If you or someone you love suffers from opioid addiction, then you may have heard the term medication-assisted treatment, or M.A.T. before. As it grows in popularity, M.A.T. programs are now touted as the “gold standard” in treating opiate and heroin addiction.
By definition, medication-assisted treatment is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. However, this approach is not always utilized in the way it is intended.
While counseling and therapy are said to be the most crucial component in M.A.T., it is often times over looked or not properly regulated. Rather than receiving a “whole-patient” approach, many are only receiving “treatment” for one component of their disease.
Like many other things, there are many “kinks” that need to be worked out regarding medication-assisted treatment. Nevertheless, the FDA is currently looking to expand this form of care. Here’s what you need to know about their current plans, and why the expansion of M.A.T. can be disastrous.
Expanding Medication-Assisted Treatment
New reports tell us that the Food and Drug Administration (FDA) plans to introduce new guidelines for expanding the use and effectiveness of medication-assisted treatment. Health and Human Services Secretary Alex M. Azar, II released the FDA’s plans in a meeting of the National Governor’s Association.
Two new guidances are set to be issued, in a wider effort to make M.A.T. more accessible to opioid addicts throughout the country. The first guidance encourages drug manufacturers to develop longer-acting formulations of existing medications utilized in M.A.T. programs. Most recently, the FDA approved an injectable form of Suboxone. This formulation requires patients to only receive the drug monthly, versus daily. It is believed that an injectable form of the drug can stem the diversion and abuse of Suboxone among users.
The second guidance, which was explained in great detail to the New York Times, will allow the eligibility of new drugs that do not necessarily end addiction, but instead aid in “aspects of it, such as cravings, or overdoses.”
A senior FDA official told the Times, “We will permit an endpoint that shows substantial reductions but does not require the patient to be totally clean at every visit if the measurements are fairly frequent.”
During his announcement, Azar told the National Governor’s Association, “The guidance will correct a misconception that patients must achieve total abstinence in order for M.A.T. to be considered effective.” He went on to explain that effectiveness of “therapies” would be evaluated based on targets aside from abstinence, including how treatment is impacting overdoses and emergency room visits.
While addiction is certainly a complex disease, and should be treated on an individualized basis, are we sure these new guidelines will expand the effectiveness of treatment? Or are we simply putting a Band-Aid on a bullet wound?
The Dangers Of This Approach
While this announcement has gotten praise from many, we wonder to what end are these new measures intended.
The goal behind addiction treatment should always be to end addiction. Yet, both the FDA and the Health and Human Services Secretary are comfortable with approving medications that may not necessarily end one’s drug use.
Policymakers and drug manufacturers often fail to mention the fact that many of the drugs utilized in medication-assisted treatment are addictive. Rather than treating addiction and aiding in the pursuit of complete abstinence, M.A.T. programs often perpetuate the cycle of addiction longer. It seems these new guidances will simply be more of the same. Except now, they are not hiding behind a mask. They are now going to say that “treatment” is effective based on factors such as overdose. So, if an addict doesn’t die, then this program is working?
That’s called harm-reduction, not treatment.
Additionally, it is imperative we bring into account the matter of continued use while taking medications, such as Methadone or Suboxone. As the FDA has said, they will no longer require a patient to be completely clean from drugs and alcohol at every doctor or therapy visit, as long as that patient’s use is fairly frequent. This guideline simply leaves too much room for error, and blurs the lines of black and white.
Who decides what is fairly frequent and what drugs are acceptable to use? Many studies reveal that when Methadone or Suboxone are used in conjunction with benzodiazepines, such as Xanax, a user is at increased risk for respiratory failure, overdose, and death. Furthermore, using said medications in combination with drinking alcohol, also poses several risks.
To allow continued drug use while on medication-assisted treatment does not only defeat the purpose of treatment, but it is extremely dangerous to the patient.
The main goal behind the FDA’s move is to help opioid users lead productive lives, even if they still require replacement therapy. Nevertheless, the quality of life provided by medication-assisted treatment simply does not compare to that of complete abstinence.
Encouraging drug manufacturers to create longer-acting medications and no longer requiring users to be abstinent only perpetuates addiction longer, and to greater degrees.
Opioid addiction claimed the lives of 64,000 people in 2016. So yes, we absolutely need new and innovative ways of approaching this epidemic and treating the disease of addiction. But, is this step really the direction in which we want to proceed?
Contact Clearbrook Today
If you or someone you know and love is currently struggling with opioid addiction, we can help.
For 45 years, Clearbrook Treatment Centers has been a leader in the treatment of alcoholism and chemical dependency. By utilizing a philosophy of treatment based on the 12-steps of Alcoholics and Narcotics Anonymous, we are able to offer our patients a life free from the mental obsession and physical craving of addiction.
If you are interested in receiving a form of treatment that gives you the opportunity to achieve lasting sobriety, give us a call today.
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