Medical News Today says that “Scientists have tested a non-addictive painkiller in primates and found it to be safe and effective.”
A team of researchers in NC have developed a drug that seems to have the pain relieving properties and potential of morphine, while only requiring about 1/100th of the dose. At the same time, the new drug does not really target the opiate receptor in our brains that seem to cause addiction, and the substance also seems to be a “blocker” in much the same way that Suboxone is when it comes to blocking other opiate abuse.
So it all sounds very good on paper, and it has apparently passed clinical trials at the level of monkeys. They are about to move the testing into human phases to see if the drug can prove to be safe enough. If it is then they are going to bring it to the market.
If all of the promises come true then this could indeed be a helpful ally in the fight against opiate addiction. However, we should remain cautiously optimistic while keeping in mind a few key principles that have been learned–some would argue the hard way–through our trials with other MAT options such as methadone and suboxone.
I am not necessarily against MAT as a method of treating opiate addiction, but I want to share my experience in working with those in addiction as a cautionary note.
I think one of the biggest problems comes in when the substance abuse community starts to see an MAT option as being a “magic bullet.”
I have worked in an inpatient treatment facility for many years now. I see this scenario happen over and over again, and I think that it perfectly highlights the danger that happens very typically with MAT options. Let me run through the scenario with you a moment:
A struggling opiate addict comes into a treatment center, likely a 28 day residential program that also includes a medical detox. They go through the detox portion of treatment and they are typically given Suboxone in order to get through opiate withdrawal.
Now the typical opiate addict has had their ups and downs, they have had their trials and their struggles with addiction, and they have likely gone through some periods of abstinence from their drug of choice. They know what withdrawal feels like and they know what it means to crave opiates.
This person has also tried to control, limit, or eliminate altogether their opiate dependence problems. They have tried various ways to limit their drug use or eliminate it entirely. And they have failed repeatedly to do so.
Most acutely they remember the physical cravings and the dependency on the opiate of their choice. They very much know what it feels like to crave opiates, to be going through serious withdrawal symptoms, and the intense relief that they got when they finally caved in and relapsed, going back to the opiate treadmill.
Keep in mind that the vast majority of alcoholics and drug addicts are not stupid people. They are not addicted because they lack intelligence. Many addicts are just as smart as the average human, some of them even smarter. It is important to understand that intellectual capacity is not the determining factor in someone who is addicted to opiates. The equation is not “stupid people get addicted, smart people avoid dependency.” That has been proven false over and over again. There are many doctors, lawyers, surgeons, and research scientists who–believe it or not–have fallen victim to alcoholism or opiate addiction. This is not about being smart or stupid.
That said, go back to our hypothetical opiate addict who has just landed in detox. This is a smart person of at least average intelligence. They know that they have a problem with opiates. They know they are addicted. And when the get into a medical detox and they are given Suboxone or Subutex, they get that feeling of relief.
Then the person is told that they could have the option of using MAT, such as Suboxone, as a maintenance type drug to help them through the first few months of their recovery.
Now here is the key:
This person is also being told that MAT works best if it is used in combination with daily AA or NA meetings, therapy, group support, counseling, and all of the other treatment and aftercare suggestions that you are flooded with while in rehab.
The experts are saying: Take this Suboxone along with all of this other therapy, group support, and hard work that we are recommending, and you will do well.
But the addict is smart. They are, perhaps, too smart for their own good. And they believe that maybe–just maybe–they don’t really need all of those meetings and therapy and support, as long as their physical cravings for opiates are removed by this magic pill, by this MAT, by Suboxone….or by this new “non addictive” opiate drug that may hit the market soon.
Smart people are efficient. They look for shortcuts and do not waste time or effort. So it is not stupid for an opiate addict to assume that perhaps they will be just fine with the magic pill, and all of that extra support, therapy, and daily meetings are for….shall we say…..less intelligent addicts? Could that be the case?
Every smart addict is going to test this out. Every smart addict or alcoholic is going to seek shortcuts. That’s what they do–they are smart folks who are not looking to do a lot of extra work. Going to an NA meeting every single day for the next 90 days, for the next few years, for the rest of your life–that is a LOT of extra work (if it is not necessary).
And so therein lies the danger in MAT, in the next magic pill solution that comes along: It diverts our attention away from real recovery.
Why work the steps, spill our guts, get honest in therapy, and challenge ourselves to self improvement if we can, instead, pop a magic pill every day?
My experience with MAT (and Suboxone particularly) has been this: Those who seek it out most adamantly often come back to treatment a second time because they relapsed. In other words, those who are clamoring the loudest for MAT solutions are people who are looking the hardest to find the easy button, the shortcut, and those are the people who often relapse.
That is just my subjective observations, my own experience, and you can take it for what it is worth–one person’s opinion. But I think that it still stands as an important cautionary tale, and that we would all do well to keep each next “magic pill” that comes along in proper perspective.