Heroin addiction, opiate addiction, opioid use disorder as it is technically called is a physical and psychological disorder in which the body and brain become dependent on opioids. This disease has been around for a long time from opium to Carfentanil, it is a disease that knows no demographics. It attacks the risk and poor, men and women of all races religions and ethnic backgrounds. Now more than ever, this is a disease stealing thousands of lives a year. Now more than ever, it is a disease that requires a multifaceted treatment approach. Now more than ever, we are equipped to treat such an illness.
Everywhere you look, people are finally acknowledging this deadly condition for what it is – not a choice, not a moral failing – a DISEASE. And just like any other disease, it requires support, lifestyle changes, and at times MEDICATION! We wouldn’t shame someone with high blood pressure who is on Lisinopril or hydrochlorothiazide. We don’t tell people with dangerously high cholesterol that they either eat healthier or they will die without offering a statin. Have you ever told a person with diabetes that they’re just swapping their pancreas for insulin? I’m guessing not, in fact, that probably sounds absurd. How many have suggested that medications for opioid use disorder are just that though? How many have used the term Opioid Substitution Therapy?
Medication Assisted Treatments (MAT), as they are called, refer to evidenced-based effective medication treatments that can aid in the recovery of someone with opioid use disorder. They work on the brain receptor – the mu opioid receptor – that yearns for opioids. They allow an individual to regain control over their life. As of now, there are three medication FDA approved to treat opioid use disorder. They all have good evidence that people on them can lead more functional and effective lives with proven decreases in blood born infections, crime, homelessness, and unemployment. What are they and how do they work?
Methadone is a full opioid agonist – this means it binds to the mu opioid receptor and fully activates it. It helps by occupying the receptor so that another opioid can’t. People on methadone are dosed daily out of specialized clinics. The methadone attaches the receptor all day and prevents withdrawal and cravings, allowing the person to effectively go about their day.
Buprenorphine is a partial mu opioid agonist. It binds to the same mu opioid receptor but only partially activates it. It still helps the prevention of withdrawal and cravings but doesn’t have a full effect like other opioids. This allows for a decreased risk of overdose and death. Buprenorphine can be prescribed which means it may be even easier for someone to return to their daily life and not have to go to a clinic daily. It is often combined with naloxone to help prevent misuse.
Naltrexone works by also binding to the mu opioid receptor. Unlike the above two medications though, it completely blocks the activity of the receptor. It holds onto the receptor tightly and prevents other opioids from binding, which means if someone tries to use an opioid, it likely won’t work. This allows for a person to effectively know that they cannot get high and thus relieves the cravings to use in time. It is available also as a prescription of either an oral medication or as a long-acting injectable once a month.
How is it different?
MAT is most effective in combination with psychotherapy and recovery support. When people use opioids, they use to escape – not feel the pain of withdrawal, not feel sadness, anxiety, physical pain, not experience the world. People effectively using MAT take medications for the opposite reason. They are in treatment to regain their lives, feel emotions, work and function in society. This is how they differ. They help people engage instead of running away.
These medications are all effective options, each with their own positives and negatives. It is important that whatever you decide, you speak with your healthcare provider. Everything has risks and nothing is perfect, but the evidence supports that medications can help. If you or someone you know is suffering, don’t let them go at it alone. Don’t let them stay in the shadows ashamed of their disease. Tell them there are options and professionals who can help, who want to help.
Need Help for Substance Abuse?
Addiction in any form is never a pretty thing. Lives are ruined and chaos is unshackled as we begin to fixate on whatever chemicals can be tossed our way. This can go on for some time unless we listen to our inner intuition telling us that everything is not okay. Justifying our alcoholic tendencies will only keep up in the misery for longer. If you or a loved one has been struggling with getting a firm grasp on sobriety and need substance abuse treatment, please call 1-855-49hills or visit www.hhills.com. Our teams of specialists are waiting by to help figure out what options are best for sending your life is a comfortable direction that you can proudly stand behind.