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The Potential Fallout of Suboxone Treatment

 

What to Expect:

 

  1. Medication-Assisted Treatment (MAT) uses prescribed drugs to help individuals struggling with opioid addiction manage their withdrawal symptoms and stay engaged in treatment.
  2. Suboxone (or Subutex) is popularly prescribed to save lives and reduce the harm of opioid addiction.
  3. What are the potential long-term effects of Suboxone in an individual’s overall quality of life?

 

Understanding Medication-Assisted Treatment (MAT)

 

Opiate use in the United States is at a crisis level–too many people are dying from abusing and overdosing on these powerful drugs. Opiates are highly addictive and a single overdose can prove fatal. 

As a result of the opiate epidemic, lives are needlessly lost or destroyed, families devastated, and the socio-economic impacts widespread.

In an effort to save lives, medications have been developed as a means of harm reduction. 

Medication-Assisted Treatment (MAT) gives an individual struggling with opiate addiction a fighting chance to recover and return to a normal life. That being said, a simple medication is not going to solve all of one’s problems–it is often a starting point where extensive counseling and therapy is necessary.

But is MAT just substituting one drug for another?

Not necessarily.

Drugs like heroin are unregulated and dangerous. Even prescription opiates are very dangerous when not taken as directed. 

MAT offers those struggling with opiate addiction safer, FDA-approved medications. MAT medications–like Suboxone–help reduce or eliminate withdrawal symptoms without producing that euphoric high.

 

Using Suboxone to Treat Opiate Addiction  

Suboxone is one commonly prescribed medication to treat opiate addiction. It is actually a combination of two different drugs–buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that blocks the brain’s opiate receptors to reduce urges. The effects are similar to an opioid, but weaker.

 

Naloxone is an opioid antagonist. It counters the effects of opioids in the system. In fact, Naloxone is a commonly used medication by first responders encountering an individual experiencing an opioid overdose. 

 

Suboxone is usually self-administered once a day as a film or tablet placed under the tongue to dissolve. 

 

Potential Future Challenges for Suboxone Users

 

As a result of the opiate crisis, we have a percentage of young people that are on some sort of opiate blocker or opiate substitute–the most common being Suboxone. 

 

The first crisis we may face in the future of addiction is the vast number of individuals taking Suboxone or Subutex for up to 10 years. We don’t really understand the long-term effects of these drugs. 

 

We don’t know how these medications affect people’s development. What happens when an 18-year-old is put on Suboxone. How will it affect their development as they reach the mid-20s? Maybe it’s hardly at all. Maybe it’s a big deal. BUT…we don’t know for sure.

 

Will it be a future challenge?

 

Will people start having mental health challenges as they reach their 30s, 40s, or beyond? Can it be related to Suboxone?

 

And then there is the issue of getting off Suboxone. It’s well known coming off Suboxone is harder than kicking heroin. So, Suboxone may be saving an individual’s life, but the detox and resulting depression can last months if not years.

 

So, in a nutshell, we are putting a band-aid on a gaping wound to help save a life. If we don’t tend to that “wound” with counseling, treatment, and teaching life skills, that “band-aid” may save lives, but not QUALITY of lives. 

 

Will we have the capability to deal with these issues? If we think proactively, there certainly is a potential. 

 

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Medication Assisted Treatment

Medication assisted treatment (including Suboxone and vivitrol)

 

Medication-assisted treatment (MAT) is using pharmaceutical medications, prescribed medications to help treat active addiction. 

 

It’s different than just the psychiatric medication that you use to treat underlying conditions of depression and anxiety. MAT treatment is a specific classification of drugs that are used to affect the addiction directly. And so there are agonists and antagonists drugs that provide an effect similar to the drug you were using, but allow you to be more functional and reduce the harm around the habit. You don’t break the habit you use something that’s like a derivative of that substance that would be like subtext for opiates or methadone. 

 

It’s a similar molecular structure and has similar effects but you can manage it better and you don’t deal with all of the negative repercussions or most of the negative repercussions of using heroin. 

 

Then there are the blockers that stop the effect or deter people from using certain substances and abuse of a trial. That’s that classes of drugs. And basically, that’s it’s come into treatment in recovery very strong.

 

It started with methadone a few decades ago, and then Suboxone a couple decades ago has become very popular. 

 

And it’s understandable. Basically, we’ve been in the midst of a pretty serious opiate epidemic and people are dying. You have city officials, county officials, government officials, parents, loved ones and society as a whole having a conversation about what we do about this. 

 

There are lots of research studies that show that people have a better chance of achieving recovery if they use medication-assisted treatment. 

 

Those studies are complex and I want to get too into that. They’re complicated questions to ask about those studies and their different opinions. It’s not univocal, and everybody has the same opinion. But I want to look at it in general. So what’s going on here? How do we think about this? 

 

You deal with different perspectives on MAT.

 

So if I’m a government official, and there are thousands of people dying in my district, or in my state, or in my city. I’m thinking, “How do I stop people from dying?” I’m gonna take 100 million dollars, and I’m going to put it into what statistically is the most beneficial thing, medication-assisted treatment, people have to stop dying. And it’s really all the government can do.

 

The government can’t assign an individual therapist, a psychiatrist, long term treatment, isolate people on an island, the government doesn’t have the ability to do nuanced individualized care. 

 

For each and every person who suffers from addiction, the government can’t assign treatment to even 5% of the people who need it. 

 

So I think, how do we stop an epidemic?  On that level, it makes perfect sense and I get it. On the individual level, it’s much more complex. I’ll give an easy example. If somebody is a poly substance abuser, let’s say somebody is 23 years old, they use and this is not uncommon. opiates or methamphetamine or cocaine or alcohol or marijuana. 

 

That’s a lot of young people, they use all kinds of stuff, whatever they get their hands on. They also lack discipline, and they lack a lot of structure and maturity. So they actually don’t know how to do basic things like make their bed. That’s something like 60% of the population and people in treatment right now. They don’t know how to live well. 

One of the things I’ve concerned about with Suboxone is the difficulty in getting off of Suboxone.

 

If you go look up, get off of Suboxone and go read the personal forums. You will see how incredibly hard it is. It’s kind of scary. It takes about 45 days, let’s say you’ve been on Suboxone and you started at a 12-milligram dosage, which is normal. And you’ve gotten all the way down to one milligram after three years. 

 

Then you decide, this is getting in the way of my growth, my psychological well being, and I don’t want to be dependent on this anymore. It’s been years. I’ve seen people want to get off one milligram of Suboxone, that it was a 45-day taper meaning take a little tiny bit just less than one milligram, little less over 45 days, and then another month without the substance to get through we call the acute and then sub-acute detox phases. 

 

Then you’re no longer having the physiological symptoms, but you’ve got months and sometimes even a year to deal with the underlying issues and depression that comes up after having been on this substance for so long. 

 

I’m really concerned about putting thousands or hundreds of thousands or millions of people on Suboxone medication over long periods of time. 

 

What that looks like if there are negative psychological effects down the road. I don’t think we know. Some experts say to never take people off Suboxone. Once they’re on for two or three years. You leave them on it forever. But there’s nobody that’s been on Suboxone for 50 years. It hasn’t been around that long. We don’t know what that means and what that looks like. We still use Suboxone individually. 

 

It’s up to the treatment providers to figure out how to effectively administer Suboxone in smart ways.

 

Then to compile that data and share it with the rest of the community.  

 

Vivitrol is another option. 

 

I’m a huge fan of Vivitrol, Vivitrol is a blocker, and what Vivitrol does is two things, it stops you from being able to get high immediately from opiates. You can do it in an injectable form, which is a little frightening, but it lasts a month. 

 

On the one hand, it physically stops you from being able to do your substance of choice. On the other hand, it’s psychologically really helpful if I’m obsessive, but I know I can’t get high. And I’m willing to get into recovery, it’s a great message to send to myself. You could do Vivitrol with very little side effects for a year and a half, or six months.

 

Even with Vivitrol, we don’t know the long term psychological effects.

 

It’s been around 20 years, but they’re not great research and study on this stuff. And everybody’s very different with how they respond to the medication. I’m in favor, in general, of anything that helps people recover and get better, and of course, in favor of people not dying. But we also have to weigh these different claims. And figure out how we use medications in a way that’s effective for individual situations. That’s not an easy task. It’s going to be everybody working together and having conversations like this about medication-assisted treatment.

 

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Medication Assisted Treatment for Substance Abuse

Overcoming addiction isn’t easy. Those struggling with addiction often require a comprehensive approach addressing substance abuse and underlying causes.  Addiction professionals use a variety of tools and evidence-based treatments to guide an individual towards a successful recovery.

 

Counseling and behavioral therapy can be effective for addressing underlying issues and triggers. Also, developing a strong support network is crucial for helping an individual through hard times and preventing relapse.

 

Can medications help with addiction? 

 

Evidence says medications can be extremely helpful for some types of substance use disorders.

 

Medication assisted treatment (MAT) is one of the many tools addiction professionals may use to help those with chronic and/or severe addiction. MAT can save lives and help get individuals focused on their recovery.

 

Addiction is a disease affecting the brain and body. Without proper treatment, it only gets worse–destroying relationships, families, careers, physical & mental health, and life itself.  Those diagnosed with cancer or diabetes wouldn’t think twice about taking medications to treat their conditions. Why should treating addiction be any different?   

 

It shouldn’t. In fact, agencies like the American Academy of Addiction Psychiatry, The National Institute on Drug Abuse, and the Centers for Disease Control all recommend MAT as a first line treatment for opioid and other substance use disorders. 

 

What is Medication Assisted Treatment?

 

Medication assisted treatment (MAT) uses a combination of behavioral therapy and FDA-approved medications in the treatment process. Studies have shown MAT is effective in helping those struggling with opioid, alcohol, and other addictions.

 

MAT helps to relieve withdrawal symptoms and psychological cravings. These medications also help to safely restore chemical imbalances caused by substance abuse. 

 

But isn’t that just substituting one drug for another?

 

This is a common misconception of medication assisted treatment. As you probably know, substance abuse can destroy your physical, mental, and emotional health. The medications used to treat opioid and other addictions are provided at safe doses that do not affect a person’s mental, physical, and daily functioning. 

 

In short: MAT replaces drugs that can destroy your life–and kill you–with safer medications that ultimately help you.  

 

MAT gives those struggling with opioid or alcohol addiction a chance to release the suffocating hold these substances create. Combining MAT with behavioral therapy allows a person to refocus on a life that is free from the dangerous substances taking control of the body and mind.  

 

Doctors prescribing these medications closely monitor individuals to ensure they are given safe, therapeutic doses.

 

What Medications are Used for MAT?

 

For those struggling with addiction to opioids like heroin, oxycodone, codeine, morphine and hydrocodone, the following drugs may be used in different situations:

  • Methadone
  • Buprenorphine
  • Naltrexone
  • Naloxone 

 

Drugs like methadone and buprenorphine activate opioid receptors to help suppress cravings. Naltrexone, on the other hand, blocks the sedative and euphoric effects of opioids. In fact, naltrexone prevents a person from getting that “high” feeling from opioids or even alcohol.

 

Naloxone (Narcon) serves a different purpose. It rapidly reverses the effects of an opioid overdose. It’s been used by first responders, police, and addiction professionals to save lives of those overdosing on opioids. 

 

MAT may also help those with alcohol addiction by using:

 

  • Acamprosate
  • Naltrexone
  • Disulfiram

 

Acamprosate, for example, helps to restore the disrupted changes in the brain caused by chronic alcohol abuse. This safe, well-tolerated drug has been used to treat over 1.5 million patients throughout the world. In fact, acamprosate is safe even when a person suffers a brief relapse. 

 

As with any drug, you want to make sure the doctor reviews your complete medical history and current medications. Discuss any potential side effects and risks of using MAT drugs. Also, be sure to consult with your doctor or treatment team before stopping any medications.

 

Medications used to treat addiction are not “magic bullets” that quickly make your addiction go away. You still have to do the personal work to address causes, triggers, and moving forward. MAT does, however, provide an opportunity to counteract some of the physical and neurobiological effects of abstaining from your drug of choice.

 

What are the Benefits of Medication Assisted Treatment?

 

As a part of a holistic drug treatment program, MAT medications are safe, cost effective ways to help manage addiction. They can also:

  • Reduce the risk of potentially fatal overdoses
  • Keep you engaged in treatment
  • Reduce cravings
  • Help stabilize your mood and emotions
  • Prevent engaging in dangerous or criminal behavior
  • Help with your social and occupational functioning
  • Reduce risk of contracting HIV or hepatitis C due to unsafe needle use
  • Improve birth outcomes among pregnant women with substance use disorders

 

Common Medication Assisted Treatment Myths

 

MAT research and data proves better outcomes and significant reductions in relapse. Still, some individuals–and even practitioners–are reluctant to embrace MAT.

 

But why?

 

For some, they may not have the correct information. Others may feel completely abstaining from any drugs is the best method of recovery. The Substance Abuse and Mental Health Services Administration (SAMHSA) states that MAT is “greatly undersused.”

 

We already talked about why medication assisted treatment is more than replacing one drug for another. Here are a few other MAT myths that need to be debunked:

  • MAT only provides short term results. Individuals using MAT for up to 2 years have the greatest rates of long-term success.
  • MAT is only for those with a chronic, severe substance use disorder. MAT uses a variety of medications that can be modified to fit the unique needs of most patients–especially those struggling with opioids.
  • MAT makes overdose more likely. MAT helps to prevent overdoses. Once someone detoxes from opioids, even one brief relapse can cause a fatal overdose. MAT helps reduce cravings and gives those struggling with opioids a safer alternative.
  • MAT keeps a person from experiencing a full recovery. MAT allows a person to function better and enjoy a better quality of life so they can focus on the personal issues contributing to their addictive behaviors.

 

Is Medication Assisted Treatment Right for You?   

 

Looking for addiction treatment in a values-based program that emphasizes dignity, respect, and compassion? Recover Integrity gives men dealing with life-threatening addiction a chance to refocus and recenter their lives on what is truly important.

 

When appropriate, Recover Integrity uses the latest, evidence-based medication assisted treatment as part of their holistic recovery program

 

Tried 30-day programs with little or no success? Our exclusive, extended care addiction treatment for men offers an opportunity to comfortably address your issues and move past the dark tunnel of addiction.

 

Call (310) 294-9030 to get help now. 

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