants (to counteract the psychological withdrawal symptoms).
Although opioid withdrawal is among the most dangerous cases out there, people will avoid seeking treatment at a professional treatment center. While the reasons may vary, a common deterrent to seeking professional treatment is the inconvenience of engaging at a treatment center. Many people view rehab as “not worth it” and attempt to treat themselves.
This is a grave mistake, and if your addiction is not professionally managed and treated, it may ultimately prove to be fatal. Self-detoxing at home usually consists of “going cold turkey,” and should never be a choice for addicts.
The term “cold turkey” refers to the immediate cessation of all intake of a certain substance in an attempt to treat an addiction. While it may sound good at first, further information proves the exact opposite. Going cold turkey should never be chosen over professional treatment. An addict’s brain changes through chronic drug abuse, chemically altering its function to accommodate the constant barrage of drugs and their effects. The body requires time to readjust from constant drug use to total sobriety, and treatment centers help this through tapering and MAT. Quitting cold turkey gives the user no time to readjust and causes extreme withdrawal symptoms.
MAT for Opioid Rehab
When you start to engage in medication-assisted treatment as part of your plan to treat your opioid addiction, knowing the proper information before actually beginning. The medications used in MAT for opioid addiction treatment are commonly used with different therapy methods such as cognitive-behavioral therapy, as well as with each other.
The primary goal of opioid MAT is to return a patient’s body and mind to complete sobriety. Unfortunately, there may be some complications, as now there is a different medication in the patient’s system, however much safer. A patient will usually taper off of the medications that they are using during treatment after they are tapered off of their addicted opioid. The weaning process of removing the medication from a patient’s system may take up to months, years, or can even be indefinite. Similar to how a broken leg requires a crutch in order to heal, brain functionality that has been chemically altered as a result of chronic drug use requires time to recover, and medications such as methadone and naltrexone can serve as the “crutch,” further speeding up the recovery process.
Unfortunately, some injuries are extremely serious and severe, and long-term opioid abuse is no exception. Sometimes, the addiction is so damaging to the brain that a user may need the “crutch” of medications indefinitely.
In 2005, methadone and buprenorphine were considered by the World Health Organization to be an “essential medicine,” stating that they are “intended to be available within the context of functioning health care systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford.”
In 2010, naltrexone was released as an injectable, long-acting medication under the brand name Vivitrol.
Previously, Vivitrol was FDA approved and used to treat alcohol use disorder, but in 2010, the Food and Drug Administration approved it for opioid use disorder despite it being considered “weak” and “tolerable.”
Common medications used in MAT for opioid addiction can include:
Methadone is an opioid agonist, working to completely replace an opioid in an opioid addict’s treatment. Methadone, which produces an effect similar to opioids, reduces an addict’s need for a specific opioid and can be used to help treat cravings. Being a long-term method of treatment, methadone’s main drawback is that it may only be administered from a methadone clinic. This is exceptionally worrisome especially when considering that methadone is usually taken every day. For this reason, methadone is extremely efficient in inpatient treatment programs, where patients can be monitored around-the-clock.
Buprenorphine is a partial opioid agonist, working to replace the addicted opioid while also not rewarding the user with full opioid effects. Similar to methadone, buprenorphine can reduce the need and craving of a detoxing addict and can help curb withdrawals. It is generally viewed as safer than methadone, coming in an adjustable-dose tablet as well as significantly reducing the likelihood of respiratory depression. For this reason, buprenorphine is slightly more expensive but well worth the extra buck.
Differing from both methadone and buprenorphine, naltrexone is an opioid antagonist. Instead of replacing the addiction with a safer drug such as methadone, naltrexone blocks the activation of opioid receptors, preventing a patient to enjoy the previously-addicted opioid. In partaking in naltrexone MAT, the long-term effects of Vivitrol (a brand of naltrexone) can easily aid those who seek treatment that do not have 24-7 access to healthcare or those who have difficulties in taking daily medications.
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While these medications may vary in function, their goal is the same: to help treat a victim of addiction in their path to sobriety. Evidence shows that methadone, buprenorphine, and naltrexone all reduce the intake of opioids, reduce the severity and frequency of withdrawal symptoms, reduce the likelihood of contracting an infectious disease relating to opioid use, and even reduce the risk of a victim engaging in criminal activity.
In engaging in MAT for opioid use disorder, a patient will always run the small chance that medications such as buprenorphine and methadone be misused against the doctor’s instruction. While this is true, most of the buprenorphine and methadone used without a doctor’s prescription is not used to achieve a high, but more to control withdrawal symptoms and cravings. Methadone and buprenorphine are only a few opioid agonists used and together account for only 15 percent of abuse reports during treatment. Oxycodone and hydrocodone, on the other hand, are responsible for a staggering 67 percent of abuse reports.
Naltrexone, an antagonist, itself does not cause the pleasurable effects that agonists do, and is a very low-risk, but high-reward medications.
Start Your Journey to Recovery Today
Here at New Perspectives, we pride ourselves on providing top-quality service and up-to-date treatment methods. When it comes to opioid addiction treatment, our MAT programs can make your addiction treatment a breeze. We understand that it may be difficult at first, and we are happy and excited to be a part of your recovery story. If you or someone you know struggles from opioid addiction, medication-assisted treatment may be the best course of action.
Whether it is about insurance or the kinds of medications used in treatment, our addiction specialists are available around the clock to answer any questions you may have regarding treatment. Our team of professional doctors, nurses, therapists, and case managers work around any and every need you may have during treatment.
Call New Perspectives today at (855) 627-3437 if you or a loved one is struggling with addiction. Our goal is your goal: to eliminate your addiction as quickly and easily as possible. We want you to see life from a clearer, sober point of view; we want you to look at things from a New Perspective.
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Recognition and Management of Withdrawal Delirium (Delirium Tremens) | NEJM. (n.d.). from http://www.nejm.org/doi/10.1056/NEJMra1407298
Unknown Author (March, 2018) Medications to Treat Opioid Addiction. from https://www.drugabuse.gov/publications/medications-to-treat-opioid-addiction/what-treatment-need-versus-diversion-risk-opioid-use-disorder-treatment