I am not a doctor. My partner is pretty smart, even smarter than me I’d say, but he is also not a doctor. I honestly couldn’t say I know any doctors at all (although I do know a handful of nurses who amaze me, but that’s not my point). But even though I am not in the medical field, I do have experience with this post’s topic, and it’s because it comes with the territory of addiction: Medication Assisted Treatment. Or MAT, or medically assisted treatment. Whatever floats your boat.
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.
Now, I gotta take a break to 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 this year: “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. I think it was partly because he missed appointments, but regardless, the point is it didn’t stick.
After the most recent relapse, he went to rehab, and I decided that my input wasn’t necessarily needed or wanted. 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.
Unfortunately, I still saw the negativity surrounding MAT, and the truth is, even in recovery, our loved ones still get judgments.
I knew that I had seen the benefits and truth of this treatment method, but others like me sometimes still thought it wasn’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.
But, when used correctly in the appropriate setting, it can be the opposite.
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.”
Even in NA, which people often site, 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.
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. Especially because I feel that my normal outside views are pretty supportive on this topic since they see it for what it is: getting help. The most often I see disdain is within our own community, because of the misconceptions surrounding it.
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.