Treatments For Opioid Addiction

Over the last decade, the opioid epidemic has reached unprecedented proportions, with about one in every three Americans knowing someone who is or has been addicted to opioids.

12/21/20224 min read

Over the last decade, the opioid epidemic has reached unprecedented proportions, with about one in every three Americans knowing someone who is or has been addicted to opioids. Every day, 128 persons in the United States die from an opioid overdose, for a total of 67,367 lives lost in 2018. Opioid overdose has been labeled a public health emergency in the United States, as it is currently the top cause of injury-related death.

Fortunately, evidence-based opioid addiction treatment, particularly prescription opioid addiction, is receiving a lot more attention. A biopsychosocial approach is used in evidence-based treatment, which involves medication-assisted treatment (MAT) and behavioral health therapy, such as counseling, support groups, and psychotherapy. Outpatient treatment with buprenorphine, methadone, and naltrexone is known as MAT, and it's crucial for avoiding overdose and death, especially in the early stages of recovery.

Treatment Based on Abstinence and 12-step Programs

There are a variety of community support programs available in addition to evidence-based treatment, including the well-known 12-step recovery programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Bill Wilson and Dr. Bob Smith, both recovering alcoholics, started AA in 1935 with the goal of assisting others in overcoming alcoholism through spiritual pursuit, community support, and accountability. NA was founded in 1953, and AA granted it permission to utilize them.

12-Steps In Its Own Fellowship/Program

Twelve-step programs for the treatment of substance use disorders have proliferated over the world in recent decades. Admitting there is a problem, getting treatment, engaging in a thorough self-examination, confidential self-disclosure, making apologies for harm done, and assisting other drug addicts in recovery are all core NA principles.

Despite the fact that AA has been operating since 1935, 12-step recovery programs have just recently been explored more thoroughly. A recent high-quality study conducted by researchers at Stanford and Harvard Universities concluded that AA is at least as effective as other behavioral health therapies, such as cognitive behavioral therapy (CBT), for increasing abstinence (from alcohol)—this is especially true when patients choose to attend 12-step programs rather than when they are forced to attend (by Drug Courts, for example).

These encouraging results for the use of 12-step programs to treat alcoholism are encouraging, especially since there are few medication-assisted therapies for alcoholism. Naltrexone (Vivitrol) is an opioid antagonist, meaning it blocks opioids in the brain and helps some people reduce their alcohol cravings. There is no evidence-based MAT for alcohol addiction other than naltrexone.

Buprenorphine/naloxone (Suboxone) and Methadone, fortunately, are safe, effective, and evidence-based medication-assisted treatments for opioid addiction. Patients taking buprenorphine/naloxone (Suboxone) or methadone are not considered to be in recovery by 12-step groups like AA and NA... It's not considered abstinence or "clean time." Patients on methadone or buprenorphine/naloxone (Suboxone) who attend 12-step groups are frequently confronted with resistance, discomfort, and pressure to discontinue taking the drugs.

There is no evidence that this philosophy helps people recover safely and effectively. This can be a depressing experience for many individuals in recovery... Discouragement of MAT, on the other hand, raises the chance of relapse, overdose, and death. When he went to his first NA meeting, a patient who was new to recovery made the following reflection:

"After years of using IV heroin, I'd recently began Suboxone... I was finally on the right track, and my rehabilitation was going nicely. I was looking forward to attending the NA meeting and talking with others who were going through similar experiences. However, when I mentioned Suboxone at the meeting, several folks stated I was merely switching from one drug to another and wasn't truly in recovery. I was in such a bad mood. I had no idea what to do... I had no idea what was true".

Dr. Brian Clear, the Medical Director of Suboxone clinic, says, "Many patients benefit from support groups because they foster a good sense of shared progress and accountability, therefore it's disappointing that many NA groups continue to exclude individuals receiving evidence-based medical treatment. A patient's alienation from a support group can be upsetting and even deadly if it jeopardizes their treatment success. I'm looking forward to the day when the 12-step perspective regarding MAT has progressed sufficiently for me to confidently suggest the group."

This isn't to imply that 12-step programs aren't effective. However, in order for community support services to effectively serve patients with opioid addiction, these programs must recognize the importance of MAT as a safe, effective, and life-saving treatment. And, in order to be evidence-based, community support groups should not only encourage patients to get MAT, but also advocate for them to do so. There is no evidence to show that abstinence-based treatment is the best way to treat opiate addiction.

Treatment for Opioid Addiction that is Based on Scientific Evidence

As previously said, there are safe and effective opioid addiction treatments available, such as buprenorphine and methadone, that have a lot of data to back them up. Buprenorphine works in the brain like a partial opioid, unlike oxycodone, heroin, and fentanyl.

Buprenorphine works by binding to opioid receptors and lowering cravings and withdrawal symptoms. Because buprenorphine is a partial opioid, it has a ceiling effect, which means there is no additional opioid effect after a certain dose, lowering the risk of overdose.

Suboxone is a combination of buprenorphine and naloxone that is used to treat opioid addiction. Naloxone (also known as Narcan) is an opioid antagonist, which means it prevents opioids from being released into the brain. As a result, the combination of buprenorphine and naloxone reduces the likelihood of buprenorphine being misused.

Methadone is another evidence-based treatment for opioid addiction, including prescription opioid addiction. However, it is heavily regulated by the government and can only be administered through federally approved outpatient treatment centers. Furthermore, Suboxone clinic prefers to prescribe buprenorphine/naloxone (Suboxone) over methadone because it is largely believed to be safer than methadone, has a lower risk of drowsiness and overdose, and most patients may safely attain the recommended dose within 1-2 days.

To avoid overdose and mortality, medication-assisted treatment is essential. According to studies, 75 percent of MAT patients are still in recovery one year later. We offer MAT with buprenorphine/naloxone (Suboxone) at Suboxone clinic to assist people stop or reduce their opioid consumption. As one sufferer put it,

My life was saved by buprenorphine. I've nearly died so many times due to overdosing. I had no idea that living a regular, happy, and truly satisfying life was possible. I've discovered a ray of hope.