Did you know?

Medicated-Assisted Treatment (MAT) is the use of FDA- approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.

Medication-assisted treatments such as methadone, buprenorphine, and extended-release naltrexone, are approved by the FDA, and have strong empiric evidence for superior outcomes compared with medication-free behavioral approaches or short-term detoxification. There are however, pros and cons that need to be considered when providing this type of treatment.
Methadone is a synthetic drug that is similar to morphine in its effects but longer acting, and is used as a substitute drug in the treatment of morphine and heroin addictions. Even though it’s safer than some other narcotics, taking it can lead to addiction or abuse. It is a liquid that is taken orally at a certified opioid treatment program (OTP) facility. Pros can include: easy induction following active drug use, lower medication costs, high retention rates, lowered drug use and criminal activity, and a long history of successful use among pregnant women. Cons for this treatment can include: requirement of a daily dose for an extended period of time, limited or no access to programs, programs can be targeted by drug dealers, patients may combine benzodiazepines or other medications to boost methadone levels, it can lead to cardiac arrhythmias, and it is highly stigmatized.

Buprenorphine is an opioid medication used to treat opioid addiction. Buprenorphine can be dispensed for take home use, or by prescription. This in addition to it’s pharmacological and safety profile makes it an attractive treatment for patients addicted to opioids. The purpose of it is to suppress the debilitating symptoms of cravings and withdrawal, enabling the patient to engage in therapy, counseling and support, so they can implement positive long-term changes in their lives which develops into new healthy patterns of behavior necessary to achieve sustained addiction remission. It is also accompanied by a variable list of pros and cons. Pros include: a minimal risk for overdose, it is easily prescribable, has flexible dosing, provides very good pain control when dosed every 6–8 hours, is often included in Prescription Drug Monitoring Programs (PDMPs) and has somewhat less stigma associated with it. Cons for Buprenorphine include: patients must be in mild-moderate withdrawal before taking first dose, it can precipitate painful withdrawal symptoms if taken too closely following full agonist opioids, has street value and can be sold/diverted, patients can intentionally space out doses and use in between, it can be more easily manipulated and injected/abused than methadone dispensed from programs, and stigma still remains.

What We've Learned

Extended-release injectable naltrexone is another pharmacological tool that is approved for treatment of people with opioid dependence. Naltrexone is reported to reduce opioid cravings and to prevent relapse. Patients need to be informed that this medication will prevent them from feeling the euphoric effect or pain relief they previously felt when they took an opioid. Pros of naltrexone include: relief of cravings, patients no longer fear going into withdrawal, blocks opioid use of any kind, injection has twice the retention rates of oral naltrexone, and there is less negative stigma. Cons include: it is the most difficult induction, and requires full detoxification, it can be hard to find providers who have been trained to use, many insurers still do not cover as a pharmacy benefit and have tedious authorization processes, there is no pain relief and must be stopped for surgery/opioid analgesia, and it lowers tolerance making patients more vulnerable to overdose risks with return to opioid use.

So how do these medications differ from one another? Both methadone and buprenorphine are controlled substances, whereas naltrexone is not. Methadone is an opioid agonist, buprenorphine is a partial opioid agonist, and naltrexone is an opioid antagonist.

Additional Insight

Agonists are drugs that activate opioid receptors, binding to them and producing an effect. Opioids such as methadone, morphine, and heroin are full agonists and have the greatest abuse potential. Antagonists also bind to opioid receptors, but rather than producing an effect, they block the effects of opioid compounds. Partial agonists bind to the receptors and activate them, but not to the same degree as full agonists. So what does this all mean? Well, basically it explains why physicians and some treatment centers are reluctant to prescribe agonists to treat opioid dependence because of their treatment philosophies, Physicians with these concerns may be more comfortable prescribing an antagonist, such as naltrexone, rather than agonists.

For most patients with opioid dependence, medications alone are insufficient. Treatment in individual or group counseling sessions and participation in mutual-help programs are also needed. Patients have better treatment outcomes when naltrexone-based treatment is combined with behavioral therapies.

Intervention Services

There is no one right way to address a loved one who may be suffering from addiction. Often the person suffering from the addiction is not only in denial but is unwilling to listen to their family or loved ones. In situations such as these it may be beneficial to seek the help of an addiction professional. Swift Recovery Solutions has certified interventionists that will to meet with you and your loved one. Your dedicated counselor will work with you to determine if the help of an interventionist may be needed.

Family Medical Leave Act

One of the hardest aspects of dealing with addiction is finding the time to not only identify the solution, but to get time off to handle it. Your dedicated counselor will not only help streamline the paperwork but work hand in hand with your HR department to get you the time you need to get better. The FMLA is protection offered to you that guarantees your job will be held for you while you are getting the necessary treatment. Working with HR, Swift recovery solutions will take the burden off you or your loved one, giving you the confidence to start down the path of better happier lifestyle.

Your Health Insurance

Our experts walk you through understanding the complexities of your health insurance, including:

  • Deductible, Out of Pocket Costs, Medications, In network vs. out of network, policy limits and exclusions.
  • The financial burden associated with going to treatment can be daunting. SRS has sponsors and scholarships available to assist in covering the individuals portion of treatment expense’s.

Contact Swift

Reach out at info@swiftrecoverysolutions.com or call us at +1.877.794.3848

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