What is Medication Assisted Treatment?
It is well known at this point that when individuals become addicted to opiates, like the prescription drugs oxycontin, percocet, and hydrocodone, or illicit substances like heroin and it’s synthetic counterpart, fentanyl, that their bodies begin to physically change and adapt to the presence of the substance in their system. In what’s known as withdrawal, without the substance in their body, they experience physical and psychological cravings to return to their previous state of intoxication. Withdrawal symptoms from opiates can be understood as the opposite of the effects of the drug’s “high”. As opiates typically operate as depressants, their absence kicks many bodily systems into high gear: physically through increased sweating, tearing, runny nose, muscle aches and cramps, nausea and diarrhea; and mentally through an overactive brain, agitation, anxiety, and an inability to sleep.
The insidious nature of opiates is that after time, one’s tolerance may become so familiar to having the drugs in his or her system that eventually the person no longer experiences the once sought-after high. Instead, these people usually continue using simply in order to avoid withdrawal symptoms, to avoid getting sick, and to “stay well”.
To assist opioid users struggling with severe withdrawal and cravings ,there are certain medications used in combination with counseling and other forms of behavioral therapy that have proven to be effective. There are three main FDA- approved medications: Methadone, Naltrexone, and Buprenorphine. All of these medications work by blocking or lessening the effects of opioids in addition to reducing the cravings to use them.
What are my options?
Some different options that may be important to consider when wondering which type of MAT is right for you.
Methadone –
Only available in specialized clinics that provide counseling and community support like ours.
This medication acts as an opioid agonist (mimicking the effects of opioids) that prevents withdrawal symptoms.
It is offered in pill, liquid or wafer forms.
Best practice suggests a minimum of 12 months treatment and slowly tapering the dose offered.
Naltrexone –
In opposition to methadone, naltrexone operates as an opioid antagonist that blocks the effects of other narcotics.
Brand names: Vivitrol, which is offered as a monthly injection . Revia, the daily pill; or the newest, Narcan,the nasal injection that reverses overdoses when received in time.
Less regulations for naltrexone, and it is becoming more widely available to paramedics and laypeople alike.
Buprenorphine –
Operates as a partial agonist that mimics the effects of opioids, while also blocking the effects of other narcotics.
Brand names: Suboxone, Subutex, Sublocade
Forms : Daily dissolving tablet, cheek film, or 6-month implant under the skin.
There is no “one size fits all” approach to treatment.
While at Peace Club, we offer these services under the care of our medical director, some considerations are important to process before deciding whether MAT is right for you. These conversations are imperative to have with your doctor, and there is no substitution for individualized medical advice. It is equally imperative that you are fully informed of your options moving forward.
We believe that while some individuals do not need medication assisted treatment, and can learn to manage their recovery through support groups and sheer willpower, MAT should be presented as a serious option for those recovering from opioid addiction. Many people find success with these methods, and will utilize medication for varying lengths of time, some even for the duration of their lives; whereas others seek to taper their dependence gradually. Each approach towards managing addiction should be treated with respect, especially considering the magnitude of the task of pursuing a new recovery lifestyle.
The science is strong.
Recent studies confirm that ongoing outpatient services are linked to better treatment retention and outcomes than treatment without medication. Of course, this doesn’t mean that recovery can only occur through medication, but it is our belief that achieving stabilization through these means allows individuals the time and ability to make the necessary life changes to continue to pursue a recovery lifestyle. Best practices indicate that medications should be used with individuals who actively engage in residential and outpatient treatment. Greater outcomes typically are associated with individuals receiving medication for as long as it benefits them. Cost-benefit analyses revealed that treatment with any of the aforementioned medications led to lower healthcare costs than treatment without medication.
Of course medication assisted treatment is at times highly contentious within the addiction and treatment community, and different things work for different people. Make sure to ask your questions and join in on the conversation to let us know what you think!
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