Medication-Assisted Treatment: Why This Emerging Therapy Saves Lives & Money

Treating drug addiction with drugs?

The idea sounds self-defeating, but it isn’t. Of the many complications drug use causes, the most feared is the condition called “withdrawal.” Taking place when drug use suddenly stops without tapering off, withdrawal is a collection of unpleasant and often serious symptoms which can cause a drug user to abandon their attempt to get clean before it even starts.

Fortunately, there’s an alternative: Medication-Assisted Treatment, or MAT.

MAT allows patients seeking treatment to gradually wean themselves off their substance, allowing treatment to progress without having to go through the process of withdrawal.

Sound like a shortcut, or a way to get around doing the hard work of getting sober?

It isn’t. MAT isn’t a magic cure for addiction, and it’s not a way to coddle patients or deprive them of what some think they have coming to them. Believe us, people in rehab have punished themselves enough. MAT is simply a way to fight the overdose crisis, help patients in a new, effective way and keep them on the right path.

And a recent study from Stanford University shows other benefits as well.

A Therapy Which Saves Lives … and Costs

For the study, researchers from Stanford teamed up with the VA Palo Alto Health Care System to analyze how cost effective 26 different opioid use disorder treatments were.

After looking at 100,000 patient records over 5 years, they discovered two things: first, MAT therapy lowers overdose deaths.

The researchers’ projections unsurprisingly showed deaths decreased with every form of treatment when compared to no treatment at all. However, when MAT was combined with other therapies found at drug treatment centers – contingency management, the availability of naloxone and education – the total number of deaths dropped considerably.

Secondly, MAT appears to save money.

“When savings in criminal justice costs were included, all forms of medication-assisted treatment (with buprenorphine, methadone, or naltrexone) were cost-saving, with lifetime cost savings per patient on the order of $25,000 to $105,000,” a Stanford news story reported.

In a Yahoo Finance story, Drug Policy Alliance deputy director Sheila Vakharia, PhD, said the results weren’t surprising. “Anyone who’s out there on the ground and seen this firsthand could tell you the cost effectiveness,” stated Vakharia.

Why Would You Need Drugs To Treat Opioid / Opiate Addiction?

First, let’s clarify something: “opioid” and “opiate,” while sounding similar, describe slightly different things. The Centers for Disease Control and Prevention describes them like this:

• Opiates are naturally derived opium-based drugs, such as codeine, heroin, and morphine.

• Opioid is a sort of catch-all term for all natural, hybrid and synthetic chemicals which interact with the brain’s opioid receptors (more on them later). Synthetic opioids include fentanyl; hybrid opioids include hydrocodone.

We’ll be sticking with “opioid” for this blog. Whatever you call them, the effects on the body are largely the same: prolonged use throw our bodies off balance.

Medical pros call it “homeostasis,” which is the term for the balancing act our bodies perform every day in maintaining our systems. Drug use causes the nervous system to release large amounts of the neurotransmitter dopamine, part of our brain’s reward system.

Over long-term drug use, homeostasis will compensate for the added amount of dopamine. When a person stops using that drug suddenly, without tapering off, it throws homeostasis into chaos. This causes withdrawal.

And make no mistake: opioid withdrawal is hard. Symptoms are like a bad case of the flu, coupled with anxiety and intense cravings.

Withdrawal is often a major stumbling block for people with opioid use disorders. Many opioid users want help, but the idea of a lengthy, unassisted withdrawal period can be too much to face for a person already struggling.

Fortunately, MAT therapy provides an easier path through withdrawal.

How Do Medication Assisted Treatment Medications Work?

Our nerve cells are lined with receptors, molecules which act sort of like sensors for the cell. Some of these receptors are tuned to opioids.

When a person takes an opioid drug like fentanyl or hydrocodone, opioid molecules attach to these sensors, blocking pain signals. The nerve cells also release amounts of the neurotransmitter dopamine, creating a sensation of euphoria – the high which drives addiction.

MAT medications work in part by disrupting how opioids interact with receptors. Also, most reduce to varying degrees the often painful and unpleasant symptoms of withdrawal.

Here’s a simple review of how some of the more common MAT medications work. All MAT medications are prescription only and their use is tightly regulated:

• Buprenorphine: Like other opioids, buprenorphine is used to treat pain and is commonly dispensed under the brand names Sublocade and Subutex. However, the Food & Drug Administration allows it to be used in treating opioid addiction. While it has the painkilling effects of other drugs, buprenorphine provides a weaker sensation of euphoria when used, allowing addicts to taper down the amount they use while avoiding withdrawal.

• Methadone: In use since the 1950s, methadone allows patients with opioid use disorders to manage their addiction in a safe, clinical environment. Also, it allows the patient to lessen the effects of withdrawal.

• Naltrexone: Often prescribed under the brand name Vivitrol (a long-lasting injectable version of the drug), naltrexone works somewhat differently than other MAT medications. While naltrexone does reduce withdrawal symptoms like intense cravings, it also blocks opioid receptors, meaning patients experience no high when they use this drug.

All these medications are meant to be administered in a clinical setting while receiving treatment for addiction.

The Bottom Line: Professional Help Saves Lives

Again, MAT is not a cure-all; it’s simply a new, effective part of a dynamic addiction treatment plan. While recovery from opioid addiction will never be easy, it’s less daunting when it’s done in a clinical environment using evidence-backed methods.

The Forge Recovery Center prides itself on creating a caring, safe space for recovery from opioid use disorders. We’re proud to feature medication-assisted treatment among our treatment modalities. If you want to know more, or explore a consultation, please contact an expert today.