This #MentalHealthMatters post is written by Gerard M. Papp, DO, Medication Assisted Treatment (MAT) Physician, Ravenwood Health. Read part one here

Continuing with our last blog, Pathways Out of Opioid Use Disorders (OUD) and Addiction, we would like to expand our discussion on the fourth of six pathways out of addiction.

The fourth, and probably the easiest and most effective treatment avenue is Medication Assisted Therapy, or MAT. It is the most efficient way to help those with opioid addiction recover their lives and self-image.

 

There are three important components to MAT:

  • Medications
  • Suboxone (buprenorphine) or Vivitrol (Naloxone) for some OUDs.
  • Counseling
  • Support from family and friends

This three-pronged approach usually produces a 70-75% success rate.

KEY QUESTIONS to consider for anyone entering a treatment program, with the desire to take a pathway out of addiction*:

  • What are your goals?
  • What matters most to you?
  • How important is it for you to quit using?
  • How confident are you that you can quit?
  • What are you willing to do at this time?

Opioid Side Effects:

  • More drug is needed to obtain the desired effect.
  • Individuals feel sick, in an early stage of withdrawal, from opioids in their body changing brain chemistry.
  • The sickness is withdrawal; the solution is simplifying the brain chemistry.
  • ADDICTION IS A CHEMICAL BRAIN DISORDER, rather than a psycho-social malady.

The primary, predictable clinically-efficient MAT is buprenorphine (Suboxone) which is a partial agonist competing with opioids in the brain. Opioids are classified as Controlled Substances, Classes II, III, IV, and V. Marijuana, in comparison is Class I.

Predictably reducing withdrawal within two hours of induction, moreover over the course of treatment correcting the brain chemistry, essentially leads to NO WITHDRAWAL.

Cravings, in which the mind develops an overwhelming desire for drugs, is simulated by people, places, and things. It gradually resolves over six months if the triggers can be reduced.

The duration of buprenorphine in the brain lasts 30-37 hours and has rapid absorption under the tongue. It changes the brain chemistry predictably with the addition of naloxone. 

This pathway requires behavior change through the five various stages and patient commitment with expected periods of relapse.

*Adapted from a presentation by NEOMED Christina M. Delos Reyes MD, Opiate Project Coordinator ECHO

Future blogs will continue our discussion on pathways out of addiction, expanding on:

  • Marijuana, Class I Controlled Substance
  • Naloxone
  • Five Stages of Behavior Change
  • Relapse

 Dr. Papp is currently reading Dreamland: The True Tale of America’s Opiate Epidemic, by Sam Quinones.