Medically Assisted Treatment

What is Medically Assisted Treatment

According to the Center for Disease Control and Prevention (CDC), more people have died from drug overdoses in 2014 than in any year on record. Seven out of ten of these overdoses involve an opioid, with overdoses now taking more lives per year than car accidents.  Frightening to say the least!  In response to this terrifying epidemic, the use of Medically Assisted Treatment (MAT) is on the rise. MAT is the use of medications, combined with counseling to treat substance use disorder, historically focused on the needs of people who are addicted to alcohol or heroin and other opiates.  Research has proven the effectiveness of Medically Assisted Treatment.  The National Institute on Drug Abuse (NIDA) and many addiction experts support this. If a person is addicted, Medically Assisted Treatment allows him/her to regain a normal state of mind, free of drug-induced highs and lows. It frees the person from thinking about the drug all the time, reducing the problems of withdrawal and craving. These changes can give the person the chance to focus on the lifestyle changes that lead back to healthy living. Taking medication for opioid addiction is not like taking medication to control heart disease or diabetes.  But if prescribed properly and under the supervision of knowledgeable professionals, medically assisted treatment medication can be an effective tool in treatment for addiction. Medication without addressing the underlying issues is a temporary stop in time, creating a reprieve from the obsession to use, allowing the addict/alcoholic a chance to engage in a process of growth.  



Drugs Used in Medically Assisted Treatment


Since the 1960s, Antabuse has been the primary medication used for alcoholism, and methadone had been the primary medication used for opiate addiction. Many of the medications used in addiction medicine, including medically managed detoxification, fall into three basic categories: full agonists, partial agonists, and antagonists. Full opioid agonists are drugs or medications that stimulate activity at opioid receptors in the brain and are stimulated by naturally occurring opioids such as heroin, oxycodone, hydrocodone, fentanyl codeine, and methadone. Medications like Suboxone, and Subutex are buprenorphine drugs, partial opioid agonists, which essentially means there are still traces of opioid in the medications. Medically assisted treatment, using medical assistance shows significant success in long term abstinence for helping with withdrawal symptoms and relapse.  Withdrawal is one of the greatest challenges in the recovery process. (The Therapist’s Guide to Addiction Medicine-A Handbook for Addiction Counselors and Therapists-Barry Solof, MD). Partial opioid agonists are drugs or medications that can both activate and block opioid receptors. Buprenorphine (Suboxone) and Naltrexone are examples of this. The use of medication, as prescribed and overseen by a physician (ideally an addiction medicine specialist), is part of the treatment support from a substance-use disorder. In the neurological process of addiction, the brain becomes chemically dependent upon the presence and consumption of a certain substance, like heroin or alcohol. Until symptoms of withdrawal have passed, it is difficult for patients to grasp the emotional or spiritual parts of recovery. The studies that utilize medically assisted treatment such as buprenorphine (Suboxone) for some people addicted to opioids like OxyContin and Vicodin, as well as heroin, show that for people addicted to opioids who remain on maintenance medication, the risk of death due to their addiction is reduced by more than half. Medically assisted treatment also dramatically lowers their risk of contracting HIV, people are far less likely to commit crime, and are more likely to stay away from their drug of choice if they continue medically assisted treatment maintenance than if they become completely abstinent. Many professionals view medically assisted treatment as a positive short-term tool in the recovery process. (Barry Solof, MD)


What Does a Doormat Have to do with Medically Assisted Treatment?

Methadone and suboxone can be used in tapering off harmful drugs if properly supervised. It is considered necessary to combine it with psychological treatment as well. Medically assisted treatment can help the addict stay away from more harmful substances, especially in early recovery, while he or she is participating in counseling, attending twelve-step meetings, and doing all the other things that have been recommended.  Medically assisted treatment is not meant to replace other aspects of treatment, but is meant to exist as part of an overall care approach.  Medication may be addictive and requires close monitoring by the prescribing physician. When the medically assisted treatment is completed, it is necessary that a closely followed tapering process is utilized.  The medications need to be administered together with rehab, behavior modification, group therapy, individualized counseling and specialized supplemental therapies.  Together, the addict can begin to see a long-term recovery.  Think of medically assisted treatment like a doormat.   The doormat helps you clean your feet so you can move forward to your next location.  But you don’t use it the entire way to your destination.  You step off the doormat, step out on your own, and move forward with clean feet without support of it.  So is medically assisted treatment:  it helps you clean up your life, step out on your own, and move forward with a clean body and brain so that you can move forward in life.  Going without either of them can be done, but it is messier, takes more time to clean up, and not proven as effective in the beginning stages of early recovery.  Using medically assisted treatment has proven successful and supportive in being clean, staying clean, and stepping forward in life without the mess.  And isn’t that what we want in life anyway!   

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