Medication Assisted Treatment


Good Thoughts

I got a Facebook message today. It’s one I’ve received quite a few times over the last 5 years. It’s the “My [Cousin/Brother/Mother/Best Friend/Employee] is dealing with addiction. I want to try to help them, what would you recommend?” So, of course, I talk to them about it, ask the right questions, make some recommendations for getting started, send some links, etc. We chat back and forth for a while and then I almost always get a message like this, “It’s crazy! I had no idea addiction is so common! Who knew?!?”

Ooh, pick me, over here! Me. I knew.

I’ve been working with addiction for the last 10 years and I’m a relative newcomer compared to those that I’ve had the pleasure of learning from. We’ve all been watching the numbers grow, talking about the need for increased resources, treatment vs. incarceration and many of the other things that people are now just becoming aware of and reading on their social media accounts. We’ve been talking about it. People just weren’t necessarily listening until addiction landed in their living room at Christmas time or on the other end of a phone call with their BFF. It wasn’t known to them, or at least, it wasn’t obvious to them. The opioid epidemic has changed all of that.

So now, we have your attention. Excellent. I’m going to take this opportunity to give you some information on the next thing that people don’t know about, outside of this field, but should. In my opinion, it’s such a vital tool in addressing addiction, specifically opioid addiction. That tool is medication-assisted treatment (MAT).

A lot of people have seen the video snippets on “Cops” or “Life in the ER” when someone overdoses and is administered Narcan. It’s a drug that saves thousands of people every day and its value cannot be overstated. There are, however, other drugs that can save the lives of people dealing with opioid addiction that are not as well known or are misunderstood. These are prescription medications, administered by doctors, physician’s assistants and nurses, that can help people wean off their opiates safely and begin to focus on their recovery.

Addiction as a disease has been a hotly debated topic for a long time, and I’m not going to try to tackle that here. However, I can say something that I know absolutely, addiction is a lifestyle. The dedication necessary for a person to maintain an opioid addiction is intense. Many do not realize that, once the person begins using, as they continue their body is changed and they must maintain the drugs in their system just to feel normal. The high isn’t even the problem anymore. They need a fix just to be able to function, to not become violently ill, to just go about their day to day existence. This makes getting sober a huge hurdle, not just because they have to learn to live “life on life’s terms” but because with this particular addiction, they must also be able to get past the withdrawal symptoms ( diarrhea, sweats, shakes, nausea, vomiting, abdominal cramping, restlessness, insomnia) in order to be able to focus on the therapy that teaches the skill they need to maintain sobriety. It is here where medication-assisted treatment can become invaluable.

The MAT medications like Suboxone, Methadone, Naltrexone and others are not widely known or understood and are therefore underutilized. Sadly, even in the addiction community and support groups, they are mistakenly seen as a crutch and carry a stigma that the people that are using them are “not really sober”. This creates another barrier for the addict pursuing their recovery. Despite the FDA and multiple studies showing the effectiveness of medication-assisted treatment (MAT), the stigma continues.

MAT medications are not designed to be a replacement drug or a cure all for those dealing with opioid addiction. They are a tool that someone can use to manage the withdrawal symptoms, stop the cyclical lifestyle of addiction, and begin to do the work to learn how they became addicted and what they need to do to overcome it. The ability to sit in therapy comfortably, without experiencing withdrawal, and learn, is necessary to overcome addiction. The ability to leave the streets, to not need a regular fix, to be able to focus on restructuring their life, is necessary to overcome addiction. Yes, there are people that are able to do it without MAT, but for many, it may seem like an insurmountable task. Each of these medications has its own pros and cons, as with any medication, not everything works for everyone. I am not a doctor, so I won’t even try to detail each medication. I will, however, say that there should be no shame for anyone that is trying to overcome their addiction to use these medications as a tool for their recovery. In the same way that we use medications to helps us control other diseases while we make the necessary lifestyle changes to improve our health, these are prescriptions, administered and monitored by a doctor, that can assist in that. When we are looking at an epidemic that is killing around 50,000 people a year, can’t we use all the help we can get?

Yes, addiction is common and, unfortunately, it is only on the rise. Many of us will keep fighting the good fight to help people overcome it. The more that people know, support and build up the people struggling, the more we can make a difference. In the same way that people are now talking about mental health stigma, we can talk about addiction stigma. We can empower people to make the choices they need to fight this uphill battle without also having to feel judgment about the way they choose fight it.

So, those messages? I hope they keep sending them. I’ll give them every tool I can to help the people in their life. I’m glad people are paying attention and starting to see. I’m hopeful they’ll also start to listen.

The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains a searchable database that you can use to locate MAT physicians in your area:

https://www.samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physician-locator

Delaine Johnson, LPC practices at CCD and provides counseling support to MAT patients.