Medication Assisted Recovery

There are a lot of different ways in which someone can recover for addiction. One of them is medication assisted recovery, which means prescription medication is used in order to get clean. This must be supervised by an addiction care physician.

About Medication Assisted Recovery

When someone uses drugs or alcohol for a long period of time, the way the brain functions and is structured are altered. This has helped scientists consider that pharmacological treatment could help to rebalance the brain, stopping people from sabotaging or worsening their attempts at recovery.

Medication assisted treatment (MAT) describes a pathway towards recovery, but it should be seen as an element of overall recovery. No medication can currently cure addiction, but they can save lives and help people start to recover. That said, there are also medications that can hamper the overall recovery. Hence, it is vital that any pharmaceutical products to be used are prescribed only by someone who specializes in addiction treatment. This is particularly true because many of these drugs can also be dangerous and addictive if misused.

Medication can be used for different elements of the overall recovery process, including:

  • Detox
  • Reduction of withdrawal symptoms
  • Blocking the feelings of being high
  • Shielding against impulses
  • Reducing cravings
  • Treating co-occurring mental disorders

Co-Occurring Disorders

In many cases, people who are addicted also suffer from a co-occurring disorder. Commonly, this includes attention deficit disorder, post traumatic stress disorder, anxiety, and depression. When these disorders are treated together with the addiction, it is more likely that people will recover. Medication is often used within mental health care, including products such as anti-anxiety and bipolar drugs, as well as antidepressants.

Buprenorphine

Buprenorphine is commonly used in MAT in order to help people beat an opiate addiction like heroin or painkillers. The U.S. Food and Drug Administration (FDA) approved this drug in October 2002 and it is the most advanced form of MAT drug available today. If used together with behavioral therapy and counseling, it is a very effective and safe treatment method.

Buprenorphine is different from methadone because it ca be dispensed and prescribed in physician’s offices. This means that access has increased significantly. Under the Drug Addiction Treatment Act of 2000 (DATA 2000), physicians can qualify to prescribe this medication in a range of settings. These include community hospitals, private offices, correctional facilities, and health departments. Additionally, buprenorphine can be offered at Substance Abuse and Mental Health Services Administration-certified opioid treatment programs (OTPs). They can only dispense the treatment, however.

There are some clear benefits of buprenorphine for those who are dependent on opioids over methadone treatments. The FDA has approved four different types of buprenorphine for the treatment of addiction:

  1. Buprenorphine-containing transmucosal products for opioid dependency
  2. Zubsolv (buprenorphine and naloxone) sublingual tablets
  3. Suboxone (buprenorphine and naloxone) film
  4. Bunavail (buprenorphine and naloxone) buccal film

Methadone

Methadone is a well known pharmaceutical product used in MAT that helps in the treatment of opioid addiction, most commonly heroin. It has been used for treating pain in this type of treatment for many years and is safe and effective when taken according to prescription. It enables people to recover and reclaim their meaningful, active lives. However, for it to be truly effective, patients should take part in programs that also include social support and counseling.

Methadone changes the pain receptors in the nervous system and the brain. It helps to make withdrawal symptoms more manageable, while also blocking the euphoria felt when using codeine, morphine, heroin, hydrocodone, or oxycodone. The drug is offered in wafer, liquid, or pill form, and must be taken daily. The pain relief lasts between four and eight hours. Methadone has also been shown to be effective if prescribed at a higher dose for heroin users, encouraging them to remain in treatment for longer.

Naltrexone

Lastly, there is naltrexone, which can be used in the treatment of both alcohol and opioid use disorders. FDA approved naltrexone for the treatment of both conditions. It can be injected or it can be taken orally as a pill. The pill (Depade and ReVia) is taken daily at a 50 mg dose. The injected version (Vivitrol) is a slow-release medication that is injected into the muscle once every month at 380 mg. Any health provider who is certified and licensed to prescribe drugs can offer naltrexone to patients. However, it is important that people follow directions to avoid rapidly going into withdrawal. This includes having to abstain in full from any opioids (illegal or prescribed) for between seven and 10 days before starting with the drug. Some patients switch from methadone to naltrexone, but they must also be completely clean from opioids first.

Naltrexone stops drugs like codeine, morphine, and heroin from making users feel euphoria. It works in a different way from methadone and buprenorphine, as it does not affect the opioid receptors to stop cravings. Rather, it blocks opioid receptors in order to stop cravings. Naltrexone cannot be abused or diverted either. Should someone relapse and use alcohol or opioids while taking naltrexone, they will not be able to get high.

That said, when people do relapse, naltrexone could place them in a very dangerous situation. This is because people who relapse often return to the dosage they were taking before they started rehab, which was the dose they need to break through their tolerance threshold. This threshold will now be much lower, which means there is an increased chance of accidental overdose.

Conclusion

These are the three most commonly used prescription medication in the treatment of addictions, and there are several more. What is important to understand, however, is that MAT is never a standalone treatment. It is designed to make overall rehab easier to manage, reducing cravings and making withdrawal symptoms more manageable. It is not designed to cure people from addiction, as this is something that must be completed by intensive therapy, training, and behavioral counseling. That said, when used in combination with this, MAT has tremendous potential and has been able to save the lives of many people across the country.