Public officials are desperate for a solution to the harrowing opioid epidemic sweeping through America. Did you know that 64,000 Americans died last year from overdosing on opioids? Although experts and scientific analysis show that medication-assisted treatments for opioid addiction are effective, some people believe they simply substitute one drug (like heroin) for another (like methadone). The stigma of this treatment method is preventing many addicted people from receiving the help they need. As announced on October 25, 2017, the FDA is now aiming to change society’s negative perception of using drugs to combat drug addiction.
The Stigma of Medication-Assisted Treatments for Opioid Addiction
What is medication-assisted therapy for opioid addiction?
Medication-assisted therapy combines counseling with drugs, like methadone and buprenorphine (also known as Suboxone), to help people overcome their addiction to opioids. How does this work? Typically when a person addicted to opioids attempts to stop using drugs, their body reacts violently, producing nausea, full-body aches, depression, and other serious symptoms of withdrawal. They often seek out drugs – not to get high, but to feel normal and pain-free again. Methadone and buprenorphine can prevent the cycle of addiction by staving off withdrawal symptoms and not providing a euphoric high. Buprenorphine stifles cravings and reduces opiate withdrawal symptoms. Methadone mitigates withdrawal as well, and it hinders the euphoric sensations that opioids induce. These are both long-acting opioids, so they don’t produce the instantaneous narcotic effects of drugs like heroin.
The length of the treatment varies from patient to patient. With the help of a physician, some people can wean themselves off the medications over time. Others remain physically dependent on the drugs for the rest of their lives. If they stop taking the medication, they will experience symptoms of withdrawal. This is not the same thing as addiction, though many people fail to recognize the difference. If a person uses opioids regularly as a part of a medical treatment but does not crave more, does not harm themselves or others, holds a steady job, maintains good relationships with family members, and is a healthy and functioning member of society, they are not addicted to the drug. They have transformed a dangerous drug addiction into a safer habit.
Is medication-assisted therapy effective?
Absolutely. Scientists and doctors agree that medication-assisted therapy is currently the best way to combat the opioid epidemic (source). The largest and most respected public health organizations in the world, including the Centers for Disease Control and Prevention, the National Institute on Drug Abuse, and the World Health Organization, advocate medication-assisted treatment (source).
Take a look at the following statistics:
- The Massachusetts Department of Public Health found that patients who experienced a nonfatal overdose and were treated with methadone or buprenorphine were 50 percent less likely than those that didn’t receive the treatment to die of an overdose in the future (source).
- A 1995-2009 study in Baltimore found a correlation between increased access to medication-assisted treatment and a reduction in heroin overdose deaths (source).
Of course, medication-assisted treatments for opioid addiction don’t work for all people. Some prefer total sobriety, some have adverse reactions to the drugs, some require the combination of drugs and counseling, and some simply don’t find the drugs effective. It is important, therefore, that patients work with their doctors to find the best individualized approach to treating their addiction.
Why have these treatments been stigmatized?
Many Americans believe drug addiction is at least partially caused by a moral failing; they don’t view it as a disease, like public health officials and medical experts. These people might look down on treatments that rely on medications, preferring to focus on therapies that emphasize changing the behavior of people addicted to drugs and demanding abstinence. They often misunderstand the drugs and overlook their benefits. This includes many insurance companies, who have been reluctant to cover drug-assisted therapy. Unfortunately, the stigma of medication-assisted treatments has kept many people addicted to opioids from reaching their goal of sobriety.
In addition, the stigma results from the fact that many people can’t accept the idea of providing someone addicted to opioids with another type of opioid as treatment. As FDA Commissioner Scott Gottlieb said, “The stigma reflects a view some have; that a patient is still suffering from addiction even when they’re in full recovery, just because they require medication to treat their illness. This attitude reveals a flawed interpretation of science. It seems from a key misunderstanding that many of us have of the difference between a physical dependence and an addiction” (source).
Former addicts are also sometimes critical of medication-assisted treatments for opioid addiction. If they managed to lose their addiction without methadone or buprenorphine, they might feel that others should use that approach too.
Perceptions of medication-assisted therapy have slowly been changing, and some organizations are beginning to embrace this effective solution. For example, one of the biggest drug treatment providers in the U.S., the Hazelden Betty Ford Foundation used to promote an abstinence-only model for treatment; in 2012, they began offering medication-assisted treatment.
How will the FDA de-stigmatize medication-assisted treatments for opioid addiction?
The FDA plans to change the labels of medications used in such therapies. First, it may alter the medications’ labels to allow doctors to prescribe them to anyone who overdoses. Second, the FDA plans to edit the labels to communicate that some people will require a lifetime of treatment. In addition, the FDA has already offered more training for doctors who prescribe opioids.
We encourage you to stay ahead of the opioid epidemic by establishing a new or updating a current drug and alcohol policy in your workplace. If you’re looking to implement a drug-free workplace through drug and alcohol testing, contact Tomo Drug Testing. Based in Springfield, St. Louis, and Kansas City, Missouri, we offer customized solutions to make drug testing simple, and our nationwide network of clinics and providers allows Tomo to be available anytime, anywhere. For a free needs analysis, give us a call today at 1-888-379-7697 or contact us online. We would be happy to help!