Where do you stand on this hot button topic within the territory of addiction?
If you know someone who has an addiction issue (depending on what kind), you’ve probably heard about some of the medications used to treat it, such as suboxone, methadone, etc.
Now, I gotta take a second to both warn and apologize for the more “bookish” direction this post is going to go, as I speak more from experience most of the time, but this topic is one that needs both experience and some sources to get the point across, as it deals with information and areas of knowledge that go beyond what I have. This is more of a medical issue, and as such, needs the appropriate information to go with it.
So let’s get to it.
According to an article published in the Journal of Addiction Medicine, “There are currently 3 types of Food and Drug Administration–approved medications to treat opioid addiction: methadone, buprenorphine, and naltrexone”. It goes on to say that, “Results of the systematic reviews from the American Society of Addiction Medicine, have provided unequivocal evidence that, when used as indicated, these medications are both cost effective and clinically effective in reducing opioid use, opioid-related withdrawal and craving, and public health and safety problems related to opioid use (eg, infectious diseases, overdose death, crime)."
Sounds great, right?
But, as SAMHSA (the Substance Abuse and Mental Health Services Administration) writes in an article in April of 2022: “A common misconception associated with MAT is that it substitutes one drug for another.”
And I’ve seen this first hand.
Well, at the beginning, when I first heard about this option from my partner, I was a little confused. Isn’t that exactly what it does? Are you still getting high from it? Doesn’t that mean you aren’t completely sober?
And it did turn out that in the past, he would get it from unreliable sources and with no supervision so yes, it did end up being used for negative purposes.
Which made me dislike it even more.
So when, after those episodes, he decided to go on methadone treatment, I was doubtful.
Why was it going to work this time?
I mean, up to that point he had tried methadone a handful of times, and it had never worked. I thought maybe it just wasn’t for him or he wasn’t doing enough. Which just added more fear and resentment.
And that time, it didn’t work again.
After the most recent relapse, he went to rehab, and I decided that my input wasn’t necessarily needed or wanted, and went beyond my boundaries I had regarding overstepping. I didn’t know what he was doing at all really, unless he told me specifically.
I remember after one visit he mentioned needing to take his craving-reducing medicine, and although I wanted to get more details, I refrained. I found out later that it was suboxone, and realized he didn’t tell me because he didn’t want me to get upset. Which I totally get.
However, this time was different. He was in a facility, under the supervision and care of a legit doctor, and was drug tested and held accountable. Even today he continues his treatment with it, and continues being monitored to make sure it is a safe set-up and stays that way.
It took a little while for me to get comfortable with it, though. I didn’t know if it was something I could put my trust in, since I had experiences in the past where it wasn’t something that lasted and wasn’t used like it was intended to be.
But after I continued to work on myself, and he had more time to handle things on his own without my control and input, I eased into the process and realized that things were getting along just fine. The responsibility wasn’t on me, and things were improving and he was doing well in his recovery.
The SAMHSA article goes on to say, “Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. MAT programs provide a safe and controlled level of medication to overcome the use of an abused opioid. And research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability.”
But due to the stigma surrounding this treatment, not a lot of people use this method, and may not be getting the help they need or should receive. Some cases of substance use are more aggressive than others, and as such, require a more intense and focused treatment plan.
As the article goes on, it also touches on this by stating, “Unfortunately, MAT is greatly underused. For instance, according to SAMHSA’s Treatment Episode Data Set (TEDS) 2002-2010, the proportion of heroin admissions with treatment plans that included receiving medication-assisted opioid therapy fell from 35% in 2002 to 28% in 2010. The slow adoption of these evidence-based treatment options for alcohol and opioid dependence is partly due to misconceptions about substituting one drug for another. Discrimination against MAT patients is also a factor, despite state and federal laws clearly prohibiting it. Other factors include lack of training for physicians and negative opinions toward MAT in communities and among health care professionals.”
Unfortunately, I saw and continue to see the negativity surrounding MAT firsthand, and it's difficult understanding that even in recovery, our loved ones still get judgments.
I know that I have seen the benefits and truth of this treatment method, but others like me sometimes still think it isn’t to be trusted.
They still think like the original statement, where they believe it’s just another drug. That it means that the person isn’t truly sober. That they still have band-aids and crutches that they aren’t willing to give up yet.
And this way of thinking also finds its way into program meetings like NA, where recovering addicts aren't seen as being truly serious or ready to be fully sober. And oddly enough, the program isn’t centered around not using anything at all. Members are allowed to use prescription medications, and the program ideology even states, “The only requirement for membership is "a desire to stop using," and members "meet regularly to help each other stay clean," where "clean" is defined as "complete abstinence from all mood and mind altering substances (including alcohol).” And as we already cleared up previously, MAT prescriptions don’t alter any moods or states of mind when used as directed.
And honestly, this is exactly the kind of behavior and thinking that we don't want, and the type of environment that doesn't help recovery and healing. Imagine that?
Truthfully, all prejudices aside, when used correctly in the appropriate setting, medication assisted treatment can be the opposite to what most people believe.
I know that with a lot of things in this area of life, we are used to being on the receiving end of opinions and judgments, and know that our loved ones are as well.
But with this issue, it seems that we have become the ones with the negative perceptions. The most often I see disdain is within our own community, because of the misconceptions surrounding it.
So to wrap this up and give you some thoughts to consider moving forward, let's lay out those 5 hard truths about medication assisted treatment, and of course, why it matters:
1. Medication assisted treatment (MAT) can be a successful method of treatment when used correctly.
2. Just because it didn't work in the past, doesn't mean it will fail in the future.
3. MAT doesn't mean they aren't "truly sober" or "not serious about recovery" or any other belief you've been told.
4. Medication assisted treatment doesn't cause them to act high, and they can have a healthy, fulfilling life while on this treatment plan.
5. There doesn't have to be a set length of treatment, and longer treatment plans aren't a sign of failure.
My goal has always been to share my story, in the hopes that it would make others feel less alone in their own experiences, to spread awareness on addiction as a whole, and to do my part to end the stigma surrounding the addiction issues of our loved ones and us.
And I feel like this is something we can all gain an awareness and deeper understanding of, as more information needs to spread about the options that can be offered to our loved ones to aid in their recovery, and how these different treatment options are not to be looked down on just because of misconceptions.
So I hope that you gained something from this, and maybe it helped to change your mind.
Or at least, it gave you a different perspective to consider. I’ve been on both ends of the spectrum of thought on this, and now that I’ve seen first hand the benefits and help MAT can bring, I hope that more of you can experience this, too.