Opioid Addiction Treatment
An estimated 2.1 million people in the United States had a substance use disorder related to prescription opioid pain medicines in 2016. That’s a staggering number of people affected by this national opioid epidemic. While there are several effective treatments for opioid use disorders available, many programs and services are underutilized by those who need them most. Medication-Assisted Treatment (MAT) is the treatment option of choice for opioid addiction.
What is MAT for Opioid Use Disorders?
There are currently three FDA-approved medications used to treat opioid use disorders including:
According to NIDA, “these medications reduce the negative effects of withdrawal and cravings without producing the euphoria that the original drug of abuse caused. Methadone and buprenorphine are medications approved for this purpose.”
About Methadone and Buprenorphine
Methadone and buprenorphine “trick” the user’s brain into thinking it is receiving the abused opioid drug, and thereby stops the individual’s intense cravings for their opioid of choice. Methadone has been in use as an opioid treatment since the late 1940s. It is considered a synthetic opioid agonist that eliminates withdrawal symptoms. Buprenorphine is a partial agonist, which binds to opioid receptors in the brain but doesn’t activate them like the opioid drug will. Buprenorphine, approved for use in 2002, can be prescribed by a certified physician outside of a treatment clinic; Methadone, however, can only be given through a SAMHSA-certified opioid treatment program.[Source: NIDA]
MAT programs offer safe and effective ways to counter withdrawal symptoms to overcome opioid use. According to SAMHSA, “Research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability.”
Naltrexone for Opioid Use Disorder Treatment
According to NIDA, “Naltrexone is an opioid antagonist, which means that it works by blocking the activation of opioid receptors.”
Naltrexone is different from methadone and buprenorphine because it actually prevents any opioid medication from producing the euphoric effects in a user. In essence, it prevents an opioid user from feeling high. Prescribed as an oral pill, naltrexone can also be given as an extended-release injection. However, medical managed withdrawal (detoxification) from opioids should be completed at least 7 to 10 days before extended-release injectable naltrexone is initiated. [Source: SAMHSA]
Which medication for treating an opioid addiction is right for you?
SAMHSA has an online Recovery Tool that highlights some of risks, side effects, and medication interactions associated with MAT for opioid use disorders.https://archive.samhsa.gov/MAT-Decisions-in-Recovery/section/which/compare.aspx]
MAT programs for opioid use disorders have proven to be highly successful, especially when prescribed as part of a comprehensive treatment program that includes counseling, behavioral therapy, and social support.
- Substance Abuse and Mental Health Services Administration (SAMHSA) - https://www.samhsa.gov/medication-assisted-treatment/treatment
- SAMHSA – Buprenorphine - https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine
- SAMHSA – Methadone - https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone
- SAMHSA – Naltrexone - https://www.samhsa.gov/medication-assisted-treatment/treatment/naltrexone
- National Institute on Drug Abuse (NIDA) – Medications to Treat Opioid Use Disorder - https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/overview
- NIDA – How effective are medications to treat opioid use disorders? - https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/efficacy-medications-opioid-use-disorder
MAT Combined with Counseling and Behavioral Therapy
While Medication-Assisted Treatment for substance use disorders alone has been proven to be effective for many individuals struggling with addiction, MAT combined with counseling, behavioral therapy, and social support can be even more successful. MAT is primarily utilized to treat opioid use disorders. However, for opioid users as well as those struggling with alcohol and tobacco use disorders, the combination of therapies can have long lasting results.
According to SAMHSA, combining MAT with counseling and other therapies “provides a “whole-patient” approach to the treatment of substance use disorders. Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery.” [Source: SAMHSA]
Types of therapy approaches include:
- Cognitive-behavioral therapy
- Group therapy
- Individual counseling and psychotherapy
- Motivational Enhancement Therapy (MET)
- SAMHSA - https://www.samhsa.gov/medication-assisted-treatment/treatment
- SAMHSA - https://www.samhsa.gov/treatment
Behavioral therapy helps people who suffer from a substance use disorder handle the social and environmental pressures that may have lead to the substance use in the first place. Counseling and therapy provides people with coping skills and ways to change their behaviors and compulsions. 12-step programs (such as alcoholics anonymous or narcotics anonymous) are prime examples of behavioral and support programs available in communities across the nation.
The National Institute on Drug Abuse (NIDA) explains the benefits of a variety of behavioral therapies here: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies
 Substance Abuse Center for Behavioral Health Statistics and Quality. Results from the 2016 National Survey on Drug Use and Health: Detailed Tables. SAMHSA. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.htm. Published September 7, 2017.