treat opioid abuse effectively

The Principles Of Successful Opioid Addiction Treatment

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There are a few simple facts to be aware of. The first is that addiction is a disease and, like most other diseases, it can be treated. Evidence-based treatment options have been developed, including methadone maintenance treatment (MMT) for opiate addiction, for instance. When successful, it means that patients are able to stop abusing opioid drugs and can once again lead a happy, healthy, and productive life.

Relapse Is Not Failure

Another important fact to be aware of is that addiction cannot always be cured. It is a chronic disease, just like asthma and diabetes, which means people need to learn how to manage it. What this also means is that, even if successfully treated, relapse is common.

“Chances of addiction relapse are higher than those for any other drug addiction, with one study reporting that as many as 91% of those in recovery will experience a relapse. The study also found that at least 59% of those who had an opiate relapse would do so within the first week of sobriety, and 80% would relapse within a month after discharging from a detox program.”

Relapse is so common that it is seen as a normal part of the overall addiction recovery process. The rates, as described above, are very high, just as they are with asthma, hypertension, and diabetes, all of which are also chronic, and all of which also have both physical and psychological elements. If a chronic illness is to be properly treated, it means that behaviors and habits that people have developed over many years have to be changed, something that is incredibly hard to do. When patients relapse, therefore, their treatment hasn’t failed. Rather, it means they require more treatment or that they should attempt a different type of therapy.

The Principles of Effective Treatment

There has been a lot of research to demonstrate that, when available, both medication and behavioral therapy should be offered in order to increase the chances of success. It is vital that the approach to treatment is tailor-fitted to the needs of the patient, which is based on drug abuse history, medical history, and social, psychiatric, and medical problems. What matters overall is that addiction doesn’t have to be a death sentence.

Using Medication Like Methadone for the Treatment of Opiate Addiction

Studies have shown that there are many different medications that treat different types of addiction and that offer help in different ways. For instance, tobacco addiction can be treated using nicotine replacement therapy (NRT), like nicotine gum, inhalers, and patches. Alcohol addiction can be treated using disulfiram, naltrexone, or acamprosate. Opioid addictions, meanwhile, can be treated using naltrexone, buprenorphine, and methadone.

Medication does three key things for the treatment of addiction:

1. It helps fight withdrawal symptoms associated with stopping the use of a particular addictive substance. These symptoms are both emotional and physical and include mood disorders such as anxiety and depression, sleeplessness, restlessness, and more. Drugs, such as methadone, help to stop these withdrawal symptoms from occurring, making it easier to undergo rehab.
2. It helps patients remain under treatment. It is common for drugs to be offered under medical supervision to avoid the withdrawal symptoms, after which the patient is slowly tapered off the drug. What this means is that patients remain calm and do not experience the strong cravings that so often lead to relapse. Through this, patients are encouraged to remain in treatment while engaging more in psychotherapy, behavioral therapy, and counseling.
3. It helps to prevent relapse. It is a known fact that there are certain triggers that make relapse more likely, with triggers being unique for each individual.

“One of most effective techniques for preventing relapse is to identify your personal relapse triggers and make a detailed plan on how you will manage them.”

There are some common triggers: drug cues (moods, things, places, and people), stress, and drug exposure. By providing medication, it is possible for these triggers to lose their strength, thereby allowing patients to keep themselves on the road to recovery.

What About Behavioral Therapy?

The fact that methadone is an effective treatment for opiate addiction is beyond question. However, it should not be seen as the only treatment available. Rather, it should be part of a continuum of treatment that also involves behavioral therapy.

“Behavioral approaches help engage people in drug abuse treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviors related to drug abuse, and increase their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive abuse.”

Behavioral therapies address every element of a person’s addiction disease. It often includes one to one counseling, cognitive behavioral therapy, group therapy, and family therapy. In certain centers, and particularly luxury and private rehab centers, other forms of treatment such as equine therapy and art therapy can also be offered. Behavioral therapy not only provides patients with better coping and life skills, it also helps them come to terms with their past and may even make medication more effective.

How to Recover from Opioid Addiction

Recovering from an opioid addiction is a very complex and long process, but it is possible. When people first seek methadone treatment, they are often at their very lowest, having their lives completely taken over by their addiction. They are compelled to seek out more drugs and this compulsion has taken over their life. Methadone can break this cycle, giving patients the clarity that they need to stick to their treatment. Slowly but surely, they can learn to manage their disease, be offered positive reinforcement solutions to help avoid relapse, enhance their motivation to stay in treatment, and develop new relationships with their families and support networks. Methadone in itself does not make this possible. Rather, it makes it possible for people to become receptive to other forms of treatment, as it stops addicted individuals from compulsively seeking out their particular addictive substance. In so doing, they get a real chance at recovery.

If you or someone you love is struggling with an addiction to opioid drugs and want to find options for methadone treatment near you, give us a call at (855) 976- 2092.

Sources

[1] Opiate Relapse. (2018, November 25). Retrieved from https://drugabuse.com/opiates/relapse/

[2] The 10 Most Common Addiction Relapse Triggers – The Cabin Chiang Mai. (2018, August 29). Retrieved from https://www.thecabinchiangmai.com/blog/10-most-common-addiction-relapse-triggers/

[3] NIDA. (2018, January 17). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition on 2019, February 19

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Details About The Methadone Clinic

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Methadone clinics are specialized services offered to people who have an opioid addiction, including drugs such as heroin or prescription painkillers. At the clinic, they can receive treatment that is based on medication, most notably methadone, brand name Dolophine.

“This medication is used to treat severe ongoing pain (such as due to cancer). Methadone belongs to a class of drugs known as opioid (narcotic) analgesics. It works in the brain to change how your body feels and responds to pain.”

The Substance Abuse and Mental Health Services Administration (SAMHSA) has stated that methadone can be prescribed in wafers, liquids, or pills. It has been found to stop the effects of other opiates, thereby helping to break through the addiction. However, methadone must be prescribed by a physician as it is a Schedule II drug.

“Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous.”

Methadone is a very effective treatment for opioid addiction if administered properly. Indeed, it has the potential to change lives for the better. However, it is not a cure for addiction, but rather a component of the overall rehabilitation process.

Types of Methadone Clinics

There are two main types of methadone clinics: public and private facilities. Both are strictly regulated by federal and state laws. The treatment they offer leads to a number of specific benefits, including the fact that methadone treatment can help avoid withdrawal symptoms and cravings for the drug and that it stops other opioids from being effective.

Who Needs Methadone Clinics?

Methadone clinics exist in all 50 states and the District of Columbia and, according to SAMHSA, they are being used quite significantly and increasingly so.

“In 2011, 9 percent of all substance treatment facilities had OTPs. This percentage has consistently been between 8 and 9 percent since 2001, when the Substance Abuse and Mental Health Services Administration began certifying OTPs. While the number of facilities with OTPs has remained constant at around 1,100 to 1,200 since 2003, the number of clients receiving methadone on the survey reference date increased from about 227,000 in 2003 to over 306,000 in 2011. Clients receiving treatment with methadone accounted for approximately 21 to 25 percent of all substance abuse treatment clients each year.”

If someone suffers from an opiate addiction, they can visit a methadone clinic, either through a physician’s referral or directly. Over 50% of those who do are males, although female admissions are also common. Around a third of those admitted have been found to remain in treatment for over two years.

One thing that the latest SAMHSA survey has demonstrated is that treatment programs are particularly popular with veterans. Indeed, they have reported that 1 in 15 veterans suffers from a substance use disorder (SUD).

“Overall, about 1 in 15 veterans had a past year substance use disorder, whereas the national average among persons aged 17 or older was about 1 in 11, or 8.6 percent. The rate of substance use disorders among veterans ranged from 3.7 percent among pre-Vietnam-era veterans to 12.7 percent among those who served in the military since September 2001.”

Additionally, there are significant differences in substance abuse choices depending on age categories. Those aged between 18 and 25 are most likely to turn to heroin. An increase in heroin abuse has been noted in those over 26 years of age, but around 2.9 million of these people abuse prescription medication. Perhaps the most worrying statistics, however, is that just 11% of those who abuse alcohol or drugs receive treatment.

Federal laws state that only SAMHSA-certified treatment programs may dispense methadone. Thankfully, there are several of these facilities available. Other services, including drug use prevention, are also offered here. Furthermore, they help reduce criminal activity and the chance of infectious diseases by improving patients’ overall quality of life.

Why People Visit Methadone Clinics

Methadone was first legalized in this country in 1947. It was popularized during WW2 for its painkilling actions, but it was quickly found to also suppress drug withdrawal symptoms, usually for around 24 to 36 hours. Unfortunately, because it is so popular for the treatment of opioid addiction, it has become quite readily available and is therefore open to abuse.

“More recently it has emerged as a drug of abuse. This trend may be driven in part by the ready availability of the drug as it increasingly is used in the treatment of narcotic addiction and to relieve chronic pain.”

The main reason why someone would visit a methadone clinic, therefore, is to get help with opioid addiction. People can sign up to a treatment program in which an individualized plan is created for them. Others attend clinics following a relapse, looking for help to manage their cravings. Generally speaking, when someone attends a clinic for the first time, they will have to go through a screening process with a nurse or counselor before they are prescribed medication.

During the screening process, patients have to discuss their history, may have to give blood and a urine sample, and will be told about the program itself, what it aims to achieve, and its rules. A clinical evaluation will be conducted to determine how drug abuse has impacted a patient’s life and whether there are any medical and/or psychological co-occurring disorders. A medical review will also be conducted to determine the patient’s overall condition and their physical readiness to use methadone.

Another reason why a patient may attend this type of clinic is to get counseling. Methadone is not a cure for addiction, but rather an element of overall treatment. Counseling is an even more essential element and one that will generally continue for far longer as well.

“Substance abuse counselors provide a necessary support system for individuals recovering from eating disorders, drug and alcohol issues, gambling addictions, and other behavioral issues. By forming a relationship built on trust with their patients, counselors provide the support, resources, and judgement-free guidance that patients can utilize on their road to addiction recovery.”

Last but not least, people may attend the clinic because it is a requirement of their drug treatment program. Sometimes, they must attend every day, whereas others may be provided with several dosages to take at home, attending the clinic several times per week. When patients attend a methadone clinic, for whatever reason, they may also be accompanied by friends or family members, if appropriate, for more information call us at (855) 976-2092.

Sources 

[1] Drugs & Medications. (n.d.). Retrieved from https://www.webmd.com/drugs/2/drug-4101/dolophine-oral/details

[2] Drug Scheduling. (n.d.). Retrieved from https://www.dea.gov/druginfo/ds.shtml

[3] SAMHSA – Substance Abuse and Mental Health Services Administration. (2018, 23). Retrieved from https://www.samhsa.gov

[4] 1 in 15 Veterans Had a Substance Use Disorder in the Past Year. (n.d.). Retrieved from https://www.samhsa.gov/data/sites/default/files/report_1969/Spotlight-1969.html

[5] National Drug Intelligence Center. (n.d.). Methadone Fast Facts – Questions and Answers. Retrieved from https://www.justice.gov/archive/ndic/pubs6/6096/6096p.pdf

[6] Wake Forest University. (2016, August 5). The Role of the Counselor in Addiction Recovery – WFU Online Counseling. Retrieved from https://counseling.online.wfu.edu/blog/the-role-of-the-counselor-in-addiction-recovery/

methadone treatment issues

Problems With Methadone Treatment To Be Aware Of

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Methadone Success Rate

During the 1960s, scientists, researchers, psychologists, and medical professionals first started to look at the potential of methadone as a treatment for addiction to narcotics. Fast forward by around 50 years and methadone is now recognized as one of the most effective forms of treatment for opiate addictions. Significant research has taken place into the success rate of different treatment modalities. Research results claim that methadone seems to be the most successful of all.

“Substance disorders can be treated most cost-effectively in outpatient drug-free settings. Savings from transitioning to the most cost-effective treatment modality may free resources. These resources could be reinvested to improve access to substance abuse treatment for a larger number of individuals in need of such treatment.”

Some research suggests that those who detox or take part in a completely drug-free modality can expect a success rate of between 5% and 10%. In contrast, treatment, particularly methadone maintenance programs, have a success rate of 60% to 90%. The longer patients remain under treatment, the more successful they become in getting rehabilitated.

Problems with Methadone Treatment

Various studies have been conducted on the impact of heroin addiction among prisoners in particular. Unfortunately, it seems that prisoners, who theoretically should not have access to addictive substances while incarcerated, are at the greatest risk of overdose following incarceration release.

“Former inmates return to environments that strongly trigger relapse to drug use and put them at risk for overdose. Interventions to prevent overdose after release from prison may benefit from including structured treatment with a gradual transition to the community, enhanced protective factors, and reductions of environmental triggers to use drugs.”

One of the key reasons for this seems to be the fact that very few inmates are offered the opportunity to undergo methadone maintenance treatment, either during incarceration or afterward. According to some researchers, this is because the focus is too strong on drug-free modalities. The prison system is cited as a clear example of why this attitude fails because the reality is that inmates are able to access addictive substances while in prison.

California has been an example of best practice to a certain degree as they mentioned methadone maintenance in Proposition 36 – the Substance Abuse and Crime Prevention Act.

“This initiative allows first and second time non-violent, simple drug possession offenders the opportunity to receive substance abuse treatment instead of incarceration.”

Unfortunately, it also seems that the state has struggled to incorporate methadone into their treatment options. There appears to be a strong bias against the synthetic opiate. This is believed to be directly responsible for the failure of treatment for many heroin addicts. Unfortunately, this also renders drug courts less effective and leads to wastage of vital resources

Buprenorphine vs Methadone

It is believed that the reason why some people are against methadone is a lack of understanding of tolerance. Essentially, people who use methadone as a form of treatment no longer experience a euphoric effect. If properly administered, methadone treatment does not make the patient high. Furthermore, there is a significant lack of understanding of the impact of chronic opiate exposure to brain chemistry. Thankfully, the National Institute on Drug Abuse (NIDA) is making an effort to increase understanding of what tolerance is and how the brain is affected by both short and long term opioid addiction.

“Tolerance to drugs can be produced by several different mechanisms, but in the case of morphine or heroin, tolerance develops at the level of the cellular targets.”

Until there is a better understanding of the continued changes in brain chemistry as a result of opiate addiction, even after detoxification, it is likely that opiate addicts who do not receive methadone treatment will continue to experience very high relapse rates.

Fortunately, there are alternatives to methadone treatment, one of which is buprenorphine.

“Buprenorphine is a semi-synthetic opioid derived from thebaine, an alkaloid of the poppy Papaver somniferum. Buprenorphine is an opioid partial agonist. This means that, although Buprenorphine is an opioid, and thus can produce typical opioid effects and side effects such as euphoria and respiratory depression, its maximal effects are less than those of full agonists like heroin and methadone.”

This medication, which has the same effectiveness rates as methadone, is currently available but only outside of the methadone system. This either-or approach means that those who opt for buprenorphine often do not receive other forms of addiction care such as counseling. It is vital, therefore, that changes are made.

Studies on Outcomes of Drug Treatment

One of the most significant pieces of research ever conducted into the outcomes of drug treatment was the Drug Treatment Outcomes Research Study (DTORS) in the 1980s, ordered by Governor Wilson.

“Taking all costs and outcomes together, the authors’ preferred analysis suggests that the mean net benefit associated with structured treatment is positive. At the level of the individual, the probability that structured drug treatment is cost-effective is 81 per cent.”

Specifically, the report showed that for every $1 that was spent on drug treatment, a total of $12 was saved. Unfortunately, there has always been difficulty in getting those addicted to opiates to become interested in the treatment options. As a result, the consequences have affected overall community safety and public health. In a study by the UCLA, it was noted that deaths due to violence, infections, and accidents, as well as many repeated incarcerations, could have been avoided had methadone been used in a more aggressive manner.

Methadone treatment works. Several studies have demonstrated that the treatment,  long term, has fantastic positive effects. It increases the quality of life of patients and rebuilds family relationships. Methadone also increases the possibility of becoming productive community members, saves the legal and public health system money. This type of treatment reduces criminality or risky behaviors. Unfortunately, those in the legislature, in particular, must still be educated on the fact that narcotic addictions are a medical condition that requires treatment rather than punishment. One way to achieve that is by demonstrating the effectiveness of methadone treatment, and by continuing to show that investing in treatment leads to considerable financial savings to the taxpayer. Perhaps then, a difference can finally be made.

If you have more questions about Methadone Treatment, please give us a call at  855-976-2092 or check out our website.

Sources

[1] Mojtabai, R., & Zivin, J. G. (2003). Effectiveness and cost-effectiveness of four treatment modalities for substance disorders: a propensity score analysis. Health services research, 38(1 Pt 1), 233-59. Retrieved From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360883/

[2] Binswanger, I. A., Nowels, C., Corsi, K. F., Glanz, J., Long, J., Booth, R. E., & Steiner, J. F. (2012). Return to drug use and overdose after release from prison: a qualitative study of risk and protective factors. Addiction science & clinical practice, 7(1), 3. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3414824/

[3] California Society of Addiction Medicine. (n.d.). Retrieved from https://csam-asam.org/404.aspx?404;www.csam-asam.org:80/proposition-36-revisited

[4] NIDA. (2007, January 2). The Neurobiology of Drug Addiction. Retrieved from https://www.drugabuse.gov/neurobiology-drug-addiction on 2019, February 20

[5] What exactly is Buprenorphine? (n.d.). Retrieved from https://www.naabt.org/faq_answers.cfm?ID=2

[6] Davies, L., Jones, A., Vamvakas, G., Dubourg, R., & Donmall, M. (2009, December). The Drug Treatment Outcomes Research Study (DTORS) Cost-effective Analysis 2nd Edition. Retrieved from https://webarchive.nationalarchives.gov.uk/20110218141228/http://rds.homeoffice.gov.uk/rds/pdfs09/horr25c.pdf