The medication that's helping get people off opioids
The world of addiction treatment is wild and inconsistent at best. Sober houses, rehabs, detox centers, inpatient programs, outpatient programs, partial hospitalization programs - it can be a maddening and exhausting process if you’re trying to find a place or solution for someone who’s actually willing to try and get help. One of the current gold-standard treatment modalities (as verified by NIDA and the WHO) is medication assisted treatment (MAT) combined with behavioral therapy, but MAT isn’t widely known about and is often misunderstood.
Why not just quit? For someone trying to stop using opioids, one of the biggest barriers to getting off the drugs is the withdrawal symptoms of detoxing the body. Going through 3-6 days of pure physical and mental hell is too much to get through for most people so they try for a short time (hours or a day) and then go back to using because it makes them not sick anymore - doesn’t even necessarily make them high, just gets them back to not being violently sick.
So if there’s medication that could change that process, and taper down the effects of withdrawal so the person doesn’t have to use opioid pills or heroin, wouldn’t that be the right thing? The good news is there are medications available for this exact process and people need to know about them - it’s especially important in the days after an overdose or when someone gets released from being incarcerated - times when the risk of a deadly overdose are extremely high due to lowered tolerance.
Two of the three medications most commonly and successfully used to treat opioid addiction are methadone (full agonist) and Buprenorphine (also called Suboxone, a partial agonist) which can stop this horrible cycle of using and withdrawing because they contain a very small dose of opioid. This small amount relieves/eliminates the withdrawal symptoms but doesn’t cause the euphoric high. This allows someone to escape the cycle and re-build their life, get housing, get a job - get back on track. It’s not perfect, but it gives people a chance.
For people who can get through 7-10 days of withdrawal and fully detox, there’s Naltrexone - which doesn’t contain any opioid at all and fully blocks (full antagonist) the effects of opioids like Oxycontin and heroin. The ideal treatment is the monthly injectable called Vivitrol which has the obvious benefit of blocking euphoric effects but also reduces the cravings for opioids. It can’t be abused, and with a monthly, extended release injection a person isn’t required to take a daily pill which can be forgotten or simply skipped. Both Naltrexone and Buprenorphine can be given in a doctor’s office, which presents less of a stigma and logistics barrier than methadone which requires a daily, in-person visit to a clinic, usually not in a great part of town and frequented by dealers looking for vulnerable buyers.
The best way to find a doctor near you to prescribe these medications is to use the SAMHSA Drug Treatment locator. There is also, of course, a need for mental health counseling and community support to provide a more holistic treatment scenario, which the prescribing doctor will help with as well.
It’s important to note that while these medications are very effective at treatment for opioid addiction, they are NOT used to treat addiction to or dependance on benzodiazepines (Xanax, Valium, Klonopin, Ativan.) It’s very common for someone who is abusing opioids to also be taking (and potentially abusing) benzos - more than 30% of overdoses involving opioids also involve them. The combination of an opioid full or partial antagonist can be a deadly combination so it’s critical that the person being prescribed is honest about what else they may be taking to avoid a potentially deadly situation.
Hope. There’s hope and it’s more readily available than most people know. Please pass this information along to anyone who may be using only because they don’t know how to stop.