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Medication-Assisted Treatment for Opioid Use Disorder
So you can get back to enjoying your life.
What is Medication-Assisted Treatment?
Medication-Assisted Treatment, or MAT, is an approach that combines medication with counseling to help a person stabilize from addiction to opioids and to live a healthy life. Buprenorphine (commonly known as Suboxone), is one medication commonly used for the treatment of opioid use disorder (OUD). Other drugs used to treat OUD include Naltrexone (Vivitrol) and Methadone. Your doctor will help you assess which medication is right for you. You can download a chart here of the different types of medications used in MAT.
People with OUD who are on MAT are half as likely to die from an overdose as those not receiving medication. Just as heart disease is treated using medication and lifestyle changes, MAT for OUD, using the same approach, has proven to be the most effective way of helping a person get off of opioids and get back their life and health. Studies show that only 10% of patients not using MAT are drug free one month after detox, while 50% to 80% of patients are no longer using opioids after six to twelve months of treatment with Buprenorphine.
Isn’t using Buprenorphine just trading one addiction for another?
Even though Buprenorphine is an opioid, it’s very different from other drugs in this class. One important difference is it does not depress breathing, eliminating the risk of overdose. Buprenorphine stimulates opioid receptors differently than other opioids, allowing the brain time to heal. However, combining Buprenorphine with sedatives can be dangerous and result in overdose and death.
Drug dependence and drug addiction are different. A person will be physically dependent on Buprenorphine if they take it regularly. However, they are not addicted to it. Addiction is the loss of control of the use of a drug and and compulsive use of the drug despite negative consequences to health, work, and relationships.
Individuals who take Buprenophine typically have improvements in these dimensions of their lives. They are able to take the medicine as prescribed, and they experience less craving.
How does Buprenorphine work?
Buprenorphine attaches to opioid receptor sites in the brain, blocking the effects of opioids. It slightly activates these sites, preventing cravings and withdrawal, but does not cause any high or impairment. Buprenorphine allows the opioid receptors in the brain to reset to a more normal level, so people can begin to respond to the everyday pleasures they used to enjoy.
How long will I have to keep taking Buprenorphine?
Everyone is different. Some people take Buprenorphine for weeks or months then discontinue it. Most people take it for a year or more, so they create a stable recovery from addiction in all parts of their lives. Managing a complex medical condition like OUD is similar to managing any other long term medical condition such as diabetes or high blood pressure. We typically do not think poorly of people who must take insulin, or medication for high blood pressure.
Although there are no set rules, it is known that the longer a person is in treatment, the higher the chances are of success. Those who experience chronic pain often find that Buprenorphine can help significantly with their pain control in a way that does not lead to problem use as another opioid may.
Recovery with MAT: A Patient’s Experience
Hal is no stranger to recovery. A handsome, bright man, Hal is a Santa Barbara native. He recalls his early childhood as ideal, raised by parents who wished only the best for him. But somehow he never felt that he “belonged.” A self-proclaimed “nerd,” he suffered from acute social anxiety.
As a teen, he discovered what he refers to as “whiplash liquor”—little bits alcohol from each bottle in his parent’s liquor cabinet. The alcohol took away his anxiety and made him feel “a part of the world” for the first time.
Alcohol and cocaine became part of his lifestyle, but by age 26 he felt hopeless and was seeking a solution for “a life unlived.” He found the 12-Steps Program and for 10 years was able to sustain his sobriety with the help of the recovery community. Then he suffered a relapse, and this time it almost killed him.
By age 52, Hal was going through a life-threatening withdrawal from a lethal mix of alcohol, adavan, heroin, fentanyl and methamphetamine. He sought help at the Cottage Hospital Emergency Room, where doctors referred him to the Bridge Clinic.
The minute he met Dr. Paule, the clinic’s addiction specialist, Hal knew he had found someone who had empathy for his patients. “Addicts are intuitive,” said Hal. “We know when someone doesn’t care or is burned out from their job. Dr. Paule was different. He was patient, and I remember the first thing he said to me: ‘Hal, you’re one of those guys who is going to stay sober or going to die while trying.’”
Hal has been seeing Dr. Paule and the staff at the Bridge Clinic for almost a year, where he is receiving Medically Assisted Treatment. He chose to share his story to help educate the public and reduce the stigma associated with having a substance use disorder.
Dr. Paule symbolizes hope to me…for all of us. We have to deal with so much stigma and suffering. To have a man willing to treat us with compassion, coupled with genius skills, gives me hope and hope for others who are suffering. I have received the finest treatment by a one-in-a-million doctor for free…and this is the best way I can give back.