Talk with your physician about all medications you may be taking. Medication-assisted treatment MAT refers to the use of medications in the treatment of addiction and the general view that medications are most effective when combined with, or assisting, evidence-based psychosocial therapies. MAT is most typically used to describe treatment for opioid use disorders, for which there is substantial evidence to support the use of medications.
Medicine is also sometimes used in the treatment of alcohol use disorder and other addictions. Alternative terms for MAT include pharmacotherapy and medication-assisted recovery. We found that buprenorphine and extended-release naltrexone were better, safer options for our patients, who typically seek long-term recovery from all problematic substance use.
While methadone is effective and useful for certain populations, people in methadone maintenance programs don't typically have an abstinence orientation, which can result in continued use of other drugs such as benzodiazepines, cocaine , alcohol or marijuana.
No, that would be a stigmatizing and harmful characterization. There are differences between substances used to get high and medications used under a physician's care to get well.
At the Hazelden Betty Ford Foundation, we maximize the impact of medications by also providing patients with robust, evidence-based psychosocial therapies and peer support. We also try to engage our patients in care for as long as it takes to help them comfortably transition from clinical management of their disease to community-supported self-management of their recovery. If our patients are using medication as prescribed and not using other substances, then they are abstinent and in recovery.
At the same time, if patients decide at some point—sooner or later—that they no longer wish to use medications, we help them pursue that goal safely. We know medications help many but also that long-term recovery is possible without them in many cases. All such decisions are made collaboratively between the patient and his or her care team. Current research does not provide information to indicate who requires medication for opioid use disorder and who does not.
As a result, we recommend medications to the vast majority of our patients who have opioid use disorder , due to the higher risk of overdose death associated with the disorder.
In addition, we generally recommend use of these medications long term—especially until the patient is in good, solid recovery. Thus, within any one facility, a variety of modalities should be available to allow treatment to be tailored to the individual. No single treatment is best for all patients, and, moreover, the preferred modality for any one individual may change over time as a result of progress in treatment or varying life circumstances.
Multimodality programs that include methadone and naltrexone enable the maximal number of individuals to benefit from treatment.
If patients who are treated with naltrexone relapse after a period of abstinence, it is possible that the dosage of opioid that was previously used may have life-threatening consequences, including respiratory arrest and circulatory collapse. As with all medications used in medication-assisted treatment MAT , naltrexone is to be prescribed as part of a comprehensive treatment plan that includes counseling and participation in social support programs.
Extended-release injectable naltrexone is approved for treatment of people with opioid use disorder. It can be prescribed by any healthcare provider who is licensed to prescribe medications, special training is not required.
It is important that medical managed withdrawal detoxification from opioids be completed at least 7 to 10 days before extended-release injectable naltrexone is initiated or resumed. Research has shown that naltrexone decreases reactivity to drug-conditioned cues and decreases craving. Patients who have been treated with extended-release injectable naltrexone may have reduced tolerance to opioids and may be unaware of their potential sensitivity to the same, or lower, doses of opioids that they used to take.
Extended-release naltrexone should be part of a comprehensive management program that includes psychosocial support. So much so, that the World Health Organization, the Centers for Disease Control and Prevention, and the Department of Veterans Affairs have all endorsed buprenorphine as their preferred method as the first line of treatment for opioid addiction. But these endorsements are not the last word in the battle, and the suboxone vs methadone argument continues.
Buprenorphine-based medications however, are not popular in criminal justice circles because defendants have used them to avoid positive drug tests. Further, there have been problems with this drug finding its way into prison systems. In some cases, this drug is being sold on the streets. With this drug, careful monitoring of patients is necessary while using the medication to ensure the appropriate dose is being given. Some also complain that not enough doctors are trained and willing to prescribe the buprenorphine, and that some who do charge cash for visits must hassle with burdensome pre-authorization requirements from insurance.
Collectively, there are options that increase the chances of success in recovery treatment. Medications can play a role in the recovery process, but tricking the brain through the use of medication is only one approach. Training the brain through a comprehensive addiction treatment program is another way.
The two treatments, working together, have shown to increase the chances of success. While the suboxone vs methadone debate continues, recovering addicts would be well advised to examine all options and speak to their treatment professionals.
Each person must do a self-assessment at regular intervals. Post-rehab is a good time to self-assess, initially. Then again as you enter outpatient treatment or sober living.
Only you know best as to how close you are to relapse. Being serious about fending off triggers will help ensure the best possible outcome. Skip to content. Facebook page opens in new window YouTube page opens in new window Vimeo page opens in new window. Methadone vs.
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