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Medication Assisted Treatment for Opioid Addiction

Addiction to heroin and other opioids is not new in our society. But with increasing coverage in the news and other media, we’re becoming more and more aware of its effect on all of us. The tragedy of an overdose death may have touched someone we know, or at least know of. More generally, there is a well-established link between opioid addiction and criminal activity — both in the illegal sales of heroin, and users who turn to crime to support their habit.

The best tool we have to counteract the scourge of opioid addiction is Medication Assisted Treatment (MAT). However, there are many aspects of this approach that are misunderstood by the general public. In the January installment of the Now You Know series, Dr. Daniel Brown, Medical Director of Meridian HealthCare, explained Medication Assisted Treatment in depth.

Historically, up until the 1970s heroin addicts were generally just thrown into prison with little effort to treat their condition. Not surprisingly, overwhelming numbers of them returned to heroin addiction once they were released.

In 1965, research began into the use of Methadone as an alternative to heroin use that could be administered in a controlled medical setting. In the ensuing years, additional drugs — such as Suboxone, Naltrexone and Vivitrol — have been developed that serve this same purpose in different ways. Dr. Brown covered each of these approaches in the course of his program, including the advantages and disadvantages of each. Space doesn’t permit us to go into this level of detail here, but there are some very important general concepts about MAT that I do want to make sure are understood.

The most common reaction heard to Medication Assisted Treatment programs is “Well, you’re just substituting one addicting drug for another.” It is true that Methadone and the other medications I mentioned are themselves opioids. However, it’s important to be aware of several truths about addiction to heroin and other street drugs:

  1. A heroin user is always at risk for an overdose, with fatal consequences. He or she also risks both contracting and transmitting infectious diseases.
  2. A user who tries to stop using heroin faces agonizing withdrawal symptoms, and has a high likelihood of relapse even if he or she remains clean for a time.
  3. A high percentage of heroin users must resort to criminal activity to support their habit.

There is an important distinction to be made between addiction and dependence. A person who is receiving Medication Assisted Treatment may be dependent on the drug that is part of the treatment, but it is being dispensed in a controlled situation under medical supervision that should also include counseling that addresses mental as well as physiological health. He or she is no longer engaged in the pathological pursuit of the original addicting drug, dealing with criminals in order to receive it and committing crimes in order to support this pursuit.

A person undergoing MAT is able to hold down a job, interact with family members and lead a relatively stable life when compared to a previous life of crime. Those receiving MAT have significantly lower relapse rates, and are 15 times less at risk for death compared with untreated addicts.

Medication Assisted Treatment may have to continue for an extended period; the medical evidence suggests that 18 months is the minimum time to achieve the desired outcome of freedom from opioid addiction. However, each individual’s treatment plan needs to be customized to their specific needs, which might shorten or lengthen their time on these medications. The positive results of MAT when compared with all other types of treatment show that this commitment is worth making.

For more information about Medication Assisted Treatment, visit Meridian’s MAT page.