It is no surprise that our nation is in the throes of a complex and harrowing crisis. In October 2017, the opioid epidemic was aptly declared a public health emergency, yet nearly two years later, millions of Americans still struggle to find solace from growing chemical dependencies and substance use disorders. Clinicians and behavioral health providers are at a crossroads, often unable to help clients break free from the grips of opioid addiction through standard detox methods and cognitive behavioral therapies. Due to the emotional intricacies and physical nuance of addiction, a multifaceted approach of medication-assisted treatment entered the scene as an option for clients who may require that level of care.
Is Medication-Assisted Treatment Evidence-Based?
In the early 1970s, renowned physicians like Dr. Robert G. Newman introduced the world of healthcare to a novel modality called medication-assisted treatment (otherwise known as MAT). This influential model of treatment combines the use of FDA-approved medications that mitigate the effects of harsh opioids like heroin and prescription pain relievers with behavioral therapy. Proven to be clinically effective, MAT reduces individuals’ abuse potential by alleviating physical symptoms of withdrawal and decreasing opioid cravings. What’s more, MAT can also be targeted to treat alcohol use disorder and tobacco cessation. Despite its efficacy and tailored treatment style, enrollment in MAT programs remains limited, with insurance barriers and social stigmas playing a part in the hurdles.
In 2013, the National Survey on Drug Use and Health released a report asserting that less than 40% of the 2.5 million Americans with opioid use disorders were receiving medication-assisted treatment. Often referred to as the gold standard for addiction therapy, MAT has been criticized as being a “crutch” and a “substitution” rather than a solution. However, medication-assisted treatment is less about substituting one drug for another and more about replacing one lifestyle with another. Though research continues to affirm the benefits of MAT and its ethical treatment of chronic substance use disorders, Medicaid restrictions and limited insurance reimbursement for opioid treatment programs still hinder its adoption.
What is Medication Assisted Treatment for Addiction?
MAT programs have consistently limited the socio-structural factors that lead to substance use disorders and opiate addiction, providing a promising future for integrated therapies. Medication-assisted treatment works by utilizing individually tailored levels of agonizing and/or antagonizing medications. More specifically, agonists are activating medications, such as methadone, that work to activate a patient’s neurological opioid receptions, mimicking the effects of opiates without producing euphoria, or a “high.” These medications work in tandem with counseling and behavioral therapies to reduce the cravings and withdrawal symptoms that often lead to relapse. Conversely, antagonists are blocking medications that obstruct opioids from attaching to a patient’s opioid receptors, thus limiting euphoria and allowing patients to wean from previously addictive drugs. The integration of medications like methadone, buprenorphine, and naltrexone to combat opioid dependence not only curbs cravings, but also rewires areas of one’s brain chemistry that may have been altered by prolonged drug use.
Treatment Options & Patient Empowerment
Substance use disorders of any kind strip patients of their agency and autonomy, subjecting those who struggle to an all too lethal circumstance. However, today patients have access to more treatment options that can reflect their recovery goals and values. Medication-assisted treatment is one of the options that has turned recovery into consumer empowerment, bringing light to the opioid crisis and hope to those who need it most.