Medication-assisted treatment (MAT) for addiction, especially opioid and alcohol addiction, has been around for many years, and it has often been the subject of debate, though mainly in social and political—rather than medical—arenas. But it has become the focus of even more attention and discussion in the last several years, with the alarming rise in opioid addiction and the number of overdose deaths, and the need to find long-term treatment options that work.
There is no disagreement that the opioid addiction epidemic has grown to become one of America’s biggest health crises. According to the most recent statistics from the Centers for Disease Control and Prevention (CDC), the number of deaths from opioid overdose (including prescription opioids and heroin) jumped by nearly 30% from 2015 (33,091) to 2016 (42,249). And, just as alarming, although it does not get the same attention, more than twice that many people (88,000+) die each year from alcohol abuse.
Naltrexone (also known in injectable form by the brand name Vivitrol) is a medication that was approved by the FDA in 1984 for use in maintenance treatment and is often prescribed in connection with treatment of both opioid addicts and alcoholics. It is a highly effective opioid antagonist that tightly binds to opiate receptors in the brain, blocking the effects of the opiates. And because it has no narcotic effect and is not addictive, patients can use the drug on a long-term basis as a tool in recovery. Patients do not develop tolerance for naltrexone’s opiate-blocking action even after many months of regular use. That is why it is used in medication-assisted treatment at rehab facilities like Asana Recovery, in Orange County, California.
Mary Guingab, a Client Care Coordinator at Asana Recovery, knows how helpful MAT can be for opioid addicts. “I have seen positive effects from Vivitrol and Naltrexone on our opiate addiction clients,” she says. “It has greatly reduced their cravings which often trigger their anxiety. With this medication on board, clients’ attention is redirected to finding healthy outlets to keep a healthy and sober lifestyle.”
The discussion surrounding long-term use of drugs like naltrexone in addiction treatment has several angles: (1) there is the fact that some studies have shown that a high percentage of people who take it as part of their treatment program suffer relapse; (2) there is the persistent view that addiction is a moral failure, the result of character flaws, and that giving the addict another drug is simply indulging their addition; and (3) many of those involved in addiction recovery believe that naltrexone use conflicts with the view of abstinence held by most 12-step programs, like Alcoholics Anonymous, and conventional medical treatment programs.
Therefore, despite its significant potential advantages, naltrexone has not been having much impact on the treatment of opioid addiction in the United States, at least until recently.
Medication-assisted treatment programs (MAT) for opioid and alcohol addiction have been shown to be quite successful long-term, and they have become the standard of care at most addiction treatment centers across the country.
It is important to note that, for naltrexone to be most effective, it should be coupled with other therapies, such as Cognitive Behavioral Therapy, in order to maximize relapse prevention through the development of coping skills. Simply put, naltrexone, while clearly shown to reduce the incidence of relapse, may not be enough by itself to prevent relapse in some patients. But for highly motivated individuals, the most effective treatment programs appear to be those that include the use of naltrexone or similar medication as a tool to supplement other therapies. Guingab adds, “At Asana Recovery, we take a more holistic approach to treatment, and incorporate multiple therapies into individualized programs for our clients, including MAT, which we find to be very effective for many in recovery.”
Fortunately, besides drug and alcohol rehab facilities, more and more of those who play a significant role in the availability of MAT to addicts who seek treatment, such as medical professionals, health insurance companies, government agencies, and the legal system, recognize the benefits of using naltrexone in a recovery program.
In fact, medication-assisted treatment programs for opioid and alcohol addiction have been shown to be quite successful long-term, and they have become the standard of care at many addiction treatment centers across the country, including Asana Recovery.
Opioid users taking medication like naltrexone greatly reduce the risk of relapse, partly because they don’t have to worry about avoiding withdrawal anymore. And individuals in recovery can take it long-term—for the rest of their lives, if necessary, or in some cases, doses may be reduced; it varies from person to person.
Some critics of MAT have argued that using medication like naltrexone or methadone in treatment is simply replacing one drug with another. While that is technically true, there is a hugely important difference. The drug that is being replaced can kill you, while the one replacing it is a drug that can allow a recovering addict to become functional again and achieve or resume a productive, normal life. You are replacing a drug that gets you high with one that doesn’t.
Few people are able to succeed in recovery from addiction by sheer willpower—by pulling themselves up by their bootstraps. The truth is that most need help from sources outside themselves, including positive relationships with others, like family, and therapy to address the underlying causes of their addiction, and sometimes medication can play an important role in recovery. For some, it can make the difference between success and failure.
As attitudes about medication-assisted treatment continue to shift toward, not only acceptance, but recognition of its value as a tool in long-term recovery, we should expect to see it become more prevalent at recovery centers all over the United States, and, along with it, a decline in the incidence of relapse. And, after all, isn’t that what treatment is all about? At Asana Recovery, we focus on what works; that’s why we believe in MAT.