Misconceptions about Maintenance Treatment in Opiate Addiction

Medication Assisted Treatment, or MAT, is an effective method of helping those who struggle with substance abuse disorder, primarily opiate addiction, find their way to recovery. Although the effectiveness of these medications has been scientifically proven, there is often a stigma around their use, even though MAT has been shown to lower the risk of fatal overdoses by approximately 50%.  Unfortunately, within the addiction community and among the public at large, certain myths or misconceptions have persisted, and these misconceptions have added a hurdle to treatment for people suffering from opiate addiction.

Misconception #1: You aren’t really in recovery if you’re on Medication Assisted Treatment or medications are incompatible with 12-Step groups like AA or NA:

Some people believe that complete abstinence is the only answer to addiction, and many folks have failed at sobriety because they couldn’t live up to that standard. We know now that every person is different, has a different story, and has different needs. Addiction is multidimensional and comprehensive treatment is necessary in order to fit the therapeutic needs of the individual. In treating the whole person, we have to acknowledge the history and experiences of the individuals in order to develop effective treatment plans, and MAT may be necessary. The 12-Step groups differentiate between taking medications as prescribed and substance use. Alcoholics Anonymous and Narcotics Anonymous were previously hostile to antidepressants stating that patients on those medications were not really sober, but the organizations have since changed their stance. Numerous substance abuse treatment programs combine Suboxone use with 12-Step facilitation

Misconception # 2: MAT treatment is “giving up” or “taking the easy way”

Addiction is a medical disease, not a moral failure. Treatment with a MAT medication allows for stabilization of opioid receptors with medication such as suboxone, so that an individual struggling can make changes in his/ her lifestyle and learn behaviors that lead to ongoing recovery rather than cycles of relapses. The mortality associated with any relapse with opiates is extremely high right now, especially with the rise in fentanyl laced opiates, so any precaution that can be used to curb the rate of overdose related relapses is beneficial. Much of the rigidity in recovery circles only exacerbates the guilt and shame that are a part of the addiction cycle and has been responsible for many people turning away from sobriety. We know now that people with complex problems need comprehensive treatment and there is no “one size fits all.” In 12 step programs, it is said that an “alcoholic or addict” must have a “total psychic change.” This refers to body, mind, spirit and everything in between. People have a right to all the help they need, which includes any medical assistance for physical and emotional issues. MAT is completely appropriate in some cases and allows people to function while getting more holistic help over time.

 

Misconception #3: MAT is short term.

Practitioners have different opinions on how long MAT should last, but there is no evidence to support the claim that MAT medication should be taken for a short period of time as opposed to long term maintenance. It is comparable to a person managing their diabetes with insulin for the long term. Each person’s treatment plan can be different, from medication dosage to treatment length. Patients can be on MAT medications for weeks, months, and even years until they are ready to be tapered off of their medication. Some people never reach that stage and instead choose to remain on MAT indefinitely to support their personal recovery.

Misconception #4: MAT medications substitute one addiction for another.

If used as prescribed, MAT medication is stable, safe, long-acting medication, usually with a ceiling effect. It is prescribed for the specific purpose of improving patients physical and mental health and preventing the death of the user. Thus, it has a clear purpose unlike substances of abuse. MAT medication like Suboxone might become more widely accepted as treatments become available for other addictions. However, at this time, no partial-agonist treatment or similarly effective medication is available for other addictions like alcohol or cocaine use disorders. Current medicines come in various forms of opioids, including agonists, partial agonists, and antagonists. Each varies in how they stimulate and protect opioid receptors in the brain. Patients are given the best medication for their addiction based on evaluation and ongoing supervision by a medical provider. Relapse and misuse are less likely when a therapeutic dose of medication is used.

To fully address the vast opioid epidemic, more physicians other than addiction specialists should be enlisted to diagnose and treat opioid use disorder. Addiction is a disease that affects people all around the world and is something that people have to live with for the rest of their lives. Still, medications that have been studied, tested, and proven to ease the process of sobriety and recovery are the key to helping end the opioid epidemic.