M.A.T., otherwise known as medication-assisted treatment, has become a widely known practice throughout the addictions’ community. The practice is meant to help curb the ever-growing opioid addiction epidemic, in which we find ourselves today. This form of therapy has gained attention from state legislatures, and even former President Obama. In its last year in office, the Obama Administration made opioid and heroin addiction its priority, going as far as passing the Comprehensive Addiction Recovery Act (CARA) in July 2016. While the bill looks to address a variety of issues, such as prevention methods and new collaboration with law enforcement, one of its main focuses is on medication-assisted treatment and the appropriation of funds designated for it.
Although former President Obama initially proposed $1.1 billion in funds for the CARA bill, that number was not approved. As it stands right now, the House approved around $500 million, with about $160 million solely allocated to M.A.T. and opioid treatment programs (OPTs), which usually include medications such as Suboxone and Vivitrol. Although there are 6 sectors of the CARA bill, roughly a third of its’ funding was approved for just this model of treatment. Why is that? And, what has it said about the way we view and treat addictive diseases?
Can Medication-Assisted Treatment Be Beneficial?
In some cases, yes. Nevertheless, it is largely based upon individual circumstance and history. Take for instance an individual who has struggled with opioid addiction for several years. By struggle we mean, someone who has been to addiction rehab and made attempts toward sobriety, but yet still finds themself in the grips of addiction. Maybe this person has even circulated in-and-out of the criminal justice system, has been homeless, and has experienced one or more overdoses. In this scenario, considering medication-assisted treatment may be an option. Nevertheless, this is rarely the exception anymore.
With funding becoming more widely available and the Obama Administration increasing the number of patients a physician is allowed to prescribe Suboxone to (increasing the cap from 100 patients to 275 in August), more and more of these cases are involving patients seeking treatment for the first time. When Suboxone was first approved by the FDA in 2002, they feared the medication would be abused, thus the 100 patient maximum per doctor. Now, with new regulations, the U.S. Department of Health and Human Services estimates 70,000 new patients will be treated with Suboxone, just within its first year of implementation.
So why now, is the FDA okay with prescribing a drug that has the potential to be addictive to more individuals? Could it be an attempt to decrease the death toll which continues to climb from opioid overdoses? Yes, the death rate may fall, but the quality of life these patients have are lackluster at best. We understand these medications can help the drug user who struggles to stay sober and has been to a variety of programs. We also know Suboxone can be helpful throughout the detoxification process. Nonetheless, to assume medication-assisted treatment to be the “be-all-end-all,” is foolish and dangerous to the entire addicted community. With Presidential coverage and attention, we’ve allowed this form of therapy to become the “gold standard” to addiction treatment.
M.A.T. Lacks Regulation
While medication-assisted treatment and opioid treatment programs sound great in theory, under the surface, they lack regulation. The Drug Addiction Treatment Act of 2000 and the approval of Suboxone in 2002, gave physicians the ability to prescribe this medication in their private practices, rather than having the individual seek treatment through an addictions’ specialist. The one major issue surrounding DATA-2000 is the necessary credentials each physician has to have in order to prescribe Suboxone.
One may believe that because drug addiction is a chronic, relapsing disease and can be compared to other fatal illnesses, such as cancer and diabetes, that the education surrounding addiction treatment is extensive. Well, in the eyes of the government, 8 hours of training is sufficient to prescribe Suboxone. A total of 8 hours is all a doctor needs to have in order to prescribe an addictive substance to an addicted individual. They need no further education on the matter. Although drug addiction kills more people today, than do car accidents and firearms, it gets little to no attention in regards to medical education and training.
The other major issue with DATA-2000 is that it does not require patients to be involved in any form of therapy and/or addictions counseling. Although prescribers are supposed to suggest therapy, many times Suboxone patients are not enrolled in treatment. Furthermore, drug testing is not mandated, which leaves patients with the opportunity to abuse other substances in conjunction with Suboxone (which can be deadly), or to misuse their prescription entirely. So in a nutshell, Obama has given this unregulated, highly detrimental method of treatment his seal of approval…and roughly $160 million dollars to expand and fund it.
Other Forms Of Medication-Assisted Treatment
While Suboxone is the leading medication in M.A.T., other drugs have been approved for the treatment of opioid addiction, including Vivitrol and Probuphine. Vivitrol, which is the injectable form of Naltrexone, blocks the euphoric effects of opioid-based drugs, such as heroin. According to SAMHSA, any physician who is licensed to prescribe medication, can prescribe Vivitrol. A drug that is intended solely for addiction can be prescribed by any doctor? If a physician is not adequately trained in the field of addiction, how could we assume they will require their patients to attend drug therapy and counseling? Most often times they won’t, continuing the cycle of addiction.
Probuphine, the most recently approved medication for M.A.T., is a 6-month implant of buprenorphine, the active ingredient in Suboxone. While the implant version definitely addresses the issue of the drug being abused or diverted, it still leaves many questions unanswered. What happens after the 6 months of “treatment?” Does the patient need to detox from the implant, since prolonged use of buprenorphine can create physical dependence? Are they required to participate in therapy and counseling? Once again, rather than finding new measures to improve clinical standards, our government would rather medicate the problem and worry about therapy later…if at all.
Addiction is not simply a medical issue, yet the government has made it to be one. For longer than most could recall, addictive diseases were considered a behavioral and psychological disorder, thus its classification in the DSM-V. Nevertheless, with the implementation of more medications, we’ve steered this issue into the hands of medical and governmental entities, rather than treating addiction as an all-encompassing issue. Drug addiction needs to be addressed on ALL fronts, including clinically, behaviorally, socially, medically, and even criminally. If medication were the only answer to our skyrocketing issue of addiction, it would have worked years ago.
Think of it this way. After the Civil War created a morphine epidemic, American doctors found a “wonder-drug” to fight the addiction problem of the time. The German-made drug was known as heroin and was marketed as a SAFE and NON-ADDICTIVE alternative to morphine. It seems as though history has a funny way of repeating itself.
Contact Clearbrook For Addiction Treatment
Have you struggled with substance abuse and now find yourself addicted to a medication that was intended to save your life? Time and time again, we come across individuals who become addicted to their opioid addiction treatment medication, such as Suboxone. Thankfully, there is a solution. If you are ready to get off of Suboxone or other medications, we are able to help.
For more than 40 years, Clearbrook Treatment Centers has provided quality treatment to those suffering from addiction. With our customized Suboxone addiction treatment program, you will be able to safely detox from the chemical and begin to experience a life free from ALL mood and mind altering substances. If you are ready to take the first step and get your life back, contact our Admissions Specialists today.