If you ask anyone in recovery their opinion on MAT (Medically Assisted Treatment), you're bound to get more than one answer. Where there's a stigma on addiction, there's one for taking any mind-altering substances while in recovery, period. But who's to stay they're correct in this debate?
I have been clean since January 2017, but halfway through my recovery, I experienced a back injury and was prescribed Percocet for a short time. After running out of my prescription, I felt the very same cravings I had back when I was newly clean. I didn't trust myself enough to keep it together once I got off of them, so I put my trust in Suboxone (which I've taken many times before). I took it for about three months and eventually took myself off it with a little help from my psychiatrist.
But am I clean? To some, maybe not, but to others, including me? Yes. Some believe any mind-altering substance is a relapse, but what if a drug prevented you from spiraling back down into your addiction? Wouldn't you want to do everything you can to prevent that from happening? I didn't want to waste my progress on a previous back injury, and I was determined to stay clean. My last run was the worst I've ever experienced, and I will never go back to that life again. If I could take medication to prevent that, then why not? But that's all just talk; let's dive into a more statistical version of the story.
The Facts & Myths
First of all, what exactly is MAT? Well, you only have but a few options. For instance, you could take daily doses of the sublingual form, which dissolves under your tongue. Another option comes with a commitment attached. It stays in your system, involving one monthly shot to block opiates.
1. Suboxone (buprenorphine) is a medication that comes in film and tablet form. Buprenorphine prevents cravings and helps the withdrawals feel less severe. Patients report feeling normal, functional, and having a clear head all day, encouraging them to make concrete choices the way they did before they started using. When combining this drug with counseling and other forms of support, it can help patients recover.
2. Vivitrol (depo-naltrexone) is a monthly injectable form of Naltrexone useful for treating opioid and alcohol addiction. Naltrexone is clinically proven to reduce the likelihood of relapse. Although, taking this medication before fully detoxifying from opiates can send you into immediate withdrawal, so be sure to take it after you've done so. Naltrexone may also be used by patients who have entirely weaned off Suboxone to prevent relapse. Naltrexone alone blocks the euphoric and sedative effects of opioids and prevents feelings of euphoria.
3. Methadone is an opioid agonist made to blunt or block the effects of all opioids and lessen the cravings and withdrawals, just like those above I just mentioned. It is only dispensed through a SAMHSA-certified opioid treatment program (OTP).
The most common misconceptions out there, primarily based on MAT, are nothing more than fundamental misunderstandings of using a prescription for its sole purpose. They say these drugs are for the weak, but they are far from being right. It's all about remaining educated and avoiding ignorance before you cast judgment. Here are the most common myths based on the use of MAT today:
1. MAT trades one addiction for another: Research indicates that both medication and behavioral therapies can successfully treat and sustain recovery.
2. MAT used only short-term: Studies show those on MAT for at least 1-2 years offer a more sustained long-term success rate.
3. My condition is not severe enough to require MAT: MAT utilizes many different medication options to tailor and best fit your unique needs.
4. MAT increases the risk of an overdose: MAT is specifically for preventing overdoses from occurring.
5. Adding MAT to your regimen will only hinder and disrupt your progress thus far: MAT has been shown to assist patients in recovery by improving their quality of life, functioning, and handling stress. Above all, MAT helps reduce mortality while patients begin recovery.
6. There is no proof that MAT is even better than abstinence: MAT is evidence-based and recommended for opioid addiction. The National Institute on Drug Abuse, Substance Abuse and Mental Health Services Administration, National Institute on Alcohol Abuse and Alcoholism, Centers for Disease Control and Prevention, and other agencies emphasize MAT as first-line treatment. (5)
7. Most insurance plans don't cover MAT: As of May 2013, 31 state Medicaid FFS programs covered methadone maintenance treatment in outpatient programs. Now the State agencies vary whether buprenorphine is listed on the Preferred Drug List. It's also based on prior authorization being required (often made established by the specific buprenorphine medication type). Extended-release Naltrexone is listed on the Medicaid PDL in over 60 percent of states. (thenationalcouncil.org)
How We View Our Addictions
*The most important myth, in my opinion, is this. It shows the different ways someone can observe their addiction based on their perception alone*
• MAT is a wrong moral decision: Some of the negative stigmas of MAT comes from our different ways of understanding addiction. Understanding the difference between a moral and spiritual problem versus a medical problem when looking at addiction and MAT is critical in learning the program and its purpose.
*Addiction as a moral/spiritual problem: There remain those from the community who view their ailment as a moral and spiritual failing, not a medical disease. So with this mindset, medical treatment may seem like a "crutch," an excuse, or just a weak moral option because the patient continues to use an opioid every day. Complete abstinence is the most common form of treatment plan in this particular view on addiction. MAT's ability to make the withdraws more manageable and less severe may not be seen as a benefit but may indicate that the addict "isn't that serious" about quitting. Some addicts in this program may even be excluded from 12-step groups due to technical opioid usage. They may be scrutinized as having "traded one drug for another," luckily, there are also many fellow room members that accept the role of MAT in an individual's recovery, just as long as they're taking it responsibly.
*Addiction as a medical disease: Rather than understanding addiction as just a moral or spiritual concern, numerous clinical experts have started to recognize narcotic dependence as a medical disease and mental disorder with how it affects the brain. The condition of addiction can be brought about by reoccurred exposure to a medication, combined with hereditary or environmental risk factors, inciting serious changes in the brain's opioid receptors. In this perspective, addiction can be dealt with using the recently-mentioned medicine provided by a licensed psychiatrist, much like any other clinical diseases.
The reality is, we need to learn to accept someone else's path to recovery. As long as those recovering are actively trying to get better, why should it matter how they got there? I have a friend that's been on Suboxone for over seven years now, and is she clean? To me, there's no doubt about it. If you compare your active addiction to taking MAT for treatment, there's a significant difference in how they live their lives versus back then in their active addiction. Next time try and remain open-minded if the next addict you meet just happens to be on this very same program.