Is Medically-Assisted Treatment "Just Another Drug"?
Few people jump happily into opioid addiction recovery. They face painful detox and painful withdrawal symptoms. But what if there was a medical path to ease this recovery transition?
Medically-assisted treatment (MAT) does just that. But not everyone understands this, and so there’s the threat of stigma in some recovery circles, including Narcotics Anonymous peer groups. Jacobin Magazine profiled this judgement and its consequences back in 2018: “Narcotics Anonymous as an organization resists full acceptance of medication-assisted treatment patients, often resulting in MAT members feeling rejected or even discriminated against during NA meetings.”
Why does this conflict exist? Is MAT just another opioid to become addicted to?
What Are Medically-Assisted Treatments?
MATs are treatment plans which help those addicted to opioids wean off their physical and emotional dependence on those drugs. There are two critical parts to the treatment: medication and therapies.
Here’s the part which many people don’t understand. Because the medications used for MAT are opioids, critics claim that doctors help opioid addicts get off one drug and onto another. But they misunderstand what these MAT opioids do for the patients who take them.
The two primary MAT opioids (methadone and buprenorphine) aren’t as potent or addictive as opioids like oxycodone, heroin, or fentanyl. There’s still some risk of addiction, but with the mandatory supervision of a doctor, that risk is much less. These medications are weaker opioids—they bring some pain relief, but they don’t give the ecstatic high of other opioids.
And buprenorphine also helps to wean your body off opioid dependence. Let’s back up: methadone and buprenorphine are called opioid agonists (meaning they give physical pleasure), but buprenorphine is also what’s called an opioid antagonist (meaning it counteracts opioids’ physical pleasure). So buprenorphine gives you the physical relief of a weak opioid while also making sure your body has less and less tolerance for opioid use.
That’s what makes buprenorphine crucial. Its pain relief helps patients through painful detox and withdrawal, but its opioid antagonism makes sure that opioids have less effect long term. MAT often pairs it with naltrexone or naloxone, which are stronger opioid antagonists that can cement the body’s rejection of opioid use. Opioid addiction is the enemy of MAT, not the accidental side-effect.
Here are some brand-name medications used in MAT:
- Dolophine (contains methadone)
- Suboxone (contains buprenorphine and naloxone)
- Subutex (contains buprenorphine)
- Vivitrol (contains naltrexone)
MAT also guides patients through integrated one-on-one and peer-group therapies. Where the medications help you break your physical dependence on opioid use, these counseling sessions help you break your emotional dependence on it.
What the counseling includes will change according to your needs as a patient. Whatever it means for your treatment, it’s just as important to your recovery as the medications, and any trustworthy doctor includes them both in your opioid recovery plan.
What Can MATs Do?
MATs can coexist with 12-Step programs like Narcotics Anonymous (notice how peer-group sessions are already built into them). Some opioid treatment centers’ doctors will recommend that their patients join NA groups after they leave inpatient treatment. The groups’ structure and discipline help cement whatever recovery progress the patients have already made.
There are definite benefits for those who receive MATs (like the lower chance of fatal overdose). Their physical dependence requires more than the willpower of some recovery techniques, and so they continue using long-term MATs. Not all NA groups criticize MAT patients or convince them to leave the treatment for total physical abstinence. But because NA groups are autonomous, some groups allow it to happen. The ongoing debate over whether MAT should be accepted in larger recovery circles needs to understand that these medications aren’t “just another drug.”
So What Now?
Maybe you want to learn more about MATs, whether for yourself or for a loved one. We at Buprenorphine Doctors have plenty of resources to answer your questions about opioid treatments, opioid addiction centers, and opioid addiction doctors. With such high stakes, we should be careful to learn as much as we can.