Category Archives: Medication Assisted Treatment

Stepping Onto The Path of Recovery

the-pathAn important consideration in examining the disease of addiction is the recognition that “recovery” is an incremental process. Many people facing their addiction will experience brief setbacks, and some will struggle for years before they are able to remain on the path of positive change.

As a counselor, I have listened to many recovering individuals talk about their resistance to change. Addiction is a persistent disease of disruptive thinking and behavior highly subject to repetition. Addicts will repeat the same bad “choices” as a result of many factors. Scientific research has shown that habitual patterns of behavior are neurochemically driven deep within the brain. These patterns can be reinforced by one’s social connections, immediate environment, and underlying belief system.

With severe levels of addiction sustained over years, it can become difficult for people to shift their lifestyle, thinking, and decision-making toward a healthy, recovery-oriented mindset. In 12 Step recovery, there is the popular expression called “hitting bottom”. This expression is typically used to describe a specific time in which a person has lost so much, or suffered such a painful crisis, that their readiness for change finally emerges. This window of opportunity is often times short-lived. Hitting bottom will compel some people to finally take the right action – to seek help – to admit they have a problem. If this happens, then a decision to step onto the path of recovery may actually occur.

Active addition is often characterized by a short range view in which consequences are not thoroughly considered. Focusing on consequences interferes with the compulsive desire to use. And even then, a recognition of consequences to oneself and family is often not enough to change the decision to get high. With opiate addiction, the decision to use is overwhelmingly controlled by opiate withdrawal sickness. This never-ending physical sickness takes people away from recovery and keeps them trapped in a desperate existence centered around doing whatever is necessary to avoid being “dope sick”.

Fortunately, this dilemma can be addressed through medication-assisted treatments (methadone, suboxone, naltrexone). These do not replace the need for a recovery program, but they become an important part of one’s overall personal recovery program. Staying on the path of recovery is the next critical phase after stepping onto the path. Medication-assisted treatment greatly aids recovering addicts in staying on the proper path. Science has proven that those with the greatest chance of long-term, successful sobriety are those that remain in treatment and recovery. Said differently, a person’s chance of recovery success is statistically improved the longer they remain in treatment.

When a person no longer has to face the crippling weight of daily withdrawal sickness, they have a chance to re-approach their overall recovery and the opportunities that lie ahead of them.

Reducing Risk of IV-Related Infections

drug-safetyOne of the risks associated with the progression of opioid addiction is the increased probability of an addicted person moving to injectable heroin as a last resort in dealing with opioid withdrawal. In the early years of methadone’s adoption in treatment centers, it was used primarily to help heroin addicted individuals detox from heroin and eventually remain heroin free.

While heroin is definitely resurfacing, the opioid epidemic of recent years has primarily been about prescription opioids taken orally. Following this pattern of use, users eventually discover that crushing and snorting pills is a more efficient means of getting an opioid into their system. Injecting is typically the last step in this progression of the disease of addiction.

But with injection comes a variety of new risks and health problems such as skin abscesses, localized infection at the site of injection, as well as hepatitis C (a viral infection of the liver) and HIV infection acquired through needle sharing with infected persons. A recent story in the news highlighted a sudden increase in HIV infections in Scott County (Indiana) in conjunction with the rise of opioid addiction there and injectable drug use.

Indiana’s governor has temporarily approved the use of needle exchange programs to help reduce the risk of virus transmission resulting from the use of dirty needles. The story indicated that the number of documented HIV infections had risen month over month. The county is presently trying to locate over 100 people who may have been exposed to the HIV virus in connection with injecting opiates.

Methadone and other medication-assisted treatments have been conclusively proven to reduce heroin/opiate relapse and injection drug use. For many individuals trapped in a daily cycle of perpetual drug abuse, the risk of acquiring a deadly infection increases with every day that they are not in treatment receiving help.

Treatment leads to recovery, and recovery leads to dramatic lifestyle change. Many patients who choose methadone as a tool in their personal recovery never go back to injecting drugs. This obviously is a life saving choice.

Someone recently stated “If you’re dead, you can’t recovery.” This is a rather blunt way of expressing a profound and meaningful truth. Addiction does rob loved ones, friends, family, and neighbors of life, health, and happiness. Recovery has the ability to restore all of these. Let us keep our minds and hearts open about the value of medication-assisted treatment. It is making a real difference for numerous people around the world.

Maine’s Governor LePage May Undermine Opioid Addiction Treatment

Maine2Paul LePage, the governor of Maine, has announced that he is considering ceasing state-funded support for methadone. As an alternative, Maine is proposing that patients prescribed methadone be switched to a more affordable suboxone option as part of a $727,000 state budget cut. The story is here.

This is an indefensible decision with dire medical implications for opioid addicted patients currently receiving methadone. It equates to government officials making medical decisions that will negatively impact the health and well-being of thousands of people.

Representative Drew Gattine (a member of the Health & Human Services Committee) is quoted as saying the proposal shows a lack of understanding of the societal costs of addiction throughout the state of Maine.

Methadone and suboxone are both effective medications, but offer very unique characteristics and applications depending on the severity & chronicity of a patient’s opioid addiction. Buprenorphine (the actual opioid agonist contained in suboxone) has a much lower ceiling effect than does methadone meaning its effectiveness would be insufficient for a potentially large percentage of stable methadone patients on 60mg or more of methadone daily. Many patients on a moderate to high maintenance dose of methadone would not have their opioid withdrawal symptoms managed by even the maximum dosage allowed for suboxone – which is generally around 32 mg per day.

For a politician to, in essence, prescribe inappropriate medical treatment for a diagnosable medical condition is a huge state liability. The repercussions are alarming. Hopefully, the local medical establishment and other state officials will step in before irreversible damage is done. Methadone works. This cannot be denied.

Methadone has a long, proven track record of medical efficacy and cost effectiveness. Maine, in particular, has suffered in recent years with a severe opioid addiction epidemic. Reducing access to appropriate medical treatment like methadone will likely result in overdose deaths across Maine and an explosion of condemnation for the governor and his office.

Medication-assisted treatment (MAT) for opioid addiction is not a fad. It is scientifically proven effective and endorsed by multiple state & federal regulatory agencies as well as ASAM.

SMC Recovery Offering Affordable Opportunity in Scottsdale

smc-recovery-2SMC Recovery based in Scottsdale, Arizona opened an outpatient addiction treatment program late last year. SMC provides a Medication-Assisted Program utilizing methadone and an Intensive Outpatient Program. Both treatment modalities are endorsed by SAMHSA as best practices in the field of addiction treatment.

Methadone programs across the USA cover a wide range of prices sometimes as high as $15.00 per day. However, SMC Recovery have implemented one of the most affordable rates in the country at just $55.00 per week. This is an outstanding value for anyone who has been struggling with opiate addiction and it is one of the most competitive rates we have learned of anywhere in the country.

Prospective patients are often unable to get started with outpatient methadone treatment because the cost is just too high for them. SMC Recovery have lowered this barrier considerably. We were informed by their staff that this price will most likely be active over the next year consequently providing numerous Scottsdale area patients an excellent opportunity to see if methadone treatment is beneficial in addressing their addiction problem. SMC’s program offers counseling & support in addition to methadone dosing.

For more information, visit the SMC Recovery website or contact their staff at: 1-480-998-HOPE (4673).

Methadone or Suboxone

addiction-is-treatable-2A common question among those seeking help is whether methadone or suboxone is the best choice for opioid replacement therapy. It reminds me of the age old debate … which is better, Ford or Chevy? Methadone has been used in opioid addiction treatment for about 45 years. Suboxone has been available to the public for 12 years. Each of these medications has been shown, through conclusive research, to be highly effective in eliminating opioid withdrawal. Both methadone and suboxone achieve a similar outcome, but with subtle differences. [view our comparison chart]

When opiate withdrawal symptoms are no longer a daily preoccupation and source of anxiety, individuals are free to invest their energy & time in productive, meaningful activities. Avoiding withdrawal sickness is the single greatest driver of continued opioid use, and often pushes an individual to desperate measures to maintain a supply of opiates so that they will not get sick.

People unfamiliar with addiction sometimes believe that an addicted person “just wants to get high”. To the contrary, most people with a chronic opioid addiction are just trying to get by, to get through the day without becoming sick all over again. Opioid withdrawal sickness is an exhausting roller coaster ride that rarely slows down long enough to allow an individual to escape. Their relief from opioid withdrawal sickness is typically short-lived, and they then begin feeling sick all over again. Quite a vicious cycle.

This is why suboxone (buprenorphine) and methadone are so valuable as a medical treatment for opioid addiction. These synthesized opioid replacement medications have a slow onset, long duration of action. This means that they don’t quickly spike to maximum levels in a person’s bloodstream like heroin. They reach maximum benefit several hours after they are taken. They then remain active in a person’s system for more than 24 hours and consequently keep painful withdrawal symptoms away. With no fear of being sick, a person can finally live their life and refocus their time where it needs to be: work, school, family, home, etc.

Methadone is a full opioid agonist whereas buprenorphine (the active ingredient in suboxone) is a partial opioid agonist. Because suboxone is a partial agonist, it is somewhat less susceptible to causing overdose and is considered easier to taper off of as individuals lower their daily dosage. As a result of methadone being a full opioid agonist, it is typically more effective with severe, long-term opioid addictions. Suboxone has a peak benefit at 24-32 mg per day whereby higher dosages than this will not produce additional withdrawal relief. However, methadone has no such “ceiling effect” and much higher dosages can be utilized as needed to eliminate a patient’s opioid withdrawal.