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Medication-Assisted Treatment for Opioid Addiction

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Medication-Assisted Treatment for Opioid Addiction

How is Opiate Treatment Medication Effective?

Opioids are the synthetic form of opiates, as they relieve pain by acting on the brain’s same opiate receptors in order to produce parallel effects. Medication-Assisted Treatment for Addiction includes Opioids such as suboxone, methadone, and buprenorphine which are utilized to treat the abuse of opiates and opioids. This is because these medications work to assist recovering addicts’ through the period of withdrawal by greatly reducing the severity of symptoms, while also eliminating the possibility of a potential relapse by blocking the opiate receptors in the brain. Experiencing strong cravings to use, both during and after the course of detox, is extremely common, especially for individuals who have a mental illness. However, when used properly, opiate maintenance treatment can help individuals effectively overcome addiction. In order for an individual to undergo further treatment and therapy, he or she must first successfully gain control over the opiate addiction. This is made possible through the use of opiate treatment medication.

Improving Medication-Assisted-Treatment Practices Could Increase Abstinence Among Recovering Addicts

The Obama administration recently proposed changes to the current addiction treatment system which would improve access to treatment for opioid use disorders. The administration’s proposal is geared towards ensuring American’s who want treatment can find and afford it. The $1 billion investment would be focused on improving availability of services but also improving the coordination and combined efforts of practitioners to improve effectiveness of the treatment system. Specifically, administrators are looking at those treatment models which have yielded successful recovery outcomes and finding ways to make them more widely available. Treatment programs that include 1-3 currently used treatment medications such as methadone, buprenorphine, and naltrexone have proved safety and effectiveness in reducing opioid use and preventing relapse. The administration has finally recognized that current policies enacted by state regulations and insurance requirements are counterintuitive and therefor diminishing the benefits of medical maintenance programs for opioid addiction.  The persistent stigma, lack of understanding for the benefits of medical maintenance programs, and decades of foolish funding have prevented addicts from utilizing the MAT programs and experiencing their benefits.

Confusing Policy & Procedures Diminishing Success of M.A.T Programs

  • Under current law, doctors can only initially prescribe 30 patients and overtime max of 100 patients.
  • Only 28 states currently cover all three FDA approved addiction treatment medications under Medicaid
  • 44 states require prior authorization to receive a prescription
  • 21 states require patients to attend counseling in addition to M.A.T
  • Minimal coverage by private and Affordable Care health insurance for required counseling
  • Health Coverage providers often have fail first policies meaning another treatment must fail first before they pay for a treatment
  • 11 states have life-time limitations on buprenorphine ranging from 12-36 months
  • 14 states impose a maximum daily dose after 6 months of therapy

Limitations and Control

The current rules and regulations that are in existence, are designed to make methadone maintenance safe, but time restrictive. Unfortunately, this system poorly addresses the needs patients in order to successfully in eliminate illicit drug use through methadone maintenance treatment and counseling. Prior to recent alterations in the FDA laws, even patients who achieved the highest success were required to undergo 3 years of treatment prior to being given approval to take home the precise quantity of methadone to last a duration of 6 days. These limitations require frequent clinic visits, hindering patients’ ability to fully reintegrate themselves back into society. This is simply because it inhibits his or her ability to travel, and enforces prolonged contact with patients who are either unstable or less-stable. In addition, due to the fact that these restrictions compel patients who have completed treatment to endure an incessant, inconvenient, and denounced routine, it may lead them to become discouraged. According to a study published in the National Library of Medicine, “Despite the effectiveness of opioid maintenance therapy, its separation from mainstream medicine and its restrictive regulatory structure have limited access to treatment and compromised the quality of care. These problems have created an impetus toward system change, supporting the reintegration of opiate addiction treatment into mainstream medical systems and a reduction of the regulatory burden.”

Commonly Abused Opioids & Opiates

Opiates can bring about the development of a physical dependency, causing a user to experience acute withdrawal symptoms if its consumption is discontinued. If a user feels as though they are unable to make it through an entire day without consuming the substance, this is considered a mental dependence. Both of these forms of addiction have the capability of causing the user to develop a tolerance to the substance, requiring that they raise the dosage in order to achieve the same effect. As a result, the likelihood of overdose or death greatly increases. Generally, most opiates are prone to causing severe withdrawal symptoms when use is stopped. These symptoms include, but are not limited to, shaking or trembling, slurred speech, nausea, and vomiting. Opiates are also known to depress one’s breathing, prompting the possibility of adequate oxygen levels from sufficiently reaching the brain. This can result in a coma. Conversely, when enduring the process of withdrawal, an addict can experience seizures. Naltrexone is a drug that is used in the event of an opioid or opiate overdose to stabilize an individual. This antidote works to counteract the severe effects of the drug that make the overdose fatal. However, despite which opiate or opioid is abused, the intense cravings, as well as the twitching and shakiness, has the ability to direct addicts back into the detrimental cycle of drug abuse

Improving Addiction Treatment

Due to the severity of opioid withdrawal symptoms, patients are typically prescribed an opiate medication; methadone, suboxone, naloxone, or naltrexone. Patients are then slowly tapered off both their addiction and the medication, while also managing other symptoms or addictions. Methadone and suboxone are the more preferred choice in treatment for reducing cravings but also for reducing relapse. It is hopeful with changes to regulations and increased funding as well as awareness will make Medication assisted treatment more widely available and affordable. As a result more addicts will have a chance at successful recovery and be met with options for an effective treatment.

Sources:

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