This article is really about the attitude that society has towards MAT, or medication assisted treatment.
Apparently there are a lot of prisons that are denying inmates their medication because they do not buy into the new model and standard of treating opiate addiction.
Obviously there are a lot of people in jails and prisons because of drug addiction in this country. And a lot of those inmates end up in a revolving door system because they end up relapsing and getting into more trouble as soon as they are released. So it would be nice in these cases if the person could actually get their addiction treated properly so that they maintain recovery after being released from prison.
This is not the vision that is held by many prison officials today. They are operating under the old idea that the world is still clinging to from the failed methadone experiment back a few decades ago. Essentially what happened with methadone in the seventies and eighties is that we attempted to replace heroin with a safer drug, and it backfired. People got even more addicted to methadone than they were to the heroin, and it simply perpetuated their addiction rather than arresting it or turning it around. Unfortunately, those same ideas still exist today in the minds of many people.
Bangor Daily News says that “…not enough prison officials are listening to doctors, and continue to run their facilities with the outdated, misinformed understanding that medication-assisted treatment just replaces one drug with another.”
Today’s MAT approach is different. Now we have medications that are not addictive in the same way that methadone was. In order to understand the difference you have to understand a little bit about what an opiate actually is and how it interacts with the human body.
So we all have opiate receptors in our brains, and when we fill those receptors up with an opiate molecule we get relief from the pain we are experiencing. We have that system in our brain as a kind of survival mechanism. Our human body can actually produce its own dopamine when it needs to up to a certain point. So if you are trapped under a tree limb or a rock falls on you in the woods, your brain can order your body to send some extra dopamine through so that you can fight through the situation and try to survive. That is why you have a system in your body of pain and dopamine to control that pain–so that your chances of survival increase.
The problem comes in when you start introducing an opiate drug into your system from the outside, and that opiate molecule fills up the receptors in the brain. At normal doses that are actually prescribed by a doctor, and taken for the right reason, there is no reason for this to cause a problem. However, if the person is abusing the opiate based drug and is consuming large quantities of it, then they are going to create a problem for themselves after the euphoria wears off.
Here is what happens when you abuse an opiate based substance such as vicodin, heroin, or oxycontin: That opiate substance that you are taking is filling up those opiate receptors in your brain, and normally your brain has to have a baseline amount of dopamine in it at all times.
So every day, even right now, your body is sending a tiny trickle of dopamine to your opiate receptors in your brain. That has to be in place for the system to work overall–you need that tiny trickle of dopamine at all times. It establishes the system and allows you better chances of survival. So when you start to abuse opiates every day, your brain realizes that those opiate receptors are being well taken care of by heroin, or vicodin, or whatever you are abusing, and the brain realizes that it does not need to produce its daily trickle amount of dopamine.
So while the opiate addict is bombarding their system with some sort of opiate drug every day, they are essentially “training” their brain to stop producing the daily baseline amount that it normally produces.
This is what creates dependence. This is what sets up the human body for addiction to occur. Our human body needs that baseline amount that it produces every day, and when we abuse opiates we “teach” our body to stop creating that dopamine. So then when we find ourselves going through withdrawal from our drug of choice, our body is not prepared to step in and replace that baseline of dopamine that we all need. That is what puts us into withdrawal and makes the opiate addict experience all sorts of nasty withdrawal symptoms.
The length of time that an opiate addict abuses their drug of choice is an important factor in all of this. The longer that they have been abusing drugs, the more their body is now “trained” to not produce the daily baseline of dopamine that we all need in order to function.
This is where MAT and Suboxone (or Subutex) come into play. Suboxone is the new standard of treatment when it comes to opiate addiction because it is a partial opiate that has very low abuse potential that can fill in all of those starving opiate receptors in the brain of a suffering addict and give them relief from craving.
In the past we used methadone, which was a full opiate. Methadone simply got people high, because that was all it knew how to do. It is a full opiate and it hits with roughly the same force as other full opiates such as morphine or vicodin or heroin.
Suboxone is different because it does not produce euphoria if you take more and more of it. The molecules of Suboxone simply fill up those hungry receptors in the brain and then they stop. They do not get the person high, and the effect is not increased by taking more of the drug.
This is effective MAT and it allows the recovering opiate addict a chance to shake off the cravings and urges as they learn how to navigate early recovery.
So the problem that we are experiencing today is a mindset towards MAT in general. Half of the world believes that this is the new standard of care and that it can really help people, and they have the studies and the data to back that claim up, especially when it comes to opiate addiction. The other half of the world is stuck in years past and they remember what a disaster methadone was and they believe that any form of MAT is just a temporary band-aid that is replacing one drug with another.
The truth can be found in the treatment industry, where real professionals are treating addicts every day as best they can, and they are collecting data as they do so, and they are learning the best methods and what the new standard of care is. If you want to know the truth then you should look at the research and the studies being done. Those studies show that we need to rethink our ideas about MAT and embrace the new paradigm.