Treating Drug Addiction with Drugs – Does Medication-Assisted Addiction Treatment Actually Work?

Treating Drug Addiction with Drugs – Does Medication-Assisted Addiction Treatment Actually Work?

Opioid addiction has been a growing problem in the United States, both through legal and illegal forms of the drug. In 2016, roughly 64,000 people died of opioid overdoses – a number that surpasses the causalities from the Vietnam and Iraq wars combined. There’s no doubt that opioids are an issue in America, and one that needs a solution at that.

Addictions are difficult to recover from, no matter what substance a person is hooked on. Opioids are particularly difficult due to the intense withdrawal symptoms. While it may be possible for someone addicted to opioids to complete detox on their own, people more often need medical and emotional support to become clean. Effective drug addiction treatments are necessary to help overcome this condition.

Any drug rehabilitation involves several different treatments, ranging from behavioral therapies to medication-assisted addiction treatments. One treatment that can potentially help those suffering from opioid and other addictions is medication-assisted treatment, or MAT. While this process can help patients suffering from extreme withdrawal, it has yet to come into common use.

How Does Addiction Work?

An addiction occurs when your brain becomes used to the effects of a substance and then adjusts your body’s level of output to regulate the effects of the substance. For example, with a stimulant, like an opioid, the drug stimulates brain activity to create a high. With consistent exposure to the drug, the brain then sets its default state to lower than usual, so that the stimulation then balances out to normal activity levels.

It’s because of this that any drug becomes less effective over time, requiring larger doses to achieve a high or any other effect. When those who suffer from addiction cut themselves off or reduce their usage, that’s when withdrawal kicks in – because the body is operating at a level to accommodate the effects of a substance that isn’t there anymore.

Americans tend to view abstinence as the only possible option for drug rehabilitation. However, this can be dangerous and ineffective for many addicted patients. Severe withdrawal symptoms can lead to intense cravings as well as extreme discomfort. Many people trying to detox from opiates ultimately relapse or even overdose, which can have deadly consequences.

What Is Medication-Assisted Addiction Therapy?

As the name suggests, MAT is a form of addiction treatment that involves the use of drugs. By administering FDA-approved drugs to counter withdrawal symptoms, those suffering from addiction have a much easier time avoiding their addicted substance and can even continue their regular lives without needing to shut themselves away through a rough detox period. For opioid addiction, there are several different drugs approved by the FDA to help with MAT:

  • Buprenorphine
  • Probuphine
  • Methadone
  • Naloxone
  • Naltrexone
  • Disulfiram
  • Acamprosate

Each of these drugs has their own level of effectiveness for different types of addiction, as well as their own side effects. Like any other medical treatment, it takes a thorough understanding of a patient’s exact level of addiction and medical history to prescribe the right drug for MAT – and even then these treatments may not be effective for some.

The drugs work in two main ways. One is that the drug is an opiate, so it produces the same effect in the brain, but takes longer to absorb into the blood. This process breaks the psychological link that comes from immediately feeling high after taking a drug. The other type are opioid antagonists that block the receptors in the brain that cause an opioid high, preventing a response from occurring if the patient relapses.

By decreasing the risk of relapse and preventing overdoses, MAT has positive results for those suffering from opioid addiction. While not a guaranteed solution, it significantly increases the chance of preventing deaths from overdoses and stopping the intake of harmful drugs.

What’s the Opposition to MAT?

While there is scientific evidence to back up the effects of MAT, there’s still a stigma attached to it. A lot of it stems from how the US thinks of addiction – that you need to detox completely to successfully recover from a drug addiction. MAT, while it helps, ultimately seems as if it’s replacing one drug with another drug.

While that’s true on the most basic level, that swap of drugs is still better than the alternative of continuing use of a dangerous substance. Because MAT makes use of regulated drugs, patients have a lower chance of overdosing and abusing their medications.

While it may seem like feeding an addiction, MAT instead diverts patients away from dangerous and harmful substances – one of the necessary components of substance dependence disorder. Over time, some MAT patients may even be able to reduce their dosages, completely detoxing from both their addiction and treatment.

IS MAT a Complete Solution?

While MAT can significantly help patients suffering from addiction, it’s not a cure-all. As mentioned, not all drugs are effective for all patients. Some MATs implement several doses a day, which can require patients to make multiple trips to clinics. Other medications have the same risk for abuse as any other drug, which can be a dangerous situation for more at-risk patients.

Opioid antagonists also have issues for after patients stop taking them, especially if the patient relapses – the change in tolerance for opiates drops significantly with this treatment, which can lead to overdoses if the patient resumes their previous level of drugs.

Medical professionals also recognize gaps in treatment knowledge. There is no set method for determining what drug and dosage are best for which patient, while some drugs carry the risk of overdose. Much more research is needed before there's a comprehensive process for administering MAT.

While studies have shown that MAT can be effective without other forms of therapy, the involvement of medical attention and emotional support will still be necessary to get the best results for patients. Ultimately, it takes a motivated patient to overcome addiction, no matter what treatment they use. As the field of MAT develops, more of those suffering from addiction will have another option to help them better their lives.

Sources:
www.samhsa.gov/medication-assisted-treatment
www.statnews.com/2017/05/15/medication-assisted-treatment-what-we-know/
www.ncbi.nlm.nih.gov/pmc/articles/PMC3670653/
www.vox.com/science-and-health/2017/7/20/15937896/medication-assisted-treatment-methadone-buprenorphine-naltrexone
www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html
drugabuse.com/library/medication-assisted-treatment/#types-of-medications-used-in-mat