The use of medications to treat addictions began in the 1990s when methadone was introduced as a treatment for heroin addiction. Mental health and recovery professionals began seeing medicine as a tool for drug addiction once addiction became recognized as a disease of the brain and not a choice. After successful pilot programs using methadone, the treatment was accepted by the FDA.
Since the 1970’s opioid crisis, the medical community has done extensive research on opioid addiction and have concluded that medication-assisted treatment (MAT) for opioid addiction is not just an option, but is the recommended treatment for moderate to severe opioid addictions. There are a few reasons for this, mostly physiological.
Why MAT Works
It is proven that the prolonged use of opioids has a profound impact on the brain. Abstinence-only recovery models are more harmful to opioid patients than others because they do not take into consideration the rapid changes in brain chemistry caused by opiates as opposed to alcohol, which was another area using abstinence-only recovery. The medication normalizes brain chemistry, blocks the euphoric effects of alcohol and opioids, relieves physiological cravings, and normalizes body functions without the negative effects of drugs.
While most of MAT is built to treat opioid addiction, there are practical uses for alcoholism, as well. Factually, withdrawal from alcohol can kill a person. It’s not necessarily the withdrawal symptoms that can kill a person, but the body’s systems have adapted to the alcohol and become dependent to function as they have been. Once the alcohol has been completely cut out, the body functions start to deteriorate. This can be fatal in some cases. Therefore, MAT in terms of alcoholism is applied by weaning a user off alcohol safely. This allows the body to redevelop healthy homeostasis.
Not All Health Professionals Agree
There is not a complete consensus that MAT should be used to treat opioid addictions. Some professionals see it as not true recovery or a way of cheating. There is a stigma that comes with recovery using methadone or buprenorphine, which shouldn’t deter someone from using MAT if they feel it is truly the best way to recover. It is best to educate your patients on what medication-assisted treatment can potentially do for them, and let them decide if that is their best course of action.
Polysubstance Abuse Disorder
Apart from the typical polysubstance abuse disorders for illicit drugs, many prescribed medications can become part of a polysubstance abuse disorder. For example, benzodiazepines and some opiates are prescribed by doctors to treat pain and mental health disorders. Statistically, there are a high number of those with substance abuse disorders and also co-occurring mental health disorders. A person can be both professionally-medicated and self-medicated. The effects of one drug may counter that of another, or exacerbate issues the patient is already having.
Availability of MAT
The biggest hurdle to medication-assisted treatments is cost. Currently, all 50 states, except Wyoming, offer medically-assisted treatments. Many state Medicaid programs are now offering assistance for medicine-based treatment models. There are currently 31 states that cover medicines for the treatment of substance abuse. This is because many state legislatures now consider drug addiction a public health crisis, especially with the rise of opiate deaths throughout the country.
There are a few minor hurdles that you may face when starting a MAT under medical care. First and foremost, there is not a standardized provision for MAT when involved in dual-diagnostic treatments. There is very little evidence-based research available to states from agencies like the Substance Abuse and Mental Health Administration or the National Institute on Drug Abuse. These agencies should phase out antiquated methods and focus primarily on medication-assisted treatments where they are proven to be most effective.
Also, there is a deficiency in data sharing between agencies that impede the quality of care for those who wish to seek medication-assisted treatments. The National Institute of Drug abuse and the FDA should fund more research into the efficacy of MAT and revise provisions on data sharing between agencies for matters such as mental health and substance abuse. Many state legislatures have provisions against implementing MAT, these should be done away with as well.
The Cost of Healing
Many financial barriers still exist that make offering MAT more difficult for patients. Apart from the states that already offer assistance, all states should expand their Medicaid or Medicare programs to cover MAT. Also, private insurance providers should open all avenues for a patient qualifying for MAT. If this is a public health crisis, then it is also up to our government officials to take part in the prevention of drug-related issues. Financial accessibility seems to be the biggest hurdle for MAT implementation.
Many programs do not account for the racial, social, or economic disparities between patients seeking treatment. While some may have an easier time accessing care, MAT, or have better family support, there are demographics that are not properly assisted for substance abuse disorders. The FDA and the National Institute of Drug Abuse should fund more research into disparities in different social and racial communities.
The legislation seems far behind the mental health and addiction recovery community in terms of what the most effective treatments are. Many states still have red tape in place when it comes to MAT. There are many social and political implications of using MAT for the treatment of substance abuse, many of them are positive. It is time for the insurance and political community to catch up.
Northstar Treatment is here to help you achieve your recovery goals and assist you in exploring all recovery models, including medicine-assisted treatment. Our knowledgeable, experienced staff will supply you with the support and strength to see success in your recovery journey. Call Northstar Treatment now at (303) 558-6400.