Medication Assisted Treatment: Our Proven Methods
When someone enters full-blown addiction and becomes completely dependent on any mediation or illegal narcotic, finding a way to recover can seem impossible. At the very least, individuals with substance abuse disorder fight with the imbalance of brain chemicals and the changes they’ve made to their behavior and decision-making ability. In the worst situations, the body becomes fully dependent on these substances and responds in challenging and dangerous ways to detoxify.
Because of these substances’ grip on users, attempting recovery can become a revolving door of abstinence and relapse. Finding the light at the end of the tunnel is unimaginable, and the repetition can become demoralizing.
Luckily, recent advances in mediation-assisted treatment have made it possible for individuals with substance abuse disorder to conquer their addictions and return to a normalized form of living. Depending on the substance, there are many options to ease difficulties associated with the recovery and focus on healing.
What is medication-assisted treatment, and how is it effective in helping users return to a life of normalcy?
What Is Medication-Assisted Treatment?
Medication-assisted treatment is a form of rehabilitation treatment that allows individuals to maintain a normal life without focusing on their daily need for a substance. These treatments may include one of many medication options with no set window of time for treatment.
Some of these treatment plans last for weeks, while some may extend up to a year or longer. One of the most common names for medication-assisted treatment is a maintenance program. It’s important not to confuse medication-assisted treatment with medically assisted detox. The latter is a short-term process in which all traces of a substance are eliminated from a users’ body. These two forms of treatment are completely different, with two separate end goals. However, in certain situations, medically assisted detox may come as a precursor to medication-assisted treatment.
The overall goal is to allow individuals with substance abuse disorder to reintegrate back into a normal personal and professional life. They are able to maintain their focus on functioning normally on a daily basis and mending relationships throughout their lives.
When individuals place their daily focus on the need for a substance, everything else comes second. This is how the life of an individual with substance abuse disorder slowly unwinds and disintegrates, as everything but the substance in question takes a back seat to the addiction. Medication-assisted treatment allows the mirror reversal of this situation, placing the attention away from the need for drugs and back on the most pertinent areas of life.
Although multiple substances that require recovery have some form of medication-assisted treatment, including alcohol, methamphetamines, and others, opiates tend to be the primary candidate in this treatment category. Because of the physical dependence associated with opiates and opioids, these drugs tend to further isolate users from a normal life even more than other drugs.
Opiates, Opioids, and Mediation-Assistance
Opiates and opioids are normally at the center of mediation-assisted treatment. When individuals become completely dependent on either of these substances, the brain is rewired, and the process of how receptors function becomes different.
Because of these alterations, several things happen in the minds and bodies of individuals suffering from opiate abuse disorder. First, attempting to quit means suffering from the most severe withdrawal symptoms. This is often the first roadblock on the road to recovery.
Second, the way an individual processes behaviors and makes decisions is also altered. It takes time to return to a normalized way of thinking and learn how to process emotions again. Dealing with the constant presence of either withdrawal symptoms during the acute withdrawal phase or intense cravings during post-acute withdrawal makes this return to normalcy extremely difficult.
Depending on the specific type of medication-assisted treatment, individuals will find relief from both of these difficulties. Individuals will immediately transition from their substance of choice into medication-assisted treatment in certain cases. Other forms of these treatments require individuals to eliminate all traces of opiates or opioids from the system before receiving their first dose in the treatment regimen.
What are types of medication-assisted treatment, and how are they unique from the others?
Types of Medication-Assisted Treatment
Although multiple types of medicine may be prescribed for various forms of treatment against several substances, there are currently three medications approved by the FDA for the treatment of opioid dependence. Each three of the following medications works uniquely, providing multiple benefits during treatment.
Methadone was the first medication approved for use in treating opiate abuse disorder. In the 1960s, methadone clinics began surfacing that provided the medication as an alternative to combat the symptoms of opioid withdrawals and ease the intense mental cravings. The original model of these clinics is still largely in place today, with a few minor changes and additions along the way.
Individuals schedule an intake appointment and must be in full-blown detox when they arrive. Individuals meet with a nurse where they are given a score on the opioid withdrawal scale and must submit a urine and blood sample.
Finally, clients meet with a physician for a physical and will be prescribed an initial dosage amount for methadone. Patients return to the clinic daily to receive their doses and are able to increase the amount of methadone daily in small increments. Typically, the increase happens at 5 mg per day until patients reach a stable dose to completely eliminate all feelings of withdrawal.
Patients are required to meet with mental health counselors regularly to craft a treatment plan and form goals for their personal and professional lives. Many clinics also organize weekly and monthly group meetings for clients to engage with one another regarding various topics relevant to recovery.
Weekly urine screenings are conducted to track the progress of each client. After a period of time with no positive markers for narcotics in the urine, clients become eligible to receive take-home doses of methadone to eliminate the daily attendance at the clinic.
There is no set window of time for methadone maintenance treatment. Some clients enter treatment with a short-term goal, while others use it as a form of long-term maintenance. It’s not uncommon to see clients participate until they are stable, maintain that dose for a short time, then decrease their dose during an opioid taper. Alternatively, clients with a severe disorder may remain on the methadone program for multiple years.
Regardless of the amount of time, the overall goal is to return to a normal life without the time and financial restraints of illegal opioid and opiate use. Methadone treatment programs are widely considered to be a successful form of mediation-assisted treatment.
Buprenorphine allows for reducing or eliminating the most intense symptoms of withdrawal. Forms of Buprenorphine treatment include Suboxone, Subutex, Sublocade, and Probuphine. The two former, similar to methadone, are taken daily to treat the side effects of opioid withdrawal and cravings.
However, the Sublocade is administered in the form of a monthly injection and is one of the newest medications available in the treatment of opiate abuse disorder. Probuphine is an implantable form of the medication, placed beneath the skin in a time-release form that is effective for six months.
The primary difference between buprenorphine and methadone is the period of abstinence accompanying the former’s administration. Individuals must wait for a period of 24-36 hours after the last use of opioids or opiates to receive buprenorphine treatment. Failure to comply with this requirement leads to the onset of precipitated withdrawal, which is the start of the most intense feelings of withdrawal during a short period.
Buprenorphine attaches itself to the opiate receptors in the brain. When all traces of opiates or opioids aren’t free from these receptors, the subsequent reaction is precipitated withdrawal. Additionally, individuals on buprenorphine treatment will also be unable to feel the effects of moderate to high doses of opiates.
One of the primary advantages of buprenorphine treatment is the medication may be prescribed in multiple settings, including clinics, hospitals, health departments, and correctional facilities. This makes buprenorphine overall a more accessible form of treatment.
Like methadone, buprenorphine treatment has no specific window of time. However, all clients are provided with information regarding a tapering schedule. If needed, prescribers may guide patients in a safe tapering regimen when the time comes. Overall, buprenorphine has also been considered a successful form of mediation-assisted treatment.
The primary difference between drugs like methadone and buprenorphine, compared to Naltrexone, is that the two former are opioid agonists. Agonists work by activating the opioid receptors in the brain, which is how methadone and buprenorphine help individuals avoid withdrawal symptoms.
Naltrexone, on the other hand, is an antagonist which works by blocking the receptors in the brain and preventing opiates from attaching to them. In the end, this form of medication-assisted treatment helps to eliminate the cravings involved with post-acute withdrawal symptoms.
Individuals who receive naltrexone treatment must remain abstinent from all opiates and opioids for a period of seven to ten days. This means the full detoxification period must be satisfied before this form of medially-assisted treatment is an option.
While Naltrexone does little in the way of relieving the side effects of withdrawal, it has proven to be effective in managing the long-term cravings for opiates. This medication is available as a daily tablet or a monthly injection. Individuals seeking to end Naltrexone treatment require no form of tapering or medical supervision, as there are no withdrawal symptoms.
Just like buprenorphine treatment, Naltrexone is widely available in multiple settings. Methadone stands as the only form of medially-assisted treatment requiring attendance at a clinic that deals solely with methadone.
Benefits of Medication-Assisted Treatment
Many skeptics have complained about the effectiveness or moral standpoint of medication-assisted treatment like buprenorphine and methadone, calling them legal ways to continue using. However, this couldn’t be further from the truth.
Clients rarely experience any form of euphoria from either of these medications during treatment. There are many significant benefits to participating in methadone or buprenorphine treatment, which is highlighted below.
- Clients don’t get high from these medications, so chasing the feelings caused by opiates or opioids is eliminated.
- Clients can engage in treatment while monitored by medical professionals via appointments
- These programs allow clients to manage their personal and professional life without the need for a continuous supply of opioids or opiates.
- Because clients can maintain and manage their cravings and side effects of withdrawal, they may place their focus on returning to a normal life.
Medication-assisted treatment should be considered a bridge to sobriety and not a tool of enablement for the continued use of opiates or opioids. Instead, they should be viewed as a bridge to sobriety.
MAT Improves Long-term Recovery Chances
MAT has proven to increase the chances of experiencing long-term recovery. A large majority of individuals suffering from opiate abuse disorder experience relapse during the post-acute withdrawal phase or even later. Mediation-assisted treatment allows individuals to navigate the later stages of recovery, providing relief from the mental challenges associated with cravings. This allows individuals to focus on the most important areas of recovery, including family and work.
At Icarus Behavioral Health, we have several options during treatment, including all of the mediations listed in this article. Our main area of focus is providing clients the tools they need to successfully achieve long-term recovery through the creation of individually crafted treatment plans. Contact one of our admissions specialists to get started crafting your personal treatment plan or any questions you have regarding our services.