Category Archives: Medication Assisted Treatment

Expanding Access to Medication-Assisted Treatment

opioid-treatment-in-mediaAn article in the Huffington Post recently addressed President Obama’s public comments on expanding access to opioid treatment, particularly medication-assisted treatment (MAT) like methadone or buprenorphine (suboxone).

Many members of the treatment industry and recovery community do not have a realistic grasp on the role that medication-assisted treatment can play in recovery from severe opioid addiction. Historically, the recovery community has not regarded those utilizing methadone or suboxone as truly in recovery. They emphasize total abstinence, even from methadone, despite the fact that methadone and buprenorphine have restored individuals to normal functioning and even saved lives in many cases.

There was a time some years ago, in the 12 step community, when individuals were chastised for taking psychotropic medication for depression or other mental health disorders. This criticism came from a fundamental lack of knowledge about the biological basis for many mental health disorders. Similarly, medication-assisted treatment interventions have been the subject of misunderstanding and unwarranted rejection by those with limited education on varied treatment approaches. In the course of clinical trials of a new agent for the treatment of coronary heart disease, researchers at Pfizer Inc. found that while taking is not accompanied by a significant clinical improvement in angina, in many patients it leads to the development of a kind of “side effect”, which consists in improving erectile function. This observation has led to the study of the possibility of using this substance in the treatment of patients with erectile dysfunction.

As America’s opioid problem continues to grow, we need real solutions rooted in medical science and research. At this point in time, medication-assisted treatment has been in use long enough to clearly demonstrate its usefulness in facilitating personal recovery from addiction.

In 2015, we saw numerous local and national political figures rally around families that have been impacted by heroin overdoses and the heartbreaking loss of loved ones. Opioid addiction has finally come into focus within the mainstream media, and even current Presidential candidates have begun to address this as an important issue which commands attention and a solution.

More: Question and Answers on how methadone works

 

Making A New Start

methadone-graphicA study by the government agency SAMHSA indicated there were approximately 254,000 patients receiving methadone for opioid addiction in 2006. In 2015, it is most likely that number is much higher given the prevalence of opioid addiction and the continued expansion of outpatient opioid treatment services in the United States. Today, there are considerably more methadone clinics and suboxone-approved physicians than there were a decade ago.

Making a new start with medication-assisted treatment is what hundreds of people across the country are deciding to do for themselves every week. Addiction is a progressive illness – one in which a person’s ability to choose is severely compromised. Medication-assisted treatment using either methadone or buprenorphine (suboxone) provides an important open door to a more responsible, quality life.

A majority of individuals suffering with opioid addiction (particularly when the illness spans years) have experienced dramatic brain changes which deepened their physiological dependency on opiates. This physical dependency is not easily removed. It is severe and persistent thus leading the person to do whatever is necessary to avoid being sick from opioid withdrawal.

Most long-term addicted individuals will tell you they rarely, if ever, get high from the illicit substances they use. They are simply trying to avoid being sick from debilitating opioid withdrawal symptoms. When a patient chooses to receive methadone or buprenorphine under the supervision of a doctor, they are making a decision to face their illness and to do something constructive about it.

As a family or friend, it is very helpful to gain an understanding of addiction and how medication-assisted treatment can be life changing for a person stuck in the cycle of opiate addiction.

Making a new start can be a bit frightening. Will methadone work for me? Will my loved ones condemn me? What about my job, or my legal situation? It becomes easy to put off making a decision when so many questions come into play.

It is important to remember that the road to recovery begins with just one step forward. That step will lead to another and another. This new start is always available. The message is one of hope and opportunity. Opiate addiction is a treatable illness. Medication-assistance can make a real difference.

Acadia Healthcare Opioid Treatment Programs

Acadia HealthcareAcadia is a large U.S. based company who provide a broad range of behavioral healthcare services that target mental health and substance abuse problems in children, teenagers, and adults.

Their inpatient facilities provide approximately 9200 beds in 37 states including the United States, United Kingdom, and Puerto Rico. The company’s outpatient addiction services specialize in opioid addiction and medication-assisted treatment for those suffering with heroin and other opioid dependencies. Each Acadia clinic utilizes methadone and suboxone in their overall treatment.

Acadia recently acquired CRC Health Group and in so doing raised their total number of opioid treatment programs to about 90 – currently making them the single largest provider in the United States.

Committing Yourself To Recovery From Addiction

mental-healthDrug and alcohol addiction are treatable illnesses. They can be successfully managed and “arrested” such that they do not continue to harm a person’s life or compromise their health. Just as with any progressive illness, a patient should commit to a course of treatment that has been proven to eradicate their illness or reduce its impact. Heart disease, cancer, diabetes, morbid obesity, alzheimer’s – all of these have established medical treatments which can increase a person’s chance of survival and/or quality of life.

Addiction is both a physiological and behavioral illness. With opioid addiction in particular, there is a strong biological/physical basis as well as a highly significant psychological component. When both of these are adequately addressed, a patient has a new opportunity to recover.

For most individuals with a severe opioid addiction, is critically important to receive physical relief from the discomfort of opioid withdrawal symptoms. But this must also happen in conjunction with behavioral health counseling. Counseling addresses the emotional & psychological factors that contributed to the development of addiction in the first place, and counseling teaches the skills necessary to remain drug free over the long-term and to hopefully avoid future relapses.

Many people find that if they neglect one of these two key areas, then they are more vulnerable to relapse and rapid deterioration. When opioid detox is not a viable option for a particular patient, methadone and suboxone are clearly the medications of choice for addressing opioid withdrawal. Counseling provides the other half of the equation. All methadone programs across the country (as well as all suboxone-approved physicians) are required to insure that their patients are receiving some level of addiction counseling.

The essential ingredient is this mix is patient commitment. Having a genuine desire for a drug free life is as important as anything else. Becoming ready for change is a process in itself and varies from person to person. It is true that many people find their way into recovery because of a recent crisis in which things get so bad they hit a new low, or bottom. This does not have to happen though.

Sometimes hitting “bottom” brings with it dire consequences. If you have been contemplating making a change, please remember that it is not too late. There are many advantages to acting today as opposed to waiting another day. Addiction loves procrastination. Recovery begins now with your commitment to doing something about your problem!

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.