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The Lowdown on Medication-Assisted Treatment

 

Nearly 2 million Americans have a substance abuse disorder related to prescription pain medications classified as opioid drugs and nearly 600,000 have a similar problem with heroin, according to the American Society of Addiction Medicine. Many recovery programs are attempting to combat this growing epidemic by combining medication-assisted treatment (MAT) with existing addiction treatments.

What is A Medication-Assisted Treatment?

Medication-assisted treatment combines the use of medication with behavioral therapy to treat substance abuse disorders. MAT is meant for high-risk addicts, often with ongoing problems with a dependency on opioid drugs, who have not had success with programs not involving medication, as in programs that call for total abstinence of all drugs. Common MAT medications for opioid, alcohol, and other substance abuse dependencies includes:

Embracing a Multi-treatment Approach

Medication alone isn’t likely to treat any type of dependency. This is why MAT is often combined with individual and group therapy and other forms of counseling. The purpose of counseling is to:

  • Determine various psychological motivations for using
  • Identify circumstances that lead to the initial problem
  • Develop effective coping mechanisms to prevent relapse

How Effective is Medication-Assisted Treatment?

Each addict is different, so everyone will have a different experience with MAT. Some addicts report great success with MAT and others return to their previous behaviors. An argument can be made that some of those people weren’t properly counseled to deal with their behavioral issues and some had other issues that affected their outcome. There is no rush for patients to get off medications being used to treat their physical dependency. Therefore, patients have more time to deal with any duel addictions, often involving alcohol, and undergo successful behavioral therapy.

MAT Misconceptions

Contrary to what some people believe, MAT is not the equivalent of trading one drug dependency for another. With MAT, cravings are eliminated when patients receive the proper dose of medication. The goal of MAT is to remove the drug-seeking behavior that sometimes results in failed attempts at rehab with programs that only stress abstinence. With MAT, there is a low occurrence of a return to drug-seeking behavior since those cravings are essentially eliminated with the medication.

MAT and Insurance

Costs associated with MAT vary, although many insurance companies due offer some type of addiction-related coverage, which is now required by the Affordable Care Act. The Mental Health Parity and Addiction Equity Act of 2008 also requires insurers to treat behavioral services that same as primary care health coverage. However, some insurance plans have limitations on dosages and restrictions on how many refills MAT patients may obtain. Medicaid covers programs using medications on their Preferred Drug Lists, with disulfiram and oral naltrexone being the most common medications covered. Specific Medicaid coverage of medications used in MAT programs varies by state.

The Unintended Path to Dependency

Developing a dependency on opioids, especially in the form of painkillers, is rarely intentional. In the case of prescription meds, people often have a legitimate need to take such medications. It’s the highly addictive properties of opioid pain relievers like Vicodin, OxyContin, and Percocet that often causes people from all walks of life to develop a physical dependency. Even with heroin, the path to dependency often starts with the use of substances some people perceive as being safer, which may include marijuana and alcohol.

A recent budget proposal by President Obama calls for $1.1 billion in new funding to address the growing prescription opioid abuse and heroin epidemic. While it’s unclear how the funding would be allocated if approved, such efforts could help raise awareness of the problem and increase access to recovery programs.

Sources:

http://www.samhsa.gov/medication-assisted-treatment
https://www.whitehouse.gov/sites/default/files/ondcp/recovery/medication_assisted_treatment_9-21-20121.pdf
http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
https://www.oasas.ny.gov/AdMed/meds/meds.cfm#Opioid

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