There is a growing trend in recent years towards the advent of medication assisted treatment in the field of alcoholism and drug addiction therapy, also known as MAT. But not everyone is on board with the idea that we could possibly cure addiction by giving more medications to people. At Staten Island Live http://www.silive.com/news/index.ssf/2016/12/suboxone_starts_shift_in_treat.html they say that many “believes there’s a lot of push back against MAT because people feel it’s substituting one substance for another.”
In other words, public perception of MAT is that it merely substitutes one drug for another. Perhaps this is because in past decades the biggest example of MAT was the methadone program in which a very powerful opiate drug (methadone) was being substituted for heroin. In many ways the methadone turned out to be nearly as bad as the heroin was, and in some cases it was even more addictive. So public perception may be tainted due to this rocky past when it comes to MAT.
The truth is that today we are constantly developing new medications that are not necessarily as bad, or as addictive, as methadone was. Suboxone therapy is a great example of this. Suboxone is a medication for treating opiate cravings, much in the same way that methadone is used. The difference though is that Suboxone is only a partial opiate rather than a “full opiate” like methadone. In other words, you cannot really get “high” on Suboxone, not in the same way that you can on other opiate drugs. If you keep taking Vicodin or heroin or methadone, eventually you go into a coma and die. If you keep taking Suboxone you don’t get any “higher” from increased amounts. It simply fills up your opiate receptors and then stops flooding the brain with more medication. It is a partial opiate rather than a full opiate.
Not only do we have newer medications such as Suboxone that are less addictive, but there is lots of research being done right now for new medications to fight back against other types of addictions as well. So there are medication trials going on right now for new medicines that can help with cocaine or meth cravings, for example. And there are several medications that are designed to help curb alcohol cravings for alcoholics. And again, there are new medications being developed and put into trials all the time, and they continue to roll out slowly to the world.
One of the big problems, however, is that not all doctors can prescribe some of these new anti-addiction medications. This is because you often need to take a special training course in order to, say, prescribe Suboxone for the purposes of opiate addiction. For example, Press Herald http://www.pressherald.com/2017/01/08/hurdles-dissuade-doctors-from-providing-suboxone/ said research “estimates that only 5 percent more doctors have become regular Suboxone prescribers since work to persuade them to join the ranks started last summer.”
So there is this medication (Suboxone) that has proven to help with opiate cravings, and it has shown to be effective in double blind, placebo controlled studies, and yet they have made it very difficult for doctors to be able to prescribe it to patients. Only about 1 out of every 20 doctors has had the time to take the course that allows them to treat addicts with this medicine. This is certainly a huge barrier to getting the opiate epidemic taken care of that has swept the United States in recent years. Why not make it easier for doctors to help opiate addicts, especially when the abuse potential of Suboxone is about a thousand times lower than any other opiate? This is something that will need to be addressed if MAT is going to gain any kind of mass acceptance.
There is a public assumption, I believe, that modern medicine should be able to cure things. That if we throw enough money at a medical problem, we should be able to make it go away through sheer force of science and research. There is an assumption that if, for example, the president of the United States had an addiction to opiates, that the highest levels of modern medicine should be able to hand the president a perfect solution that will effectively cure the problem.
The truth is that no such tidy solution exists when it comes to drug and alcohol addiction. There is no magic bullet, no sure fire treatment, no matter how much money you throw at the problem. We are only about a hundred years or so in terms of medical development when it comes to addiction, whereas most areas of medicine have more like several thousand years of knowledge and research that has been building up. We are only starting to explore how we might “fix” or “cure” the problem of addiction. We know only a little so far.
That said, we are learning rapidly. New medications are being developed on a continuous basis to help treat addiction. I think a turning point may be reached in terms of public opinion regarding MAT at some point. This will only happen after a large number of struggling addicts or alcoholics will have their recovery significantly impacted by a new medication. In other words, people need to see the results happen on a broad scale before they truly accept that MAT is beneficial for addiction recovery. Until then, until we see widespread success with these medications, I don’t think we will see the current stigma change too much. The problem is that so many prescription drugs already have the potential for abuse, and people know this. Everyone knows that if you take enough of the right prescription drugs you can get high from it. So giving prescription medications to addicts and alcoholics is going to continue to raise eyebrows from the general public, at least until we can show MAT working on large groups of people.
Hopefully there continue to be more medical breakthroughs, and perhaps one day we can look back at this time in history and wonder how we could have been so primitive in our medical technology. Hopefully we will have a medication that perfectly fixes or cures just about any type of addiction that is out there. But for now we have to be realistic and work with the medicine that we have. There is some MAT options out there but not a ton of it. More is coming, but we are far from having an actual cure at this point.
It is important to get real treatment and therapy alongside of any MAT that you may be using to treat your addiction. For now, pretty much every MAT option performs significantly better if you combine it with counseling, therapy, and 12 step meeting support. In other words, it is not yet a magic cure. But it can certainly help in some cases. Talk to your doctor or ask your treatment provider if there are MAT options that might help you. Also, keep in mind that starting MAT after inpatient treatment is nearly always the preferred path to better outcomes.