How Effective is Medication in the Treatment of Addiction

Treatment for addiction with medicine-based therapy does not amount to pushing the envelope in the process of curing any addiction but it can make people productive again and lead normal lives as opposed to craving and seeking an illegal substance.

Misinformation or a lack of knowledge on Medication-Assisted Treatment/Therapy (MAT) may drive you to search for other methods of recovery from addiction.  This is why it is necessary to get well-versed with MAT.

Medication-Assisted Treatment/Therapy works by using opiates that are released in the neurological system. They cross the barrier of blood-brain and attach to receptors that are present on the brain cells. This process triggers an outpour of neurotransmitters and generates a high that is felt by the receiver.

This medicine-based treatment technique generally works in one of the two ways:

  1. Doctors may prescribe patients opioids that will trigger the same receptors that but are      absorbed in the blood over a longer period of time, rebutting the withdrawal symptoms and breaking a psychological link between consuming a drug and instantly feeling high.  Methadone is an example of such a medication, and is officially referred to as a full mu-opioid receptor agonist.  Another example isbuprenorphine which is a partial mu-opioid agonist.
  2. Doctors may prescribe antagonist opioids such as naltrexone or naloxone. They are drugs that cover the same receptors and creates barriers against them. And if the condition of any patient deteriorates or relapses, they should not feel euphoria if an illegal opioid is used, unless that dose is large enough to displace the blocking drug.  Opioid cravings are reduced as well and there is no abuse potential with naltrexone, or naloxone.

Is MAT genuinely the way to go to cure any addiction?

So far, the data and the statistics that show the success rate of MAT is significantly high enough to outweigh any drawbacks. Better outcomes are seen with this form of therapy than those without medication assistance. It reduces the danger of relapses, has the potential to prevent grave diseases like HIV, and has been known to be effective in preventing overdoses.

In spite of all the positive outcomes, experts believe there are quite a few gaps in this technique. One of the gaps is determining the suitability of each drug for an individual. It is of utmost importance to choose the right drug for the right patient. Each drug has different risks and benefits for different psychological states. For instance, the patient can overdose and die on methadone whereas they cannot have any such ill effects from naltrexone and with buprenorphine it becomes less likely.

Ultimately, the decision is made through discussions between the patient and the medical professional who decides the best course of treatment. Working together is the best course to determining what the right treatment for each patient will be.

Opioid Use in the United States

The use of opioids is widespread and common in many first-world countries and is only globally second to cancer medicines in the rate of usage. Hundreds of millions of pain prescriptions are written each year, for various reasons, and the market for opioids is around $24 billion, an astronomical amount. While you would think that this number would be distributed throughout the world, it’s unfortunately mostly concentrated in the United States. This number works out to around 80 percent of opioids being used in the United States.

Lack of limitations

One of the reasons that the United States leads with the amount of opioids prescribed and used is likely the past lack of limitations on the drug. Previously, people who used opioids for pain relief were easily able to get multiple prescriptions from different doctors or have prescriptions renewed before they should be in an effort to take more medications. Another difference between the United States and other countries in opioid prescription is medical culture.  American doctors were much more willing to prescribe the pills for people suffering from acute and chronic pain. In other countries, opioids are only prescribed in extreme trauma cases, like childbirth, severe burns, and end-of-life care. Studying in Europe it was rather rare to see patients ask or receive the various potent opioids inappropriately.  Conversely, when I started my training nearly ten years ago the culture was to liberally give out opioids at the slightest whimper.  Since U.S. doctors were more willing to prescribe opioids, less serious medical conditions were and sometimes are treated with opioids.  Only now is the pendulum swinging the other way and there have been new regulations limiting opioid prescribing.  

Amount of prescriptions

According to the American Society of Addiction Medicine (ASAM), a number of opioids prescribed has quadrupled, with close to 300 million prescriptions written in 2012, “which is enough to provide every American adult with a bottle of opioid pills”. Not every American adult has a bottle of opioids, which is even more concerning because it means that others have lots of different opioids they’re constantly taking. While it may be still fairly easy to acquire a prescription from a doctor, many people also receive their opioids from family members or friends who have their own prescription.

High risk of addiction

Opioids whether legal or illegal can be extremely addicting, which is why it’s so concerning at the rate they’re being used in the United States.  In this document, ASAM breaks down a lot of the numbers associated with opioid use and addiction. People are willing to share pain medication, especially when they receive it for less serious medical conditions and then end up having pills or prescriptions left over that they can give to loved ones suffering from chronic pain, or to sell. Unfortunately, opioids are also a gateway to heroin usage. Many people initially start taking opioids and then work their way up to heroin, because they’ve become addicted to their prescription pills and need to get that high. It’s important to limit, or at least carefully monitor, the amount of opioids being consumed in the United States.